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HomeMy WebLinkAbout22516-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 8-23639 Date MAY 15, 1995 THIS CERTIFIES that the building NEW DWELLING Location of Property 350 KENNY'S ROAD SOUTHOLD NY House No. Street Hamlet County Tax Map No. 1000 Section 59 Block 3 Lot 33 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 28, 1994 pursuant to which Building Permit No. 22516-5 dated DECEMBER 2, 1994 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 SINGLE FAMILY DWELLING WITH ATTACHED ONE CAR GARAGE AS APPLIED FOR. The certificate is issued to CORI & KAREN LANG (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-94-0095 MAY 9, 1995 UNDERWRITERS CERTIFICATE NO. PENDING MAY 2, 1995 PLUMBERS CERTIFICATION DATED APRIL 26, 1995 COTCHOGUE EAST PLUMB & HEAT Q""/, ~k " Building Inspec r Rev. 1/81 f / 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) 9 Date.........../. ..Z 19..`... NP 22516 Z Permission Is hereby gra d t . .1. ....1. to..1.... >~~1~7T C ....Gc.7.............. co'.0ow 9.'.Ww7.'f-.7 V - Y-0a - at premises located at..... I...... I......~U ...I.. ~~..',..qq........................~. County Tax Map No. 1000 Section Blocky ..........f~....7.... Lot No. pursuant to application dated G1..lF......... Zd 19../....T'..., and approved by the Building Insspector. $.4~.... Fee . Building Inspector Rev. 6/30/80 1 3y-A5° }fw~u~ G~ wv2k'~ aq8-,Y33a Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT ho TOWN HALL MAY 41995 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPAN Y`- 1,1"~°~ 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 electricmi installation from Board of Fire Underwriters. 4. Sworn statement fromtp.lumber 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. 8. 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 Buildinc - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 51 Temporary Certificate of Occupancy - Residential $1 G.OO, Commercial $15.00 Date ...~l 3 New Construction,,,,,,, Old Or Pre-existin11 g Building.. - Location of PropertyJA0~ 5r}fl~Ijy House No,.Street pp y Hamlet Onwer or Owners .f Property ...4ed 1, i~ n1 7 lj 7J [ At o 6r County Tax Map No 1000, Section ...,,,,..Block... 5 ............Lot....... Subdivision S~PI N .I0vIU5.. Filed Map............ Lot.......... Permit No. d-."5 ,`,Z'„Date Of Permit....... . . . . . . Applicant.4. ..//s~aen.havepi Zfin.r Health Dept. Approval ......Underwriters Approval Tanning Board Approval 2equest for: Temporary Certificate........... Final Certicate........... 'ee Submitted: $ p' (~J. 1 x3103 ;r.: s i y- t I! 