HomeMy WebLinkAbout11996-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
THIS CERTIFIES that the building .. ~..44i!:,i-.o.q/. 0..1.t.e.r..a.t.~.qn. .......................
13110 New Suffolk Avenue Cutchogue
Location of Property ...............................................................
House No. Street Hamlet
County Tax Map No. 1000 Section .... 1..1.6 ..... Block . . .q6. .......... Lot 016 _ ---.
Subdivision... X ..... Filed Map No. X .Lot No. X
conforms substantially to the Application for Building Permit heretofore filed in this office dated
October 18 19 .8.2. pursuant to which Building Pem~it No. l 1996 Z
dated ...... .N. qy.e.m.b.e.r...3 .......... 19..82,. 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 .. i~la. ....
addition and alterations to existing dwelling.
The certificate isissued to NICHOLAS & RACHEL MINUCCI
(owner, ~'e~
of tko aforesaid building.
Suffolk County Department of Health Approval .... .N [.A. ..................................
611661
UNDERWRITERS CERTIFICATE NO ............ .N .....................................
Rev. 1/81
:TOWN OF SDuTHO~D
BUILDING DEPART/vlENT
TOWN HALL
SOUTHOLD, N, Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMI
COMPLETION OF THE WORK AUTHORIZED)
1199(; Z
iS UNTIL F~ULL
Permission is hereby granted to:
...~ ........................................................................ . .............. ,....~ ............... .~....~......~ ..........................
pursh*nt ~o ~ppl[cat[on doted ....... ~.~...?..., 1~, ~nd ~pprov~ b~ tho
Buil~llng I~spector.
Rev. 6130/80
'""' ! Building Inspectov
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. '['his application must be filled in typewriter OR ink, and submitted i~u~ to the Building Inspec-
tor with the fei/owing; for' new buildings or new use:
1. Final survey of propm~y with accurate location of all buildings, property lines, streets, and unusual
natural or topographic featu res.
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, h~dustrial buildings, Multiple Residences and similar buildings and' installa-
tions, 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'd_.
land uses:
1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or
topographic featu res,
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 informa-
tlon required to prepare a celt/tie, ate.
C. Fees:
1. Certificate of occupancy $5.00
2. Certificate of o~:cupanc,y, on pre-existing dwelling/ land use
3. Copy of certificate of occupancy $1.00
--Fre-.Existing C,O. $15.00
Vacant land C.O. $ 5.00
..... :1 .7 ......
New Building . o ./~?.d~.i-~. ....Old~or Pre-existing Building .~t' .~.5... ................... . Vacant Land
I'lou~ No. .$treot~ ~l~ Hem/et
County Tax Map No. 1000 Section //~ Block ~ Lot... ~(~
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No. /.'~...~.. Date of Permit .#.~. ~?/.l~. '~...A pp lice n t ./.~t./.d.~ ,.~/4 . ~: . .(~'.~../~ .d~. ~ .......
......
Health Dept. Approval ...... ~: ;' ............ Labor Dept. Approval ....
Unde~riters royal .............. Planning Boar royal ............. ' .........
Request for Temporary Certificate ...... Final Certificate ~. ~:" ~
Fee Submitted $ ..............................
Applicant .... /~.~. ~/. ~F~.. ~/~/'~/. [~ ....................
~ooo~oz THE NEW YORK BOARD OF FIRE UNDERWRITERS
)-~'~ BUREAU OF ELECTRICITY
~-- SS JOHN STREET, NEW YORK, [~EW YORK 10038
Da~e ~ ~, ~ ~pplicatlonNo. onfile~7~-8~ N 611661
THIS CERTIFIES THAT
Ni~las & ~chel ~,n~ci~ N~ S~l,k Ave, 2~5 ~le~ $/O ~. 25, ~tti~,
~,, .~...~.~d ,,., Ju]:y 25 , 1983 and found to be in compliance with the requirements 4 this Board.
FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
49 57 36 49
DRYERS I~OTORS
APPLIANCE FEEDERS TIMECLOCKS UNIT HEATERS MULTI.OUTLET DIM~JERS
SYSTEMS
NO. OF FEET
SERVICE DIECONNECT~ S E R V I
OTHER APPARATUS:
2-G.F. L
1-G.F,C.£.
