HomeMy WebLinkAbout7284-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. Z6~09 Date Ja~ e~ 19.7.~.
THIS CERTIFIES that the building located at ~o.b..~..s.o.l~..R.~.:&d. p. ri..v.a.t.~... Street
Map No. I.~ .a.~..d.~..~e..PtBlock No ........... Lot !l~)~.......8..o~..t.hg.l.d....N.;~.; ..........
conforms substantially to the Application for Building Permit heretofore filed in this office
dated .............. .P~..][.. ~ 19..7~.. pursuant to which Building Permit No.
dated ........ B.a.s....~ ...... , 1971+ ...., was issued, and confoms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is . P..r.~.~..t.e..q~..e..f..a[n..~.l.y..d..~.e.i. 1..~.ng. & ~,eee s sory ( Bath or 9eaeh house)
The certificate is issued to .~.~. 9.r[~...~.ay.t..~.~ ..... . .0~..$.r ....................... ......
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval J..~1....2.~...1.~.~...bY .R.,...V.~.i.i.$ .....
UNDERWRITERS CERTIFICATE No. ~.. 2.02.0.~ 8 ..... .J~.. 6...~ 97~. ...............
HOUSE NUMBER ..... 37.~.0 .... Street .. l~ob~l~. ~[ ........................
FOBM NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N~. Y.
BUILDING PERMIT
(THIS PEPJ~IT MUST BE KEPT ON THE PREMISES UNTIL FULL
CONtPLETION OF THE WORK AUTHORIZED)
z
Permission is ,hereby granted to:
buJ.:M ney one ~ c~vo~.~
pumuant to ~pplicetion dcfl'l~l ...................................................... , 1~......., am:t approved ~ the
Building Inspector.
· BUILDING DEfARTMIMTq .,~_/...,. ~ ..~ ~/-. ~..
T~N QLF~K'$ OFF~',~/~.'/ ' '1 .~ _,
SOl,ri'HOLD, N.Y. (.~./~,,.-,.d~ ·/,/'/x.-,,,,'Y / ~ o/~,,. ~'1
,~o~licat~on Na.../.. ............ ./.. ...........
................. '-'5 .... .
proved ................................... t.., Pe ,t No...7... .................
Disapproved a/c~ ~///7 ~ ~O.
..............
' , APPLI~TI~ FOR ,UlLmHG PE~IT ~ ~' '
Date ................................................
INSTRU~IONS
In--r, with 3 ~ of pl~s, accurate pl~ plan to ~ale. F~ ~i~ to ~h~ul~.' '
~ "~ pIn~ showing I~ation'of Iot'~d of bullies ~ premises, relationshiP to ~joining premiss or pubJic str~
ar~, a~vi~ a d~ailed d~zipti~ of I~ otp~ m~t be dra~n.gn the diagram ~ich is ~ of this ~lic~.
-~o~ c~er~ by thi~a~ iCation m~ n~ ~ com~ ~fore i~uance of Bui ding Pe~it.
d.. ~: appeal of th~s a~Ji~t~;~e Buddi~ I~torwdl ~s~ a Bu*id*ng Permit to the ~licant. ~h ~it
shall ~ k~t on ~e premis~ ~ailable ~r in~ti~ ~ro~ ~ ~rk.
e. No buildi~ shall be ~cupi~ or u~ in whole or in pa ~ for any pu~ose whatever until a ~ifico~ of
shall have ~en gmnt~ by the Buildi~ In--tar.
APPLICATION IS HEREBY ~DE to the Buildi~ D~ment for the issuance of a BuJldi~ Pe~ t
Building Z~e O~inance of the Town of ~ld, Suffolk Count, N~ York, and O~er applicable
R~ulations, for the constr~ti~ of building, ~iti~s or altemti~s, or for m~al or demoliti~, as heroin ~ri~.
The applicant agr~s to comply with all a~lic~le laws, ordi~es, buildi~ c~, h~si~ c~e, a~ ~1~i~,
admit authoriz~ in~to~ on premiss a~ in ~i~i~s ~r n~ Jn~tions.
