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Home My WebLink About10387-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No .... .Z.9.9!7 ........ Date .... .Ap.~%.l...9.,.. !~.8.0. ............. 19... THIS CERTIFIES that the building ............................................. Locat~on of Property 2~q~O Middle Road (C.R,27) Cutchogue, N.Y. County Tax Map No. 1000 Section ..... 0..~l./+....Block ..... 0.5. ........ Lot Subdivision .............................. Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...J. 13~. Y.. 1.9 ......... , 1979. pursuant to which Building Permit No ..... 79.~.8.7..Z .......... dated . . .$ SP.t.e. lll~0.e,r. .5, .......... 1979., 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. ~.e.l.l.i..n[~. The certificate is issued to ..... EIIlIIIy..l~l&ll,d.& .nS[ .C.o.., ,..lin. 9: ........................... {owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .. 9.-.~.Q7.6.8.....~/.7./..8.0...R..~..A?...V.:[.1.]:.§ ..... UNDERWRITERS CERTIFICATE NO .......... .~../~.7.2.2.7.7. .............................. / ! Building Inspector Rev 4/79 ~0~ ~0, ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10387 Z ,o .......... : .............. : .......................... i~...:~/ : ...... / ................ : ............ '/:'i ....... ~' ...................... ............ : ..... :'""'.'".'"':~:~'"' ~~"~:'"'~':'~" ~'~)'""i ...... Of premises Iocote~ or .......................................................................... ~....._.....~ ............ ..... '"'~'~z" ~ ? Building Inspector. Fee ...................... Building Inspector ~ORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. NOTICE OF DISAPPROVAL · Date File No ......................................................................... 7~/~'~/~ ..... '~~,~ ~......~z~ ....... ~ orion dated pLEASE TAKE NOTICE that your apphc .................................... ~ ...... for permit to construct ~~ ................. at the prem~ ~ Z~ - ~'~ Block ....~ .......................... ~ot .......~.Z.:.~..~.~.- is ~~.~. z~z~4:... ~. ~.~~~.~..~...~--.;~... HENRY E. RAYNOR, Jr. ~ Cln_m. FREDERICK E. GORDON JAMES WALL Bennett Orlowski, Jr. P ~D $outhold, N.Y. 11971 August 21, 1979 TELEPHONE 765-1938 Mr. J. Becket Emmy Building Co., Inc. 5040 Express Drive S. Rgnkonkoma, New York 11779 Dear Mr. Becket: The following action was taken by the Southold Town' Planning Board at a regular meeting held August 15, 1979. RESOLVED to release retained lot on property of Lawrence Chen and Frank Cho said lot located on Middle Road, Cutchogue. The remainder of the property has had the development rights purchased by the County of Suffolk. The Board considers it would be a hardship to file for a minor subdivision. Yours truly, HENRY E. RAYNOR, JR., CHAIRMAN SOUTHOLD TOWN PLANNING BOARD By Muriel Tolman, Copy to Building Inspector q// Secretary TOWN I-IF SOUTHE)LD rIFFIBE nF BUILDINB INSPEP-TEIR TOWN E:LERK'E~ OFFICE SDUTHOLD~ N. Y. Commissioner of Public Works Suffolk County Yaphonk Ave., Yaphank, N. Y. Dear Sir: In accordance with Section 239K of the General Municipal Law of the consolidated Laws of the State of New York, this is to notify the Commis- sioner of Public Works of the County of Suffolk that ...................................... ....... ;..':~.