2-3 ~ort A.C. tk~r.;a
l'rackli~hti~5:bi;0 ;faa, 22 li~es~
NO. OF CC COND A W.G. NO OF HI.LEO A, W, O NO. OF NEUTRALS A, W, G
pER ,~' OF CC. COND, OF HI-LEO OF NEUTRAL
~ 2/0 1 2/0
L. A. Elect. Ialc.
23 Valley Dr.
East Moriches, N.Y., 1].940
LIC. #2240
This certificate must not be altered in any manner; return to the office of th, e Board if incq~rect. Inspect~?s may be
COPY FOR BUILD(NG DEPARTMENT. THIS C T BE ALTE
their credentials.
' MANNER.
FIELD I~ S~PE~TION
1.
FOUNDATION (1st)
COMMENI'S ~' ~ 1~
FOUNDATION (2nd)
2.
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
C~DE
FINAL
ADDITIONAL COMMENTS:
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
REMARKS:
DATE
~ UN~)ER THE ~EI4VIRON~TAL CONSERVATION LAW ',~' · ~ ,~
qte~ tton of Ya~er) ~ ~ ARTICLE 25 (Tidal Wetlands) ' ~ :~ ~'~
~(FrePhWai~r'wetlands) L~J ARTICLE 36, (Construction In FIo~ H~za~ A~as) ~ ~ ~,-' ~
~Chin 75' of ~an hi W~e~
eo~t~uc~on.
~,~, Sou=hold
. , I DAM NO. J PE~I~ EXgi~TION DATE
r': GENERAL CONDITIONS ~
of ,the aflpro~iate Re~iona[ 8. That the State of New York shall In no ca~ be labia roi any dama~
commence work at least ~ or, injury to the structure or work herel~ a~th~izeg,whic~y ~ ~aused byol
a~ shall also notify him resu t from future operations undertaken by the $tat~ f0~l~ COnservation or
' mprove~nt of navigation, or for 0 ~r pur~ses; ~ n~c a · or right to
com~nsation shall accrue from any such da~age~
by a~ authorized
Cogse~vation who may 9. That if the display of lights and signals on any WO(~hereby authorize~
~ires. ' is not otherwise provided for by law, such lights a~ slg~l~ as may be pre
scribed by the United States Coast Guard shall be ingtall~ and maintained
hi;s,[ applicant has ac- by and at the expense of the owner.
~llcatio~, the full legal mspon-
nature, a~ by who~ 10. All work carried out under this permit shall ~ ~rformed in accor-
~d he~e[~ a~d h~s agrged to ' dance w~th e~tabl~shed engineering p~ctice ~ ~ a woik~a~like manner.
from suits, actions damages and
from th~ said project. 11. If granted under Articles 24 or 25, the Depart~t ~eserves the right
, ~, ~ to reconsider this approval at any time a~ after due notice and hearing to
, .~; of the work herein ~rmitted continue, rescind or m~ify this permit in such a mantlet as may ~ found to
large refuse piles, ridges across the be just and equ tab e. f upon the expirat on Or revoc~tio~ of this permit, the
deep hoes that may have a tendency to m~ification of the wetland hereby authorized has not been completed, the
· c~use injury tq navigable chb,~ls or to the banks of the waterway, applicant shall, without expense to the State, and to s~h extent and in such
~ ~ " '~ . ~ time and manner as the Department of Environmental Conservation may require~
}~ ' 5. Any, mat~r![~ to '~ ~e~l~ed~ or dump~ under thru ~rm,, edher m
~ t~e wate~ ~S~p ~dVe bi~water mark, shall be de,sited or dum~d remove all or any ~rtion of the uncompleted structure or fill and restore the
~ 10~a[it{~ o~*~h~rawins hereto attached, and, if so ~escribed site to its former condition. No claim shall be made against the State of New
~;;~t~-Wl~hi~'e~'~ht~&'a a~*and substantial bulkhead or bulkheads, such York on account of any such removal or alteYation.
