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Home My WebLink About10912-z FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.Z1355.3 . . . . . . . . . . Date . . . .Ju1Y. .9 . . . . . . . . . . . . . . . . . . . . .. 19$5. THIS CERTIFIES that the building . . . ONE . . . . . . . .FAMILY. .D.WELLING.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Location of Property . , , ,1405 NARROW RIVER RD . ORIENT . . . . House N . . . . . o. Srreet H.amlet County Tax Map No. 1000 Section . . . . . .Block . . 03. . . . . . . . . . .Lot . . . 0.06 . 0.0.3. . , . , Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated S e.p t ; , 2 6 , , , , , , , 198 0. pursuant to which Building Permit No. 1 0,91 2.Z. . . . . . . . . . . . . . . . . dated . Act : . 8, , , , , , , , , , , , , , , , , , , , 198 Q. ,was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is . . . . . . . . . . . .QNF. F0 xLx .PWALr TNG•. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . . . . . .$ERI,T , LALLI , , , , , , . . /owner,YeYs �1�I1� of the aforesaid building. Suffolk County Department of Health Approval . . . . ).q- 0.-.01 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . .N56,1,29i3, , . . . . . . . . . . . . . . . . . Building Inspector Rev. 1/61 i FORK'NO. 2 i TOWN OF,SOUTH 'kp 6 BUILDING DEPARI/v- 7 TOWN HALL " SOUTH'OLD, N. BUILDING PERMIT; }, (THIS PERMIT MUST BE KEPT ON THE PREMISl S UNTIL FALL COMPLETION OF THE WORK'AUTHORIZED) u I a Date f•+ t r / .......... ......... 19.�+v 1�T(l 10912 Z `� d� t Permission is hereby granted to: k11 . to ...... Q.lSt 7f ..7 .. ?rS✓s1 ..fair. ,l ",t. e,� //.C�t.t . ..................... ......................................... ..................... ..... .." .er ..... at premises located at .«�5 ........./.!�! ._.�..- f1� / �t. , ..................I............. ..................................... ................................ Block ,.. ano. Ji -.G.G.w . County Tax Map No. 10,00 Section 0..�* -7- ..... LoY N pursuant to application ;dated /t �! r 19 d approved by the Building Inspector. I Fee. I... . . ..... 3 .. " 'Builing ;Inspector a E�(IY f t Rev. '6/30/80 re �n N 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 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 informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15 .00 3. Copy of certificate of occupancy $1.00 4 .Vacant Land C.O. $5. 00 . . . . Date . . . . . . . . �°•�/r7 �g . . . . . . . . . . . . . . New Building . . . . . . . . .. .. . Old orPre-existing Building . . . (. �. Vacant Land . . . . . . . . . . . . . Location of Property . . .�./. .Q '. . . . . . . w?Ft'. . .! ! . . .►�tX . . . . . . . . . . . . . . . House No. Street Hamlet Owner or Owners of Property . . . .�JAC-r.?-. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No. 1000 Section . . . . .a a. 7 . . . . Block . . 0 3. . . . . . . . . Lot . . ( d. . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . . . .Lot N/o. . . . . . . . . . . . . . Permit No. 1b. 9./. A.4 Date of Permit8Q. .Applicant . . . . . ? 44. . .SJR.t/ -: . . . . . . . 