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FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-27057 Date: 04/26/00 THIS CERTIFIES that the building ADDITION Location of Property: 1155 OLD HARBOR RD NEW SUFFOLK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 117 Block 3 Lot 9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 7, 1998 pursuant to which Building Permit No. 25521-Z dated FEBRUARY 4, 1999 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 SECOND STORY ADDITION AND RENOVATIONS FOR AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DOROTHY & HOWARD SARGEANT (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N 519312 03/27/00 PLUMBERS CERTIFICATION DATED 04/10/00 MIKE JACOBI )Aut rized Signature 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. 25521 Z Date FEBRUARY 4 , 1999 Permission is hereby granted to: DOROTHY & HOWARD SARGEANT PO BOX 667 NEW SUFFOLK,NY 11956 for CONSTRUCTION OF A SECOND STORY ADDITION AND RENOVATIONS FOR AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at 1155 OLD HARBOR RD NEW SUFFOLK County Tax Map No. 473889 Section 117 Block 0003 Lot No. 009 pursuant to application dated JANUARY 7 1998 and approved by the Building Inspector. Fee $ 75 . 00 Authorized Signature ORIGINAL Rev. 2/19/98 TOWN OF SOUTHOLD __ /ct1[_ J 1p) s ([ BUILDING DEPARTMENT E TOWN HALL N 5.4 765-1802 APR 2 4 .�C F APPLICATION FOR CERTIFICATE OF OCCUPANCY t>� t,U;.DEFT 9P F..�. "KFv"JN mF 1llTk 1L ,Vion must be filled in by typewriter OR ink and submitted to the buildinf 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 17 lead. 5. Commercial building, industrial building, multiple residences and similar buildit 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 ar - "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 Occupancy 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, .' C, 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 - 2 , 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 / . . . . Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. Old Or Pre-existinttg Building. . f ((� Location of Property. . . . . . . J.�?�i . . . . . . .. . . . t4;a iz ,.:'. . . . . . . . . . . . . . . � .f•J� . . . . . . House No. Street H inlet `� SA � Cr� .4I Onwer or Owners of Property. .L/.G.1�. •4�.�� . . . .57: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . . .1.1.1 . . . . . .Block. rJ. . . . . . . .. . . .Lot. . . . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . .Filed Map. . . . . .':. . . .Lot. . . . . . . . . . . . . . . . . . Permit No. ., - J.zDate Of Permit. y/1.�. . . . . . . . .Applicant. . . .` Health Dept. Approval. . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . ... .'. Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. ,____ . . . . . jeFSubmitted• cri�. . . . . . . . . . . . . . . . . . . . . . a`1©5'�1 . . . . . . . . . . • APPLICA T �'. . APR Towdl.Ba u,.65 M' [R: :01d:.t .� i Y Fax (516)765-1823+ P. O. Box 1179 Telephone(516)765,1902 Southold, New York 11971 d OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE: f fO �© Building Permit No. Owner: � I4 5 J 0.x G i— (plle�as(e, print) Plumber: I // I �i C J&�� i (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers nature) Sworn to before me this day of I$ moo p Notary Public, Lr/=/=6 C/-,/t County �1�; � r� ELIIABETHASat Te MS 0N(L 018T6008173�3 ffolk CquytoyAt Tem►ExpftsJum 8,2US�P THE ' NEW ,YORK BOARD OF FIRE UNDERWRITERS PACE 1 1115101 BUREAU OF�ELECTRICITY`� - - _ 40 FULTON STREET, NEW YORK, NY 90038 MARCH 2-1 2000 19612099/99 N 519312 Date A lication No. on fd¢ THIS CERTIFIES THAT Y�RMIT NO. 25521 _ only the electrical equipment as described below and introduced by the applicant named on the,above application number is in the premises of DOROTHY SARGEANT, 1155 OLD HARBOR ROAD, NEW SUFFOLK, NY;.