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Home My WebLink About15566-zI '-7 FORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-16443 Date November 27, 1987 THIS CERTIFIES that the buildhlg Addition & Alteration to existing one '' {~n'£ ]~' 'd'~J& l'l'i'r~ j ............................ Location of Propertv 8335 Main Road East Marion, New York House No. Street ..... ~l~/e~ County Tax Map No. ] 000 Section 03 I .Block 2 .Lot 14 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated December 4, 1986 15566 Z ...................... pursuant to which Building Permit No ...................... dated.....December ......... l.....1, 1986 .......... wasissued, and conforms to a]l ofthe requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ADDITION & ALTERATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to GERTRUDE IGLESS IAS ..................... .................... of the aforesaid building. Suffolk County Department of Health Approval N/A , UNDERWRITERS CERTIFICATE NO... N 8 2 8 3 7 8 PLUMBERS CERTIFICATION DATED: September I7, 1987 Building Inspector Rev. 1/81 FOI~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 15566, Z Permission is hereby granted to: . ~ ~~ ~.,~. ..................... ............ . at premises located at ...,~..~. ....... ..~.~...~ ........... ~,..~.~.,~.~ ..................... County Tax Map No. 1000 Section ....... .~...~.~ ...... Block ..... .~/..~ ..... Lot No ...... )...~. ............. pursuant to application date~.....~... ................... , 19.~...~., and approved by the Building Inspector. ~ee *...I..~.~.:.~ .... Building Inspector Rev. 6/30/80 RICHARD SAETTA, INC. General Contracting 4 Bootleg Alley Greenport, New York 11944 (516) 477-1633 (516) 749-1060 November 27, 1987 Southold Town Building Dept. So,hold Town Hall Main Road Southold, New York 11971 Dear Sir: Enclosed please find our check in the amount of $15.00 for a Certificate of Occupancy for the Iglesias house in East Marion. (Permit No. 15566-Z) A check in the amount of $10.00 was previously paid on 9/23/87. Mr. Saetta will stop by on Tuesday morning to pick up the Certificate of Occupancy. If you have any questions, please don't hesitate to call. Respectfully yours, (Mrs.) Beverly Bredemeyer Secretary Enclosure RICHARD SAETTA, INC. General Contracting 4 Bootleg Alley Greenport, New York 11944 (516) 477-1633 (516) '149-1060 September 23, 1987 Building Department Southold Town Hall P. O. Box 1179 Southold, NY 11971 Re: Iglesias Residence 8335 Main Road East Marion, NY 11939 Dear Madame or Sir: Enclosed are: 1) Application for Certificate of Occupancy 2) Plumber Solder Certificate 3) Copy of Final Building Dept. Inspection 4) Copy of Underwriters Certificate 5) Check in the amount of $10.00 We look forward to receiving the Certificate of Occupancy. Thank you. Respectfully yours, Richard Saetta President RS:bwm Enclosures - 5 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Dates~pf~mb~r ]7~ ]987 Building Permit No. 15566Z Owner Gertrude Iglesias (please print) Plumber Frank Meyer (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumbe~ff' s signa~re) Sworn to before me this /7 day of ~~ 19 ~? . Notary Public, ~~ , ~OTA~'Y PUBLIC, STATE OF NEW YO~ N(} 52-05794~¥q~f~O~ ~- CO?TY County Notary Public THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000~/08 BUREAU OF ELECTRiCiTY THIS CERTIFIES THAT Iglasi~, 8335 Main ~** East M~rlon~ in the yoltowlng location; ~ Basement ~ Ist Fl. ~ t~, Section Bilk Lot n~s examined on ~ ~ ~ 3 ~ 19~7 attd found to be in compliance u'ith the requirements of this Board. FIXTURES RANGES OVENS DISH WASHERS FANS FIXTURE SWITCHES OUTLETS INCANDESCENT FLUORESCENT 16 35 35 15 DRYERS FURNACE MOTORS APPLIANCE FEEDERS TIME CLOCKS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT S E R OTHER APPARATUS: 1-30 amp. Transfer 8witch SMOKE DE'~ECTORS~ 3 TP~%CTK LIGHTING~ 30t-0"~ 13 lites l/O C SI AWG, NO OF NEUTRAL OF NEUTRAL i l/o Sal Prato Electrician Wiggins Lane Greenf~rt~ No¥. !!,944 lLc.