~:£..:'.~!!:..~:[L~,J. Ir.-.,...~.q.~,...~f~: ~. .......................................................... ~ P.~.~L~ .:z~'?~.~:~ .. D,~J,:~. ~..~p.u .¢!~ ~ ..~.~m.t~A['~pm~.,...~:~ ,.Z~......J. J ?:7..~ .. has applied to the Town of Southold for a permit to construct a building on .(, F.):U~.~)F.. ~. ~P.~ ~),..2. ~. ~ ...~lJ~ ...~G ~ ~ ..................................................... as shown on the attached plot plan, submitted in triplicate, dated ................ We shall withhold further action on this application for ten days or as otherwise provided in the aforementioned Section 239K. Very truly yours, Building Inspector Town of Southold, N. Y. FOP*M NO. 6 TOWN OF $OUTHOLD , Building Department Town C:lerks Office Southold, N. Y. 11971 APPMCATION FOR GERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector 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 installations, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approvo~ 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 property 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 formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date ..~.../.~.-7.t .O. ............................... New Building ..... L/......... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ...... .~..~..).'~........c~..'C..~.~...~....~...~.. ......... .~.~2_..6~.!...~...~.........4~....~..~.~..~.....D...4..:.~. ......................... Owner Or Owners Of Property ....,~:'J..~....~7...~. ....... ..~..~,:.~.~.,::~ .~......~2.°,.:.......~'. ,~3.~.:......-T7 .................................. Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Permit No. /.o~ 7 7__ Date Of Permit ?.L.~.L?.~....Applicant ~,~ ~,~,~ . ~L~ .~ · .. ................................................ Health Dept. Approval ................. ~ ....................... Dept. Approval Underwriters Approval ..... ...~..~...,~..,~,.7..~....~..~..~.~. ......... Planning Board ,~proval ........................................ Request For Temporary Certificate ........................................ Fined Certificate .......................................... Fee Submitted $ .~.~;~.~. ......................... Construction on above described building and permit meets all applicable codes and regulations. App 'ca ..~ ................................................................................. Sworn to before me this ~'?, 0. ~ ~/~ ................ day of ............................................ (stamp or seal) ~/'*/~,/'~' Notary Public .................................... County Memorandum from.... -- BUILDING INSPECTORS OFFICE TOWN OF SOIJTHOLD TOWN H^LL, SOUTHOLD, N. Y. 11971 765-1802 Tl~is sheet may not be duplicamd without the architects written consent, / JEROLD L. AXELRO1D - I ......................................... ARCH ITECT ......... 27~ BROADHOLLOW RD. MELVILLE~ N. Y 11746 ANALYSIS & NOTES FOR COMPLIANCE OF THIS STRUCTURE WFD-I THE N. Y. S. ENEt~GY CODE l 2. 3. 4 5. 6. 7. 10. 