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Home My WebLink About11795-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z13509 Date June 11 1985 THIS CERTIFIES that the building .... O..n.c..f..a..m.~.l.y...d.~.e.~.l..i.n~. ..................... Location of Property/:/~s~ )V'o' ' 1. 59.5...J 9.c.k. e. y..C.r.e..e .k..D.r. $ y.e ............... .S .o.u. ~. h..o .~.d.... · Street Hamlet County Tax Map No. 1000 Section ... 9~.0 ...... Block .... 9.2 ......... Lot ...0. J .9..fi. 1. ....... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... J..u .n.c.. 2. .8 ........ 198. 2.. pursuant to which Building Permit No. 1. .13.9.5. .Z .............. dated ........ J.uly..12. ........... 19~.~., 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 ......... .One. family...d.w.e.l. 1..ip~.. The certificate is issued to Herbert S. g. rm (owner, ~e~g ~9~,~;~ of the aforesaid building. Suffolk County Department of Health Approval 1 2 - $ O- 7 5. .N619627 UNDERWRITERS CERTIFICATE NO ................................................. Building Inspector Rev. 1/81 ~N? 11795 Z S 0NTIL F;ULL (THIS PERMIT MUST BE KEPT ON: ]~HE PR[~IS COMPLETION OF THE WORK AUTHOR ZED) : ~ate ...:...[.~, ~.Z.~ .... ..~.~. ....... ..... : ......... , ~9.~.~,~ Permission is hereby grarlted to: County Tci× Map No. 1000 Seqtion4...~70...:.;~,. Blo¢~ f..~'~:,..}:Lot No.~,O~.~../~. porsuant ~o application' dated' .~/~...~t .......... '4,.~;.. ~..;-;, l~and approved by the Building I~spector. ~ ' ~' . ; ~ Rev:. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor 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 d,isposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwr'iters. 4. Commercial buildings, Industrial 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"-_ land uses: 1. Accurate survey of peoperty 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 safeW inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 / 2. Certificate of occupancy on pre-existing dwelling / landuse--?re-E×±st,±~g C.0. ~15.00 3, Copy of certificate of occupancy $1.00 ~ Date ~/~(/~ New Building ............. Old or Pre-existing Building ............. Vacant Land ............. Lo .t on ..... ¢.* .. ......................... Hou~ No. 8tract Hamlet Owner or Owners of Proper~ '. ...... County Tax Map No. 1000 Section ............... Block ............... Lot ............... Subdivision ................................. Filed Map No ........... Lot No ........... Permit No.I .I.~.~..~. · ·~. Date of Permit .]~¢~. .... Applicant ............................... Health Dept. Approval ../.'~....~.~....~..~. ......... Labor Dept. Approval ..................... Unde~riters Approval.. ~... ~.~.~ ....... P~anning Boar~'Approval ................... Request for Temporary Certificate ..................... Final Certificate .. ~ ........... Fee Submitted $ ............................. Applicant .. FIELD 'INSP~CTIO~ ~ 1. FOUNDATION ( 1 st) COMMENTS FOUNDATION 2. ROUGH FRAME & PLUMBING {2nd) INSULATION PER N. STATE ENERGY C,ODE FINAL MARTIN LANG DIVISION OF SOUTHAMPTON DRA[NAGE CORP. 395 TUTHILL ROAD SOUTHOLD, N.Y. 11971 Health Department Ret. No .... ! ~'''- 5 O- 7,~- (Owner or Builder) Iqxq~erty location (include the distance to nearest cross street) .. ..... ~..