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Home My WebLink About12128-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall $outhold, N.Y. Certificate Of Occupancy No. ~1196~. ......... Date ...... .O9.~.q¥~.~. ~. ................ 198.5. THIS CERTIFIES that the building. 3]E~. ~.~G ................................ Location of Property .. J 205.01.e.. J~t~.a .~Ra ......... ~E~t~; ~.h.~Q3; ......... House Ho. Street ..... I~l~t~l'e't County Tax Map No. 1000 Section . ...fl ~. ..... Block .... ~)5. ........ Lot .... 3.-.O.Q~L. . .i - Subdivision ~[vIi~o~c..JO[m..~i~a~CiC~ ........ Filed Map No ......... Lot No ..... 'l ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated .... ff..a]2~a~y..~ 0 ...... ,19.83 pursuant to which Building Permit No.. J ~2,~$ ............. dated Jarmary 25 19 83 was issued, and conforms to all of the requirements of thc applicable provisions of the law. The occupancy for which this certificate is issued is ......... · .. P..or. a..new..one. £.amiliT..d~eZliz~g .......................................... The certificate is issued to ... JO~ EZ~'IICIC~ ........................................ (owner, lessee or tenant) of the aforesaid building· Suffolk County Department of Health Approval ~ 2-~o-fl ~ N616597 UNDERWRITERS CERTIFICATE NO .......................... . ........................ Rev. 1/81 Building Inspector BUlL IH( PEPLJ~,I' ~ (THIS PERMiT, MUST BE KEPT ON ;THE PE, E~I~ES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ' ~ : ~12128 ':oat, .:..~,.. peT~mission,: is hereby gronted~/~/y/~E~ .2;;;, 19....~, and ~pproved by the / FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 1197! APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. 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: I. 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 idisposal-(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. B. 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 safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 ~ 5-/$ 2. Certificate of occupancy on pre-existing dwelling land use ~! 5.00 3. Copy of certificate of occupancy $1.00 Date .. ~.e.~..e.m.'q.e..~..2.~,.. ~2.~.3. New Building .. Y.(~ ....... Old or Pre-existing Building ............ Vacant Land .......... Location of Property [~.0,~ .0~.e, .~-.~..T~..~.,..~.~.~..~.~.C,~. ............................... House No. Street Hamlet John S. imi ci ch Owner or Owners of Property ........................................................... County Tax Map No. 1000 Section 122 Block 05 . Lot 003.004 Subdivision ................................. Filed Map No.. ......... Lot No .............. Permit No...~.~.~.2.~.~.. Date of Permit .~..2.Z'.~.2....Applicant . .~P.~.~.. ~.~.m~.'.c.~..c.~. ................ Health Dept. Approval ...~.~ .................. Labor Dept. Approval ........................ Underwriters Approval...~ .e .~ ................. P an ning Board Approva~ .... .~.e. ~. .............. Request for Temporary Certificate ..................... Final Certificate . .]~,~. g ............ Fee Submitted $ ............................. Construction on above described building an~ pe~rmit m~ts all applicab!e ~od/e.s and regulations. Applicant ~..~..~{~/~.z..~.'-; .~' .~.. ...................... Rev. 10-I0-78 looooql THE NEW YORK BOARD OF FIRE UNDERWRITERS 'Y~ BUREAU OF ELECTRI~t~,,'iY ~- 85 JOHN STREET NEW YORK, Nr~W ~ORK 10038 THIS CERTIFIES THAT only the electrical equipme~t ~ described below and introduced by the appl~an~ ~ed on t~ a~ application ~un~ber t~ tl~ premises of J. S~cich, ole Julela~ S/Of N~; S~fo~ Ave,, ~.~ti~, N.Y~ in the following IocatiotH ~ Basement ~ 1st FL ~ 2nd FL Secrion Block Lot was examined on &~ ~ , ~,9~ and found to be in co,npli~nce with the requirements of this Board. FIXTURE FIXTURES OVENS DISH WASHERS EXHAUST FA~S OUTLETS SWITCHES DRYERS OTHER APPARATUS: Motors: 2-F. Panelboards: I- 24cir. i~G.F.I. 1-~moke Detector 200amps ~ s E R ~, tv ~ 3/O C O~ HI-LEG OF NEUTRAL 3/0 Peter BoDovic Ma~ Rd. $outhold, N.Y., 11971 This certificate must not be altered in any manner; return to the office J DEPARTMEN~T. THIS i Board !f IN ANY'MANNER. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: INSPECTOR COMMENTS FIELD INSPECTIO~ .~ FOUNDATION ROUGH FRAME & PLUMBING (2md) INSULATION PER N, STATE ENERGY C,ODE FINAL TIONA] FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 -"'~ TEL.: 765-1802 Examined/~/: ~ .6~....