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26291-z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27684 Date: 05/15/01 THIS CERTIFIES that the building NEW DWELLING Location of Property: 55 AKA #11 SOUND RD. GREENPORT (HOUSE NO. ) (STREET) (HAMLET) County Tax Nap No. 473889 Section 35 Block 1 Lot 8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 7, 1999 pursuant to which Building Permit No. 26291-Z dated JANUARY 24, 2000 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 SINGLE FAMILY DWELLING WITH ATTACHED ONE CAR GARAGE AS APPLIED FOR. The certificate is issued to THOEDORE & MARIA PETIKAS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-99-0104 04/14/01 ELECTRICAL CERTIFICATE NO. 48475 03/20/01 PLUMBERS CERTIFICATION DATED O5/11/01 GAH PLUMBING & HEATING Authorized gnature Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 26291 Z Date JANUARY 24 , 2000 Permission is hereby granted to: THOEDORE & MARIA PETIKAS 225 STEWART AVE BETHPAGE,NY 11714 for CONSTRUCTION OF A NEW SINGLE FAMILY DWELLING WITH ATTACHED ONE CAR GARAGE AS APPLIED FOR. at premises located at 55 SOUND RD GREENPORT County Tax Map No. 473889 Section 035 Block 0001 Lot No. 008 pursuant to application dated JULY 7, 1999 and approved by the Building Inspector. Fee $ 656 . 20 Authorized Si tature ORIGINAL Rev. 2/19/98 -' Form No. 6 ' { - TOWN OF SOUTHOLD i BUILDING DEPARTMENT TOWN HALL •' ,:i. 765-1802 ,� EE 6',l"nG. ' �Tr ' 1__. I , APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form) . 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and ' "pre-existing" land uses: 1 . Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occgpancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. - 2. Certificate of Occupancy on Pre-existing Buildine - $100.00 3. Copy of Certificate of Occupancy - .25Vp 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . .>—�C? . :Q./. . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . ! Oldp Or Pre-existing Building. . ; 11 ! Location of Property. . . . .��. .4J.�'i! �1�.�1 . . . .. .�( .Q 0.4 J'. . . . . . . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property.. E.-P E2P.4. . . . .,P.f-.7./J.< . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . . 3.-5.. . . . .B10Ck. . . . . d.//. . . . . . . .Lot. . ! . . . . . . . . . . . . . . Subdivision. . .. . . 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed/ Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No) aiO. .�4_.Date Of Permit. . . . /.'. 'z.y. -.TPpl"is'Qt. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . : . . . .. . . . . . . .Underwriters Approval. . . . . y l. . . . . . . . . . . . Planning Board Approval. . . . . . .v.). .. .. . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . ob / Fee Submitted: $. . . . �.�. .:. . . . . . . . . . . . . . . . . C ��7 APPLICANT P-lY' Gf �'+ , t�j �tr�'�•s� i�:�V'r r�*t�`\s!�'�•t�/. r'�r i ME }s P :£. 'V r. , i=, J:. =t�1r''• lY.4 �t•. S ' 7: (4 t. •.t.r'•M1iy ttll•r'r', 'iiri.t�. 7.e,E7 tfst ? f;rh.. ) 1./�'.?�{�' �,,,4i l; J;y al„U''r}'(, tt .s llf/•. .tiv`�7'.p,• ......,1f•C;'�,(:t,tyv''c. .si;,>� � j)� �;tC :•S,, .,,!t",... 1, if., ��;��. rl ul.,,{�s,. ..1�1,..:.� v:,u l..,, £r.:.; a r,,,�Rv, !,'t•. ''a�.•, r'. .,,,t�,,>�;n ;. J},. �.:i, ,.