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HomeMy WebLinkAbout28239-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29449 Date: 05/20/03 THIS CERTIFIES that the building NEW DWELLING Location of Property: 215 SOUTH ST SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 70 Block 10 Lot 5 .2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 2, 2002 pursuant to which Building Permit No. 28239-Z dated APRIL 3, 2002 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING WITH COVERED FRONT ENTRY AND ATTACHED TWO CAR GARAGE AS APPLIED FOR. The certificate is issued to WALTER BERRY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-01-0053 05/16/03 ELECTRICAL CERTIFICATE NO. 1047150 04/21/03 PLUMBERS CERTIFICATION DATED 05/16/03 GEORGE S BERRY SR th ized Signature Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 28239 Z Date APRIL 3 , 2002 Permission is hereby granted to : ASKREN (W BERRY) 215 SOUTH ST SOUTHOLD,NY 11971 \ for CONSTRUCTION OF A NEW SINGLE FAMILY DWELLING WITH TWO CAR GARAGE, AND COVERED FRONT ENTRY AS APPLIED FOR at premises located at 215 SOUTH ST SOUTHOLD County Tax Map No. 473889 Section 070 Block 0010 Lot No. 005 . 002 pursuant to application dated APRIL 2 , 2002 and approved by the Building Inspector. Fee $ 1, 032 . 90 Authorized Signature COPY Rev. 2/19/98 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings,property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building,multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses,or buildings and"pre-existing"land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy-New dwelling$25.00, Additions to dwelling $25.00, Alterations to dwelling$25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy- $.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial $15.00 Date. Jl New Construction: Old or Pre-existing Building: (c ck one) Location of Property: S 50(,v House No. // Street Hamlet Owner or Owners of Property: /7�'/ ��� Suffolk County Tax Map No 1000, Section Block Lot Z Subdivision Filed Map. Lot: Permit No. ��a3 Date of Permit. Applicant: rr� Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: � (check one) Fee Submitted: $ 2 p J "' OS Applicant Signature NJ JrL3'i:nL3.rL3rPr3PLffi3jAJ�rSrJ�rJ�rJ�ntJrJ�rJrJ�IrJ�rJrnt�rJrJrJ�rJrncnr�rJrJ�cPr�cn�PrrrJrJ�r�rJr�rJrJcnr�rJrJ�r�rPQ3j-J�r3PcnrJf3n rJ-rJ-L3rd3 o 5 � BY THIS CERTIFICATE OF COMPLIANCE THE 5 NEW YORK BOARD OF FIRE UNDERWRITERS S 5 5 BUREAU OF ELECTRICITY C5 40 FULTON STREET — NEW YORK, NY 10038 5 5 CERTIFIES THAT 5 5 Upon the application of upon premises owned by 5 5 G &S ELECTRICAL CONTR. WALTER BERRY 5 5 BOX 215 215 SOUTH STREET C 5 SOUTHOLD, NY 11971, P.O. BOX 247 5 SOUTHOLD, NY 11971 5 55 Located at 215 SOUTH STREET P.O. BOX 247 SOUTHOLD, NY 11971 5 5 Application Number: 1047150 Certificate Number: 1047150 5 Section: Block: Lot: Building Permit: BDC: NS11 5 Described as a Residential occupancy, wherein the premises electrical system consisting of 5 electrical devices and wiring, described below, located in/on the premises at: [[[5 5 Bascment,First Floor, Second Floor,Outside,Attic, 55 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was 5 5 found to be in compliance therewith on the 21st Day of April, 2003. 