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Box 1179 >f ,F: y p Telephone (516) 765-1802 Southold, New York 11971 a~ ~y OFFICE OF THE BUILDING INSPECTOR ~0 TOWN OF SOUTHOLD ~ca,~ I t C E R T I F I C A T I O N~ d "r~' Uy s DATE: aL { Building /Permit No.1~ Owner: C. r--, + t\'RE'j (please print) Plumber: 't,GK 67 ,S t C ulicZwgie (please print) V I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. lumbers Signature) Sworn to before me this day of 199-1- Notary Public, .CclFF0/K County NEANrI o ~„ftZECKI Notary Public, State of New York No. 4961037 Quatifted in Suffolk County MY Commission Expires Jan. 8, 199 4 - CA Fax (516) 765-1823 Town Hall, 53095 Main Road C2 P. 0. Box 1179 Vk Telephone (516) 765-1802 Southold, Now York 11971 ~p OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD May 2, 1995 Mr. Cori W. Lang P.O. Box 1083 Cutchogue, NY 11935 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) xx 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 # 22516-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. (D ATIQY ~(lst) _ y ~I MATIOU c (2nd) _ ;H FRAME Lo . y LA,TION PER N. Y. II n H STATE EIIERCY CODE !I _ • I I ~ • m FI Ila, ADDITIONAL CO!q`tE TS: m x 9 rn 4 O r m TO PRONE NO. ; 15162980412 FEB. 1. 1995 4:13PM is 1 FPOM . PALMER ASPHALT COMPANY 198 WEST 5th STREET • p.0. Sox 58 BAYONNE, NEW Jamey 07002 Ta*ph": (?U1) 339.0855 FAX: (2017 330.0320 COVER SHEET DATE] FEHRUARX Is 1995 TOTAL NUMBER OF PAGES 1 (INCLUDING COVER SHED' TON. MS. RARER LANG 1-516-298-8412 FROMI LEWIS RIppS j PALMER ASPHALT COMPANY PAX #201-339-8320 i( COMMENTS AND/OR MESSAGEt REGARDING YOUR HUSBAND'S INQUIRY ON CHALLENGER FIBER ROOF COATING# PLEASE NOTE CHALLENGER FIBER ROOF COATING IS SUITABLE FOR USE AS A FOUNDATION COATING, AS AN EXTERIOR BELOW GRADE POUNDATION COATINGr ON MASONRY SURFACES. NO BACK BILL SHOULD TARE PLACE UNTIL MATERIAL DRIES. THANK YOU. i l I-,. p ,TOWN FSOU~THOLD r.+r • SINCE 1932 • MANUFACTURER9 OF BULLOOM AND PRIVATE LABEL COLD APPLIED CdATI~'G9 AND COME" JAN 18 1995 d .,BLDG'DEP° T. J()wN OF S " HOLD Job ues Type 22989 T1 _ FINK _ _ Ply PENNY/22990 P',p,J. GOMPONENTB 3.000 s JUn i 1994 MITek lntlustdes, Inc, MOn Jul 16 tO;OT,081994 Rage 1 -1-PQI 62-14 I 11•11.0 I 17.1.2 F p3}p ,24,Fq 1414 8-214 84-2 }ST 0.2-14 -I 0 M4r 4,00072 3 r^' I" a 1x4 4 y 2 4 t'. 7 8 C 3x4 _ 3x4 = p4 = 3x4 c 5 3x4 = , Iw }2.9 t}47 1 224.0 bP 1 6+0.17 626 LOADING (PSQ SPACI O 2-00 C51 DEPL (In) ((oc) Well PLATES Alp -y TOLL 30.0 PIaWalncrs,.. 1.15 1C OAe Ven(LL) 0,16 716 999 M20(20ga) 21 16 TOOL 7.0 Lumber Ina, It 1.13 FC 0 72' Ved(7L) 0.28 7/6 999 SCLL 0.0 Rep Stress I YES VVB 0.21 H42(1L) 0.07 5 Na BCDL 10.0 Code TPI Min Length/LL den=240 Weight: 66(1") LUMBER BRACING TOP CHORO 2 X 4 SYP No,2 TOP CHORD Sheathed or 2.11.9 on center pudin spacing. BOT CHORD 2 X 4 SYP N0,2 BOT CHORD 1.6:0.3.0, 7.6:6.3.0, 6.7,8.34, 5.6 6.3.0. WOBS 2X4SYR No.3 REACTIONS (IW346) 1.1157N-3.6, 5=115710x$ Max Horz 1=-17(load cast 3) Max UpIIR 1=46(load me 2), 5••66(load ces1 3) FORCES TOP CHORD 1-2=-2380,2.3--2066, 3-4=-2066, 4-5=•2380 BOTCHORD 6-84249, 