G~enn ~. ~e~d~m~n & Son ~ne,
(~ig~m of applicant, or ~me, if a co~mti~)
P.O. Box E. Fairhaven, Jamesport, N.Y.
............................... · i,llliii~i; 'i;~'~};ii;;iiji ........... 'zzv~? .......
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Builder
Name of owner of premises ......I~......G.?...o..~..~...e.....~..a..?.~.i...s. ..........................................................................................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No .....................................................
Plumber's License No. Metro Plumbing Eas~
Electrician's License No ...... .7...8..3...-..E. ...... '.....G..o...o..d...a..1..e.. ~'.].eotric
Other Trade's License No ........ .N...o..n..e.. .............................
1. Location of land on which proposed work will be done. Mop No.:........................................?amadi~e ?oint Lot No .........................
Street and Number .......... Poobd, n~or~..R~l,~.....~u.~o.l.c]. .....................................................................................
Municipality
2. State existing use and occupancy of premises and int'ended use and occupancy of proposed construction:
o. Exisiting use and occupancy ................... ~/~a,~n.t,..te~ ..................................................................................
b. Intended use and occupancy ................... ~n~:"f~mi'%i"dwe'~T~g ........................................................
3. Nature of work (check which applicable): New Building....:...~r~ ....... Addition .................. Alteration .................
Repair .................. Removal .................. Demolition .................... Other 'Wo?k .....................................................
~.Z ~ (Description)
4. Estimated Cost ....... ~..~0..~)0~,~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 ........ i~....... ....................................................................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................
7. Dimensions of existing structures, if any: l:ront ............................ Rear ................................ Depth ....................
Height ........................ Number of Stories .......................................................................................
Dimensions of same structure with alterations or additions: Front ..... : .............................. Rear ............................
Depth ................................ Height ............................ Number of Stories ................................
I
8. Dimensions Of entire new construction: Front ..... b~ .......................... Rear ........ LI-8 ............... Depth ..... 6..3.~. ............
Height 27 t Number of Stories 2 .............
9. Size of lot: Front ............. 3,~.1~.t .................................. Rear ......... ]..;~.l ........................ Depth ........ :~p.l.i, ..............
10. Date of Purchase ....~. ................................................... Nome of Former Owner ........................................................
11. Zone or use district in which premises are situated ..... S.~'3.Ee].e..~?a,m;J.,],~r. ........ : .......................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ..... ..~..o.. .............................................
13. Will lot be regraded ..........~.e~ .......... Will excess fill be removed from premises: (x) Yes ( ) No
14. Name of Owner of premises Geoz, ge Kaytis Address Mattituck Phone No. ~,~.~...')4,],Ll~.
Name of Architect .................. .D..o...~...,D.~TX;I.~ ....................... Address ...~aJ~e~[oo~$. ...... Phone No. ?..~...~..-.~.~.Z...];...
Name of Contractor .................~..e..~..t..m....a~.~.....~....~..o..p: ........ Address ....~...a~..~/~.~.~ ....... Phone No.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock 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 Y/ORI~./. ,~ / I ¢ ¢
COUNTY OF~.,f'~;~.,
................................................................................................. being dul.y sworn, deposes and soys that he is the opplicom
(Name of individual signing contrac~ -:- ~' o , .
above name.
He is the .............................................................................................................................................
(Contra~or, agent, corpgrate officer, etc.)
of said owner or owners, and is duly authorized to perform or have perfo~ed the said work and to ~ke and file
this applicati~; that all statements coato~ed Jn this application om tree to the ~st of his knowledge and belief; and
that the work Will ~ performed in th~ '~ahner set fo~h ~ the application fil~ therewith.
Swam to bef~e me this _ __
~ (Signa~re of applicant)
JUDI~ T. BOKEN
Nola~ Public, Slate of New Yo~
No. 52-0344963 Suffolk Coun~
Commiili~ ~pires March 30, J9~
FORM NO. $
TOWN OF $OUTHOLD
, Building Depo~tment
Town CleM. Office
Southold, N. Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
I nstructlons
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:
1. 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 disposol--(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 19§7), 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 in-
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
[~te ............ ~ ..................