5 5 Name QTY Rate Rating Circuit Type 5 5 5 Alarm and Emergency Equipment 5 Sensor 1 0 Carbon Monoxide 5 5 Sensor 7 0 Smoke 5 fj Appliances and Accessories C 5 Range 1 0 50 Amps 5n 5 Dish Washer 1 0 1.2 KW 5 5 Exhaust Fan 2 0 F.H.P. 5 Furnace 1 0 Oil 5 L5J Wiring and Devices 5 rj Receptacle 49 0 General Purpose 5 Switch 28 0 General Purpose 5 5 Receptacle 7 0 GFCI 5 Disconnect 22 0 Incandescent 5 5 Receptacle 1 0 20 amp Laundry 5 rj Receptacle 1 0 30 amp Dryer �5 5 Service 5 5 1 Phase 3W Service Rating 200 Amperes seal L5J Service Disconnect: 1 200 cb 5J 5 Continued on Next Page 1 of 2 L''5 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 5 5 O rrJffl3nPr � n� n �ra�PcnnnJ�rJ � a � n@l caPr r�cnr3Pr Pr rfffnrJ��l awl o O rJrJ�rJ?JrJ�nrJ�rJrJ��nr�rJrJ��PuRI rJ'rJ'rJRFU MI'R W=1'arJ'�.nr2 frJ'arlUrJ a�nr�rJrJ arlcnrJ acncnrJ�rJ@nrJ�rJ rJ�rJr�rJrJrJrJ�rJ a�nrJ�rJrJ�rJ�rJ o 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 BUREAU OF ELECTRICITY c5 40 FULTON STREET — NEW YORK, NY 10038 5 CERTIFIES THAT 5 5 Upon the application of upon premises owned by 5 SG &S ELECTRICAL CONTR. WALTER BERRY 5 5 BOX 215 215 SOUTH STREET 5 5 SOUTHOLD, NY 11971, P.O. BOX 247 5 5 SOUTHOLD, NY 11971 c5 5 Located at 215 SOUTH STREET P.O. BOX 247 SOUTHOLD, NY 11971 c5 Application Number: 1047150 Certificate Number: 1047150 ee��5 Section: Block: Lot: Building Permit: BDC: NS11 5 Described as a Residential occupancy, wherein the premises electrical system consisting of S 5 electrical devices and wiring, described below, located in/on the premises at: 5 5 Basement,First Floor, Second Floor,Outside,Attic, 5 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was 5 5 found to be in compliance therewith on the 21st Day of April,2003. 5 5 Name QTY Rate Rating Circuit Type 5 Meters: 1 5 5 5 5 5 5 5 5 5 5 5 5 5 seal 5 5 2 of 2 5 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 5 D �PrJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�tPrJ�r�rJ�r�r�rPrJ�r Pc PrJrJ�rJ�r�rJ�rJ�rJ�rJrJ�rJ�r�rJrJr PrlrJ orJ�rJ�rJ�rJ�rJ�r1 arJ�cPr�cPcPrJ orJ � rJ�rJ-rJLrL3j- PfflrPcP l7 ��O�gUFFO(,�co o � 1 9 PfMri Go Town Hall,53095 Main Road oto ' Fajr(631)765-9502 P.O.Box 1179 'y �0� Telephone(631)765-1802 Southold,New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Date: / b d Building Permit No. Owner: o (please print) L _ Plumber: r �1 ti �� �eCC�piG �L�m�/�y T l re ITI (please print) / / I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Aj" (Plumb s Signature) Sworn to before me this `6 day of s 20 © 3 C� Notary Public, ILC ounty Not"KW�ddN"Nwk No.OIE Oua4fin 8u�frmk 01 Commion iss9 13IJ:l -iINK/ CA [LL �IS`_I Applicant/ Date Owners Name: Li.