%I049-E ~ ~ GENJRA~ MANAalER p,.,. (C. This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their- credentials. COPY FOR ?UILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT 765-1802 BUILDING DEPT. INSPECTION REMARKS: FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] IN~'LATION FRAMING [ ~ FINAL DATE INSPECTOR FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted I ~ 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: Additions $25.00 1. Certificate of occupancy New Dwelling.$25.00, Accessory,S10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occ~gpancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ..$~p~r~r.~l.~ ....... New C on s t r uc t i on ...... Old or Pre-existing Building ~ .......... Vacant Land ............. Location of Property 8335 Hain Road, 'East Marion, NY 11939 House No, Street Ham/et Gertrude Iglesias Owner or Owners of Property ............................................................ County Tax Map No. 1000 Section 031 Block 02 14 ........... . ...... · ........... Lot ............. ... Subdivision ................................. Filed Map No ........... Lot No .............. · 15566Z Permit No ........... Date of Permit 12/11/86 .Applicant Rich. Saetia General Contractor, Inc. Health Dept. Approval ........................ Labor Dept. Approval ........................ Pending Underwriters Approval ........................ Planning 8oard Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted$ 10.00 Construction on above described building and permit meets all, applicable codes,and reg,ulations. Applicant .... . .......... Rev. I0-10-78 Richard Saetta General Contractor, Inc. 4 Bootleg Alley ~7/~ Greenport, NY 11944 OUNDATION {1st) OUNDATION ( 2nd ) OUGH FRAME & PLUMBING iNSULATION PER N. Y. STATE ENERGY CODE ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH pLBG. 765-1~0,~ BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ] FINAL DATE ~INSPECTOR /' ×? ~i~ INSPECTION [ '] FOUNDATION ~ ~lmH Pr. Be. ] FOUNDATION ~ND[ 1 INSULATION ]FRAMING [ ] IrlNAL '/ ~ / // / - ~.f ~ - ,. DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [~]~I~GN PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL 7654802 BUILDING DEPT. INSPECTION FOUNDATION IST []ROUGH PLBG. FOUNDATION 2ND []INSULATION FRAMING I' ]FINAL 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND FRAMING [ ] INSULATION [~FINAL REMARKS, DATE //2-- q//~ INSPECTOR _~A-S'I' Ebtb ,SHEE'I' PAE'I'AL CO. P.O. Box 1184, Mattituck, N.Y. 11952 516-298-9683 516-298-9728 Bill Walters October 9, 1987 Here is the information you requested on the gas furnace at Inglesias house. Bill Waiters 18-CH15D] 1st Printing, 195~ Venting and Condensate Drain Instructions For Elite Plus Gas Furnaces (BLU, BLD-K-A) Study these instructions carefully be- fore beginning installation of ventin~g and condensate drain fittings. WARNING FAILURE TO FOLLOW THESE IN- STRUCTIONS CAN CAUSE PROBLEMS. 