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Home My WebLink About6726-zFOKM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy THIS~C~E,~RiT~I~IE~S~that the building located at Il/8. ~$1~l~h~',. ~' ....... Street Pe~e ......... Map No .......... ~~o. .Lot No.~ .~. ~.5 ..... Or**n}0r~...~,X~.. conforms substantially to the Application for Building Permit heretofore filed in this office dated .........~...~ ~i..., 19~3.. pursuant to which Building Permit No..67.~..~.. dated .... ~..1~..y..~3 .... , 19~.3.., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval D~...~. ~..1.~..~..R?. Y.~! .~. ..... HOUSE NUMBER . ~[0.8~. Street ~.&ysh~li'~..Rc~. \ Building Inspector ~OEM NO. ~ TOWN OF SOUTHOLD BUILDING DEFARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: pursuant to application dated .............................. t...l'....'~/y/:'~'"', 197_~'", and approved by the Building Inspector. ;?.1'~ \ BUREAU OF ELECTRICITY ~-- \ eS JOHN STREET, NEW YORK, NEW YORK '10038 THIS CE~IFIES THAT James Koblenze~, e/side Ke~tn Blwt., app. 2000Z s/o R.R. T~acks, Southold~ L.I. in the following location; ~ B~ement ~ 1st FI. ~ 2nd FL outside Section Bilk ~t wasexami~don ~V~$1 ~, 197~: andfoundtobeincompllancewiththerequirementsofthlsBoard. AMT. K, W. OIL H.P. GA H.P. AMT. NO. A, W, G RANGES SERVICE DISCONNECT I NO. 0 METEI 1 100 S TIME CLOCKS B~U. UNIT HEATERS MULTI-OUTLET SYSTEMS mT. UPS. TRANS. NO. OF FEET V I C NO. OF CC. CONE*.A.W.G. NO. OF HI-LEG A.W.G. PER ~' OF CC, CON{). OF HI-tEG 2 EXHAUST FANS DIMMERS E NO. OF NEUTRALS A.W. G, OF NEUTRAL SPUDS Elec'Svee'Ine'Ep.o..Box 166 St.James, L.I. 11780 11 Per COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. Z~'*O~[ NO. 6 TOWN OF SOUTHOLD Building Depo~tment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date ...~]~.~.J:.]'.....]:.?.l.....I..9..??. ........... New Building ..~ ...... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ..... .]:..~.~.8.~.~..~.~.~s.~..~..r.~.e.~.~..]~.~.~.~.~.G~e...n.~.~.~.~..~.~ ............................................. Owner Or Owners Of Property ...~.~.,,m.~ .s....S..t....~....~..o..s...e...~.,o.b..1..e..~..~.e..z'.. ........................................................ Subdivision .... .~..~.,c.o..n.~.9....~...~.3f....E.,s..~,~...e_s. ............... Lot No. ~.~'/..~. Block No ............. House No ............. Permit No...~..?...~...~..~.. ....... Date Of Permit .?../..1..~/..?..3.....Appllcant ...~..o..s...e....~...o..~..,~.,e.n.~..e...~. ............................... Health Dept. Approval ..~..S..0..-..~.0...0......~./.~/.]~..Labor Dept. Approval ................................................ Underwriters Approval .... .~....~..2.~..,8.~.......4./.~.0../.,7..4...Plonning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate Fee Submitted $ .6.. ~. .0. .0. ........................... Construction on above described building and permit meets all applicable codes and regulations. Applicant Sworn to before me this (stamp or seal) SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D. Reference No. APPLICATION F~.01~P~P~VA3~,, TD,~.~I~jC~_A PRIVATE 1. Applicant 2. Property ,~,i9~ Village ~ Township I~,] ; ~/ 9. Public water 3. Public Water Company name/P~T ; ~stance to main. 4. Lot size: Width feet Length fee~(Enter on center plot below) 10. Sewage Disposal System: A. 900 gallon septic tank: ~ecast ~Equlvalent Block B. Leaching pools: Number 3Precast Block Special SEWAGE 5. Subdiv. 6. Section 7. Lot No. If private well fill in blanks belq~: Tank capacity~) Gals. Pump G.P.M. Total well Depth to G.W. Street Amount of water in well Test Hole Data Feet 0 2 4 6 8 10 12 14 16 18 The undersigned ERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Department of Health's current stand- ards ther~§$~"~/ ~l ~ * ~ } Date Signed ~0~ ~ ~.