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HomeMy WebLinkAbout12560-zFORM NO. 4 TOWN OF SOUTHOED BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ...... ~fl ~.~.7© ..... Date ......... .~.uKu. ~..~..~.~. ............. 19 .~.~. THIS CERTIFIES that tl~e building ......... ~..e.w..D.w..e.l.lj:.n..~ ......................... Location of Property 655 ff. Birch Rd. Southold House No. ' Street Hamlet County Tax Map No. ] 000 SectiOn ;"....0.5.9. ..... Block ..... .0.2. .......Lot 0 0 8 Subdivision ........ .X ...... !.. ~.., .......... Fried Map No....~. .... Lot No .... ~. ........ conforms substantially to the Ap~ication for Building Permit heretofore filed in this office dated ....... .~.u.c. tu..s.~...1..1.., 19.8..3pursuant to which Building Permit No....1.2.5.6..0.g ............ dated ...S.e.p.¥.e.ra.b.e.r...2., ............ 19.8.3., 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 ......... .... New Private One Family Dwelling .... .- The certificate is issued to KEARNEY, MARIE (owner, of the aforesaid building. Suffolk County Department of Health Approval 13-SO-74 N64982.9 UNDERWRITERS CERTIFICATE NO ................................................. Building Inspector Rev, 1/81 1~0~ ~0. 2 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? 12550 Z Permission is hereby granted to: ........ ..........· ....... ~ .~(...... ~z..~.....~ ...................... ........ Z~.~../,/.,~..../-~o=.~.....~ ..~.//~--~7 ~o ..... ..~..~.z~.~.......~.~.~.....~.... .~.~.~..~.......~.~.~/.../z~.q ..... ~ I ............. ...~.~.~...~.~z/....~~. ........... Z:Z. .,~.~z~.,,~z./~ .................. at premises located at ..../.~.~.~.~.(~. ........... ~..~..f~.~..~'.~..VZ~.......~..~.~A~.. ............................ ............... ~.....~.~.~'7~./....~., ................................. ~ ........... ~.o.z~..~..:.~=~ County Tax Map No. 1000 Section ....~,.~ ..... Block ..,~,,,,,~,,, ......... Lot No. ~, .~., ........... approved by the Building Inspector. 7° Fee $.../..: ....... ~.~... 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 Certii icate OI Occupancy No ...... TZ12630 THIS CERTIFIES that the building new dwelling 655 Birch Rd. Southold Location of Property ............................................................... House No. Street Hamlet County Tax Map No. 1000 Section .... 0.5. 9, ..... Block 2 .... Lot 8 Subdivision ........ x ..... Filed Map No. x .... Lot No. x conforms substantially to the Application for Building Permit heretofore filed in this office dated August 11 198..3 hi hB ildi gP rmit No 12560z ................. , pursuant tow c u n e dated ............. · ·.... · · · .. · · ..S e p t e m b e r 2 198. 3.., 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 dwelling. The certificate is issued to MARIE KEARNEY {owner, levee or-te'n'ant~ ' of the aforesaid building. Suffolk County Department of Health Approval 13- S O- 74 N649829 UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev, 'I/81 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions Bo This application must be filled in typewriter OR ink, and submitted ia II~ 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 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. 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 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 informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 $15.00 Date .......................... Owner or Owners of Property ..... h~... '~..~. ~. .............................. County Tax Map No. 1000 Section .... :-~. ,~.? ..... Block ..... ,~.~. ...... Lot... d~, ~ ...... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No.. ~,:~/.