* ^ in the following location; ❑ Basement ElIst Fl. U 2nd FL Section]17 Bloclt3 Lot 9 was examined on MARCH 21,2000 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLET$ INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. I K.W. AMT. I K.W. AMT. H.P. 7 19 17 7 1 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS I BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K.W. OIL N.P. GAS N.P. AMT. NO. A W.G. I AMT AMP .AMT.' AMPS. TRANS: AMT. H . NOSYSTEMS.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF - - S -E R - vi� - I _ _ C E __ METER NO Of CC COND. A W.G. A.W.G. A.W G. AMT, AMP. TYPE EQUIP. 10 2W11 0 3W 3 0 3W 3 0 4W PER 0 OFA W. G., NO,OF HI-LEG OF flIW LEG NO OF NEUTRALS OF NEUTRAL OTHER APPARATUS: PADDLE FANS F-2 WHIRLPOOL BATHr.j SMOKE DETECTOR:-•3 K.F.C. ELECTRICAL CONTR. LIC44718 E d tows 3 PROMENADE DR. AQUEBOGUE, NY, 11931 GENERAL MANAGER 11 �; Per 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 BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE 'MUST NOT BE ALTERED IN ANY MANNER. S1dFF0j.t Town Hall,53095 Main Road p Fax(516)765-1823 P.O.Box 1179 o ,? Telephone(516)765-1802 Southold,New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD March 4, 2000 Dorothy Sargeant P.O. Box 667 New Suffolk, NY 11956 RE: 1155 Old Harbor Lane, New Suffolk. 117-3-9 . To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons : XX An application for Certificate of Occupancy is not on file. (Enclosed) / No Underwriters Certificate on file. `/ XX The check is (not on file. ) $25.00 No Health Department Approval on file. No final inspection has been made. XX No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 25521-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. New York State Department of Environmental Conservation Building 40 -SUNY, Stony Brook, New York 11790-2356 Am Telephone (516) 444-0365 Facsimile (516) 444.0360-0360 John P.Cahill Commissioner LETTER OF NONTURISDICTION-TIDAL WETLANDS Date: May 5, 1998 Dorothy Sargeant RE: 1-4738-01939/00001 2800 Woodley Road NW Sargeant Property Washington, DC 20008 1155 Old Harbor Road New Suffolk Dear Ms. Sargeant: Based on the information you have submitted, the New York State Department of Environmental Conservation has determined that the property landward of the functional bulkhead greater than 100 ft. in length and constructed prior to 9/20/77, as shown on the survey prepared by R. Van Tuyl on 9/9/70, is beyond Article 25 jurisdiction. Therefore, in accordance with the current Tidal Wetlands Land Use Regulations (6NYCRR Part 661) no permit is required under the Tidal Wetlands Act. Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary, as indicated above, without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and your project (i.e. a 15' to 20' wide construction area) or erecting a temporary fence, barrier, or hay bale berm. Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies. Very truly yours, ✓�� ��gssyrLA� Permit Administrator cc: Nancy Steelman, Samuels & Steelman Architects, 25235 Main Road, Cutchogue, NY 11935 Bureau of Marine Habitat Protection, NYSDEC File DMG OFFOJ4- Town Hall Albert J. Krupski,President ,\� r/y 53095 Main Road James King, Vice-President P.O.Box 1179 Henry Smith y Z Southold,New York 11971 Artie Foster 5 Ken Poliwoda Telephone(516) 765-18192 Ql �� Fax(516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD May 6 , 1998 Samuels & Steelman, Architects Nancy