~,..1¢..,¢.. ~. ?.,,...~%...c~x...~ .,,'~ .~ ............................. 'la,,,Ict ..... S.~..t4 .~ .~.~..~: .................... Township Subdivision ..................................... Lot No ........................ Type of System Installed: Septic Tank (a) Vohlllle 900 gallon lb) Type ~(./uivalent, block) Leaching pools: fa) Nnmber & size of pools {1~) Type (prccast block) three 4'x8' rings one 6"x8' slab I hereby certify that the private subsurface sewage disposal system described above has been installed according to current criteria of the Suffolk County Department of Health. Title . .//~¢~.~ff~.~¢C7r~ . ....... Mary Ann Grefe President COUNTY OF SUFFOLK PETI~R F. COHALAN SUFFOLK COUN~'Y £XECUTIVE January 3, 1985 DAVID HARRIS, M.D.. M.P.H. Mr. Herbert Arm 1675 Jockey Creek Drive Southold, NY 11971 · Dear Sir: Re ~' Pesticide Analysis 12-3-84 - Outside Tap 1505 Jockey Creek Southold The Department of Health Services Labor~tory has analy~ed a sample of your water supply for the flve common pesticides listed below: ~i~ aldicarb (Temik) carbofuran (Furadan) oxamyl (vydate) carbaryl (Sevin) methomyl (Lannate) The results indicate at the time of sampling, no detectable concentrations of these pesticides were found. Should you have any questions, feel free to call this office. Very truly yours, Senior Sanitarian Drinking Water Supply Section FFf/j dm W-57 348-2776 DEPARTMENTOFHEALTHSERVICE~ COUNTY OF SUFFOLK PETER F, COHALAN SUFFOLK COUNTY EXECUTIVE November 20, 1984 Re: Water Sample: 10/30/84 Mr. Herbert Arm 1505 Jockey Creek Avenue Southold, NY 11971 Dear Sir: DAVID HARRIS. M,D.. M.P.H, Analysis of a sample of your water supply indicates at the time of sampling microbiological and chemical constituents tested were within the recommended standards set by federal and state health agencies with the exception of iron. An additional analysis per- formed for common synthetic organic and hydrocarbon compounds showed no detectable concentrations. Iron is not normally considered harmful to health, but may cause off-taste, odor or staining problems. Your water supply contained 0.33 milligrams per liter iron. The recommended standard for iron is 0.3 mg/1. The Department of Health Services recommends connection to a public water supply wherever possible° If public water is not available, installation of a polyphosphate feeder (micromet) should minimize any iron related problems you are experiencing. Should you have any questions, please feel free to contact my office. MT/jdm Results Enclosed Very. truly yours, Martin Trent Senior manltarlan Drinking Water Section ~2a Location SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES DRINKING WA~.R SUPPLY SECTION Sample date Result Limit coliform ......... ~z.~ <1 : <2.2 free ammonia ..... o,~ nitrate .......... -z,~ 10.0 mg/1 pH ~ specific cond .... ~ chloride ......... '~, 250 mg/1 sulfate .......... iq. 250" iron ~,?, 0 3 "* manganese ........ ~,o5 0.3 "~ copper ........... o u,~ 1. 