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Home My WebLink About22683-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF ~C~3PANC~ No Z-24272 Date APRIL 10, 1996 THIS CERTIFIES that the buildin~ Location of Property 4375 MILL LANE House No. County Tax Map No. 1000 Section 107 Subdivision NEW DWELLING MATTIT~CK NY Street Block 4 Lot Filed Map No. Lot No. H~let 2.5 conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 27, 1995 pursuant to which Building Permit No. 22683-Z dated APRIL 18, 1995 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 NEW ONE STORY SINGLE FAMILY DWELLING WITH AM ATTA~D GARAGE, PORCH AND DECK AS APPLIED FOR. The certificate is issued to of the aforesaid building. KEITH & CHRISTINE PIACENTE SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10--94--0089 APRIL 2, 1996 UNDERWRITERS CERTIFICATE NO. N375744 JANUARY 19, 1996 & FEBRUARY 6, 1996 PLUMBERS CERTIFICATION DATED JANUARY 8, 1996 DAVID J. O'BRIEN Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO Z-24273 Date APRIL 10, 1996 THIS CERTIFIES that the building ACCESSORY Location of Property 4375 MILL LANE MATTITU~K NY House No. Street Hamlet County Tax Map No. 1000 Section 107 Block 4 Lot 2.5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 27, 1995 pursuant to which Building Permit No. 22683-Z dated APRIL 18, 1995 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 NON HABITABLE ACCESSORY GARAGE AS APPLIED FOR. The certificate is issued to KEITH & CHRISTINE PIACHNTE (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N375744 JANUARY 19, 1996 & FEBRUARY 6, 1996 PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. N_e 22G83 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby aa,,r_nted to: , , ~:,~...~ ....... ../...¢..~ ....... ~¢....: ........... . ~..,..~.... :.,..~ ......... at premises located a ................................................................................................................ ................................................. ~~ .............. ~/....: ....................................... OounlyTax MaP No. 1000 Seoflon~,~..,.Z ............ Block ....... ..~?.~.,,. ......... Lot No,' ....,~,..C~ .......... pursuant to application dated ......~/.... ~ .......... ~ ............................ and approved by the Building Inspector. Fee $.../.'~,., ./...~..:,, ,,(,.~,, /~' E~ilding Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTi<ENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCLrpANCY This application must be filled in by type,~ritar OR ink and submitted to the building inspector with the following: for new building or mew use: 1. Final survey of .property with accurate location of a_ll buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from ~ealth 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 certifyiug 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. For existing buildings (prior to April 9, 19575 ~on-conforming uses, or buildings and Upre-~xisting" 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 ~he applicant. 1. Caruificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory bu~_lding $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildin~ - $t00.00 3. Copy of Certificate of Occupancy - $20200 4. Updated Certificate of Occupancy - $50.00 5. ,Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ... AP.B I~ .8, .~S~S ........................ Jew Construction....~. ...... Old Or Pre-existing Building ................. Location of Property..43Y~LO/..~.S.)..Nil~..~mms..~ ..... Nm~L:~c$~ .......................... Mouse No. Street E~] et Dnwer or Ow-acrs of Property ....... KeJ.~b. S..~b¢i~timm. Rism~n~e ............................ %ounry Tax Map No 1000, Section.~O3..OO ...... Block. D.~.OO ......... Lot..O.Q~,D. Q5 ............ {ubdivision .... ~O~f..~. II..~.O~0..%$TA.T.~$ ....... Filed Map .S./.~.i/.~Q...Lot...~O.y. .~. ?e=it ......... ate of erm±t ................ :.+.. Rea!th Dept. Approval. 6.T.T. 4C~.~.D. i [ ::.4./.e../.~.~..]..Underwriters Approval..A.T./.A.C..H.~.~ . ( J/.i~/95.. ]. Planning Board Approval ........................ .equest for: tee Submitted: Temporary Caruifica:e ........... Final Certicata... ~ ...... APPLICANT Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-t802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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. For existing buildings [prior to April 9, 1957) ~on-conforming uses, or buildings and qpre-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. i. 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 Buildin~ - $100.00 3. Copy of Certificate of Occupancy - $20]00 4. Updated Certificate of Occupancy - $50.00 5. :Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ...AMMIL.8,J~.R6 ....................... New Construction...~ ...... Old Or Pre-existing Building ................. Location of Property..43Y~O/..~.SO..Mil~..Lmmm..~ ..... Mmg~L~c~ ......................... House No. Street Hamlet 3nwer or Owners of Property ....... Kei.th.$..Cb=i~timm..P. isc~mte .................. i ......... ~ounty Tax Map No i000, Section.~O3..OO ...... Block. O~..OO ......... Lot..O.Q~,~.~ ............ {ubdivision .... ~O~..~. I.T..P.Q~D..~$IA.T.%$ ....... Filed Map .~/~.l/.~O...Lot.. %O.T..~..~ ........... ?e=it ......... Date Of Permit ......... ~ealth Dept. Approval. 6I.I. 4 Q W.~.Q % ~ 7.4./.2. ./.S.S.. ]..Underwriters Approval..A.T.T.6Q W.5.~ . [ .1/.%~f ~.. ]. Planning Board Approval ..................... . .. -equest for: Temporary Certificate ........... Final Certzcate....~. ...... 25.00 Check # ';47 ...................... Towa Ilall, 53095 Main Road P, O, Box 1179 Soulhokt, New Yolk 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTFIOLD CERTIFICATION (please print) (please print) I certify that the solder used.in the water supply system contains less than 2/10 of 1% lead. Sworn to before m~hJ.$ County FIE~D INSPECTION REPORT fl COMMENTS FOUNDATION FOUNDATION (2ND) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE II NE~ PER~PECTZ~E BUZI..D;N~ ZNDo F~X TRANSMII'IAL CO~ER SHEET DATE: F'ROM: ~.~; ,~.-t'(.~,-,,o TIME: PLUS 5 PAGES, PLE~ ~JONFIRM WHEN RECEIVED~ '~-[ ~ - ~ L~ I ~ 'STANDARD GABLE END DETATU - ~ D~AL OR L-~AC~ ' ~ TO. T~L~ ~0~ TRUSSES AT 2~" O~ ~ 2X4 LAT~L &RACI~ ~ ~ --,-,----,~---,,---.,.,.