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HomeMy WebLinkAbout23119-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 2-24477 Date JULY 2, 1996 THIS CERTIFIES that the building NEW DWELLING Location of Property 1425 ARSHAMOMAQUE AVENUE SOUTHOLD NY House No. Street Hamlet County Tax Map No. 1000 Section 66 Block 3 Lot 16 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 2, 1995 pursuant to which Building Permit No. 23119-Z dated NOVEMBER 19, 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 ONE FAMILY DWELLING WITH ATTACHED GARAGE (STORAGE ABOVE), OPEN PORCH, BALCONY, REAR DECK AND PARTIAL SECOND STORY AS APPLIED FOR. The certificate is issued to DAVID CICHANOWICZ (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL-RIO-95-0115 JULY 2 1996 UNDERWRITERS CERTIFICATE NO. JUNE 27, 1996 PENDING PLUMBERS CERTIFICATION DATED JULY 1, 1996 DAVID CICHANOWICZ !22n f Building Inspector 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) NP 23119 Z Date. f 19.aJ. Permission Is hereby granted to: y~ . 6'7. e, ~0 . ..y..l.I:..... ~r9 ~ , . ' .....~d/.. ~e,-...............~i , . 1....~........r~y/~ y at premises located at... ...A-4 'Ip?o~ ......C 7 .i I...... County Tax Map No. 1000 Section ja.~~........... Block. 3 Lot No. pursuant to application dated 19rq~......., and approved by the Building Inspector. Fee $..(..p...~. Building Inspector Rev. 6/30/80 Form No. 6 'j TOWN OF SOUTHOLD 7-3 7~R,3 BUILDING DEPARTMENT TOWN HALL ~p RAJ 765-1802 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 17 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 - .?51~. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . J. 1.~. .~..~~6.~ New Construction... .....Old Or Pr ting Building Location of Property .1...-7.(~~~~....................... House No. Street Hamlet Onwer or Owners of Property. ....b.Adi~...!ILIEA~C7WtLZ County Tax Map No 1000, Section..4.0....... Block 7~ .........Lot...~r Filed Map............ Lot r ~j 9 Permit NoR°:4 ~ ..Date Of Permit .s....Applicant.. ,1~ Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval / Request for: Temporary Certificate........... Final Certicate........... -ffi Fee Submitted: $ F (9;; &O-e- 5155s, ' n_e ~a l APPLICANT FIEL j ' NSPECTION REPORT D TE COMME S ______=====r=- n H FOUNDATION - ~ 11 II I II I FOUNDATION ( ) I s CJ' ROUGH FRAME & PLUMBING ij Gt a - z rid INSULATION PER N. Y. H STATE ENERGY ii ii CODE it u n u it n II Ij II I n u FINAL Aoi,'' - ~ ADDITIONAL COMMENTS: J.J 1/3/?6- s N xv 'f 2d (~~5 H ~ ro H Off. 00 _z y~ Town Hall, 53095 Main Road Fax (516) 765-1823 P. O. Box 1179 -v Telephone (516) 765-1802 Southold, New York 11971 ~,f.~ O~ OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N/ DATE : Building Permit No. c>)-3 /I Owner: CJ/W/!J ~11~6`<?N<J~'«2 (please print) Plumber: ~lG'~wlGZi (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers Signa ure Sworn to before me this NoMq I I d~pllVAt aAM AMw~l1 a day of 199~ Co MOO' lAon6~AM0101nAM L1 Notary ublic, County e J tiv f, . t_ C Albert J. Krupski, President h~o~OS~FFO(,~COGy Town Hall John Holzapfel, Vice President o° 53095 Main Road William G. Albertson rn x P.O. Box 1179 Martin H. Garrell O