50" zinc ............. ~,~/ · sodium ~ ~ ~ Result Lire'it Iron &manganese combined concentration should not exceed 0.5 mg/l Moderately restricted sodium diet should not exceed 270 mg/1, Seve~ restricted sodium diet should not exceed 20 mg/lo chloroform carbon tetrachloride .. 1,1,2 trichloroethylene chlorodibromomethane bromoform . ...... tetrachloroethylene ... cis dichloroethylene .. freon 113 1,1,2 trichloroethane . Result ~THM) ~5' '-(THM) ~(THM) benzene ....... toluene ....... chlorobenzene.. ethylbenzene... o-xylene Result m-xylene .... .......... p-xylene . . .o total xyle ....... . bromobenzene o-chlorotoluene . m-chl orotol uene p-chlorotoluene .... .. total chlorotoluene .... __.~ 1,3,5 t rimethyl benzene 1,2;4 trimethylbenzene o ~ _ m,p-dichlorobenzene .... o-dichlorobenzene ...... ~__~__ p-di ethylbenzene .... ..~ 1,2,4,5 tetramethyl benz 1,2,4 trichlorobenzene . lj2~3 trichl orobenzene s-tetrachl oroethane Recommended limits for vinyl chloride and benzene are 5 parts per billion each. All, other compounds listed have guidelines of 50 ppb each, except for trihalomethaneso The THM limit is 100 ppb for the sum of the compounds° NOTE: < symbol means "less than" indicating n~o detection THE NEW YORK BOARD .OF FtRE UNDERWRITERS BUREAU OF ELECTRIC~IT~ 85 JOHN STREET, NEW YORK, NiEt~"V ~ORK 1003~ THIS CERTIFIES THAT in the following Iocetio.; ~ Baseme.t ~ Is~ FI. ~ 2.d Fl. Section Block Lot was examined on OC~e~; ~ ~ ~9~ u~td found to Ye i. compliar~ce with the requirements ef ~his Board. EXHAUST FANS 26 33 30 26 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT S E R % V NO, OF CC COHO, A, W G PER ,~' OF CC, COHO. .1. 310 OTHER APPARATUS: Motors° 2-Fo ~ Electric Room Heaters:3-2o0 £{~W., l-L5 K,W., 2-1o2§ K.W~, 1-1,0 K,W, 1-G.F.CoI. 1-Smoke Detector 1-4.5 it.W. t~ot Water Heater 1-3 ~on A.C. gni~ I ' C E NO, OF HI-LEG A W.G. NO OFNEUTRAL$ A. W G OF HI-LEG OF NEUTRAL 3/0 Joseph J. Frobahoefer Sox 817Rt. 25 Southold, NoY., 11971 LIe. ~962 This certificate must not,be qltered in any manner; return to the office of the B0ard if InspectOrs COF FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. '1t971 TEL,: 765-1803 Examined.., 19ey/ , .... .......... Approved (~ff7 ' 7 .......... Disapproved a/c ........... APPLICATIQN FOR BUILDING PERMIT Date INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted.~,,~4;~J~ to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. '- b. Plot plan showing location of tot 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 drown on the diagrmn which is part of this appli- cation.' c. '~he work covered by this application may not be commenced before issuance of Building Permit. d. IJpoti approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such peri, tit 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 Occupan ~y shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Pe,'mit pursuant to t~e 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. Th~ 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) (/(Mailing address of applicanf~' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......... /5.~/.x ~. ~ ........................................................................... Name of owner of premises .. ~./~-~./~..