//. e t '.' Reviewed: Architect/ �j� Date Engineer: t _ Subniined, / / — SCTM M: District: MOO Secyjon: 70 muckI Loc S Project r� Subdivision I..ocalion: cs((� � - ___-- Name', Single S separate Required Cr cenlf�6ation: Yes /No q/��yp—� Rey. ,�y� Iicq. ^` Zoning Dismc( 11J— Ilul size'. _y Actua( 7 _I (Lal wveragc a0 L Propoxd-�4 Rcq. qi/ /_ l Req. ��j �r Req. (front Yard Proposed _) (Side Yam r 75 _ Proposed 1 (Rear Yard _�7,5_ proposed b 1 Project Description: �J AGENCiP� ERMITS Permit REQUIRED FOR REVIEW N.A. NO YES Num r Suffolk County Health Dept. R/O-0l ooS� New York State D. E. C. _ Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation??? Flood Zone: i L b Notes: f t 3 723 04, 52/2552 51: 55 531258825^ GECISI7N PAGE 32/52 DECISION 2000 REAL.ESTATE SERVICES,INC. VARIANCE SEARCH Title No 02-08-2659 County of Suffolk) State of New York) This is to certify that Wal er Berry is the owner of record of Tax Map No. District 1000 Section 070.00 Block 10.00 Lot 0 35.002. That he acquired title th o by need dated 10/15/01 recorded on 10/31/01 in liber 12150 cp 597. That we have made a se h of the records in the Suffolk County Clerk's Office and find that neither the said owner nor any pr decvss it in title of the said premises owned contiguous property at any time since 411/57, except: Prernise>on West and Premises South That the applicant herein Ices not own any contiguous property except as follows: None This certification is trade vith tha intention of the reliance thereon by the Board of Appeals and/or Building Department Of tl Le 2 own of Southold. The limit of liability and -thL. certification for any reason whatsoever, whether based on contract or negligence, shall not exe d $::5,000.00 and shall be confined to the applicant to whom this certificate is addressed or the U)unty of Suffolk. Decision 2000 Real ,Estate Services, Inc , _ By_ alt C7aC PAR4-6Z ct__. Carolyty'141cPherson Sworn BeforeThis March, / V 27"'Day of 2002 Notary Public Sutfo ( unty N Y. lvotary Public Strife New Yart ✓ Reneld C. a 3 7 2._ QudWed in Cbuaq No.01KAiI53 5 My Commndon Expire al/ 915 DECISION 2000 REAL ESTATE SERVICES, INC. Title No. 02-08-2659 SUBJECT PREMISES: District 1000 Section 070.00 Block 10.00 Lot 005.002 Monica G. Gallagher Deed To Dated: 2-14-28 Andrew Gagen and Rec'd: 2-14-28 Sarah Gagen, his wife Liber 1332 cp 210 Andrew J. Gagen died 3-12-32 Sarah E. Gagen died 8-25-57 Harry J. Gagen a/k/a Henry J. Gagen Deed To Dated: 8-31-62 Charles A. Gagen Rec'd: 9-12-62 Liber 5230 cp 33 Charles A. Gagen, as devisee under Deed The Last, Will and Testament of Dated: 12-14-74 Sarah E. Gagen, deceased and as grantee Rec'd: 12-27-74 In deed from Harry J. Gagen a/k/a Liber 7773 cp 100 Henry J. Gagen dated 8-31-62, recorded In Liber 5230 cp 33 on 9-12-62 To William J. Kodgis and Theresa Kodgis, his wife - CONTINUED - DECISION 2000 REAL ESTATE SERVICES, INC. Title No. 02-08-2659 Theresa Kodgis died 4-19-91 William J. Kodgis died 7-2-94—Doris L. Kodgis is the spouse and she dies 7-24-98 Paul Askren, Marla Askren and Deed Valley View State Bank, as Executors Dated: 11-14-00 Of the Last, Will and Testament of Rec'd: 1-10-01 Doris L. Kodgis, deceased Liber 12095 cp 877 To Paul Askren and Marla Askren Paul Askren and Deed Marla Askren Dated: 10-15-01 To Rec'd: 10-31-01 Walter Berry Liber 12150 cp 597 (Last Owner of Record) DECISION 2000 REAL ESTATE SERVICES, INC. Title No. 02-08-2659 PART