New Building ..... ~... Addition ................ Old or Pre-existing Building ................ ¥ocant Land
Location Of Property ...~4~!'~'...~....~.~...~......~..~).... ....................................................................................
Owner Or Owners Of Property .....~..~-.~..~....~..~-... ...... ..~..t~j'.~..~'..~..~
Subdivision ................................................................ Lot No ............. Block No ............. House No .............
n r fL
U derw iters Approval .............................................. Planning Board Approval ........................................
Request For Temporary Certificate ........................................ Fin~ Certificate ...... ,Z~ ..............................
Fee Submitted $ ....................................
Construction on above described building and pe,~qit meets all applicable codes on.d regulations.
Sworn to before m ~s
...... of
Notary Public ....... County
SUFFOLK COUNTY DEPARTMENT OF HEALTH
H.D.Reference No ~U-~
APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS
Approval to construct said systems is requested,pertinent data herewith: Date~
1-Applicant .~lenn -~'. ~eidt~ann ~ ~nn Phone~-Sub div
Address ~'.0. '~.ox £. '."airnavonm J~ucesoort. ?:.Y. 7-Section
2-Detaile~.~ property location P~t~adlse Point 8-Lot No.
Hamlet ~outbold Town Jouthold 9-Private well?
3-Public water supply name Distance to nearest main
4-Lot Size: Widthl2-~, ft. LengthS21 ft. (also enter on center plot plan below:)
5. Dwelling: Singl.e Family ~ Two Family? ~ /Cellar? /x/~Slab? ~ ;Crawl Space? /
lO-Proposed system. Septic tank ~/PrecanCel/Cesspools / /Shallow pools ~_/Otber / /
Il-Septic tank insl.de dimensions_'..~Volume~O_~als.Length, ft. Width ft. Liquid depth "f~.
12-Precast sections. ~_/Number~Square~. Cesspools. Block sizeL incs.D ins. H ins.
Total blocks below inlet: ~1 ~2
PLOT PLAN
Capacity 3 Gals.
'~ G~. P.M. ~horse
~ ~ ~ burk
0
?eet
0
2
6
8
10
~6
~ m Strut
m Ind5 rte
~ "< No'
The Undersign~ CERTIF~S: "Constmction of authorized installations will be in
aceo~aneo with %ho Suffolk Count7 Hoalth Do~tment~' cu~ont Standa~s~ Bullotins,
and amendments thereto, covering Private Se~ge Dis~sal Systems".
Date ;ay 29, 197h Signed ,, ,~ ,,,~ ..: ;~ ~: .... ~
FOR ~LTH D~P~R~g~ ~S~ ORL~, Bas~ on [h~ 5nfoma~5on p~o,~nged h~ro~h, 5~ ~s gho
opSnSon of ~he Hoalgh Do~m~n~ ~hag an ad~qua~e and ~a~5~faego~ So~g~ DSs~,al
can be installed on this Plot.
Date ~"~ ,t~
(10/65 Revis.)
S-15
Signed
THE NEW YORK BOARD OF FIRE UNDERWRITERS
,s,,,,,January 6, 1975 .~,,t~,.~,io,,~,,.o,,fu,. 753067 N o ,>,-:'~
tis CERTIFIES THAT
George Kaytis, s/s Robinson Rd., 1500' e/o Paradise Point Rd.,
Southhold, L.I.
d,e£olt,,u'in~l~'atl ..... ~ R~s*rae~t ~ l~t~'l, ~X12ha *'1. outside
:9 ~ 61 30 [ 49 1 17.1 1 1.5
, ~ ,
~ i 1 30~
; 200 I SW ' I I x ,
~otor/s: 1-1bp
~anelboard/s: 1-40cir 200amps.
Furnaces, Oil: 2-~/8hp, 1-1/2bp.
W.B. Rul and
Ele ct rlcian
G~NERAL MANAGER
Matt it uck L I
must not be altered in any manner; return to the office of the Board if incorrect Inspectors mo¥ be identified by theJr
4/ SO /V
(,pRiVATE}
Al distances to wells and ce~ Is a
Y bcotio, from houseowne, and fed
obse~ations, since mos wells and c~-
pools a~ not visible these dimensi~s
cannot be certifi~.
