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Home My WebLink About7057-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Ot~ice Southold, N. Y. Certificnte Of Occupnncy No. Z6037. ...... Date .............. Au&ult...~..., 19.~. THIS CERTIFIES that the building located at . .N/8..G~'ange. l~Q&d ........ Street Map No~ollth. ]~arbo~loHc°km~o ........... Lot No..~ ..... Southol~t..N o¥., ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... ,Ti~ ... ~l~B., 197~.. pursuant to which Building Permit No. ~O.~.~.Z · · dated ............. ,Tall .... 29 19..~l~, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ...P.~. $.v.a.t.#..o~.e.. f..m~. ~.y..~l~Ll.~g ..................................... The certificate is issued to Tlle.e~ol,~..&. Therein& .gtlSl~k:[ ........ Q~el', ........ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ,Tune .26...19~...b3r. ~,. Yllla ..... UNDERWRITERS CERTIFICATE No. II..~1~ ..... ,T~®. 5...1 ~)~ ............... HOUSE NUMBER .....1~.. ....... Street .... 01'lt~ge. I~4 ......................... Building Inspector mN~ l~lMrr (THIS PERMIT MUST BE KEPT 'ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 705'7 Z Permission is hereby granted te: IIA ~.emM,~,e.. AAnme ~...,1;~,,~ .................................... .......... ~.,g.,,~m...a~ ........................................... .......... ~.a~la~ ....... ~.~.¥.~ ............................... to ...ltmt.ld...nm,.. ar~ .. f, aail~...a ,.,e.L1.;l~a~ .................................................................................. at premises Iocatedat Ae~...~ ...... am~Ta..ZJa, z'Jao~..~..&~t ................................................... ....................................... Ox'Amge...~d...; ........... ac~,At, tmXA .... Ja,, :/.,, .............................................. pursuant to application dated ...................... ,~,,a~,......!..~. ................. 19....~...., and apprevm:l by the Building Inspector. THE NEW YORK BOARD OF FIRE UNDERWRITERS tab BUREAU OF ELECTRICI"L'~: ~ I- BB ~o.. BT.ET .EW ~O.. "EW~'~"OO~B~o, ?. N 163646 THIS CE~IFIES THAT . · heo~o~e Xudlinskl, n/8 urange ~-;,~" w/o ~ew ~u,, oou~flo~, , . . RXTUEE [ECEI~A I WIT I FIXTURES OUTtLq'S II CLE51 S CriES 32 DRYE~ FURNACE MOTO~ ~U~ ~a~E ~T.' K.W. OIL H.P, G SERVICE Dh~.ONNECT i 200 CB OTHER AFPAItATUS: RANOES ,MT. K.W. R 2~i l.~2W 1~3~ 3~'3W 3~'4W S TIME(LOCKS BELL UNIT HEATERS MULTI-OUTLET SYSTEMS V I C E i~pecial Receptacles: 1-50amp 1-30amp eUnit Heate=s= 1-~.SKW Electric Room Heaters: 2-2.0KW 2-1.SKW 1-1.25KW ~-.?SKW Lot EXHAUST FANS DIMMERS Towle & Sons Inc. 33 Lincoln Ave. Mastic BeaCh, L.I. 11951 COPY FOR BUILDING THIS COPY OF BE ALTERED IN ANY MANNER. FOltM NO. 6 TOWN OF SOUTHOLD Building Depmtment 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: ]. 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, o 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 ]957), 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 Date ...J'..u..~..y....2.3. ,~....]..9..7...~ .................... New Building ......Z. ......... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ..E~.S...C.~.,3.oge,.~d.,..~...~5.~.~....W/.~..~i~37..~,gw..~.(l,,,..~g~.~g~.~ ...................................... Owner Or Owners Of Property ......... ../~.~.e.9..d..~..~..e.~.~..~..d.~../~...e.~.e..~..a.~..[~...c]..[..:f:..~.§.~..1. .................................................. Subdivision ..~P~.l;.h...~.a..~'.b..9..~....E.~...e..s. ......................... Lot No ............. Block. No ............. House No ............. Permit No..7.057.7, ......... Date Of Permit .,[e.u..Z3~..~.9,~licant ..P,/.~:~..el.e..~;~.e,~.~...~;t¢. ....................... Health Dept. Approval ............ ..4.~..0..-..5. ..................... Labor Dept. Approval ................................................ Underwriters Approval ....... [63.6.~.6 ............................ Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ................ .~ ....................... Fee Submitted $ ....5.:..0..0. ......................... Construction on above described building and permit F0epts all 91~plic,~ble~c,~les and regulations. Applicant ,~. ............................................... Sworn to before me~hi~ ~ ry Public .(~ ......................... County (stamp or seal) ,,-- _' s.m~_ ._N~_ _.yOp, X ....... i N',~. ~uvL iNS. _K~_ ~._..2~j.E_ _O_D.Q~ _~..TltF~ ,q ~ ........ COUNTY ..................... IN~T~UCT~O~--De~cribe all materials and equipment to be included in the propo.~ea w,~,'k, wt~ere space , ~c~ent. enter "Sec Misc." and describe umler llem 31, or altech addit onal ~heets. ~1~ work not .~ de~enh~d be ~hown on the related drawbtgs. OENERAL.---Each item O[ material and equipment shall equal or .w.,,.d that described ar ' ~ s~]i bt performed in a ~,orkmanhke manner an in accord~lce with rite best practice. I. EXCAVA!IO~pe Sand and Gravel .......... Minimom d~h excavauon bdow fin B~aring so,L - ............................. 2. I~OUXD.'~TIO~S: 3000 psi_ ..... Size_.l--6.'-'.-~--8-"-- Fo:;r.3a.ion wall M:~terial~OnerO'J;e'----Size-~'I'~'~/l-t'~'- Rclnforcirg: Type ................ Size .................. I',ll~ __~50_0__ps.i_Remfon wi! '>i'e ....... Size ........... Girders: M~terml ~nd sizes .--~9~-~-~--~-~ ............. Windo~ areaways ........................................ · Basement cnlrance area~ay ..... ~g~io~ .............. Footing drnins ........................................... .......... ~e~_~phalr.m ........ Purging ................................................. ...... z ......... Special foandauons ....................................... ~ ( 3. CllIMNE¥S: Prefabricated [make and qize~ ..................... 7 .................. TH~c: U~ qchd furl; ~ f~z~ burning; ~ mrculamr (make and ~tze} .................................. w,,..,I ~amc' ~ ~,Oe and species Remfir_J~Z ........... ~ Corner brucmg. Budding na¢-r or felt ................. ................. Lin,els ........................... ~ Dc:~ sl~s .................. Window sills ................................ ~ lcd r~"r - ~cs' Dampprocfing .......... coats oI ........................ ]' ~ 3 where re[qired olb~¢s ~.2~ cor.'/~l{on: ~ Same as main wall; ~ other ........................... m,x %'3-~ ---; th~cLness .... ~- .... ; reinforcing ............. ,, 7 ~IBi-LC3212C: tDc~crd~e underfloor~tg lot opecial qoor~ under acm 15) , eld" ~._; ~"pc _.F~ ........ l.~tl: ~ ~,r~t f,c,~; ~ ~cco=~ floor; ~ attic ............ rq ft.; ~ dia5ona; ~ filht angles Sleds' V,'..~;~. fr-:de and species Hemfir #2 ............... 424-2 ~crs: Wood, grade and species .... ~mf~_~2 ..... }__ si~e2~x~_ s~ aci~ _!~ ._" o. c c~:~a: ~::m _~___.~ 5h'.~;h~ca:: (;,/~de and ~pcc,cs __ Pl~ood -g~P-~ ....... ; size -_~[~__; Material floor closets ~all to Wall carpeC~ g - p~ r Rivers~8e Homes samples ......... ~c 5 ........... ~ ................... ~_~b area onl~ l ~: ' >p, --clamshell; r, c a white 'pi~e; I,*c' 'l'vve clamohell Do, rs ....... ~arnisk . 'r,.i,~ Paint ~'~ c Double hung . n"e Caradco ma~ '' Wood 1-3/8~ f. :,~c ~SB ......... ~l sash u'eigl-tr; ~ ',:,l'wces type Sprznt loaded · ' ',I c,,- 2 alumln~ Clamshell - · c white pine P~n Latex ' ' Friction ............... mah ~a;ll ....... alu~num ~,:. Al~inum ...... Wcathc~hqqmu: 'lypc V~y~ ~_ ..i ~32 white F~_~e ......... ; Paint ..... C~INE'rs ?,',D EQtrlP,',I~NT: ....... 1~! . shelf width ~ good ........ ; counter t~p ..... ~ ................ ' : ........... ait:h~,, ~q,,,,~,~,,' xh.~e :,,,,~ ~oad ...................................... ]]-]~ .... -~ floor (Double) Amc ..... } ........ __-:-:z==---:.~ ...... ~ ..... ;.I ......... ~=-',-~= ...... ==-- -- - ~5 .... ~-~_~. 1 _Xitch~ .... ~rigg~ .......................................... 20~518'J Col=s-. ra,a:~r~ ....... L_! .....gathroo~ .__}rlggo- ............. : ............................. _ ............. wz~:,- .