11. Name of Builder I Emmy Building Company Name of Model Vista 90 Plan File No. Analysis of the "U' values of the wall, roof and floor assemblies are as per the pages that follow. Slab edge insulation to be provided in all living areas as shown on plans. The "R" value of insulation is to be R=5 for unheated slabs. Glazing to be either insulated glass or storm windows, U=. 69 (including frames). Exterior doors to be urethane core or wood with storm door, U=. 40 (including frames). Window & door manufacturers to provide certification of compliance - inclading infiltration loss per E402.4 of the N. Y.S. Energy Code. Calculation of heating loads are included herewith. Design of mechanical system to be by others in conformance with sect. E403 of the code.' Domestic hot water to be as per sect. E404 of the code. Manufacturers certification to be provided, as required. If the space heating boiler is also used for domestic bot water, the. standby loss of the boiler may not exceed: 13.3 (PMD) + 400: BTU/hr. Max. standby loss. *n No. of Baths PMD Max. Allo. w..standby loss No. gal/hr BTU/hr I 29 2656 l } 3o 2699 2 42 3240 2-} 42 I I3240 : 3 45 3375 " ' *n- assumed at.296 Boiler manufacturer to certify compliance with the above per sect. E404.3 (d). All exposed hot water piping and ductwork in unheated basements to be insulated as per sect. E403.9 & E403.10 of the code. Fireplace units, if provided, to include a tight fitting smoke damper, tight fitting, heat resistant glass enclosure doors, & a duct for outside combustion air, fitted with a closeable damper. The design basis for heating analysis is as per code, as follows: Outside design temperature = 10 (Suffolk County Airport) Inside design temperature = 72 Heating Degree Days = 6000 The design will be predicated on Part 3 - Design by subsystem analysis, as modified in E302.3. The total heat loss of the building envelope will be compared against the "standards" of E402. (l) ~ ~ Thi s sheet may not he duplicated without the architects written consent.. JEROLD L. AXELROD -ARCHITECT, TYPICAL EXTERIOR WALL 275 BROAD[qOLLOW RD. MELVILLE. N.Y. 11746 N. Y.S. I~ncrgy Code req'd U = . 08 (Part 5-Acceptable Practice) Component outside air film asbestos shingle* 15 # felt ~" fiberboard sheath'g fiberglass batt 3/8" gypsumboard inside air film 2"x 4" stud (3-}"act.) Total With 3/8" plywood sheathing R ~ II - 3 l/2"Batt g(@batt) R(@ stud) NOTES: U= 1/R = U=.073 U=.140 U=.077 U=.159 R- 13-3 5/8"Bart ' R(@batt) R(@ stud) 0.17 0.17 0.17 0.17 0.21 0.2t 0.21 0.21 0.06 0.06 0.06 0.06 1.32 1.32 1.32 1.32 11.00 .... 13.00 .... 0.32 0.32 ,,'0.32 0.32 0.68 , 0.68 0.68 0.68 ..... 4.37 ..... 4.37 13.76 7.13 15.76 7.13 U=. 063 U=. 140 [J=. 067 U=. 159 Table 5- 1 of sect. 5 calls for a U=. 08. None of the R- 1 ] assemblies meet it. All would require computations of the overall heat--'~i-oss of the structure to see that any one is acceptable. This will be done - see the calculations that follow. *Asbestos shingles have the lowest R. All of the followiag other materials would increase the value as follows: wood shingles with backer board: 4" common brick veneer: I x 8 bevel or lap siding: R U with R-Il Uwith R-13 1.40 ,067 .120 .059 .120 .80 .070 .130 .061 .130 .80 .070 .130 .061 .130 **3/8" plywood reduces the R-value (R=0.47). If used with asbestos, the U value of the wall increases as indicated. Proportional decreases in U valhe would be made for other assemblies. NOTE REGARDING ttOUSE-GARAGE WALL With 1/2" gypsumboard on one side, 3/8" on the other ~md R-I 1 bart between the studs the resultant U-value is. 076 at the insulation area and. ]54 at tho framing. If R- 13 insulation is utilized the U value for the enti~;e wall assuming a 20% framing factor is U,~ . 