6.7=1tiW, 7.8.1662, 141-2248 WEBS $e~•416, 3.0.61)1, 3E=601, 4 6=418 NOTES 1) This truss has been designed for the wind ioode generated br, 80,0 m.p h. v nee dt 26.0 Not abme ground Iva[, using 7.0 p.s.f top chord egad load and 10.0 pa,1 bottom chard dead load, 100.0 WNS Rom hurricane oceanline, on a ere legol • I enclosed building, of dimensions 45.0 by 24.0 wlth expoSUre C (ASCE 7.86), Lumbe Increase = 1.33. Plate Inereast = 1.33. Both end ve16cols we expose i, 2) SIMPSON H2.5 recommended for connection of truss to hearing walls due 1 , uplift atloints(s)1. 5 LOAD CASE(S) Standard . , y r (3t(~f 0-;_i% TOWN OF S66 1 FfL?LU :®,,.....o,.,...,.a.,..~-..~...~.~ JUL 15 ;94 01:00PM PDJ CUMPONEIY75 P•3i4 Job 229 Truss Truss rypa 2 ' 22088 T2 FINK 10 1 FENNY/22999 rap PONENT Jun 11994 MRBk IIMUattlea, Ind, Mon JVI 16 1 ;27 j884 V2ge 1 rL-ml 110.14 I it-64 i6•i.3 224.0 _ 149 610.14 5.1.2 5.1.2 &10-14 1-00 4x4 • 4.000P1~ 0 1x40 i%4 ri ~Qy Y7 d t i 4x4 • ,.,d = Sx5 x It „ 4x4 = 744 146.0 22-M 7.44 7-40 T•' T-44 Plata UBsetG (X,Y): (1:0-04,0-03J, JB:04.0,0-3.OJ, J5:0•G-U,0.0.3J - (,;+r IQADINO (paq SPACING 2-0.0 CSI DI FL (n) (loM d)) UdMI PLgTEa CR1P TOLL 40.0 Plottla Im4reeaq 1.13 TC 0.33 Vs 1(LL) 0.22 7 OB9 M20(20ga) 2331218 1•COL 7,0 Lumber Increase 1.15 BC 0.77 Vt t(TL) 0.31 713 643 ' l 0.0 Rep Straw lncr YES WB 0.26 He 2(TL007 5 Ne BCDL 10.0 code YPI I MI L_en)th/LLde0.240 Weight 61(Ibe) LUMBER BF gCING TOP CHORD 2 X4 SYP M.2 TC > CHORD Sheathed a 2.3.1 cn center puriln spacing. BOY CHORD 2 X 4 SYP No.2 Bc r CHORD 146-",6-7:63-0,5-66-3-0. WEBS 2X4 SYP No.3 REACTIONS (Iba/s12E) 1=1331N•3.3, 5.1331/03.6 Max 110(2 1.16(bad case 2) Max Ul 1=-64(Icad case 2), 5=44(Icad case 3) FORCES TOP Cl 1-2-;•2737, 2.3=2423, 2-4=-2427, 4.5=-2737 BOTCHORD 5.64589,6.7-1781,1-7=2556 WEBS 2.7-475, 3.7439, 3.6=741, 4.0-474 NOTES 1) This trues has been designed per the-Intl Wads generated by 30.0 m,p,h• winds al; i,0 rtet above dr0und level, Ucing 7,0 p,s./. lop chord r.: d load and 10.0 p.11 bottom ohad dead load, 1000 mlle6 prom hurdcans oceanline, one category I encl0 ad b Alding, of dinlensione 45,0 by 24 0 with exposum (ASCE 7-88). Lumbe Increase • 1.33. Plate Increase = + 13, Doth end venicais are exposed 2) SIMPSON H2.5 nademmended far n insertion of truss to beefing walla due to upl,h : Joln s(s) 1, 3, / LOAD CASE(S) Standard l 6 16 iq B1 . T/ NR•01 y4 , as;NNrl2AaaA PAAW , T l 1' illd"T18 1 Mitill (MiIUWUJm W, ;wv l j 46C~ G.i~ 1 N•?J2' 1 _ -N$-1 2"4 _ uU 1"^x00- *44 .1 .ia.a ?M iJ-1 isA t YIF S 1.0001 Ida td9 { 1~° AO,~ 2a/a S • t1 ,i ,L/~ St{1i I.3•A M100 431 sQ 9PACWa 24.0 am bATL (In) (fr1 6000 KATB0 GAP TOAD PWea Ina"s 116 YC olu Ven)LL) 0.17 7M m M20(2004 2Uala 7.0 L l Irma 1.16 AC 0.37 WOL) 0.20 710 990 do Rap Abe" Va YES WO 0.21 Hai(11.) 