OF PREMISES EAST: District 1000 Section 070.00 Block 10.00 Lot 037.001 Max W. Newbold and Deed Mildred D. Newbold, his wife Dated: 10-1-51 To Rec'd: 10-1-51 William F. Goubeaud and Liber 3275 cp 420 Ann Marie Goubeaud Ann Marie Boubeaud died 1974 William F. Goubeaud died 12-29-80 Philip J. Goubeaud, as Administrator of Deed The Estate of William F. Goubeaud, deceased Dated: 4-23-01 To Rec'd: 5-16-01 Philip J. Goubeaud Liber 12118 cp 832 (Last Owner of Record) DECISION 2000 REAL ESTATE SERVICES, INC. Title No. 02-08-2659 PART OF PREMISES EAST: District 1000 Section 070.00 Block 10.00 Lot 037.002 Max W. Newbold and Deed Mildred D. Newbold, his wife Dated:10-1-51 To Rec'd: 10-1-51 William F. Goubeaud and Liber 3275 cp 420 Ann Marie Goubeaud (As to P/O Tax Lot 037.002) Charles A. Gagen Deed To Dated: 9-26-62 William F. Goubeaud and Rec'd: 10-4-62 Ann Marie Goubeaud, his wife Liber 5241 cp 585 (As to remainder of Tax Lot 037.002) Ann Marie Goubeaud —Died 1974 William Goubeaud—Died 12-29-80 Philip J. Goubeaud, as Administrator Deed Of the Estate of William F. Goubeaud, desceased Dated: 10-26-99 To Rec'd: 11-10-99 Jeffrey Citera Liber 12000 cp 180 (Last Owner of Record) DECISION 2000 REAL ESTATE SERVICES, INC. Title No. 02-08-2659 PREMISES WEST: District 1000 Section 070.00 Block 10.00 Lot 006.000 Kasimir J. Felko Deed To Dated: 6-24-55 Suffolk County Mutual Insurance Company Rec'd: 6-27-55 Liber 3914 cp 389 Suffolk County Mutual Insurance Company Deed To Dated: 9-18-56 Sarah E. Gagen Rec'd: 9-22-56 Liber 4518 cp 110 Sarah E. Gagen Deed To Dated: 6-14-57 Edward A. Lademann, Jr. and Rec'd: 4-22-66 Charlotte M. Lademann, his wife Liber 5945 cp 406 as tenants by the entirety Edward A. Ladmann, Jr. and Deed Charlotte M. Lademann, his wife Dated: 5-28-66 To Rec'd: 6-3-66 Antonio F. Anelich and Liber 5967 cp 535 Mary Anelich, his wife as tenants by the entirety Antonio F. Anelich and Deed Mary Anelich, his wife Dated: 3-3-69 To Rec'd: 5-14-69 Mary Anelich and Liber 6549 cp 244 Mary Anelich and Deed Mario Anelich, her son, as joint tenants with Dated: 11-16-89 rights of survivorship Rec'd: 3-1-90 to Liber 11025 cp 49 Mary Anelich Mary Anelich and Deed to Dated: 10-1-01 Manzi Homes Inc. Rec'd: 12-24-01 Liber 12159 cp 824 (Last Owner of Record) DECISION 2000 REAL ESTATE SERVICES, INC. Title No. 02-08-2659 PART OF PREMISES NORTH: District 1000 Section 070.00 Block 10.00 Lot 004.000 Ray I. Young and Deed Helen S. Young, his wife Dated I1-18-54 To Rec'd: 11-23-54 Frederick Mazzaferro and Liber 3797 cp 119 Kathryn Y. Mazzafero, his wife (Last Owner of Record) DECISION 2000 REAL ESTATE SERVICES, INC. Title No. 02-08-2659 PART OF PREMISES NORTH: District 1000 Section 070.00 Block 10.00 Lot 003.000 Sarah E. Gagen Deed To Dated: 12-5-47 Walter V. MacNish and Rec'd: 12-8-47 Ruth J. MacNish, his wife, Liber 2782 cp 372 as tenants by the entirety Walter V. MacNish and Deed Ruth J. MacNish N/K/A Ruth J. Reinhardt Dated: 4-26-69 To Rec'd: 5-23-69 Walter V. MacNish Liber 6554 cp 69 Walter V. MacNish Deed To Dated: 8-27-69 Walter V.I►4 Kuh and Rec'd: 9-15-69 Helen MacNish, his wife, Liber 