HomeMy WebLinkAbout12793-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22113 Date JANUARY 15, 1993
THIS CERTIFIES that the building DWELLING
Location of Property 655 {a/k/a 702) FLINT STREET
House No. Street
County Tax Map No. 1000 Section 48 Block 2
Subdivision Filed Map No.
GREENPORT~ N.Y.
~ Hamlet
Lot 15.5
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 6, 1983 pursuant to which
Building Permit No. 12793-Z dated DECEMBER 9, 1983
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this cerqificate is
issued is RECONSTRUCT EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to CHRISTINA M. DINIZIO
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL G-18 - NOV. 29~ 1984
UNDERWRITERS CERTIFICATE NO. N-676342 - JANUARY 24, 1985
PLUMBHRS CERtIFICATiON DATED·
~-~T~lding Inspector
Rev. 1/81
FOB,~ NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING FERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
12793 Z
Permission is hereby granted to:
................
...~...~...~.~.....~ .............................
...............................................................................................................
at premises located at .............. ~.-~.~..~.' .~.......~ ...... ~.~.~.~ .........................
County Tax Map No. 1000 Section ..... ..O,,,.,~,,?. ....... Block ..... ~.~ ........ Lot No ....... ~...~. ............
pursuant to application dated ..~...1~.~.,.,-~, ................... , 19.~....~.., and approved by
the
Building Inspector.
Building Inspector
Rev. 6/30/80
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
TEMPORARY
Certificate Of Occupancy
No .... .z.1.3.1 ~3.6 ....... Date ...... ?.e.~..v.u.a.E~-., .6 ............ 19 .8.5.
THIS CERTIFIES that the building Remodel dwelling
Location of Property 7.0.2..F..~.~.n.~. . .S.~?.e.e..~ ........... Gz'ee. nport~ N.Y.
House No. Street Hamlet
Connty Tax Map No. 1000 Section 0.~..8 ......... Block ... ? ........... Lot...gfi. ...........
Subdivision ............................... Filed Map No ......... Lot No.:: }:.;-~;~e~
Sept. 6 198.3, . pursuant to which Building Permit No. 12793Z --'"~"
dated ...... .D .c.c.....9 ............... 198,3. ., was issued, and conforms to all o~" the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is .........
Remodel private one family dwelling
The certificate is issued to .g3~J~.N~OI~.T..~0~J,S.%SG. AbL~rA.2¢~ ...........................
(owner, le~q~ q,~y~q~rC~rF.~ X
of the aforesaid building.
Suffolk County Department of Health Approval G-IE Temporary .90 days
Building Inspector
Rev. 1/81
~NI' IH' ~ H ~-,P d :" I r ; 85 JOHN STREET NEW YORK NEW YORK 10038
IIl!~'p~,e": '~anuary~"24!L [985, ~p~,t~c,tlo,,No. onfi~, 297820-84 ~ ~7~9 ~'
THIS C[RTIFIES THAT,t~ , ~ , ~ ,
' ~ Greenpor~ Ep~s~ng' All~.~n~e, Flint St., Greenport n.y
~n the follotving location; ~ .a;encent [~7~ i~t FI. ~ 2nd FI. .%,etlo,, Block Lot
15 38 31 15,
TIME CLOCKS UNIT HEATERS MULTLOUT[ET DIMMERS
SEIEVICE OISCQNNECT ~ S E
,Smoke Detector
Sal Prate E,lee.
Wiggins Lane
Greenport N.Y.
R v I c
3
11944 Lie. 1049 E
This ce?tificate must not be altered in any monneo return to the office of tho Board if incorrect, Inspectors may be identified
FORUM NO. 4
TOWN OF sOUTHOL, D
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
$outhold, N.Y.
TEMPORARY
Certificale Of-Occupancy
Remodel dwelling
THIS CERTIFIES that the building ....................................
Locatmn of Property .7...0.2;.ti $ .z.n.~...S .~.p.c~ e..C ................. 9£.e.e..n p.o. rs..6,
County Tax Map No. I000 Section 0.4..........8 .Block ...........2 .... Lot
Subdivision ............................... Filed Map No ......... Lot No...
Date .. Fe?uav~ 6 19 ~
ttan~lot
.(
conforms substantially to the Application for Building Permit heretofore flied in this
...... .S.e.p.~.:..6 ....... , 19~3.. pursuant to which Building Permit No..?.7.9..3~.... ~-~'. ........
dated . .D .e.c.....9 ............ 198.3. . , was issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for wtfich this certificate is issued is .........