~o,:, .... .__ 2 .... _ Bg~!9o_~ ...._gr itgR .......................................... ~aln t.~ .........2 ....-t~athroo~----Briggs'; ........... Sho..~cr over tu~). __~ .... _gathroom ..-~rice---P£is~-ez'- Sta3 sho~er ............................................... .._ 5_'. __. ............................. 4" i Chror~e_ Hou,: drnm ns~oc}. ~kCast ~ron: x~ other .... P_'~C ........................ -~ .... - Sdl Cock~: Number -- _2 wa,c, s~:r.p!y ~ .,~ ......... ~_~OR',k~LLS-~350.~ ....... U ('ommu,fi~y S~cm Walcr p~ ng ~ Lal~'m~/cd steel ~ copper I brig; C] other ............................................ v'a,cr ~e..,cc J'vr.¢ - Electric ..................... nla~e alltl model .... ~eem ............................. ~:o~apt [~m, -~:,t,.n,~ Pneumatic- galvanized .......................... capacily ......... ~.2 _. mouc~ ~ECTR%C HEAT ...... ' a,___~O ...... Voll~ Output .......... }Itu. 23. Legend Input---2-50 .... Watts %umver ........ Make and model ........................... ...................... ~ ~HA 424-2 (Rev. .... ............ . ......... f .............................. · ~,~,.~ XX~rh,'~,~ ..... 200 ~am_220:240._v~l~...'. rJ u,,~..,,,,,,,d .................... 6 ~.,. ,~.', 'i~-~'i~ .... ..... 3. po~celcin_ fixture~- &m ~a~ment , ,~ ~ .... 6'~ - . .Fib~gla~_Batts_~tap~ed ................................................... ........ 4" .... Fi'oerg!a~_D~ ~p_l~ .................................................. ~JJ FiSergla~8Batts Stapled .... _ ....... ........ Go~ b_or__comparable---- hrass-pl~g- Attached garage as per plan ~,, -t,x~%(:l; i)I5}'O:;AI.: 2 Board of Health app~v __In the e~ent_fil~ is ~P__~_ ~_Qggh~__tq_th~ ~qbsite or removed fr~ ' ' ' ~he jobsite, the owner will pay' ~ ~ --A~Ans~-7 -C6h-~r ~ill bury tree~' ...... in one sp9~ 05_~e}]~.~ .p~?~_% .............................................. ......... _~ ~h i~_ ~a~ ~5~ _ ~_~ ~. _~I ~ K - ~P~ ~fl- ~ SUFFOLK COUNTY DEPARTMENT OF HEALTH Health Department Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY Applicant Theodore Kudltnsk! Phone 765-1063 Address Main Roadt Southoldt Ne~ York Property Location North side 'Gran§e Roadt 355' West of Bayvie~ Roadt Southold, Village Southold Township Southold Public Water Company Name Lot size: Width lO0 feet Length 184 feet Sewage Disposal System: A. /OAallon septic tank: Precast ~h~'Equivalent Block B. Leaching pools: Nunber of pools Precas t/~J~) B1 ock Special If private4vell, fill in the following blanks: ~ Tank ~paci ty ~)a,llgns Dep~round water_ ~ ,~uno~n'~ of water' in 5. Subdiv.~p of South aider 6. Section 7. Lot Number S 8. Private Well 9. Public Water Distance to main (For Health Dept. Use) The undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Department of Health's current standards thereto. This application will be valid for one year from the date of approval indicated below and may be renewed if' ' a current local Building Department Permit is in effect. /~;~.~.:~:~ ~,. D-'- x z. ~ .. . v,c~ ,R~s,~,~ P.O. ~OX 274 i: ........ LZ::: ......................................... ' .... ~ 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 ,and Water Supply can be installed on this p)ot. APPROVAL DATE S-15 Rev. 4/1/73 J e. This ~91irati~m mus.t ,he ;ompletely filled in by W~iter or in ink and submi~ in tri~i~ to ~ ~iMi~ I~r, wi 3 ~ of ~ ~ '~t ~ m ~. Fee ~rdi~ to ~ule. b. ~ ~ ~ ~ti~ of lot ~d of ~ild~ ~ premix, reiati~ip to ~oini~ ~ ~ ~ic ~ or am~, ~ ~ ~ m~ ~ dr~ ~ di~am ~i~ is ~ of this ~i~. ~vi~ J ~ ~ Iw~t of c. ~ ~ ~ ~ ~ ~g~t~n ~y not ~ ~ ~ ~a~ of Buildi~ ~rmit. d, U~ ~ ~'~ a~ion, t~ Bui~ing. I~or will i~ a Bui~i~ Permit to ~ a~i~t, ~ ~it ~all ~ kept ~ ~mi~ ~ ~ im~i~ thro~ut t~ ~. e. ~ ~ ~1 ~ ~p~ or u~ in ~le or in ~ for any pur~ ~a~r until a ~ifi~ of ~ ~all h~ ~ ~ ~ ~ ~11~ In--or. APPLICATION IS HEREBY MADE to the Building DKmrtment for the issuance of a Building Permit purmmt to the Building Zorn Ordlnlf~e of