• >,•'�:k,�., ,.:a: ,�. •{ ;�5 �”: 1 ,,,lk ,,n�•• D , a;;:�f Y�• •�`� ,syr �' ,r,>'JJf2";ie5 , �i%i�e�;.•;I.,..;rs�;�itiyu .��aL�� '�f�it :,, jfa}i'. 'f ^,!f }ti.x tfj#�1: os slide}i '� rtz<::i'`^°�i:'"rss : t ;S'+t/ss�=tS�+si ..,s�;; t' l JF :r:e Electrical Inspection Certificate Electrical Inspection Service, Inc. 375 Dunton Avenuex� „t East Patchogue, New York 11772 (831)286-6842 =rj„ Date: 3/20/01 Application No. : 48475 z issued to: Ted Petikas --' Street: 55 Sound Road t�„> 'Av .� Village, Greenport Zip: 11944 Town:Southold _»>•. Section: 35 Block: 01 Lot: 08 Introduced by: Neubauer Electric Inc. Lic.# 3867-E -b jb)A was examined and found to be in comp/lance with the Natjona/E/ecfrica/Code ;,;�;-•- ❑Att/c WlstFloor []indoor © Residential El Pool [I Det. Garage % :M�Y`+'•-•,r ? OBasement ❑2nd Floor ❑Outdoor ❑ Commercial ❑ Hot Tub ❑ NV Defects y,. Switches Receptacles Fixtures GFI Heaters A/C Fans w»> 26 46 30 9 1 1 Dishwasher Washer/Amp Dryer/Amp Oven Range/Amp Garbage Disposal «„ 1 1 20 1 30 1 40 =' x Furnace Oil Gas Circulator Smoke Detector Bell Transformer 4r'' <,//f• iii"' Meter Amps Phase UG/OH Telephone Television Carbon Monoxide pay ZOO 2 g'•J;r:>. � k Other Equipment: r «<,y Hugo S. Surdi > ' > President Building Permit NO. This certificate must not be altered in any manner • �-.;�:� Inspectors may be Identified by their credentials a "' s NHL. 77-.,.'.. ^�„ :. } .^Q '•,fA' .`i' :.. :'� 'i 4ri.'". . .ak-i<ii 1x Y,q � o,.t..•>-.' I . o. y£/f,. :•i £s.. . !i „f:f„! t..£s,l. ..a,.i•i7v£„^:P r. ;t t.,£;t•„ :^tt v,7,,. �R.ee.£ _.' iv,i,,";,;Ss,.3: L:.;"':,:,"`itiv7' '1/!.,ll�i :ti .�iv, ¢va ..��.f,• '::, .,�} .,,:n... £:':93.. .... .lid -caw /' Ui• 'ey ,1. )74t5:• Jiro . Oti'•ls,4v'J,'; :Hili i9Y+"jit#+;<•t +!•' -•Y"e ';•r�7.°`' e, '�.. y ;% �:,• y� :ns 17- , t 'hr's'£}•t.: 'i}nt;.,:.: y;;`Y+i; i ,} c' `i"' 1iv i 'i y� .t�41' t(s� k t) •t{.Y Wtgg� t Vt. iP"il.,��S� j(;liyp`{p• 1;l Y`, t• !{iFWtl. s,..{�ti `ii t ' ! ' "�'• 'j• (SV'•,R)'A "Sf.,r'S' s Sr t=' •ij.1•�0 i !i}.;' sf{+4.r•i - N . �A itti / /!� iA 't. : '.t. .ct� �1.'t. JN> >h? si. J i AA• li.•,lts'. ��O��gUFFO(��OGy o � TownHall,53095 Main Road y Z Fax(516)765-1823 P.O. Box 1179 u% Telephone(516)765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE: Building Permit No. Owner: leg ew-J`i��5^� (please(�print) Plumber: (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. ( lu a 4Sign&fure) Sworn to before me this day of ( 13 Zoo Notary Public, County ELIZABETH A STATHIS NOTARY PUBLIC,State of New York No.01 ST6008113.Suffolk County Term Expires June 8,202F- C�-ROU,nf Qv :=-S- Otii�, ARCHITECT,P.C. 46 CONKLIN STREET FARMINGDALE,NEW YORK 11735 TEL: (516)249-0055 FAX: (516)420-1791 May 4, 2001 �� o Town of Southold Town Hall Main Road Southold, New York 11971 Attention Building Department Building Inspector Re: New Residence for Theodore Petikas Southold,New York Architect's Job# 9943 Gentlemen; This letter is in regard to the inspectors concerns regarding the non-structural cracks in the foundation wall. The builder has stated that he will repair the cracks, as necessary. T ou of your consideration. Very my y urs, W. §01is," sident Ir RWS:rC oe) �51 � 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH LBG. [ ] FOUNDATION 2ND [ ] 1 CATION [ ] FRAMING FINAL [ ] FIREPLACE & CHIMNEY