~ as:w p~ e~ck~ o~ t~ ~a't~r a[ into he waterway. 12. This permit sba not be construed as conveying to the applicant any
~ . ~ , right lo trespass upon the lands or interfere with t~e riparian rights of others
shalJ ~ no ~r~aso~able interference with navigation by the to perform the permiUed work Or as authorizing the impairment of any rights,
title or interest in real or personal property held or vested in a person not a
~ S~ate of New York require an alteration party to the permit,
~ln authorized, or i~ in the opinion 13. The permittee is responsible for obtaining any Other permits, a~
it shah cause unreasonable provals, lands, ease~nts and rights,f-way wMch may be required for this
~aters or f o~ f ows .or endanger project.
~r~[e of t~ State, m loss or ~struc~[on
ordered by the Depart- 14. If granted under Article 36, this ~rmit is 8ranted solely on t~ basis
, obstructions, or hazards caused of the requirements of Article 36 of the Environmental CoBservation Law and
'a~lf, u~n the expiration or revocation P~rt 500 of 6 NYCRR (Construction in Flood Plain Areas having S~cial
excava[ion, or other m~ification of the Hazards - auilding Permits) and in no way signifies that the project will
~ot ~ ~ompleted~ the owners shall, free from flooding.
xtent a~ in ~uch time and manner 15, By acceptance of this permit the permittee agrees that the ~rmit
structure or fill and restore to its former is contingent upon strict compliance with t~e special conditions on the
the watercourse. No claim shall reverse side.
an account of any suc~ re~val or
(SEE REVERSE SIDE)
STt~I{ZEY J. W%Ii',~EY~ ~eing duly sworn, deposes and
states tnas, as the request of' Niollotas fflinucci ai!d others~
of New Sui'i'oik Avenue and Peconic Bay, Cutcnogue, New ~ork~
~e }~as examined ttae improvements on property vested in tt~e
canes o~' NIuHOLiS ]vJtNbOOI and his wiI'e, .~AOH~;L RtJTUCOi and
designated OR Suz'fOlk OOUnSF Tax Agency maes as .Eistricz
iLOOO~ SecZio-a !Ib~ Block 00%: Lot 01b~ cdnsisZing of a one
~omy and baseme:at single-l'amily residence and detached
garaqe~ ~einS t.~e came described in a dee~ recorded in said
Suf~t'o_Lk OouN~y in .hioeP 911P~ page 20~ on ~ecemoer a~ 1981.
~_e ori(~i~aal structure was built beE'ore tgbO~
~.,zt ~ ad J. it~ ocs in 19~P and 1972 tota_,_zng approz-~imate]d?
"~.2.1~ ,~'O0.)o(X~ '~ r,~.a,~ml~ ..... was constructed in 1_968 cosllinI ~1,400
tl!H&'Z Z,~e d. welii~tg is rou~i~ly H-seeped, aaa approx-
imazely 2~480 square fees of' living area over a ~asement
area oI' 2,2~0 square Jfeet and a 200 sq,,rare foot patio o_~. the
bay side~ and. is in excelL_Lsnt condition. It is wood-framed
and sheathed~ with psi?shed wood siding~ ~he pitched roof
'being co~rered with tabbed asphalt shingles. The windows are
of the best qualit.y l,~aimtod double glazed and the fenestrat-
ion is good.
!I!RAT tile interior double floors are of oak excerpt
ceramic fils in bath~ dry wall construction,~ very good qual-
ity ?dinted trim and doors and excellent cabinetry~ with
amlote closets and s-homage spaces. I~,'ul! thick insulation was
insto, llad in the walls and ceilings,
'EH'AT the -o!umbins fixtures are o~' the best quality
a~d built i'~ a~,~J, iances were installed th~onghout
arocl wa%~r $~rF,!)ty limes were ~!sed
ho$-w~,ber Paseboard heati~g system cf
~,.{A ~ the
.... ~ _ , ,~zt~ ~)oiler ca~acity greater -t,naa req. uired
,~o,. best ~na itv ~-' ' .
is aden'aate ~qor co~ti~).ued s~b-zero weather and tl~e domestic
hot wate-~ ,ou~L,ly ms ample for any expecoed usage.