Remodel l~r~vate one family
'Ilte certificate is issued to .~ ~ J,~.Iq ~9 RT..?J OlJ~.:~ ~G..g4 L. ~rA~ ~ ...........................
(owner, leTts~qf~e~qOX X
of the aforesaid building.
Suffolk County Department of Hea~th Approval G- ~ 8 TempoPar7 90 days
UNDERWRITERS CERTIFICATE NO ........... ~ ~.7.fi ~ (~ ~ ...............................
Building Inspector
Rev, 1/81
Community Action
of S0athold Town
FORM NO. 6
TOWN OF $OUTHOLD
Building DepartJment .': ~At, ~3
Town Hall ~ ~ ~
~outhold, N.Y. 11971
j: . RECEIVED
APPL CATION FOR CERTIFICATE OF OCCUPANC¥~.'i:.'
instructions ..:'.,~ ,~,,~ :.~..~.... ~
A. This appli~cation must be filled in Wpewriter OR ink, and submitted ±n du~ t he 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 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.
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 p~operty showing all propertv 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 informa-
tion required to prepare a certificate.
Co F~es:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling ,~15. O0 ,
3. Copy of certificate of occupancy $1.00
4.Vacant Land CoO. $5.00
,-~,~ Date .. Ja~%ua~¥..~ ~ ,. -3-9 $ .~ .....
New Building. { .r.e.~.o.¥.~,t.e,d,)OId or Pre-existing Building...,........ Vacant Land ,..... ...... ·
Location of Property .. '~ Q,2, .~.~t.. 5~;~.eel;..-..~re.~npor.t,. ~F..~.~,~, ................... '
House No. Street Ham/et
Owner or Owners of Property ..................... ! ......................................
County Tax Map No. 1000 Section 0~ Block .2. Lot ~.~
Subdivision ................................. Filed Map No ........... Lot No ..............
Greenport Housln~ Allla. n~ge,..Inc.
Permit No..~.2.'~..2.. Date of Permit ~.2./.~./'.8.3..Applicant ............ ~. ................
Health Dept Approval , Labor Dept Approval .........
Underwriters Approval A~t,~C,%.(td Planning Board Approval ....
Request for Temporary Certificate Final Certificate att .a.che. d. ........
Q0. "
Fee Submitted $..1 ~;.. .......................
Construction on above described, bui~ing and/~rmi~s and regu,a~ _
7 / /
FORM NO. 3 [
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
File N4~ ........ ~:?o. · '~U ~"~ ....... Date .......................... , 19 .....
To/~....~. ~;~9,'' .*..'T:'. ·. ,m~ 0~ ~ .........
' G ~:' ~; "~ ~':": ..........
PLEASE TAKE NOTICE that your application dated . .~. ¢~ ~'~ ~ q 19 ~ ~
~ouse ~vo. ~treet [ , I e
County Tax Map No. ] 000 Section .... c~. ~..~ .... ~lock .... ~ .~ ..... Lot ...... ~ ......
Subdivision ................. Filed Map No ................. Lot No ..................
is returned herewith and disapproved on the following gro,unas, .,. ~,.*... :... ;..-'. .................
· '"~'~ ""Y"¢~":"' '~'q '~ ..... ~' '" ~": .............. ': ......... t ....... ': ....... : :"" .....
.. ~. . .~. . . . ~ :. :. : . . ~ ~. ? : ~ . . 7~ . . :-~. ~ ~ . ~. . . .~ ~ ~ .c. ! ). . . ~. ~ .~ . .
Building Inspector
RVI~O
FOUNDATION (~st)
FOUNDATION
2.
(2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
qODE
FINAL
ADDITIONAL COMMENTS:
PECON C ASSOCIATES, INC.
Engineering, Marine & Energy Consultants
Environmental Planning
29 November 1983
54655 Main Road P.O. Box 318
Southold, New York 11971
(516) 765-2669
GREENPORT HOUSING ALLIANCE,
18 SOUTH STREET
GREENPORT, L. I.
NEW YORK - 11944
INC.
- FLINT STREET UNIT
II.
III.
IV.
