HomeMy WebLinkAbout12221-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
'Certificate' Of OccuPancy
No...g.'lJ. 9..59 ......... Date ........ O- 9.~.°?.~..r. ~. .............. 19.83..
THIS CERTIFIES that the building . .~.o.w...Dw..~.~.Z.j:..~ .................................
Location of Property q~ 0or~r C:eeek .Lane Southold
House No. Street Ham/et
County Tax Map No. 1000 Section . .7.~. ........ Block . .../4:. .......... Lot ..... ~..0.' .....
Subdivision..0.o.z:~r..0~.o.o..~..E.8.~..a~.o.~. ........ Filed Map No../4-.9.~.3.-..Lot No....~ .........
conforms substantially to the Application for Building Permit heretofore filed in this office dated
.... ~.~C~-..'% ......... 19 ~33. pursuant to which Building Permit No...q. 2..27~.~. .... ' ........
dated .... ]~a~..ct~. 3.0. .............. 19 $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 .........
..... A .new..one. £amil~..dwelling ............................................
The certificate is issued to CH. APT,E~ .I,AP~RX' .&. ~xl/LhTC~..~..,. Fi.C..0O~%QI~ .................
[owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval ~ 3 8o 3~1 -
UNDERWRITERS CERTIFICATE NO ~700/~ '
Rev. 1181
Building Inspector
BUll
COMPLETION
i12221
-~ei~iss ~n s hereby granted
6t ~rem~ses located at
~ty Tox Mop No. I000 ,Section
nt ~ pi '
~:U~uao ap |cation dot~!. ......... .....; ...... ....:...~ .......... , ~ i..
ctor.
¢ :NO.:'. .......................
.~., and ~approved by the
FORM NO. 6
TOWN OF $OUTHOLD
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 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 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.
C. Fees:
Certificate of occupancy $5.00 d~ 5'/$
1.
Certificate of occupancy on pre-existing dwelling -- land use ~/ 5.00
2.
3. Copy of certificate of occupancy $1,00
Date..~, .c~,, ,~,~,
New Building ...... .~ ..... Old or Pre-existing Building ............ Vacant Land .............
Location of Property ../~. :~.'.~..~0. ~-.~...~. r~. ~:-~.~. ........ ,~& 1~.~ ......... --,~. ~.t..~.~O~..
House No. Street Hamlet
Owner or Owners of Property ~-~, Z.~.~ ~ ~t.~.~.. ~...P~.~.'~'.e~-.~'.~...
County Tax Map No. 1000 Section .... ~..o~.. ..... Block ...~, .......... Lot .... c~.O. .......
-)
Subdivision,..~ (~. ~.,,v., ...~.~. ~.~,/~ .......... Filed Map No..~..~.J~..~.....Lot No..c~.$~ ......
...
Permit No. ~.~..~...~-. ~. Date of Permit -- pplicant . . .~ f..,Y~.. ,/~/~.. ~-->..~.~.~.~.,..~.,~.
Health Dept, Approval ........................ Labor Dept: Approval ........................
Underwriters Approval .... , .................... Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate ........ ,~ ............
Fee Submitted $ .............................
Construction on above described building and per,~t meets all applicable codes and regulations.
Apphcant ...... ~---~, ~[~...Y~... ~'~J-;~¢~ . . . . ... ,' ~'J'~ · .......
Rev, 10-10-78
FIELD IM~PEC~ION
FOUNDATION
(1st)
FOUNDATION
2.
ROUGH FRAME &
PLUMBING
(2nd)
INSULATION PER N. Y.
STATE ENERGY
qODE
FINAL
COMMENTS
ADDITIONAL COMMENT~:
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
Date.. ~.~. ~..... ~/:~. .... , 19..~. ~v..
File No ................................
PLEASE TAKE NOTICE that your application dated... ~~... A ....... , 19 .~
for pemit to construct ...... ~6...~.~.. ~3~: .................. at
Location of Property .,. ~.t...~. ~ .......... , · · · / .........~ ~'-. .........
~ouse mo. / Steer Hamlet
co~tv ~x ~ ~o. ~oo0 s~ctio~ ...~F~. .... ~o~k . .~ ....... ~t . ~.~ .......
S~d,~,o~T~'/~r~il~d"~o ..... ¢~ .... ~o~.o .... ~ ........