~ ~).. Date of Permit . plicant ..................... Health Dept. Approval [,~ -~(~ - ~ Labor Dept. Approval t~ ~ ~ d App Unde~riters Approval ....................... Planning Boar royal ...................... Reque~ for Temporary C~ificate ..................... Final Certificate ...... ~ .............. Feo Submitted $ ............... Construction on above described bu ilding and permit meets all ~oli~le codes and regulations. C'O "~-~ ~0'-/~ 0 A ,'cant .~,,, . ~.~, / ppi ..... ~', ' ..... ~.~ .............. ¢.~ ................. FIELD IN~PEC%~ON COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C~.~O D E FINAL ADDITIONAL COMMENTS TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 May 16, 1985 TEL. 765-1802 Mr. Garard Kearney 166 Yale Street Roslyn Heights, NY 11577 Dear Mr, Kearney: Please be advised that your Bu.ilding Permit 12560Z and Tem- porary Certificate of Occupancy TZ 12630 hav.e been extended to September 2, 1985. After that date, the life of the permit~and Temporary C.O..will expire and a new permit will be necessary. If this is the case a new building permit application and fee will be required. We look forward,to hearing from you before September 2. Yours {ruly Vic~o~ iLessard ~ ExeCutive Administrator VL:ec April 29,1985 Kearney Permit# 12560Z Building Department Town of Southold Southold, New York Gentlemen: Due to financial difficulty~ I am unable to complete our home within the prescribed time limit. Therefore, I request my present Certificate of Occupancy be extened for a short period of time. Thank you for your understanding. FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ~utho~d, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitte~v.~ic=tc 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 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 o~ 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 topograph ic 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. 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 New Building ..... ~ ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ............... : .................. .~ ................... House No. Street Ham/et Owner or Owners of Property ......................................... County Tax Map No. 1000 Section ., g9 ~-c~ Block .~.~. Lot .<~. Subd~wsmn ................................. Filed Map No ........... Lot No. PermitNo. [~ ~ Date of Permit ....... Applicant ~'~~ . Health Dept. Approval .... l~ .-~'~. ~ ......... Labor Dept. Approval ........................ Unde~riters Approval... ~ ~.~.~ ~ ......... Planning Board Approval ...................... Request for Temporary Certificate .... ~. .............. Final Certificate ....................... Fee Submitted $...ErO.~. ¢..~,~ ...... Construction ~n above described building and permit meets all applicable~odes and regulations, C o. i ao X,,. _' _ ' ~ I Applicant ........... ~%~.k.~~ ............. SPEC]~Fi[CATIONS AN0 TNFOR~ATION ICE: NI~IW 1.~. f~TORY Rh]SID~]NCE FOR MARIE KEAJ~NEY 6.5.5 BIRCH ROAD SOUTtIOLD~ NEW YORK THE DRAWiNgS DATED AUGUSTi~I, ~-1 SITE PLAN, BECT~(N, PLFMBtNG' A-2 FLOOR PLANS, FOUNDATION OWNER/[]U I L'0 ~J~ KEARN'I,',Y ~46 VALE STR1,]Ff.i' TQOSL~N ili'f, tGItTS, 516 621-2962 NI£W YORK 2 lt. 6 F, xc avation: A [~ull J3asement ,,>ectlon Excavate frou exmstzng grade to a level point below exmstzng grade. Ba~kf~T1 will raise2or~%a~,~l grade to a ~oint ~8" below :top of fo~n~at~.On B Crawl Space'Section - , - : ocratch a trench to a point 18 b~ow exLsti2g~.: graaeo Back- f~ll w~ll ra~so ,grade tO a p~int above old grade and provid~ for frostline regulation. ~ oogn.ng~. A Shall be of poured concrete, 3000~FC-Transzt,~ ~lze. 16" 8" deep. Set wi~h bottom of sol~d undisturbed earth. Use side :Terms off'all ,footingS'.' prey:;de 2" x 4" key for all walls. Depth, to. 3'0' below frost line and finished grade.. Foundations: A Shall