~..T...,.~,,./~j~.../~.. (as on the tax roll or latest deed) ' If applicant is a corporation, signature of duly authorized officer. . PERMIT INCLUDES APPROVAL ~--" TO ?.EMOVE EXCESS FILL (Name and title of corporate officer) FROM ABOVE pREMISES Builder's License No ..................... . ..... REGRADING LOT DP,,JVEW^¥ CONSTRUCTION Plmnber's License No. MI,~...g(/~C~/~./. ....... CE§SPOOL CONSI'RUCTIOi~' cttu,~ CoNST~.UCnON -------- Electrician's License No. ~.~'. ~..~./¢,4~/1//'/.~.&..~.~'~-fi'- OTHER Oth~.r:,T~l,de's License No ...................... 1. Location of land on which proposed work will be done .................................................. .....,,.,,~ .:. ........... /x/.~.~/. ~,x~ .~x....Z).,xx r. ~. ......... ,..7.~. ~.-r.//~,x.~ ...................... House Number Street Hamlet County Tax Map N;. 1000 Section .... .~. ~ .......... Bloek .... .2,. ............ Lot.../~.'A ./ ........ ;:.~ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and oc6upancy of proposed construction: a. Existing use and occupancy .... .~. ]~...~, ~./~.~ .'77...~-/t2 ~ .......................................... b. Intended use and occupanc~ ....'~JJg &Z,~,.. ~. ,4¢.ff//~,q.. i .~:'~.t~. &4-~-j.tO..~. ......................... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ....... .*.. Repair .............. Removal .............. Demolition .............. Other Work ............... 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 stractur~s if any Front ~'- Rear Depth Height Number of Stories r)imensions of same structure with alterations or additions: Front .. ww.: ............ Rear ....--v. ............. Depth ...... ~ ............ . i.. Height. . ......:'T:: ............ t Numberdpf Stories .....'--7.'. ..... Z ' >~ ..... 8~ Dimensions of entire new construction. Front .... ~. ~. ....... Rear ... ~.. .......... Depth . .~. ~...~ ....... ~ ' .Nun) Height ..... [ ~. ....... bet of Stories ..... ./ ....... ~. ............................ ! ' L' ~-w ...... 9~ Size of lot: Front. ./.?.;~... ........... Rear .../.~..~. .............. Depth ..,~,,~.'~W..~ .......... 10. [)ate of Purchase .......... i ............... Name of Former Owner ............................. 11. Zone Or use district in which pr~mises are situated.. ~../~,~& t.'~.[/~.g,- ...................... ......... 12'. Does proposed constructiq!1 violate any zoning law, ordinance or regulation: . .~.~. ..................... / ..... 13. Will lot be regraded ... ~t ~.. ................... Will excess fill be removed from premises: Yest/ No 14. Nmne of Owner of premises ~/~4t/h~.-$,,/~ ..... Address Z~.~.~'. ~/~.,~..~t~,.. Phone No ............. PLOT DIAGRAM Locate clearly and distinctly all. buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blocklnumber or description according to deed, and show street names and indicate whether interior or corner lot. i STATEOFNEW~'~K, ,/ /1 ~ , S COU~ ..... · (Name o f individual signing contract) above named. ~' being duly sworn, deposes and says that he i..a ~he applicant Sworn to before me this Notary Public ......... 2 ~ ........ ~ ~--,d,~.