t~_s opinion~ the replacement value as of
tOHAgJ in ~-
tee 23rd day of October, 1982, of tke dwelling alone, si'tar
-2-
educting 20?6 2'or depreaiation~ is
ON.?J [!i]i~TDRED .~'I~'T~ ONl~ THOUSA~TD ~'OULd HUNDRED
.~LLSl~400.OO~ DOit[bARS. '.~e garage value is ~'05R THOU~S~kND
5~;~N HU~RE~ (44,700.00) JJO~6AJ~S. !~he combined total flor
residem, ce and garage is O~i~ HC~D±IEJ) PI.~"±'Y SIX THOUSAND OFE
[-~UNDi~EJJ ~ :~15 6,100. O0 ) DL)I~.bARS o
'~HAT in his ovi~.ion the fair market value as
compaq, ed to the recent sales o±' similar dwellings~ of the
structures alone~ without th~. land, is:
TH!.~? tbs deponent has no interest~ present or
contem~lated~ i:.a the ~roperty appraised and that neither the
~emplo?~e~t to make sa~ a~praisal, nor the compensation, is
co~tingem, t upon zhe value o~~ the property. He furZher s~ates
t_~a-~ he has personally i~s~ected said property and that acc-
ordi~og to the best of hi~ knowledge and ~eliet'~ all state-
merits co~.tained .;le~ei:o. are true aP.d co:crect~
!~ifAT the -oroperty was appraised as a wh5le~
in 2'es simple and u~aemc~_mOereO~ su~jeet to ti~e contingent
an~ limiting condiZions our, lined herein. The dimensions
zhe property were taken from availa01e public records and are
believed to be accurate~ but the 'precise dimensions and bou~
~dary locations are s~bject to the facts as revealed by a
lo~al survey. The dimensions o±' t~e structures on the proper-
~y used to calculate replacement value by deponent were take~
at t~e nearest w!lole n~oer~ ±'factions omitted~
Sworn to oeZore me this
day 02' .__~~ 19~2.
JOYCE M. 5K',¥ARA
IgOTARY PUBLIC, State of N*'.¥ 'fork
F-lo. 52-4663491
Qualified m SuffoJk County
~.~,ommJa*ion Expires March 30, J98~
~tan.~?/, Waimey /
IApplication Received
Disapproval Issued
Permit #
19
FORM NO. l0
APPLICATION FOR DEVELOPMENT PERMIT
In the Town of Southold
1. Type of Development Proposed:
Addition and/or Alteration~
Other (specify) ' -
2. Elevation Data in relation to above mean sea leyel Of:
(a) Lowest floor elevation, including basement -feet
(b) In a V Zone, bottom of lowest
FIRM--Flood Insurance Rate Map,
Owner of Premises ~t~OLFg
New St'ructure' (including Storage tanks~
Flood Proof Below Base Flood Elevation~
inches
structuval member fe--~ inche~
Zone designations ~ . .
Location of Property:
County Tax Map No., District, 1000, Section
.... 9q, TCqo o, _
Block Lot(s),/
Subdivision Filed Map # . Lot(s).
% nt abovemNew owner
6. Permission to be ed:
IZlUnder Contraot]., ,[ Lessee { I Contractor . ~/~e'- 7e'z/O .~
7.Approval Fmom o~hem(s) before Peri2 is issued:
e
DEC o~ ia ~ m~ WET LANDS
HEALTH SERVICE ZBA
(Town Board)
BUILDING PERMIT PLANNING BOARD
I, ~lAO~ ~-_0~-~ ~, the applicant, am the 0wner[-~, Co-
0wner~, New 0wner[~}, Under Contract~, Lessee[--~_, Agentj~f~[, Con-
tractor~, and agree-to comply with all applicabl~sections of the Code
of the To~ of Southold; Cowry, and State ~d to a~it authorized in-
specters to premises authorized to pe~fo~ o~ have performed the said
work ~d to make and file this application, that all statements contain-
ed in this application are t~ue to the best of my knowledge and belief
and that the work will be pe~fo~ed in the mannerset forth in the
application filed therewith. ~.
