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Home My WebLink About12089-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.. 2.1.1751) ......... Date ......... ~T~ THIS CERTIFIES that the building .. erin ~ farai 3. ¥..d.w e J_ ~-.~.n g ....................... 985 Silver Colt Road Location of Property ... 9.3 5 ............. O. 1 d. S.a d 013..L a ~ .e ................ ~ Ia.fi. q I~ p g.u.e. House No. Street Hamlet County "['ax Map No. 1000 Section ...Q95 ...... Block .... Subdivision. ,0.negoz~ .~ie~, ,Es ¢,~.t, es ....... Filed Map No. ~.2, Lt 1...lot No... ~ .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ·. l~e.c, ombe~.. ~ 5 ....... 19 $.Z pursuant to which Building Permit No..120~.~ ............. dated ... Da.cembe~..30 ............ 19 82., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... · · ne.~. ¢ne.--£ am&.J.y · d~.~l 1 ~_n.g .................................................. The certificate is issued to .. CHARLES & MARY JO PETERSON ................... ?o;d,;ok,'l$~'o'd~'t3&h~l ...................... of the aforesaid building. Suffolk County Department of Health Approval 12 - 50 - q 50 N603270 UNDERWRITERS CERTIFICATE NO .......................... Rev. 1/81 Building Inspector TOW. o~ s°u~°~' TOWN HALL sou,.oil,, N. Yi BUILDING (THIS PERMIT MUST BE KEPT ON THE PiPElinES UNTIL COMPLETION OF THE WORK AUTHORIZED)i N? 12089 Z ...~.~....Z~...~.....~;~ ....... : ......... [ : "7~;:~:'"~:'~'"~ ............. ~ ..... ~' , ~ ~0 ....................................... ~...~ ......... ~ ............. ~ ........ ;t...~. ............. ~ ........ ~ ................. .... . ~ -- 'w'"'7~ .... t~,~/ b- ..................................................................................... ~ .......... *'""~ ............. ¢~ ...... ~ ......... Cou~W Tax Map No 1000 Sec~o~;..[ ...... ~. .......... Bilk 4-..: ............... ~f ~o ........................ ~, , , ~*Cr~~~g- !'~. n' v '' the pu~uant to application aat~ ............................................. ~....~......, y.....~..., a a ~ppm ~ ~y Building I~$pector. · ', Rev ~6/30~80 Building FORM NO. S TOWN OF SOUTHOLD , Building Deportment Town CIcrks 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: 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 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 bui(ding. 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 in- formation required to prepare a certificate. C. Fees: I. 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 .... ~/...~..~../...~....~.. ............... New Building ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property .......... Owner Or Owners Of Property ..... ~.~G.~.L~..~. ....... ~...../~.~......~.s~ ...... .~..~..~...o.~ .................................... Subdivision ...~.~'.e~.a.~. ....... ?..~§.~........~..~.~.~T.e..~ ......... Lot No .....~. ..... Block No ............. House No..~..~...-~'.... Permit No.../..~...O....~...~.... Date Of Permit .~..~.~/.?..~.....Applicant ...~.'. ............................. ,....~'9..~O. ............. Health Dept. Approval .... ~./~.../.: .......................... Labor Dept. Approval ................................................ Underwriters Approval .....~..//~./.~..~. ....................... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ .................................... Construction on above described building and permit meets all opplic~able codes and regulations. Sworn to before me this Applicant ...... ~_.~....~.~..~,~.~..~. · .~...-- day of ....... ~/~.~.1.....~...~..~.'.~...-- (stamp or ~1) THE NEW YORK BOARD OF FIRE ,UNDERWRITERS ~L~J~ BUREAU OF Et~ECTRIGIT~ Date ~Ly k~O~ ~.~.)~SG JOHN STREET, NEW YORK, NEW ~ORKAO038 ~,.~,,~.,on~o.o~,~ ~/~ N 803270 THIS CE~IFIES THAT only th~ electrical equipment as described be~w and introduced by tl~ applican~ ~m~ on the above application nu tuber ~n ~he prorates of FIXTURES RANGES OVENS DISH WASHERS FANS DRYERS UNIT HEATERS MULTi-OUTLET SYSTEMS NO, OF FEET OTHER APPARATUS: S E R V I C A, WG PER ,0' OF CC COND, t 310 ~O OF NEUTRALS 3/O Electric~l Ventures ~. O. Box 151 Center ?~ori~/~$, lt'Y. 11934 lic. 847 COMMEN'IU$ '~ FJ ELD 1, FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY qp~E FINAL ADC COMMENTS: TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ........ ^pp,cat,on ............. ,~oproved ~.~..~....~..........~...~.. ............ , 1~ Permit ~o. ~~.~ ...... ~iso~rove~ o/c .~ ...................... ~ .......... ~/~ ................... ~ ........................ .......... ...... : ........ ~ (g~ilding ~spector) ' APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter ac in ink and submitted in triplicate 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 giving a det¢iled description of layout of property must be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this oppllcation, the Buildi'ng 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 Buildiqg !nspector. 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 ir~ buildings for necessary inspections. (Signoture of applicant, or name, if a corporation) (Address of oppJicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................... ..................................................................................................................................................... Name of owner of premises ..~r h.~..~. ( ¢, S .~..~..?..