-.,~..,,:,....,,g ~o v~m 3X~ ~ ~T. ~"A~ TO ~T~ C~ TRUS~ ~ , 7'-8' - ~-5' J 3 ~U~ A-~ ~,, O~ ~'-5' j ~ - ~ -, ~X]~ V[~TICAL STUDS HEIGHT, 3~ ~m ~ I ~ ~-e-o I ~-~o-~ e-2-o _ ,~ , ,.~ B-4-10 6-1-5 NOT~ - ~.~B~ ~ ~ ~ ~L~, 3~ COPt ~S ~ TOCO~R~ . T~ ~ V~ TO ~ ~ BY PRO~ ~ vv~ ~- ~ ~ ~R e~ ~ ~* ~;~',~, , T~OR~q~ ~ p~ ~ DFROOF STS~~ " TCP '~e 7 D=?.AV)I BY , SP^C}~G 2'~ Inch OC. p~*a. ST~SS, ~s ....,~ ' .. OENERAL ROOF TRUSS DATA SHEET ;"~' ~ ~ ~" ~ THF_eE NOTE8 ARE IN ADDITION TO, THE NOTE8 THAT APPF.,AR ON EACH OF' THE INDIVIDUAL TRUSS DRAWING8 FURNISH A GOPY OF THIS SHEET TO THE ERECTIONCONTRA~TQR, t. "~e ~,llow'~.G t~'~sscs v,,em '" · ~'~hn~or ~ato ~ncm~r or ~ T~ ~r ~d ~r~o~ ~ ~t a ~ ~ engin~fi~ ~win~. T~ Me d~i~ ~ ~d~ ~m~fl~, ~:~ ~g ~ ~ ~ ~ ~ ~ ~t~ M pr~ ~ f~t for Indi~d~ ~SS mem~ only. ~e ~ ~unt ~d pM~r I~l~tion of~o~ ~e~ bmci~ ts '~ ~lc rc~Jlf~ of · ~ d~fgner of the ~mpl~e s~c, A~te T~c~g; [~ ~ ~le ~ib~ ~ ~c ~ e~*)t. Co~nt pr~iom ~. ~e ~tom chord s~t ~ latcr~ly ~p~ M~ pro~af~ch~ ~n~nuo~ lat~ bm~n~ at i0'~" ~.um lnt~ u~ not, lo. 't-n& cf~ect or ~ale[al fAru~t (force) and ~n~ ~t 6A ~ ~p~ ~i~r ~ ~ Is M a ~l~mdon of ~s d~. ~= d~;~ ~or b,~der ~~.m~ ~ d~ ~l~d~n to ~ lateral ~ ~ ~on~l mov(~mtnt ~ ~ ~J~r t~ m th~ ~tgfl ~ ~n~mon o~m~ ~ ~. N~lher ~e ~ d~r, ~ plato ~u~r nor ~= t~ fab~mr ~sum~ ~y t~nsibiliW for ~ d~ ~ ~cflon of t~ ~s ~p~. ~ofusio~ advice should ~ ~ 12. Tsuss~ should be inspected prior to ~nd ~t~ ~-ec~on ~ ~ ~ ~ ~. T~ sh~d ~ i~ for phta . truant, ~nm~ lo ~c I~ ( ~c~ b~. ~ etc.). ~w. ~on ~m pl~b e~.. For a ~11 li~ ~f~delifl~ ~-~ gl and QST · 86, 13, ~1 ~lo ~ (non~) 14. ~s r~fl~ ~e 6-7,4 "' 4-e-'~o ~ ' 3.4.2 ~';g-lO 2-g.10 '--~-2 4.a,,e 4,4.i~ ~.7'-4 1,,~0 eOT CHORD 2 X 8 8VP Ne.2 'r~x~epl- B2~XeSYP$$ WEBS ~X4 5YPNo.3 A~.A, OYIONa ,(v~am~,e) A-1~?II0-3-B,/4"t771/0-3-0. M~x Hor~ Mex Up]~t A--eS3(kmd ~MO 4), GOT CHORD A-~&3-O. R~:g,-..~0, N~.G..3.0, M--N:e.a~. ~fl;~O. P~:&~, ~:&~' I R~ at mmpi ~T, T,H ~0. 6m~ lO3 Mo,roe Tu~ ' - ' JNEW PERSPECTIV~ BUILOINO IND. TC Be 0.~ · Ve~(I.L) 0.00 I -- M20(20ga) Z~1~216 : ~' Von(TC) 0,0o / ' Welll~l: 113 01;) BLDG. DEPT, ! CODE RE( UIREMENrS from thc CABO I & 2 FAMILY DWELLING CODE (]992) R-602.3 l~,e~ring:,,~, The ends of each jo!st, bea~ or ~rder shall htve not less th~ 1 inch~ of Bb~ off wood or m~ai ~d not less thn 3 hc~ Off maw~ ex.pt suppon~ on a l-ingh by 4-inch ~bbgn s~p ~d ngl~ to thc adja~t stud or by use of appro~d joist h~gcrs, ' ' Floor syst~s ~vlngjoists ~n~ ~om oppo~te sides over a b~n~ suppon shall be fi~ together by lapp~ joists a ~mum ~3.inches or ~th a w~d or me~ splice, or by ~ntlnuity officer sheat~ng overlappin$'tfi~-ends of joists at least 3 inches, orby other npprov~ mvthods. Joists ~g into the side o~a 'wood ~rder ~1 ~ suppo~ by approv~ ~amins en~hors or on I~$er strips not less th~ no~na 2 inches'by 2 inch., R=602.4 Lateral s~pport and brMglng: ,Joist!shallbe suppol!ed laterally at the ends at each support by ~ul[-depth solid bl~ ~.'ns except where the ends et'joists nm nailed or bolted to · header, band or rimJoist.or to an adjoinin8 stud. Solid blo~kin~ shall be not less than 2 inches ' ' Joists ha¥ia~ a depth*to-thlc~ess ration exceedin~ 6 to I based on nominal dimensions shall be'supported laterally'by solid blocking, dia~onal bridSin~ (wood or metal) or a 1- by 3-!ach brid~lnlt nail~l to the bottom ofthejoist at intervals not exceedtnl~ 10 fe~t.. R-6O2.7 Floor framing: Fio°r framln~ shall be nailed in accordance with Table No. 40'2.3a Where posts and beam or slrdcr cotlstruction is used tO support floor framing, positive connections slmll be pro¥1d~ to ensure asainst upldt and lateral displacement. Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD ~pril 5, 1996 Mr. Bruce Palmieri P.O. Box 583 Moriches, NY 11955 Re: Wolf Pit Associates - SCTM#1000-107-4-2.5 Prem: 4375 Mill Lane, Mattituck 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 ks not on file. (Enclosed) No Underwriters Certificate on file. xx The check is not on file. $25.00 xx 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 # 22683-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. FROM : Panasonic FAX SYSTEM PHONE NO. : .'HAY O? 'gE. i6:!l P~."iL~",E~ A~'?.4ALT U ~J7 5'- / g ~ 5 ?ALMER ASPHALT COMPANY BAYONNE. NBC JC_..q~' 07008 Jul. 05 2995 08:44RM Pi P. APRIL 7, log5 TO: A TO Z CONCRETE FAX ~ 15-~95-5066 COVER FROM:: LF.W I S, PALM,iR ASPHAf,.T COi"iPANY FAX ~201-3;39-..$320 AND/OR M~SSAOE~ PLEASE ~E AOVISED THAT CHACLENG~R FIBER aOOF COATING IS MANUFACTUR[O 8Y OUR COMPANY AND IS SUITASLE FOR APPLICATION TO A BELOW GRADE, EXTERIOR MASONRY FOUNDATIon. - 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING ] ROUGH PLBG. [[ ]~.~Ug, j~TIoN [/,/j' FINAL DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] IN~ATION [~INAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION [ ] FOUNDATION 2ND [ ] FRAMING [ ] [ ] ROUGH. PLBG. [ IJ/~NSULATION [ ] FINAL FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR/~~d~/ ~~ INSPECTION [ ] FOUNDATION 1ST [ R~~OUGH PLBG. [ ]/~UNOATION 2ND [ ] INSULATION [ ~"FRAMING [ I FINAL DATE INSPECTO 765-1802 BUILDING DEPT. [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARKS [ ] ROUGH PLBG. [ ]INSULATION [ ] FINAL ,)ATE INSPECTOR THE NEW YORK BOARD OF FIRE UNDERWRITERS 1095011 ', BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~ F~BRUARY O6,1996 10514895/95 N 375744 Date Application No. on file THIS CERTIFIES THAT o~y the el~trlcal ~uipment ~ ~scri~d be~w and int~uced by t~ ap~icant ~med on the a~ve applicat~n ~umber in the prem~es of ~ITH ~ C~IS PIAC~NTE, HILL ROAD, ~TTA~CK~ ~s examined on ~U and found to be in compliance with the N~onal Elect~e~ Code. ORYERS ~RNACE MOTORS ~ ~URt A~LtA~Ct ~S AMT. ~P. ~T. ~PS. TRANS. ~ NO. OF FEET ~T WATTS SERVI~ DI~ONNECT / ~. OF I ~ ~ S R V I C OTHER APPARATUS: K. V. ELECTRIC INC. LIC.83389-E 150 PLYMOD~I~{ BLVD. SHITHTOWN, NY, 1.1787 GENERAL MANAGER Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. ~nspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT, THIS COpY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER, THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF: ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT o~y the electrical ~uipment ~ ~scrlbed below a~ int~uc~ by t~ applicant ~med on the a~ve application nu tuber in t~ prem~es of ~ITH ~ CHRIS PIACENT~, MI[~ RO~, HATTATUCK, N, Y. . . J,~Y 12,1996 and found to be in compl~nce with the N~onal Elect~cal Code. FIXTURE | T I I FIXTURES RANGES ICOOKINGDECKSI OVENS [DISHWASHERS EXHAUST FAN! 41 ~ 41 36 ~4 17 2 DRYERS [ FURNACE MOTORS [ FUTURE APPLIANCE I~EDERS 'ECIAL REC'PT, TIME CLOCKS I BEtL ~ V~UL,'r~I~,O~UTLET DIMMERS 4 F ,B .... 