the ToM~ of Southold, Surfak County, New York, end other iJppliclble I. ew~, Otdinanc~ or Rl~ul~ms, for d~l ~onltructldn of buildings, Idd~tiOflS M Mtlrltlom, o~ for removll or demolition, as herein described. The Ipldicint Bgmes to aomply with Iff i~Ngiad)le IIws, ordinmau, building co~, housing code, and regulitiom, ~cl to ~dmit ~uthorized imlxctors on premlm and in buildings for nemem~ imixctlons. (Signature of eppllclnt, o~ nlme, if. ~orpor~tion) ...................... ................... , .......... -Z. ..... (Address of .pldicent) //~P~ / State whether applicant is owner, levee, ,gent, architect, engineer, general contractor, electrician, plumber or builder. ..................................................... ~......~.. ....... ~ ................................... ~.=**~o.,~..,.~= ............... Name of owner of premises .... ~..(~.~.~..,.~....::!.' ..~..~.'~.; ........ /,.'""..~.'~.~..'~_~.:..~..~.~......~.?..~.~.'..~..~*.~.'~.~' ......... ..*~...'~.....:. ............... ..~..,..c..~.~...~...........~.....~....~.~: ....... ..r../.~.....~..,~....~ (l~hime and title of corporate officer) Builder's License No .......................................................... Plumber's License No ................ .Z.~...~..........~... ................... Electrician's L cense No . .~.~....~? -- Other Trade's License No ....................... Locet on of land on which o work will be done. M No ......... .~.....~.; .~.. ~ u,~ ~'~ 1. pr .r~ed ~o ........ ~ ......, ............. ot ._. ,....,~, .............. ~tmet.~ ~.=be~ .......... ~./...~ ...... ~~...~, ...... ~..':...;....~./..~.......~.~./.~....:.. Municipality 2. State existing use and occupancy Of premises end intended use and occupancy of proposed construction: a. Existing use end occupancy., .............................................. ~,~...~... ............................................................. ~. ,,te~d,se and o~,pa~ ............ ~.~,.....~.,...~/..~..~.....~...~....~...~...~.......~=...~_.. ....................... . 3. Nat~Te'c~'work (check which apoliceble): New Building .....~:: ............. Addition ..................... Alteration ............... Repair ......................... Removal ......................... Demolition ........................ Other Work .................................... (Description) 4. Estimated Cost ....... ~....~/....c.~.~..~.. ................... Fee.....~..~..~e'....O. .............................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units .......",Tr.....-..Number............. of dwelling units on each floor ...~ ............................ If garage, number of cars .................. ./.. ......................................................................................................... 6. If business, commercial or mixed occuoancy, 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 ........................... , ............ Dimensions of entire/new construction: Front ....... .~..~.....r. ..... Rear_zz_......~..,~'...c~..../. ........ Depth ......~....: ............ 8. Height ........... ~ ........................./t,~ ;r' Number of Stories~....~......,,,......./~. ............................. /.....a~..~. '~ ........................ 9. Size of lot: Front ....~.....,.,,..~...~.. ............. Rear ........ ......... Depth ....... .............................. 10. Date of Purchase ..~ .~...~...'7.....~.. ........... Name of Former Owner ..... .~-:....~...O....~....~..~...... 11. Zone or use district in which premises are situated ..................................................................................................... Does ro sad construction violate an zonin law ordinance or lati : 12. p po y g , ragu on ......... ~ ............................................ 13. Wiillotberegraded ......... .~...