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Home My WebLink About10136-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No, Z9788 ' Date December 13 ' 19 79 THIS CERTIFIES that the building ................................................ Location of Property .... .~.~.9.0.. ?.h.~..L. 9.rl.g House glo. Street Hamlet County Tax Map No. 1000 Section ...°.~.9 ...... Block .... 0. e. 9 ........ Lot ..... !.2.~ ......... Subdivision..P?.~.B..].?..B.~..8.~.h..F.~.I~..8. ........ Filed Map No ......... Lot No .... ~. ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .M.87.? .h..2.0. ....... , 19.77. pursuant to which Building Permit No .... ~..0J.~.6.Z. ........... dated ................ lull:Pcb 2'1 . ........... 197.'.9. , 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 ...... T..,.G.,.M~..QO.I~.8. trsl...o.$~,~0~ ~..~ ....................... (owner,~ of the aforesaid building. Suffolk County Department of Health Approval .. .~.-.~..0-'[~. .... .~.q .~.e.~.b.e.~. fl.9., . .'I~.7. CJ .... UNDERWRITERS CERTIFICATE NO ............ .~I../~..~.~.~t.f. ............................ Rev 4/79 FORi~I NO. 2 TOWN OF SOUTHOLD 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) 10136 Z Permission is hereby granted to: ~o ..... ~~...,~,..~--~-~..~c~~..~~ ..... .................................................................... ~ ......................... ~. ...................... ...~. ................................. at premises ocated at ............................................... ~'""-~'r' ........... i ................................. ......... :. pursuant to application dated C~/<~ 19Z.?. and approved by the Building Inspector. Fee $....~.. :.~.......~'.~.-~..... ........................ ~ii~ing Inspec ~ ......................... 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 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. 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 unusuat 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. C. 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.OO Date./':'~:..~./'.~." ~..~. :. ...... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ~. '~.~.' .~..'.'?...~.'~;...~..~-. · ~ ?. ~ ........ -z~.~..~7..~7..:,. ~ ?. ~/?..~.z .......... House No, Street Hamlet Owner or Owners of Property r.. ~.. :/... ~.~lY2:~ .~. ..... ~:~ .~. ................................ County Tax Map No. 1000 Section ~ .............. Block [~;~.,~.? ....... Lot ................ Subdivision ~./??~f.L.~-~. ~.~',.~.C?.,. t,~.--~/.~!..~. ........ Map No ............... Lot No./~.....~. ~, ..... Permit Uo.].O,/.?.Z'. i~ Date of Permit . .Applicant' ./."~.vz~.-~ .,:~.../~.~.~.',-2:,~,~... ~: .-~?;"'.~..'... Health Dept. Approval ./.. .-j~ .... ].~./.' ~.,.Labor Dept. Approval ........................ Underwriters Approval .~. ~.,'-~'~'~ .~.~¢~... !1.:t..'. ~.~.':iPlanning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .... ~ ............... Fee Submitted $...~,' ~. ~. .................... Construction on above described building and permit meets all applicable codes and regulations. Applicant ~ ~. ~? .~./... ~ t?~.~, .'7~¥.. ~-?:~., ~.. ..................... ,. 6 A i"9 ID I 'FI c_~t.~l X-x, I__ FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-18013 E amined.. :/ / ....... ,1 Approved ............ ,1 . Permit No. Disapproved a/c ....... ~ .--~... :":". ........... .~.'. ...... -- / (Buildir[g'Inspector) Application No..f~.~//."f .'~. ....... APPLICATION FOR BUILDING PERM IT ~ate .~../...~....I..., 199.7 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. .~.,..5..: ~:....c,q. ~ ,~T.e:..,..~.. ~e.' .............. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder~ Name of owner of premises . . .'"f~..'..~.,.~.'. ~/ol'Ff~. co ~.?. ~ ........... ..... (as on the tax roll or latest deed) ~ If applicantjs a corporation, signature of duly authorized officer. (Name and title of doi'porate officer) Builder's License No .......................... Plumber's License No.. ~..~..~.....~. ............ Electrician's License No. ~./..~....~. ............. Other Trade's License No ...................... b 1. Locationoflandonwhichproposedworkwillbedone.........~-~"~ ........... ~t: ~'2- .. .... i~..~.~ .~...o~..~...~..g.~'B. House Number Street Hamlet County Tax Map No. 1000 Section .. ~ ......... Block ...~.~. .......... Lot ~':..['~ ..... Subdivision ~SL~ ~c~ F~5 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 ..... ~..~. ~. ~ ~. ~ ~ ~' b. Intended use and occupancy ...