HomeMy WebLinkAbout13051-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Z'138q7 Date September 3 19 85
new dwelling.
THIS CERTIFIES that the building ................................................
Location of Property .... 7.~:5 .................. ~g_.m.m.5,~..I)?... ................ ~..~.i.~u. 9k
t~ouse No. Street ~ Hamlet
County Tax Map No. I000 Section .... .'I.0.C~ .... Block ........ '1. ......Lot ....... .~.~ .......
Subdivision .............. X ................ Fried Map No .... .X .... Lot No. X
conforms substantially to the Application for Building Permit heretofore Fried in this office dated
...... JaI~.uary. 2~...., 19 .~3q-pursuant to which Btrilding Permit No .... .~3..Q~.'l .~. ..........
dated ..... g,p~.Sj[..!.~ .............. 19 .~./~., 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 .........
...... A. ~e~r. ~.w.e~-~-~g, ........................................................
The certificate is issued to .............. 33~"~O~..&. ?.~1~..X..Q .g~.._~, .~.~. .....................
(owner~
of the aforesaid building.
Suffolk County Department of Health Approval ......... 'l 3-S0-2~ r?
N662392
UNDERWRITERS CERTIFICATE NO ..................................................
Building Inspector
Rev. 1/81
FORM NO. ~B
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PEPJ~IT N[UST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 13051 Z
County Tax Map No. 1000 Sectio~n ...... ~...0...~¢. ....... Block ...... ..~...[ ......... Lot No ....... ..~....~. ...........
pursuant tO opplicotion doted ...~.......~...~ ................. , 19.~....~., and approved by the
Building Inspector.
Building Inspector
Rev. 6/30/80
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 ia ~[11~ to the Building Inspec-
tor with the following; for new buildings or new use:
il. 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. Su bm it P lan n lng Board app royal of completed site p lan requirements where applicable.
B. For existing buildings (prior to Aprit 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of p~operty 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
c.o. _
Dat .~.
New Building ...."~ ....... Old or~Pre-existing Build, in9 ............ Vacant Land .... , .....~. ·.
Location of Property..~'.-. ~. .... ~~./~ ................. .'~.~,..~..~.C:~...
House No. Street Hamlet
Owner or Owners of Property .~..~--~-4~,~,>,~.',*,.v-~..w .~.~¢~ .........................
County Tax Map No. 1000 SectionYf--~. ........... Block .. Z~Z ......... Lot..(~. ~J.~. ........
Subdivision ................................. Flied Map No/' .......... Lo,t~lo.. ~. ..........
Permit No../.~.d,,.).~. ate of Permit . .Applican ........
v" ~ ov
Health Dept. Approval ........................ Labor Dept. Appr a ........................
Underwriters Approval ~'. ...................... Planning Board Approval ..~/./~.-~..f~.'~.'. ..........
Request for Temporary Certificate ..................... Final Certificate ~ .....................
Fee Submitted $.. ,~.~.~..(~....~'..~. ~.~. ....
Construction on above described building and permit meets all applicable codes and regulations.
Rev, ~o-~o-78 ~f
James V. DeLucca
12 LindaLane East
Riverhead, NY 11901
April 4, 1984
Town of Southold
Building Department
Town Hall
Southold, NY 11971
Mr. & Mrs. Byron Canaris
735 Summit Drive
Mattituck, NY 11952
Dear Mr, Hinderman:
TO answer your notice of disapproval dated Jant~ry 27, 1984,
referencing the above building permit, the following corrections
are being made so that a building permitmaybe issued:
SITE PLAN
1. Letter from owner, .(which is enclosed) r~eleasin~i~th~' To~n
of Southold from any liability of structural damage.
2. Access to the building is off Sound Beach Road, with
appropriate driveway rather than Sunrait Drive (survey enclosed).
BUILDING PLANS
1. Calculation of glass area verses wall area is noted on
sheet 1 of 5 and lneets Energy Code Requirements.
2. All other items listed ~der your conr~_nts are not re-
quired for the reason being, this is a totally new structure.
Please note estimated cost of construction of new structure
is $90,000.00 verses $120,000.00. I would greatly appreciate if
you would expedite this building permit.