be poured concrete 30 00// FC Tr'ansit ~mix sizes and thickness shown 0n drawings. Install,, anchor bolts at all corners ~nd ohanges in :direction:?, side of doors. , ,, .... Slabs: AFull basement sec¢ion shall l~ave a slab 4'~ thi6k~ top of gravel base with 5 ~il thick plastic; BCrawl space shall havo a 2~' screed coat with thick plastic. Waterproofing: A Foundation walls and footing~ to bo waterproofed, The oxCerior walls to b0 c6a~od with troweT'"applie b~tum~nou mastic (Karnak or ~qual) A Guaranteod soi.1 poisoning treatmentI for t0rmite control to be ~erformed by~a~ approved pest control contractor. I III IV pL UMB.~}~f G,./HEAT ING '~ . ,. Alt work will conform with ~1~ applicable 'loca%~i,/'}!; state rules and regulations., ~ ~ Pipe s~zes and material as shown'in plans. 'SepgiC,:;'. :, ~ystem and ~ater oupply as mndmcg~ed pn Board oF,., Health approval, ' 1 B Heating '~ ' "~ ' ' ' There are no present plans ~o~ heatln~ the hous~ .~,"~ as it ms to be used as a summer, ~ resmd~nce 'only,~?,,.,,/: ,,./, , ' ' ' ' : 1 ELECTRICAL ~ . . A All work ~o be pe~fformed b~ l~cen~ed elecSm~ci~ Regu&ations of National Electric Cods, Board 'Of. Fire'. Underwriters shall be complied with ~nd all l'oq]~" and state codes. ' B All work as indicated on plates. .... A tll work shall co~form with th,~ New g~rk' Sb~ge,lf: gonstruction Code and ,Cods ~anlUal Rec~mmendati'6n~ for Wood Framing and all local codes, ,, ,,,, ;, B gross bridging shall be spac'ed' on '8' centers, &~d~ shall be 2" nominal wood blotk~ng of same 'slze,~':l(/: 1, joists and rafters. ' ~ , ; '. Jpists shall be set crown side~'up, leveled nailed to supporting lintels ahd plates, doub~ed"l'..~. under supoorting walls, stairs~ tubs an~ as needed~~, Sizes as indicated In plans.' ' All sills resting on masonry s~all be set in Portlan~d~ cement mortar. All sills shall be CCA treatedtfir yellow pine, and shall be Set On concrete foundation wall with Owens Corning Fiber 'Glass "Sill Seale~" 1" x 6" insulation between fbundation,~sills. AlS sills shall be 2" x 6" and shall be Shimmed~level,~~ When floor beams are placed and leveled the sills shk~,~ have Portland cement mortar applied from both faces to completely fill the voids b~tween Sill and top,df" foundation wall. Sill seale~ ~hall b9 packed tight:ly, ~o provide space for mortar,. , ~ E Sheathing shhll be ~" CDX on W~lls and roof. Finished exterior wall shall be "Text~r~ ]-1]" grooved paneling. ,C , D V VI ~O0.FING Shall be 225~~' asphalt Ail £1aohmng shall be 5" aluminum gutters and dow~nspouts. INSULATION .' Walls: 3-~~,, fo~l faced fiberglass. Floors: 6{~' foil faced £iberglas5 (su ported grid wire)° 2" rigid insula,t, ion.,a, ro~.u~nd b~se~en.t and c~aw~ space..:, a~. ~...~, :. Insulation to be "packed" at all door~ Wmndow ~mame~.'{~. ~ aluminum O~acceptable FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ .... .../..~'....F~..~...~7.~.. ........... PLEASE TAKE NOTICE that your application dated ..... ~ .............. for permit to construct... Location of Property County Tax Map No. 1000 Section ...O.~.. .... Block .. ~. O~. ....... Lot . .(J(~. ~.. ...... Subdivision ........ ~. ........ Filed Map No. - -- . ..... Lot No. " ' ... is returned herewith and disapproved on the following grounds. ~,//.~..~.(..~.. ~. gS.~/~. ~.. ..... · .~o.~ ~/x--.~.~... ~,.7-~... w~t~ ~r.,-e. ~o. xo... ~.,,:~....' .o. ~.7 ............ ...z~.oaO.~f~7,v.~..~ ....... zs~..~.,..~././.~.~.z~. .... : ./x..~Z....o. ?. ..... ....... 0~...&,f~x~./..~. ......................... .~.~~~~/..? ...... :~,..! ................ RV 1/80 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST /~] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING FINAL REMARKS: / DATE ..