NEW YORK STATE ENERGY CALCULATIONS AND COMPLIANCE
(ACCEPTABLE PRACTICE)
BUILDING TYPE: Single Family Dwelling,- 2 Story
ENERGY SYSTEM: Heating Only - HW Baseboard &.,,,,Radiator
DESIGN DATA:
a, Heating Degree Days
b, Outdoors - Winter -
c. Indoors - Winter -
BUILDING ENVELOPE DATA:
Area In~!. Proposed Code
Walls:
1. Opaque Wall ~45,~ R-il Uw ,08 U~ .08
2, Glazing ,,257 Ua .71 U~ .69
3. Windows ~ ~ !4.7 ~ 23.0
4. Doors 38 Ud ,40 Ud ,,40
5, Walls Overall 1747 Uo .179 Uo ,.,,22
* NOTE:
Even though the U factor of the windows is
not in compliance the overall U factor is
significantly less than the code
requirement, therefore the entire building
is in compliance.
Basement Walls: Not Insulated,
Roof/Ceiling: ~619 R-$,,0 Ur .93 ur .05
Floors:
Floors Over Unheated
Space 703
R-19 Uf .05 Uf .98
GREENPORT HOUSING ALLIANCE
FLINT STREET UNIT
VI.
VII.
VIII.
AIR LEAKAGE:
a.
Infiltration Rate:
1. ~indows
2. Sliding Glass
Doors
3. Swinging Doors
4.
Proposed Code
0.5 cfm/L.F. 0.5 cfm/L.F.
0.5 cfm/S~F. 0.5 cfm/L/F.
1,0, cfm/S.F. 1.0 cf~/S.F.
Joints - Caulked and sealed between walls and
foundation, walls and roof, all
exterior joints and o~enings.
Overall NTE One air change per hour.
COOLING PERFORMANCE: Not Applicable.
MECHANICAL EQUIPMENT PERFORMANCE:
a, Gas/Oil Heating Equipment
Efficiency
MECHANICAL SYSTEM CONTROLS:
a. Thermostat
Proposed Code
75% ..... 75~
45° - 75° F. range
IX.
MECHANICAL SYSTEM INSULATION:
Sizes Insl. Th. & Rating
a. Ducts ., N/A
b. Piping 1/2" 1!/2 Inch R-4.0/In.
1" 3/4 Inch R-4%9/In.
1 1/4" to 2" ..... 1 Inch R-4.0/In.
PLUMBING SYSTEM:
Domestic ~ater Heater: Meet ASHRAE 90-75 Standard.
Heat Loss NTE 15 BTU/Hr./S.F. of Tank Surface.
Electric ...... 4 ~att Hours/S.F. Standard Loss
b. Piping Insulation:
Pipe Size - Up to 1 Inch - 3/4" Insl.
Controls:
Automatic Temperature Control with High Setting
NTE 140° F. with Separate Shut-down Switch.
2
GREENPORT HOUSING ALLIANCE
FLINT STREET UNIT
XI.
XII .
ELECTRICAL DISTRIBUTION:
fnstallation to be in accordance ~ith the National
Electric Code.
b. Power factor of eguipment rated greater than
shall not be less thanm 85~.
c. Voltage drop to any service termination shall not
exceed 3%.
d. Local switching shall be provided for each lighting
circuit.
HEAT LOSS CALCULATIONS:
BTU/Hr.
Walls .............. 7,000
Glazing ............. 11,000
Doors .............. 900
Ceilings/Roof .......... 1,120
Floor ........... 2,100
Infiltration (Factor = .027) 17,000
Total
October 4, 1983
Greenport Housing Alliance,
18 South Street
Greenport, L. I.
New York - 11944
I~lc.
Re: Flint Street Renovation - Greenport
8ou~ sing Alliance.
Project consists of the renovation 6f~'two'~f.2~),~houses
relocated from Corwin Street to ~he corner Sf.~th Street and
Flint Street.
The houses are basically in/good structural condition, but
otherwise need a complete ~rehabilitafion to make them
livable. Originally, the plan wa's to convert both houses
into two family units, but a detailed inspection indicates
that House ~ 2 shou~d~x~ain a single family, 3 bedroom, and
that House ~F 1 be ~n~(~a%~d as a.combination, two two-bedroom
units (one up andyne down).'
In order to keep'~'cpsts to a minimum, the Housing All'ance
plans on accomplishing as much work on a self help basis as
practical.~., The.~wor~.~d.~9~s ~to be. accomplished include the
Bouse ~!:
Replace deteriorated sill members.
Repl'ace~'"~fl
Repair chimney.