.. ~,...~~ ~., ~~7... ~~ ...............
Building Inspector
RV 1/80
7GS-180~
BUILDING DEPT.
INSPECTION
FOUNDATION 2ND [ ] INSULATION
~/..~] FRAMING~ [ ] FINAL
DATE
INSPECTOR
THE NEW YORK BOARD ,OF FiR~ UNDERWRITERS
BUREAU OF EL~=CTRI~IT~
85 JOHN STREET, NEW YORK, NE~V ~ORK 10038
/)ate Se4~tember 19, 1983 ~ppllcatlan No. o, file 2~1169/83
N 617004
THIS CERTIFIES THAT
only the electrical equipment as ~scrlbed be~ and int~duced by t~ applicant ~ on the ab~ application number in the premises of
~ ~ ~, 1135 Corey Cre~ ~ive, ~ld~ N.Y.
Ioc~tion; ~ Base~e,,~ ~st Fl. ~2nd FI. Section Block Lot
the ~ollowing
w~ examined on ~ L~ ~ ~ and found to be in comPllahce with the r~quirements of this Board.
FIXTURE FIXTURES RANGES OVENS D~SHWASHERS EXHAUST SANS
DRYERS
18
FURNACE MOTORS FUTURE APPUANCE FEEDERS
UNIT HEATERS MULTI-OUTLET
SYSTEMS
NO. OF FEET
DIMMERS
SERVICE DISCONNECT
OTHER APPARATUS:
C
NO. OF NEUTRAL~
AWG,
OF NEOTRA[
Larry McCormick
1135 Corey Creek
Southold. N.Y. 11.971
This certificate must not be altered in on' manner; return to the office of the Board if
may be
THE NEW YORK BOARD OF FliR~ UND RWRiTERS
BUREAU OF ELECTRIq)TY,?
~ '~' ~ ' ' 605004
in the follo~,ing location; ~ Basement
wasexaminedon ~ ~ l~
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS MULTI-OUTLET DIMMERS
SYSTEMS
SERVICE S E R ~ YV I C E
OTHER APPARATUS:
This
OF CC COND,
NO, OF HI-LEG
OF HI-LEG OF NEUTRAL
Howard
Laurel, NoY.
ust not be altered in any manner; return to the off[ce of the Bocsrd
,%¸
Approved~..~...c~'...50..,
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1803
Application No...ff2dd./. .......
Disapproved a/c ~..r~~ ...... .~ .....
..... .... ....
......
(Building 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 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 insp~5~tions.
· ...........
(SignatUr annllcatm orname, ill corporation)
Larry McCormick '
R. F. D. Box95
.......... Whale Bone Landing ...............
Souirha~pton, N. Y. 11968 tnt)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
...... .~. tJ~.~..~ ................................................................................
Name of owner of premises .~. ~. .o~r'. /¥~. J**Y:.~.~V. ./'J~. ~,r~.~?~(. . . ~. ~.4~.~.4/. . ~]~, . . . .~. .~. .~. .~.~.~.".~./f ........
Z}// _ , __ , (as onthe tax roll or latest deed)
~.,~.v lao4, '? .(z'/'.¢e,/~.~ ~t/d,. P ~,'~.,~,~, (~s of F~ ~'7)
If applicant is a corporation, signature o~ amy aumonzea Olncer.
.... /(o~../,z,... ~.erv~O..~.~'-..z,.'.~.,, .................
(Name and title of corporate officer)
Builder's License No ..........................
Plumber'sLicenseNo. ~....~....~
Electrician's License No.~.../.'~.. ~
Other Trade's License No ......................
Location of land on which proposed work will be done .......................... <.~ ........................
.... ............ C ..w
House Nnmber ........... it/e~iI .............. ~t;~n'let ..............
County Tax Map No. 1000 Section ..... '.~.~. ......... Block .... ~ ........... Lot .... .~o.D. ............
Subdivision . ~O ~.~.~....~: ~'.~..e..ff... . Filed Map No ............
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .. ~./duc ~ ............................. ...........................
b. Intended use and occupancy ....~../.t!'.~ & .... 4& .>'M..r~/X... ?7.4~.<td ./-5~..c~ .........................
3. Nature of work (check which aOplicable): New Building ........ Addition .......... Alteration ..........
Repair .............. Rem6val .............. Demolition .............. Other Work ...............