~ / ? //INSPE OR 0 'T r,,IA.P OF Pi2OPEI~T'Y' FOIL SUI-LVEYED h'lA[ t E ¥ 0 STATEMENT THE WATER SUPPLY AN SYSTEMS FOR THIS CONFORM TO THE ~'S" SUFFOLK CO. DEPT, IS) APPLICANT SUFFOLK SERVICES -- FOR CONSTRUCTION ONLY DATE: SUFFO~.K CO. TAX M, DIST. SECT. OWNERS ADDRESS: ~OS, L~N- DEED: L.30~I '- "~EST HOLE TQPSOtL :.SANDY: ~AVEL FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ,pp oved ..... . Disapproved a/c ........................... ~ / APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ..... ~'//./, 19 .~ Date ........... , a. This application must be completely f'di~d in by typewriter or in ink and submitted to the Building Lnspector, 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, ~lationship to adjoining premises or public streets or areas, and living a detailed description of layout of property must be drawn on the dissram which is part of this appli- cation. ' .. c. The work covered by this application may not be commenced before issuance of Buildin$ Permit. d. Upon approval of this application, the Bulldin~ 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 ~ranted by the Building Inspector. APPLICATION IS HEREBY MADE to the Buildin~ DePartment for the issusnce 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 a~r~s to comply with all applicable laws, ordinances, build'.m.g code, honsing~ode,, and regu.la., tio_~ns, and to admit authorized inspectors on premises and in building for necessary inspections~/~ ~ '" i~i~[t~r~'~f applicant, O''~ "~ ~l~e', ~i ~ ~'r~la~io'~) .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .................................................... /(as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. , (Ka~n,' e and title of corporate officer) Builder's License No ..... ~.'~-.. ( ~ ............. Plumber's License N~....~.o.. Electrician's License No. (l tt ~" Other Trade's License No ................ ; ..... 1. Location of land on which proposed work will be done .................................................. ..... , ./ House Number [00'~0 6' '~,''o~t~'~ir~;i .... :' '' Hamlet CountyTax Map No. 1000 Section ...~?. ........... Block .O-- .............. Lot..~.. ..... ~ '. Subdivision ........... ~(. ........................ Filed Map No .... .X'. ......... Lot .... (Name) 2. State existing use and occupancy of premises and intended use and occupancy o1' proposed construction: a. Existing use and occupancy .......................................................... , ....... blnt dd · ene use and occupancy ................................... 3. Nature of work (check which applicable): New Building .. Y.. ..... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost ..................................... Fee ........................... (to be paid on/'ding this application) 5. If dwelling, number of dwelling units ..... ~../J~ ...... Number of dwelling units on each floor ................ If garage, number of cars ...... ~ ~)~. .......................................................... 6. If business, commercial or mixed occupancy, specify. !l~ture and extent of each type of use . .. ~./~ ............ 7. Dimensions of existing structures, if any: Front. Y~//~ ......... Rear .............. Depth., .... ' ........ Height ............... Number of Stories .... ' ..................... - .............................. Dimensions of same structure with alterations or additions: Front '..Jd/~. ............ Rear ................. Depth ...................... .Height ......... ? ............ Numbe~'~of Stofles ........... .. ~ ......... 8. Dimensions of entire new construction: Front ~- . Rear . ~ Denth . Height .. ,-.~. ...... Number of Stofies .... ./.'-./~ ....... ~ ....... ~ ............................ Size of lot: Front ./~,.~..g ............ ~.. Rear .... 7..~. ?'.~. ............ I)~epth ./.~.d:.7.z/..'