Steelman 25235 Main Road Cutchogue NY 11935 RE: DOROTHY SARGEANT SCTM #117-3-9 Dear Ms . Steelman, The Southold Town Board of Trustees reviewed your survey dated and received in our office on April 24, 1998 regarding the construction of a new second floor addition over an existing residence, to be out of the Trustee jurisdiction under Chapter 97 of the Town Wetland Code. However, any activity within 75 ' requires a permit from this office. This determination is not a determination from any other agency. If you have any further questions, please do not hesitate to call. Sincerely, Albert J. Krupski, Jr. President, Board of Trustees cc. Bldg. Dept. I 61g& b 1 / f507 a ■ MATCH SEE SEC.N0.110 R = 7 4 a a LINE 7 FOR PARCEL N0. SEE SEC.N0. G 8 A 110-8-034 1-24c 1.IA(c) LL 3.1 O 201 fS0') yr I.9A(c) 1 1 ti 4.2 9 195 1.3A 11.5 $ 4.1 1 , 5 2 2.3A(c) O I-BA 17Le) 18.1 3 w: 3.IAfc) 5 a 3 _ _ _ A 12 a 5 1 4 6 N 0 17.3 17.5 2.8A Q / 5 1.2A(cl 3 7 + ++r L, f 5 6 ' „ , « 7 X8.6 is 8.4 c) 24 0 75 a 19 25mill # 9 b. R mill51.1 4r 6.2- � _y UA �9 4a C 18.2 5 34 ! �1.4A(C) a 26 a y i w� 12.1 10 5 33 N 0.S w 8 27 1 '22 14.1 IAr" ze 9 Sz 29.1 \' e.l ��'#R 4( CUTCHOGUE s 31 i 2.2A(c) 50 15 9 w S 28 27 29 a 30 a 1.3A(c) an Ll - t 1 IA a 40DERNO - 4 L410 14.2,J .. 47 Sctod Hou" Crook. �q :• 38 34 33 - 6 3046.3 a ' 2.2A(e) 40.4 S.BAIeI 36 B u ' s 8 ■33 34 5 5a 37 78 39 44055 41 43 72 a w .1 (4 MAW 29 S 12 5 13 21 2 v 26 a 7 N 4 ' 23 ' {50) O 29 5 30 0 1 A 7 10 4 s s 2 24 5 5 27 31 ss 20.2 28.1 a 2 g i a6 a 1 2 26 32 5 31 °° SE{ A 28.2 1 a ••+ NEW 9 6 g 11 16 R 27 32.3 4 SUFFOLK 23 18 ) i� 21 6.6 K B e 3 c DIS e 7 a 10 ! 12 9x15 3.5A1G sou F i 5 ® 22 it 24132.2 32.1 1 9 2 MAW a B 9 New York State Department of Environmental Conservation Building 40 • SUNY, Stony Brook, New York 11790.2356 AM Telephone (516) 444-0365 Facsimile (516) 444-0360-0360 John P.Cahill Commissioner LETTER OF NONJURISDICTION-TIDAL WETLANDS Date: May 5, 1998 Dorothy Sargeant RE: 1-4738-01939/00001 2800 Woodley Road NW Sargeant Property Washington, DC 20008 1155 Old Harbor Road New Suffolk Dear Ms. Sargeant: Based on the information you have submitted, the New York State Department of Environmental Conservation has determined that the property landward of the functional bulkhead greater than 100 ft. in length and constructed prior to 9/20/77, as shown on the survey prepared by R. Van Tuyl on 9/9/70, is beyond Article 25 jurisdiction. Therefore, in accordance with the current Tidal Wetlands Land Use Regulations (6NYCRR Part 661) no permit is required under the Tidal Wetlands Act. Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary, as indicated above, without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and your project (i.e. a 15' to 20'wide construction area) or erecting a temporary fence, barrier, or hay bale berm. Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies. Very truly yours, Permit Administrator cc: Nancy Steelman, Samuels & Steelman Architects, 25235 Main Road, Cutchogue, NY 11935 Bureau of Marine Habitat Protection, NYSDEC File DMG o��gpFFUJ/( o Town Hall Albert J.Krupski, President h� Gy 53095 Main Road James King,Vice-President < P.O.Box 1179 Henry Smith y Z Southold,New York 11971 Artie Foster O Ken Poliwoda y� �� Telephone(516) i�2 Fax(616) 766-1823-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD May 6 , 1998 Samuels & Steelman, Architects Nancy Steelman 25235 Main Road Cutchogue NY 11935 RE: DOROTHY SARGEANT SCTM #117-3-9 Dear Ms . Steelman, The Southold Town Board of Trustees reviewed your survey dated and received in our office on April 24, 1998 regarding the construction of a new