0.06 6 Ate 100 COG TPI MIn 1+Q%/LL 00A+210 wow 98 OW) ~04401X49YPNO1 WPCHORD ahutnWaS.2.4maAtspW111yrde10. CHOW 2 XA6YP N0.1 60T p10RD AIOq 00vOWai1910Y 1t1gpY10, a ID-0(1'•001A gpfAA! A4At'Pp. ' {OFt , 2 Y. x 9vP N61 ,O,tSO-0, Os:a1,0, taltlt ~AWMrYttl) 1+1wu9.9r,~+„Aal6~A ,111X?Y12 1+1lQGO oW 9) IIYtt ~ 1+tlOpwO raa 9); S+E9l9rM AfM s1 I,'S81fi+~402 ~ • T" 100 n ft*d AX9rwnuAfx01GWAQ 0by80.0 d1w1ocat26011Wa00Y0yrl. kx{16YpT.0 l0P0n0f0dfj W06PUWn a0 0 mwx wan ,mount lu.wn0, en a awe0ory I NxlaOefi t+rdnl. Of IIYn1Ana11Ylr 45.0 W 2•l.0 0 Yrn 01o0dn C (A6 A6CR r4$), LUIIAp WW"" W""yflYt a 1..7x,, Pa6P Mom ambs A I a 1033. Balh ow v0/lmrk Ya A"" ? H2 6 og wcM mwrmUww to WAAW W" W bm" WIN 0w 10 t4M m TWA: 4nA Wim"a 19 ANO 1, 6. I 21 aIW. W.1N OAaaAtE(6) Surow ' &Qii ~Nj'k#'11)l{iwV~ ~ p Saak abarSe# Wig ra be mCaptetl rep~n l..p A r~1A W $ 011 Omit, wkMtA prior n6ldioebar by c ' , j! V~'ihln>W haurcs t~ inv99bgatbrl w • r~OJ COMPONENTS, INC. NO Sxarpnano. is TMIIS CONFIRMS SPIECIFIOATIC ACOURATQ AS f3HOVY ~T mowed br +1 _ ,~11ARNW0^Y0~(Iyr+Y9. 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PWM PAC lnlNeeea ' (909 70 I.Uf,+t+KtadteAC4 t.14 na 0109 YMI(n•) D:R4 7f8 fW0 9-06 5 (A 00 Rep Stara Ira ES We 0.21 min i ALL ad 240 W*m fNl Opal 10.0 Cade ppC11CAb ?x~a1M Nat OOT040po sirwYrhta?44OntaArpN1N ~D. SAT f211gNp 18 W41, fe:654• S 7,4 s0, SO;B 10. . Trylppp RX48YpNe.1 68 2X48YPW.3 &A "Ns f5 sm" ta110010•5a. S4t100A•R•0 AAMMM td lk40~oaw22).54'6µldad44u 9) OP4IPRO1.9-2R3A.2,1••t9Y6.9•M•+f10.4-6~•2RSS _ Amacm $6.2110, 0-Y-1476,7411476. iA-2i3O M04 2-6-41117. U-589, 14MI 44-Ml 'Aw OWN* NOYf13 mr a1a wtNl {ee44 pp,erMM M BD.O roAh vA1t014t 28:01?tt ett0la 4tOVIW taxA +MOq 7,0 p,e,f. top pgf0 p4A,41e4a 4nd 10 D pulPb" es. 17tti14ts4luetXwtll4l~p 7 11ed17fX1,D 11NN AY4a Iµ4htetM I Ott i WWI;" 1 attada40 bukYla, of 1511114rt1el0ae 45:4 op 24O VII tA4 C (AfitY .95)* Lt411pA II a 1' Boo W4 vwwa4 ua finium R~&MPDUNHuawmatusIseonof OW aeoMedumt5ae014pvAlkdotoupM04foftn'Om t*vww 1 OW(41, e. 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NoM W AWrt6MO'Or*ea an ° ' fQd• WtJE0:G0 r ~ f ' ' r ~f M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 15T [ ) ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS TION FRAMING [ FINAL REMARKS: l 94, DATE ~ INSPECTO M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN LATION FRAMING FINAL REMARKS: hDATE INSPECTO F; M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION iST [ /I ROU LBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE 0/x:~/5z~INSPECTOR 765-1802 BUILDING DEPT. I NSPECTIO [ ] FOUNDATION 1ST [ ROUGH PLBG. [ ] FOU N 2ND [ ] INSULATION [ ]FINAL REMARKSle DATE c=~r INSPECTOR 1802 BU INSPECTION [ ] F UNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE I INSPECTO M-1102 BUILDING DEPT. INSPECTION [ ] FO ATION 1ST [ I ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: / 0~ DATE INSPECTOR -TI M-1802 