Replace exterior trim,
Replace broken and missing asbestos shingles to matc~
existing.
Install storm windows (combinationL0
Hook up water, electrical and sewer (Village Systems)r
Construct a new entrance with door for both floors.
1
Greenport ~ousing Alliance,
October 4, 1983
Inc.
Modify interiors to provide a living room, kitchen,
bath, and two bedrooms on each floor.
Remove interior plaster walls (self help).
Rewire and install new electrical service.
Insulate walls, floors, and second floor ceiling (self
help).
Install new dry wall (self help).
Install new oil fired H. W. boiler and uel tank.
(Reuse existing radiators if poss~ible.) System to
be zoned for each occupant, t~
Install oil fired H. W. heater.
Replace plumbing where required..
Install new kitchens in' total including window
replacement. ~ ~/
Replace bathroom fixtures, and install exhaust fans.
Install new floor '~'~erlayment~%throughout.
Install tile ~flooring in kitchens and bathrooms (carpet
to be used in other rooms - supplied by occupant).
Spackle~ ,wa!ls &nd~ceilings.
Ext~ef.{or trim painting.
Interior Painti~'ng (self help).
Install glazed hardboard on kitchen and bathroom walls.
~4alk, an~ driveways.
Landscaping (self help).
Estimate for Renovation of House ~ 1 .... $47,50~.0~
Greenport Housing Alliance, Inc.
October 4, 1983
~ouse,,~ ~
Replace roof.
Repair chimney.
~ook up water, electrical, and sewer (Village systems).
Replace exterior trim.
Install gutters and downspouts.
Replace exterior siding.
Install storm windows (combination),
Install new entrance doors ~/~storms.
Replace kitchen floo . ,
Remove interior dry w~lls (sel'f help).
Insulate walls, floors, and Second floor ceiling (self
help). ......
Rewire and install new~,electri~al service.
Install new dry wall (~e~f help).
Install,~,new oil,fired'H. [4. boiler and fuel tank.
/?:~ExiB'ting~, radia~{or~ to be refurbished and reused,
Install oil fired H. W. heater,
Replace plumbing where required.
instal'l~,~ kitchen in total including new relocated
wi~ao~s.
Replace bathroom
and dryer.
fixtures and make provision for washer
Install exhaust fan.
Install new floor underlayment throughout.
Install tile flooring in kitchen and bathroom. (Carpet
to be used in other rooms - supplied by occupant.)
Install glazed hardboard on bathroom and walls.
Spackle walls and ceilings.
3
Greenport Housing Alliance, Inc.
October 4, 1983
Exterior trim painting.
Interior painting (self help).
Landscaping, walks, and driveway
(self help).
Estimate for Renovation of House F~ 2 ....
Total for Renovation ............ $83,90~.0~
A. E. Fee including preparation of
Plans and Specifications for
Contractual Accomplishment- 6~ $ 5,~0.~
Contract Inspection at $4~.00/Hour (Est.)'
Total Project Estimate - -J- .... ~89,900.0~
NOTE }} 1 - Renovation work Will bring
buildings
into
full
compliance with all codes including New York
State Building and Energy Codes.
NOTE ~ 2 - Water h~0k~'~"by
Village
of
Greenport.
NOTE }~ 3 Connections to Municipal Sewer by Southold Town
Community Development Funds.
NOTE F~ 4 -.Elec~ri~l~.,~e~vi~e by contract included in the
?~ ~,aboPe estimat~ '
Respectfully submitted,
PECONfC ASSOCIATES, INC.
MEW/iw
Merlon E.
President
Wiggin, PH.D.,M.E.
4
Examined..~. ?..c~...~...~..., 19~.~..
Approved'i 5 ~.~.~.~....~.
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-180:a
.., 19}.~. Permit No. l 4~.."J.~..~ ..~
Received .......... ,19...
Disapproved a/c ...................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date .~? .P.~.°..6.: ......... 19~.
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 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 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 Occup~y
shall have been granted by the Building Inspector
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Buildi.ng 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 regul_atic~?_, and to
admit authorized inspectors on premises and in building for necessary~)ge~ons.
· ..................
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises Chri~l;X:a~ Mo ]3inizZo
~r~~ f,/'~~ (as on the tax roll or latest deed)
If applicant is a corporation, signatur~e o~ duly authorized officer.
~.homas R. Watkins~
(Name and title of corporate officer)
Builder's License No ..........................