Unauthorized alteration or addition to this survey is a violation of
section 7209 of the New York State Education Law.
Copies of this survey map not bearing the land surveyor"s inked
seal or embossed sacl shcl~ not be considered to be a valid copy.
~ca ed hereon shall run only to the
s ~n For whom the sui,,~.y is prepared, and on his behalf to the
':~k. company, governmental agency and lending institution listed
erecn, and to the assignees of the lending institution. Guarantees
or certifications are not transferable to addltional /nstilutions er
SURVEY FOR
GEORGE JANE KAYTIS
AT PARADISE POINT
TOWN OF SOUTHOLD
SUFFOI. K COUNTY~ N.Y.
SCALE: I"= 60'
JAN. 29, 1973 APR.~O, 1974
MAR. I?,
LAND SURVEYOR
N. Y.,~. LtL. 190. ~e7'~5
NIVERHEAD~ N. Y.
////
/
by location from house owners and field
SURVEY FOR
GEORGE ~ dANE KAYTI$
liT P/IR/~DISE POINT
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
SCALE I''=60'
OliN. 29, 1973 ,,3PR.$0,1974 JAN 21, 1975
MAR. IT, 1975 JliN 6,1975
L AND ~uNVEYOR
N. Y~S. L/C: &tO. 3872~;
RIV~RH~AD~ N, Y.
Co~lV.z",z
L
APPROVED AS NOTED
DATE: ~/~'~
FEI:: /~7
NOTIFY BUILDING DEPAP*TMENT AT
?GS-~&6O 9AM TO 4PM
ED INSPECTIONS:
1. BEFOKE BACKFILLING FOUNDA-
TION OR ~TAKT FRAMING
]. BEFOKE COVEB. ING PIPELINE
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OUTLINE SPECIFICATIONS
9.
10.
11.
12.
Excavation and Site Work: Excavate for foundations and footings. Provide
clean sand fill as required. Footings shall rest on undisturbed soil with
a minimum bearing capacity of 2,000 lb/per sq. ft. Rough grade to wi{tin
six inches of finish grade. Finish grading, topsoil, lawns, landscaping,
walks and driveways are not in the contract. Protect existing trees as
directed.
2. Sanitary System: Install a 900 Gallon precast concrete septic tank followed
by one cesspool with 3 - 4'-6" x 8'-0" diameter precast concrete rings to
provide a total of 339 sq. ft. of sidewall area, provide dome section,
precast concrete lid w/concrete lawn marker.
3. Concrete and Masonry: All concrete shall be min. 2,500 psi strength. Fermi
all footings. Fill top block ,of foundation wall solid with mortar.
Reinforce block work every third course with Duro-wall. Brick shall be
used brick.
4. Prefabricated Fireplace: AS manufactured by Majestic Co., Huntington,
Indiana. Model 42A, with pref,abricated chimney sections and me{al top
housing. Installation shall conform to the manufacturer's instructions.
5. Rough Carpentry: Ail framing members shall be min. 1,500 ~ Douglas fir
"Cqnstruction Grade", no hemlock permitted. Plywood sheathing shall be
DFPA "Plyscore Grade".
6. Finish Carpentry: Windows -~KA~O/IIq%UL~ ~Pt~,% Ali. operating sasb
with screens. ~0 sliding glass doors with tempered glass and
screens. ~J~T~ ~¢~L.~)
Doors: Interior shall be hollow core birc~ veneered select; exterior
front - allow $100.00 for door and bardware. All exterior doors shall
have interlocking weatherstripping and interlocking thresholds.
Interior Trim - S4S White Pine., clear, kiln dried, ~
actual dim. 3/4 x 5" shiplap, ~ Grade.~--~
Exterior Trim & siding - rough sawn cedar~
Interior Wall Finish - 1/211sheetrock walls and ceilings throughout house,
spackled and painted. Use ~alvanized metal bmads at all corners' and edges.