4 20 $RRVI~$ DI$~ONNSCT I NO. OF I $ E R V I C E ] 200 CB 1 X I 4/~ i 4/0 OTHER APPARATUS: WELL PUMP- 1 G}%RAGE - 2 MOTORS: 1-F H.P, PANELBOARDS: 1-4 CIR, 125,1 "3 CIR, 1OO E[~C. WATER HEATheRS:: 1-4.5 K,W. G,F.C.I~-'7 ~MOKE DETECTOR: -1 <<< Continued on Pa~Je 2 GENERAL MANAGER Pet' 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. THE NEW YORK BOARD OF FIRE UNDERWRITERS 2. ~-~[~(~(~9 BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT o~y t~ electrical equipment ~ ~scrlb~ be~m a~ int~uced by t~ applicant ~med on the a~e applicatlo~ number in the p~m~es of KEITH & CHRIS PIACENTE, MILL ROAD ~ HATTATUCK, N.Y. in the foliowing location~ [] B~seme. z [] I~t ~7, [~ 2ad FL OUT Sect~m Brock ~s examined on JANUARY 1.2,1996 attd found to be in compliance with the National Electrical Code. Lot DRYERS I FURNACE MOTORS FUTURE APPLIANCE FEEDSRS T. K,W. O~L H.P, GAS H,P, A~T. t40, A~W G OTHER APPARATUS: RANGES SPECIAL REC'PT E R COOKING DECKS OVENS DISH WASHERS V I C E NO, OF CC COND PER ff j EXHAUST~FANI A, w.G. NO OF HI,LEG CC, COND. JOHNS ELRC/J. TROVATO P.O. BOX 91 WOODBURY, NY, 11797 LIC.#3389-M GENERAl, MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect, Inspectors may be identified by their crede~tlals. COPY FOR BIJILD~NG DEPARTMENT, TH~$ COPY OF CERTBF~CATE ~U$/HOT ~E ALTERED ~N ANY ~ANNER. THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGe, 1J.0500~ BUREAU OF ELECTRICITY ~--~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date JANU~Y 19,1996 /~pplicationNo, onfile 10514895/95 N 375744 THIS CERTIFIES THAT ordy the electrical equipment as described balmy and introduced by the applicant ~rned on the ?have application nun~ber in the premises of KEI~'R & C}fRIS PIACRNTE, MILl, ROAD, MATTATUCK, N.Y. i. the fotiowl.g tocatlo.; [~ Basement [] Ist Fl. [] 2nd FL ,OUT Section Block Lot J/~NUARY 12,1996 and found to be in compliance with the National Electrical Code. FIXTURE L FIXTURES OUTLETSIRCEPTACLES SWITCHES iNCANDeSCeNT FLUORESCENT OTHER 41 36 24 17 ~Dr~YER~w. [ o,t taR,NiCE M~OES..,. [ FU?~.taU,~E A~LI~oNCR 4 F 3 SERVI~ DI~ONNECT ~ ~. OF I METER ~I~ P~-I G~GE-2 MOTORS: 1-F H,P, P~ELBO~DS~I-4 CIR. 125,1-3 CIR. ~C. WATER ~TERS~: 1-4.5 K.W. G.F.C.I~-7 ~MOI~ <<< Continued on P~ge 2 >>> RANGES ;PRCIAL REC'PT 4 20 R TIMECLOCKS BELL IUNITHEATERS MULTI-OUtLET SYSTEMS V I C EXHAUST SANS DIMMERS AA~T. WATTS 4/0 i 4/0 GENERAL MANAGER 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 CE~T~F~CAT~ ~JST NOT BE ALTERED IN ANY ~ANNER. FORM NO. 1 TOWN OF SOUTHOLD ~t; ~l~tt', DEPARTMENT~ TOWN HALL SOUTHOLD, N.Y. 1197J TEL.: 765-1802 Disapproved a/c ................................ /(Sui~Srki'fig Iffspector) ' APPLICATION FOR BUILDING'PERMIT SURVEY CALL .-. ~ HAIL TO: Date .. ............ 