079 which will comply with Part 5 - Acceptable practice. (2) This sheet may not be duplicated without the architects written consent, JEROLD L. AXELROD ARCHITECT 27~; BROADHOLLOW RD. MELVILLE, N.Y. 11746 TYPICAL CEILING N. Y. S. Energy Code req'd U = .05 (Part 4 or Part 5) R-19~ 6" bart R(@bat[) R(@ ceil.bm.) . Component ~~4. ~'i~.~- attic air space (min.)' 0.61 0.61 "~"~'*,~ ~ 6" R-I9 fiberglass batt 19.00 .... i',4~~ 3/8" gyp. sumboard 0.32 0. 32 inside air film 0.6] 0.61 x.~ 2x6 ceil'g beam (5~"act) '---- 6.87 Total R = 20.54 8.41 U= 1/R = .049 .119 NOTES: N. Y. S code calls for a U = . 05. The above assembly does not meet it. Calculations will therefore be required. (3) This sheet may not be duplicated without the architects written eonseflt. JEROLD L. AXELROD ARCHITECT 27~ BROADHOLLOW RD, MELVILLE~ N.Y. 11746 N.Y.S. FLOOR OVER UNHEATED BASEMENT Energy Cod6 req'd U =. 08 (Part 4 or Part 5) Using a R- 11 (3½") batt Component inside air film carpet & rubber pad, 5/8" plywood air space ~2~3" R- l ] fiberglass bart air film a(~,batt) j-{(@ S~tld) 0.61 0.61 t. 23* I. 23 0.78* 0. 78 I. 00 .... 11.00 .... 0.61 0.61 floor beam 9.37 Total R = 15.23 12.60 U = 1/R = .066 .079 NOTES: N. ¥. S. code calls for a U =. 08 so this is ~nore than adequate (almost 20% better). However using an R-7 batt would be inadequate. *Oak flooring on 1/2" plywood reduces the R by approximately. 40 and reduces the U to. 067 at the insulation and to [J =. 082 at the framing. All heating pipes and ducts must be insulated below the insulation. (4) This sheet may not be dnplicated without the architects written consent. ~_/LE ~ J~OLD L. ~ELROD Ty~ff o /Kv ........ ARCHITECT Wails: Ceiling/Roof: , Floor over garage: Floor over basement: Slab Perimeter: Uo x Aox TD = BTU/hr .72 x /J'77 x 62 ~tSgozBTtl/hr Up x Ar x TI) = BTU/hr .03 x /h'5 x 62 ,, 5'~'?V BTU/hr Uflx Aflx TD = BTll/hr / · 05 x l& x 62 3°0 BTU/hr ~]/~x Af-T~ TD = WFU/hr .08 x - ~ x J~ -'/ * lITU/hr IAn. f~7, x Q /~Z x 50 _~/~0 BTU/hr Total of Envelope Sul)sy~ terns Permitted III. CALCULATED ttEAT LOSSES ON SUBSYSq EMS AS DESIGNED: Wall insulation specified: R- ] I Ceiling/Roof insulation specified: R- 1 9 Floor over basement insulation specified: R-'Il Floor over garage insulation specified: R-19 A) ACTUAl. tl VALUES: Walls: Ceilings: Floor over garage: Floor over basement (7) ' '5'hts sheet may not be duplicated without the architects written consent..F/l~ ~ J~OLD L. ~ELROD ~ ARCHITECT' ~7~ BROADHOLLOW ~D. I. SQUARE IvOO'FAGE TABIJI,ATIONS: Exterior house wall area (Aw) Area of windows (Ag) Area of doors** (All) Opaque wall area (Aow) Iasulatedarea (Aw~ Framing area* (Aw-2) 2)(~mmr ~ ~.$:), ~ sq. ft. 3) 3 7 sq. ft. '1) /.