second floor addition over an existing residence, to be out of the Trustee jurisdiction under Chapter 97 of the Town Wetland Code. However, any activity within 75 ' requires a permit from this office. This determination is not a determination from any other agency. If you have any further questions, please do not hesitate to call . Sincerely, Albert J. Krupski, Jr. President, Board of Trustees cc. Bldg. Dept. 4 1°00' 00" WICK ZONE AE (EL 8) OAK ST TUTHILL RD 3 � N ZONE X °16 , . o °9 r' A !,. GEORGE RD CUTCHOOUE HARBOR u . w a sit i s s F afm'9} �I .ES LN s -ZONE X y L T �', swpsa ! I!, � Ra•��j;�` .gip. I BUNNY LA x = ST Town of KING Southold 360813 , sT MAIN ";ar a isf�r,i ZONE X ST JACKSON f sf �s� Itis !I snit . "C. sqi si�i�sl ?si �I H. f.+ K COASTAL BASE FLOOD ELEVATIONS APPLY ONLY LANDWARD OF 0.0 NGVD C '"Rel M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] RO PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACES CHIMNEY REMARKS!: , w DATE O6` 0 INSPECTOR a53-2,1�- M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ "F MING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: o r ��G DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION ( ] FOUNDATION IST [ ] ROUGH FLOG. [ ] FOUNDATION 2ND [ ] INSU ON [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: _ 4 � C DATE INSPECTOR BUILDING PERMIT REVIEW CHECK LIST Application Name: _,,� G N�i DMNX 2C'� 3?,'? 079FO Architect/Engineer: C 0e�o + Ati.. Date Submitted: �-7" — SCTM #: istrict: 1,000 Section: �7 Block: 3 Lot: 1)5? ,, �bC Subdivision Name: 1. oz( h N Req. K Req. Zoning District:///ttt ; / [Lot sizes: Actual t5 ACOC ] [Lot Covera a Proposed: 1 Req. y RegeAfJReq. ' :Mroio, [Front Yard P sed: [Side d Rear Yar / �V( ] Project Description: o�D ��' (�pp►1to� �"oXtStwS �eSIO-P'u'+C AGENCY PERMITS Permit REQUIRED FOR REVIEW N.A. NO YES Number Suffolk County Health Dept. New York State D. E. C. M (?KvK r Reoo Qco f-"z'-M3yO000) Town Trustees 0)A t V er-,- Town Zoning Board approval: Town Planning Board approval: _ Flood Plane Elevation ??? �I �� - Flood Zone: I�ti�' At(F,S'$� T6 8011KYOtO Notes: s 0\5 FIELD INSPECTION REPORT DATE COMMENTS assxasxxaxxxxxaxasxxxxzxx�xxoxaaxzlf zxxxxsxsxxxcxxx=xxxxxxxxxxxxxxxxaxxsasxxss.xxxsxxsxxsaa FOUNDATION OST) I� I� FOUNDATION (2ND) _ u axmaasazsasxaxxaaasxsxaaz xxs-axma�axaxx�xsxxaxxsxaaxxxxaxxxaxxxxxexxasazs=zxsxxaaassxaxsa Wr y� 9 o ROUGH FRAME & ul PLUMBING i U i d 1 II saaaxxasxsxssseasxxxsaaxa�xxa� x� sas-- _ ------s-xssssaasmssssssxaa:aaaassa oQ INSULATION PER N. Y. q �I STATE ENERGY i u i� CODE �! II�i�N kv zz s:saaxassaaaaasaaxaaaa:aa�: saa�xasa�saaa----sss asasaaaaaaaaxaasssaxssssasssasszeas u u I ° �00Ilool (Z 1� J FINAL A M ss:s:sass------xszassassa�ae---- "° as—�-asaaraa:as-s----asaa----sasaxaaaa:zasaaasasa ADDITIONAL COMMENTS: aasassaaassazsxx:xxaassaaaaxasaxaaxssasxxasssazzs -ssxaaaasssaxzzazaaaazaaaaaaazzsxxss V H ,-C 1 H H O Z r� BOARD OF UL'ALI'll . . . . . . . . . . . . . . . DORM NO. I 3 SETS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOIITIIOLU SURVEY . . . . . . . . . . . . . . . . . . . . . . . : BUILDING URPARTHENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . 'roWN HALL SEPTIC FORM . . . .• . • . . . . . . . . SOU1,1101,1), N.Y. _ 11971 Th1.: 765-I802 NOTIFY: CAU, 62Qz).-47.7�5-eO i:w�nitxKl....2...1yC ......., 19T MAI L TO: . . . . . . . . . . . . . . . . . . . . Apuprovoxl........�:.. .., 19..L.1 Permit No. .................................... . ... .................................... I)isar4woved a/c ................. .. ..... ... .. .., < ,� l5 � � U � � IAoilding Unpaecaor) " PLICAI'hON FOR BUILDING PERMIT nib - 71998 nate. •I�- . . . . . . , 19.98 BLDG DEPT- INSTRUCTIONS WN OF SC UT4, O1.n a. 