~.../.3.~: .~.~.. i ' Date of Purchase ....... .7/../~. ............... ,~I~ame 9fFo,n~. er. Owner ~..d.~ ..... ~.~...~. .... ~ ....... Zone or use district in which premises are ~ituated... (~g~ C~. e..~.~ .~./...~...'~.. ~.~. ~. ~ .C.~/.Z'. ¥'.~..~./. ....... Does proposed construction violate any zoning law, ordinance or regulation: .. ~...o ......................... Will lot be regraded ....... ~.~.~... ,., ........,.... .... Will exc ,e~.fjll be removed from premises: ~ . No Name of Owner of p. remiseE./f/2[~. _J~/~q, ~.~...g.~... Address /'~.~./..~..~.~'. ........ Phone No.J'./~.: .~.~'-,-,-,-,-,-,-~/.~.~.~. 8. ~.. ......... ~ .... /c~.~ ........... ~ ..................................................... Name of Contractor .......................... Address ................... Phone No ................ 10. II. 13. 14. PLOT DIAGRAM ' Locate clearly and distinctly all buildings, whether existing ~)r 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 coroer lot. STATE OF NEW,'Y~K, . COUNTY OF'~d'~2i"d-'~('~';-'- ~/.¢~,~.~ ,t~e~'° ~ . (Name of individual signing contract) above named. He is the ..................................................................... (Contractor, agent, corporate officer, etc.)' of said owner or owners, and is duly anthor/zed to perform or have perfoirned ~the .~id work and to make and fde 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~erformed in the manner set forth in the application filed therewith. Sworn to before me this THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY~ ~b ss JO.N S'rREET, nEW YORK, NEW ~0"~ ~OO~ .-,~u~ ~, ~4 ~--"~-.~,-~.o-~"~zo3~-e4 N649829 THIS CERTIFIES THAT ~. Kearney~ ?/~':/C Birch F,t., was exa.~ined on J~ ] 8 ~ ~ ~ attd found to be in compliagce w~th the requirements of this Board. FIXTURE FIXTURES RANGES OUTLETS 2! 37 18 21 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS OVENS DISH WASHERS EXHAUST FANS T!ME ~LOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: S E R ',V I C NO, OFpE~C,~COND./ A, W, G. NO. OF HI-LEG A, W, G, NO, OF NEUTRALS A L G. Kearney, ]46 Yale ,,treetp ROS lyn, Heights, N.Y., 11577 This certificate must not be altered in any manner; return to the office of may be identified by ~l ANY MANNER. ~ ~ /~ ~ STATEMENT ~ INTEN~ ~. ~ ~ /? SUFFOLK CO. DEPT. OF ,' .'~" ~/~ ~FOL K COUNTY DEPT OF' HEALTH: : , 1~ .-'/' SERVICES -- FOR APPROVAL JUL 10 ~ ~. ~. ~. ~ ~r~.~. ~ 'sE~ t facilities' for this loca%io~ have bee~ ' :% /' / AN~ SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. 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. APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY DATE: H. S. REF. NO.: APPROVED: SUFFO~, K CO. TAX MAP DESi~]4CATtON: DIST. $~CT. Bt,,,J:X:K PCL: ..... S' ; ADDRESS.: L~ ~WY~K ¥ 0 EXC, AVATIm ~EC~ ~ // \/ V~ U~ NEW ~K SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. 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 DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY DATE: H. S. REF. NO,: TOPSOIL SEAL, / SECTION A- A copper tubing is used [or water distributing sys em~ piping shall he ,.~ ty~eS K or L on~ G O.C, EL NON U, MENT O, ]~RDN PIPE Loi- A~e~ Looo, tion si6e Y~,-d Sec USE IS UNLAWFUL Wl'[' f tJT CERTifiCATE OF OCCUPANCY APPROVED AS NOTED FOLLOWING INSPECTIONS: ~IINDATION ' TWO, REQUIRED h ~ pOURED CONCRETE 2, ROUGH - FRAMING & pLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE coMPLETE FOR C, O, ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N, Y, STATE CONSTAUCTION & ENERGY CODES. NOT RESPONSIBLE FO~ DESIGN OA CONSTRUCTION EAEOA5, esi dcnce /' IqE. ARN E¥ A-I sh~ 7 OPE~ o oi F__TRSTFLOOR PLAN ~" c-o:,_. ~2 'o" 2'o Y, 8" 2'0" N L our e~edWigr ' -'" $c reed',. o :, T'-' ' ~:' ,¸1] F~NDAT/ON PLA?4 Y,i':,!.Zo... FLOOR 5 'tO" t r J