BUILDING DEPT. INSPECTION /3FOUNDATION 1ST j I ROUGH PLBG. [ ] FOUNDATION 2ND [ I INSULATION [ ] FRAMING C I FINAL RE ARKS: G~ DATE / INSPECTO THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE z 1195099 BUREAU OF ELECTRICITY F- 85 JOHN STREET, NEW YORK, NEW YORK 1003E Date- MAY 08 r 1995 Application No. on file 07151295/95 N 350965 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 CORL LANG, 350 HENRY'S ROAD, POLE NYT 4, SOUTHOLD, N.Y. in thefollowing location; ® Basement ® lst Fl. ? Pnd Fl. GAR/OUT Section Block Lot 3 was examined on MAY 02 r 199 5 and found to be in compliance with the National Electrical Code. i1XTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANG OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT, K W, AML K.W. AMT K.W. AMT K.W AMT H P 14 37 17 14 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECPT 71ME CLOCKS BELL UNI7HEATERS MULTI-OUTLET DIMMERS SYSTEMS FEET AMT. WATTS T. K. W. OIL H. P. GAS HP, AMT. NO. A.W.G. AML AMP AMT. mps TRANS. AMT 'H. P. N SYST MS AM 1 F 2 20 SERVICE DISCONNECT NO, OF S E R V I C E WT. AMP. TYPE EQUIP, 1,0 3W 1,R 3W 303W 3,e 4W NO Of Cc COND. OF CCCOND NO. Of H4LEG Of HIE NO'OF NEU1RAl5 OF NEVfRAL PER a 1 100 CB 1 X 1 2 1 4 OTHER APPARATUS; DUPLICATE-1 MOTORSt3-F H.Y, G.F.C.It-3 SMOKE DE'T'ECTOR t -1 k E ~ JIM SAGE ETLEC. INC. LIC43635 E t. 350 MARINE PLACE GENERAL MANAGER GREENPORT, NY, 11944 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. ,I COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. 6 ~5 -=BOARD OF HEALTH . FORM NO. 1 . i 3 SETS OF PLANS Nnv s 1994 TOWN OF SOUTHOLD SURVEY BUILDING DEPARTMENT CHECK TOWN HALL s SEPTIC FORK :7isaC;_ f Et'i SOUTHOLD, N.Y. 11971 "ihVr?tivIt~. S~~LSFYC?r5, TEL.: 765-1802 t:oC L# CALLL Examined . 19 !j. MAIL TO Approved 4 Z 19 t. Permit No.~a. r • • • • • • • . Disapproved, a/c . (Building Inspector) AP LICATION FOR BUILDING PERMIT J Date 19 ?f 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 stieets 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 B>ilding 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 regulations, and to admit authorized inspectors on premises and in building for necessary inspe tons. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Ow A) G- (Z Name of owner of premises *...S/°.Y.KV~0U'6S ~~I ~d~~~I CO S . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ~~cer) Builder's License No. y, ,7,..1, , , , , , , , Plumber's License No. . Z?. 77P Electrician's License No. .~3 Other Trade's License No. 1. Locafion of land on which proposed work will be done . . :5-C-) :Sow /16 5; House Number Street Hamlet County Tax Map No. 1000 Section / . Block ...-5 Lot 3.