~.. ...... , 1~ _ Application No..~/~ .' ...... Approve~;~~ ~3~ , 1~ Pe~it No /d/de~ Disappr~'~/;'":"~'-~'}'-:~ ................. ..... 'Y'- ~ ''~..~... (Building Inspector) ~PPklC~TIO~ FO~ ~IkDI~G Date .~Q~ ...... 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 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 in building for necessary inspec, tigns. ~, , / __ . ..... (Signature of applicant, or name, if a corporation) ... ~:~9_~.~..x~....~.~....y (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ... ............................................................................ Name of owner of premises../~.../~..~.....~..~.../~...~....~. ?../.~..x~.. ?.~U..~7...~..~...D.~ ~ .................... (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. 7~.//~.~-. ~. ~.g.' g..~..~..~.~... Plumber's License No..'...~.?-~.'./~././.~.~_~.~.. , , Electrician s License No.. /.~. ~.. Z... Other Trade's License No ...................... 1. Location of land on which proposed work will be done. ~... / .~.q.S. 7 ............................................................................... House Number Street Hamlet County Tax Map No. 1000 Section ..../..~..~. ......... Block .... ~..~. ......... Lot.. ~...o..2...q.q..¢:.. /6 ,' ,~ ~'Ob '/V ,5. /)~ )c ,'c ~ ........................ / Subdivision...u...~. ................... Filed Map No. Lot .... .~. ......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ~J.~.~ O-A~. ........................ b. Intended use and occupancy ..... .(~..~..~..~.~.O~..~BJi ! ~...~O~...L(~.% ................................. 3. Nature of work (check which applicable): New Building ...... Addition .......... Alteration .......... Repair .............. Remoyal .............. Demo' lition .............. Other Work ............... 4. Estimated Cost ..... ~' ..~'~. .................. Fee .......................... i ~ (to be paid on fihng this apphc~ion) 5. If' dwelling, number of dwelling units.. ~.../~. ~ ..... Number of dwelling units on each floor .Q ~ .&. ...... If garage number of cars ... 77. i//O..D ............................................ 6. If business, commercml or mixed occupancy, specify nature and extent of each type of use 7. Dimensions of existing structureS, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... i.. Height ...................... 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 ............................. 1 1. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction wol~te any zoning law, ordinance or regulation: 13. Will lot be regraded ......... ~ .................. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .O-~..%.??). (.~./.e./~.. Address ................... Phone No~?ff. ~. 54'7.~. 6.~... Name of Architect/~tJV77..~&. ~ .~i .o7.-..~.~.. ~ ./.D.... Address .~4 .~.rT'...~'.~.- .~..t74~$'.a.~.. Phone No ................ Name of Contractor~//-~ /~./Sz/T. ~.. ~3~/.~>4/~. Address~t~. Phone No,~ ~.~.'.~;-?.4 .~.. .... ........ E>2'd-'o'&L~- 'Z ~.' ...... 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 ~ umber or description according to deed, and show street names and indicate whether interior or corner lot. STATE~OF NEW YORK COUN~ Y OF .~q.~ ff...~.0/~..~ ...... ~.S (Name of individual signing contract) above named. being duly sworn, deposes and says that he is the applicant (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 apphcatmn; that all statements continued m thxs apphcat~on are true to the best of his knowledge and belief; and that the work will be performed in the manner iset forth in the application filed therewith. Sworn to before me this LINDA lt. NOTARY PUBLIC, Stats of I'lew Yeti? U0.5:2.4524771 :' (SignaturCf applicant) Quarried i~ Suftolk County 11 remission ExI!~ros March SUFFOLK COUNTY IIEALTH DEPART~EN~ OCT 5 198~' se~ disposal and ~a%e~ sup~lF facilities fo~ this location have been ~o~ ~ee ~ ng ,( ii OCCU~HC¥ OR ~f~fi'Ir~'i' A?~D AS NOTED ~ NO~I~ BJILnI~EPART~ NT 765-18~2 9 AM TO 4 PM FOR THE 2. ROUG~ - FRAMING & PLUMBING STATE CONSTRUCTION & ENERGY DESIGN O~ CONSTRUCTION ER~O~5, J 14-'- U" 7~~ _ .4fl SLAB INSULATION Degree Days Min. 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 dawn the foundation wall. FOUNDATI Orl [IALL 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 slabs ~rotective § ovBr insulation 32 Z .RCHI WECT for Water distribulina of types K or L q i ARCH[TECT