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Home My WebLink About12452-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...g ~,2.6.4..1 ......... Date ............... G..u.ly..2. 6. .......... 19 .8.4. THIS CERTIFIES that the building.. Ol~.e..f ~traj_.]Cff..d.w.~.~ .1;[B.c2[ ....................... Location of Property ~[~[ts?~3.o? ............... ~'0~. .~ti~g~.Rd, ......... ~.a.s.~. . .M.~.r. $9.n' ...... Street Hamlet County Tax Map No. 1000 Section 02~ ........ Block ,, Q~5 ........... Lot ...0.0o2. ........... Subdivision Pebble Beach Farms .Filed MapNo. 62.6.6. .Lot No...1.$.2. conforms substantially to the Application for Building Permit heretofore fled in this office dated ... ...... ...~.uly...~51983. pursuant to which Building Permit No. .....1245.2.Z ....... ... .... dated July 29 19 ~33, 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 ......... Private one family dwelling The certificate isissued to COSTAS & HELEN BOUKLAS ..................... lo',;n'e~, '~ ~,,~ ~') ...................... of the aforesaid building. Suffolk County Department of Health Approval ...1.3.-.S..O.-.~.1.~. ............................. N645716 UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 FOF~ NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 12452 Z Permission is hereby granted to: ~.~....ZS..~.,~./....~........~.. ........ :~.~.~. ............ ~.~.~../.~.~ ....... County Tax Map No. 1000 Section .... .~..~./ .......Block...~....~...-~. ......... Lot No....~....~'...-~. ........ pursuant to application dated ......... .~.~. ............. ./.~. ................ , 19 ...~..., and approved by the Building Inspector. Fee $...Z~../.~... PERMIT INCLUDES APPROVAL TO REMOVE EXCESS FILL FROM ABOVE PREMISES BY REGRADING LOT DRIVEWAY CONSTRUCTION CESSPOOL CONS i RUCTION CELLAR CONSTRUCTION OTHER Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall ,%uthold, 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 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, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. §. 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 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- tion required to prepare a certificate. Co Fees: 1. Certificate of occupancy ~"" $5.00 / Certificate of occupancy on pre-existing dwelling / land use 2. 3. Copy of certificate of occupancy $1.00 / --Pre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 Date...,,J.U lklJ~. ,/'{j. J, ~.~, .~. ...... New Building .. ,N~/., ....... Old or Pre-existing Building ............ Vacant Land ............. Location of Property. O. ...........7-. ...... .E. ?... House No. Street Ham/et Owner or Owners of Property .. C C~ :~.-T~ 5.. ~ ;~.E..~.t~.l~....~.O.~..~,..L~ icj. S .................... County Tax Map No. 1000 Section ...C~.o~,. ~. ....... Block .... (~ .~. ....... Lot...C).O~ ....... Subdivision ~.~.~...~p.~ .OL~....~.~$ ....... Filed Map No..~..~.~.(~....Lot No...1'.~.. ...... Permit No. J ~,~'~),...~. Date of Permit ?/~?/.~ .Applicant. Health Dept. Approval ....... J.?). ~f..~..O.r. [I.~ .... Labor Dept. Approval ........................ Underwriters Approval . ~..~.~ ~..~.J.~. ......... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate . .~..' .................. Fee Submitted $. ~ ..... ~..~.' .q.~. ........ Construction on above described building and permit meets all applicable codes and regulations. CC~-Z ~ ~L~qt Applicant . .~P.% ...~.. ~. ..... ~ ...... Rev. 10-10-78 FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY ~ODE FINAL ADDITIONAL COMMENTS: lOOO771 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 1OO38 THIS CERTIFIES THAT only the electrical equipment as ~zcribed below and introduced by t~ applicant ~m~ on the able application nu tuber in the premises of Gus ~as, N/S ~e Strand L~ ~0' W/O The ~ Way La. ~ Pebble ~actL E~ ~rion,H.Y. in the following loca~ion; ~ Base~en~ ~ 1st FI. ~ 2nd FL ~ Section Block Lo~ was examined on ~Y ~ ~ ~ artd found to be in compliance with ~he require~nen~s of this Board. FIXTURE FIXTURES RANGES ~ OVENS DISH WASHERS EXHAUST FANS OUTLETS DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT OTHER APPARATUS: ,,~tors. l~-3/4hp Z~GF. C.I. 2-Smoke Detectors S E R · V NO OFp~CRC~.COND.A.W.O. OF CC. COND. 4/0 I NO, OF HI-LEG AW, G, OF HI-LEG NO. OF NEUTRALS OF NEUTRAL Rul~d Electxdc Co. P. O. BOx 143 ~gattituck, N.Y. 11952 This certificate must not be altered in any manner; return to the office COF Board if i~co, 11 Per may be by their MANNER. ?GS-*t 802 BUILDING DEPT. - INSPECTION FOUNDATION XST ~ ] ROUGH pLBG.~ FOUNDATION 2ND ~-:~INSULATiON ':~ [ ] FRAMING [ ] FINAL DATE LiNSPi~CTOR ' ~~ 7SS-,IM2 BUILDING DEPT. INSPECTION [ ] FOUNDA'nON ~,ST I:ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION ..- / .,:.o~ REMARKS: to 'the standards of the Suf/ok BEACH FARMS" doflock oss~lo~es 31~ wesf m~n sfreef ~ ~/~ SUFF~'~UNTY DEPARTMENT OF H~LTH ~ER~ICE~ :.verheod ~ ~~ F~R ~ OF CONSTRUCTION ONLY (516)~69-1T1~ (212)7~-~20 ~ 1~19~ ~ ~ APPROVE~ 530 -r~ A~t~g L~ Z 0 T 152 MAP OF "PEBBLE BEACH FARMS AT £AST MARION TOWN OF SOUTHOL. D SUFFOI-K CO, N.Y. FILED JUNE 11~197~ donack associates $1;~ west main street rNerhead ,new york 11901 [516)369-1717 (~>12) 7,0,.6-:5020 dune :~0, 1983 del) N-.q 83-297' 1000'021-05-02 Scale :.1" FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1803 Examined .~/~./~...'47.7..., 19.~.~. Approved .~./~...~.t~..., 1~..~. Permit No. /.~..~.ff...~..~ Disapproved a/c ......... ; ' ' '~' (Bffil~ing Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted 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 build/ngs 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 issued 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 reguiation~, and to admit authorized inspectors on premises and in building for necessary inspections. c,c. ~.~.x. --,~k;...~... ?.. e-/~.. ~,,X .......... (Signature of applicant, or nazne, if a corporation) g .Q, ~Og."J~ ..... lO.fiD..kl.o, me~e~. (Mailing address of applicant)~l-~,.~l:o State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................... C~E [l.F..r¢.61 .... C0.hI.TE. IhCT~.o.K. .............................. Name of owner of premises ... C-,O~ .~.~ .... '~. [~ k,~ ~ ..... [~Okl ~. k-~.~ ............................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ...... ~.~.5 ....... ' ......... Plumber's License No .... q..!.'