~ Subdivision.. SF~12D.I~Oit 4s,or-~/ f7.e4rx /zPs. Filmsed Map No Lot `1.......... (Name) / 2; State existing use and occupan ,y r•~ y -.,;vises ard.' .rended use and occupancy of proposed construction: a. Existing use and occupancy ..4=.Ir/l. ).71 ...eP . b. Intended use and occupancy . f 25 ~~j ~~uG 3. Nature of work check which! ( applicable): New Building ..:f/ . , , . , Addition Alteration Repair Re . • • Demolition Other Work . . 4. Estimated Cost , . 7 /J, Fee 36 (Description) S~ lS, (to be paid on filing this application) If If d garage,wellinnumber number of of cars , dwelling units / .....f , Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each 7. Dimensions of existing structures, if any: Front'type of use . . . Hei ht Rear,. Depth g . • • Number of Stories . Dimensions of same structure 'with alterations or additions: Front . i ' Rear , . Depth . .Height . Number of ~ories . 8. Dimensions of entire new construction: Front 6 , , , , Rear < , De'pth' - ~.V 22.. Height /S" . , . Number of-Stories . 9. Size of lot: Front ../OTp~ Rear'..... ,/.4.7 ~.j.. . . Depth 10. Date of Purchase Name of Former Owner s5~$ tax' 7~ijQ/j//as Q1~ Zone or use district in which P remises are situated Does proposed construction violate any zoning law, ordinance or regulation: . 11/, d . , 13. Will lot be regraded Will excess fill be removed from, ,premises: Yes 14. Name of Owner of premises 40.10Ll. t`fCf1AW M/.1, Address /,Lc.el Phone No.:i.~~, Name of Architect 44, , . , , Address Phone No. 7,4,5',-, Name of Contractor . 5'.?~~r, . Address . Pho e No. . 15. Is this property within! feet of a tidal wetland? ~c " " " " " " 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. t I 1 Y uo0 V~?cRN~ c~ STATE OF NEW YORK, COUNTY OF I C" r~ ` w I, L.I,,. 6 ' ' ' . ' ' ' ' ' ' ' • ' ' • being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the OW NE(~ (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'Iset forth in the application filed therewith. Sworn to before me this ......5?c dayofa.r h:( 119../nY VotaryPuublliic. , , County V~V LINDA J. COOPER Now Notary f ub6c, State, of Now York V No. 4622b63, Suffolk County (Signature of applicant) (Term Expires December 31, li j 1 Li ~j t i{$f P BLDG. DEPT. TOWN OF.., SOUTHOLD ~ N -IO 1 '~Y ~C IVAG.~ Q p 6; z o ~ W (PU3i_ic wAi. = 2 ~JI ~ A KENNEY'S ZOrtD N~ '~Irn 3 wnre2N_ io~;/ 1. Iil 217.05 Ipm!~ w N IZ!vNw~m ~ i Z m 7- ;~i;5 FA ~~o 2z A £ o m ono riv<~v g y N_ COFKR.GO[lNDA3 ) ir3b i ul IN.Q - :m z f~j R L 71 io aY W O O Ol ,z. al t T S,Q40550 S.q2"16`2O E. Joe, ~I . f A v O / T m m zm 1° r x 13 ~z ~9~lom I G1 cn \ A A n p ~~~`1J IN ('7S7'7'~~ Q ax o n NN Co nm 8~ 1 r m o Z o~ AMapz;a zzym T, ,nmm~ a ti A gym <p in0omf m go m r w m < m- r r 3 a m £ E loo p p n v O a rr m' c n a x 3 n m o A z v n a v x z tiZ m e0 fn ICI n A n O O n O -i m m n iJ N w k ~.~IJm 400 2I0 n pOACy O, f,7~x NOn 'f 012 2 m~ r3 X r O -1 .•f m C C m 2 D. cad RpQ 9TH iT: C U I D z to r a O p Z m 4 ~n m ,„,.is d C.: In V3 !1 m 9 v a O .Z-i G 2~ r y_ lhl~l ~F y I 6 5 D Imo, T• A O -rl al O a m 1 r << m = ON Z m ^I 'V a a m n O 0 r I p 0^ N n Wr z > < m F o n O-r a i mmr- a r A I m r r :i >_3> ¢ U. w I- w a VI ~ 1( 4 ,e s ' t r, ,y7 1 bd 0 Z W 4. Q y t t Fg~t'S j y 'N'A$ J Z v=a _ tol oH 41 ck: Q X - C1 m IA .,,1 q~ ' p ut -1 P at to FEB 1010 n7 BLDG. DEPT. ' L33 , TOWN OF SGUTHOLD . { _ . ji4 D ILUI i t. z { w ~7~yyy, dzWa r fir, wr' ` -371 T7M 71'Y9f9 # ` r a a~ w Q, W S .0 E 6 <1 1*2 Orl to w 00 0 F+ UtU-Ui (tt - - - 0. t. LLI { v. { Qa ~ ~ o r, ~ t V rV# ` cn ow - , lJ Ut LW- a w W , a Q cj~'._ ~,nrt _ ' zr e. }r eft! V jLz, ~ butt C~ z~) ~o <+n) ( VA) 4 1Q y _ J W s ~rJ2 W Fp 4 W fJ © T le 0 p ~F- Y XtJ^J w fi U Ll (A AIA V , 1i~rk w } . ~v4 ` p r AG . lop N ~ ~ 1 m • a ~ ~ LY t O~ I Lij ci CL ° S Cj a LL Z k O . vi ~ -'1 Q c+ S N D- 21 w ! iy 1 1 z t U 0:w~ . in co ca 0 z ! w Ln tnlp 3? i_ C) Btvrn :w7gnd) W O ~Zy SBZ) u~.J - tJ g ~ ' . L i ~,9h euJ _ L e-~ f 1/ i e tn~ APP LD AS NOTL~ DATE: B.P N . p r FEE: NOTIFY ~BN- NOTIFY BUILDING DEPA ENT t;7 P n s!._ 765-1802 9 ANA TO ei F013' THE r 4 I^ A r^ P y FOLLOWING it ~{„7FOAL^a; 1~ 1„d R1:5 $lAiNq ALL COhISTRLi' 0,"J SHALL MEET THE REOU19WENTS OF THE N.Y. E R R STATF CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS ' 77 SF COI,9'r: PIG"i C i P.LU!?IS3EJ4 CERTr 1 fTTA~7lV ~DpO~ NOT PROCEED NNTN Of'r1 LEAD CO1VTEh7,S,EEORE FRAMING UNTIL SUMV CERT;:gCAa 'F- OF OCCURAIVCY OF FOUNDATION LOCATION SOLDER USED 11V WATER WS BEEN ArFWft SUPPLY SYSTEM C jf,(NOT EXCEED 2110 Of 1% LEAD. If copper tubing is used for water distributing system; piping shall be of types K Or L only PLI-MARiNG ALL PLUIl7BING WASTE & WATER LINES NEED 0 TESTING BEFORE COVERING ee K VI euJ 7 `N *~EOF NEp YO ?1 eNCE TL 9 le_ s W22N., 7~a x4~-o~~ ? / ~ / ~ ~4~FEA4YONP°~ .--^I GeRn6L DR I ~ {ter ~f`..t Phone 477-0400 r NiF.,, A Main Road GREENPORT, N Y. 11944 0L- NG Nlvs ~6Z vNT V / E u~ uw~ e / 4 PLAN NO -SBALE ~ r ` C 1 NI ~ TIPP- 4 I ~ f } k~Nµ ,L I1 i ~~N I I~, rxbd ro~y8 lay dwrd boy n~T ry`.~_ F^ J I ama~ yehrog ~tUMBInIG seHMA7ic par ro SCALL ti ~ Gta~drnb~?ranrJ7 ~ z 'W ~ '3 ~bbd~ T I1 "vm i , i` wew- as a elf $ t irx+` =tie /1 4F1 6 far ~ n R o -M -[phrprNG' AR l8 ~,Ad1i.[ GkrKlt ' ' . i1N.D kS iF k~ s fc fi EIRIOGi Ny Mkk 'SP M Copt 77777~~"~ tot wx s¢ pottvj x ~ ~OYIDEpRENIN ~ IID6D?EIIIN~S FQK , _ Z U CO r f L Fi] a EMENCENCYESGAR ECENCY ESGApE AS li fEQUlfdbC IIiEvNtl~ipI~IG COIIE ~///,~/'~\/~/+/y veg ST{ - f r •5ip~~G &CE T FZ ¢i /~l! A ' O~ (e, 'i L a 29 a ~s =2W , ON PROVIDE OPENINGS FOl1 s . PROVIDE OPENIN65F01 EMERGENCY, ESCAPE AS OPENIR65FOR i Zy a ~bt"~ ~ EMERGENCY ESCAPE Al ICYESCIIP~'AS ~ '/r~s' ~ 2 ~ It'K~~ wlgkiwai~ REQUITED BY PART 11 F REQUIRED BY PART 714a Pr PART. 71412F : /Vo h c% ~t P AA4 N.Y. STATE BUILDING GOR N Y STATE UILDING',COE AUI~DING,CDDE ~ ~~s- ~~ss;_ Ff/ds~jti~~ / f?~ ~n~cP1~~S roe-/ 7,77 „