20084-219-R0 August:1984 dwg. no. 21A137234 P. O1 TALL R' iT FITTING MATERIAL - STAINLESS STEEL and liquid tight single wall metal vent fittings, designed for ~tance to corrosive flue condensate, MUST be used for inside gs. Listed below are 31/2'' O.D. Type 29-4C stainless steel fittings that do meet these requirements. se fittings and fitting accessories are available from Trane. I~'BAY69X138 Type 29-4C BAY69X140 Type 29-4C PIPE BAY69X135 Type 29-4C PIPE BAY69X136 Type 29-4C SLIP JOINT BAY6gX137 Type 29-4C ~[de vent terminals must be ~less steel Type 304 or 29-4C. VENT CAP BAY69X123 Type 304 dwg. no. 21A137234 PO1 INSTALLER'$ GUIDE VENT Fill'lNG MATERIAL - PLASTIC Gas and liquid tight single wait verrt fittings, designed for resistance to corrosive flue condensate, MUST be used for inside fittings.. Listed below are 3" size fittings that meet these requirements. PIPE JOINTS: All joints must be fastened and sealed to prevent escape of combustion products into building. PVC VENT FITTING MATERIAL. These Fittings are available from TRANE Gas Furn;~ce Distributors, 91 ¥~" ELBOW' WALL MOUNT FLANGE HORIZONTAL VENT CAP BAY69X141 BAY69X147 BAY69X146 PVC VENT Fl'iq'lNG MATERIAL These fittings are commercially available. Use 0nly 3" Schedule 40 NSF-PW PVC 1120 ASTM D-1785 260 PSI at 73.4 Straight Pipe Sections Couplings NOTE: 45° Elbows Follow Venting instructions Carefully when using PVC Pipe and 60° Elbows Fittings either exc us vely or in combination with Noryl Fittings. 90° Elbows BONDING OF NORYL HORIZONTAL VENT CAP NOTE: Use only high temperature silicone sealant, such as G.E.'s RTV-102-400°F, Dow Corning RTV-732"400°F or equivalent. 1, Make certain that the ama to be cemented is clean and dry. (frae of dust, d~l and grease) 2. About W' from the end of lfl. m pipe, apply a W' bead of sealant completely around the flue pipe. 3. As flue pipe is inserted into Horizontal Vent Cap, rotate 30° to 60* CAUTION: Adjustment of fittings (:an be made only within the first 5 minutes after insertion. It takes about 30 minutes for sealant to set up. BONDING OF PVC FITTINGS C(~mmemially available solvent cement for PVC and CPVC m~st be used to join PVC pipe ;~nd fittings. F~ollow instruct[ohs on con- tainer carefully, When PVC is to be joined to Noryl, the high temperature RTV Silicone Sealant must be used. dwg. no. 21A137234 P01 page .' [NERAL INFORMATION IS FURNACE MUST BE VENTED TO THE OUT- ~ORS. ~E UPFLOW AND DOWNFLOW RECUPERATIVE RNACES ARE INDUCED DRAFT VENTED AND )ST NOT BE CONNECTED TO A NATURAL DRAFT NT SERVING ANOTHER APPLIANCE. !NERAL ~per venting is essential to obtain maximum effi- racy from a recuperative furnace. Proper installation the vent system is necessary to assure drainage of ~ condensate and prevent deterioration of the vent stem. ~erican Gas Association has certified the design of :uperative furnaces for a minimum of 1" clearance ,m combustible materials with a single wall vent pipe. rangement of vent fittings must conform to National el Gas Code ANShZ223.1-1980. ,cuperafive furnace flue gas temperatures exiting at ~ top of the furnace are shown below: INPUT TEMP. 40,000 Btu/hr 103OF. 60,000 Btu/hr 110°F. 80,000 Btu/hr 118°F. 00,000 Btu/hr 11 S° F. 20,000 Btu/hr 125°F. ~e recommended system is assembled from 3" hedule 40 PVC pipe and fittings. Where the system is uted to the outdoors through an existing masonry imney containing flue products from another gas inca, or where required by Ioc;~l codes, then 31/2'' O.D.. nting of 29-4C stainless steel must be used in place PVC. iR FOR ,COMBUSTION AND VENTILATION ~e flow of combustion and ventilating air must not be ~structed from reaching the furnace. Air openings pro- ~ed in the casing of furnace must be kept free of ob- ructions which would restrict airflow, thereby affecting ficiency and safe operation of your furnace. Keep this mind should you choose to remodel the area which OUTSIDE AIR SUPPLY INSTRUCTIONS contains your furnace. Furnaces must have air for proper