6622 cp 52 as tenants by the entirety (Last Owner of Record) DECISION 2000 REAL ESTATE SERVICES, INC. Title No. 02-08-2659 PART OF PREMISES SOUTH: District 1000 Section 070.00 Block 10.00 Lot 005.001 Kasmir J. Filko Deed To Dated: 6-20-55 Suffolk County Mutual Insurance Company Rec'd: 6-27-55 Liber 3914 cp 389 Suffolk County Mutual Insurance Company Deed To Dated: 9-18-56 Sarah E. Gagan Rec'd: 9-22-56 Liber 4518 cp 110 Sarah E. Gagan died 8-25-57 Harry J. Gagan a/k/a Deed Henry J. Gagan Dated: 8-31-62 To Rec'd: 9-12-62 Charles A. Gagen Liber 5230 cp 33 (Last Owner of Record) DECISION 2000 REAL ESTATE SERVICES, INC. Title No. 02-08-2659 PART OF PREMISS SOUTH: Gagens Lane M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH P G. [ ] FOUNDATION 2ND [ ] INS TION [ ] FRAMING [t' FINAL [ ] FIREPLLAACE & CHIMNEY / � ryyt EMARKS: T /, DATE 3131103 INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ;"FINALINS TION FRAMING [ [ ] FIREPLACE & CHIMNEY REMARKS: DATE 3 INSPECTO 765-1802 BUILDING DEPT. INSPECTION [ FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ) FIREPLACE & CHIMNEY REMARKS: DATE D Y INSPECTOR M-1802 BUILDING DEPT. 1 ECTION [ ] F NDATION IST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLAC CHIMNEY REMARKS: 1112 DATE SPECTO M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ROUGH PLBG. [ ] FO ATION 2ND [ ] INSULATION [ 7- FIREPLACE NG ( ] FINAL & CHIMNEY REMARKS: � DATE / Lolro J� INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ]�RH PLBG. [ ] FO DATION 2ND [ INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE 1 �� INSPECTOR 1 FIELD INSPECTION REPORT DATE , COMMENTS b t� ` r FOUNDATION(1ST) c ------------------------------------- FOUNDATION (2ND) t=' z i � x ROUGH FRAMLNG& - { PLUMBING r y INSULATION PER N.Y. y STATE ENERGY CODE FINAL ADDMONAL COMMENTS 0 z - z m o' b W C z fi x c � y _c x 1 b C y Q� H l.,r TOWN OF SOUTHOLD BUILDING PERMIT APPLIQATIQN CHECKLIST BUILDING DEPARTMENT Do you have or need the following, before applying? TOWN HALL Board of Health SOUTHOLD, NY 11971 3 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey PERMIT NO. :2$`0234 � Check Septic Form N.Y.S.D.E.C. Trustees Examined 4f3 20 0;�- Contact: Approved t(3 20 DY Mail to: Disapproved We Phone: Expiration _ 20 Building 0 - Tl i PPLICATION FOR BUILDING PERMIT APR 22002 Date 20 ( _ _ INSTRUCTIONS a '� ' tto�t 1164 pletely filled in by typewriter or in ink and submitted to the Building Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and waterways. 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 a permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date.If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. 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 comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. � (Signature of applicant on e,if a corporation) Po CZ,x 07`/7 56 ¢lo a /t/f' 1197/ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder I ICcAn k t5 0(�Wer Name of owner of premises lj�Gt �{�( �� L�e (`r (As on the tdxdroll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: { o L"A"i t C� q� Lc d, 44- Sow w l House Number Street Hamlet County Tax Map No. 1000 Section 70 Block / 0 Lot S D. Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy — b. Intended use and occupancy 3. Nature of work (check which applicable): New Building_VAddition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost /Do, 000.,0 Fee (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 no r-\ Rear — Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories S. Dimensions of entire new construction: Front S 7, Rear 57• r? Depth 3 O' Height �6 Number of Stories 9. Size of lot: Front /00 , / `/ Rear / 3 ?, 21 Depth /5- c/• 6 2 10. Date of Purchase /0//5/0/ Name of Former Owner Pc,"i (,,A r I G 11. Zone or use district in which premises are situated Res. 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES VNO_Will excess fill be removed from premises? YES ✓NO_ 14. Names of Owner of premises Address Phone No. 765 0o v Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO )C * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NOS * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF ) , &� � �er being duly swom, deposes and says that(s)he is the applicant (Name of individual signing con a t) above named, (S)He is the Ok)(\cr- (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 filed therewith. Sworn to before m ;ojtaryblic 20 U JOYCE M.wILKINS Signature of Applicant Notary Public,State of New York No.4952246,Suffolk County Term Expires June 12, , Loo3 Town Of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT Date: 04/02/02 Receipt#: 1132 Transaction(s): Subtotal 1 Septic Permit-Construct- Resid. $10.00 Check#: 1132 Total Paid: $10.00 Name: Berry, Walter H. Main Road Pob 247 Southold, NY 11971 Clerk ID: BONNIED Internal ID:52060 2E5. u /zE5 2E5 . /rcl �,eorYT /(IELC /N FTSE Map of Described Property Situated at Southold p c.P �+ N �� Town of Southold, Suffolk County, New York v p District 1000 Section 70 Block 10 Lot 5.2 C) `1 v `N 1 37 /0"E /�37 -7/ 23 -d d U IV ;1TFF0L< .;C1UPT N DEPARTMENT OF HEALTH:ERV ICE, prop 2 2 �h 5 E W PT+ vAEIN;I'f FOR APPROVAL OF CONSTRUCTION FORA �5 ySTC- P 'i -� SINGLE FAIIIILY Rr^.SIDENCr•.ONLY �r�-1(7 Z I uATE 2 1 .NO. If/D � APPROVED 4 2zz.om 7 3 g "� FOR MAXIMUM OF-.g-BEDROOMS % �� 2 EXPIRES THREE YEARS FROM DATE OF APPROVAL _�. � s Ip 00 _off Zo Ground Surface Elevation 15 0 Z / � 0.5' Dark Brown Sandy Loam (OL) 213. 72 I /®� azo 3� I u/� C iov . ¢ N 17' 2.5' Brown Loamy Sand(SM) _ ANTHONY ABRUZZO R.L.S. �GE wy wr�e / 14' Pale Brown Fine to Medium Sand(SP) z.o REGISTERED LAND SURVEYOR No Water 1700 Hortons Lane 0 i)T f-H cE-77- } Test Hole(By McDonald Geoscience 1/11101) Southold, New York 11971 C,9�pH Su 2• , r (631)-765-6242 j 0 2/IoNT U� Locations of adjacent septic systems and wells are by owners and are approximate X12 �1 \ SURVEYED: Janua 8, 2001 17//J,/ l p Revised proposed septic system and well: 3/14/01 7/z2/o/ �' t5 Scale : I" _ _ File No. 2425 ( • 1 . l�G-L4 J pA?V w/ �G��EIL� iL� %l�C= C.257EI,-FJ 7V TC7 Otbl FXr'/G ��1 Q�1sa3� 2E5- w Eco Map of Described Property P ��S . Situated at Southold Town of Southold, Suffolk County, New York O � District 1000 Section 70 Block 10 Lot 5.2 20 ! 