If you have any questions regarding the above, please feel
free to contact me.
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
$OUTHOLD, N.Y. 1197!
TEL. 765-1802
April 24~ 1984
James De Luca
12 Linda Lane East
Riverhead, N,Y. 11901
RE: B.P. #13051Z-Byron Canaris
Dear Jim:
This is in answer to your inquiry regarding access-
ibility requirement to premises from both Sound Beach
Dr. and R.O.W. off Summit Drive.
Once the R.O.W. has been improved and approved by
the Planning Board~ you may amend your application for
this permit by abandoning driveway access from Sound
Beach Drive and submit new site plan showing R.O.W. from
Summit Dr. as access to property.
Only the R.O.W. from Summit Dr. will be recognized
as the access to premises and driveway,from Sound Beach
Dr. will not be required for purpose of issuance of Cer-
tificate of Occupancy.
Trusting this will clarify any questions you may
have.
Ed Hindermann
Building Inspector
EH:hd
THE NEW YORK BOARD OF FIRE UNDERWRITERS
10000~2
BUREAU OF ELECTRICITY
~- 85 JOHN STREET, NEW YORK, NEW YORK 100~8
THIS CERTIFIES THAT
only the electrical equipment as described beJo~ and int~duced by the applicant na~ed on the above application number in the premises of
B. C~n~ria~ ~ of :,[iri~n ~ad & ~ ~nJ.t Drive, C~tz~l ~ ~i~ ~, ~;~tituck~
in the yollowing location; ~ Basement ~ 1st FI. ~ 2nd ~7, Section Block Lot
wasexamlnedon ~O~i~X' ~7~ ~.~ andfoundtobeincompliancewiththerequirementsofthisBoard.
FIXTURE ] [ FIXTURES RANGES COOKING DECKS OVENS DISH WASHER~ EXHAUST FANS
~1 40 39 41 i 11.7 1 ] '
3 F Z ~0
I
SERVICE DISCONNECT NO. OF S E R ~ I C E
~T. ~P ~PE EQUIP. 1~2W I ~3W 3~3W 3~4W NO OFpERCC~COND OFAccW, G,CONO NO OF HI-LEG OFA'W'GHFLEG NO~ OF NEUTRAL: oFANEuTRA[
~ ~5o cbx, ~ ~/0~' ~/0
227 N. B~vat~ ~ad ~ ~.~- } /
~ttJ.~ck, N,Y. 119,52 Lie. 1529 GENERAL MANAGER
This certificate must not be altered in any manner; return to the offce of the Board if incorrect Insnectors ma be identf
~~~.~~~~ y ed by their crede~trals.
YOFCERTIF
ANY MANNER.~
TOWN OF SOUTHOLD
OF£.iCi.; Ok BUiLDiNG INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-I 802
CERTIFICATION
Date
Builains Permit ~o. ~ ~ O
(please print)
pluraber ~ S~m,~R~
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
(plumber' s signaturei
Sworn to before me this
~-~ay 0f~2)~7£l~ ,
Notary Public,~._~_COunty
I~SPECTION COMMENTS
FOUNDATION (lstl
FOUNDATIOH (2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
C,ODE
FINAL
ADDITIONAL COMMENTS:
TOWN OF $OUTttOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y, 11971
November 5, 1984
TEL. 765-1802
James De Luca
12 Linda Lane E.
Riverhead, N.Y. 11901
RE: B.P.#13051Z
Dear Mr. De Luca:
This will confirm that a final inspection
was made of dwelling constructed under this per-
mit and was approved for issuance of Certificate
of Occupancy.
Please refer to my letter of April 24, 1984
(copy enclosed) which makes reference to improve-
ment of R.O.W. from Summit Dr. before a certifi-
cate of occupancy can be issued.
If you have any questions regarding this
matter contact me at this office.
Elt;hd
Byr~ Canaris
i38 37 62nd Ave.
Flushing,
Buildi/g Ynspector
N.Y. 11367
P.S. Underwriters Certificate, Suf, Co. Health Dept.
and application for C.O. required.