REMARKS: .Ae eo ;;p le ,DATE '��� �� INSPECTO 366 M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND j ] IN ATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY �EMARKS; 0 ,DATE • INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND A,[-jj 1 SULATION [ ] FRAMING [ ] FINAL [ ] FIREPLAS CHIMNEY REMARKS: / Q/C�f DATE INSPECTOR T 1 1 • 1 / r • ! ! i M-1802 BUILDING DEPT. INSPECTION [ ] FOU TION IST [ ] R GH PLBG. [ ] UNDATION 2ND [ INSULATION ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS:-./,l - ,DATE__� r INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ) FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: DATE 9ZI � INSPECTOR "` ' dJ/11/ ewdd d1:5`1 5<k4aLJ1/71 oJ i:' -- , �: \ O�EOtt �'✓ • C�Ott.s� ARCHITECT, P-C. ;G ( 2009 48 CONKLIN STREET m..� FARMINGDALE.NEW YORK 11735 TEL:(510)2480055 FAX:(516)420.1791 August 11,2000 Town of Southold Town Balt Mata Road Southold„New York 11971 Attention Building Department Building Inspector Re: New Residence for Theodore Petfl= Southold,New York Getttl0mea; , This letter serves to certify the conditions at the job site in regard to the phone conversation of August 10, 2000. The 8 inch thick foundation wall on 8x 16 inch footing, as built on site,is the result of the client eliminating the brick veneer. The chimney foundation was elininatod in lieu of a Sucks heating system.The front porch wing walls will be installed,as necessary,to meet applicable budding codes and standards and the Building Inspectors approval.'1'.he foundation wall and footing below the overhead door and at the porch will be installed,per code,wlth i4 inch dowels 7-0"on center(vertical)to tie into the existing walls. The Architect has not been retained for supervision or testing and assumes no responsibility for the construction. Thank you for ur conslderation. AgGy V lyyo t � 1WIM �T Robert rn RWS:m F OFFICE OF THE TOWN ATTORNEY TOWN OF SOUTHOLD o`Q$UFFO(KCO o G�2 pe4; xS Lao a.,,a bi d v iS 2 loo --q S C (3) - • No M°�p '�- TITLE NO: FNT9713206 DISTRICT: 1000 SECTION: 035 . 00 BLOCK: 01 . 00 LOT: 008 . 000 Town of Southold Southold, New York Gentlemen: FIDELITY NATIONAL TITLE INSURANCE COMPANY hereby certifies that it has searched the records of the Suffolk County Clerk and/or the Suffolk County Registrar for deeds affecting the captioned property and properties immediately adjoining and finds : SEE ATTACHED And the records of the Suffolk County Clerk and/or Suffolk County Registrar disclose no other further conveyance of any of the foregoing lots other than as set forth. FIDELITY NATIONAL TITLE INSURANCE COMPANY certifies that the above- captioned property has been in single and seperate ownership of: Theodore Petikas and Maria Petikas, his wife and his/her predecessors in title since prior to 1957 except as follows : (see attached chains of title) . The liability of the Company is limited to the amount of the fee paid. Dated: 12/2/97 FID �LITY NATIONAL TITLE INSURANCE COMPANY MARIE PAGE Sworn to before me this 2nd day of December, 1997 �/f'l�/l,�l�rJ1 c k V Notary Public MARGARET VOLLMOELLER Notary Public, State of New York No. 01V05032469 Qualified in Suffolk County Commission Expires August 29, +4 . TITLE NO. FNT9713206 STATE OF NEW YORK) ss : COUNTY OF SUFFOLK) MARIE PAGE, being duly sworn deposes and says : That he/she has had a search made of the records of the County Clerk of Suffolk County with reference to an application for a variance affecting the following premises : SCTM 1000-035 . 