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 permit meets all applicable codes and regulations. Applicant . . . . . . . . .Qti. . r . . . . . . . . . . . . . . . . . . . . . . . Rev.10-10.78 */*?6 7 0 1000773 THE NEW YORK BOARD OF FIRE, UNDERWRITERS 1 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW FORK 10038 Date May 13, 1982 Application No.onfile 117546-81 Al I'9 THIS CERTIFIES THAT I N�1 1+!): 8 only the electrical equipment as described below and introduced by the applicant nanFed on the above application number in the premises of Michael Mili, Narrow Diver Rd. Orient .N.Y. in the following location; ® Basement ® lst Fl. ® 2nd Fl. Section Block Lot was examined on May 10, 19€32 and found to be in compliance with the requirements of this Board. FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES CO kING DECKS OVER DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT MvppOR PMT K W AMT K W AMT K.W AMT K W AMT ry p 2.0 33 27 2U l g DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALRECPT TIMEC LOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT K W OIL H PGAS H P AMT NO A W G AMT AMP AMT AMPS TRANS: AMT H A SYSTEMS NO OF FEET AMT WATTS SERVICE DISCONNECT NO.OF S E R V I C E AMT AMP rypE METER NO OF <C COND A W EQUIP. 4W 3W 3$�W 3,e"4W PFR d OF CC COND NO OF FRAEG A W G NO OF NEUTRALS A W G OF HI LEG OF NEUTRAL 1 200 (M x l 2/0 1 2/0 OTHER APPARATUS: Rlec. roorn heaters s 9-1.0kw, 3-.5kw.--Motors #, 1 frac.hp. Panels : 1-21, cir. 200amps. 1 GEI, 1 awoke detector, 1-4.5kw, hot water heat Arthur Ruroede Main Rd. (3riCCTt pN°Y° 11957 23,34E NERAL MA AGER This certificate must not be altered in any manner; return to the office of the Board if ricoriect Inspectors may a id Ified,by herr credentials COPY FOR BUILDING DEPARTMENT THIS COPY OFE i 'ICA 1E�ED; IN ANY MANNER. FIELD INSP ,CTIV DATE CONMENTS • 1 ro FOUNDATIOst) o FOUNDATION (2nd) 2, �/— 46 ROUGH FRAME & o PLUMBING y F4—/ ^ 3. i h _ — ni INSULATION PER N.Y, a< v �P T STATE ENERGY ZYf CODE ID FINAL I � . ADDITIONAL COMMENTS: m N 0 m NI d 1 10 op qty uhf M Tolwi of glouVo 't. r � rv. �,. "'"titHa& 62z a);WIS SURVEY VIOLATION uK,wwrwR suUP"t"d}:bkS '�+t,"'TY F?E_d D,ZPARfiMOT _ - O 7HI5 SURVEY IS A VIOlAT10N Of ° DOM 7m OF THE NEW YORK STATE �i �,y ' f2llFAtpN uw ° . . .,., r o ?ri. t1 s'�`iai `rUif�r"iti r::Pla+� '.tFiYSa •�'*r+° $ . DATE LRE LAND SURVEYOR'S @MEL SEAL OR _°,Tamlg T L"OSSED SELL SHALL NOT U COM4ftft .- - �� I- L`' Gv ,ti=#3 ,t�': •: '94C= 'j.'6t t3r'„•Ftf .3, y- i^�.."'4€ e LO BE e A VALID TRUE CORY f r� i._°' ; - T} 'A_ 4i."4" _ GUARANTEES INDICATED HEREON SEE ONLY ONLY TO THE PERSON FOR WHOM i#��Y pc' � �f fi !S PREPARED.AND ON HIS SEHALF RLOYI b e 32L i 5fa CLc='� -t/ v�+. nf4 TITLE COMPANY,GOVERNMENTAL AGEPC` a. J\ J-+-^�-'"- • p �� LE06E4fa INSTITUTION LISTED HEREON. ,v C♦' E;: S i C i ^.'_' "61 f THE ASSIGNEES OF THE LENDING IMS • yy,,}}('/*�}y(�»Ig"r.,.... "{{ pp H'yyl+ '+`�' j"�f]y"p-gt -_4481.GUARANTEES ARE NOT RANNfa.. °+8""1CA$ A Id"� ) L� .:.? F �.. , v S+V'6 fr FA si 4vF¢ < ijQi 9 I�IONAL rk x ITRNK OR sunup. _ T " R X14. IRASSE GRADH As mucessomy IN _ fc6WOOL WA so a�� - �c� -:;; :5.7r_ TFti F-�9 - � ` sysum CAN f3a�' i4w +o1 �Ei1 I � � 7-i-8o 1 01 I , a 'IT P N s- i loo M TOWN' of 6OUT OLI); ky. _. -a„� - x"..� c - , _ ,.•.-crt.r xro. _-, 4t,rs<,� ,w x. ., .r_.. _. �Cn"-'• ma 3 X1+97_ __ - __ t0/ 1�G- 'T `�""r, '1`f' T. sE � Es1F r1c t7 --g �� . A q nate i{. 