'Ibis application must be crngletely filled in Uy typewriter or in ink sax] uhnitted to the Wilding Inspector will 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan allowing 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 mist be drawn on the diagram which is part of this application. .. , c. 7be work covered by this application nxny not be connencel before issuance of I9uilding permit.- •• w d. Ulan approval of this application, the linildir ,, Inspector will issue a Building Permit to the applicant. Such 17�L111j.t. silail, be kept of the premises available 'd4i� inspectiai chroxy)nout tlne work. •utever until a Certificate of e. No building rlcatl be occupied or used in wlale or in part for any purpose gY g y . . � ffolk County, New York, otlhenrsvallocalbleerlaws, Ordinances lnceino �cu nx: shall have been granted b the Building Inspector. AP17.1CNr1(N IS IMCISY MALE to tine Building Department for the issuance of a WildingPermit pursuant to the r 'lkuldin ,on, Ordinance of N,e 7bwn of Southold, Su Regulations, for tine construction of buildings, additions or alterations, - described. 11ae applicant agrees to coniply with 811 applicable laws, ordinances, building code, housing cote, and relpdatiols, aux] to admit aut.larized inspectors on premises and in building for necessary spectioins. of a licant-�•me, if a corporation) (signature .Via•.��.�z...��.�tlk,.lYX:.1.1.9. (hailing address of applicant) Stale whether applicant is,owner, lessee, agent,,atchitect, engineer, general contractor, electrician, plumper or builder. .............. Ii h . art.......... Nave of owner of premises ...............•.................... (as ,M the Ca Il or latest deed) If ar4d icant is a corporation, signature of duly auUarized officer. .............................................. (Nano and title of corporate officer) lluilders l,irense No. ......................... Pludners license No. ......................... - -� E3cctricians License No. ..................... Odes 'IYnle's l.dcenee No. .................... _. I. t«:aCicn of pant om which piiopxused work will be rlone..••••••••==•-•••••'•••••- ...r'.. ..........._�na;.o.-.:...... 115S....................�1d..linho.- ..................Nein. E r�lk ...................... Street Ilanlet Ikxnse Nini�er 1-7 (kxnly Tax Map NO. 1000 Section ..... 17........ Block ......... fol ........... .......... Filed MIP No. ............... lot ............... ��`� i�;.�:. ?�,�'-•. (Name) c a.. proposed construction: •. isl:ing use and Occupancy of premises Bull terxkKl use mel occuparncy of props•. . ., .... ,,,: • a.'-r xisting. se=cued occupancy .r.���a CC.�.................................. ................... - ''>',•'�b. Inteixkvl�n:.e ant occnpsxy .......................•. ' 1. Kitwe of rotk (dwck l>t vAdch a rl • 'icable): Pka+ Ihrihlin7l .......... fwklilion ...,)(,-.... Ail.erztCion .......... ,�'t, Itceair Itaarval ....i,......... lkltnlil.ioa OlheriJntk =• e� (Ikescrtpticxr) 11. FSHIllted Cost`7:-N.pono.......I1. ....... fee .............................................. (lo,be lucid on filinll.this application) 5. If: chvelliag, trulter of AmIling }mils .... ....... tinier of thaelling tails on eadr floor ...7:........... Ifgarage, tenlxer of cars ...:...........:.......... ... 6. If lewineas, amential or mi)aecl'1 mmilancy, sliecify nature mkt extent of each type of use......... ............ 7. Itisensions of existing st'ntctorea, if ally: Frcxa .....652 ....... Rea, ....... floplh .....JCJ......... - Ik i . tsions •oJ.s.