Southold, New York 11971 Peter Wenczel Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD November 2, 1995 l~ \V David Cichanowicz k; 'x. 2 X99 - a E P.O. Box 160 NOV Peconic, NY 11958 "N . Jng- T RE: SCTM #1000-66-3-16 Totso-_ Dear Cichanowicz: The Board reviewed the-above referenced survey dated September 13, 1995 and find that the proposed house is out of the Trustees jurisdiction. Any landscaping done within our 75' jurisdiction would require an approval from this office. If you have any further questions, please do not hesitate to contact this office. Si rely Albert J. Krupski, Jr. President, Board of Trustees AJK:jmd cc: Bldg. Dept. New York State Department of Environmental Conservation Q~N DaYl Building 40 - SUNY, Stony Brook, New York 11790-2356 s Phone (516) 444-0365 Z Fax # (516) 444-0373 < 2 100 P~~ h, ,.tt fNTAV It October 30 ' 1995 Michael D. Zagata ~ 0 d Commissioner q IIg9f15 'Mr. David Cichanowicz Nov _ L I P.O. Box 160 F)H'T. ° Peconic, NY 11958 ~ o 1-4/935-01167/«x00 RE: Cichanowicz Property 1425 Arshamomaque Ave, Southold - SCTM #1000-66-3-16 Dear Mr. Cichanowicz: Based on the information you have submitted, the New York State Department of Environmental Conservation has determined that: the property landward of the 10' contour elevation on a natural, gradual slope as shown on the survey prepared by Roderick Van Tuyl, P.C. dated November 22, 1994 is beyond the jurisdiction of Article . 25. 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 an 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, ~Zel Deputy Regional Permit Administrator MMR cc: J. Fitzgerald, Proper-T Permit Services Joseph Fischetti PROFESSIONAL ENGINEER HOBART ROAD SOUTHOLD, NEW YORK 11971 516 - 765-2954 Date: April 5, 1996 Reference: Permit #231192 Cichanowicz v Southold Building Department i 1 Town Halt i Main Road OR - 8 W6 Southold, NY 11971 BLDG. DEPT. TOWN OF SOUTH01.0„-,J Dear Sir, Please be advised that due to field conditions during construction the following changes have been made to the architectural drawings submitted for the above referenced building permit: 1. The framing over the garage has been reversed with the instillation of a girder spanning left to right. The girder consists of (3) 2 inch by 12 inch douglas fir with (5) layers of 3/4 inch plywood. 2. The double floor joist under the first floor bath North wall has been eliminated. 3. The double floor joist in the living room floor has been replaced by a girder consisting of (3) 2 inch by 12 inch doug fir members with a %2 inch by 11 I/2 inch steel flitch plate. An additional steel lally column will be installed under the main girder supporting the flitch on the North side. The lally column will be offset 8 inches to the East and have a 12' by 12" x''/2 inch steel plate at its base. 4. The living room double top plate is cut to allow for the return air duct. - - 5. The second floor fire box has been installed in the Master bedroom. The above has been completed in accordance with NY State codes. IF N OF ~,y Y 3 ~Qa FISC 09,f, ~ o 2 4W Joseph Fischetti, P.E. 0525'0 4 OFESSIO~P~ cc: D. Cichanowicz t 3 S^u s ENCRGY CV116 6ALCULATIoN5 h ' (For Non-el`eatrlo