00-01 . 00-008 . 000 That the said records indicate the following chains of title as to premises and adjoining lots since prior to 1957 . SUBJECT PREMISES: 1000-035 . 00-01 . 00-008 .000 Edward H. King Dated: 4/19/52 to Rec'd: 4/28/52 Augustus A. Straussner Liber 3345 cp 384 Walter Kszyminski Dated: 4/19/52 to Rec' d: 4/28/52 Augustus A. Straussner Liber 3345 cp 388 Augustus A. Straussner Dated: 5/8/69 to Recd: 5/16/69 The Sfaelos Realty Corp. Liber 6550 cp 290 The Sfaelos Realty Corp. Dated: 9/17/84 to Recd: 10/12/84 Emanuel G. Sfaelos Liber 9657 cp 351 FIDE,bITY NATIONALTITLE INSURANCE COMPANY BY: MARIE PAGE Sworn to before me this 2nd day of December, 1997 Uc IJAVAO Notary Public MARGARET VOLLMOELLER Notary Public, State of New York No. 01V05032469 Qualified in Suffolk County/ Commission Expires August 29, 1 Emamuel G. Sfaelos Dated: 12/27/84 to Recd: 1/3/85 Spartan Holding Co. Liber 9708 cp 288 Spartan Holding Co. Dated: 4/5/85 to Rec'd: 4/24/85 Theodore Petikas and Maria Petikas, Liber 9777 cp 577 his wife LAST DEED OF RECORD PREMISES NORTH: 1000-035 .00-01. 00-006 .000 Walter Kszyminski Dated: 2/21/51 to Rec' d: 2/26/51 Joseph O. Brandi and Beatrice M. Brandi, Liber 3187 cp 398 his wife Walter Kszyminski Dated: 2/22/52 to Rec' d: 2/23/52 Joseph Brandi and Beatrice M. Brandi, Liber 3323 cp 76 his wife Joseph O. Brandi and Beatrice M. Brandi Dated: 10/18/82 to Rec' d: 10/20/82 Dimitrios Kartas and Stella Kartas, Liber 9258 cp 374 his wife Stella Kartas, surviving spouse of Dated: 10/28/94 Dimitros Kartas Rec' d: 11/14/94 to Liber 11702 cp 173 Antonis Natsoulis and Ellen Natsoulis, his wife LAST DEED OF RECORD FIELIQTY NATIONAL TITLE INSURANCE COMPANY BY: \ �Q MARIE PAGE Sworn to before me this 2nd day of December, 1997 y r LADAAk 1/ wtw_ Notary Public MARGARET VOLLMOELLER Notary Public, State of New York No 01V05032469 Qualified in Suffolk County Commission Expires August 29, PREMISES EAST: Sound Road PREMISES SOUTH: Main Road PREMISES WEST: 1000-035. 00-01 . 00-007 . 000 Frank F. Salter Dated: 5/13/44 to Rec' d: 5/15/44 Walter Kszyminski Liber 2358 cp 20 Edward Kszyminski, John Kalinouski, Dated: 6/10/70 Leonard Kalinouski, Legatees under Last Recd: 8/13/70 Will and Testament of Walter Kszyminski Liber 6790 cp 75 to Sophie Raynor LAST DEED OF RECORD FIDEI�iTY NATIONAL TITLE INSURANCE COMPANY BY: MARIE PAGE Sworn to before me this 2nd day of December, 1997 Notary Public MARGARET VOLLMOELLER Notary Public, State of New York No 01V05032469 Qualified in Suffolk County49 r Commission Expires August 29. N0 W I N �UA"U Uk 0"�l. . . . . . . . . . . . . . . . TOWN OFRSOUTHOLD 13 SETSY AN �y� 71999 b I,..0 JI.L BUILDING DEPARTMENT CHECK . . . . . .. . . . . . . . . ... . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . .. . . . . . . BLDG.Df" SOUTHOLD, N.Y. 11971 TOWN OF TEL: 765-1802 NOTIFY: CALL Examined...... . .. 19.... /, / j, MAIL TO: . . . . . . . . . . . . . . . . . . . . Approved. .. O(/fes (�✓ .... 