~ ~ ..... ~ ~ ~Y ..... ~.(~[~.¢kff .......................... 3. Nature of work (check which applicable): New Building ... ~ .... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... /~ / -~ (Description) 4. Estimated Cost ..'"~..t..O.O..O.. ....................... Fee .df....-~.. .............................. (to be paid on filing this application) 5. If dwelling, number of dwelling units .... O.I~..~ .... Number of dwelling units on each floor ................ If garage, number of cars .... O¥¢..~ ............................................................. 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 ... l~t.O.'. ....... Rear .../~.~ ........ Depth . .'~. ~. ......... Height ...~. iZ. [ ...... .~. ~Number of Stories . ...~. ~...q... ~ ............................ t .............. 9. Size of lot: Front .... .,~..o ............... Rear .... .~.o. .............. ~Depth . . .~.'2..° ......,, ........ 10. Date of Purchase . . ~.."~...~<... (I~.7. ~ ............ Name of Former Owner .~'.~...~.t..~...~?..~..~.~......[~...~.~. 11. Zone or use district in which premises are situated.. ~..~.~ .... ,,,~...~. ~..~Y....t.9'iPJ.! ~l~'.~q .~'.x.~...cf.. .............. 12. Does proposed construction violate any zoning law, ordinance or regulation: .... ~,-& ~. ....................... 13. Will lot be regraded ..... ~ ..o .................. Will excess_fill be removed fr.q~ premises: Yes Nov 14. Name of Owner of premises .~.~..~... Name of Architect .~..11~. ¥.~...'~!~.\~..~?. ...... Address ................... Phone $o,I'L ~.. ~..~.~f~.~.~t~__a~-'~'' Name of Contractor~..~x.O...c~..ly)?..%...ee.,~... .... Address ~.~.. W~.!i~_P...~. Phone No.Sfl,. ~?.t. ~'..~..T~.~.. 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. 0 2-9o STATE OF NEW YO~Kg/. ~/ S o COUNTY OF.. ~:/.~.c~. , ' ' ', ..... ~.. ~ ~ ![ I..~ ~ .... ~ ~.e~ .................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the .~'. ~' 0~- ~. ~. ~- (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly authorized to perform or have perfo~ed the said work and to m~e ~d file ~is application; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the work will be perfo~ed in the m~ner set forth in the application filed therewith. Sworn to before me this ......... .. ~ .day of ..... JUDITH T. TERRY Notary p',bl:.c, ?;~te of N~w York ........................... Gommission Expires March 30~ · 60.00 facil~ie~ Pop %his looa~ou h~e been = ~nspee~ed b~,t~is depart~ent md found , ~ b~ s~tisfac~or To THE $ FOR 4reD; ~1616 ~7. ft. Lot 51 CORP. BEACH F,~F~I~$ ' · IUN£P~ 1979 SCALE: /.= 40' NO. 79 -73 ~:AOO r o~ ~ THIS 7209 OF THE THE LANo SEAL SHALL LY TO IPANY, GOVERN- ITION LISTED LINES SPECIFIC ~ }ESTABLISH OF FENCES GUARANTEED TO = 400 OSYRANDER AVENUE RIVERHEAD~ NEW, YQEK { II II APPROVE~ A~ NOTED · NOTIFY BUILDING DEPARTMENT AT 1. EEFORE BACKFILLING FOUND~ HOT RESPONSIBLE FOE DESIGN 5. ALL CONSTEU~TION MUST MEET .-ff UNEX. II k, ' GARAGE -? 4 DECK LIVING I¢ II I.'9- I& _ II II i I II OWNERSHIP OP DOCUMENTS THESE DRAWINGS ~, SPECIFICATIONS ARE INSTRUMENTS OE SERVICE AND ARCHITECT. G~E~L NOTES FROM PERFORMING HIS WORK IN ACCORD~CE WI~ STATE A~ LOCAL COOES, 2. ALL CONCRETE SI~LL BE CON~OLLED STaNE CONCRETE HAVING A SIN PROVIDE BRIDGING AT CEN~R O~ ALL SPANS. PROVIDE SIN 2-2" x 6" WOOD HEADERS O~RALL OPENINGS UNLESS OTHERWISE NOT,D. 5. F~TINGS DESIGNED ~OR ~O TONE PER 8Q. FT. BERING CAPACITY TO BEAR ON UNDISTURBED SOIL, FLOOR JOISTS UNDER PARTITIONS PARALLHL ~ FLOOR JOISTS ~ OVeR ORDI~NCEg, ENERGY CONSERVATION NOTES_': [NUW YORK STATE ENERGY CONSERVATION CODE) PERCENTAGE OF GLAZED AREA IS NOT GRRATE~ THAN 25% OP TOTAL WALL M1EA. DEGREE DAY ZONE = 6000 DEGP~E DAYS. (SUFFOLK COUNTY) THE FOLLOWING VALUES OF ~HE~/AL ~ANSMISTANCE SHALL BE MINII.~IM VALUES FOR USE TN TMIS PROJECT: ROOPS AND ELOOP~ EXPOSED TO A}~IENT CONDITIONS EXTERIOR WALLS GLAZING ENTRANCE DOORS .~, FLOOR~ OVER OR AB{lIVE GRADE BASEMENT WALLS. EN~%OSING L~HEATED SPACES SIAB EDGE INSULATION UNHBAT~ SLAB SLAB EDGE INSWLATtON HH~TEb SLAB HEATED BASE~BNT/CELLAR WALLS (^SO~ ~A~E) ~EA~n ~ASS~WT/CELLA~ WALLS ~RE~OW ~E) Ri = 8.0 Ri= FIREPLACE CONSTRUC~'ION SHALL BE TN STRICT AC~I~BANCE WITH EN-RGY PROVISIONS OF SEC~0N E-402.4 OF ~E NEW ~STATE AL~ DOOP~5 AND WIN~O~ TO BE DE$1~NI!D AND COI~TR~TED TO AiR LEAKA~ ~N ,~R~NC~ WlT}~ SECTION E:40~,Ab OF YORK S~ATE ENERfi'~ BUILDEN~ MECHANI~C~L SYSTE]~B SHALL B5 IN sTRICf ACCORDANC~ ?PART S * BUIL~'~I~ BY ACCE~tE ~CT~C~ O~ 7 ,3