Plumber's License No ...................... r..
Electrician's License No .......................
Other Trade's License No ...................... - '
1. Location and on which proposed work will be done.. ~ az ach,~d
House Number Street Hamlet
County Tax Map No. 1000 Section Oq-$ Block O~ Lot .... 98
Subdivision ..................................... Filed Map No ........... ' Lot ...............
(Name)
2. Slate existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy Unoccupi~,d subs'candard housing u~it : '
b Intended u~e ~,4 ........... R~,z~ova'P,d uni-¢~ for occupaucx ( t~t- ,
~ ~ ................. ' ..................... ,..v.'.:~..O-::::~.~]./ ..........
3. Nature of work (qheck which applicable): New Building .......... Addition .
Repair ' Removal Demolition
...... Alteration ..........
. Other Work ...............
, (Descriptioni
$58~000.00 '
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 .I~.,.A....., /
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .R. 5'.a;L.d.q~9 .~ ....... :. '.
;~ 7 Dimensions of existing structure~ if any: Front Rear.. - ,, Depth
Height ............... Number of Stories .... 2. .................................................
Dim6 io of ith It raft dditi F nt
ns ns same structure w a e ons or a ons: re ..... , ................
Depth Hight N r of St ri
, .. ................... ~.. e ..................... umbe o es...% .............. ,.
8 ! Dimensions of entire new construction: Front Rear Depth '
Height ............... Number of Stories . .2,.. i ...............................................
*,9. Size of lot:Front ........... : .......~... Rear ................ ' .....Depth ..,
10. Date of Purchase. d.o. nat ipio,. ............... . . Name -,ne Fnrm~-___~, ,-,w,,~,r~ .... .W'a~t...,..w'n(:l i .~l~p.' .~<....~.o.'m.' p.' .a.~ '.
11. Zone or use district in which premises are situated. ¢9.a5. ,~. ~.n.t.5.a. 1. ........................ . ............
IZ Debs proposed construction violate any zoning law, ordinance or regulation: ...............................
13. Willlotberegraded ..~'~ .... ............ ' Wille,,ces~fil,,- ....... ~ ....... . ~ -,
· .. . ,, x eve tro prmmses. ~ r~o
14. Name of Owner of premises~.~'.,i'~-J~l~t.. ,Hp.u.~.~.¢~. Address~.~.' ~.ou'~ ~,
Name of ArchitectlV?,z~9~.~.:L~-~,n-ns a,t,~,~--Mazn ~d.. oou~ho%~l;,. ,. 765-'2'g69
........................ ,.~...~Sa ........... 0 ....... FIlOne rio ................
N,'nne ofContractor~o~d, ~hO;c~.. ~;cg.a. Ma.~..nr~ Aclctr~ssEas'b Ma~ion, ~ Ph,,,,~ la,, /4~7-2525
K~nn~lly Brothers Movers $outhampton~
, ' PLOT DIAGRAM '
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-babk dimensions from
property lines. Give street, and block number or description according to deed, and show street names and indicate whether
interior or corner lot. ., .... : . ·
o~ a~ach~ s~t~ an
* So~ attache(
dim nsmons
COUNTY OF .~ig-f-4[ .... ; ~"~'
.,. :. ~-.~. ? ,. beiilg .duly sworn, deposes and says that he is the applicant
[marne et lnOlVl(lUal slgmng contract) 'J:rlOm~ .k(. W~ICL~2$ ~ ' ,
above named. ' ' ' ' ~ '~ "
He is the ~.:~iip. rl.~ q~e~.pqr.'~ ,Hp, q@$.n~, Alliance. ~' Inc. ' ' '
.(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
a l~ation; that all statements conta ned in this a lication re tr ' ' ·
,~P[!i ..... . .... ~ _ PP a ue to the best of hm knowledge and behef, and that the
w0rg ~! .p.?, penormea. ~n the manner set forth in the application filed therewith. , ' .
Sworn to bet'O[~. ~e thru . i . .
............ ..... dayo,!
' , li~ ~,~'. mr~h ~, t~ ' (S~gnature of apphcant)
FORM NO, 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined ................. 19...
Received .......... ,19...
Approved ................ ,19... Permit No ............
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
.................. , 19.
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 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 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 Buildi,ng 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 regul_atio_n!, and to
admit authorized inspectors on premises and in building for necessary~~s,~
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
N ~ ~ . Christina N.D.~nizio .
owner or premises .... ~ ......... - ...................
~ ~x~,x.~ ~), ~V,~3~ (as on the tax roll or latest deed)
If applicant is a corporation, signatur, e o~ duly authorized officer.
_Thomas R. Watkins, ~r^sid.~nt
(Name and title of corporate officer)
Builder's License No ..........................
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
· Pli 9..rs ~.ep 9r.%.
1. Location of land on which proposed work will be done. n~ S%P~-~% ~..
S~,~: at-~ac~h~d map
House Number Street Hamlet
County Tax Map No. 1000 Section .Q..&~8 .............. Block 0..2 ............. Lot...95 ..............
~bdivision ..................................... Filed Map No. . ............. Lot ...............
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
Existing use and occupancy Unocc. upi~d substandard housing uni~
b. Intended use and occupancy Rqn. 9¥~.'~.~.ql. Rn.~q~. ¢?.q~;~. 99.o.q~gggy,, ..~. ~.) ...............
3, Nature of work (check which applicable): New Building .......... Addition .......... Alteration ...,.. ......
Repair .... ~ .......... Removal ......... , ......Demolition .............. Other Work .R. ~. .1.o .e .a?. ~ o. '.a ,o~
~ , : .. two housing units (Description)
4. Estimated Cost j~5.a.,0OQ,90 .................. Fee ......................................
r ' (to be paid on filing this application)
5. If dwelling, number of dwelling Units ....... ~ ...... Number et; dwelling units on each floor ..... .1 ..........
If garage, number of cars .~,/& i ........ ~ ................................ ; ...................... · .......
~i d fly r,~s ~.cl~nc ~ ·
6, If business, commer al or mixe occupancy, spec nature and extent of each type of use . ;1;....;..., ..........
7 Dimensions of existing structureS, ifany: Front Rear ' Depth
Height Number of Stories 2
Dimensions of same structure with alterations or additions: Front Rear
Depth .: ................... ,., Height ...................... Number of Stories,., ~, .................
,~ 8, Dimensions of entire new construction: Front ..... 2' '" ..... Rear ........... '. ,., Depth ..... , ,. ......
Height ,' .............. Number of Stories .....................................................
.~ 9. Size of lot: Front ........... ........... Rear ...................... Depth ,.. ..................
10. Date of Purchase , .d.o.~a, ,~.,ip~. ................. Name of Fenner Owner ~a.a, .~, .~,.n.~,..S.up~'..~.o.m.t~a..riX.,.
11 Zone or use district ~n which premises are s~tuated
q 2. D.?s proposed construct.ion violate any zoning law, ordinance or regulation: ..............................
13, Will lot be regraded .. ,t.%a. ,.., ................... Will excess fill be re~oved from premises:
14; Name of Owner of premises~5$1~8,~, gp,u. q5,~.~6, Addressl. q ,S. ,olaie.h...S?....q .~.9'?Phone No, ./??, -, ...... .0,..N.o,
N.'une of Architect }1~2~] on..t¢iga£aa .......... Addressaq¢.n.. .d.o... .o.u. gg. .ctPhone No .....
Name of Cent actor ~q~r.~ S~or Excavat~n ~ast Mar~.on
, r ~.. ...... ~.. · ......,~Address .. ............ , .... Phone No..¢.77.-?.5.2.~ .....
K~nn~lly Brothers Mov~r.s. $ou'~harapton,~ 285-2820
PLOT DIAGRAM ~ "
Locate clearly and distinctly all Jbufldings, 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.
S~. a~ach~d si~ plan ~ '
* S~-. at-~ach~d dlm~nsions
STATE OF NEW~'-'I~, .~d %,, '
cou rr¥ oF .... ?"
(Name o~individum signing contract) ~ omas R. Watk~ns ~ , '
above named.
He is the ?r~sid~n~ Gr~npor~' Housing Alliane~ ~ Inc. - ~
(Contractor, agent, corporate officer, etc,)
,of said owner or owne~, ~d is duly authorized to perfo~ or have perfo~ed the said work and to m~e and file
application; that all statements contained ~ this application are true to the best of his ~owledge and belief; and that the
work will be perfo~ed in the m~ner set forth in the application filed therewith,
Sworn to before me this
Nota~ [ublic, .... ,., .~. ·, ~,: .~ ...... ounW ~ ~
. T~m Expires March ~, I . _.___ _(Sianaturo of annlican~/~....