~ 3 72- sq. ft. 5) 200 t 5 sq. ft. 6) ~ 3~ 7 sq. ft. Wall between house and garage (Agw) 7) Insulated area (Agw- 1) 8) Framing area* (Agw-2) 9) sq. ft. sq. ft. scI. ft. Gross exterior wall area (Ao) 10) Ceiling/Roof Area (A r) 11) Insulated area (^r- l) 12)_ Flaming area* (Ar-2) 13) sq. ft. sq. ft. sq. ft. sq. ft. Floor over garage/crawl space (Afl) 14)I I / ~ Insulated area (Afl-l) 15) .... ~ Frandng area* (Afl-2) 16) ~k sq. ft. scI. ft. sct. fl. Floor over basement Insulated area Framing area* (Al2) 17 ?4Z sq. ft. (Af2- 1) 18 ..... aeq~_.__ sq. ft. (Al2-2) 19 q~/ sq. ft. Slab pcrimeter 20 9 7 lin. ft. Window percentage (%) of overall wall area (Ac)) = Framing areas are assumed as 20% on gross wall areas anti 10% on ceiling or floor framing,areas. Includes door between house and garage. MAXIMUM PERMITTED IIEAT LOSS (From Section E402) Maximum permitted U values: Maximum permitted R value: walls Uo = .22 gar/roof/ceil [Jo = .05 floor overbsmt Uo = .08 slab edge R = 5.0 (6) ' ~p~ 136"~-~.~t 9/5168) PERMIT UNDER SECTION 136 of ARTICLE V! of HIGHWAY LAW .~l~hl~.ge, sew?.Rr.w_at~r pipes underg.round., e~xc.ept under, s.uc.h condU~oni and_regulations as may be prescribed by the coul~ty super- WHEREAS, a certain highway I~nown as the ~.~DDT'I~' ~ CR No. ha~ been improved and is on the Suffolk County Road System and NOTE: ONLY ONE L ACCESS TO CR 27 FROM 'SUBJECT SITE. ~. WIq~EREAS, ~',{l%~lY BU,'uLDIN¢, CO.. INC., 5040 ?,xpress Drive';3.. New York requests ~rmi~sion to bUild residential access as.per :evi.s?d plot' plahand re~_ainder of R.O.W. to receive top~l and sees ~ ~e s/s/o ~ddle ~ ~., 1000'~ e/o B=idge L~e, H~et of NOW, ~R~RE, ~issJon is hereby grant~ to said ,, ~ RT.~. ~.~ INC. to do said work u~n the following condigo~: CONDITIONS AN~ ~en con~e~ ~ ~mov~, cut eonere~ ~t~ coyote ~w %w~ ~eet outs~e the limits of the p~ e~vation ~d for t~e full ~nel ~th. ~n the cut is ~ In pavement ~t~n 10 f~t of ~e pane! joint, the ~Vement ~ ~ ~oved for full p~el width from ~ cut on the far side of tho excavation to the ~ ~o~t. o~ ~aee. 8. ~pl~ pavement, sidow~k or su~e ~ ~ e~n~; ~ conc~te, repine 4. If conc~ curb Is r~ov~, replace with sl~l~r curb 1:1~ :3 ~ ~. 5. ~e Of J~kin~ Pits or ~y other exezv~on sl~ll ~ not less thmn 5 f~t fro~ ~we of P~vement. ~o undereutt~ ~owed in Pit, 6. ~o~fy ~ Depsr~nt ~t ~aph~k 4-B4~1 when the work ~ to ~n ~ that ma ~Is ~it sh~l not be assigned or tra~f~ without the written consent of the Com~ssioner of ~blic Wor~ ~e work authorized ~ this ~lt sh~ll be perlo~ed under the su~ls~on ~d to the satisfac~on of the m~toner of Public Works or his repr~entative Particular attention is call~ to the ne~ssity of thoroughly ~paeting the ~cR fill, which wdl ~ reqmr~ by the C~sioner of Pubhc Works. ~e ~missioner of Pubic Works sh~l ~ given one w~k's notice by said applicant ~ the date when it ~nds to ~n the ~ck au~hoNz~ by this ~lt, and p~mpt not,ce of its ~mpl~tion. ~e ~ld applicant he.by agrees ~ hold* the State, COunty and T~n ha~less on ac~unt of d~ag~ of ~d ~tch may arise during the progress of the work authoriz~ by this ~t OP by re.on ~her~f. A~licant cer~fl~ a~l ~o~ concern~ with actual ~ork uoder th~s pe~lt are duty ~ve~ by Wor~en~s ~m- ~tion I~uran~ ~d the State, County and Town shah ~ held ha~less on accent ther~f. ~e ~ssioner ~ Public Works ~se~es the right to at any t~me revoke or annul this ~lt