`.......... e • Umber of SI"oriel ....Z............G P I •-� 1 alterations Or ntkli Cions: Front ............... Rear ....�1.�....... IkeDiledlts.....o•sante a... ... fl wit ... L............. M■drer of Stories ...2:......,., Diiiiisi R. Iletisiflions • � orenti're new ccxsCnI.i<x : Frcxil. — _ Rear ...... 6 ........_............ Risherer of Stories ...... 9. Size of lot: Frrxrf .....C7�7.t..'�L....... hear ....IjC(l ........... Depth ...�g,?J'.�..lc�.�.n.... 10. hale of Hncbn:u ..... Mile of Fonar Owner ........... ............................. "l. Lcxre or use district to wlndr ino �}� .............. • ., Fries Are si:haCed Tom.:g-V ............ - kres l l )sed const nw.Lion viola a any 7A)a16b...laxi, orrli once or iegulat.ioni ..no.................... .1xr1J.._. , 13. Will lot: be reflrmlecl ......ns..l ........ Will excess fill Ire rea arved frn premises: YES l� ESS 14. Hanes of Owner of roui's�er; J"C?T11G. G� YA6.t... twklress . iQ:.P2o.X..�R .Z� Nam of ArchlLect �3iJu.�x.� �Cs:!Y.Y1�S1.�1"P. l�c .i5 Address 252'� .Hojz "xme No. .............. Namof Contractor .............II..................... Adklless ...............................I'llote No. .............. 15. Is thisI ro)erC within 301) feet!of a ti(lal wetland? * YRS ..}(...... NO .......... y *IFYES, fxxrllCAD 31XIN •IRIISIIITR liumn, lid l kEtAfIRIi). —Tt-v j"{Y�.S kbyl3f)r15dIC},lbr�,,, PLOT IIIA(iitAM Yi)cat:e clearly anal distinctly all buildings, whether existing or proposed, all indicate all set:-lack dirmosions frau pnolxerly lines. Give street mxl block nuaber or description according to (Lee(], and slim street nares arxl irxlicate Mietiler nrLen'or or comer lot. srAn': lA� w' SS (l A1NIY fAe ....... ................ I ••I�1b� ...--SJP t.)Cel n..'.k..............Ix:ing duly skarn, del%)sea still nays (fat he is (lie applicant- Mile of ilxlividlal signing contract) aline naiad, IMis the .............. ..............1,....................................... ..............I................ (Uritractor, agent, (-c)rfc)roto officer, etc.) of said mailer or (miers, mxl in duly mithoriml to lxerfoon or have fxerfornred (he said work sad to "rake atxl file Ibis application; dial. all sCala)eLwcont" ned in this. ;Ij)licnHoo are I.rrre .Lo Ute Deal- of his klKVIEXlfle mill 1)(0ief,;),sLxl Ihnl. [lie mnk will lie perroraml ]n the Iarunxer set Porth in the apptication filed therewith. 9wcnn to IMfore nrd this .......tla of .. 17? J.... 19.qpp:L... Nil Illy Nblis1k A4� (Sillnalm, o4�1vijfvlt; Eboni Miller Notary Public Districtof Co ttm a My Commission Expires: 2 PROsV' NR. FIRE Y RATED °,,TION TO PART. 7or SITE DATA N.Y. STATE�BUILDINGICODE. SCTM # 1000 - 117 - 3 - 9 PROPERTY: 1155 Old Harbor RarzDE SMOKE-DETECIING L ADDRESS New Suffolk, NY 11956 SRM DEVICES AS TO PART.721.1 — - - OWNER: Dorothy Sargeant N.Y.SBUILDING 00DE. PO Box 667 New Suffolk, NY 1 WIDE OPENINGS FOR c, _ SITE: .47 Acre EMERGENCY ESCAPE AS AREA 20,900 sq.ft REQUIRED BY PART. 714 OF N.Y. STATE BUILDING CODE. - ZONING: R-80 FLOOD: Zone C _ _ ! ZONE ') APPROVED AS am SURVEYOR: Roderick Van Tuyl DATE 2-1.22 NRS Greenport, NY 11944 -_: - � --- 7,y III � �, License # LS 25626 NOTIFY BUILDINIII DEPANTMIIR AP Dated September 9, 1970 'SII 765.1802 S AM TO 4 PM FON THE FOLLOWING INSPECIIONN: I 1 FOUNDATION • Will TIBOINNED OCCUPANCY OR i FOR FROMNQIETN 2. ROUGH UGH - USE IS UNLAWFUL FMIAIIG PIJNAlr10 3. INSULATION 1 4. FINAL - CONSTRUCTION MUST WITHOUT CERTIFICATE LETE O. L CONSTRUCTION SH OF OCCUPANCY - - -- -- --' -_"- ---- --- - ALL CONSTflUCT10N SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION B'. ENERGY / CODES. NOT RESPONSIBLE FOR UNDERWRITERS CERTIFICATE DESIGN OR CONSTRUCTION ERRORS REQUIRED a, CUTCHOGUE 'i (( I,Fi , CUTCH USE. ''- r ��Iev'T�9e�✓ �.