19.... Permit No. ..:............. Disapproveda/c .................................. ................................... ....................................... .!. ..... Building I or) A ICATION FOR BUILDING PERMIT p q Date. . . .sz... . . . . , 19 f./• INSTRUCTIONS \ a. 'this application must be completely filled in by typewriter or in ink and submitted to the Building Inspector wi 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan slowing 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 application. 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. * APPLICATICN 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, lousing code, and regulations, and to admit authorized inspectors on premises and in building for necessary in tions. oc ....� .................... (Signature of applicant, or name, if a corporation)_ (Mailing address of applicant) U 11-71 State /whether 1applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder\ .......................................................'.y........................................... Ll Name of owner of premises r aJhp �Q..�A.....,/ ,7..1.ts e-j.................................... (as on the tax roll or latest deed) f' If applicant is a corporation, signature of duly authorized officer. ......................................................... (Name and title of corporate officer) Builders License No. ......................... PlumbersLicense No. ......................... Electricians License No. ..................... Other Trade's License No. .................... 1. Location of land on which proposed work will be done...SOCA l✓.`,�...Aoad....:*s W 1:GYM•l. Y✓'��:.. ....................................................................................................................... House Number Street hamlet County Tax Map No. 1000 Section ................ Block ................ lot ................ Subdivision ...................................... 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 ................1/1�.y .............'......�............................... b. Intended use and occupancy ......fQy Q....0".QIVa 1 xtck...... CQ&A x ......................... *WVA"16f4W$ ai.l(aUq yJqATM �11pRl)�lAaltu8,C�Sf800n3T2t0&A u.�l`i.8irt{IL�FAIB� 9f ... ..... 1 1 3. Mature of work (check which appr�icable): New Building f:/... Addition .......... Alteration aAa « „,. ,„) S Repair Removal ......... Demolition Other Work s (Description) - . .,. 4. Estimated Cost ..� +� � fee .............................................. A00.0 (to be paid on filing this application) S. If dwelling, nuiber of dwellingunits ............ Hmber of dwelling units on each floor ................ Ifgarage, nwber of cars ...A................................ 6. If business, coamercial or mixe�l occupancy, specify nature and extent of each type of use...................... 7. Dimensions of existing stxucturga, if any: Front................ Rear ............... Depth ................. Height Dimensions .. same structure will, Nuhber of Stories ...................... .......... .. . .. structure with alterations or additions: Front ............... Rear ............... Depth Height .................. limber of Stories . . 8. Dimensions of entire new constr IWtion: Front ... ............nn Rear ...AXR Depth ...�.�.... !]eight ........................ � Nudher of Stories ....2............... 