0 �' I `p /V g2 37 /O"E /37 7/ C 0.-7A1 -Z.0 i ZZ '� �A`Y 6 2002 s r 5EPTI C '6 Y6TSy'4 \ ExT 27,0 z.z.o n t� �, co vc2erC r g 3 1,1: ° V27.oI�V') Ground Surface Elevation 19.0 0.5' Dark Brown Sandy Loam(OL) 0 213. 72 /90� 4,zza 3-7 ' !o 14 J95 17' 2.5' Brown Loamy Sand (SM) 7 y 14' Pale Brown Fine to Medium Sand (SP) ANTHONY ABRUZZO R.L_S. z.o REGISTERED LAND SURVEYOR + I g, �2,4//c�- Te/LJvE' No Water 1500 Horton Lane Test Hole (By McDonald Geoscience 1/11/01) Southold, New York 11971 (631) 765-6242 16117— OF Locations of adjacent septic systems and wells are by owners and are approximate. V p' Gl/f/ Revised proposed septic system and well: 3/14/01 '1/mz/o l SURVEYED: Tanuary 8. y 2001 Q 4, 15 Z Foundation Location: Ma4, 2002 ,2�s . « � � � Q 44 wE� �✓\�s.T, CL Scale:1—r = 30' e No. 2425 pA7UM Z2Ex E,5 � 7 4 5 C4STEr a/ TO +�• 's Tim;=oe5f,4 dreI,v f/sE w 2E5 . 2F5_ /'v '02wo.v - 19 Map of Described Property O P Situated at Southold Town of Southold, Suffolk County, New York o� / K 20 O e. P. District 1000 Section 70 Block 10 Lot 5.2 O • 2% .^) n N N o.7n/ ., —.. a.aev Zz.v l� I b 410E, _ /7, 83vS.F. k' V c� S,T; vo 27.o Q/�A• z , I rieSES . Q 23. 7 FF 23w � Z70 ,3 N N c..¢N m \ h$��Y �� � r (J ov. rC o Coo� 146-1 � 1 \ ) J lU�w Col— Certified To: q_ _ Ground Surface Elevation F®urao g Walter and Christina Bety 0.5' Dark Brown Sandy Loam(OL) 3;'v iy o J95 17' 2.5' Brown Loamy Sand(SM) ANTHONY ABRUZZO R.L.S. /y REGISTERED LAND SURVEYOR - Pn� Gey wile 14' Pale Brown Fine to Medium Sand (SP) 1500 Hortons Lane z o No Water Southold, New York 11971 � i 6.ro �2,QUEL D/z-/vE �ov7' H 4!E37- Test Hole (By McDonald Gcoscience 1/11/01) (631) 765-6242 (A �5pH -5U 2,> SURVEYED: January 8, 2001 iii SD ' /e/la//T OJ= Locations of adjacent septic systems and wells are be owners and are approximate. Foundation Location: May 4, 2002 50 ' z Q lvAy o Final Survey: March 29, 2003 z __J -gyp - UQ Q 4¢' S' �'V Offsets and measurements are to the foundation. OLS T ((/ELL Well and septic system locations are by the owner. Elevations refer to the Five Eastern Towns Topographic Map Scale: 1"=(3,4J File o. 2425 �? V t i I II U N � l� I _ 0 I� 11 O _ W 1- N 0' O Z o - 'r `00 ti0T PRaCEED WITH o FRAMING UNTIL SURVEY 9 W OF FOUNDATION LOCATION g - la HAS BEEN APPROVED. 4 -Ilii JI' PROVIDE SMOKE-DETECTING PROVIDE OPENINGS FOR =. - — AS RATEDSEPARATIONRT AS TO MARALARM DEVICES ESCAPE4 \. 0 L 721.1 EMERGENCY X14 Of REQUIRED BY PART. PART- I (1) OF N.Y. STATE BUILDING CODE. STATE APPROVED AS BUILDING ,E. N Y S BUILDING CODE. CODE. NOTED t r y BUI1>�� PLUMBING DATEJ �{ ;� P. - B. # +I I - 1 I- __ _ - ALL PLUMBING WASTE FEE: BWATER LINES NEED NOTIFY BUILDING DEPARTMENT AT TESTING BEFORE V _- ' I I F I � II - , I,I •iI i, COVERING 766-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS I. FOUNDATION - TWO REQUIRED PROVIDE ANTI•SCALD AND/OR FOR POURED CONCRETE THERMAL SHOCK PREVENTING 2. ROUGH • FRAMING & PLUMBING _ ? 