Lionel besigs+ ~fritpY~' ~ U Deg r` I'~ ~R: ~~I$U2 C K M ?1, OcvIC _ 4l SURSYSTRM APrt1 UE92GN TI FRMEL s RATIN4 hFMl1RKS rxrPrior Walls (npaque? bQ4IC-,• I,7CC1 f jRGctS s~W . Illy iliny/Roof (opaque) 03Z Z~f I? 3o wrs. M lar ~iy s vilyllte a N14 i y~NT .03 /-Zq P30 tMS-~ rl+undation Walla ttutect ( F g 9 PPP nuilding Nnvelape ,oyek6100,,ta meet requikemenE cif `7e15, x nrf~U X1995 nvnC Equipumoht'•t6j~, Gti'l iwpquiremanto of 7815i'11 nvnC sygteme`;td mgd ~bWtOmente of ' 79MJ2 Duct Bydt mH ~C1 Mtl 1I 1 ii!6@11tg Of yN15a13 ` v~ntiltrtidh~:~y~~IA b`M~~t,xequiremente of°;7915 14 Inpuldtlbny.fsi pi~~ ~ ~M~'t~ most r~gui enientg aE .701'5 r..•rviae' W&E6ly.il d 11~ liti>fe' 6' 1r ui ment q P ta,,mek'~~~jtlil~ptbnEtoot y915it as rtectriddl, I~;Lightlitg byb't~m9 rr 9quipment f@qulismontg of!le15.11Ta the beet ~fal~ii.;knbtoledyer „a belief,: ~.,ptdf~dbiandi • Judgementij the~~l!e'"p idne are in compllance'With thCode, oF',swY P ty 8; "~3 2 ,z r+.. uFp 0520 ~~~ES510N' ~ irhn; M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND ( ] INSULATION [ ] FRAMING [ INAL [ ] FIREPLACE & CHIMNEY zrz 14 REMARKS: etAll ('0 0 t DATE ®0 INSPECTO 4 M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS N [ ] FRAMING [ INAL [ ] FIREPLACE & CHIMNEY REMARKS: e~sp_ d Yt-~~i 4-4 Gam. _'.a 9? /r ~~fslX„ DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] "OH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPL ` CE A CHIMNEY REMARKS It DATE leVl INSPECTO C31 765-1802 BUILDING DEPT. INSPECTIO [ ] FOUNDATION 1ST [ ROUGH PLBG. [ ] ATION 2ND [ ]INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: Akw/ DATE INSPECTO ,23/1f 76S-1802 BUILDING DEPT. INSPECTIO [ ] FOUNDATION 1ST [ ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY r REMARKS: - - - - - - - - - - - - - DATE INSPECTOR M-1302 BUILDING DEPT. SPECTION [ ] OUNDATION 1ST [ I ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: i i low DATE INSPECTO i p/J M-1802 BUILDING DEPT. PECTION [ FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: r tee- ~7 DATE Z" j INSPECTO t* Joseph Fisehetti PROFESSIONAL ENGINEER HOBART ROAD SOUTHOLD, NEW YORK 11971 616-765-2954 Date: April 5, 1996 Reference: Permit #231192 Cichanowicz Southold Building Department Town Hall Main Road « APR ~ 819% } Southold, NY 11971 BLDG. DEPT. WNTO 0 pLD.........,.; Dear Sir, Please be advised that due to field conditions during construction the following changes have been made to the architectural drawings submitted for the above referenced building permit: 1. The framing over the garage has been reversed with the instillation of a girder spanning left to right. The girder consists of (3) 2 inch by 12 inch douglas fir with (5) layers of/4 inch plywood. 2. The double floor joist under the first floor bath North wall has been eliminated. 3. The double floor joist in the living room floor has been replaced by a girder consisting of (3) 2 inch by 12 inch doug fir members with a'/2 inch by 11 %2 inch steel flitch plate. An additional steel lally column will be installed under the main girder supporting the flitch on the North side. The Lally column will be offset 8 inches to the East and have a 12' by 12" x %2 inch steel plate at its base. 4. The living room double top plate is cut to allow for the return air duct. 5. The second floor fire box has been installed in the Master bedroom. The above has been completed in accordance with NY State codes. SP of New Y 9 ~QN FISC F 09'P O 7It A r ~ M ~ 2NF yO. 05260 C>~=~ Joseph Fischetti, P.E. O-'Es toNPa cc: D. Cichanowicz R. GOUNTY _ OF SUFFOI-K iNOV 21995 I BLDG.nE a.r.a ALD, - 4owv o SQUTr~oLO - ROBERT J. GAPFNEY v SUFFOLK COUNTY` EXECUTIVE,µ _ ~ - DEPARTMENT OF HEALTH SERVICES • :w1ARY E. IjIBBERD; M.4 '`M. P,H;' COMMISSIONER PERMIT " T1IE~AIITACHED PLAN; *1111 DULY SIGNED 73Y A REPRESENTA IVE 'OF THE , . DEPAI,TMENT; CONSTITUTES A PERMIT ':TO rCO ISTRUCT A WATER= SUPPLY` AND/OAR A SEWAGE ; DISPOSAL SYSTEM' FOR THE PROPERTY- AS DEPICTED. CONSTRUCTION MUST CONFORM ' WITH ; APPLICA 3LE 'STANDARDS INCI UDING THE STNS FOR CONSTRUCTION 'OF SUBSURFACE SEWAGE DISPOSAL= _SYSTEMS FOR SINGLE F " LYAESIDENCES AND STANDARDS AND PROCEDURES FOR P VATE WATER'SYSTEMS. - T THE PERMIT (PLAN) EXPIRES `THREE (3) YEARS:'ApTER THE APPROVAL,"DATE.-- - " ANY MODIFICATIONS; WHICH MAY AFFECT,- THE SEWAGE. DISPOSAL SYSTE vI OR WATER SUPPLY REQUIRE SUBMISSION;'OE A REVISED-PISAN ANDANY, ADDITIONAL FEES, PRIOR TO CONSTRUCTION NO 'INSPECTIONS WILL BE PERF&MED BY THE DEPARTMENT ON EXPIREDPERMITS PERMITS MAY BE REISSUED 'UPON .THE SI BMISSJON OP NECESSARY -APPLI ATIONS, -PLANS SAND FEES, ANDWILL BE REQUIRED -T0 "MEET `THE ' STANDARDS IN EFFECT AI' THE TIME OF REISSl TANCE. 51 APERiGiTT`MAY`BE"TRt1NSFERRED INTO ANOTHER AR'TY'S NAIVfE UPON RECEIPT " - OF ~WRITTEN PERIvIISSION FROM, THE ORIGINAQL APPLICANT AND:THE RECEIPT OF A+,-REQUIkiD 'TRANSFER FEES IN;_THIS C SE, THE PARTY PAYING THE' . "ORI<iII1 L APPLICATION-;FEE WILL BE OONSID BRED ..TO BE THE ORIGINAL" s APPLIQANT. , a. w. 1VI-05 8 PAGE 1 1V 2 q DIVISION OF ENVIRONMF.-NTAL QUALITY COUNTY CENTER. - RIVERHEAD. N.Y 1 1 991-33 99 852.2160 78.316..12/92-" a. INSTRUCTIONS FOR FINAL APPROVAL OF CONSTRUCTED SYSTEMS It is the applicant's responsibility to call the Department to arrange inspections of the sewage disposal system and water supply facilities prior to backfilling.I These include inspections of the soil excavation for the sewage disposal system and inspections of the water supply well, well lateral, public water supply line, disposal system, piping and final grading, Other inspections may be required. Following satisfactory construction and inspections: I. The applicant must submit 4 prints of an as-built plan (up to and including 1 Vx17"), by a licensed design professional, of the subject property showing the following: a. the lot location and dimensions; b. the lot number(s) and the name of the subdivision, if applicable; c, permanent structures (i.e., buildings, driveways, walkways, swimming pools, decks, etc.); d. the exact location of the private well, if applicable (give at least 2 dimensions measured from the comers of the building); e. the exact location of the public water line, if applicable; f. the exact location of the septic tank and leaching pool(s), if applicable. Give 2 dimensions from the building corners to the covers of the septic tank and each leaching pool; g, the exact location of the sewer line from the dwelling to the street; if applicable; and h. have a clear area at least 3' x5" for the Department's approval stamp. 2. The applicant must submit a certificate from the sewage disposal installer attesting that the system has been installed according to the criteria of the Suffolk County Department of Health Services, when applicable. 3. If a well has been installed as t e potable water supply, the applicant must submit a current well water analysis (within one year) and a well drilet's certificate. If the well or water quality does not confonn to standards, proof of corrective measures will be required. Refer to "Standards and Procedures for Private Water Systems." 4. In those cases where public sewers are utilized for the dwelling, the applicant is also to submit one (1) copy of the sewer line inspection approval from the public sewer district. In districts operated by Suffolk County, two (2) copies of Form S-9, duly executed by the Suffolk County Department of Public Works, are required. 5. In those cases in which the installation and connection of the public water service line has not been inspected by the Department of Health Services, a tap letter from the appropriate water company is required. HEALTH ;`DEPARTMENT REFERENCE NUMBER MUST BE ON ALL CORRESPONDENCE OR DOCUMENTS SUBMITTED. SUBMIT ALL NECESSARY FINAL PAPERS AT THE SAME TIME. PHOTOCOPIES OF DOCUMENTS WILL NOT BE ACCEPTED. WWM-058 PAGE 2 OF 2 i 18.380.12/92 3. Nature of work (check which applicable): New Building Addition Altetatibn Repair Removal Demolition Other Work (Description) 4. Estimated Cost I Aro ODO Fee . (to be paid on filing this application) 5. If dwelling, number of dwelling units i......... Number of dwelling units on each floor If garage, number of cars A . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use NV?......... . 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 . 8. Dimensions of entire new construction: Front . !P~P Rear ......3.Z...... Depth ...7~......... . Height Z.~....... Number of Stories . 9. Size of lot: Front R2............... Rear Depth a 7?. !yzw? z 5?.?w 10. Date of Purchase ....!`N4Y, . 9,-I . . . . . . . Name of Former Owner . kigFwit,.. sv 4 ...1~(0l 11. Zone or use district in which premises are situated , , , , , , , , , , , , , , , , , , 12. Does proposed construction violate any zoning law, ordinance or regulation: .N9 13. Will lot be regraded ........'y> ~ Will excess fill be reroved from premises: Yes Op 14. Name of Owner of premises D. W4P? G. ff-14AN. W'P.'4-AddressPWA, .I bO , k4.4-0c , , Phone No. 7 .:792-3 Name of Architect Address Phone No............... . Name of Contractor Address Phone No............... . 15. Is this property within 300 feet of a tidal wetland? *Yes No......... *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 NEW YORK, S.S COUNTY OF ~D U l IF , ,G,I G ~}~401NI G _ , , being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the 5~?w:~4 P2 (Contractor, agent, corporate officer, etc.) of 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 work will be performed in the manner set forth in the application filed therewith. SUSAN J.NAGY Sworn to before me this NWypubk,SMOfNOWY01% 9 NO. 4806735 day of ~ICIW~ f!1i........, 197.4 OuW*dIn Suff0kO unh <w~nnilsrloe Exptra My 20,1017 Notary Public, ..C County to of applicant) I S h Y BOARD OF HEALTH FORM NO. 1 3 SETS OF PLANS TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . ...'NOV - 21995 C11ECK BUILDING DEPARTMENT TOWN HALL SEPTIC FORM _ 61..?u. (.~Ea'-f. ~ ~I SOUTHOLD, N.Y. 11971 TEL.: 765.1808 NOTIFY: CALL Examined /1/q 19 1 . MAIL TO : Approved ...4111F 19F:~Permit No,:0-31.1 4 . . Disapproved a/c :"t..... (B 'din nspector) APPLICATION FOR BUILDING PERMIT Date dY...A J INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and egulations, and to admit authorized inspectors on premises and in building for necessary ingges (Signature of applicant, or name, if a co oration) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .....5~i /~~.L~...c--1~i1 tCZ (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. , ...IL . . Plumber's License No. , ...I Electrician's License No. . Other Trade's License No. ...!i I . LocationsJ of land on which proposed work will be done . . . /arGS 4AMaM1}C~VG, ,AVM Souk c~ I-louse Number Street Hamlet County Tax Map No. 1000 Section 1? Block Lot ) (q SubdivisidnY alrr + yV.; f?!?l' Filed Map No. . 14 72...... Lot ...~.5 W+'15 d~ rtf (Name) ~A-FRRvvMa 't3 V -r--O V `E)oAR D -14g1. Qte~' wls".," r ,r, 2. State existi~npN' -oit>~~g"~ of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy y..a: U L-P. JIy IT T b. Intended use and occupancy I..... v.'!VG.L ~!~r?/,/,L}/ DV?/~`~/.P(~ gVENU~ i, oNA,e~~A2o a2 A6 ~ e C OALINTY DEP~I 1T_~IEAI~tiSENVICf:S .aa SINGLE FFAAsMI WWN%MLY zl~~y. u p 2 lM H.B. Ref. wo&o- 95 -oils a G {.>a,,,~ 0 \I V /,~ao~a y 0 The oew"s dleposaA end water supply fall "os q, ^ @A ft WCSIODA ttare boon InepecW-d end/or 1 0 owbyad by lift Department or other agencies w« e y and found to be aaOstuMM. -A neea~ 0- Coz., 8 A. Costa, P.E., ChM Oflk to d Water and Wastewater Man matt! 0 UneutlmrlZed elleraNOn or addldon to tds survey la a dMation ol section 7= 0l"Now York Stale Eduaakn law. Copies offt WPMstep netbwMp V v erwte uduMaMbeOder ewlldlrad N robe avWtrue 4W. p °dyuw feeM"r1noforwhmft t W" le prepanad, nd an We bNdl in ft ht - tide oat l10 W, Governewwal and Wift Institution u to to au mn l M MM~IrIa MWNON. ran"" InWaBm or subsequent additional owners. t tl~ r &eiD uti0 pow os 9° B A 0 tl~ ~~yr~yldR n s !i oes® i .SaeY~YFO,¢r fJA?~D Cl/C.~?r4NO/Y~cZ ~D.~,Vav>'rVrCe~iv~von~err. LOT /6 Steex2 /Yl.OPO,~' iE.YEacw~>.vlE ~fy'.o ~/•f/7P RO~JA~f/~C[9 . ~o~vria-v• ~e~.sdao. ~~~'.zv Ccw.v>~ N.?. 1~r.~o~N.~! O~rE:Jvwe~z9i99~ r~iaaa-t6-a3 i6 S.C. DFRT. OF THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 2 I -1001071 BUREAU OF ELECTRICITY I 85 JOHN STREET, NEW YORK, NY 10038 Date JULY 02 ,1996 Application No. on file 11241296/96 N 390141 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 DAVID CICHANOWIEZ, 1425 ARSHOMOGUE AVENUE, SOUTHOLD, N.X. in thefollowing location; IN Basement ® Int FL T 2nd Fl. GAR/ATTIC/OUT Section Block Lot was examined on JUNE 27,1996 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER T. K.W. AMT. K. W. AMT K.W. AMT K. W. AMT. H: P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K. W. OIL H. P. GAS H. P. AMT. NO. A. W. G. AMT. AMP. MAT. AMPS. TRANS. AMT. H P SYSTEMS AMT. WATTS NO.OF FEET SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP, TYPE METER I p tW 10 3W 9 9 3W 3,e' AW NO.OF CC CONp A. W. G. NO. OF HI-LEG A. W. G. NO. Of NEUTAAIE A. W G EQUIP. PFR P' OF CC. COED OF HI-LEG OF NEUTRAL OTHER APPARATUS: G & S CONTRACTOR LTC. #5'78 E L L BOX 215 ANN SOUTHOLD, NY, 11971 GENERAL MANAGER 11 »5 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. WEIR COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY, MANNER. (~y~" ~ ~ fig. ..u1 ~ Q ~ $ 2~~~~d l~ ~ 1~ U s~ g 61 L Y CY .5 .i- lFl; j t[y11, 7 - y A n z m L9 ? 0. Q ~x~ m sE 8'$. L44 e $ ~ ~R _ (WW o ro w'`nE w,aV 4e J"Vq~ S~9Q nit (CSJ -c- Z. In 111 t .t m u $ $ S° 8. N a 3 5 PLC 5~ L~~'~~ . 'i 0 u a m ` _lt fl1 . 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OY N Lp Ile U ~-N~ ~ N CN T, Irv o i a n~ ~S N E o r - a I ENERGY CODE CAL CULAl1GtJS IFor Non-ElecEric Ilene) uesign crltPrlh,-.-~F;onu','negr~~~na t+'' ~ - to^F I A 1/G nR: 1)/3U2 Cv- l~ r~qn 0401C F-- VEM -_3,5 13,E 35~ 12 !S / ~33~'BL`' Z " TO 1f F, f ~Y ~Z,S I zNG' GC7 Y FUBSY S'fEM AREA UERIGN T IPRMEL HUN RATING REMARKS ...-.rte-'-- = 4 rnt erlor Walle IOpagUel - 161 0 ,0464 176 - - - -f-._ 1,17,1 Illy _ _ _ ~ Fyyyr \ X III q)r9 ~ 1 L - _ ~ ~-~f~4. Id / } r~.llinyl Roof (opaque) ISCC- > L~3> ZI - RdC7 ---/"dS ~ ~ Ims m Car - _ 4 lr Gfl r'Jp r3l2 0i1 UNDERWRITERS CERTIFICATE 63 f Z? P 3o 'v'QNT Gk;'; rl Uh.RTMCATEE REQUIRED :Inb N~A Ell j ~ ;I ~ r I I kk'9,,h.~ a^ kt,9Xf4'~ II „ _ _ •;L l o-'.v 'FY? $ PtV f4Y!'v' iFd° - - TCTAL Pill 1rl . kI y PROVIDE OPENINGS FOR DO NOT PROCEED WITH r°'d°y `Felx`,co OF EMERGENCY ESCAPE AS FRAMING UNTIL SURVEY Y'TE COMNOST fris &holu & HILaE - REQUIRED BY PART. 714 OFOF FOUNDATION LOCATION' r "+~rtl •3RU%c~lc~r, r rcpa ; N.Y. STATE BUILDING CODE. r F-j-' f I' 1 r PAO IE- WI sr .4774)400 Main Road Y.11 - 4& OF NfW~*, ' 7 2P Y n ~j . QN.FiseH GREEi~f~OA N Y.. 11944, SAVE G'ICN'Akt d 'tC AiU Ti J I~ _ 0.0525) s~~ MWS4 C`1- ,V.~`f IV,w24 t ' c RsEL.I t~ NlM1dg y;: /~q Nb[ k 7P P p jr { p + i v k r s ' i - Y. 4~' ail t} ~c 1 -IF brlcur 9l1m4,- alm-~ WJ S'ac7 hrairn9 ; Capn ea /it,~ats A3,0-40.) In h*° 2 7ar~ { C f'!~Mtj ~ ),x ryrnP 61 /YmGae7i S )r4dl nib , - t~ - rzrsr a~ gay ~~~r 1a ~~a ~nei , q {ovlrn~ s. i - = c( fyai~~ 5rp r/o,~t~+5 frr f nr j~ *'Gt tev~L 'fie"a'Lrr f ~ r r~l' 1 _ .F "I4 I t µ -23(101 6 1~ aF 1 n . ~ "'S^ Nkyy 1 r ~ d ~ ya~ r* I I a ~ ~f ~~FEBk F II ~ "wY a€'.x> ~ R F A 9 RI H7 S. Dr PCeun,n,tig9/~'fyy I£~ ..m...._~pW`~ " 1 I (J 1'7 G 1~` PRy l X11.: I J e~Yz cuz Otis zKty; fie( over ~ T L- J ~L i (.Raab tuw K404] 1 1- j 13Ay(MtNI ~ \ } l p ! t$ t kA L,S t x~ I - I U pD9rr rah - - I ~ti N _ I cal i `^nII cy RbCOrrvt t~ i AL: t 3 ijx4 )I,frAD~M \y-1^ I u,(JR Z0K10a. _a j+~-7 q(~1~~ ~ 77 . I Poor" u n~ P' CA S" ""PAC r4~ 4-"'PW"-7 t j L rt sf r ;.g..c_.4' 2 - - ( -i.~ a~13 pp 4 i fi 'ate; 1 ~avv~~ am ~ ~ , 002 M07C. yFTIFY 1>1M~`~5/0 X(s _ GdtM1*[ ~ ~ ,jj, rj "4 Y.: f Pr X ryid ~ r&k1,DW 6R+ye ~r of .u y,, fir. y~ --.e'f~'a.