9. Size of tot: Front ... p m.;........ pear .....1p A.?O... Depth .....9wo ....... ii 10. Date of Purchase .............. ...... Nam of Former Owner ........................................ 11. Zone or use district in which premises are situated .............................................................. zoning12. law, ordinance or regulation: ........�Q.......... 13. Will lot bi e� tion violate any Will excess fiQl��l be 7,2 ed fran premiaea: YES Q1D/ 14. Hams of Owner of premises �r,, a�d( ••��,lK!]6tidresa �5 . ..... Bane No: Nam of Architect .............' .... Address ................. Phone No. .....:........ Name of Contractor .................. Address ....rT;/ //.�..............Phone No. IS. Is flus Property within 300 feet .� * of a tidal wetland? * YM .......... tw! ....... ]F YES SOtMM TUM TWSIPI;.S FINKET MAY BE RFiQUUM. PLOT DIAGRAM locate clearly and distinctly ail buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street andlblock ember or description according to deed, and show street nares and indicate whether interior or corner lot. SPATE OF NW YORK, I Coma OF rct)............"'•••being duly sworn, deposes and says that' he is the applicant (Nam individual signing contra above named, Ileis the ......a W.N. 1.......................................................... ............. (Contractor, agent, cbrporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work aid to make and file this application; that all statements conu#ned 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 .......7 .........day of /•�.. Notary Public / � ?! Y1/. CJ .... . C_�• 3ZS4.. .... ... NOTARY MO � 1bA (Signature of Applicant) YMgI I T1'90 Jam..pUit49 � Z a u ` 0 OQ to � •p �I g �'� Yi sj1=r w • ^! C+ i ^aIle, I' ,U. ✓�7"G'`�`'' /O,v�' Cyt � c; h�'�5 II .a s; �,•, >j%l t^ eof 29, ,3 �� �y z ��� � � Y✓AYGi,(rI61 (� ��, � b�7 �✓' 2,C,gflq/L 4d� t n •J o � ci Q1 IkN h �� D SAN rESE=ddwn uthodzed altwHona addition �$� O Ov is survey is a violation of Section 72080ltla NswYes Stela 94�� atiwolaw.O es ofI platbe lrqM surwywsealttossed batanaidwa avaddew copy,YmnteeeIndkaNd bow WAruna the penal for whwn dw surveyepared,and on Ma behalf a da ompany 90"ammenWa9eneyaMinglrmtitution9etedhemnwd aselaneq of the lending MOL4Wn.MEntees w notbanaterabN F to additional Institution$«oubaaquem O` P/�R,C f3.r7jAi%t/ owners. yT6;SIC '1d.PRcYJUG'.s/4.S�irlE7//i9✓E°'/�iri,°aC/e K/.oT.t".e. fid,¢✓EyFaL• TiSc�-�1,C7dLZE �T/.F'/s�✓ .«_ ._ B.�I�N.tia�ET �oc.�rrnv G.erF�•vvu�rTow,✓o,C-�r..�Lo. 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[ ] FO DATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: Kiev ,DATE / INSPECTO t I 'Do Ae 'o : i BUILDjlNG • INSPE ION rb�/FOUNDATION IST ROUGH FOUNDATION 2ND INSULAT • FRAMING FINAL AP T r M-1802 BUILDING DEPT. INSPECTION [ ] F NDATION IST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: C DATE doo°tl INSPECTOR �' � IS - Id -- -11"S --- � --- - - -'• -- --�. '-- �- -- ---- EL TE HEATING -- --3V- F.r✓`..�-r 'r-- ovtyn.- 2, 3 -I' ' - F _ APPLI NCESI " S --1 _ : _ _ - -- -- TS bJ 11 ... - --_ _ REQUI ED BY PART. J L ulv - - -L _ a sl�.h. _. ... 7 5 717• (s)(4)OF - 1 ---- - _ _ _ ry N.Y. STAT BUILDING CODl. -- l — ai _ 3 I � a �� � 'i __. -.