should the said a~ltcant fail to ~ply with the te~s ~d conditions u~n which it is grant~. The applicant ~s to pay all n~essa~ e~ made~t ~ supe~isi9O t~ ins~t~on by reason of the ~tl~g of such ~lt ~ ~rtlfl~ by the Com~ssioner of ~bhc Works, such ~ent to ~ made with n tea days ¢~the ~nde~ng of the ~rtl~d a~nt. ' Work U~ ~ls ~it to ~ c0mmenc~ within thirty days f~ the da~e of ~it ~d ~nttnu~ in an ~Uoua ~e appBc~t shall submit a detailed pl~ of structu~ to ~ built, w~th a des~ptio~ ~ p~ me~h~ ~tmction. It Is unde~t~ ~at should future ch~ges in'the alig~ent or grade og !~e highway ~uire cha~es In the ~k ~ve~ by ~s appUcaQon and ~it, the a~lic~t' s~ail ~ ~asonablb not!~ f~ ~e ~ssio~r of Public Wor~ make such n~ssa~ ~ges at h~s o~ e~nse ~thln [he time so s~i~ i~ hotly. , ~c sh~l ~ maintained by the applic~t on t~s s~tlon og the highway while the work is in p~ss and A ~Certifl~ ~ in the sum of $..~..p~yable to the Co~ty ~e~u~r of ,Suffol~ County is ~lt~ ~ ~u~ty that the highway will ~ r~tor~ to its original ~nd~tion whe~ distur~ at the e~n~ of ~e ~pHc~t, ~ s~n as t~ work h~ ~en ~mplet~, and the said ~m~saoner M ~blic Wor~ ts be~by authodz~ ~ ~ ~1 or as much Of such de~s~t ~ may be n~ary lot ~at pu~e. shoul~. ~ sa~d q, pplicant n~!~t or ~ AVO~ S~O~ DAMAGE TO V~AL U~GROU~ F~L~I~, PLEBE CALL LONG ~LAND LIG~- FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 e4:~.~~ TEL.: 765-1802 Examin -'. ¢~.'~ ....., 197~. Approved .~.:~?~...'~... .... ,197~. Permit No.. ~.~.~ ~ / APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No. :~).O... Z ...... a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 issue a Building Permit to the applicant. Such permit shall be kept on the premises available for mspection 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 describ, e,~q The applicant agrees to comply with all applicable laws, ordinances, building code, housing cock~Wd regul,~tion~ anq/[,~ admit authorized inspectors on premises and in buildings for necessary inspections./ ~7~ 6/ (Signature ofapplioan~0~~~i,~-:~' (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~? 'F'~J (as on the tax roll ox la/test deed) /'~" )27 '~' fi' (Name and title of corporate officer) ff ~ ' / Builder's License No ......................... Plumber's License No. . .22/. .00 /'~ ~ ~q'~' ~ ~ ................... ~ ~-- -~/,-~/~? Electrician's License No...~.g~7~.' ............ Other Trade's License No ..................... 1. Locatignoflandonwhichproposedworkwillbedone..~/~.di~..~..~:/~.~.~.~/~. ~.~ZO/i ~.~..~.~.~?.~: ...... ?, .................................. Ho~se Number-~ ~D--/~ C) Street ~J Hamlet County Tax Map No. 1000 Section ....~. ?..~.. ........ Block ...: .(~3.'-~:~-~' .........Lot .~.tc?.. f: ./. ......... Subdivision: ........ ::~ .................... 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 . i~ ........................................................ b. Intended use and occupancy . .t~..~)....~~.'~ ~' i.~ .~. .................................. 3. Nature of work (check which applicable): New Building . .1~; ./..'