~... .............. Will excess fill be removed from premises: [ ] Yes [ ] No 14. Name of Owner of premises ....................................................................................................................................... (Address) (Phone No. Name of Architect /k~r c-[~t"~e ~ ~'ut ,~/~:) ~ ~ -t' ~c - ' ............................................................................................................. - . ..... Name of Contractor ..... ~././~..~./....~.~ ...... ~ ......... [~ic~,)..,..~,,,.. (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and illdica~,~ d!mensions from property lines. Give street and block number or description according to deed, and s~ street alines and ~ndicete wheth- er interior or corner lot. STATE OF NEW YtJ~:t K,~Z' OUNTY OF .........-~.. 7.-~.~r/~;' ....................... ) ............... ~...~..... -~~..' .......... ; ......... being duly sworn, deposes and says that he is the applicant above named · (Name ofind~n~ntract~ ~ . _ ~ · , . ' He is the ............................................. ~-~ .. , ,. -~ ~--~..../.~....~~ .............................................. i ........................................................... -- -- /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 apf)lication are true to the 'best of his knowjeJ~l~l~.dE~f~; and that the work will be performed in the manner set forth in the al~alj~tion filed there~h. , Notmy Public Stale of ~lew Yor~ ~ · ~. . ' t'Jen ~2~n0344963 Suffolk Countv~ ........................... · .~..~....day of ....... ~J~ ............. 1~o..~...~....o Expire,re, /~:h 30 ! 9~ ~. ~. ~ ~ Notary Publi ounty ............ J. H, LEHR LOT 5 ~,lOlff¥ BUILDING DEPARTMENT ~' /b5.2660 9A~ ~O 4P~ FOR REQUI~ iNsPECTiONS: BEFORE BAcKFiLLiNG FoUND~ FION OR sTART FRAMING eKE COVERING piPELINE ~EF .... co~FLETED '-INAL WHEN l~- ~ ~, R CON' q GRANGE RoAD Unauthorized aherafion or addition to this survey Is a section 7209 of the New York Slate Education Low. Copies of this survey map not bea~ing the land surveyor's Inke seal or embossed :eot :?,otl not be considered to be a vahd cop1 , o, ~.4 .... ~ns indicated hereon shell run only to th, ~,~r- , ,vhom the survey is preporod, and c:n his behcl[ lo th, SURVEY FOR THEODORE JR. E~ THERESA M. KUDUNSKI AT $OUTHOLD TO~N OF 50UTHOLD ~UFFOLK COUI~JTY, SCALE: I'% 30' DEC 5, 1973 REFERENCE. MAP OF SOUTH HARBOR HOMES FILED JULY 4~ 1964 FILE N0.4096 ~UARANTEED TO: 7,5 - S-06347' LEHR SUFFOLK COUNTY HEALTH DEPARTuf~ The sewage dispossl and water supply facilities for this location haYe been inspected by this department and found $0 be satisfactory. ' · ~ ~ Chief of General Engtneertn$ Services LoT 5 I GRANGE ROAD All distances to wells and cesspools are by location from house owners and field observations, since most well[ and cess- pools am not visible these dimensions cannot be certified. T IIEE Et TtfERE. 4 KUDLINSKI &T $OtlTHOLD Unauthorized alterallon or addition to this survey is a violation of section 7209 of the New Yark State Education Law. Copies of this survey map not bearing ~he land surveyor's inked seal or embossed seed shah not be considered to be a valid copy. Guarantees or certifications indicated hereon shqll run only to the person for whom the survey L, prepared, and cn his behalf to the tit! camnany, tavernmental agency and lending institution listed he,eon, and to th.: assignees of the lending institution. Guarantees or cettificcrtlons are not Iransferable 1o additional institutions er MAP OF SOUTH HAIt~OR HOMES FILED JULYI4, 1~4 FILE NO. ,I~EO AS N~_TED NO'JIFy BUILDING DEPARTMENT A~ 765-2660 9AM TO 4PM FOR REQUIR- ED INSP~CTIONS: 1. BEFORE BACKFILLING FOUNDA- TiON OR START FRAMING ~. BEFORE COVERING pipELINE 3. FINAL WHEN JOB COMFLETED NOT RESPONStBLE FOR DESIGN OR GGN- STRUCT~ON ERROR~ ',4, API~OVED AS NOTEI~ NOTIFY BUILDING DEPARTMENT AT ';i 7~$.~E&O 9A/~I TO ~PM FOR ~ouIR. L 1. BEFOre BACKFILUNG ~UNDA. ::'~ TION OR START F~ING 2. BEFORE COVERING PIPELINE '~ 3. FINAL WHEN JOB C~LETE~, ':~ T