performance. OUTDOOR AIR IS REQUIRED When installing an Elite Plus gas furnace it is required to use the venting provided for outside air, unless the furnace is installed in a confined space with the neces- sary combustion air. This combustion air must come from the outdoors by way of attic, crawl space, air duct, or direct opening. This must comply with the require- ments for equipment located in confined spaces. DIRECTION OF FITTINGS All stainless steel fittings must be installed with male end towards the furnace. All horizontal stainless steel sections must be posi- tioned with the seam on top. All horizontal sections must be pitched up -- minimum of 1/4" per toot. All long horizontal sections must be supported to pre- vent sagging. PIPE JOINTS All joints must be fastened and sealed to prevent escape of combustion products into the bqilding. Make sure that vent fitting installed into collector collar on top of furnace does not obstruct condensate drain opening. ' All joints must be checked for gas tightness after instal- lation. CONDENSATE Droplets of condensate may form inside the vent pipe as it passes through spaces cooler than the flue gas tem- perature. This will flow by gravity into the collector collar on the top panel of the furnace. The collector collar drains into the condensate drain. See Pages 11 and 12 for Condensate Drain instructions. FOR UPFLOW AND DOWNFLOW FURNACE.S NOTE: 2' (23/s'' O.D.) schedule 40 PVC (Type 1120 or 1220) pipe and (PVCI or PVC12) fittings should be used for out- side air supply (not provided). Use only approved PVC solvent cement (Not Provided). pvc * ii PVC ELBOW NOTE: support weight of inlet pipe. To avoid damage to blower, support must be provided as illustrated at left. Inlet pipe connection should be inserted all theway intocoupling (solvent cement joint) before assembly (through top panel) into outside air blower housing. This provides support, by the coupfing, from the top panel. STRAPS OR OTHE~ SUtTABLE SUPPORT INLET pipE C0NNECTJON' UPFLOW. 2%. O,D, x 9~" tge 4 dwg. no. 21A137234 PO1 VERTICAL VENTING HORIZONTAL AND VERTICAL VENTING ,Either is the method of preferred venting. See PAGES 5 thru 9 FOR INSTALLING VENT PIPE THROUGH FLOORS, CEILINGS, ROOFS AND CHIMNEYS. INSTALLi=R'S GUIDF HORIZONTAL LENGTH SCHEDULE VENT MAX. HOOD ELBOWS LENGTH I 2 40 FT. I 3 30 FT. 1 4 20 FT. STAINLESS STEEL VENT SUPPORT EVERY 3'-6~ WITH FIRST SUPPORT AS CLOSE COUPLING TO FURNACE CONNECTION AS POSSIBLE (PLASTIC VENTING T ILLUSTRA~ONS ' HEIGNT BELOW 30 I 4~a" UPFLOW MODELS DOWNFLOW MODELS HORITONIAL AND VP:RTIC^L VERTICAL ·'SIZE FLUE PIPE CPVC -- VENTFLANGE ON FURNACE 120,000 RTUR FURNACE MODEL ONLY - SPECIAL FLUE PIPE CONNECTION INSTALLATION · , 6¥~' LONG SECTION OF CPVC PIPE IS SUPPLIED FOR 120~000 BTUH FURNACE ONLY AND MUST RE INSTALLED BEFORE PVC COUPLING FAN HOUSING CONNECTION SEALING NOTE! APPLY PVC/CPVC SOLVENT CEMENT TO PVC PIPE AND THEN fNSERT ALL THE TEMPERATURE RT~Z SILICONE SEALANT TO SEAL STAINLESS STEEL FLUE PIPE* iNTING THROUGH ROOF ~)ITIONA'L METAL COMPONENTS FOR VENTING SYSTEM: COLLAR METLVENT3RS METALBESTOS31326 OR EQUIVALENT JUSTABLE ROOF FLASHING METLVENT3RF METALBESTOS31278 OR EQUIVALENT 10' ON LESS Termination 10 Feet or Less From Ridge, Wall or Parapet HEIGHT ABOVE ANY HORIZONTALLY Termination More Than 10 Feet From Ridge, Wall or Parapet VENT CAP TO COUPLING WITH I STAINLESSSTEELVENTCAP ADJUSTABLE ROOF FLASHING VEN?ING THROUGH ROOF ~e 6 dwg. no. 21A137234 PO1 VENTING THROUGH FLOOR INSTALLER'S GUll' [TING ROUTED THROUGH A MASONRY CHIMNEY SEE CAUTION PVC PLASTIC VENTING - ONLY THROUGH UNUSED CHIMNEY )UPLING WALL FLUE PiPE AND CENTER IT IN THE CHtMhtEY OPENING W)TH ANGLES .SEE CAUTION COUPLING AS REQUIRED CAUTION m Do not run vent through chimney for wood burning or oil furnaces or incinerators or any other gas appliance. IMPORTANT ~ The single wall flue pipe joints must be sealed, The 90° elbow connection to vertical pipe must be sealed to prevent condensate tea~.age to base of masonry chimney. 