. . Addition .......... Alteration .......... Repair .............. Removal .............. Demolition ............. Other Work ............... i ~Description) (to be paid on filing this application) If dwelhng, number of dwelhng umts ......... Number of dwelling units on each floor ....... If garage, number of cars ... ~ .................................................................. 6. If business, commercial 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 .................... ... Height ...................... Number of Stories ...................... 8, Dimensions of entire new construction: Front .... ~'9: ....... R~ar . ~ ¢/ .......... Depth .~ f .......... Height ............... Number of Stories.. d'~,t.[:~ ................................................ 9. Size of lot: Front ..../.&~i~ .~ .............. Rear .... /.2-~: ............ Depth .C~,~ .' ............... 10. Date of Purchase ........... ! .................. Name of Former Owner ............................. 11. Zone 6r use district in which pr~mises are situated ..................................................... 12. Does proposed construction vie!ate 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 .................... Address ................... Phone No ................ Name of Architect ~.~,~tt,/,x,~*,~;~..~.. Z~¢.~ ....... Address i~'$.'~'~'~:)?' ;,~'3~t''' Phone Noog~ Name of Contractor ~;~ .~.~ ~.~;~ ...... Address ~5,,,yO ~c&~O,% Orr 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. STATE OF NEW..~YO]~7 COUNTY OF..~.q?.~.i/.~ ...... ,S.S ........ .' '~.~ "'~7~ ~.~./4~p.~O.i .................... being duly sworn, deposes and says that he is the applicant x-{Name of individual signing contract) above named, i , , He is the ............. ~O.~.~ ................................................... , (Contractor, agent, corporate officer, etc.) i of said owner or owners, ~d is dul~ authorized to perform or have perfo~ed the said work and to m~e ~d file this application; that ~1 statements cont~ined ~ this application are true to the best of his ~owledge and belief; and that the work will be perfomed in the m~net set forth in the application filed therewith. Sw0m to before me this ......... ~. ..... day of .............. 19~ Notaw Public ............................. F... County . . ........ ................ NOTAEWPUOLIC, Stat~ of New vorg , now or Yormerly L~wren~e ~h~n ~ Pr~n~ Cho I SUFFOLK COUN~ DEPARTmEnT OF H~LTH SERVICES EMMYBUILDING CO., INC. AT EAST CUTCHOGUE DATE dULY I0, 1979 FOE APPROVAL OF COHSTRUCTIOH ONLY ~W;N ~F SOUTHOLD SCALE 1"=50' - ~ U~H~ Z[O ~ER~ION O~ ~ODmON m mis GUARANTEED TO= __~ SU"VEY IA V OLATION ~$ECTION 7209 OF THE APPROVED ~~ ~Ew Y~eK~T~[ ~OucA~ON LAW THE TITLE GUARANTEE CO. *COP~ES ~ Tats SURVEY NOT ~ARING THE LAND RIVERHEA~INGS BANK suew~a[s iNKED SEA~ OR E~BOSSED SEAL SHALL EMMY BUIL~ING CO.~ INC. HEALTH DEPARTME~:~DATA FOR ~PPROVAL TO C~STRUC T ~ RSI FOR WHOM THE SU~EY IS PREPARED ~ NEA~$TWATER IAIN~I ~ NSOUR~E OF WATER ~I~TE~PUBLIC~ MENTAL I~O[N~Y AND LEE~DING INSTITUTION LISTED WiLLNOTHERW~E~ THEC~FORM WATER THaN ARE THOSE $Up~y ~ TO DWELLI~ S THE SHOWN a~ STAN~ROS S E~AGE HEREoN'WITHIN OIS~AL OF THEIpO FEET SUFF~K SYSTEM OF COUNTY F~ THISrHiS PRORERTY DEPARTMENT a~OE~ W otSr~c °WNEaS ToINS~TI~ TO EX/STIAOOITIpNA L~,~,~ S aUARANTEES STRUCTURES SHOWN tNSTITUTI~S HSREON ; ARE ARE OR PROM