C~mmAL OONDITIONS
All work of the entire project shall c~1¥ with state, county, local
laws and regulations including the D.E.C. All material shall be new and
of good q~alitv. All workmen shall be skilled in their trades, and all
workmanship shall be of good quality.
The contractor shall unconditionally guarantee all materials And ~rkman-
ship furnished or installed by. him or his sub-contractors for at least one
(1) year frcm the cc~pletion of the entire project. The contractor acrrees
to ren~dy and deficiencies of the above appearing within that period with-
out expense to the owner.
The construction contract shall include and provide all labor materials,
~equipment, transportation, taxes, etc. necessary to the completion of the
house and decks as specified in the construction drawings and in these
specifications.
The contractor shall include everything necessary for sati~facto.rv cc~-
pletion of the work including all work not shown or called for that in
c~.,~'on practices would be deemed to be covered by or reasonably able to be
infez£~d frc~ the specifications and drawings.
The contractor shall be responsible for satisfactory performance of all
work, be responsible for all acts and ~issions of all parties involved in
the work, ensure that each trade is fully informed of full extent of work
required and coordinate installation of all _equipment and systems includina
items supplied ~v the owner.
Work shall conform to the published specifications of the applicable
manufacturers unless othez~ise specified or indicated.
The contractor shall at all times keep the site clear of debris and
rubbish, and at the completion of work prc~otlv remove tools and ecn/iD-
ment, rubbish and surplus materials, leaving the house and site clean of
construction debris.
.~XCAVATION AND ~ILL
All ground cover where proposed' house will be located must be re,Dyed
off site. Top soil must be stripped as required and stock piled on site.
At the cc~pletion of the house top soil must be spread as reGuired.
Excavation and fill as reouired for driveway and foundation, ali. as
deterred_ned bva licensed surveyor and the Town of Southold, N.Y., setback
and elevation requiredments.
It is f-he contractor's resronsibilitv to maintain and restore any
damage w~ich may be done to the Right-Of-Way Driveway.
FOONn~I~
All footings are to be footed c~ virgin soil and be made of 3,0~0 lb.
concrete mix. All concrete foundation walls are to be 8" poured concrete
and 12" footing poured concrete below chimney.
Basement and garage slabs are to be poured on compacted fill over
%rapor barrier with 6" X 6" steel re-enforcing wire throughout.
Foundation is to be dampproofed in L~o (2) stages. First staae to
be brush on coat of dant0proofing. Second coat to be trowel on with damp-''
proofing mastic. Before tittle,roofing is apglied snap ties must be broken
off at ¼" below surface of foundation and marqed with portland cement.
Fireplace Living t%oom to be brick front up to mantel height and 1 ft.
on beth sides of fireplace opening. Brick type to be chosen ~ c~a~er.
Fireplace flue liner to be 13" X 13" clay pipe and boiler flue linin~
to be 8" X 8" clay pipe.
Heatalator to be a 48" Model A Heatform brand, with an' 18" bluestone
Provide firestopping at floor and roof framing at chimney.
Flatroof to be U.S. Intec Brai, Mebrain tyme. With three 3" internal
drains, aluminum gravel, stop at edge and cover roof with alumin~n roof
coat.
Pitchrcof 240-1b. selfsealin9 asDhalt shingles over 15 lb. felt. Color
of shingles to be chosen by owner.
3% batt insulation in ey+erior walls (kraft foil).
9" batt insulation in flat roof (Kraft Poll).
3%" batt insulation (foil faces) at underside of floors.
facing unheated space.
Provide adequate roof ventilation as shown on drawings.
12" bart insulation pitch roof.
Pac~e -2-
EXTERIOR
1" X 6" T/G cedar sidir~, grade No. 1, treated v~ith preservative such
as Cupinol or ecp,~l. No loose or open kDots. 15 lb. building paper.
1/2" sheathing grade plym~od, CDX.
2" X 4" wall studs at 16" o.c.
3% fiberglass batt insulation .
1/2 plasterboard - ta~ed, .spackled with at least 3 coats to provi~
smooth and indistinuuishable joints and painted.
All framinq lumber must be Douglas Fir #l.
All 2" X 4" wall studs must be kitm dry.