4. Estimated Cost ... Fee
(to be paid on filing this application)
5. If dwelling number of dwelling lunits ... ~. Number of dwelling units on each floor . .
6. If business, commercial or mixe~ occupancy, specify nature and extent of each type of u~e . .gv(.a.~.~,4.~.~?.~..~.~..
7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ...............
Height ............... Number of Stories ........................................................
Dimensions of same structure w~th alterations or additions: Front ................. Rear ..................
Depth .................... 1.. Height ...................... Number of Stories ............... ;~ ......
8. Dimensions of entpe new construction Front ./'~.4/.~. ..... Rear .. ~.~./ Denth ~.~.~£
Height ... ~, ~. ........ Number of Stones ...... 42~ ............................................ ; ....
10..D. ate of Purchase ./~.~oA. ~d~ '/ff~'~' ......... Name of Former Owner . Jl/f~,/a~ .... dY/ff~/~gt¢i.
12. Does proposed construction vie!ate .any zoning law, ordinance or regulation: . .~.o .................
13. ,Will lot beregraded . .5'.¢&,..! ,.~t/.~./r/j ........ ,...Willexcess fill be removed from premises. Yes
Name of Architect .... ,~'z~y.~ Address a.v.n, aox 9s ~one No.
..... , ........... Whale Bone Landing ...............
Name of Contractor ......... ~q.. a-s~w.~ .......... Address Southampton, N.i Y. 11968 [one No ....... t.t ........
PLOT DIAGRAM
Locate clearly and distinctly alll buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block inumber or description according to deed, and show street names and indicate whether
interior or corner lot. ~ O t~ ~ )2 ~ A~ ~ ~'/( /~ d/
STATE OF NEVtVSW)RIC. .~ ~
cou rr ,-o x
.... .......
(Name o]~individu'al sign!ng contract)
being duly sworn, deposes and says that he is the applicant
above named· j
He is the
I (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 contt0ned in this application are true to the best of his knowledge and belief; and that the
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
·
Notary. Public, . . . ~,~ . . ~_, .... .County '~/'"~',..~.. C ~ -- (~ '"' ,t~. f.~' ~
I """ ~qO~a~te~oi~Vl~eLwt ~o*~ / ¥ - ~>/ .......... (Signature of applicant)
No. 15'2-$12DS§0, Suffolk
50"E '
,t
r
104.25'
LANE
N Bi° 05'10"W
m
GUARANTEED TO,
MAp OF LAND LoCaTED 'AT' ,": ,":
TO~ OF SOUTHOL. D COUNTY Of ~UFFOI. K
, , SU RVEYF. D, FOR
NICHOLAS J. M!CC!CHE
0
24
,~ $ 61° 56' 50"E
104,25'
54'
m
N 61°05' I0' W
26
O
O
LANE
DA'CUM LL S.G.S,
UTILITY POLE
I Disr I SECT I RLK I LOt 11 IFOUNDATION ,
MA~ Of COREY CREEK ESTATES
AUG. I5,196'7 MAP N0.4923
GUARANTEED TO LARRY MC CORMICK
MAP OF LAND LOCATED AT
SOUTHOLD
NICHOLAS J. MICCICHE
D^~E 3--31--82
· :^~,. V'= 30'
ROCKY POINT N,Y Jl778 MAP.O 15488
/
~ ~L~: U/~"= I.o*' ~u~ ~F E ,r tubing i~ used
piping shall b~,
insulating gl~s at all exterior glass ~eas & tempered glass in all slip,sS. NOT
. § ..
copper 'robing is ~ .~l.~lal.-
· ~ ~ ,~' ,:,':~ ~ .... == .....
,r ] t/4,, ~¢~ ,
' / t I
~ % ~ _
tJOHN D. BLOODGOOD
A.I.A. ARCHITECT
2923 S.W. 30 STREET
DES MOINES, IOWA
copper tubing is used
~or water d:~ctributing
s¥¢em; piping shall~ be
of types K or Lordy___
FIX~
I1'
J I
II
LJ
I£
A.I.A. ARCHITECT
2923 S.W. 30 ETRF-ET
DES MOINES IOWA
MATERIALS LiST ~
OWNER: ' L~CATION:
CONTRACTOR:
PLAN NO, 74-~¢
This materials list is provided only as a guide to facilitate'
the pricing of your new home. You ~us~ amend this list as re-
quired by local building conditions, final selection ~ finish
materials & any other items your building contractor d~ems
necessary ?or the complete construction of the project.