-x~ Owner or B~ilder FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the opinion of the Health Department, that an adequate and satisfactory Sewage Disposal System can be installed on this pl~ ff ~~)/J ~/~ . ~/~ Date [/[~//~ Signed ]~O~ S-15 Revised 4/]/7~ a. This a~licmi~ must be completely fill~ in by ~writer o~ in ink and s~miff~ in triplicate to Buildi Ink,tar, with 3 ~ of pl~s, ~cumte pl~ plan to ~ale. Fee a~o~ing to ~h~ule. b. Plot plan shying I~ion of lot and of buildings ~ premises, relationship to adjoining premises or public st~s ar~s, and givi~ a detaJl~ de~ripti~ of I~ ofpr~ m~t be drawn on the di~mm which is ~ ~ ~is ~li~ati~.t c. ~e work c~er~ by this a~lication may n~ be c~me~ ~fore issuance of BUilding Pe~it. d. Up~ ~pmval of ~is ~licati~, the Buildi~ In--tar will issue a Buildi~ Permit to the applicant Such perm t. shall be k~t ~ the pmmi~ ~ilable ~r in~ti~ ~r~h~ the ~rk. e. No'buildi~ shall be ~cupi~ or u~ in whole or in ~ ~ for any pu~se ~ever until a CedJfi~ate of ~cu~ncy shaU ~en gmnt~ by the Buildi~ Ink,tar. APPLI~TION IS HEREBY ~DE to the Buildi~ ~a~ment for the i~uance of a Bud ng Pe~it pu~t to ~9. ~u~at~s, mr the c~tru~[~ of budding, ~iti~s or a~terati~s, or for mmpi ~ de~liti~, as ~mtn ~ri~.~ ~ne app,cant ag~ to comply with al a~ cable I~, ~i~ buildina St~t~ wh~ther opplicant i~ ~ner, I~sse~ ~Oent, ~mhit~t, ~n~ine~r, Oen~ro~ contractor, olectrici~n, plumber or buil~r. If applicant is a co~mte, signature of duly authoriz~ officec (Name and title of co.orate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ........ -- ~¢ ~ ~' ~.,~4 ~ d.T£ T 1. Location of land on which l~oposed work wi be'~en~ MapNo ..~......~...:.~..~.~....~.. ................. LotNo ./.~.~/'~...~... Street and Number .~..~)/~'h 0/~.k.-..~.....~..O/~ .~. .~.~../~/JS0~ T - "' ............... Munici~li~ 2. State existing use and ~cu~nw of ~ises and intend~ use and ~cupancy of pr~ed construction: a. ~isiting u~ a~ ~cupancy .................................................. ~ ......................................................................... 'ntend~ u~ and ~cu~ncy .......... ~..~C.. ~.~..~..[.~../.....; ~..~.~.~.(.. ,.~ ............. ~--....~ ............ b. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ............. 4~ Repair .................. Removal .................. Demolition .................... Other Work ..................................................... (Description) 4. Estimated Cost ..................~ .............................. : ....... 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 ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ l~umber of Stories ............. = ................ ~ 2/' 8. Dimensions of entire new construction: Front ...... ..~....~" ............... Rear .......?..~ ............ Depth ..... ~....../.?. ....... Height .................... Numbs' of/~_ tor~es ........................................................................ ~ ..... ~ .................... 12. Does proposed construction,~iolate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded .......... ...~..~....~1 be removed from premises: ( ) Yes ( ) No 14. Nc~me.of Owner of premises .................................................... Address ................................ Phone No ....................... Name of Architect ...... .~.jrj~.~....~.~ ........... · ...~.~.;~A~__Address ................................ Phone No ....................... Name of Contractor ............................................................ 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 n~mes and 'indicate whether interior or comer lot. STATE OFN COUNTY ~OF~....../~.~~ ........ ;;;~.....;..; ........................... ; .................... ~ ......................... being duly sworn, deposes and says that he is the applicon! · (Nome o~ individudl signing controc~ ' ' (Contractor, ag~t, co~orote officer~ etc.) of said owner or owners, and is duly authorized to perform or have performed the said wor~ and to ma~e and file this application; that all statements contained in this application are tree to the best of his ~nowledge and belief; and t~ the work will ~ perf~ed in ~e manner set fo~h in the application fil~ therewith. Swam to bede me thru'. {$i~ture o{ ~pplicant) T~RI LEE E~K ~y PUBLIC, State of New York No. 52-6168295 Q~iified in Suffolk County ~mi~ion Expires GUARANTEES INDICATED HEREON SHALL RUN o~y ~o r~ ~so~ ~o~ w~o~ tH~ S ,¢ ~: I, ~NOTE ~ SCA FILED 0FF~Cg A5 GLIAE&NT=ED TO THE A!AEETCAtq TITLE : KI$ ~J ~AI,ICE C0~APA~Y AS SUrVeYeD . DECE~&E~ {0. 1973 V~N TUYL ~ SON ~ICENSED L&N~ ! I~AYSH02£ ~.~ /.44p , PI~OPEETY FO?- A 2,51.4 A/:~o,,.. A q:J E ' ~ N.Y. TOWN OF SOUTM~.LD., II -1 ~'/~ /Vo COVEZ,,e,~G~, 0 ~4 7'H/,.~ -~1~,=' I Al 5 NO ?-cb/ 5£E 5K£~0~4 0 40 -5 58 "0" MH ~VINDO~ ~/~ ?ILL£,(' TH/5 5TON£-DBL£ ~p /1 C ?- 7 iV'O COV,E~.,'9,~'~' / ,IN ~ TU~ 37" Lo~v5 1Al S oPEN/N~ 9 C l l/z O~ Y~I$ 51DE 2~ CO" i S-FLOE, Y,,L BEDR 0 0 ',,/1 ~:o XL BEDROOL1 -4 L_ 'VhNO P00kf EKTEV--IOE DUCF I FUFiN,~,CD %0 BE LOt~I~-ED ONI I~GOF APPROVED AS NO~ED NOTIFY BUILDING DEPARTMENT AT CONCEPT 8,0 DATE ,- 7.8-?.cFLOOR PLAN 24 4 8EDROOk/I DOUBLE WIDE REVISEDS-II -aC.. FRONT ~ITCHEN kAO-)EL ~4 4F, 05 REVISED DESIGNED BY DRAWNE d h4 BY SCALE '" I '- O REVISED NATIONAL HOMES CORP. )we N, O24_4KO_5 REVISED LAFAYETTE ~ INDIANA 5H NO 4, LO,, ,~)~0 (LEWQsTbl OF CJW~TI IFZ'-o'' 4-'-o" /, )"/ /2" MODEL 24- 4KO-.S CONCEPT DATE ,~ ~,te..-.-¢_ FOUNDATION PLAN P4-4 BEDROOM FRONT KITCHEN REVISED REVISED DESIGNED BY DRAWN BY ,~ALE I/4" = ilo'` REVISED NATIONAL HOMES CORP. DWG NO REVISED LAFAYETTE., IND!ANA SH NO NATIONAL HOMES CORP.~ CENTER BEAM SPANS AND 'COL.I~ FOOTING SIZES MAX SPACINGMIN, REQUIRE~ COLI~N OF~ COLI~N MIN, REQUIRED BEAM SIZE* FOOTING SIZE" TD ]SE THE 4-2" X 8" WOOD BEAM IN THE ,~LOOR SYS~EN ~,~ "D~S SPAN N~TH ~, 26" X 26" X 8" 10' 0" JsE THE 4-2" x B" WOOD~E~ ~N TH~ 30" 30" 8" - ?LOOR SYSTEM AT THIS SPAN ONLY WHEN X X DHERE IS NO BEARING PAI~TX'i'±uD~ ~OVE ]2'-0" ~7X20#, MSXL~#,0RM6X20# 32" X 32" X ]2" 12'-0" ~SX18,4#,0RWSX17# , /[6' - ¢" ~8 X 2q#~ ~8 32,fi#~ oR slOX 25,q~ 5q" × ~" X ~" 18' - 0"~10 X 25~ ~8 X 35#~ OR $10 × 25,4# ~" × ~" × 12" 20' - 0";]~ X 31,~ OR w10 X ~# ~" X 38" X 12" 22'-0" ~]?X31,~oRwlOX29# -- 40" X 40" X 12" 24' -0" dOX54#ORs12X40,8~ *NOTE: BEAM ,~xlD COLU~ FOOTING DE$1~ BASED ON MIN, 2,OO0 PSF SOIL BF_/~RING CAPACITY AND 2,000 PSl CONCRETE WITHOLFF REINFORCEMENL SUPPORTING ONE F~L~XDR~ PLUS ROOF ;%ID CEILING LOADS ONLY, ~ILING AND GLUING SCHEDULE BO~ PLATE TO ST~ TOP PLATE TO STUD SECOND PLATE BO~R TO FLOOR JOIST BOXER TO BOXER COMER STUDS BO]TOM PLATE TO JOIST BOUDLE C~ PLATE CAP PLATE LAPS CEILING JOISTS TO PLATE CEILING JOISTS (LAPS OVER PARTITIQNS) BRIDGING TO JOISTS 1/2 PLYWOOD WALL SHEATHING 5/8 T & G FLOOR LINDERLAyIVENT BUIiLT UP BEAN,S CO~INUDUS H-EADER - TO STUD CONTINUDUS HEADER - 2 PIECES 1/2" FIBERBOARD SHEATHING & GLUUD W/D286E BY ARMSTRONG 1/2" GYPS~ SHEATHING ~2" EXTERIOR ~URED PLYWOOD AL~IML~ SIDING ~ILING 2 - 1GD DI~CT 2 - 16D DIRECT 3 - 16D / S'D~D SPA~ 3 - 16D DIREU 3 - 1ED / JOIST SPACE' 16D DIRECT @ 30" O,C. 16D DIRECT @ 24" O,C, 2 - 16D/STUD SPACE .2 - 16D DIRECT 3 - 16D DIRECT 2 - 16D DIRECT 3 - 16D DIRECT 2 - 8D END 16D @ 12" O,C, 2 1/4" SCREW SHANI< 16 GA NAILS @ 8" ON PERIME]ER, 12" INTF_RI~EDIATE & GLUED W2T~PE 33 CASEIN GLUE 16D @ 32" O,C, DIRECT 4 - 8D TOENAIL 16D @ 16" O.C. DIRECT .i 1/8" LONG W/7/16" CRQWN - 12 G,A, 1 1/4" LARGE HEAD CORROSION - RESISTIVE @ 4" O,C, ON EDGE~ 8" O,C, INTERMEDIATE & GLUED, W/D286E GLUE BY ARMSTRONG 16D @ 16" O,C, & GLUED W/[~86E GLUE BY AP~BTRONG 1 - 6D AL~INUM NAIL PER STUD