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HomeMy WebLinkAbout3701-zFOEM NO. 4 TOWN O!: SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHO/D, Fi. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at N/~ Hya.~,t; Road N, (PVT RD) Street Map No..~ .............. Block No ............. ~... Lot No ........ ~ ....... ~.~.~.~..]~.t.~.~ ................. conform~ substantially to the Application for Building ~rmit heretofore filed in this- office dated ................................. ~O~ ....... ~ ............. , 19..~. pursuant to which Building Permit No. dated ........................... ~O.~ ....... ~ ......... , 19:..~, was issued, and conforms to all of the requirements of the applicable provisions of the Iow. The occupancy for which this certificate is issued is ........ The certificate is issued to ...~[&~,..[~.~ ....................... ~ .............................................. (owner, lessee or tenant) of the aforesa.id building. l[~h gep App~ova~ t~ay 1~, 1968 by 11, Building Inspector FORS~ NO. ~ T~VN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK's oFFIGE $OUTHOLD, N. ¥. BUiLDiNG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULl COMPLETION OF THE ,WORK AUTHORIZED) ~: Permission is hereby granted to: : pursuar~t to application dated ............................. ]J~ll.~.~....t..3 ........... , 19..~.., and'~ approved by the ' Buildin9 Inspector. ]:ee $..J,J~hd~J .......... S-9 SCHD SUFFOLK COUNTY DEPARTMENT Date Bldg. OF HEALTH Permit No. TO WHOM at IT MAY CONCERN: The sewage d~sposal facilities for a structure located (Give dee~ l~catton) ' have been inspected by this department and found to be satisfactory. District Engineer FO~M NO. 1 'r'OWN OF SOUTHOLD BUILDinG DEPARTMENT TOWN CLERK'S SOUTHOLD, N. Y. Examined ............................................. Approved ........................................ , 19 ......Permit No ............................ Dmapproved a/c .......................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the'applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Buiiding Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with alt applicable laws, ordinances, building code, housing code, and regulations. (Signature of applicant, or name, if a corporation) ......... S.a~thol~l .................................................................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Contractor Name of owner of premises ..... ~.i]~7kl~...t~.ll~.t~ ............................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ..... ~y~l..~.~....O]~,~. ............ Lot No.: ....~ ............... Street and Number ...~Z~...~..~.~...f.~.~.....~.....~.~.~...~.~.l...~.~g.~ .............................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of propos~ construction: ........ b. Intended use and occupancy ..g.~...~.~...~.~.~ ................................................................................. 3. Nature of work (check which applicable): New Building ..~ ...... Addition .................. Alteration .................. Repair .................. Removal ........... .zljZ.. Demolition .................. Other Work (Describe) ........................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ....~ .................. Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................Height ............................Number of Stories ................................ Height .................... Number of Stories ................. !..~ .......................................................................................... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ...... ~......~...~. .............................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? .......... J~O. ............................................ 13. Name of Owner of premises ]~IL.,,,I//:I~',t,~. .................. Address ............................................ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ~-¢ -- STATE OF NEW,YO, R~_, ~ ¢ e COUNTY OF ...~-.Z.:.O.'...~,. ............ ............................................ .~..O...~..~...~..~.....'..~..~..~...~..~. ...................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ................. C~.t~.~,¢~.~ ................................................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application fLl~l therewith. Sworn to before me this , _ - I ~ '-'~'~-~ .................. 3... day of ............. ~"~"2~ ............... , 19......