All exterior he~ders shall be (2) 2' X 12") except as noted
All exterior nailing shall be done with galvinized nails.
All exterior decking and sfai rs shall be CCA lumber.
Ail exterior siding soffit and facia shall be 1" X 6" V oroove
All exterior lumber must be pre-stained before installed, including
CCA lumber.
INi'~RIOR W~tT .T ~q
All framin.~ lumber must be Douglas Fir #10
2" X 4" walls studs 16" o.c.
1/2 plasterboards both sides - taped, spackled and rk~_nted.
Use waterproof sheetrock, be~hind all ceramic tile work.
CEILINGS
1/2 plaster board, tarried, soackled with at least 3 coats and
painted.
All window,s to be c~radco w~od case3~nt with insulated qlass
and wood screens. Sizes as noted on drawinqs.
EXTERIOR SWINGING & SLIDING
Ail exterior doors are to be Peachtree type with insulated class.
Screens to be provided for slidinq doors. Sizes as noted on drawinqs.
SKYLIGI~fS
All skylights are to he Insula Dome, clear tk~e %~ith insulated
qlass. All skQ~,li~hts to be vented type. Sizes as noted on drawings.
Should be flat ~an~t~ v.~dl w~th cedar ap.~lie~ to ~atch sidinq.
Sizes as note~ on
IDleR/OR F/NISHING
All interior doors are to be birch veneer stain grade, except as noted on drawings.
Interior base t~im and door jam trim to be 1/2" X 3" square
edge stain qrade pine.
Closet ~aelving and supports are to be of #2 pine stain.
Medicine cabinet for master bedroc*n bath s~u3_ll be Miami Carey,
(Broadview CSP 422-60) Antique C~ld.
.~licine cabinet for hall bath, quantity two (2) (Broadview
CSP 420-36) Antique c~ld.
Stairs frcm living roc~ to bedrocm area are to have oak treads.
Handrailing to be of oak frc~ liv/n~ room to bedroom area.
Spi~al staircase frc~ basement to loft must be Mylen type~ (C~q-100)
with pipe railing as rec~uired. 1% oak treads and platfozm is to' be
installed on stairs as r ~equired.
Loft railing is to be manfactured to match railing for spiral
stairs.
Floors ~ to be prepared to accept finishing. Materials as
noted in finishing schedule.
Walls are to be water~roof sheetrock.
Unglazed cer~ic tiles on floors and walls (4 '-0" high) except tub srea.
All tiles selected by owner.
PAINTING & STA!NIL~
Ail walls & ceilings to have two (2) coats of latex r~mint. C~lor to
be chosen by owner.
Ail interior trim to be either painted ~rith two (2) coats of semi gloss
paint or stained as rec.,/ired. Owner to choose stain or paint.
Exterior %~indow & door trim to receive two (2) coats of oil base paint.
Owner to choose c61or.
Exterior siding, facia and soffit to receive one (1) ~oat of oil base
stain before installation. O%~er to choose color.
ELEt'rRIC-AL
Codes, perm/ts, certificates: Regulation of Local and State Authorities,
National Electric code, Local Telephone and Electric Cc~oanie$, shall be com~
plied with. Obtain necessary certificates and perm/ts frc~ Board of Fire
Underwriters, arrange for electric, telephone service installation with
local utilities.
Electric service to house shall be 150
Provide and install general or e~uiva/ent circuit breaker type panel
box in basement. All wire to be copoer Romex, sized to code.
Page -~-
HEATING
Installatic~ and equipment shall cc~fozm to New York State Energy and
New York State ~uilding Code.
Insulate all heat piping in baser area R -- 4.6 minin~ra.
Equipment and systmns subject to damage from freezing shall be adequately
protected against freezing.
Provide and install a complete 3 zone central oil fired warm air system
with heating capacity guaranteed to assure an even 70 o F. indoor temperature
with ~ outdoor t~mperature of 10 o F. and a 15 mph wind.
Provide and install 550 gallon oil ..tank (fiberglass coated), complete
with fill and vemt lines and fuel supply lines to burner, with a filter
bet-w~en tank and hamer.