3. INSULATION •I��1 19 DEVICES BU LDIN COD x) 0. FINAL • CONSTRUCTION MUST 4 NG CODE. n Vx BE COMPLETE FOR C.O. N.Y. STATE BUILDING ALL GY O CONSTRUCTION SHALL MEET I I PLUMBER CERTIFICATION THE REQUIREMENTS SI THE N.R —1 - - -- - - -- -- — - - - _- I - ' STATECODECONSTRUCTION NOT RESPONS RESPONSIBLE y b DESIGN OR CONSTRUCTION ERRORS W I' ON LEAD CONTENT BEFORE 2" 10 CERTIFICATE OF OCCUPANCY SOLDER USED IN WATER SUPPLY SYSTEM CANNOT x EXCEED 2/10 of I% LEAD. h�bl J.+J If copper tubing is used for water distributing system; piping shall be PANCY OR of types K or L only USE IS UNLAWFUL' o UNDERWRITERS CERTIFICATE WITHOUT CERTIFICA w REQUIRED OF OCCUPANCY a ' a i 'y J 7 � i7 Q W L N �. Ay 1 Y � Ij % S -7s Ci1#fii& - x7. -- ma < � - - I I , a LL i Ix _ I i I _ Y 4 0' e 4 1L II it n , F nN 2 c i O 0 O I FM EILI TI Ll _ l I I o OF � P im 3 �`I _ y I I ILII J1 I I ' , n -Egr n z I C a if _ K I 17 ij ' ___-_ 3,l _ ".IG"-] - - -' 3'�`w.:»;'�' .: _ _ ':1�5- __ _`�•,; �; :� - k'4,-` ' . 7f 8 . 2r, 51 Fj OL zi e 1 n ' . �I+ W 4� 4 j _ i T4 ,.m le llJ -4 JA or i _ - t ............�.:-.r- '--..-.^,-�.r.,. {-{ r t ' t 1� y, - _ _j 3'�Uy _• ,V "` � . - .` g fd' ��yy 1,. I �=.PL 3�'f�X„IYa �1sYlta�t , 4 � 1 � rr'�,-• zl � ,g . R I � Y I : ;, , i 1 1 .,I �2'�1.3.!.aY3.ucc � ��1• � -$S�',r13o M'g � .r f i( .�n1 � ,I r . IN 71 13 Y / {r _ _ ar In " y ns, f 'I � ✓�Q � : t .. '" � . � NDN 034154.1 �V R�EEsSIGO' .: I J 77 j s r l r, ler J4 LL.O- r r 1 -•+: _ _ _ 1 r, d•-e-•--r^-w-p!:�i+e�nn.-:-�-wr:=1...+-..,...k1Y+�e+'�:.-n^H+�re-.•.i.h,yw _ a, 111111 -• � - .,. - � - , ', .�, .. ., ' - "---. 17,11 r �G l ' '.gib� •, . � � I�—� n 1 __"752/a�( _-1Ssasa..•- ��7..�?'TI3CICA r 7 ` NEIV J, 01, ig4WV - '�QI L P ��� �1�'fi�#�.•.5��., Ii:'nz,_. . "'7 � '�OEesslow°'` II ='+7,trie�ar-:pro 1 - dI1 7aKa a. a� i 3 N 'IX a 4 ," - - ', , : — � - -- �,. � - -::�zs.:a��c- � 4Ft�Ncee�c„ea � - "-3 i3dr.-n {s tl'E5`o'vvg'c l ME I r 9oFFS3IONN�'� P� 00 , F�; 1;NLIIGY CUUL•' CALCULA'T'IONS (For Noll-Electric heat) Uesiyu Cri Leria 6, 000 Deyree' usys /� G. A. lU°F I .A. 70°F Ile t. /3erry YLR: Dena C 6`• 1f 21741 Iron: /f V4 ee 't /.fn S 0"f6, d DATED: 2Z/ 0 a/ SUUSYS'1'CM AREA O"U., 'RATINGL REMARKS "U" RATING Fix Lerl.or Wailu (Upaque) /G 71 , OS' r77` �lo 't h t•Jrn -pj. - mr-L7 Glaz Loy 326 . 3`/ - 6 S a. eW✓9/ Doors �� ,['L, - 23 Ceiling/Roof (Opaque) 102 ' .0 .i 0 Skyliyh Ls _ B Floor 10 21f .0 S IPouudatlon Walls Slab Insulation TO'T'AL X87 Notes: IlullcllIly Lnvelope SysLems to meeL requiremen Ls of 7815. 2 _ IIVAC Lquipemelt to meet requirements of 7Ul5 . 11 IIVAC Systems to meeL requirements of 7815. 1:2 Duct Sys Lens to meeL requiremeilLs of 7015 . 13 'Ventila Lions Systems to ,meeL requiremen Ls of 7U15 . 14 lusu.la Licu of i'ipiny Systems to meeL requir.emelLs of. 7U15 . 15 Scrvtce Water Ileahiuy SysLems 6 LquipmenL to meet requirements of 7UT5 . 21 h.lec Lri.cal s LiyhUng Systems s GquipmeuL to meeL requiremeu Ls of 7815 . 31 '1'o the best of my knowledge , ,. )�ENF~�9 belief, 6 professional j mlyenlent, these plans are 11l compllancc wlth the code . w JF, 0321544 l,U cp90FC5S10P�r 4, 7'L 7 S 9� k� (204 04v 1 1 Lin I I 1 } L � 5 F HE (-�— ;E _W )3 54-1 t1V V FESSIONP yy/vl �aa,l�Pw P IPJOf