SWORN TO THIS. DAY OF ..... 19 .... -
- -~Sta~y Pubi'i6
Applicant's mailing
address and phone #
if not given above:
I80
P.O. BOX 728
SOUTHOLD, NY
11971
FORM NO. b0
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
(516) 765-1802
TOWN HALL
MAIN ROAD
SOUTHOLD, NY
APPLICATION FOR DEVELOPMENT PERMIT
Instructions: The application to the Building Inspector includes (each
~L'n dUplicate) 1. Form No. l0 filled out in ink or typewritten, 2. Sur-
vey~ icl premises with! elevations above mean sea level, 3. Drawings of
posed work. The application must give complete infor~aation to show that
the Proposed can comply to the Local Law No. 1-1980, Chapter 46 of the
Code of the Town of $outhold known as "Flood Damage Prevention Law" of the
Town of Southold. The applicant must submit approvals that any other
agency requires.
Genemral Standards as! required in Section 46-17 of the law to minimize flood
amage:
~. Anchoring ofl structures, including tanks and mobile homes
B. Use of construction material and methods
C. Design and locatmon of utilities
D. Subdivision proposal with drainage, public utilities design and
base flood elevations
~S~pecific Standards as required in Section 46-18:
A. Residential construction
B. Non-~esidential construction
C. Mobile homes !
The applicant must submit plans and specifications as well as any other
information requested by the Building Inspector to substantiate the facts
thatl the structure has or will have the lowest floor, including basement/
cellar, elevated above the base flood elevation or; if permitted by the
Federal Regulation, that: 1. such structure is flood proofed in such
manner that below the base flood level the structure is water tight with
walls substantially and impermeable to the passage of water, 2. that
structural components a~e capable to resisting hydrostatic and hydrodynamic
lOadms and effects ofl buoyancy, 3. applicant must sub~it certification by
a registered professional engineer or architect that the standards set
forth in Section 46-i8B (1) .(2) (3) of the Southold Code are satisfied.
~_oasltal High Hazzardi area (V Zone) 46-19. Applicant shall submit plans,
specifications including"the required certifications and such other in-
formation as the Building Inspector may require in that ~he provisions of
46-19 a~e complied with. Mo~ile homes are prohibited. The lowest portion
of the structural members of the lowest floor cannot be lower than the
base flood elevationiwith all space below open except breakaway walls.
Sand dunes. If sandl dunes exist on the.premises and the applicant pro-
poses to alter same, i~plans and specification must be shown in detailed
nature of any alteration submitted.
~Building Per,.it. A Building Permit is also required for any structure.
Both a DevelOpment and a Building Permit must be issued before any work
can start in a speci$1 flood hazzard zone. A written disapproval or a
permit must be issue~ within ten (10) working days.
During construc~ion, lthe inspector shall be notified in time so he may
make~ the required inspections.
UponI completion, the required certification fo the final elevations and
work m~ust be submitted before the approval to use or occupy can be
approved.
4/8o,
(Fill but the form on the back of this sheet)
FOFtM NO, 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL,: 765-1802
Disapproved a/c ................ :: ....... .;/,vf ........ -- /
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date .Oc~.'tOl~.l~.~-.. ~ ...... 19~,7-.
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted.i,.~.d?.'&.oJ~-to the Building
Inspector, with 3 sets or, 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 giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
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 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 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 comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in buildings for necessary inspections·
(Signature of applicant, or name, if a corporation)
/ ...~o~..SE!lt..Co~x,t~.t~zAe3t. ~O..Y,
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.................................... P,..e,.~. L'r.~.~ ..................................................
Name of owner of premises ..... to.~ .c. ltO~,lh%... ~...~,~.C.l~[k,...~.~ ~0.O.c;..c-I ..................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
,
Plmnber's License No. /~
Electrician's License No~'
Other Trade's License No ......................
1. Location of land on which proposed work will be done... ,~.O~?8..,qltl>~;....IOr~0. ,~.~.P. Ir0.1-1L..IkVIk. O.~- ..........
.... ./~. ( (..~. .................. 0o, o. ~t~..~ .~.~ ........... c,u. ~' e,~ ~ .....................
House Number Street Hamlet
County Tax Map No. 1000 Section ...... II/~. ........ Brock ...... .~. .......... Lot...[~. ............