1. fine 3 zone heating system with Rmpco boiler with tankless coil
for domestic hot w~ater or equal
2. 3/4" Grundfus circulator or equal
3. Beckett burner with Honeywell controls or equal
4. Embassy 3/4" baseboard or equal
5. Honeywell T 451 line voltage thermostat or equal.
KITCHEN
Allowance to be provided. I~itchen to be selected by the o~ner.
Appliances to be selected by o~ner.
PLI~YBING
All fixtures to be American Standard. Color and model selected by owmer.
(fiberglass tub enclost~res).
All faucets and tub diverter shall be C~rber or equal.
Provide two hose bibs at the exterior..
Provide floor drains where required.
All pltm~bing ~rk to be done in full conformity with local and state
codes.
Equipment and systems subject to damage from freezing shall be adequately
protected against freezing.
Sanitary. drainage syst~n to include all required septic tanks, cesspools,
and drainage pipes.
Contractor to obtain all permits, inspections, and approvals.
Pa~e -5-
Cmntractor to maintain cleanliness during ccnstruction. Cx~ntractor to
remove all debris at the final ccmpletion of the construction.
GRADLNG AND lANDSCAPING
Ccmplete all grading as required, + or - 2".
landscaping to be provided by owner.
5" well to a depth of 180 ft. at ground level.
5' ft. stainless steel scl~en.
1 H.P. ~uld sui~ersible pump.
1" galvanized drop pipe.
No. 12 sutmmersible .Dump cable.
5" well seal.
Block ~11 pit and trenching.
DRi%~E~V
20' wide asphalt driveway with, 1½" wearing course .New York State
Mix .Type lA. & 1½" base course of stone blend.
Page -6-
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
File No. ,. ~ .............. · .............
PLEASE TAKE NOTICE that your application dated ... .- ~. -, 19 ~<~.
for e~it to const~ct...~/~., ~ ~(~ ................................ at
P ~
Locauon o] rrop Y ~s~ No. Street "
County Tax Map No. 1000 Section ..[~ ....... Block . .~.~ ........ ~t .~.~ ......
is returned herewith and disapproved on the following grounds ................... . ............
............ . .... ~. ~r<~.~r/~... ~cr2x~xm~ ...............
$3uilding Inspector
RV 1/80
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST I/X,] ROUGH PLBG.
FOUNDATION AND [ ] INSULATION
[/~/FRAMING [ ]
FINAL
REMARKS:
DATE
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined....C~... ! .~..., 19~.~.
Approved . . .C~...~.~...., 19~.q. Permit No.]. .~.O.~.)..'~..
Disapproved a/c .....................................
Received ........... t9...
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Date ................ ,
a. This application must be completely filled in by typewriter or in ink and submitted 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 issued 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 f%r~removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, buildi./~.g//code, housi~, and re~d~)ior~s, and to
admit authorized inspectors on premises and in building for necessary ~ //~ j ) ~
· ~.-~'~e'o'~ ~pli~e, ~fa corporation)
/.//..z../, :.T./T,
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.... .....................................
/4,,
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.. [/,¥I~./UOW..~...~..-[7.. T./?l/.
Plumber's License No. t~..P/k./Y.O.~.~. ·
.... o
Electncmn s L~cense N ·
Other Trade's License No ......................
1. Location of land on which proposed work will be done ..................................................
· · ./3. ...... ...
~ House Number Street Hamlet
County Tax Map No. 1000Section ...... /~..~. ...... Block ..... .C?.[. ........ Lot. '~4
Subdivision C/q~...~?./t~/ /~/~t~ ~" .~.~.~../T.~'..~.. Filed Map No...~. ~:>.7..~. .... Lot.../..~. ........ ~
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed constrttction:
a. Existing use and occupancy ....................... .~ ..........................................
b. Intended use and occupancy . . .'~.../. '.~Y~.~.~.'r~...../~...~. · .~7./- (/· · ../~- - -/'~- -/~.~. -~. //.~.-
3. Nature of work (check which applicable): New Building ......... Addition .......... Alteration ..........
Repair .............. Removal .............. Demolition .............. Other Work ...............