�. •?T�!:CL''t r ', �� - �� ���� ' �,�r�" I�� � �� � T ��ti '�°� I z � ) M - � i r /- stl1�I / r rcr�our E„ t. :( Api:JIT Ory To = ,... . ,., F L SII G ..� NEW SUFFOLK - _ CTII�gI•I� fZ�-.`�'i,.zEiAC..E •` � i � t� -_ OF 5M]i Z ST - 33 LOCATION MAP a F MN I f j SITE PLAN d RENOVATIONS & ADDITIONS to the 5 A M U E L 5 & SCALE : 1" - 20'- 0" S} e S T E E L M A N SARGEANT RESIDENCE ARCHITECTS25235 ROAD CUTCHOGUE,NAIN New NEW YORK 119]5 Suffolk / 2_-)b-LV 1 New York Z (516) 73"405 FAX(516) 734b 107 i srocnor+..n.c roaM xo m,ss saxesr II i I 6TT'INC..._F1nCn.i ! ED ' I i AW16t'A Off. Fin i j III I � I RIFTED SEPARATION TO En.I TI ` c CaCic'T1 y PART 717.3(1)(1)OP 01 STATE BUILDING COOL h� --'• � �i=s..,Ft.rn�w� t- I .TIN PROVIDE OPENINGS FOR EMERGENCY ESCAPE AS REQUIRED BY PART. 714 OF N.0 STATE@UILDING CODE. TcH F/J�onFtl IN 6 _ I r^/ERIFY I-IE/K 17f.6 EXIEyr q II'4i �Q1I.� I 512Gs MIN• Z-o J,II _ E�Jw,� e"i�J A.� z•�' �- - _ - -- -- --1 FIRST FLOOR PLAN T1-! Fhl SCALE : 1/4" = 1'- 0" —. -- EC.U" =4Ua T�ryiRdcC PROVIDESMOKE-DETECTING r, ALARM DEVICES ® - `}� AS TOPARV.721.1 N-YS BUILDING CODE. SE OF Vr 1IJTD Go�,UMN3 6irc *SGy . SOA Ekl`�'r _—� ST I - 17953- �Vh 17 F FA£D � � a —� RENOVATIONS & ADDITIONS 2 S A M U E L S & F S T E E L M A N to the ° ARCHITECTS SARGEANT RESIDENCE i 353)5 MAIN ROAD CUTCHOGUE' NEW YORK 1191.5 15161 7366405 FAX 6161 734 6407 .oaM„o ...1, ,os„ New Suffolk, 2 - ig• 96 New York � I I it I i I II ! Ek1T, EntF3TI�y Jails ' vF2lF`r To AR-cNrf'Ecr ExI Tlhl � � ExI �,T•INe� E.xIST1N.Ici oEwwc, P (.. C' ;vY B .,IolsTa VFX:. N-1 �JPPb;,.Tf.Nv .ATT,AcI4+ AC-rJT PRO✓u�t, G><IPTIIJ4 I�-It>.I.l T4 v�E -- i -- F;�TcH YP. f.+,(�, .o. .y 4 - REF?�IR F%-ATCH C,kt`' F31� F�aLTIvE �u .Noc �ci GzElnov6 I•'�T4Nc ,Yi �F \ RE4 IRE AT4l��l_s,: WALL=: c%�ILIIJG AT, RLCQJ1PEv AXI F>Tu-1 c, I�g1or:. 1--_�-_ aai' 2:Ei41NCi J�AToH GvV I8 - L - _ �E I,:.+TINSCI la��[,E ,.aa REQ�1 H'2EV � __ CK I�uTIN� NkA D4=1z �! NCiJ 2rI0 RE s12E 7t) ARGUITEoT 01 4" O, G. reIn vN II � 'O '1� 2a10 G� �` mo �.• `"�" _...._— E.xl ITieJ C.l KNEE. I�rALL @IFTL.1= ' "I �yT - - - - - �- -�- -- - - --+-- - F�R7RT NEV�C EL.Ic, Joi�F'7a _ A�I ;' R .J+aG Er�IwT, I j _ ,tF 1 IN G614.II'•IC. ,f t11�' N 3G FINK^+-1 { c�lurJcl �EI71z,00ti� 6157_-i,,i� o � -� rxool�.'I w a d7 / V d F - ' two", 4 ys �\ AV 4 -1 +d1- ,I SLO F'Ev tr E+ u I , O�1u fa.C4zN/1 - 1 +LEEP GEil4..INC� S4-Opp.E7 CEIL.INC,i I IJ FxI:�TI+-J C:1 P.�EdR,�NG — _--_llllllll bJ T 24310 A TO --__.+ --J -,r- - i.f'ti l-IITEGT ■ 1 l.^-K, 'ti 1 I"1 p a CEJTL-"rz, i. y�u `-._ LA FLod wlu4 Td+ nAn"IC+I Gn.15Y, Fts�T cL14.IrJ�-y "SSWP61 LI m fwflu pol.J'?R h^^'*TGH E,X16TIiJGI a - F 12r.IC� IZ R } � N O P,,.ELOW 0 10" O • G y .. ' c12Cj nEluNci 2R'x Co T` j c����c, G125 ' � -I`- , _ - - >b T� �o ,� a !� _ SECOND FLOOR PLAN $ 3 5' SCALE : 1/4" = 1'- 0" TILL'S FL&�a ExTE . I o VEas-I-{.a r•I cl PROVIDE OPENINGS FOR I I i I 12." f�ROnil Face or- 7 EMERGE I�t�YESCAPE AS �� I-4SW FL-�R'"�G9 PROVIDE SMOKE-DETECTING g N ta; N EnlsT{I y ALARM DEVICES F�KT L1aLLTY' REQUIRED] YPART 7140 pv a� pE4s.�a c, P� DETp I Lwc To NWTc1 N.Y. STATE PUMPING CODE, A$TO PART. 721.1 Of NE 4 - u N.Y.SBUfLDINGCODE y�0�` . srFF roy o * - l z k -& 4u �,- ¢„ q„ + r. 0179 3-1 �— RENOVATIONS & ADDITIONS g S A M U E L S & s S T E E L M A N to the ARCHITECTS SA RG EA N T RESIDENCE 15215 MAIN ROAD p CUTCHOGUE, NEIN YORK 11935 i (516) A46905 FAX 15161J34-6902 New Suffolk, �_ - �g- g� New York socP[owrT,xc FaR-0 ioi Rz eozssl rNE.vJ f''RcFa� ExI�,TII-1 c� OHIM�I L-V fb E'Yn`-In j Rw�:,E VErJ'T -E1c I6TIHG zl�>4E To REMHI-I ('RDVIpE Z.,0 R•R- �E.ThIEE,-: Ca<<cT 21DG6 4 'IE.J rROoFING TD T iA,-rc 4 ExIen:-4 :, •--NEW 21110 ISR BTfzUCTLI F-i*�.. 