4E38.? `cpm ftt 28.22 TD t11NQ IT. = 57V_ 6 L- INAUTHORIZED ALTERATION OR ADDITION - F OCATHIS TIONSURVEY LA4/S A VIOLATION OF EXCALATION EM REQUIUD CiION 72090E THE NEW YORK STATE EXCAVATION!(��9��1� ,,u{,p/atl�' AJCQFU5 OF THIP SURVEY MAP NOi BEAR{NG E LA\D Sl. V YOI'S NKK D_;AL O0. J �'{�F~ 1 p NBO.SCp'CAL SN..LL NOt Be CONSIDERED no-is ' I /V }�”;T I+ L�' -- fO BE A VALID TRU-COPY , ,yy Watersupply contains niRat DYs I-An M }GUARAN-E:5 iDr A HEREON SHALL RUN � ...�_� �♦3-Ts w..+Sxb. �,:✓ ��.•�`"x'y FANw TO Tr s FOR v,',Cl,,THE SURVEY possible pesticides . Pr -yto ' c a. p IIS LE -ARtD A D O H Da:;ALF G m_ a' potable Water supply aGC@ 't,$' h t0 e ; --^`-^�^"" . r'„E • '—"�"� TVT! CC'n"A Y GV ,A. Al AGENCY AND _ A .} pF A - x -- -- tENe GI\'Til. QN srro nRov AND Department of Health must, be yyyyv�.CT" , fro THE ASS "EES OF TME ._LADING INSTI, - -btlDd� `4'*'�". ,�- aQ .abl,e •Turaa. GUA:ar.r-cs Az:,cr r,uusFERABLE act the Department CL¢dENl81' "irJ'A sampling s TO ADDITIONAL aNSThUUONS OR SUBSEQUENT and possible treatment ri as r Contact 7, , ._ . I b" r,c i1T i`, ASSL`iF, i> t4.0 t-i EVA 1aCi c cepa �. _ FjU: wl- '1I t%vlia0 4r. 4Qftl %)r— Irb.i Iveo�a: 9 ctSaPCOL AREA so TIWI-7 ,�' .. POOL SYS-16M GAN QE ixtb'IALA.a to - So - G Com- .1 1 c too V%" CKRED ALTERATION OR ADDITIONTO Tf_S SURVEY IS A VIOWION OF �a ' ESOT 3N T'<L OF ThE NEW YORK STATE /]�l��'�• IWO w'��.wr EP1I A 72 IAO. Y Y9Mw�. 1Rp1Cyr ,P�p(ar((' CO°IES Of THIS SURVEY MAP NOT FEARING THE LAIZ SU:..,EYOWS IN�-D SEAL OR t EffE:_S�SEAL SHALL NOT 6E CONSIDERED y ' 1, � �.'i J .+�«. I O � ••.� � r � { T? K A VAUD TAU=_COT'. Y\O lE �(•-' i r _ _ - _ r .0 . ... - . f-., - - a - I '3tR�iiE3 INDICATED HEREON$HALL RUN 3. -: 7 OTME&$ .EORWHOMTHESURYE `^ater supply contains nitr!-j�41 ,s 3.9LG_T.A.—C- HIS KHALE TO THE `qnd possibly pesticides♦ 4r - :MDA,1Y67ICN :t Tm H.LAGENCY to occupancy, a potable Water SS7pp].y 'yh:.. EA$iIT�iE`:1 L'ETEp H.nLON.ANC Tb =,- AE --^ZE$ OF THE LFNDRVG INRT• acceptable to the Dept, o, z' 1 Ya ' W �♦ TZ- foUAR 1125 ARE NOT TRANSEERA y� e p ;.-TIONA/a4TGJTHSNS«slssEw must be made available . �otacb the Department prior to appMrng for SL2vbX, 4 I occupancy concerning sampl n and possible treatmen L) A ASSUTA E AT ��1.�eil��'9� t'✓Y.Lry P+t�l'�+Sl"J I II C`....._-- 1- 1 4" -- - - - f t �A t • _ UNAUTHORIZED ALTERATION OR ADDITION • A C^NT\ TO THIS SURVEY IS A VIOLATION OF ' d• •�.• '� „"','r, I' •. a 5• `• 7YY l+I E• (u/J F+ f SECTION 7209 OF THE NEW YORK STATE •�,C?� ,; •t l; a: - Y( KK••!�V .E a EDUCATION LAW. _ '' ' ' t • ' �'{2•23 - •+---w--••-'-'�'LCi1L5 OF THIS SURVEY MAP NOT BEARING ' // E• VS �^ \\ _ THE IAND SURVEYOR S W4:D VAL OR [. �• Y' ` �,b�a �� EMBOSSED SEAL SHALL N'T BE COMMIRED 4 - ) ' DV :P 7 TO BE A;VALID L Vi WPY. O GUARANTE,S,.NIH ATED HEREON SHALL R j• ,. r \_. /6� \9 S•( T-.� ONLY TO THE PERSON FOB `di,:M INE .RVff / IS 'FEARED, AND Ci, H.5 GhAtF 10 E -R; ` TITLE COMPANY, GOVLRNMENTAL AG Y AND _ J '4 'O~• a� LENDING InSi,TL T,ON LISTED HLRCO AND �O M TO THE ASS.O L,5 OF THE LFNDIN STT - _ \V• y TUTION GUA.✓.RIIECS A..".E NOi 7 SFEgABLE +T;T]. J7^7TfT; „"�. ,e W !A • (� - / Y,y V . E TO ADJ TILnnL IN50,UuUN5 0 UBSEQUENT ,' a,. t)S`� �E9yiL' OWNExS. •• -t:'' '-`d N9Y' Tb?9tv._ tv - �� ' gay' �•'':� M .y G[.Gy�^G7.-''' i^ 7 ""'�°�:'� � ' ' ' � - � .