Install 3/8" chipped board underlayment over all su~-floors O~ ~
7. Insulation: Use fiberglass ~att insulation, foil faced, R-13 in sidewalls,i
Appliances: Allow the sum of $1,000.00 for the purchase, installation by
Contractbr.
Interior
Shellac,
Doors, trim for doors window and base - ~inwax stain and 2 coats
Ail colors to be selected by the Owner.
13. Roofing: Architect ~ roof shingles by ~ir~.
14. Skylights:
15.
16.
Operatable skylight: Ventarama
Fixed: single dome clear plastic w/"L" frame by Naturalzte or
equal/ size 14" x 46" inside curb dimension.
Plumbing: All V'//-~T'~'~, ]~I*Fp.~:~ ~r-~. , below grade C.I. ~valve all fixtures~
Fixtures: Tub - ~erican Standard Designer Line, Fiberglass Tub and
surround, color, w/heritage w/acyrilic bath/shower trim.
Lavatory - American Std. A~ualyn, color, aquarian trim
~.C. - American Std. elongate~ cadet, color.
Kitchen Sink - ~erican Std., sm~set single bowl, St. S%., w/ aquarian
faucet with spra}y.
Pantry Sink - ~erican Std., su,nse%, ST. ST., w/aquarian trim.
Outdoor Shower: there will be .an out~r~hower betv~een the house and
beach. Provid,e cold%tObY'er line with shower bead.
Distance from house aprox. 35'.
17.
Domestic Water Supply: Allow the sum of $1,000.00 for the installstion
of the well. Well system is to include well, submersible pu~ap, screen,
piping, water storage.tank, wiring to p~lp from control box in house.
System is to be complete from point to house smde of storage tank.
Provide water analysis, water and ~b system to be approved by Health
Dept. of Suffolk County.
18. Iieatin_g: Provide a complete folrced warm heating system designed and
guaranteed to maintain inside temperature at 70°F. when the outside
temperature is -10°F. and the wind at 15 mph.
The system stall be designed ancl layed out to provide for the addition
of future air conditioning. Si,~e and insulate all ducts for future air
conditioning.
~stallation shall conform to the codes of the National Warm Air Hea¢[ng
[d Air Conditioning Assoc., ThC National Board of Fire Underwri%ers¢
~d~ local authorities havin~ jurisdiction.
'___ .... '::>- i
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19.
Heat Source: Electric Resistance Heater.
Power & Control Wiring: by electrician.
Ductwork: Galvanized sheetmetal ductwork with lined insulating
Grilles, Registers and Diffusers: Lima w/baked finish.
Filters: washable (provide space for future electronic filter~
Humidifisr: Provide space for future humidifier.
Start UA & Balancinq
A. System shall be cleaned, and placed in operation
B. Completely balance and adjust entire system.
C. Instruct Owner in proper operation and maintenance.
manuals, guarantees and parts lists.
D. System shall be guaranteed
Electrical
acoustic
Provide all
for one year after acceptance of system.
General: Ail electrical work, materials and methods of installation are
to be in strict conformance with local applicable codes and the N.B.F.U.
Code. Fire Underwriters Certificate shall be delivered to the Owner prior
to final acceptance.
Electric Service: Electric service is to be 200 AMP and installed overhead
in accordance with the regulations of the Long Island Lighting Co.
Distribution: Provide and install a circuit breaker in the Lower Floor.
The board is to be large enough to accomzaodate all circuits plus at least
(4) spares. The Electrical Contractor is to ~erify locations and loads of
any special equipment which the Owner may have.
Materials: All wiring is to be Romex, non-metalic concealed in construction.
Switch and receptacle plates are to be satin finish stainless steel.
Convenience receptacles are duDlex and switch silent-type tumbler.
Fixtures: Make an allowance o~: Four Hundred Dollors ($400.00) for
electrical fixtures which are to be selected by the Owner, furnished and
installed by this Contractor.
Door Buzzer: Provide front and rear door with push botton door chime
L-30 Nutone.
Telephones: Notify Owner wheh house is ready for prewiring by the Telephone
Co. to determine tslephone locations.
H~ating System
Electric warm air heating system provided by Heating
Provide power wiring and thermostat hookups.
Contractor.
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