(Description)
4. Estimated: Cost, /-/Al,
i (to be paid on filing this application)
5. If dwelling, number of dwellin~ units ....... L. · · .,. · · Number of dwelling units on each floor..'~ ........
If garage, hum ber of cars .... i ~ ....~,A/~./~'' ~.~.~._q~.. ..............................................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ........ ~ ............
7 D' ' fex' 'ngst tures 'f F -- Re D pth
· lnlenslOllS o lstl ruc ,1 any rout ..., ar ..... '7 ........ e ...............
Height '--' Number of Stories
Dimensions of same structure with alterations or additions: Front . ' .............. Rear ..................
Depth ~ " Height Number of Stories
8. Dimensmns ofe ttre new construction' Front --~ . .F~/~' Rear O ~ De th .4(0 ~ .
Height .. 2..~....7~.... Number of Stories ..... / ..................................................
9. Size of lot: Front .... /_O_O..!.~.C~.. ........ Rear . /O.~f..-.O.&? ....... Depth,~../~.~'...,~.zJ.~..,~(~ .....
10. Date ~feurchase ./~./.D.~(.. ~.q.'7...~. .......... .~,~ ~a~; ;~Former Owner . .~.AY//q~.~tf~.fK2./~./ ..............
1 I. Zone or use district in which premises are situated./('~'.,~/..~..4f~. ,/.~.~ ................................
12. Does proposed construction viblate any zoning law, ordinance or regulation: ../~/l~P ........... i .............
13. Will lot be regraded ...... x~ .,!/!~;~· .......... Will excess fill be removed from premises. Yes
14. Name of Owner of prergises ~ltfaPf/l~l~.,ffL,.U--.~.g~/~l..~..Address/o~.",.~,7..~ .fl.//~. .... PhoneNo ...............
Name of Architect . G/.~tt4. ~.~....~'..'/~.~.. ~.~¢ff.,~.. Address /2,J[-.IKOgq./-,,f~7~...~./~.'~hone No.'2~.7.~..~.O.O. . .~../7~;
Nmne of Contractor .. g/~t. ~.~.O(,<~za/ ........... Address . .,~ .~.F./~.~./J?. ..... Phone No ................
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and bloci: number or description according to deed, and show street names and indicate whether
interior or corner lot.
TAFE OF NEW YORK S S
~K/f.~?/~/Es /~i'..~. ~ ~2~C~ being duly sworn, deposes and says that he is the applicant
abov~ namied.
He is the
(Contractor, agent, corporate officer, etc.)
of said owner or owners, ~d is d~ly authorized to perform or have performed the sai~g[k and to m~e and file this
application; that a~l statements con~tained ~ this application are true to the best o~$~d belief;and that the
work will be perfo~ed in the m~ner set forth in the application filed therewith. ~, ~ ...."* ..... O~ ~,
Sworn to beforejn~ this ~ ff~*'~RENE j~o...
....... ~. .......... day of. :'. ....... , 19.~./ ~ No. -~
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT
N SUFF CO. TAXM~F DIRTI000 SECTION 106, IM. OCK OI LOT 44
K. TME~ ARE NO DWgLLI~$ WITHIN I00 FEET OF TH~$ PROPERTY
ADDRESS
''~MONUMENT FOUND O= PIPE FOUND
AREA= 25,608 S.F.
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY
ON JAN. 19, 1949 AS FILE NO. 1672.
ELEVATIONS EHOWNTNUE, ~o 0 ARE REFERENCED TOMEAN 9EA LEVEL
SURVEY FOR
JAMES DELUCCA
PART OF LOT 15, "CAPTAIN KIDD ESTATES"
AT MATTITUCK
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
DATE:
SCALE:
NO.
SEPT. 7, 1984
AUG. 29, 1983
I": 40'
83,-701
!1
YOUNG a YOUNG
ALDEN W. YOUNG, PROFESSIONAL ENGINEER
AND LAND SURVEYOR N.Y.S. UCENSE NO. 12:845
HOWARD W. YOUNG, LAND SURVEYOR
N.Y.S. LICENSE N0.4§893
400 OSTRANDER AVENUE
RIVERHEAD, NEW YORK