~. ~. ............... Electrician's License No. ~u[o,.¥1~..~.~..esze..: ....... Other Trade's License No ...................... Location of land on which proposed work will be done ...... }~. ~.B~. ~,~... 1~ {~tC.~... ~. S~r~;~.S .......... 5 3.0 ................. ~.E ...... ~TC<. ~,U. 0....h. ........ /~ 155.T... }4. ~ .~ .~.r) t,J ............... House Number Street -/ Hamlet County Tax Map No. 1000 Section .. O.~-.l .......... Block . .0.5 ............. Lot..:~i[,..O.0~,, ..... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......... ~/.O,~¢.ok~.~-. ..... I.O.~. ........................................ b. Intended use and occupancy ...b.uic[ .... o,...o.~..~... 5 .or..m.j. [¥ .... .~.~ y~.e ...................... ; 3. Nature of work (check which applicable): New Building .. ~ ..... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work.. ~ ............ 4. Estimated Cost. .' O Fee .... (to be paid on firing this application) 5. If dwelling, number of dwelling units../.'~.o~ ~ ;.I.~.... Number of dwelling units on each floor...I ............. If garage, number of cars .... ,~.~.~....~.r'..~.~ ~. ........................................ 6. If business, commercial or mixed occupancy~ specff~) n~ture and extent of eack type of use . i .... ' .... 7. I)imensions of.existing structures if any Front· .~ ......... Rear . ~ ........ 'l~pih' i ~'~. i i i i Height . .~.. ......... Number of Stories ... ~ .................................................. Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Stories ............... . . 8. Dimensions of entire new construction: Front .. 5 3! ......... Rear . ,.~.1 ........ Depth . ~.~ ..~ ........ ~eight . . . I.'J.~ ......... Iqumber of Stories ..... [ ....... ~... ~ ........................ ~ ............... 9. Size of lot: Front .... ~*~.O ........... Rear .... G~.~ . .O ........... Depth .. ~.~.[g .............. 10. !)ate o'fPurchase ... ¢.]. li.[.'J5 ................. Narrle of Former Owner . ]~t0~*.~. ~.v~,t~ ...... 11. Zone Or use district in w[ich premises are situated... ~.e$.r.~e.~.~.1................................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... ~O ........................ 13. Will lot be regraded ..... )t~ ................... Will exc~e.ss fill be removed from premises: ~ No 14. Name of Owner of premises ~O~'~a.~ ~O0 k~t~ AddresslqS.~,.~L'~,..~;~t, Phone No ~ , .. .. ~-_-~,~.~,~, · ~ ..... ... . Name of Architect .V4~ ~°t . ~., ~. L .!:..~-~t~ .... Address ~,. l~le~..l~e~-. .... Phone NoSI Name of ContractorDl ~o,5..~.!e.~.~ I~ .......... Address gm _~a>t .~11..~. ..... Phone No...~.'C/. J.~.$ .... 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 t~o, deed, gBd show street names and indicate whether Lof Is.t. .,._ . ,.,.,,...t"._,;' STATE OF NEW YORK, S $ COUNTY OF ..... · · ~_~.o~..~ .¢~. t~ .~./.' t~ Pti.... 2 m/.'..~..~ ................ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ......................................................................................... (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; 9nd that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this day of k..~ .......... 19 ..~.