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 ........ ~R, .~.~.L'~.~.~g~ .................................................
b. Intended use and occupancy ..... .'5~.¢ot41}..~....ircJ~... fYt;~l?rlo~)...To....r~-~...l'J:~C¢E. ....................
3. Nature of work (check which applicable): New Building .......... Addition ...~: ...... Alteration . ,:N .......
Repair .............. Rem6val .............. Demolition .............. Other Work ...............
(to be paid on filing this application)
5. If dwelling, number of dwelling iunits ...... 1[ ........ Number of dwelling units on each floor..'T .............
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...O.~.';~, ....... Rear . G ~..-.~, ....... Depth.. 5.7. ..........
Iteight .... %.'/. ......... Number of Stories ......... J ..............................................
Dimensions of same structure With alterations or additions: Front ...~7,-~ ......... Rear .. G~:.-G. ..........
Depth ...~.'/ ................ Height .... '~.'/. ............... Number of Stories ..... ~. ................
8. Dimensions of entire new constrUction: Front ............... Rear ............... Depth ...............
Height ............... Number of Stories .................................... ' .... ................
raze of lot: Front ....... '~.O, ........... Rear ... l.Oo ............... De .................
10. Date of Purchase ..... ~gr, JIn,~*,~,.. 1~15.1.. ] ...... Name of Former Owner .............................
11. Zone or use district in which premises are situated ...... 1~ .............................................
12. Does proposed construction violate any zoning/aw, ordinance or regulation: ..... J9.O. ........................
13. Will lot be regraded ........ ~.. ................. Will excess fill be removed from premises: ,Yes
Name of Architect . .':'~! ~1~. ~ [4~,gOt.'~ .......... Address t.o.t~T881~'.r.~.~..eg..~.e.t4.. Phone No. Z,~.-fi.o.~ e/ .....
Name of Contractor . .I'A~R~t~.~-.. ~.~,Og$O ....... Address .lq. .l?t2tOtoo~'.tL .go.~.~.. Phone No..q~/~t:.¢.7~ ....
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 YORK, '~ '
COUNTY OF...~ [JFFP.~I~.. ..... : s.s
......... !...'~J I~10l~.. .... R~l~tO'l'~l~ .................. being duly.sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
He is the ..................... i ........... gk~;,~r ..................................................
(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.
Sworu to before me this
........ 1 ~.tt~ .. ......... daKof.. O.~?P.~.~q~. ........... 19 ~.~.
Notary Pu~_.~. ~.~...5..&.~/?.~./.<... County.
LINDA ANN REW'F
NOTARY PiJBLIC, State of New York ...........
No, 47~,1317, Sulfolk County
T,rm E~pnes M~rch 30, 1983
(Signature of applicant)~
??TLE t40, 17.8I~~446
:.:".'. -- :- = ~ , _:- t USE ,o~.-....---~. .
'<',-:,. ,-,~" :: x'.:: . :, . ' . , . : ' ' ' ,, . ' . :~.T ~ ~ ,,-,. , ',.,.,, ,. , ,,.,.:,.., :,, ':-.. ,
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......... ...... ~ , ~ ~o~ ~ .....
~ '( ~~.~// ~.~' ~CFOLLdW1Ng U RED -
.... . - , ~ FouNDAT .....
, , ~ A, ' ~ ENTs'oF THE N; .... . ,
' - , THE REqUIR~M ~., . ENE~
loss
glazinE
windows 435.5 .52 70 15850.2
sliding doors 244.8 .57 70 9767.52
fixed glass 116.5 .52 70 4240.6
exterior doors 21 .40 70 588
floor over
u~eated 2330 .08 70 1304.8
ceiling 2455 .04 70 687.4
skylights 69 .52 70 251!.6
walls 3474 .08 ?0 1945.44
total heat loss
36895.56 Btu
total mlazing
797 sq ft
/ total wall area
/ 4292 sQ ft =
18.6~ glass area
Il
If copper tubing is used
Jar water distributing
sysiem; piping shall be
of types K or L onl]
AP,PRC~VrD AS NOTED
NO~I'NG D~P'~"C~ENT AT
1. FOUN~,~TION - TWO REQUIRED
FOR PCUe~P CONCRETE
2. ROUGH - FRA~fNG & PLUMBING
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