~. ~ /~--J'~ ~ ,~_ ~, /" I//'/^ _ / / ..... ~' ....... /,~"~' ................................... '~'~"f '"'"'"~ ................... Notary Public, ,I.l~.~,~f,~....l~t..:...[~ County (Signature of app~ant)J ~ ..... ~ MARION A. ~EGEN/ NOTARY PUBLIC, State at New York No, 52-3233120 Suffolk Cougty ~erm Expires i~arch 30,. Examined ........................ ~,.¢ .............. 19......r, TOWN OF SOUTltOLD BUILDING DEPARTMENT TOWN CLERK'~$ OFFICE SOUTHOLD, N. Y. Application No ............................. Approved ........................................ , 19 ........ Permit No ............................. Disapproved a/c .,..a .............. ~:....z:.~..,¢~... ................. t:zz:~.,,~.~.. ............... ......... APPLICATION FOR BUILDING PERMIT Date, ....................... .}I..~Y.D~.~: ....... D ....... 19..~.~. ..... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shah have been grante'd by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department' for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New' York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to co~nply with all applicable laws, ordinances, building code, housing code, and regulations. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, Ibssee, agent, architect, engineeF, general contractor, electrician, plumber or builder. 8oni;~aeto~, Name of owner of prem ses · lg;~.;L.];i~L~z..;~'~t.].:¢.~ ............................................................................................................... If applicant is a corporate, signature ~)f duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done..Map No.: ...... I'I.y.&t;.t~..8IlA ............. Lot No.: .....:li~ ............... Street and Number ~t~.~`~y~T.~a~d.~I~X~]~))~:~`~.z~P.~i~)`~~&~ .............................. .. Municipality 2. State existing use and ¢ccupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupangy ~.~;~`.f5~9~d~¢~L]~.T~.~b~e~.V~c.~a~d~e~D~.~ ........ b. Intended use and 0ccupandy ..pztf~...:Ca~;!.]4a..0.~?.e.L~J.zl~ ................................................................................. 3. Nature of work (check which applicable): New Building ...~(~ ..... Addition .................. Alteration .................. Repair .................. Removal,~ ........... .~[... Demolitian .................. Other Work (Describe) ........................................ 4. Estimated Cost ........ ~'~,~,...?LO....~..~ ..................... Fee ..-10~.00. ........................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ....O~G ................. Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................Height ............................Number of Stories ................................ 8. Dimensions of entire new construction: Front ...... .,~..~)..c.~r:.'h ........... Rear .......~[f,~..'T...r~ ......... Depth ....~.~ .............. Height .................... Number of Stories ................. 1...~¢....'. ...................................................................................... 9. Size of lot: Front ......... ~.~..~ ....... Rear ....... ~,~....+.. ......... ;. ..... Depth .......... ~:qg..,~,~ ......... 10. Date of Purchase ........................................................Name of Former Owner ........................................................ J 1. Zone or use district in which premises are situated ....!!~l.?...~,,&t. ............................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ........... l~ ............................................ 13. Name of Owner of premises .W~,..~l~'.t,~ .................. Address ............................................ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Cqntractor .~Gb¢....j~,y.~.t,~; ......................... Addrqss .......... ~oU.tb.f~].~ .............. Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate STATE OF NEW YORK. 1S S COUNTY OF ...~.g,f..~,'.Q~ ............ )' ' ' ........................................... ~¢~.~Z,~..,..~[~.~ ...................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) ~bove n~med. He is the ................ ~e~¢'~O~ ................................................................................................................ '~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duty authorized to perform or have performed the said work and to make and file this application; that all statement¢ contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application fi~ therewith. Sworn to before me this '., .................. o, ....... .................. , ............. Notary Public~~.....