1/a I.L EY � ] oN 3DB R07FtlJG, f'i.PCR eN � IPKo1/IIDE rIV W4Ic..lIJE / PLL4-JV 01.1 i GLIWS Tti'f''I GSL HEYJ I'R E+F/°n l 2xloRR.© IG" o,G, W IKIOCEvu +T NEYJ z low j fL-3o Nom, j +TT W9ULATI0N �120v1.3E � � ! BkT�LRZ CIJ,cT uwERM c0 F7 RIDGE >i' J + � IJ� 1n� G,iIERBATT 7 0 =Xr IL11(JC PP-0V Dv I-�IEW F.aEt lr> G IGIGF-EI ALID - 1 - -- " - - qu rew soF T FIS f RDV EI,.I — - �1 11 _i= V T O M.e�TGH EMa bTl,v I2 V �.,�.-,� I F'"A6� 41NC, A l t 254 VERB S \ FRnV I V VF-WTI JvOJv G/o uI�NEY �� ..-_. _ _ - t>oFIT vEI-+T r.l� S 3 /4 vEI�I�Y ��S�y.Ep YI *+ �_2�� F�oofz- _. � i tiEMo.G la'f �— II _ vEK1l'Y 18TI1 To IVI1.TGrl En1,-TNv.C,I LI-IEYJ cl`(P -_ I.IEvj c_,-1P \ RCCC' W..*FTE�j '5 P,�D FIJ18H a 1" 2G WALL 4- '� \ IZ — - VA R�EE> To y J Fitilsr4 TYP, �fq CTI..ILA1.. SEC..a'�H1,J \ UktE.L'F+ 40zlLi � I � �'r ',i�Yp rq.•rGr+ F•+Ecl.� 'I"- E--- PArGU d IZER�•I:L / y�Yres2T 1 - ! FLaoF ,�— F,y IaTINc r1K n II {� Nelc l r . r AI-� cyp, �✓-6 / �ASL'M ErJTAtr L. %E F=E WI a/E;J <---AiJ P�:. Gh-1 \� �.•EG'TI O].J,/i„ ,�., IJE LSI li 8Ui'�FrbE,1 HE; 4 zOP / To PSE (Z ^nvEIJ ( --�--- G 11 I-IE1Je.L . 1 7. FIcb::1�ci TO T� 6x,r,ERO Mn TGi-+ i.XI GTI�G I�LPJ(ii Hyl R19 �tw-f�'r — �I �� 31 w/ 1 I "� M � 1 IN6c.JLATiOJ I ��I Fxle,Tl,-Ic., h.�EWJ �.� 1 : TO Rl�.14 -� NE12.oOM � Ili II I \\ 31 -rYl�lcr.� To e.Lie,FLb:7R z 11 �t3T R Jc.Ti-ane. j^, _e>�I , —ic, SEPA 12N� � fs7 <' R R li-I vv F.ATcN TO i-- i . k ExIe,TINc, I I CN-1 P II Ft D, f gx . I.IVIn1I,sT-I�NdCZOM PJAT�R.00M i �-- NI�JE'>Y'EJ f2IiOII F2.OD. .J jN EJ�I��TI nJ TR,rG, ( TO PAI RL. i FH YY FLGF'h l{2.. I .t vx _ c> �/ NG Erl ..l_ l � ~ ci TI ro acrlr�cT t.nE `T �` BUILDING SECTION BUILDING SECTION :d , SCALE : 3/8" = 1'- 0" SCALE : 3/8" = 1'-0" OF MFN, STe> 5 ri FF�� i 01795 -1 �V �6 RENOVATIONS & ADDITIO to the g S A M U E L S & S S T E E L M A N ARCHITECTOAD S 25135 MAIN RSARGEANT RESIDENCE i CUTCHOGUE, NEW YORK 11915 (516) 734-640S FAX 15161134-640) New Suffolk, /s -ss New York 0 SIIXXOn6]INc iOPM na iOi fl fi0]95] r— iNE.�.i ENT NEI+-1 6N�fP DoRMEK. / � rOpl21„lE,l2 IJ%e,W f�2Epv.Y,� /1 �' R-Irac,E ve'nJT E7tiI CTIt+i Gy L— -- — /—SEL _A , we ' 4 20o F � FXI STI / W 11,411 -- _ 2E!'Ls.cEPAs - NE.W P,a6G.l.a. En.It�IIrJc.� �„a,(�� j fC GQUI FUJ:� Ex-I ,TI � N - JGJ ic" P�wns S iu[T -- 0I,& , P9Z FAP. ,, Exl TIrJ<, coLlJI INa ( f cl-IIraNGY F->, 8:Tl INC.I '� BIfJIN<7 i j _ NORTH ELEVATION SCALE : 1/4" = 1"_ 0" SOUTH ELEVATION I�ROVIDG NEW --- Rcc..FIUG To I`-tATc.l-I Exle'r ,cI Nom..! PRE FIA Pt i FJTv� 91-1 Ei7 tX fel+-IEVL. cRIoKE r eE n y rIEW P J W� �E Rlopu vr1 T F�IvInE a5W SCALE : 1/4" = 1'- 0" Fl-H`NIr.IC4 AT -- li" ovr-� 4-{,ate nF,�TAIL.. .--?ij" vJn�c c.ELf�al� �I-+IwlciGe, a�i�;Ir,Icj GNIM NEY TRIM M^TG rl �.,A(I STIN C,� ��"'`'r'Y .l FL/�SMr�+C1 A �t - PRG1vIvE Ex?Erin nvE_R-Na - I � Y -t I', IL, - GETr4r.INC1 — IvIATG H Fj.' 16TINq - TYI�ICA6.. ------- rxEaalrs ,,^° Iow A.g r lil l t1 FnI6Tlu rvac a J (fib© f'RVVU9L $/4 a-�4 TRIM 'II CUV 612G[UEril � LIf ETi6..l RIP eAP pWINDOw� W /69s(. D � i 6xIPIX �¢ I�ovElw-E,J'S 2�Y3AIAI 12 /6TGN A S r lI D ETsAI w r�I G F-k1F..�T�7J C� GNIir11�rM"_-__'Y �EXI &TIrJ �I I�j INJIr-+I���J _:Tlati E {aTINzy CI WEST ELEVATION os�f��o DTF T ER12"c6 SCALE : 1/4" =F 1'- 0" 1t a i RENOVATIONS & ADDI I g S A M U E L S & to the S T E E L M A N ARCHIY SARGEANT RESIDENCE i 15235 MAIN ROAD g CUTCHOGUE„ NEWEWYORK 11935 (516) 734 10.5 FAX(516) )34310) New Suffolk 12 -/p-as New York socrcou.rurc roa"no iai.z coven