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Home My WebLink About10259-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate O[ Occupancy No... Z986.~ ......... Date ....F.e.b..~..S?Z...;4 .................. 19.80 THIS CERTIFIES that the building ................................................ Location of Property .... 575 .]~Lnga. lO.w..I,,/~.e. .................... Ha.~t lqJLLC, k,. N...Y. HOUM No. Street Hamlet County Tax Map No. 1000 Section .... ~..23 .....Block .... ~ .......... Lot ...... ~ .......... Subdivision. ~P.~'~.t;.o.c~k~. ~.~t~'k ............ Filed Map No .... '19...Lot No... 7 .......... conforms substantially to the Application for Building Permit heretofore t'fled in this office dated .... 0'~r~e..'12, ........ , 19 '79. pursuant to which Building Permit No ..... .f10259Z .......... dated ...~TLe..I..2 ................. ]979., 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 ......... The certificate is issued to ........ ~.8~,e..inlet. 7-J3,eer~ .BerS~en ........................ (owner, ~ Of the at'ores=id building. Suffolk County Depaztment of Health Approval ........... ~- ............................ UNDERWRITERS CERTIFICATE NO. .N../45.1.~'~.2 ...................... Building Inspector R~, 4/7S FORI~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, ~l.. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10259 Z Permission is hereby granted to: .~.~.~...~£~.~.~..~..~.....: ...... ~ ....... z~.~.z~.~.....~ ~.~ ...... ~o,. L:~.~v.~,c~......~ ~.~..... ~:~' "7'"' .~,,~'~.o ~.... ~.. ~,..--C..,~. z~. x"~.. .. 0~.~-...~.~.Z,~.~-.%.-.. z~,,,~_'~/./.~..~q ............................." .~. .................................................../ pursuont to opplicofion doted ........................................................ , 19 ........ , ond opproved by the Building Inspector. Fee $.,/.,.~,..,...-~'.. ...... ...... FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 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: 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses'. 1. Accurate survey of peoperty showing ail 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- tion 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.. J./~./.~) ............. New Building (~. ~ ~ ~9~,.. Ot'd 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 ,../t.~. j. ...... Block ..... ~ ......... Lot .... ,~, ......... Subdivision .~'-~~~.../~..~¥ .~'. .... Filed Map No...L .~. .... Lot No...~.. ........ Permit No../0~.--~.~... Date of Permit .~/~-).~....Applicant . .I ................................ Health Dept. Approval....~/.~ ................-- Labor Dept. Approval . .1~.]/~ ................. Underwriters Approval.. ~, ..~..~.~ ~, ~.~...Planning BOard Approval ...................... Request for Temporary Certificate ..................... Final Certificate .. ~ ................. Fee Submitted $..~-~.' .C~.0 ..................... Construction on above described building an, d, per, nit meets all applicable codes and regulations. Applicant. ~~.~..~~ .......... : .......... THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~r 85 JOHN NEW YORK 10038 STREET, NEW YORK, THIS CE~IFIE$ THAT in the followlng location; [] Basement [] 1st I~l. [] 2nd l~l. Section Block Lot was~;.~do. D~=eab~: 3.8, 1979 andfoundto~elncompl;~ncewit~therequirementso~thisBo~rd. RXTURE [ECEPTA LEI [ RXTURES OUTLETS /~R C $EW TCHEE INCANDESCENT. FLUORESCENT ~v~C~Y DRYERS FURNACE MOTORS FUTURE APPUANCE FEEDERS~ A,V,T. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. RANGES COOKING DECKS OVENS D~SH WASNERS AMT. K.W. AMT, K.W. ~T. K.W. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET SERVICE DISCONNECT OTHER APPARATUS= E R V I C EXHAUST FANS AMT. H.P. DIMMERS AMT. WATTS A. W.O. NO. OF HI-LEG A- W. G, ~O. OF NEUTRALS A. W- G- CC. COND* Of HI-LEG OF NEUTRAL T=:~c~ LXght~zX6' -0' ' 4-LXtes Ruland ~-lec. Co. P.O. Sox 143 Ymtt/t~k, 1~. 119.52 242 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by thei ~entials.,, ~ T~L ~/'4 ~ I N EG FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ~×ami~ed...~. :../.~ .... , i~Z? ^pplicationmo./~. ~.~. ....... App,oved. ~:./. ~ ...... l~7~Pe,m,t $o.Z~. :~.. Z~ / Disapproved a/c .... 5~ ................... ~ ....... (Bufldifig Inspector) APPLICATION FOR BUILDING PERMIT Date ~'~,..(o ....... 19 .Z { 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 scMe. Fee according t0 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 Pe~it. d. Upon approvfl of this application, the Building Inspector will issue a Building pe~it to the applicant. Such pe~it shMl be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pa~ for any purpose whatever unt~ a Ceaificate of Occupancy shMl have been granted by the Building Inspector. ~PLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Pemit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for ~e construction of buildMgs, additions or Mterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordMances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessaw inspections. . . ~ ~ :/[.~ ~.~.. ~3 ~ I.. ~0.~...~.~.~,,b ....... ~... (Signature of applicant, or name, if/a corporation) .::.~ .... ::~{~.t.{~ ..... U./ ............... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~. [~l~,dv, D.. ' ~"~3 , ~ . ~ ..... .'