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Home My WebLink About10245-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No .... Z9~07 ........ Date ....... Daeezaba~.. 2~ ............. 19.7'-9 THIS CERTIFIES that the building ................................................ Location of Property .. 65.0 .......... .The. a~t, ana ................... ~a~ .Marion.. House No. Street Hamlet County Tax/flap No. ] 000 Section ...03.1 ....... Block .... 0J~. ........ Lot . .0~ .... 7. ~. ...... Subdivision..~bble. Be.~.,~la. Fat*!~s ........ Filed Map No..~2~ · .Lot No...~.~ ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated · .. I~Ia~t. 25. .......... , 19 [[9 pursuant to which Building Permit No .... .'l.0..~,t}5. Z ......... dated .............. JUlele. ~1 ....... 19..7.~ 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 ......... ............. Pri~a%.~..on¢. ~.amtl.~: .dwelling. .................................. The certificate is issued to ..... l~...&, l~.s .. ~OOX'ga .l~o~lkO~. ...................... (owner, of the aforesaid building. Suffolk County Department of Health Approval . UNDERWRITERS CERTIFICATE NO ...... ~)'./4. 51.~86~ .................................... Rev 4/79 FO~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. ~ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 10245 Z Permission is hereby granted to: ............. ,...~.~,~,..~..~..., ....... L~x~-.~.z.~........~. ~.. ......... · ..'~....~~....~x~.~. ........ to ..~ ~. ~ x..~:~ ~z ...,..~ ....... ~.z~.....~.~A~..~..//~f.~ ................ ~t pr~m~.~ ~o~.t.d ~t ~.~¢~...~....~..~Z~'~...:: ~Z ......... ~ ..........................~1~ ........................... Building Inspector. ........... FORM NO. 6 TOWN OF SOUTHOLD 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 featu res. 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 a)l property lines, streets, buildings and unusual natural or topographic 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- lion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date.. 2/, .~. T.%~.~. 7,. :~, .~. ....... New Building ..... V ....... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .~. ,~?....:/.~.~..~,, ~"?'.t~.~.' .~.~. ........... .~.' .~.~...'~ .~...~?.~. ~'~.l.'~..~.~ ........ House No, Street Hamlet Owner or Owners of Property ~.\.~.'~'.~..~;~\~.:~, .... .L~.:...~.~.~=~.C~,.~.9~ ......................... County Tax Map No. 1000 Section . .~. ~.~'~. ........ Block ...~).~.~. ,~. ....... Lot ................ Subdivision .~..~..~. ~..L..~....~.~.~.~.., ~F.~.~...~, .Filed Map No ........... Lot No.. 1~'.-~ ....... Permit No.~.O..~. ~..L~Date of Permit .~:! '. ?.~...Applicant '..'~..~ .J.~....(~..~..~7'~,..~?. ?: ...... Health Dept. Approval..~.; .,.~.~. 2'. ~.,'~ ........... Labor Dept. Approval ........................ Underwriters Approval . . .~.. ~ ~ .~.~.~ ~.- ........ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .... ~ ............... Fee Submitted $....'~.": ~.~'.'~. ................... Construction on above described building and perm~iZeets all applicable codes and regulations. Apphcant., .~. ~.'. ........... .~.~r~ ~. · ..... ....... Memorandum from.. ~. BUILDING INSPECTOR'S OFFICE TOWN OF SOUTHOLD TOWN HALL, SOUTItOLD, N. Y. 11971 765-1802 TOWN OF $OUTHOLD Building inspector's Office Town Clerk Building Southord, N.Y. 765-2660 ' 'd:oseP, Crocombe P.O. BOX ~175 Ce~g'e~ Morich~$ ~ .F' I IxJ ,~X / ~'~E) E) itt c.~ txJ /-* L ~4~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ....~...-~...t/. ..... ,1977 ...... , l .Pe it No. Disapproved a/c . . .~ ~ 7 ~ ........... /~ ........ .~ (Buildgng Inspector) APPLICATION FOR BUILDING PERMIT Application No. ~.~..~...~.~...-~. ..... INSTRUCTIONS 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 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 buildings for necessary inspections. .-rS...c~.,..,.~..~ .~.7...~.:...~.. ~ .~.~. ........... (Signature of applicant, or name, if a corporation) (Mailing address of applicant) It~-{~ 6 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . ~.o. (as on the tax roll or latest deed) If applicaot is a corporation, signature of duly authorized officer. (Name and title oY corC/b~te officer) Builder's License No .......................... Plumber's License No... }~..~. ~ . ..~. ........... Electrician's License No.. .~ ............ Other Trade's License No ...................... 1. Location of land on which proposed work will be done..~.0.' .'~.. ?.. ! .3.;~.. '.~.~I~..~./~.~.-~...~.~.~.~. j~]-. ~..,~.f~ .~. '$../(. ~'~'°,.O.~.....q', .~..~ ..... .g..q2...c?~... ?..~ ......... ~4..W~. · ...m.&..gx~..~-~..: ................. House Number Street Hamlet County TaXll Map No. 1000 Section..~..~.. ! .... Block..~. .... -.~... ....Lot..~.'...~.. ........... ,.,._ .~, h . .............Lr;~. L ~.3. ....... Subdivision ~.~.' .~.~..L,.~.-...~..~.&..c.~.% .... .f~...~x. & ..... Filed Map No. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... .~...~..C: .~'.X~...'~. .... .[v. ~.~..~b ......... .. ........................... b. Intended use and occupancy .O..~..~. .~U~'xXl- .~/ ~. Nature of work (check which applicable): New Building . ...~...... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... ~/ . ~ (Description) 4. Estimated Cost ~.~.,. ~O..O. ........................... Fe:~.. ~..~. ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units ,..0..~..'~.. ...... Number of dwelling units on each floor ................ If garage, number of cars . . . ~-....~,~,/.C~ .......................................................... 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 ............ t ......... 8. Dimensions of entire new construction: Front ,.-,~...7~ ...... Rear . ,~'.'~.' ~. ....... Depth . ~;~.o..... ....... Height . . .t~,l,~...~...,. Number of Stones .... O .1¢.. ~. ............................... t ............. 9. Size of lot: Fro~t ....~..~ . .-':. ............ Rear ..... .~. ~ ............ Depth ...~..~.~.. ~. ........... 10. Date of Purchase . .~.~e~C,~:.. [.~.'~.g ........... Name of Former Owner ~7~1~.~ ~...l~.l,~.~.e. 0:../~..~.=..'~.t.T. it: 11. Zon~ or use district in which premises are situated...O. I~..~'.... ~: .~..*Q..~ .~.~.... t~.1~$.1. ])~.~s,¢..~.~.~%1~ ........ .. 12. Does proposed construction violate any zoning law, ordinance or regulation: . .~..~?...~. ....................... 13. Will lot be regraded IO .o..q ...................... Will excess fill be removed from premises: Yes No ~ 14. Name of Owner of premises .~.~.c~*...~. ¢..P~ .~i~.. [k:., ~.. Address ................... Phone NoT-I..~:.~.~.~..'.~/.I.~.. ]5lame of Architect~.g~. ?..'~..~.g.~.~.~.T..~. ? ........ Address~. f.~.~.~. ~ ~...lff,-~:. Phone No~.~. ': ~.l'.~.'t~.~..F~... Name of Contractor~.~..~.. ~.. ~ ~.~-.~:..~...~q.: . . Address pl[~.~l¢.~.... ~...'~.-. Phone No~;/~..~./*.~77 ~..~..o..')~ PLOT DIAGRAM Locate clearly and distinctly ail buildings, 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, ~ K STA rE OF NEW Y~3iR ..... S cou r¥ ........ · ...... 'x ~. ~jOj~.~' ........... being duly (Name of individual signing ~ofitract) sworn, deposes and says that he is the applicant above named. He is the . (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 contained 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. ~Swom to before m6 this .'?. ...... ~. ...... day of, ~.Notary l~rm ~xpires March ~$~o ~U~Obg 'JOt~ ~W. ALT~ DEPART~ this ~lepar'tment ~d found efo. Oene~l ~tneertM HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT ~NEAREST WATER MAIN__MI.-+ ~OURSEOFWATER, PRiVATE__PUBLIC__ ~-SUFF CO TAX MAP DIST. SECTION BLOCK LOT ~-THERE ARE NO DWELLIN~IS WITHIN I00 FEET OF THIS PROPERTY OTHER THAN THOSE SHOWN HEREON. ~ THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES APPLICANT~ · : MONUMENT m: ~TA~ SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON JUNE II, 1975 AS FILE NO. 6266. * THE LOCATION OF WELL (W},$EFTIC TM,JKIS T) & CE:~*poOL$ (CP) $HOWN HEREON ARE FROM FIELD OB~RVATIONS AND OR DATA OBTAINEO FROM OT SURVEY FOR GEORGE MESAIKOS ~ ANNA MESAIKOS LOT 133 OF "PEBBLE BEACH FARMS" AT EAST MARION TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK NOV I ,~979 SEPT. 20, 1979 APR. 27,1979 MAR. 28,1979 DATE DEC. 21, 1978 SCALE 1"-'50' NO. 78-822 SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION L~W CHICAGO TITLE INSURANCE CO. *COPIES OF THIS SURVEY NOT SEA"lNG THE LANO EQUITABLE FEDERAL SAVINGS ~ SURVEYOR'S INKED SEAL OR EMOOSSED SEAL SHALL LOAN ASSOCIATION NOT SE CONSIDERED TO SE A VALID TRUE COPY N GUARANTEES iNDICATED HEREON SHALL RUN ONLY TO ~ ~~ THE PERSON FOR *"ON THE SURVEY ~S PREPARED, YOUNG a YOUNG ALDEN W. YOUNG,PROFESSIONAL ENGINEER AND LAND SURVEYOR N.~.S. LtCENSE NO 12845 HOWARD W. YOUNG, LAND SURVEYOR N.Y.S. LICENSE NO. 45893 SURVEY FOR APPROVED ADDRESS ~ ~ LJ~U ~L= ~Y V~I/~I~ 4DO OSTRANDER AVENUE ~,~ ~. ~,r~ '~.' ~,~:~-?~ I i YOUNG 8 ~uu~ ~,w..~,.~ ~o.~ * 7-~ , diia__n_n. / 14L4II llL21 ~ ~ '~'~_ ~ II-~ = } ~ ¢ ~.~' ~ pit ~ , -,....... ..' = ,-.;... ... .~.~. .... AFFRO~ A~ ~ ( ~el~ NO DE ~ ~ ~ ,/ 765.2660 9AM to 4PM FOR REQUIR- / ED INSPECTIONS= I'q ~ / I~ ~11 ~'[ TION OR START FRAMING ~ = / ~. ,.,~ w.