~....~.~unty (Signature of op~ No. 52-3233120 SuilolK O T.rm E~p~r~s ~arch 30, ~L ,,( 0utline Specifications 1. Excavation And Site Work t ne~ house to be located on site of existing house which is to be removed by others. Surfaces under footings to rest on undisturbed soil. Rough grade away from house. Finish grading, lawns, landscape work, walks and driveways are not in Contract. Remove trees only at house Iooation, Use existing cesspools. 2. Concrete And Hasonry= all concrete to be 2500 psi strength, form all footings. All found- ation walls to be concrete block, fill top block solid with motar. Fireplace damper Donley sized to fit opening. Rough Carpentry: all framing members to be min. 1200 f. HConstructton Grade~' douglas fir. Sheathing for floors, walls and roof~ "PlyscoreH grade plywood. All ply~ot~ exposed to weather to be exterior grade. Underlayment plywood= int.-0FPA- plyscore grade. Cedar shingles= Blue Label Grade Certfgrade red cedar, 18" long with 6" to weather, rebutted- reJointed. ~. Finish Carpentry= interior trim~ ~htte pine Colontall Paneling= Lg~ Craftsman Hickory Well~ood, glued to ~" sheetrock, ~ouldings to match~ sheetrock= tapered edge, ~" thick on walls and ceilings, ~" vinyl backer board behind all ceramic tile, use Balv. metal beads at all corners and edges. Windows = ~ood as manufactured by Anderson, H Narrowllne" daublehung,~Beauty LineH and casements as indicated. Provide all windows with screens. $11dtng exterior door by Anderson. Exterior doors: Woodco~ interior doors: ponderosa pine six panel colonials and louvered v/nero indicated. ~eatherstrip all exterior doors Series IO-~ and aluminum interlocking threshold, Finish ~ood flooring: select or better, 25/32 '~ thick oak, 2 ¼' width. Bart insulation= fiberglass with aluminum foll one face. 5. Hardware: interior butts: 1 pair brass plated ~ exterior I ~ pair solld brass. Locks: Lock,od or Yale" Litchfield, AZIO, U~3. Exterior 5307, Baths and Bedrooms 5302, Basement (heed of ttairs) 5303, others 5301. ~. Kitchen Cabinets= (and Vanlt(es) Allow $800.00 Cabinets as selected by the 0~ner. 7. Appliances: By 0~ner, installed by Contractor. 8. Ceramic Tile= Crystalline Blaze, American~Olean Tile Co. Tile to be adhesive set; tile to ceiling behind tub~ at sho~er~ tile walls and ceiling. Provide soap/grab at each tub and sho~r. Resilient Tiler Vinyl flooring - Vermont Flagstone 10121, Ruberoid Co. Sandura Division. Toilet Room Accessories: Hiami-Carey Basement Toilet - Paper Holder 6011C Towel Bar 6013C Soap Dish 6008C ,Hedlctne Cabinet 2050 Other Bathrooms: Add to above Tumbler & Brush 6007C II. Painting~ Hanufacturer - Pittsburgh Sheetrock= 2 coats Latex ~allhide Kitchen: 2 coats ~alihide Gloss Enamel Exterior Trim: 2 coats o11 base house paint Exterior Shutters & Boors - 2 coats Sun-proof trim Cedar Shingles - Cabots #2~1 Bleaching All colors as selected by the 0~ner. Allow cost of installing wallpaper- bathrooms and dininB room * paper by Owner. 12. Plumbing~ Allow $1,~00o00 for installation of a ne~ well. Well allowance to include point,pump, well~ tank and electric wiring from box to pump. All ~rk to conform to Health 0apartment regu- lationso Connect house sewer into existing cesspools. Hose Bibs= one each side of house as directed. Fixtures~ American Standard, ~hite. Lavatories: Basement 20Hx18~ Comrade~ others 0valyno Bath: Contour recess w/non-slip feature. Water CIosets~ elongated compact. Kitchen Sink~ Cus¢om-line P7017, 32"x21u with W/N q013-l fittings. Shower fittings: C2]8-1. 1)o ~eating~ Provide hot ~ter baseboard heating system with three zones am follows: Zone 1 - Kitchen 0fnfng and Living Roomst Zone 2 BR #1, 0eh and gath) Zone 3 - second floor. Each zone to have its o~ thermostat and B & G ctrculate~ pump. All piping copper. Heating Unit - American Standard with ~lant-ffn radiation. Oo~stic hot w~ter by tankle~s cotl in boiler. Contractor to guarantee__ insf,d~ heating to 70e F. v~len outside temperature is Zero degrees and wind at 15 HPH. ~IG ~-~ ~5~1~. lq, Electrical= Service to be underground I00amp. 110-220 V. single phase. ~nsta1! circuit b~eaker in stair to basement. AIl ~ring Romex non-metallic concealed in construction. Convenience outlets and receptacles are duplex and switch-silent type. Allow $3S0.00 for electrical fixtures to be selected by the Owner, furnished and installed by the Contractor.