[. County ILL8 .... No, ~:8125~0, S~olk ~. / ~ (Contractor, a~L~fit, corporate officer, etc.) ' of said owner or owners, and is duiy autltr~rform or have performed the said work and to make and file this ,qpplicationl that all statements contlained in this application are true to the best of his knowledge and belief; and that the work will be performed in the mann4r set forth in the application filed therewith. SUFFOLK CO. HEALTH DEPT. APPRovxL SY~EMS FOR THIS E~EDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOL~ C~T.~ UEALTH SERVICES~ ~PLICANT ' SERVICES -- FOR APPROVAL OF SUFFOL~ ~UNTY ~T, OF HEALTH CONSTRUCTION ONLY. ..... fine serape dtspoaal and ~aler supply ,'acllltles for ibis location hays been inspected by this de~tment ~d f~ Ohief ~f ~eneral ~n~ M,~I~ o~ /=~:~)P~I[~'Y ..~Ou T/--KDL O :r L. ,.% ~ ITATI~)~I~T ~ MTEHT I'H~ WAI'~R SUPPLY AND SLfWA~ DI~AL SY~"rM IrO~ TH~ ~ WILL CONlrOWM TO TI,~ 5'TANDAffD~ OF' THlr ~IJIrFOLK CO. D~. OIr I. IlrALTH M.rffVIClr$. ~JJrFoI. K ~TY DEPT. OF HEALTH SlrRViCES -- FOR APPROVAL OF CONITIt~I~T ~ ~ V DATlr: lO00 O'TO ~ t g. I I J ,,, me ass,gnus ~ t~ ~ ~ CONCRETE WOrK ~ ~ ~M~ ANP W~. u'/r , ,~r~/ D~PPROOFING C~PENTRY I~ ~ ~ ~ M,a iS U WFOL CER FICAE [NSU~TION I METAL5 APPROEED AS NOTED ~ ~ ~ ~e ~, FEE: ~ -- BY: .~ ~ ~ FOLLOWING INSPECTIONS: FOR P~URED CONCRETE 4. FINALcoMPLETE- CONSTRUCTIONFoR C. O. MUST ~ WH~ffB ~[~(M~ ~R~I~ THE REQUIREMENTS OF THE N.Y. DRYWALL I LIST OF SYMBOLS ~ LIST OF , A~ PASEME~T AND M~N A~ IN~D~ ~ E~ E~V~ION~ PI ~ei~ ~ ARM RESIDENCE SOU~HOLD, NEW YORK .~E61 OOCDBER6 ARCHI~CT, RC. : , NEW YORK I0011 TITLE / N(~'E% CON'I;, TILE WORK RESiLEN~ FLOO~IN~ ~TO~L~ , ~ ,.~. ~ L ........... ~)~o¢ w~v ~ , _ L~__ -~_~-,-.~:,-~ ~ ~g,,~ ~.-~,.~o,~,~ i HA~PW~ ELEC~ lC I ~ ~' I j I~ I ~ ~ ~ 4~av ' J ~ ooq~ SCHEOUL~ ~ I ~ ~ m I_ ~ m ~ m , m ~ J i m I L ~ m ~ ARM RESIDENCE ~j J J .~ [ ~ [ I I SOUTHOLD, NEW YORK ,ESI SOLDaERe ARCHITECT, RC. [ L .... ~ I ,~ SWEST ~OtH STeEET J J NEW YORK IOOII TIT~ 6ASEHEHT ~ I~T FL~ ~_ 5'O"x~B"~.l'~/,~" METALCLAg WeO~(EXl") ~1 SOOTH ELEV/kTION 2 E/k%T' .E, LEVATION SCIkL~: V4' = IlO" ~ NORTH ELEVATION ~ WEST ELEVATION F ~ DATH-UTIL. ELEVATION (.$ BATtt-UTIL. ELEVATION ~'~,~-15ATH -UTYL ELEVATION ¢)~' 5kTH~ :,,¢, I~ L~VATION -- ,,o,, ~) 5/kTH' E LE¥.A,TION~, ,/~.,, ._,,o,, /1{ ) · ~L,[~: V4-~'-- PO" ,SCALE-V~-~',~I'O'' ELEVATION )i/I KiTCHEH ELEV~O_N KITCHEN ELEVATION ~ALE: I/4~; I'O'' KITCHEN ELEVATION i. JX.~ KITCHEN ELEVATION ARM RESIDENCE SOUTHOLD~ NEW YORK REGI GOLDBERG ARCHITECT, RC. 5 WEST 20TH STREET NEW YORK IOOII TITLE INT. ~; EXT. ELE~ J~ NOTES, CON~, [/~/~,' c~c. ~, ~c~ ~q~ //~ ~ T~, "* "" ' '"' ~ '~ 62~- tO-C& (~4u) TYPICALSECTION ~ LIVI ;E 5ILL i ~,, ~ ~ GA~A~ T'N~ DAS'M'NT WINP~ ~-,~-c~ , - ...... - -: -~ ~ ~i~L ~ , - ARM RESIDENCE $OUTHOLD, NEW YORK ,~_ REGI 6OLDBERG ARCH.ITEraTe% §WEST 20TH STREET .Ew,o. ,oo,, ,,TITLE ' SECTION ANP PETAIL~ '1 I '27 gjl,~" L 1-20V'/ Z ARM RESIDENCE SOUTHOLD, NEW, YORK REGIGOLDBERS ARCH T£CT, ECL $ WEST 20TH ~:STR'EET , IOO I.,, LI D NING,~M' '1 LIVING U~ ~r. AV~TP-D ' 4, rum4c, ~J,4'~ w/IoAo W,~l. '1 1 I L~ I i i k/ I ~ I~,, '-.~4,,¢r .vim.~ 'mA, w, ARM RESIDENCE $OUTHOLD, NEW YORK REGF~OLDBER6 ARCH ITECT, RC. '-WEST 20TH STREET I0011-: