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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-24656 Date SEPTEMBER 26, 1996 THIS CERTIFIES that the building NEW DWELLING Location of Property 170 KING STREET ORIENT, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 26 Block 2 Lot 42.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 8, 1995 pursuant to which Building Permit No. 22842-Z dated JUNE 20, 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 ONE FAMILY DWELLING WITH ATTACHED 3 CAR GARAGE AS APPLIED FOR The certificate is issued to JOHN HOLZAPFEL (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-95-0041-SEPT.12,1996 UNDERWRITERS CERTIFICATE NO. N-378717 - FEBRUARY 26, 1996 PLUMBERS CERTIFICATION DATED MAY 6, 1996-MATTITUCK PLUMBING & HEATING Building inspect r 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) .�,,""m� Date............ o............ 19 NQ 22842 Z Permission Is hereby granted to; � . ..hl...y.,...... ... ... ..� ..... . to ... :y�lr�� ? ++�"�r...,.. '�C� ............ ......1...�- &�!� .. .. . ...... ..... � .... ........ ............................................................................................................................................................ ............................................../.................... .. .....,.�...... V`...................................................... atpremises located at......... (fl. ......G.4.., / .... ............'.......................................I.............. .......... :..ve........... .. . . ..... . .. // County Tax Map No. 1000 Section ........p,..... Block.....�...........C.....,Lot 'No. !..I.............. pursuant to application dated .................... //Vic.. . .......... 19..../....J...., and approved by the Building Inspector. Fee$..1.,/.�Q............. h } ......... ... .......... ..?Ins ..... -ior......... n......... Buildingpector Rev. 6/30/80 C,Ck-Q Form No. 6 p.`"" TOWN OF SOUTHOLD � BUILDING DEPARTMENT TOWN HALL n 38 765-1802 B DEPT. EpT TOWN Of spl3TH(1LPly 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 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, 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 - .25C 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 , // Date . . . . .11`.C?f'/. . zZ-. . . .01 �. . . . . . . . . . . . . . . . . New Construction. . . . .V . . . Old Or Pre-existing Building. . 4r . . . . . . . . . . . Location of Property. . . .IC> . . . sST�.'£ i. . . . . . . . . . . . . . . . . . . . . .�R!k!'l r. . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . . ZAP . . . . .Block. . . . . . Z . . . . . . .Lot. . . . . . Z l. • . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . .Lot. . . .... . . . . . . . . . . . . . . . . Permit No. ..zg'JZ .Z., Date Of Permit. . .�r.?r-.Q-.q! .Applicant. . ."... &&:� .5..4rP4,- . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . �. . . . . Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . (X-Q,c, S 19 7,5 . . . . . . . --. . . . . . . . . . . . . C O-�a lf6 sg APPLICANT ©gUFFDJ/( ca � Town I tall, 53095 Main Road Fax (516) 765-1623 P. O. Box 1179 Telephone (516) 765-1802 Southold, New Yoik 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD August 26, 1996 Mr. T. Samuels 25235 Main Road Cutchogue, N.Y. 11935 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons : An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. The check is (outdated/not on file. ) $25 .00 %%% No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984 ) . BUILDING PERMIT # 22842 Please contact our office on this matter. Thank you for cooperation. �— SOUTHOLD TOWN BUILDING DEPT. SAMUELS & STEELMAN A.RCHITEaS 25235 Main Road CUTCHOGUE, NEW YORK 11935 (616) 7346405 l\\\ l` _ K 1 �t4 LLJls �. � i. _ AAAttt T 1 o ^p V fy,' ED 4)?o h 9 O GIS a 7 Project No: Drawn 8 Y lJT 1(. ' i1;:7 N 4ivi7 t5 p ij>� Checked El T' tz?lp, g v+ F Date: 3 / i3 (RS i� Scale: Ag t-AOTe-t> Sheet Title: 1,11 suF = 066W NPAMIMO of HFATH sMUS SITE FOO APMOVAL OF CONMUMO of PLAN SWLS FAM 4.Y ROSOW"QNI,Y �'• OAMVR 0 3 JQ35ws aEF. ► o AaOvi A A�.. R'XPII�$111RE� YBAP{�Fi101+1 DA.� t!i`' c::,,r�� � Sheet No: u,w Ur: lRl 91 �6. - 1 , sa 3arnra�s lu Iv11r a 140 ;,, .finnan �iud�ns pit ) 000 I FC;irj i` p l p 4 / :'; '00 AAL amp"Ma -CAQ14- .j.� "� C7 '�. IT,.tii�•Y �Y6Ti3t.� loii+�1':.S�in M4,M', Hic4H I,E� C-q F•'HINco- ���J`� t HIpH PyTW44 I � -gyp v 0 w y�O FO �4 'ex �PePi r , LP LP r / r / �.<, i vIRM 059 (3/93) OFFICE U3E ONLY $ nnnenr . rnrrntr A W,px !. itini8b, II.b., A.b.i. •,i1.Y.Y P)'Fl t!L11.Ivn �,� Comm(A.Inna[ YIIY'L fir, Hr.1V TFl c SVFit�oLt� dat)N��E b1�ttAtt'J:�t3� tib ttfkAts'tt! ����ttcEs ' ( o�-hlbtE b�' �Ati�iMii AttiS tOA��it9�A�eEtt M1AMiAtf�MEN�+ '� E\ti(i 2 9 1�19� adtte��tt ��#�e�;tt t+tEttttEab, RAN itom 11001 F -._WZ. . ....... ... .. . 1 APPLICATION roh t0M§ltiit &tON 0 §*#Kdlt btAtb§Ati fkCit,f iXg AMb WAftft Sttf+ ht Pdft MHOU PAMttt it b#Mt titNd3 Before dompietitil thlb �ppiidAtiah tetef to the bulletin "Procedttte & ttegttitbm"tb roi- l . ot1 . NAME OF APPLICANT' tr ADDRESS Zr✓ ZAt� /5044&0 AygA�W �<��HO E 5ll�! - e� 2 . NAME OF AGENT (iP NOT A VIACANT') ADDRESS HONE, 3. NAME OF CURRENT' PftO ttt'y OWMA(tt 140t APPtiCAf1flMM AW— ' ADDRESS 4 . TAX MAP NUMBER- bfSTttfCTApeo _SECT'IoN 2.00 Bbock :tLOT 424 S. SUBDIVISION NAME it ro!f NUMbkR(if A,hY) 6. PROPOSED WATER, 8UPPL3tt (CHLCk obit) [ )PUBLIC WATEtt SbPt bL tl tifttATE WILL 7 . PROPOSED SEWAGE biSt?OSAhi (ct3ECK 0H9) t11oN-SfTt SEWAdA btgPOSAL StWth B . Arc Any of the tdll0Vlhq tbcjttitbdl (CHECK) a) Wetlands pethilt - WSbEC/tOWMl t 1116 t3tjRO b) zoning vAtiandb - TOWN/Vfht,AGhl t 1t" t"jMO Application is hetcby MAdc tot A p@tthlt to do"ttuA A watct guppiy and setmlo dibpdbal Wt6hi fdf A 91hJ16 fdt&iiV t:bsidbticb in accordance With thiA appliddtibHt 9ti3 MVp And pianA Attbtnitt@d, f ?•.. herebycettit¢ that f halm bttA�iinbd thl§ 86hipl@t@ Appli6Atl6H And the stat@mbhtb thbt•bih AfA ttU@ And hbtt@dti and that affil ttbt_k Mail YY • t be done in , ACcotdAH66 Fenn 01.1 apPlinAblA '. b*ft, d8uhtt+t Stat@ And Federal Ldtds Ahd dnd@A r' IlAtty fA A@ Atatbt om 1fAd@ h@tAiA iA punishdble As a r>liadbffibAnor WAUAHt td 62M O b€ Roy vakk §too �< Pendl •� SIGNATURE � bATE7' PRINT NAME THIS APPLICATION WST tab ACCOWARtIb by ttEOVIAW bLANS AND frbbS ib•B3d4..1i9a, `y., { (ff � � � , / .f:Kms• _ < Y !fr. v,�l y x�yam. �A i",+"j , IAO o �. ? �, L •� �, � , - $�rstefris ,.rurfl oitforrn to atvr�dor., _ e� � .� � If , t / of cSr�f�ol.� courrfy Heafth Z7Q�.': t Feb..z7.r98� June 2613.9.89 ? - Jul Z 1.989 1ci ( C�rci`Q slc��cL� P �r, tri at de d f f`O rrf V e1 ; Jz Fief t;f Vcc.7 71wyl� :P G. • to ine :::. :-sss�iFs Sa:d7�.r.:i- „, -T.-- . ' •. : �:cr,.i-:.,:..r;.sn ere ri�iran,;;araplc / J 1 _��L. t; I�. w a'c;�ax+l In.Btutions ae_suw`e�veni _ L/G B/T t6>e O LCT/7G 41 rlT"i?�a'tf OY.3 y ATES ��ob 6t '� � `!o r✓lfthae! Haff,�'S � c'`= � �• � Citi �� �'�� / {j{ _ -_ .h-• ZonBt� J2e,sial�.zfial clq f�f b0/40 :•'z�`-- �.; � . . � _ .�-' .. � ` _ '� cad ?. �. �:� 1 � ' _ .;L �j�„ .3,. '' ...;@• rsr. ..a``A: -a.. -.r- .� .u. ,s,...�;' _ '% !t': li-�� 'x �.., � + _ ,,,�1' —'� :fit'-'.Z; .t'�%.• i•�:•.r' -.`w1% _ ... ,. ��_.^.:rte �, \ . y � � f i •:: 1���- �y ^�St' 7 b c �2='✓;'�'... �Lt .,..:� :.', '�'. `-.` a `y+ "yx. ;C !'l /\ ;� j ' i4"x q 'f N.. 'e!. M\'.4.h` ` "__ y �� � � 3.b •"d" - �.i.�^ ♦ y 1'FIP III, I =1 111i IrV ILI' Town Hall, 53095 Mi;rl Road J Fax (516) 765-1823 P. O. Box 1179 Telephone(516) 765-1802 Southold, Now York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T 1 0 N DkTE, -44- Building Permit No. 22 g4z . Owner: (please`— print) Plumb4r: T, Weprint CO I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. 4P "umbersiAgn '�� Sworn to before me this day of 19 vgzal-- Notary Public, County �-'0z C E D21' ON F J N"pitNo.fic,F. of4920768 New York Oudkd In Suffolk County Term Ex*9 Feb.18.llft7j- 6 - - 4 , 1 THE NEW YORK BOARD OF FIRE UNDERWRITERS PACE 1 1195099 BUREAU OF ELECTRICITY F 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date FEBRUARY 26,1996 Application No.on file 10322695/95 N 378717 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of MR. & MRS. HOLZAPFEL, KING .SryT. , ORIENT, N.Y. in thefollowinq location- ® Basement 0 ry�! Ist Fl. IN 2nd Fl. GAR/ATTIC/OUT Section Block Lot wwa examined on FE=BRUARY 22,1996 ound to be in compliance P 1996 and lean¢with the National Electrical Code. FIXTURE I FIXTURES RANGES ICOOKING DECKS I OVENS DISH WASHERS E%HAU57 FANS OUTLETS ECEPTACLES SWITCHES INCANDESCENTFLUORESCENT OTHER T. K W. AMT. K W T. I K W. AMi K W AMT. H.P. 46 71 54 41 5 1 1.2 1 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS ISPECIAL RECPT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K.W. OR H.P. GAS H.P. AMT. NO. A.W G AMT AMP. AMT. AMPS, TRANS. AMT H P SYSTEMS "T WATTS NO.OF FEET 2 F 2 8 600 SERVICE DISCONNECT NO -- - S E R V I C E METER NO.OF CC COND A.W.G. A W G. A.W.G. AMT. AMP. TYPE [QUIP 10 RW 1 0 3W 3.e 3W 3.a'4W PER a OF CC.COND NO OF HI LEG OF HIAEG NO.OF NEUTRALS OF NEUTRAL E z 150 CB 1 X 1 4/0 OTHER APPARATUS: f GEN TRAN 5 CIRCUIT 125 AMP-1 TRANSFER SWITCH-1 WELL PUMP-1 SMOKE DETECTOR:-5 TRACK LIGHTING:--30 i JIM SAGE ELEC. INC. LIC.#3635E 350 MARINE PLACE GENERAL,MANAGER ! GREENPORT, NY, 11944 per J This certificate must not be altered in any monner; return to the office of the Board if incorrect. Inspectors may be identified by thew credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. 1 1 1 §N 1 Ll DUO 6� \ 1 1 1 - ,.- -- h.f �i j Lim i V, v M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] R UGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL [ ] FIREP CE & CHIMNEY REMARKS DATE ;A INSPECTO I 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ " ] ROUGH PLBG. [ ] F NDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: �.1� 7� 0: '��. �� ✓rte �- s.. Cr ti DATE INSPEC e2,f P M-1802 BUILDING DEPT. SPECTION [ ] F NDATION IST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLAC HIMNEY R ARKS: DATE INSPECTOR /i 765-1802 WING DEPT. SPECTION [ FOUNDATION IST [ ] ROUGH PLOG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACES CHIMNEY REMARKS: g DATE 1 NSPECTO d T65-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH P G. [ ] FOUNDATION 2ND [ ] IN ATION [ } FRAMING FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR voze�� , 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS ION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR c,;2aFva 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING , [ �] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: �✓Z -� -e � /� _ �2tq� 42 DATE 7 INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING FINAL [ ] FIREPLACE, &CHIMNEY REMARKS: /L1� DATE INSPECTOR i FORM NO. 1 :� OA • RO Or HEALTH . . . • • , - Y FORM N0. 1 ✓ 3 SETS OF PLANS - TOWN OFSOU,THOLD SURVEY . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CjIIECK • • • • - • - • - • . . . . : . . - TOWN HALL /SEPTIC FORK. . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 OT-L FY ; /, "- "• CALL Examined . . W �!r 19 , . .'. •, P1AIL T0 : Approved . . alis G. L!/. ., 19/./. . Permit No. Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . . . . . . . . . . . - (Building Inspector A LICATION FOR BUILDING PERMIT Date . . . . . . . . . . .... . . . . . .. 19 . . . i INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the huilding Inspector, with 3 ets 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 r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. c. The work covered by this application may not be commenced before issuance of Building Permit. - i d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit I hall 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 hall 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 luilding Zone, Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws,Ordinances or j regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. -lie applicant agrees to comply with all applicable laws, ordinances, building cod ousing code, and regulations, and to dmit authorized inspectors on premises and in building for necessary insp . . . . . . . . . . . . . . °. . . . . . . : . . . . . . . . . (Signature of applicant, or name, if a corporation) (Mailing address of aapplicannt) lectricia6 S state whether applicant is owner, lessee agent, architect, engineer, general contcfC r or builder. . . . . . . . . . . . 0*1 . .e{/. 7 � . . . . . . . . :. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Janie of owner of premises . . .���� dCf1?/ Z - Z ,pp�� ... . . . . . . . . . . . (as on the tax roll or latest deed) f 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. . . . � --- — — - Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . i ... . . . . . . . . . . . . . Jog� � �' . . . . . . . . . . . 7. . . . . . . . . . . . . . . . . . .. House Number Street Hamlet JJ County Tax Map No. 1000 Section . . ... . . . . . . . . . . Block . . . .Z. . . . . . . Lot . .� ?,1. . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ./. . . . . . . . b. Intended use and occupancy . . . .CJRx-)4-!��� . . . �iC� .�/ � ' " rt,, �� 3. Nature of work (check which applicablej: New Building _4:�A . , . . Addition . . . . . . . . . . Alteration . . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . .. . . . . . . . . �a �y (Description) 4. Estimated Cost . . . . . . . . . / /. ® . . , .. . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . � filing(to be paid on this 5. If dwelling, wellin number of dwelling units . . ... . . ; ; ; . ; . ; Number of dwelling nit on each floor . , , , , , , , , , , , , . , . . . . . . . . . . . . . . . . . . . . . . . . . . .If a, number cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . . . . . . . . 7. Dimensions of existing structures if any: Front . . . . . . . . . . . . . . . Rear . , . . . . . . . . . . . . Depth . . . . . . . . . . . . . . Height . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . ...-.-. . . . . . . . . Rear . . . . . . . . . . . . . . . . . . Depth . : . . . . . . . . . . . . . . . . .',. Height . . . . .- . . . . . . . . Number of.Stories . . I . -. . . . 8. Dimensions of entire new construction: Front . . . . PST, Rear . . . 2 "[ �� . . Depth . . lQO Height, . :� 9. . . . . . Number of Stories'. . . . . . -Zc , , , , , , , ', , , , , 9. Size of lot: Front . ..f-.� F Z-p& F77, . Rear . . `/�. "�,•,s3 Depth 7. . t . . / 10. Date of Purchase . . . . . . . . . . . . . Name of For er,3wnerPC/Ow. , 11. Zone or use district in which premises are situated . : . . . . . . . . . . . . . . . . . . . . .. . . . . . . . 12. Does proposed construction violag any zoning law, ordinance or regulation: . . . . . . . . . . . ... . . . . ... . 13. Will lot be regraded . g premises• • . . . . '. . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes �o 14. Name of Owner of J©ils?O Ab fes. ddress �'hone No. . Name of Architect 151f/bl(.4e15.0 e,�� ,tl�d?4� . . , . Address :?`� '? lff)AV!. 'Phone No. .�'✓1°.G ✓. . . Name of Contractor . . . :N. . Address . . . . . . . . . . , . . Phone No. . . . . . . . . . . . . . . . 15. Is thisro ert within 300 feet of a tidal wetland? *Yes. . . . . . : . Noj . . . . P P Y *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether, interior or corner lot. STATE OF N.FW�YSIS OUNF SiP S being duly sworn, deposes and says that he is the applicant (Name of individual signm¢ contract) 'above named. le is the . .. ... iQC.1>< /,7-Ee 71 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) )f said owner or owners, and is duly '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 vork will be performed in the manner set forth in the application tiled therewith. ;wom to before me this O . .:ry ? . . . . /..day of. ti . . `� �. . . . . . ., 19 40 Pu t' /.// �"(/ County LINAFORD MH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Notary publie,State ofNew York (Signature of applicant) No.4985863,Suffolk Court Term Expires Sept.3.1$ $` SUFFOLK CO. HEALTH 'cawp '. eTV WS. No.�_,^ 1G�KG aST.2��. ID STATEMENT OF INTENT 1THE WATER SUPPLY AND SEWAGE DfSPOSAL .� � S I SYSTEMS FOR THIS RESIDENCE WILL � I r � �Q a CONFORM TO T-HE STANDARDS OF THE by Ai13 ? 1 ! SUFFOLK CO. DEPT. OF HEALTH SERVICES. # IY APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES — FOR APPROVAL FOR CONSTRUCTION ONLY 1 H. S. REF. NO.: t:F CO!'!CYHYe= APPROVED: tail '�✓ - ---�00' tg} ro- SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. @t.00K _ PCL. - c¢ Iy ,r a I�r .'4;r~-� .0 F._-_ i..: �.,�'%.'';�'_�<:'f•:f` OWNERS ADDRESS: 1 s F r r a,. It R � V 0&7 DEED_ L. P. S vuF=an a TEST HOLE STAMP R. e' a To.rYt ;fa ct. jsbi...p h,,. �. GDS`' �, —. - - , Unawhorleaf aheraion weddAWe to this survey is a violation of k saoranrmam neNewrosata `'.� 7"s ��, ? .Sv'-4*f2 fG�O t•• emwenon taw. arino jba r?o.'` meiandsunstmeis saninkeasea or ` 4 Aa uA : c5. 377 ACZF.5 embossed sea shall not beoons tle ed �c g£ to be a validtnre CW. '� M eStlf Jho CY7. 7-OK f'r�`ec,01, loco - 26 - 2 - 4Z-1 o btame�nmwatar the survey - G�. is Preps Aemital tshehafflaft 5.�. .+r� title company,govmMal emea9encY5nA �y8 lending institution i6tedhereon and g•' Cha �1tr1e�7e a'� �`! (4, ('l95 totheaasgneesofthelendmgns* tutionGuarerdeesarenotbansiereble \� Q y to atldaional nstaNnneweeD6equent raved J Chrcagd r.Ffle 'rtsurcfrfce Co. ��ix F`v 140 r`r7 TG7ll/ri- [f. I , �Q, xcK10 . mfi+ftar -5VbdOrr iVi5 trfOp 461 " Afjp�0f- rertm&Cir / arf d *0 Mog o<,c naves V,gN� y oo <� as surveyed -weld xl ,1993. RODERICK VAN TUYL.P.C. o y 6 0 25 0 LAND5V o = �iilFie. LICENSED LAND SURVEYORS GREENPORT NEW YORK 'IIttclraE qui "81329 . _ y SUFFOLK CO. H£ALTH'GEFT.APPROVAL -- --. �--- — _ - -. 330_t,,5 ., STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL C \ S - CONFORM TO THE STANDARDS OF THE e> SUFFOLK CO. DEPT. OF HEALTH SERVICES_ �¢- F Lx Got: 1010 %Q_ffffw �Sf APPLICANT' ri 3 � �y SUFFOLK COUNTY DEPT. OF HEALTH c ➢TIC A.L j RF$4d 6i Nk q , .,gyB SERVICES — FOR APPROVAL FOR .+' .F_ - -. _ - O,w I #`''_j r Iyp "'A lt�:'o+ -i 3 r o' 3Y+,b°At 0*Ltoa`ea ' .. _1 °'^ '� CONSTRUCTIONONLY DATE: C �. •=y' sa L,.& � , I9 a"etl fi ,t. H.S.REF. NO.: zic-95`4r1 ys�' 14 a 0 APPROVED: .. - "�_! fCjF SAtky .. +.—.IflP �3`8:`� .,t i t .c"�'n'' uwc.•x "�Y'#Q" +3 ' YIl £ *R • a ,v., a*"a tS � SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL. w "1 it 7— OWNERS'ADDRESS: � rwritt 4� # ul ����Il`ty'�"'&� �',�z� ��,` � 1996 DEED: L. P. $� cgV16 S� G ✓`BPy� azs a ° � T4&y"hf G5 .�`3 °c}1 rs �L?x «a�. X TEIT HOLE STAMP Qap, �- - -,..... Liva9lwheaa,C�aaat+rMarw 'VZ7< / �i rotl kau YeY 6avb at and $:414' = lLr6+ =l secfiW7e0eormerNMY0rkSW / , Eaueetion LM\ �'�t7.d copies 0t9Jswrveyot9pnot617mhg r, KA -.E7. 37? AC9ES me wr+a survByatsitkBtltteaior � 1D 00 ZA .4'z �J y,I �n�sea�mmenoewwtera�au .I` 1-4-K .dti7°rfcg;. — .� mnea.arewsmOle a do. ?' � 1" 6uararaaesSxGmleO�klWnEhafa^5 � "�• � " �,$>. .duy i oNy� Ptxsm bBhaifm �• +�" ti �! tale camPany,govemmentalttp�wgaad 4met`Ode 44iGr, 1.4, 1`995 -MQy Iia. f��d—___---__� Ierandaing jnwuuon row hereon a / to'he ass.gneosd the lentlugbuill. T : 1L^ft..L'-':a^.:1:ces am not hans(erabho to or subsequ s l6tf49l_ll rl t4l0d to SEAL at` r�vr r i rs re Oe to 7'0WA*-a r0w0r1 Glia-Crate xs� IrzcRuro�tse Go. t RODERICK VAN TUYL.,P.C. " oo TGA - - 6 s trr4Htflr76,r7 f' � 3 ca �6rre LICENSED LAND SURVEYORS zh ,oe GREENPORT NEW YORK ���� SITE DATA ' 150 FT RAPItJ9 Fp.ON �WELL9 mR oEeeli�oLB \ NOTE' i5 NEo.P-EST L AIMi,IIJ SCTM # 1000-26-2-42.1 L.oc.•o.Tl✓v 4%4y*.r MIL-05 l..IksToN VACI- 7' ny 12ol.JTG 2S AWO SWP`(Af+D LaNE PROPERTY: 1670 King Street 3. \ O Y. gy W E.+6T hr1A 12ioIJ Y ADDRESS Orient, N.Y. 11957 Wv � 30„ I\p OWNER: John Holzapfel c - ( N/F OoU CnLAS Jbyce Halzapfel I i 1J/F OGoI�IN ER. PO Box 210 o ,\ - \ Tel.# 1-516 - 765-1045 Southold, New York 11971 � / bACANT v`� 'w� // � SITE: 6.377 Acres Oil - � SITE 0c1 AREA W _f yp ZONING: R - 60 / T O \ ^� / C. NRo v. ry SURVEYOR: Roderick Van Tuyl I�FY vA[✓W T / Greenport, N.Y 11944 O License # LS 25626 2 �- Dated: May 21, 1993 I� - f \ Re P. L ' NOTES: Elevations shown are based Z T I - ✓-- - - 0 vv�rlT on Suffolk County >, 1\ I�biJfMY o li -�w \ ryUj o Department of Public Works Q N Aerial Survey.Public water Is not available within 500 It of property. U) J The locations of wells and LU {;3IJ IL°IN9 + WELLS cesspools shown hereon are �. r.l/F v� L•L.o I,�I 'TIE-912-'TIE-912-ACE FvK . 8 I`3+0 from field observations and 12.E or data from data obtained from others. J HEALTH "I am familiar with the ■ . \ - standards for approval and W ry � DEPARTMENT construction of subsurface U. 6 Sg STATEMENT sewage disposal of ,L__ subsurface systems for a 0 4p , �� single family residences and ide by the IS conditions sill bset forth therein m / \ I 'WI/F DOtJGn Li,55 177 m / I and on the permit t0 vr•G.•••w•T 5$ �• / construct." O C SIGNED: _,I � D i' /. / N r S 0 U N n 0PIFHI � PROFt78E� •9AIJ IT.nA-Y 9Y8TEM � _ „ ,�, � 0 I- Yexn, CaAL a6P c ThIJbL n.,,.„•,,.r -� ,., ) l�,a. FT I?I� .4,1'T HICgN LEACM IIJCy RD� Jh �J'J.4 " y- � FT, :p Imo, +•4 PT NIgN FUSilRIE. t a' Fo � �•iY 5%<.'" - �o,,' MW ��• �Q '< U R l E N 7 alb, ¢ • a ° 517E lP •,, "� \ t 335 Rif Peters Neck Pt 2 pRoF'o9E� i 11- ¢ ~ • U Oa - "� / NG14NIYeaINy in v� . P PRofllA9ED \ OS.t�E04q i" 511J CaLE Fi.p.11LY � - -- - " ' � ��w 3 c• "`'6�'��°.d. GCI. B VATlonl E,aBE7•.IENT / @'�1'� '`+ .n O1�E K ` o , ` I r �'l\• : a - 1 Jg -f�rn5 5 W Project No: n O .75 piJ 0 F S r+ a��a \� PIT -r1;�' - , Drawn By: U-17 P o rel w �o r49 ��: it o�P910 - s � i JUN Checked By: rs - -• - . - - - r0 I Date: 3 / 13 /95 r� " ' . .. ... ... . .. . , . Y - Scale: As IJo rmn� o ! o F Frtot�aEi�.PRavc �M /� pI20FL�5EDoaE. I Sheet Title: ry 1,4P-L-L EL-.* I,•F,5 l -- - -- -- - - suFFax ODUNTY DEPARTMENT OF W;X' i SERVICES SITE 7a2-,mil o FOR APPROVAL OF CONSTRUCTION OF PLAN \ N/F cS FH a-S SINGLE FAMILY RESIDENCE ONLY qrA�.CAPDL DATA4PR 0 3 9995 HS REF. NO. DIF I N EiC.p11bo 0.IN4 L.a.M 6„ 4` W 3t. L SILTY APPROVE LOAM EXPIRES THREE YEARS FROM DATE Cf' 1, '-'gl Sheet No: so.Lo br: 1111 9t 61114 96. w W.TErs 17•- S391023',H Na'71f j0 1d30 711 1-1c:51LE ,110dJns a 4 - r Ifw1eA1 r- vIZ5le> ES fi ` \ SITE DATA I . 7 /C1 s, g 150 FT {2.�.piLJ S F Rc�r.�1 � t4E"S e,12 t.IOTE rs NEAR =�T F'UCdL.Ic. W�TEt l/I�o lel---� SCTM # 1000-26-2-42.1 I ' ' VA�-i T tif�y R 1.1T'C 254s��� Ms. a, IrJ t� T c rJ Y!•*C=D L,.a 1 c IN ;T rvlsa� c•f\1 PROPERTY: 1670 King Street t \ o ADDRESS Orient, N.Y. 11957 J F OWNER: John Holzapfel �- i e,� W I Joyce Holzapfel til/F oGcNNEsz I PO Box 210 F 1 `• Southold, New York 11971 0 VAC-Ar-1T �` � I Tel.# 1-516 - 765-1045 PLUJt•?'/3ER CERT/ F1120-IF-CIT F/CAT! s ON SITE: 6.377 Acres ° \ '`_✓ s I -E o ON LEAD CONTENT,8EF ` � I AREA bRE CERTIFICATE OF OCCUPANCY SOLDER USED /N r' ZONING: R - 80 MATER ALL PLUMBING WASTE Ia Ra P. t , N SUPPLY SYSTEM CANNOT &WATER LINES NEED SURVEYOR: Roderick Van Tuyl Y /. ./ ,� \o EXCEED 2110 of // LEAD. TESTING BEFORE COVERING I Greenport, N.Y. 11944 p VAG�atilT I i - - 1L11 .� Licenses # LS 25626 }- Dated: May 21, 1993 ry 7etm N _ _ _ _ NOTES: Elevations shown are based z ©R I EMIT � ,.�, ,a -'---- � - . t ~ v ~T on Suffolk County }- �'"T j 2� �' t•-� -¢ \ ryc I f copper tubing is Used TI P�L. l e-�•f \ I. Ta=�z pE�'r i ,i�p o / for wator distributing Department of Public Works system% Piping shall be N Aerial Survey.Public water is not available within 500 ft b�`r M.� -"" Y S of property. i�iJlLM: ys / The locations of wells and cesspools shown hereon are from field observations and O c or data from data obtained C)CAN 0 ... from others. t-11 C�t••I Imo.-r-E(� N1U1W'ULME Is HEALTH "I am familiar with the w .. Nt,q f.z.•K standards for approval and U o S `' "E A�'P 13VE S NOTED DEPARTMENT construction of subsurface 'a� �01" LRH � � # . '� STATEMENT sewage disposal of DATE. - �B.P - E �. ^° y subsurface systems for - r. �° _ 0 _ .,� ! NOFEE ^ENT ,N�' single family residences m NOTIFY BI.Ul.C)tNG E 195 i 765-1802 9 AM TO 4 tF and will abide by the ~� • �� C�G"�U�!_A5� / � �,��- .. � F®Lt..�3�"�„N,G INSPECTIONS: i conditions set forth therein � `- ��*G�.Iv'r �7' S FOUNDATION - Tta!'t�REQUIRED ” \ and on the permit to / FOR POURED CONCRETE construct." 2. ROUGH - FRAMING PLUMBING = 3. INsuLATION SIGNED: d - 4, FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. 'i c ALL CONSTRUCTION SHALL MEET N THE REQUIREMENTS OF THE N.Y. t� STATE CONSTRUCTION &. ENERGY CODES. NOT RESPONSIBLE FOR I N r DESIOI�I.OrtCOMMUCTION ERRORS, 1 ' r 1� j , ,,. t jl • 4 pFzc�Ioc,E o s.�r,l►'T'AR-, arsTErd . / DLJ NOT Mit �E®�"�'D' N I- qao c;AL. scPTlc- -r�r.I� FRAl V33 U11TIL SWIM - r FT 01.1 +• 4 FT MI N LE.acNltJ '� fh a- 95 FT '.p 1^ ,�4 PT 141a�4 FUTt 12-F- �, '�,%>� �-� ` 3- c� O FOU��DATIO�� 1Q ,1t . . �ao�•s HAS DEEB P� er0'yD. 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K M A�c�N �`y' G+-I 11.�11•J L �( I L FRIEZE BOARD - 1x12 I z SOFFIT - 2" insect screen. {'�Lov IO t.�l 1 L. -- JFJ F G R L 1 P: F.U EEL11 v c J q WINDOW & DOOR CASING - 5/44 Prime Trim at sides & top w/ drip cap & flashing. /- COLL_Al2- Ir GUTTERS - prefab aluminum gutters and downspouts - white. - - �o Di r-a.4N =- - 4 8 Ty� I 2x to •F-T� n I NGLF . 2. � I Ste, LES f�i..UM GuT' r_� 9 W1 sS!1.T rbc z F=EN " �-•, I -------3-2x8 I { 0 >- T7 n.l'=xJL,Y ?` �URR�•Nt_ PS ! ---- - �' 4 v x . X i . 2" Fl.-I�- ToP , f ` ti,.•- � . ..,_• ' t j iz" F J ' ` ' 2 t O © 16,11 Z 9 ---A L 1..1 M I N►LJ M �UTT>=.R,. }; (! �����S d N J AI 'S, ��# �,c-�'1 L � , � t� ,l. F,J` i �.,1' �( � , •! • f (11 � �=�� NCS �v/ r°' �'"�>�til, 4 1 T E � h L = .n 1 t �" c i , I FL(Z,I,I LAT i �- C L T - ! 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DEl v J W SII ?J T 1a,F-Lo IEE:N i i F� F _ Kms. !��N G r2�> ��I I { z w T r F1.4O2 Joic3TS M ^T G DCS E c'aF I I 2}/.4"QUsI�TE,F� {zG1Jt1L� f� j Ln :n - ` �' ,� 1 ` Lilo cO F�..C�`Fz-Ir►+� c?^l ; i u i kr 9F>L4 - - - ----- - - G C. MAIN HOUSE EXTERIOR FINISHES TYPICAL EXTERIOR WALL 2x6 studs @ 16" O.C. w/ 1/2" exterior plywood sheathing with building paper (Tyvek), w/ 18" kqzl. long red cedar "perfection" shingles, 7"+/- to the weather (see elev.) (painted), or w/ 1/2 x 6, beveled clear VG (vertical grain) sulrfaced western red cedar siding, with 4 +/- to the weather. Provide woven corners, or 5/4 x 4"' corner boards, where required (see elev.). �. y, k -,���cc.�; oti x�+{C�-A)�.,2 -O' OP tvEW°t° TYPICAL ROOF /2 SIU- PL^TE- W/ 2x8 or 2x10 rafters 16" O.C. Wi { I I% T,J,I S lr i ° - i� �. �i /�I`� x�8°AJ G i'�OL j Pro ect N @ / 5/8 plywood sheathing with 30# building paper w/ BIRD, 1 I___ r �,v f•w - Y o: q 4r, rc Inc., "Architect 90" asphalt roof shlingles. rJ s ,UT, FASCIA - 1x6 Prime Trim w/ guttelr (see elev.). F; Drawn By: RAKE - 1x6 Prime Trim. �� FRIEZE BOARD - 1x12 Checked By: �:E•, = - SOFFIT - 2" insect screen. WINDOW & DOOR CASING - 5/4x4 Prime Trim at sides & top, w/ drip cap & flashing. -4. 5 2 G Co / i 95 GUTTERS - prefab aluminum gutters and downspouts - white. _ �_ I Date: W 2 _ -�'Vr CORNER BOARDS - 5/4x4 Primes Trim. Scale: Aa I�oTEo EXTERIOR DECKING - 5/46 clealr cedar decking, with CCA structure. ttillt�l�x�vJ SIL.L. (EX7 -v-1r1z� - V1� if� G.�ar, i$ 8`�Z�o �T �L-L (�I�.1r�C' �l "�% I I I Sheet Title: WALL .aA . SECTION f 1=+ & DETAILS r, 3. ry:'. 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