19 · INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 st~'eet oF areas, and giving a detailed descriptioh of layout of property mu~t be drawn on the diagram which is part of this appk cation. e. ' The work covered ' · · ' by this apphcahon may not be commenced before issuance of Building Permit. . d. Upon approval of this application, thc Building Inspector will issued a Building Permit to the applicant. Such permi 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 Oceupanc. shall have been granted !,y the Building Inspector. . .. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of South')Id, Suffolk County, New York, and other applicable Laws,Ordinances o 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..p..~e, and regulations, and admit authorized inspectors on premises and in b~ilding for necessary inspe~~ (Signatur9 of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, iesseC~rchitect,'~¢ngineer, generai ~contractor, electrician, plumber or builder. Name of owner of premises '.l~..~t/r/ ~.C-/~*O (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 ................. ' ......... Plumber's License No ....... ', ........, .......... Electrician's License No ....................... Other Trade's License No... .................... 1. Location of land on which proposed work will be'done ........ House Number Street ................... Hamlet Conhty Tax Map No. 1000 Section · /~ 7 Block ' ~ ' · ~, ~ omv~s~on ..................... . ....... Filed Map No. , ~F~ ~ (Name) .............. Lot ............... 2. Statd ex/sting use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing Use and occupancy ~ ~ b. Intended use and occupancy . .~fi~d~ ..... .3. Nature of work (check which gpplicable): New Building . ' /'/ Addition · ,~.:' Alteration ........ Repair .............. Ret royal ............ . Demolition ..... : ....... Other W.ork...- .... (Description) 4. Estimated Cost ........... . . ... Fee ..................................... (to be paid on filing this application) 5. If dwelling, number of dwellin units'. ............. ... Nurhber o~' dwe 1 ng units on each floor .............. If ga age tuber of cars ' 6 If bus commercial or m ' d cc specify nat ' d ' . mess, !x '~ cupancy, ure an extent of.each type of use .... 7~.'. ............ 7 Dimensions ' ' ' if any: Front Rear · ct exmting structuFes - ' - ' ' Depth ' Height :-r Number of Stories .............................. Dimensions of shine structure ~vith alterations or additions: Front : Rear Depth ; :... ~4~ ~u, --~ ,. .... ' ..... ! .....~ ..... '2 .; .......... ,... rqumoe/otStones..,.,....../.~~ ' ' 8. l~lmenslons oI. entire new construction: Front .. ~'~....~ i/$ ~ ' t-'-o- ?$ ~ t/2- · ........ · ,,~a~ . .-vt. r.,.~. ..... r'lumOer of Stones /. ' ' ........ 9. Size of lot: Front .2..~..g '~.~ . · ~,,' 2.1-~2 ~,5~,' ' .. ., lFi/~.'~g ............. 10. Date of Purchase 'i ....................... ~..' ..... ; ......... J~epm ..................... ....... ' ............. ' ....... v. Name of Former-Owner - 11. Zone u .... ' ' · - . ' ............. ~: ...... or se district in which p[emlses are situated .... .~... ~.O.... ,g~. '. ~..~.. ~. ....................... . .... 12. Does proposed construction violate any zoning law ordinm{ce or re,ulation' k5/e'' ' ' W ~..ill b~,,r%raded ....... ,...w .................. Will excess fill be removed from premises: Yes 14. r~ame of~wner of~remises ... . a,qa ........ Name of Architect .-~'..t/7.-~r?..it 5'.qi~ ' a~ .... b,4.f/,,.,,~-'~ 4~ /g~or' ,-- ,, ~-,~ ;/Z..V .... o~.~ u~,..umrac[or ........ I ............ Address ............ ; ...... Phone~qo... .............. 15.' I.s this property within]300 feet of a tidal wetland? *Yes ........ "~ _kY__ , ' *If yes,'SoutholdlTown Trustees Permit may..be required. ' au ......... ... I . PLOT DIAGRAM Locate clearly and distinctly alll buildings, ~heth~r existing or proposed, and. indicate all set-bank dimensions from property lines. Give street and blocI~ number or description according to deed, and show street names and indicate whe{her interior or corner lot. STATE OF' NEW. YORK.a COUNIY'~'S ....... ....... '.. (Name of individual signihg contract) ~bove named. . ..... being duly sworn, depose.s and says that he is the applicant is the.......... ~ ........... .... ............. .. .. . ' i (Contractor, agent, cor'porate officer, etc.) .... ' ............ . saldic '°wner. or owners, and is dul~ authorized; to perform. . or have. performed the .said work and to make and file this Pp anon, that ali statements conta?ed m th~s apphcatmn are true to the best of his knowledge and belief; and that the ~ork will be performed in the manneriset forth in the application filed therewith· ' ' ;womtobeforem~ . '"~~ ' ...... .'...day of · '.., '/°'taryeu'blic, '~'~.~.:.~...(..~,.. Count~ ~~x.~') HELENED. HORNE ' '" Notary Public, Sta~e of New ¥~rk ,' No. 4951364 Qualified in Sul~olk C, oun Commission Expires May 22, (Signature of applicant) i I t i \1 SURVEY OF LOT 6 "WOLF PIT POND ESTATE$" A T MA TTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY DEP~T~T OF H~LTH FOR APPROVAL OF CO~T~UCTION O~Y APPROV~ ~ I am tamiliar with the STANDARDS FOR APPROVAL AND CONSTRUCTION OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES end will oblde by the conditions set forth lherein end on lhe SUFFOLK COUNTY, N Y. ~,,mit to ,o,,t,,a. 1~ - ~X- ~ - 25 Sc~e: r'= 60' ~~~zv~ o~y Aug. 2,1994 ~ ~E ~S ~ ~ ~ ~mOv~ SEPT. ~, /99~ Oes/ bor/ng) / "~ MILL 2*5' 17' TEST BORING ROAD o~'~z' ~ % ° .~ CERTIFIED TO ~ ~ COMMONWEAL TH LAND UTLE INSURANCE CO. PECONIC SURVEYORS, P.C. ~ ~r m ~r ~m~ ~ ~ "~8Y' (516) 765 - 50~0 ELEVATI~S A~ C~TOUR L~S ARE ~-T~A~ ~ ~T ~ C~ ~ ~ REFERENCED TO T~ FIVE EAS~RN TOWNS SOUTHOLD, N.Y. 1/971 TOP~RAP~ ~p. 94-255 SURVEY OF LOT 6 'WOLF PIT POND ESTATES" A T MA TTITUCK TO WN OF SOUTHOLD SUFFOLK COUNTY, N. Y. 1000- tO7- 04 -25 I ~ // I StJFF(X.K COUNTY DEPARTMENT OF' HEALTH ~_.RVICES FOR APPROVAL OF CONSTRUCTION Ot~Y DATE HS. ~_~. NO. R10-94-0089 APPROVED I om familior wtlh Ihe STANDARDS FOR APPROVAL AND CONSTRUCTION OF SUBSURFACE SEWAC~E DISPOSAL SYSTEMS FOR SIN6LE FAMILY RESIDENCES one will abide b.Y /he conditions se! forth fhere~n ond on permit 1o co~lrucl. I' 17' / , .,.,O't § $11~I.E FP&~.Y DWELLING O~.Y I / I I / ,. £LEVA TION$ ~ CONTOUR LINES ARE REF'E~E~D TO THE FIVE EASTERN TO~VS MILL ROAD TEST BORING 836.32, 0~0.96' CERTIFIED TO' KEITH PIACENTE CHRIS PIACENTE COMMONWEAL TH LAND TITLE INSURANCE CO, L-I$$. 554 PECONIC ABSTRACT INC. S. LIC. NO. 49618 P , P.C. MAIN ~ SOUTHOLDs N. Y. 11971 94-255