� soil�"• � L'�:i � ,; '• '::. ; a WA�T�E Et ..... to y ('3$4.41 To A,' ^;,S lt`4 14ti"'1V.. - 141.&0 \ .'�; KING 5T. A � ° T) H La ro tl > r e .•!'1 rF _ - . • r ". ' - W x NrE mV7 ^. .v ,[ta'�' `.-'Sa�, i"Y• ''•,'+ - 3 w- b\ GK 's:,f7"s.Vo "..4:::'��:• C.a ... :T'1:•,•L.•^':L' E\ j\ -i .�.V i „ ^'�� V 1 1.:1�. 1 �1 F1 f��11 t-, S4. F`{�l� rv�e••"::,y:G :a1' ,SUIZVOR) FDR a •',`,N`�,• P`'_g'lf��'1 ,1`�.'S.w J x 4 R 0N • Lf1dA 24WT4 CD o 2T & j t B L D G TT :; > � ,•r' ., a � Da .� - ". tQ1A1sAIti�J:QbIA;tttb.S't�tlll�Ot,b 5'4Vtnt(1�'z.^�;-; P o j T i (, •";,'y"!, r y'L J. a -S'i�5,t{7/7�A7{A� "EAS a 514 M i )U+\Y�f�d7�dt:1tL 7,i'F1'J •! l'�'- �r, •�-'� r.•'d° ,1 �L, • .AY'Y t t+. 4 - w N A• > �•{`, 'J .'.or •.'i '*.•!�4'r ,? ,,,; ^„i1, J f. ' 0 t i "'< -� H, N c �'l'°� ;- TOWK OF SOUTHOLIt 't��(. a• H o° f/J/fes*�± 7” r f ` } 'tt R'; a' : 0'•`, „\ s 4•. 1: .. . . ,l ' ',. ,• ,, ' , - ! Y1✓'tsii' 6.. a^'F L f�/.!�,✓k6+'rd _ -d° Ijarzi�c= �SSUrn�P` :to.o �L L V4 AT Sou D FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined . . ., 19 Application No. Approved(oC� . . . . ., 194. Permit No. Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . di nspector) APPLICATION FOR BUILDING PERMIT Date . . . . / . . . . . . . . , 19 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 ins ctions. 17 4�j (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State jwhether/applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises //...... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License No. e o. .3. . . . . . . . . . . . . . . . . . Plumber's License No. /o1 . . . . . . . . . . . . . . . . . . . . . Electrician's License No. S/� . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . vz R 1. Location of land on which proposed work will be done. .!. .dYy`.�� . . . . . . . . . .`.!. . . .A.? . . . . . . . �lti�o iw �(ice b el . Qp..,[ . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section 0?.7. . . . . . . . . . Block . . P . . . . . . . . . . . Lot . A� . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of 12roposed construction: a. Existing use and occupancy � . .G . . . . . . b. Intended use and occupancy Y 3. Nature of work (check which applicable): New Building . .! ' . . . . . Addition . . . . . . . . . . Alteration . . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . . . . . . (Description) 4. Estimated Cost . . . . 3.�' d Co C). . . . . . . . . . . . . . . . . . . . . . . . . Fee�.�� . �. . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 5. If dwelling,number of dwelling units . .b'�F. . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . . Ifgarage,number of cars . . Q. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 . . . . . . . . . . . Rear . .l Depth . . . . . . . . . . . . . . . . . . . . . . Height , ,ber of Stories . . . Z: . . . . . . .�. . . . . . . . . . . . . . 9. Size of lot: Front . /�.. . . . . . . . . . . . . . . Rear . /.14. . . . . . . . . . . . . . . . Depth .14.n.1 . . . . . . . . . . . . . 10. Date of Purchase . . . . . . . . . . ... . . . . . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . I . . . . . . . . . . . . . . . . . . . 11. Zone or use district in which premises are situated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: d. . . . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded . . . . . . F5. . . . . . Will excess fill be removed from premises: Yg. 2 No 14. Name of Owner of premises .�! "�t. . ! ��. . . Address lei3 /? rrr,.c !Phone No.�. `�.?. . . . Name of Architect . . �./. . f/�l.;�'!d."r' Address / < .1��/ 5 Phone No.Qfr Name of Contractor .UKc4 rL R . . . . : S V'!�. Address 3417.0 .0 . . .t`. . . .. Phone No..?7�.�7:: a'3 1 D gq, /,/, .8 a�s s7r• c, �i�s4 4�/cnys� c�•y /oG ojl _ `?/jl �l/�S`36� o'� 0?9r&sgePLOT DIAGRAM' � y 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. 27 5'0 �jdwBw �/vel �?bd c( .�io ✓ lof STATE OF NEWRK, S COUNTY OF . . . . . . . . . . being duly sworn, deposes and says that he is the applicant ame o in ividual sa ng`contra above named. He is the . . . . . . . . . . . . . . . . . . . . on ractor, 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 . � W. . . . .day of. . . . . - . . ., 19 Notary Public. . . . . . . . . . . . . . . . . . . County ELIZABETH A tiavp g applicant) NOTARY POBLIC,State t New York (Signature of a licant No.52-8125850;Suffolk Cou�y \ Term Expires March 30, 192!9- CONSERVATION CODE COMPYJANCR - — — OWNERF/�!�� L"�GG7�� --�� DATE Hol1SS IACATION_ SECTION SNEET BLACK LOT _ DcvN DATA: l'J$GREF, D��7lS : UESICN TGPSP, 1I13A'P EN G: OUTSIDE INSIDE 7Z.° THERMAL_TRANSMITTANCE VALUE SHOWN ON PLA[_.=__ _ —_ ----- R V7,111E U Vi.LUE CODE V _____ SUB-SYSTEM _ -_ _ lASULA'PIO;] SU B_t;YF_1'EF7 _ RE`/UL f:XTERIGR WAI. 1, GROSS ( include heated U. r____• Ud = LOO'AS (exterior doors to unheated r'IAGr.;> vrr_ am31i E` OR jo�_ut unbo_ted sync ci _ .__jL_/�J Uf__� BASEMENT '.%ALL (heated bsmt . below - -_-__— grade____ __ R ca 0. _ju nhtod_at :�l' _ 6 '_ 5'. DISS U—N W-.AT L%+.,S ( inc Ludas infil Lr'ntiou) IAV TLf/hr . S,FY G S'o-o-o EEATING El1U i PMENT: (Type and sin!-) �LL�Gj2�6 6fASBh•_ ;;F]RV]CE lJ*;PCR HMMTR: Maximum tcmporatnre eotting Lo Lc 14f1o1' 1'IWPIPIOSTATS : Provide thermostat for each zone 1DAG 7O—_.P:6'S ; Ptovade minimum of one ( 1) rom: per floor 111FULATION: Type : 1,d thicknosn aINDO4q: All glass to be insulated typo; op-rable windo :e, to be w( ,the, t:GORS : All doors to exterior & uuhcatcd arn•a to be iuSui.:ted t� }„ (U L -� --- than .40) . Doors to be wcalherstripped four (4 ) sicic:.) . PIREPL.AC2; Provide .losable combustion air intake, temp. glass doers ce _---Y opening and chimney damper . 4� OF NEk, 4F i r0 � O 8 M certify Lh.-IL the°.0 pinns 11,13 t:pcoi tications comply with cable sect-icns of Lho New York State Enerqy Con- �jr„' MO sq ?1S aer VMAGn Code . ��CClfION�I � (si qno ter e) (d. lo) I l A to a YCN f VT&Abj)0 AO) 10W440 -fforn LilnANQY, M. opium (Oe• woo xwrwwo i i c 44A409M 4416466 ' I . j fi1LLONX 6APPPoVE0 AS NOTED I hALNuY FEEL 27 A9- BY : � I I I - QEtVA.f I•.Il . _.- . NOTIFY BUILDING DEPA T� 765-1802 9 AM TO 4 PM FOR THEFOLLOWING 1. FO{L,N ATIONP- TWO SREQUIRED I I I i l I I FOR POURED CONCRETE \ // 2. ROUGH - FRAMING & PLUMBING I I / 3. INSULATYON _ ./ \ (1 ` A / ! ex as ��ll PGYwop FT 77 ' 11 I 4. FPNAC - CONSTRUCTFON MUST I l y If T 7, I BE COMPLEJE FOR C 0 i ., ALL CONSTRUCTION' SHALL MEET - THE REQUIREMENTS OF THE N. Y, w - ' 'STATECONSTRUCTrON' & ENERGY I i / LOuCODES. NOT RESPONSIBLE FOR 4• h"tKSMES _' l/ JJ IPcUOR;CONST.RUCTI'ON' ERRORS. 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