29-4C STAINLESS STEEL VENTING - USE THROUGH CHIMNEY THAT VENTS ANOTHER GAS APPLIANCE MAX, VERT. HT, 30FT. OP OF FURNACE SUPPORT THE SINGLE WALL STAINLESS STEEL GA.S VENTING CAUTION -- Do not r[~n vent through chimney for wood burning or~ oil furnaces or incinerators. If remaining free area between single wall flue pipe and masonry chimney is to be used to vent another gas appliance, venting area must be sufficient to vent that appliance end that appliance must be connected to chimney with separate entry opening. IMPORTANT m The single wall flue pipe joints must be sealed. The 90° elbow connection to vertical pipe must be sealed to prevent condensate leakage to base of masonry chimney. m 8 dwg. no. 21A137234 PO1 INSTALLER'S GUIDI HORIZONTAL VENTING THROUGH WALL CAUTION: If the furnace is to be vented through the (~ wall, do not install through wall exposed to the prevail- ing winter wind. Excessive wind can overcome the combustion blower pressure and shut off the burners. A wall most sheltered from the prevailing wind is least likely to experience excessive wind pressure° j AS POSSIBLE ' ~ N~TE: Any fi~ings ~assing 4a~~ UPFLOW MODELS through ~n unheated sp~ce ~WNFLOW MODELS HORIZONTALLENGTH SCHEDULE VENT MAX. HOOD LENGTH ELBOWS 2 3 4 40 FT. 30 FT. 20 FT. RIZONTAL VENTING THROUGH WALL ~PLAsTIC ~:,.-;q MIN,MEM '--'J I [I I[ ow ccu u o. (AtE SPACE) Venting Through Combustible Walls Pitch - ~/4 Inch Per Fl. COUPLING PLASTIC ~0 PIPE) Venting Through Non-Combustible Walls Pitch - 1/4 Inch Per Ft. vent/wind cap must be located at least 12" minimum ce normally expected snow accumulation level. cap must be at least T' above grade, if it is adjacent ublic walkways. id areas where staining or condensate drippage may problem. vent/wind cap must terminate at least 3' above any ed air inlet into the building that is within 10' ~f the , The cap must also terminate 4' below, 4' horizontal ~ or 1 ' above any door, window or other air inlet into ;ling. ;H ~ Venting through wall must maintain 1/4" per pitched upward. MBUSTIBLE MATERIAL WALL ,~ld material must be minimum of 24 gauge stainless luminum sheet metal. Minimum dimensions are 12" x -- OUTSIDE ,, COMBUSTION > ^,._~, ,.~E~_. . ~ MINIMUM SEPARATION FOR ^ir Inlet and Vent Gap - Common Wall · 12". Shields must be fastened to both inside and outside of wall. Use screws or anchor type fasteners suited to the outside or inside wall surfaces, A minimum clearance of 1" to combustible materials must be maintained when using single wall stainless steel venting. NONCOMBUSTIBLE MATERIAL WALL The hole through wall must be large enough to maintain pitch of vent and properly seal, Use cement mortar seal on inside and outside of wall. LOCATION OF OUTSIDE AIR INLET Outside air inlet may be installed through any convenient wall. Refer to view above if common wall is to be used for air inlet and vent. dwg. no. 21A137234 PO1 INSTALLER'S GUIDE CONDENSATE DRAIN INSTRUCTIONS FOR UPFLOW AND DOWNFLOW FURNACES A hole is provided in each aide of the furnace cabinet for drain con- nections. Standard arrangement is for drain connection on left side (facing front of furnace). Connections must be made to an open drain. Refer to illustrations of typical connections and select the most convenient for applica- tion -- left hand or right hand. Illustrations are for upflow furnace installations -- downflow fur- nace installations are similar. NOTE: Use 1/2" size (%" O.D.) CPVC pipe and fittings throughout for drain connect{ohs (fitt[n(JS, pipe and CPVC so~vent ce- ment not provided.) TYPICAL RIGHT HAND DRAIN INSTALLATION PVC ELBOW MUST BE OPEN CPVC PIPE TO OPEN DRAIN HOSE MAY BE ~SED IF DESIRED) MUST BE OPEN CPVC TEE TYPICAL LEFT HAND DRAIN INSTALLATION 90o CPVC STREET ELBOW{1~ SIZE) CPVC NIPPLE ~CPVC PIPE MATT[TUCK, NEW YORK 11952 D~nlel O~ldon MASON FIREPLACES, PATIOS. BRICKWORK (516) 298-5387 iq ir"7 DESCRIPTION AMOUNT FLORA $, LUCE NOTARy PUBLIC In the State of New ~ork Res~d~.E In Suffolk County Suffolk County Clerk's No. 52-761~500 Commisslo~ ~plres Marc~ 30, 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ~]/*kOUGH PLBG. [ ] FRAMING REMARKS: [ '1 FOUNDATION 2ND [ ] INSULATION [ ] FINAL DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND *[ ] INSULATION ~ ] FRAMING DATE '~ INSPE~OR FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL,: 765-1802 _. Received ........... ,19... Approved .c'~...c,~,c,.~... [1 ....19~ ~. Permit No..)..',5~.~.".~.[~ .~.. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .D.e.c.e.m.b.e.r. /4., ........ 198.6. INSTRUCTIONS a. Tkis application must be completely filled in by Wpewriter 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 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 inspectom on premises and in building for necessary inspections. .R.i.cb~r~l. ~e~l-o~. general. Contractor,. Inc ...... (Signatur~pf_applican~, or name, if a corporation) .4..B. qo.t.l.e.g .A.l. le.% ............................. , .qr, e. enpqr.~' ~ .~e.~. ,'~q~k..11,944 .......... · (mailing address of applicanC);~i1~;;. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or General Contractor Name of owner of premises . .G~.r.~.ro~t.e. IglesJ~O ...................................................... (as on the tax roll or latest deed) If appli~i~)is a corp~rati .~..,.~f duly authorized officer. ... .'. (Name and title of corporate officer) Builder's License No...1.3.0.8.6.H.I ................. Plumber's License No...13..8.6.P ....... . ........... Electrician's License No..19.4.97.E ................ Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. 8335 Main Road East Marion House Number Street Hamlet County Tax Map No. 1000 Section .... 93..1 ........... Block ...2 ............... Lot...1.4 ............... N/A Subdivision ................ (~q'a~) ................ Filed Map No ............... Lot ..: ............ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .. 1.. t.~n)$~7. R.~$qleuc~ ................................................. b. Intended use and occupancy ...Sa.m..e..a.d..a.bg.v.e ..................................................... 3. Nature of work (check which a ~plicable): New Building .......... Addition .......... Alteration .......... Repair Removal ............ Demolition Other Work Renov,atSon ~jtt (Description) Ss9 ooo .! ..... Fee 4 Estimated Cost ~ .............. , ................... ~ (to be paid on filing this application) 5 If dwelling · . · .1 Number of (/~'elling units on each floor . , number of dwelh~g umts .............................. If garage, number of cars . .N./.A .................................................................... 6. If business, commerciai or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front .S.ep..S.u.ry.ey ..... Rear .S .e .e . .S p .r y .e y .... Depth .S9.e..S.u.ry.ey ..... Height .. 