I~ FOOTINGS & FOUNDATIONS:
A. Ready-Mix Concrete for the following:
Foo~ings - 6 I/2 cu. yds.
B. Steel Reinforcing: 300' #5 rebar;
560' 8" Dur-O-Wall
C. Brick &Misc. Masonry Materials: BOO - B" cement
blocks, 15~bags masonry cement~ 20 bags Portland
cement
D. Aggregates: I0 T. Masonry sand (fill); I0 cu. yds.
cover crawl space (Rea gravel)
E. Dampproofing & Slab Vapor Barriers: I0 Gal, founda-
tion coating~ 900 sq.ft. .006 mill Visqueen -
ground cover
F. Anchor Bolts: 30 - I/2 x 12"
Crawl Space Coors: 2 - 2x8-[21; 2 - 3° S.C. doors;
2 sets 3~ weatherstrfp; 3 pr. 4x~ hinges; I - T
Astragel; 2 keyed locks
ii. FRAMING:
,A. Sills: 1241 6'l sill sealer; 5 - 2x8-12;; 2 - 2xg-14';
E. Wall Studs: 1450 lin.it. 2x4 plates; 540 2x4 studs;
style (?)
~2 ~r, L. B. Iouvered; i - 2-6x6-Bx Y 3/8"
2 dr. R. H. Iouvered
Trim: I= g-6x6-ax4 1/2 int. jamb no style;
I - 4-Ox6-ax4 l~2 lnt, jamb no s'~yle; 14'
Ix4 trl~ ~6' Ix2 trim
IV. FINISH CARPENTRY:
A. Base & Shoe: 500~ each
B. Shelves & Poles: 30' closet pole W~8 pr. pole
brackets; 52 lin.fl, Ixl2 closet shelves W/
4 center shelf supports; 4 - Ix4 12' closet
ribbon~ 5 - 4x8 3/4" hardwood plywood; 16 po.
6' metal shelf standard; 88 metal shelf std.
cllps
C. Medicine Cabtnets: 2 - 18"×36" recessed;
I - 48x48 & I - 30x48 ) mirror 1/4" W/clips
Kitchen Cabinets: 13' wall cab. W/adj.sheJves~
23 1/2' base cab. W/adj. ~helves; 5' wall cab~
utility; I - 30" base cab. utility; I - 54"
desk
E. Vanity. Cab~netB: 1 -48"; I - 30"
Laminated Plastic Counter Tops: I pc. 24"xl44"
lam. plastic; 6 l/2' bar top kitchen; 2 qts.
contact cement; 13' base kitchen; I -48"
, vanity; 1 - 30" vanity; I - 54" desk topl (opt.)
G. Stairs: ,I - 60" metal spiral staircase W/
handrail & top landing
H. Unde~layment Flooring: 4l pc. 4x8 5/8"; 3
rolls red rosin paper
I. H_~_ar~war~: I Iockset; 5 latchsefs; 2 dummy
, knobs; 2~roJler catches; 3 privacy sets; 2 -
,sliding door Ioc~s;'@ ba~e and 3 hinge pin
bumpers; (hinges) - I J/2 pr. 4x~ [3 per dr.)
15 pr. 3 I/2 x 3 1/2 (3 per door)
J. Thresholds: I - 3-0 W/vinyl insert;
K. Toilet Accesser'les: 5 towel bars & brackets;
I soap & grab W/clamp; 2 paper holders W/clam~
I - 5t shower rod
V. PLUMBING SYSTEMS: (Labor & materials to include the
installation of 1he following)
A. f - 3~..21 kitchen sink; 2 lavatorles; I fiber-
glass tub & shower comb,; I 5' tub; I water
heater (size by owner); hose bibs--I auto.
for washer hqo~up; I - 24x21 deep laundry
sink; 2 water closets; sewer connection--main
to heuse; water service--main to house.