~. ,o~ ~o=p~T~ unexoavated ,I ~, or CONSTKUCTIO. Gr~O~S ~t ~o~ ~ I / REQUIREMENTS OF N.Y. STATE CODE ~ IO .~,~. ~ ~. ~ ~a~ --' -' foundation plan details pit bedroom ti ii ¸il ENERGY , CONSERVATI,ON NOTES ( NEW YORKSTATE ENERGY CONSERVATION CODE) COUNTy SE .~.~w~. 'PERCENTAGE OF GLAZED A/tEA IS EQUAL~o~ FOR G~UNTY. 2. THE HOLLOWING VAL~ES OF THERMAL TRANSMITTANCE SHALL BE MINIMUM V~J~UES FOR USE IN THIS PROJECT. RooFs & FLOORS EXPOSEDTO AMBIENT CONDITIONS .................. Ur .05 EXTE~OR WA3~LS ...................... Uw= .08 GLAZING . ............................ Ug= .69 ENTRANCE 'DOORS ...................... Ud= .40 FL~ORS O~ER, OR ABO~ GRADE BASEMENT W~LS ENCLOSING UNHEATED SPACES ..... Uf= .08 SLAB EDGE INSULATION UNHEATED SLAB .. Ei= 5.5 SLAB EDGE INSULATION HEATED SLAB .... Ri= 8.0 ~ HEATED BASE~NT / CELLAR WALLS (ABOVE GRADE) Uw= 08 HEATED BASEMENT / CELLAR WALLS 3. FIREpLAcE CONSTRUCTION S~AL~ BE 'IN ACCORDANCE 'WITH TEE PROVISIONS OF sEcTIDN E - 402.4 OF TR~ N. Y. , STATE ENERGY CONSERVATION CODE. 4. ALL DOORS AND WINDOWS TO, BE DESIGNED AND CONSTRUCTHD TO LIMIT AIR LEAKAGE IN'ACCORDANCE WITH SECTION g - 402.'4b"OF THE N; Y? sTaTE ENERGY CONSERVATION coDE, 5. BUIL~iNG MEcHANIcAL, SYST~S SHALL BE IN ACCORDANCE WITE pART 5 - "BUILDING DESIGN BY ACCEPTABLE P~ACTICE OF TEE N.Y. STA~E .ENERGY CONSERVATION CODE, SECTION E- 503.p. ', P - : 1 GENERAL NOTES " 1. ALL CONCRETE TO BE CONTROLLED STONE CONCRETE HAVING A MINIMUM COMPRESSIVE STRENGTH OF 2500 POUNDS PER SQUARE INCH AT 28 DAYS. 2. BOTTOM OF ALL FOOTINGS SHALL BRA/{ ON UNDISTURBED PL~VING A MINIMUM BEARING CAPACITY QF ~¢0 (2) TONS PER SQ~RE FOOT. 3. PRovIDEMEMBRANE WATERPROOFING AT.EXTERIOR FOUNDATIO~ WALLS. 4. NO NOT~ OR DETAIL OR LAUE THEREOF $~ALL ~ CONSTRUED ASRELI~VING THE CONTRACTOR FROM EXECUTION OF A~L WORK IN ACCORDANC~ WITH A~L/STATE AND/OR LOCAL CODES. 5. FRAMING LUMBER SHALL BE STP, ESE RATED DOUGLAS FIR OR SOUTHERN PINE STRESS RATED 1200 POUNDS PERSQUARE INCH MINIMUM FOR BENDING,(lb) FOR SINGLE MEMBER USE~ AND 90 pOUNDS P~R, SQU~-RE INCH MINIM~FOR SHEAR (Fy), ~ND HAVING A,MODULUS OF ELASTICITY 0F 1,500~000 UNLESS NO~ED OTHERWISe. VALUES ARE FOR ~HRFACED DRY LUMBER ONLY USED AT 19% MOISTURE CONTENT. 6. HEADERS AND TRIMMERS TO BE DOUBLED WHERE REQUIRED. ' DOUBLE ALL FLOOR JOISTS UNDER PARTITIONS PARALLEL TO FLOOR JOISTS AND OVER 6'-0" LONG. 7., ALL PLUMBING WORK TO BE ~N. STRICT ACCORDANCE WITH LOCAL TOWN ORDINANCES. '~' 8. ALL ELECTRICAL WORK TO BE UNDERWRITER APPROVED. 9. CURBS, CURB CUTS AND PAVING MUST ~0NFORM WITH REGULATIONS AND REQUIREMENTS OF TEE PUBLIC WORKS. OWNERSHIP OF DOCUMENTS THESE DRAWINGS AND SPECIFICATIONS ARE INSTRUMENTS OF SEREICE AND SHALL P~EMAIN TEE PROPERTY OF THE ARCHITECT WHETHER THE PROJECT FOR WHICH THEY ARE F~%DE IS EXECUTED OR NOT. THEY ARE NOT TO BE USED ON AN,Y OTHER PROJECT EXCEPT BY WRITTEN AUTHORIZATI'ON OF THE ARCHITECT. _section ii¸ II il living , ~,~,~ ~,~ .~_~ bedroom -,0] ~,*,,~' ,-,, ~ -~ - - bath basement section ' b- b' /, front -- II II I :rear left side I¢ 1¢ right side' elevations