•. /41 AWCH4(.! .r; ao -OAK 5'Mt{p' kQ _ - ' FOOT 44 CiY y - , ryO qy J,, 12UZ~,'. f~ fa.~. ~ fl /p*.k rT{h ~ ..K, Off` :~ur i 11 m r I TR Z' t EB "DE C1 FOR OP I " . 8111 REQUIREER TOAS IN t - ee ST~TB full )l1.OF 30 WMG CODS 1. 1,T , M -55 I I r.`o I lob i I' L N 149 U v_!F.I( OO M I; - - CD' 1-3 ewtdz" ~~.:'Pt~Trr ' al i 4AL'~1 :NI. ' 4 1 3fINk SC: 'Paa7{ - Fr53CMlY II ilTtNG I Pf?GL FUTWC Ed K GCi~,iNG % 1 { YparrbC TeWY, S+rr~s ,u?~_'- - 2 bo PodN- , aR AFQK 1 '~9( 1 - - - _ COAS4 C HEN l~ \ 510 TY4+E1~•"GYrsm r LAbN~+'~ i pFI M9us. WALL d - t Cei!intG{JlK NR kYl a 'SCi`'Fl4'Fnw~. av - ` I ~ I t Yi, 5z ~ , x' PROVIDE ~f NO. FIRE m g.y "RATED SEPARATION-TO. G f aaS PART 717.3 (i)(1) Of I as ccorrsf C J C15 AISoYE cwz35 - L~ N.1 STATE BUILDING CODE. r I 23 Nf- t iya7( ~L TIM { t" III r All a" cl i 4 e ~ 010 T FL 1 1.._'("~ ~p7f V~1~faY .YN4M5'FA+I~t',4 V110116'477,04 (~j yt~~Fl_sc~~F T~A~'ll V Y (1}~~ r, `Z A1?wu'k` -~-r- y"a„ ~Ltil Jy' i. t0_ ..+.f Py?Y i M. 35K QJrs ~ 7r C ~lG IV r } ,I A I, sµ~ ! I, \ ,ShhPnre , r.'ur e Uu .,c Ar 1 ' i Roof Ftn,iw 'BELAW yr _ u ! ~ ~ksRrrna, ~ - CRrtrcE1 Q~ ~f iLnltr B is c f o ' . 01, It, w C~ ii r y _ ~,I ,.,r a ! in \ 7 ; 62kD&L~' ..~.A `\y F', CIi4NE. PFA 1~ yl m _ - - r C ZPIET %vE PA.~ C25 - C,t5 ~ r ~ p~ ~ ham; I~rnT ~ _~~~''V `j ~ X'a wcKrJz ~ApR AB2V ~ - ! Z7 it 'fin :1~~ F•oaf'.f.J~ 1 I.~ Mfr I PF10MIOE OPENINGS FOR PNINGS FOR EMERGENC7 ESCAPE AS If ESCAPE AS . 4vier REQUIRED BY PART. 714 01 ry PANT. 714 OF { W.V. STATE, BUILDING CODE IUILOINO CODE 11 I I V,> ,1 ` 3 (arE u~rr D ci< arcs _ - fi' w - i i JEir. G Y9l % t" etco~N'FI l aiu477 ~(nb~ Ylrt o., I~VA Pfe14EGI'w ~ i iu; rN.'~fY! r..-M f5SI0Flf yy ~~-r~ 77 . ~ e. ~~f~ ~ • 'purl v \ ~k 2 ,`Y•1 AM1'tc ('RAMC 'I rr~ %L x N ! \ r, I ~ ! lzeu 11 i I -G_..~ klo aln {xti .1 - F ~ Snr t k nI IVI i / I~ Y~ull 1 1 "li ~b -J ~zbtfl aIN I MI IN RN p''" --{•CIP 4 [ 1 BAftA54~ l ~f _ { ~ 2k IO~ ~ 111 /f I 2 1 f4c I LIV P. ~i ^I f , h nE« I ~F,; III 11 6 2X12 ~ ° - _ - ' Lill," , V \ yF ~~_~2K6-!~oC -WNW9 2%IR 10 Rhf!OP~ Olt' 3z ,wFN, to 4n 4~~ - uu-rmm+ e4f61ri T''LY J I Im~ .y~2x$ f~AFT~.R> } I 1y I f Q. N tu. tx°on C 4 (r'u+?e ' II yul, F-. ~~x14 fr pC ~u ~ ~ ~'~Y ~ 2't,-Lnw~erZ 1ur.H ~ ~~CCl i., n. c+-~ ~ ~g i 1 O-A ~ _ I ~ 1 ~ ~ ~ ~ -Q-~~ i Sra , Cn 4. _ tAN9~ 6 ~~c8~ ~ ~ _ - N~1w; °V~{,tl F'( UrMk N514 N,$ ~A . ' ..4 _ ~ Cl.+t2 Ntr c~~f~t, ~ ~ 2Yf' ~ ~ - { z'c'"X ~'v:,x ~,a,~ - _ ,-._.12~ ~ { * oye 1 G JE'f s Nk k3f s. N Y i I e ,I I p r- ij A„ i I. 2%E STVDS'~'~. _ . ~ I~Dovf Rp'r- , 'i. If r i $I'nlfJ ~ AREA $?ACC - I ~I I I Ll,,L 10'11K Mm 70 4- Dint. Frv nr d.- i : I - 1. CAI ~ ~ i- ' - FDD'i}1VG ! i I i j i L. i I I I r PLUMBER CERTIFICATION PWA181N0' Al1~~Np~.UMBINGWASfE ON LEAD CONTENT BEFORE 8WA7EN UNES.NEW CERTIFICATE OF OCCUPANCY TE8TINE1 BEFORE COVERING SOLDER USED IN WATER SUPPLY SYSTEM CANNOT EXCEED 2110 OF 1% LEAD. N copper tubing is used for water distributing system; piping shall be of types K or L on 19~- 1 'TE 01 p - Ll 13 7 i ~ ~ S-'~ i i ~a~d b gtµ v.Ut~D. w / FAQ fUtM tER~(f ~}Irq(Vh'S fd A(5 ~ --~k.~,M~i~ yI , , ut', PO I f1 ym ~7~7 edit 1'9ain it~r3e3' IT~AVE" t'! IdA~(C M ELTf1)hj,'~ G+F y~ i