VI, ELECTRICAL: '(Labor & materials to include install-
ation for but not limited to following:)
A. I door chime system; recessed light fixtures--
2 kitchen, I lower bath, 4 dine &tamTly;
,surface mounted fi×lures (ceillng)--I utility;
I B.R. #2~ I over laundry sink; I B.R. #3;
I lower closet; 5 - 18" flourescent under cab.;
I foyer; I hall up; I - 12' track liv. room
Wall Bracket Fl×tures--I strip make up lower
bath; 1 strip makeup bath up; 2 patio; I front
Circuit Breaker Panel Board--200 amp.~ 20 -
circuit min,; Entrance & metering--main to
meter; outlets--I floor; 2 - O.S. weather-
proof; 29 duplex; switches--lB single pole;
I0 - 3-way; equip, connections--furnace &
air~conditloning; water heater; cook top over
dryer hood & fan; I bath exhaust fan; I bath
exhaust fan & light combo; I bath unit; I bath
unit & light combo.
B. Cook Top - I; Garbage Disposal - I; Built-ln
Oven - I; Special ~sland Hood W/venting
material - I; Dishwasher - I; Automatic
VII. HEATING: (Materials & labor for complete installa-
tion of following systems to be filled in by the
local contractor)
A. Heating:
D. Baseboard Units:
VIII. FIREPLACES/FIREPLACE ACCESSORIES:
A. Prefab Metal Fireplace Complete: I - 36" open
front
B. Stacks & V~nfs W/Cap or Flues~ Flue 261-0"
~ioor to roof exll W/rain cap & flue ~lashing
to roof
C.Manfie: I - 6xl2--41 timber
D. 70 sq. ft. ~ace brick (labor & material); BO
sq.ft, wood paneling (ownerls selection); 60
lin,ft, matching wood cove
iX. INSULATION & VAPOR BARRIERS:
B. Floors: lO0~ Rig Cant.; 900~ R-19 floor
D. Vapor Barrier: 3 roils 8-3x200' .002
X. ~NTERIOR WALL FINISH:
A. Sheetrock (hanging, taping & ~inlshlng): 450
sq. ft. 1/2" waterproof g-een paper; 5000 sq.
B. Ceramis Tile: 30 sq. ft, tub area (labor &
material)
XI. FLOOR COVERING: (Ownerls selection)
DECORAT4NG: (Owner's selection)
INTERIOR
I xllr. EXTERIOR DECORATING: (O,,'mcrls
' XIV. DECKS/PORCHES:
A., Footings: I/2 cu.'Id, ready mix conc.
B. Joists: =12 - 2x6-10~; 2 - 2xl2-16~; 5 -
i 6x6-6~ post; 4 - 2x8-16'; I - 6x]4'-18~
6xl4-16' timber
C. Decking: 1050 lin.ft. 2x4 redwood
b. Railing: 5 - 2x10-14' steps; I - 2xB-
E. Mist,Hardware: 3 - steel column caps;
12 - 2x8 single joist hangers; 76 - 3/4"
x 3/4" - 4'-0" steel bars; 25# 16d gaiv.
box nail
XV. MISCELLANEOUS:. I bale shim shingles; I whit~
glue; I pkg. fine sandpaper; I - 3/4x4
I/2 - 151 hardwood cap; 6 - 2x4-B'
Each Sect on of Walkway: --I - 2x4-12'
redwood.; 2 - 4x9 5/8" R.S. plywood;
2x4-8'; 13 - 2x4-61 deck; 2 - 41 cont.
, trusses
This materials list Is a guide provided t~'~aci)ltate th~ pricing of new ,home. -
YoHrshould amend thls Ilar'as required by the building conditions on paP~,lcular
slbe and location, ,, :,
The architect accepts no responsb~lllty fo~ the spec f c Quant t es Or
of the materials listed. The but!lldet 6~':ea~h house must ~ev e~ these d~aWin~
and ~e.rial lis~.~nd]udge For, h:imself $,he sultabillby of ~h shousA'to~y~
specific site. The maberial Ilsb'should be modlfled~b~ ref~e¢~flnish m~erial
selecbions such as painb, stain. Ceramic ~iie, cabine~s~ dounter bops, du~work,
wiring, piping, kinds of Ilgh~ #i~burea ex[er ~r pablo, aod. e~c,.,
yoor new house sheuld tnclude labor and m~ber als for all ,the lbems listed.,
is not necessa,lly II~i,bed to thelifo~lewing )i~t~. Vet fy al mea~uremenbs $[$ced.:~'
§
JOHr~
AJ,A, ARCHITECT
30 STREET