~ LI~,,, i-. KOWAL~IKI No. 52-4524771 (S~gnature of applicant) Qualified in Suffolk County , Commission Expires March 30, GENERAL NOTES 1. ALL CONCRETE TO BE CONTROLLED STONE CONCRETE HAVING A MINIMUM COF~RESSIVE STRENGTH OF 2500 POUNDS PER SQUARE INCH AT 28 DAYS. 2. BOTTOM OF ALL FOOTINGS SHALL BEAR ON UNDISTURBED SOIL HAVING A MINIMUM BEARING CAPACITY OF TWO (2) TONS PER SQUARE FOOT. 3. PROVIDE MEMBRANE WkTERPROOFING AT EXTERIOR FOUNDATION WALLS. 10. NO NOTE OR DETAIL OR LACK THEREOF SHALL BE CONSTRUED AS RELIEVING THE CONTHACTOR FRON EXECUTION OF ALL WORK IN ACCORDANCE WITH ALL STATE AND/OR LOCAL CODES. FRAMING LUMBER SHALL BE STRESS RATED DOUGLAS FIR OR SOUTHERN PINE STRESS RATED 1200 POUNDS PER SQUARE INCH MINIMUM FOR BENDING (fb) FOR SINGLE MEMBER USE, AND 90 POUNDS PER SQUARE INCH MINIMUM FOR SHEAR (Fy), AND HAVING A MODULUS OF ELASTICITY OF 1,500,000 UNLESS NOTED OTHERWISE. VALUES APsE FOR SURFACED DRY LUMBER ONLY USED AT 19% MOISTURE CONTENT. HEADERS AND TRIMMERS TO BE DOUBLED ~HEP~E P~EQUIRED. DOUBLE ALL FLOOR JOISTS UNDER PARTITIONS PARALLEL TO FLOOR JOISTS AND OVER 6'-0" LONG. ALL PLUMBING WORK TO BE IN STRICT ACCORDANCE WITH LOCAL TOWN ORDINANCES. ALL ELECTRICAL WORK TO BE UNDERWRITER APPROVED. CURBS, CURB CUTS AND PAVING MUST CONFORM WITH ALL REGULATIONS'AND REQUIP~Eb~NTS OF THE DEPARTMENT OF PUBLIC WORKS. ' n is used copper tu~i g ~ .-,ater distributing oJ tYPes K or L only i ABBEO',/ED AS NOTED NEW,NS BTKK T ENT 765-1802 9 AM TO 4 IPM FOR ~H~ FOLLOWING INSPECTIONS; 1, FOUNDATION - Iwro REQU~ FOR pOURED ~. ROUGH - FRAMING & pLU~IN~ BE COMp~TE FOR C.O. ALL CONSTRUCTION SHALL THE REQUIREMENTS OF THE N STATE CONSTRUCTIO~N & CODES. NOT RESPONSIBLE 4J~ 4" 0 OCCUPANCY OR USE IS flli 11 CERtiFICATE w/ THESE DRAWINGS AND SPECIFICATIONS ARE INSTRUMENTS OF SERVICE AND StLALL REMAIN TBH PROPERTY OF THE ARCHITECT W~ETHER THE PROJECT FOR WHICH THEY ARE MADE IS EXECUTED OR NOT. THEY ARE NOT TO BE USED ON ANY OTHER PROJECT EXCEPT BY WRITTEN AUTHORIZATION OF THE ARCHITECT. -{3 A -4 %, 4 ENERGY CONSERVATION NOTES ( NEW YORK STATE ENERGY CONSERVATIO~ CODE) 1. COUNTY OF ~-J~1~ PERCENTAGE OF GLAZED AREA IS LESS THAN ~% OF TOTAL WALL APCEA. DEGREE DAY EQUAL ~ FOR COUNTY. THE FOLLOWING VALUES OF THERMAL TP3~NSMITTANCE SHALL BE MINIMUM VALUES FOR USE IN THIS PROJECT: ROOFS & FLOORS EXPOSED TO AMBIENT CONDITIONS .................. Ur~ .05 EXTERIOR WALLS ...................... Uw= .00 GLAZING Ug= 69 ENTRANCE DOORS ...................... Ud= .40 FLOORS OVER, OR ABOVE GRADE BASEMENT WALLS ENCLOSING UNHEATED SPACES ..... Uf= .08 SLAB EDGE INSULATION UNHEATED SLAB .. Ri= 5.5 SLAB EDGE INSULATION HEATED SLAB .... Ri= 8.0 HEATED BASEMENT / CELLAR WALLS (ABOVE GRADE)..... . . Uw= 08 HEATED BASEMENT / CELLAR WALLS (BELOW GRADE) ....................... Ri = 5.5 FIREPId~CE CONSTRUCTION SHALL BE IN ACCORDANCE WITH THE PROVISIONS OF SECTION E - 402.4 OF THE N. Y. STATE ENERGY CONSERVATION CODE. ALL DOORS AND WINDOWS TO BE DESIGNED AND CONSTRUCTED TO LIMIT AIR LEAKAGE IN ACCORDANCE WITH SECTION E - 402.4b OF THE N. Y. STATE ENERGY CONSERVATION CODE. BUILDING MEC~IANICA~ SYSTEMS S~ALL BE IN ACCORDANCE WITH FkRT 5 - "BUILDING DESIGN BY ACCEPTABLE PRACTICE' OF THE N. Y. STATE ENERGY CONSERVATION CODE, SECTION E- 503.0. ,/ -- I ---I kI 4-I