~..C..5.. O. ~.. .......................................................................... If applicant is a corporate, signature of duly authorized officer. ........ ...... ...................... (Name and title of corporate officer) Builder's License No .... ./...?..g..~...Z..l~..-~ ..................... Plumber's License No ..... ~....~...~.....'.~...~. ........................ Electrician's License No .... .~..~.~.[:....~. ........................ . Other Trade's License No ............................................... t ~ ~ 1. Locat on of and on which proposed work wi be done Map No .... ~ ........ I ..... ....-~Lot No .....~. ................ Street and Number ...................... .~...O..f...~..e'...C ....... .°..'~....~.iJ.V.~ .~.../~..,...~.~.~......0.~....~¢~..I.~. ............................ (~ _~:75~. Z.¢., Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ..... .:./..,..:,>" ..................... b. Intended use and 0ccupancy 3. Nature of work (check which applicable): New Building.......~.. .......... Addition .................. Alteration ................ Repair .................. Removal. ................. Demolition .................... Other Work ................................................ . .... ..~.~......~.:.,.~...,~..~2 ""' , Fee,~,~' ~ (Description) 4~ ~timeted Cost . .. : .....~ ...................................................................................................... (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 Wpe of use ............................ 7. Dimensions of existing structures, Jf any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure ~with alterations or additions: Front .................................... Rear ............................ Depth ................................ H~ight ............................. Number of Stories ................................ 8. Dimensions of entire new construction: Front ..... ~ .....................Rear...~.~ ...............Depth ~,~ ............... Height .~ .......... Number of Stories ......... ~. ......................................................................................................... 9. Size of lot: Front ..... /.~.~. ......................................... Rear ...... .~.~.~? ..................... Depth ..~-~ .................. 10. Date of Purchase .................. : ..................................... Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. W II lot be regraded ......~ ............ Will excess fill be removed from premises: ( ) Yes (~) No 14, Name of Owner of premises ..G.b~.cl.~.....~.c~.~ ......... Addre~ ................................ Phone No. Namb of Architect .................. Address E~sT ~p¢o, Phone No. Nome of Contractor ~.%.h.{.~L...~..q.~.~L....~.~.~.~ ..... Address~../J~....~.~.~ Phone No. PLOT DIAGRAM Locate clearly and distinctly alt buildings, whether existing or proposed, and indicate all set-~ck dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate ~hether interior or corner lot. STATE OF NE~'~RK.,/ _ , ~, , u ,, /.-~/~be ng duly deposes and says that he is the applicant ............ ~~~;...,. ...... :..~ .......... sworn, (Name of individua~ si~ning contract) above named. ,. ,. ................ .............................................................................................................. ~Q/(C~actor, ~gent, corporate officer, etc.) of said owner or owners, and is ~ly~perform or have performed the said work and to make and file th s app Cation/ that all statement~ in this application are true to the best of his knowledge and belief; and tha~ the Work will be performed in the manner-set fo~h in the application filed therewith. Sworn to before me this . ..... ..................... ~arm ~pires March 30, 19~ SUFFOLK CO. HEALTH DEPT..APPROVAL H.S. NO. ~ , ~ = ~ STATEMENT OF INTENT SYSTE~ THE WATER SUPPLY AND SEWAGE D,S~SAL FOR THIS RESIDENCE WILL ~ = :~o~J~r~+ CONFORM TO THE STANDARDS OF THE XX SUFFOLK COUNTY DEPT. OF SERVICES -- FOR APPROVAL OF DIST: ~CT. BL~K ~L. a~t'~ nitrates. ,, ~~, ~.~. l required. ', ~Te t.~- ~)m "m~k o~ ~ ~,~ ~,,,. ~°"'~'°'~. ,,w ~AL ~~ ~ LI~D L~ND S~VEYORS GREE~T NEW Y~K ...,%) 'x SUFFOLK CO. HEALTH DEPT. APPROVAL H.S, NO, ;2- $0-1~ STATEMENT OF INTENT THE WATER suPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. (Si ..... APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY DATE: , APPROVED: ....... SUFFOLK CO. TAX MAP DE~$1C.-~IAT~: DIST. S~CT. BLOCK PCL. DEED: L N/A P. SEAL 6CCU? ,HC¥ 6R copper lubing is used [or water distributing system; piping shall be of types K or L onJy i I ~.-- -hr Ii -I~ ~1 - I - -- AP?~.O~%D AS 'NOTED DATE:/~.P. FEE~_~-'~Y: NOTIP/'BI.JILDING DSPARTMENT AT 765 1802 9 AM TO ~ PM FOP, THE '~ L ~_ V Aq- 't 0 k.4 R~4C~ LLOU%~ ~-C)~G~ULIILL CC)LL%T, CO. F RGT FLC)Q~ P L. ~k3 2 slabs SLAB INSULATION Degree Days Mir, By Zone R Value 5000 5.5 6000 5.5/ 7000 5.5 8000 5.5 9000 5.5 The insulation must extend at least 24" under the slab or at least 24" below grade down the foundation wall, FOUNDATI 0;~ ~ALL The insulation is installed on the inside face of the foundation wall and provides a thermal break between slab and foundation. OUTSIDE FOUNDATION WALL The insulation is installed on the outside face of the foundation wall and provides a continuous thermal barrier at the slab edge and foundation wall. All exposed exterior insulation above grade should be covered with a protective material. lternate location )rotective over insulation I I I I I (lOUSE_.. FOM GRL)t4I LL COLL%T. CC). [FTC. ~o 1/9