.b ~. ~ ............................................. (as on the tax roll or latest deed) If app~ is a corp~atu,e of duly au~ized officer. Plumber's License No.. ~a~ ........... Electrician's License No...') .................. Other Trade's License No..~2x~..~v-m?. ............ 1. Location of land on which proposed work will be done .................................................. ............... ......... ...... ..... House Number / Hamlet County Tax Map No. 1000 Section .. ~ .~ ............ Block . ~. Lot...'~... Subdivision.....~..,~..f.~..~..,q../.~.q.O.~....~.~..~..~.... Filed Map No... q .......... Lot...7 ........... (Name) 2. State existing use and occupancy of premises~3d intended use and occu'pancy of proposed construction: ~. ~x,,,n, u~ ~n~ o,u~..:'... :?/~;~...~.~.,~.-Z~:~.'. ................................. b. Intended use and occupancy ..... > ..,-~...~:>>"~d..e.~:5'.. './2~./. ff~-~g-~ ......................... 3. Nature of work (check which applicable): New Building .......... Addition..k-(....... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... / .~.,.e~ (Description) 4, Estimated Cost ... ~-..~>./.~..-t2~.. ......................... Fee .................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... 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 . ~'~ ~7. z ~. ....... Rear ............... Depth ../2( .......... lte~ght . ./~.. ~:..D ...... Number of Stones ..... ~. ................................................. 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 10. Date of Purchase ............................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .............................. ~ 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes ~flq'~) 14. Name of Owner of 1/Lemises .,~7~.',/~.d. ~,~ q,e~, .... Address~_~j~M..~.~.~'~//~4~.-~one No ............ ~ Name of Architect/,-~/v,~./a/. .~..e,d~P~2'.../'.. ..... Address~.~..~.4.~.~.~,z~'~.-'-id. Phone No ................ Name of Contractor /-~'t/~'.. ?.,,Cor~'~ ....... Address ./~.<~.~.'~.,gf. fir. Phone No..~J'..,qf.-.6~./~ .... 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 number or description according to deed, and show street names and indicate whether interior or corner lot. abow; named. being duly sworn, deposes and says that he is the applicant 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. Sworn to before me this ........ ......... ...... ....... // $otaryPublic, .. ..... ~ ..... ~ .... ~ County [/// N//~('~//~x~//. // .. .................. L/ ~OIRRY F6BLI_C~, $ta,e o, ~ Lm' / (Signature of applic~t) APPROVED AS NOTED NOT~Y BUILDING DI~PAR$'/,/,[-NT AY 765-2660 9AM te 4P~ ~Og ~UIR, ED INSPECTIONS~ 1. BEFOR~ gACK~ILL(~G ~H~A, TION OR ~TA~T ~A~IG 2. FRAMING [~i'S~?[O~ 3. BEFORE COVERI~G FIP~ 0F ANY KIND 4. FINAL WHE~ J~ COMPLETED OR CONST~TIO~ ER~O~S ALL CONSTRUCTION UUST U[ET REQUIR~[~S OF N,Y. STATE CODE AND TOWN HOUSING CODE & ZONING Sx I~ I DONALD A. DENIS A.I.A.,,.C. I ~ ARCHITECT b \ I DONALDA. DIENIS A.I.A.,P.C. · ARCHITECT II DONALD A. DENIS A.I.A.s P,C. ARCHITECT DONALD A. DENIIS A.I.A., P.C. ARCHITECT SPECIFICATIONS minumum bearing capacity of 2,000 ll0/per sq. ft. Rough grade Rough Carpentry: shall be DFPD "Pll,SCOre Grade". Use ~15 s~,turated felh. Finisb Carpentry: Windows - Andersen "P~rma-Shield", ~nsul~ted class, supply screens - white finish. Exterior Screen Door: Use existing locking mechanisN door. Interior Wood: 1" X 4" T & G "C" or better N~estern Red Cedar. Decking: Redwood "Construction Heart" type. 5. Sheetrock.~ All walls 1/2 inch tapered edge. Use fiberglass batt insulation, foil faced, R Value as per drawings. 7. Finishes: are mn proper condition. Ne shall protect adjacent work against soiling or damage, as well as his own wor].. All surfaces to be painted r~ust be sanded smooth, clean &drv. Shellac sap streaks and knots. Interior: Ties, Ceiling: as selected by Interior Interior One coat Olympic stain, semitransparent, Sheetrock: Two coats of Latex Flat. color 8. Roofmng: Roofing shingles to match existing in type and colnr, 9. Concrete Slab: Slabs shall he placed o;cr well tanped ~i11, slab shall be ~lfOrg] thickness, scrced snooth, fJoat, thor trowc] smooth wlth steel tlowel. General: All electrical work, materials and Fethod nf ins stallation to be in strict confnrmance with local applicable codes and the il.l}~F.U. Code. Fire Underwriters Certificate Distribution: Prnvidc and install an additional circuit breaker panel~ The new beard zs to be large enough to accomm~odat~ all Dew circuits, plus at least Your {4) spares. The Electrical Contr~ctor is to verify locdtions and loads oil any specia~ equipment, which Owner may have~ Materials: All wJ.r%r,g is to be Romex, copper, non-metallic concealed in construction. Switch and receptacle plates are to be bakelite, color as selected. Convenience receptacles are duplex ahd switch silent type tumbler. No alu"~num wiring. Fzxtures: Make an allowance o[ $250.00 {TNO IiUNDRSD FIFTY DOLLARS) fo]' electrical f~xtures which are to be selected by the Owner; furnished and installed by this Contractor. HVAC: Ccnnect into the e}{isting system, nod~fy as needed ~or Nitchen Equzpment: Provide hookup & instalh New wail oven & cook tel. Provided by the Owner. PLastic Laminate: a. For all kitchen counter tops. b. "Formica" - color as selected by Kitchen Cabinets: Finish to match existing. Exterior: Cedar Shingles: Finish to match existing~ Windows: Prcfinished ~ Gutters & Leaders: Wood; suuplied by Owner~ Paint existing~ ARCHITECT ,