25! .......... Number of Stories... ~[½ ................................................... Dnnenmons of same structure w~th alterations or additions: Front Same ............. Rear See. $~ryB7 ........ Depth.. 5¢¢. ~0rwy ....... i... Height ....S.a.m.e ............ · Same ·.. Number of Stones ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front . See. Surv~ ........... Rear. See. Surv~.y ........... Depth ~. ~ry~y ............ 10. Date of Purchase . .U .n .k .np .w .n . . i .( .I .n .h .e .r .i .t .e .d ) ........ Name of Former Owner .M.r.s....Gpp.rg.e' .S.A.n.d.e.r.s..N.o.wp.l.l..' ' h 11. Zone or use district in whic cruises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: . Np ............................. 13. Will 10t be regraded ... No... .............. ; ..... Will excess fill be removed from premises: Yes (~No~ 14. Name of Owner of premises .G .e r .t .r .u .d .e. .I g .l .e .s .i .a .s . . . Address .8.3.3.5..Mp.ip..R.d..'..E....MppfiOf~e No. bYY:.!s97 .... Name of Architect . .F .a .r .i .w .e .a .t .h ? .r . .8, . .B .r .o .w .n ....... Address .G .r .e .e p p p ,r .t . ......... Phone No. 477-9752 Name of Contractor .R .i .c .h .a .r .d . i S. .a p .t .t .a' . Address GreenI)ort Phone No. 4.77:-1.633 . . 15. Is th±s property located w±thin 1.00 feel: of a t±dal wetland? * Yes ..... No ~( .... ~ If yes, Southold Town T~ustees Perra±t may be requ±red. i . I PLOT DIAGRAM Locato clearly and distinctly all buildings, whether existing or proposed, and~ indicate' all set-back dimensions from property lines. Give street and bloc t number or description according to deed, and show street names and indicate whether interior or corner lot. See attached survey. STATE OF NEW YORK, S.S COUNTY OF ................. Richard Saetia ........................... ~ ..................... being duly sworn, deposes and says that he is the applicant ~ (Name of individual signing contract) above named. He is the General Contrac. t,qr . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is d¢ly 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 Notary Publi .Suf£olk. County. B~.V£RLY ^, BREDEME ~E~O~.k flora y Public State of N~ ............ N0. 4734549, Suffolk C~qnf~r~ (Signature of applicant) P~ OPE fJ_.T'Y If ~opl~ tubing Ii u.ecl for water distributlno PLUMBER CE~TIFICA T{O~, , ON LEA~ CONTENT BE~O~ ~" TE OF OCCUPANCY SOLDER USED IN WA~ER SUPPLY SYSTEM CANNOT EXCEED 2/10 of 1% LEAD. ~£?£0o3q/~,'4 "-'/~ ' /20NMA £NL-L, ASIIE5 /V/AIN, t~P £A~SFMA£1OA/ ~z/" .~ I' DNA ~/N ~¥ ~. ~AEC"rA, r--,~C /- FAMILY ~. o O ~. PLUMBER CERTIFICATION ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY LIV!MQ r-4. O o iv\ SOLDER USED IN WATER SUPPLY SYSTEM CANNOT EXCEED 2/10 of I% L~AD. OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY AP~ ,'~r;-)¥~D aS / ,- :~i),~/~ 7/, /~~ ~0~1~ ~OlLOlNa Bi~ltT~f~T AT FOUNDATIO~I ~0 REQ~RED THE REf~U~g~k~Efd ~S O~ TH~ N.Y STATE CON~TRU~TI~ · ENERGY m~GN OR CC~STRUCTION ERRORS, t C, A V~NT ~r~ /8x7 !l Unauthorized alterahon or addition to this document is a violation of =ec~-!en 7209 of the New York S~;e Education 7~0" ' MALL Unauthorized alteration or ~ddition to this document is a violation of ~ecEon 7209 of the New Yorl( $,~a~'e Education Copies of fhJs document eot bearing the eng~noefs Jnhed ~eal or embossed s~al shall not &*~ gC. WALL'" GAP2_AQ 1 Z4. LO" · ddition fo this document is a ~iolafion of section 7209 of Se New York Sta~e Education Copies of this do:ument not box 1180, 632 roanoke ave. T & L R.V. ° LIn~utha~i~&~ alteration or vlola~ion o~ section 7209 of the New York S,a~e Education Co~oie$ of this document seal 6r emboased seal shall not r addlt~on to this document ~s a v~olat~o~ of section 72.0g of seb~el or embossed seal sha!l not /