--_---�µ-STI I - ___ N r I� _ ' V I •J :f � _ I 4t � � � '� -1 I . � � , of l _. - ,r y� � ��I , � , _ �� ) ,r a• 1 � � � I ) ( .� �� ,�� C6)z ' I 'I 5-[) I I I:.- 'Y-�• - ua.� ��Pi:llEfi�l Cr:;A I `1 rlo' I 20 .41 �> a s - '3 >i - i - �-- 3/4 1161RE RATEDISEPAR TION TOi- I < _ . 41 i . , N.Y. STATE BUIL ING CODE. i G PART. 717,3 O (Il) OF ` k, a - ' ' - - - - -- - - ` 1 J, r l-,.YI-.rYl TI Gr,. 7 I � 'f 'I I _ � ` � •� - - - - _= jY� � i ' J _ Y ;I r` 1 A W ,- "_a_l I ���� �, EpQE SpAQ ' p� { . . �. I i E �j p�R p�V dpE —� TL- r " p' �a Cv°� z i r� � �' t ` �,� o .h ff � j� 0 QPM\ Cp 4 A H <� �,V Yb0 y Gij \ y e a x t ro cn. I yl o LN ✓' __ - II �o� �� -_ _ � _ _�; ' _ J- �- � '• �� / � , 4 � li 1 --- - - ---- _ - -- , - - - � ' 1P 3 , , -I , L L -�; /zx "-Ir' - - � / 'U� DNDERWRITERS CERTIFICATE Q f �J - -- -- - — -- - - - -I - --- - { ;�� _ --- -- - -- - - - .._I REQUIRED RE U z ,o � , I I yar:..,F'. . , = tz.; : . ��,A� ME_ ( � �_ �� -- _-- - 00 NOT PROCEED WITH ,, -- '- - -" -- -- IDE SMOKED FRAMING UNTIL SURVEY P OV e,•.p �_ v�� FP CIG n�l ' . I' n ETECTINC 0 FOUNDATION LOCATION ALARM DEVICES -. I HAS BEEN APPROVED. S 70 PART. 721.1 - ! ' I' ? N.Y3 BUILDING CODE P ED. 7 - 1. i _'�u _ PLUMBER CERTIFICATION AS NOM ON LEAD CONTENT BEFORE BI► CERTIFICATE OF OCCUPAAO'Cy P� Ez'_Icv a 11 \ IE . .,-. 1 \ --L - - = -- ----- NOTIAQ BIL ING D t A -- SOLDER USED IN WATER Te3•uas B AM To PM POB TNS SUPPLY SYSTEM CANNOT ,~PoPr�N INSPECTIONS:NeGY1NeB - -- t EXCEED 2/70 Of 1% LkAD. PORPOtrMCOMMETE = ROUGH • FRAMING A PLUMBING ON 4 FINAL CONSTRUCTION MUST 1 BE COMPLETE FOR C.O. i_ PLUMBING F ` ,r_ J I ALL PLUMBING WASTE ALL CONSTRUCTION SHALL MEET tv WATER LINES NEED THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION A ENERGY - - _ - _ ,- --- ,- - - _ _ _ _ _ _-___ __ - - - TESTING BEFORECOVERIN ` - -_--t. __.:_,, _ ..__.., -- . ,..r.,� .� . - - .-- -- - . _ - - _ - - _ - DESIGN OR CONSTRUCTION ERRORS _ I CODES. NOT RESPONSIBLE FOq - I _ NCOPPertubing isUsed PROVIDE ANTI-SCALD AND/OR T ! I fOr water distributing THERMAL SHOCK PREVENTING Q SYSMm: Piping shall be DEVICES AS i0 PART. 902.6(X)O OCCUPANCY OR Of typos K or L only N Y• STATE BUILDING CODE. _'_ IS UNLAWFUL r.�_ G' - - I I I_ Iz � � :lbs 1� - I % � WITHOUT CERTIFICATE - . I � P � _ .. . _ . ._ -.. ucy OF0 UPA l CC 00 rG4", D v .nty7 FIRST Fig ' f LAJ- FC'.e�T �� el __ -'�" - . -- ._._._.- - _ -----' --_. - .---I--. __ --' - --- - - -- �II,} cr ;f,• -C, T SCF V,l O\ ��j� i� owv ao. 3 c,p x- I A SP 411 y y�y'S �1.L-VATIq•1 (i>.�MENT (�"L, vd ro 41 TfJ � � `: ZR9 C20Hf1F7EUCT ,P.C. NRET r : VFARMIHEWE (51ISYTEL:@16)249-0055 p N g a 1 IIS d,� F•``2`0� 15 Jr� O O�'E-R ,moi _•- At I ' ~l� __ ___..__ _ _ - _ _ __- - _ _ �_E-ILItiIU• b -L r n1a�Tscz p �tl O C-r - 00 iq v - u 'c Zb - __ '� i � h (, ' *°SII � \ Z"*? YJ n„— Z• (z)2' e �'a' s ,o,ocs• I [ '. 4” 31 1 - --- -- — - - -_ - � � — - ---� - PRO s 1 - 4- u VI E OPENINGS FOR 4 o -- -'IUb7� Ln1. LZs cM ER ENCYESCAPE'AS + n — N cAA-k{�uP5N0 - I �- -- - • �� -_- ��� ? � �-�� I - ro x� x N�LY,WbolxxE mllc� tTouc�urBy PART __ _ IT�H _ I �, gonl QD U n-1 - -41LY BUILDING COD I'( .. E.P. 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NO YES Number Suffolk County Health Dept. j( New York State D. E. C. Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation ??? ' Flood Zone: to • M