FOR ~T SUaSE~UENT T~SFERA BLE APROPERTY SPECIFIC LINES~ ' ~ AL~N W YOUNG~ PROFESSIONAL [NGIN/ER ~ ANO LAND SURVEYOR N Y.S UCENSE NO 12845 HOWARD W. YOUNG, LAND SURVEYOR ~ L~ ~ W~L(W},SEPTIC TANK(Sf)e CESS~OLS(CP) SH~N HEEE~ N YS. LICENSE NO 45895 I ~E ~,ELO OBSE~ATIONS, ~O OR D~TA OBTAINED F~OM OTHER S ~0~ L~ ~ ; Zaw~enc~ Chen ~ ~ran~ ~o SURVEY FOR SUFFOLK COUN~ DEPARTMENT OF H~LTH SERVICES EM~Y BUILDING CO., INC. AT EAST CUTCHOGUE DATE dULY ~0, FOR APPEOVAL OF CONSTRUCTION ONLY I" 50' ~WN OF SOUTHOLD SCALE DATE~ HS REF; NO. .~'~' SUFFOLK. ; . COUNT~,. NEW. YORK NO. ~ ff ~TH~IZEO ALTERATION OR ADDITION m ~lS GUARANTEED TO: ,~ ~e~STAT[ ~UCAT ON LAW APPROVED ~ ~ co~[s ~ ~TmS sUrVeY ~OT ~Am~ ~[ ~.~ RIVERHEAD SAVINBS BANK SURVEYOr, S ~A[O S~A~ OR [~OSS[O SLAg SH~L[ EMMY BUILDING HEALTH OEPARTME~ATA FOR ~PPROVAL TO C~STRUC T THE ~R~l FoR WHOM ~H~ SU~/Y IS PREPARED ~ ~' AND ~ HI~ BEHALF ~ ~HE TITLE COMPANY, GOV~N- / ~ ~ NEARE~TWAT~ IAIN~'~.~ ~SOURCE OFWATER ~t~TE~PUBLIC~ MENTAL ~ENCY AND LE~OING INSTITUTION LISTED / NS~FC~.TAXMAP ~T/eeo SECTION~84 BLOCK~LOT HERE~, A) D TO ~E AS~IaNEES OF THE LENDING / [ ~ / ~ ~[~ ARE ~ OWELL~S ~tTHIN {~0 FE~T OF THiS PROPERTY TO AOQITI~NAL INSTITU~I~S OR SUBSEQUENT / J THE WATER SUP~Y AND SEWAGE DIS~AL SYSTEM F~ THIS R~IDE~ ~ DISTaNCeS SHOWN HE~EON FROM PROPERTY LINES ~ / ~ /~ ~ WILLC~FOR~ TO THE STAN~"OS OF ~"E SUFF~K COUNTY DEPARTMENT ~OEXJSTIN:6 ST"UCTU"~S ARE FO~ A SPECIFIC I / ' ~ [ ~ /~ OFHEAL~H S~tCES ' PURPOSE ~NO ARE NOT, TO BE USED TO ESTABLISH ~ "' I ) YOUNG s YOUNG., ....... ' T~ '~J AL~EN W,~UNG, PROFESSIONAL ENGINEER ~l ANO LAND SURVEYOR N Y.S UCENSE NO ,2845 : m I HOWARD W. YOUNG, LAND SURVEYOR .~L~W~L(W) SEPTICTANK(S~)aCESS~OLS(CP)SH~NHE"E~ ~ .~ I~ NY~.LICENSE NO 45893 HO,~D [C I~ 27) TITLE NO. 79-52-28131 EL=405 t 0.0 TEST HOLE TOPSOIL LOAM SAND GRAVEL NOTE: now or formerly Lawrence Chen ~ Frank Cho HEALTH DEPARTMENl%DATA FOR APPROVAL TO CONSTRUE T )~TH£R~ ARE NO DWELLINGS WITHIN I00 FEET OF THIS PROPERTY OP HEALTH SERVICES AODRESS TEL ~ THE LOCATION OF WELL(W)~SEPTIC TANK(ST) 8 CESSPOOLS(CP) SHOWN HEREON ARE FROM FIELO OBSERVATIONS N~IO OR DATA OBTAINED FROM OTHERS SURVE~ FOR EMMY BUILDING CO., INC. AT EAST CUTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK APR. 3,1980 FEB. 8, 1980 FEB I , 1980 OCT. :~, 1979 DATE dULY I0, 1979 SCALE J": 50' NO. 79-376-A RUNRUTHO~IZEO ALTERATION OR ADDITION TO THIS SURVEY IS:A VIOLATION OF SECTION 7209 OF THE NEW YORK ~TATE EDUCATION LAW ~COPIES OF tHIS SURVEY NOT BEARING THE LAND SURVEYOR~S INKED SEAL~ OR EMBOSSED SEAL SHALL NOT B~ CONSIDERED TO BEA VALID TRUE COPY NGUAF~ANT~[ES INDICAtEO HEREON SHALL RUN ONLY TO THE P~RSON FOR WHOM THE SURVEY IS PREPAREO ARD O~ HIS BEHALF TO THE TITLE COMPANY, GOVERN- MENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON~ AND TO THE ASSIGNEES OF THE LENDING INSTITUTION GUARANTEES ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS ~DISFANC~S SHOWN HE~REON FROM PROPERTY LINES GUARANTEED TO= USLIFE TITLE INSURANCE CO. OFNEW YORK RIVERHEAD SAVINGS BANK EMMY BUILDING CO., I1~ YOUNG s YOUNG ALDEN W YOUNG, PROFESSIONAL ENGINEER AND LAND SURVEYOR N Y.S UCENSE NO 1284§ HOWARD WYOUNG~ LAND SURVEYOR N Y S LICENSE NO 4§8cj$ RIVERHEAD, NEW YORK