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HomeMy WebLinkAbout22360-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23863 Date SEPTEMBER 11, 1995 THIS CERTIFIES that the building NEW DWELLING Location of Property 1455 MEADOW BEACH LANE MATTITUCK NY House No. Street Hamlet County Tax Map No. 1000 Section 116 Block 7 Lot 7 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 12, 1994 pursuant to which Building Permit No. 22360-Z dated OCTOBER 4, 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 TWO STORY SINGLE FAMILY DWELLING WITH ATTACHED DECKS, OPEN PORCH AND GARAGE UNDER AS APPLIED FOR. The certificate is issued to JOSEPH & ELLEN SULLIVAN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 93-SO-96 JULY 27, 1995 UNDERWRITERS CERTIFICATE NO. PENDING SEPTEMBER 6, 1995 PLUMBERS CERTIFICATION DATED AUGUST 29, 1995 K & K PLUMBING & HEATING 14W 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 22360 Z Date ...ll 19 r.. Permission Is hereby granted to., to a..... k?fG... ...V....`°f YA~Yi ~,~4...... ......I. . , . ............f , 3..................... at premises located at.... mad'...... . y~... Y................................................................... CountyTax Map No. 1000 Sectlon.//i7 Block'... 7................... Lot No. ..........7............. pursuant to application dated ./11~ 19J.7r.~..... and approved by the I V. Building Inspector. Fee /QTJi~ P'.~a1~~iC~?~j~/~ ding Inspector Rev. 6/30/80 Form No. G - 5 (f~ U L5 I f 95 y TOWN OF SOUTHOLD !!4 BUILDING DEPARTMENT 219961m TOWN HALL 765-1802 Ton Cif SOIL CF§Ot.D 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 19, 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 properly showing all property lines, streets, building and r 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. 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 - $20.00 4. Updated Certificate of Occupancy - $50.00 5, Temporary Certificate of Occupancy - Resid nti $15.00, Commercial $15.00 D t..~. lew Construction...... Old Or Pre-existing Building Location of Property House Nt/o.~~~ Stree~. Hamlet ")nwer or Owners of Property.../`/F ":ounty Tax Map No 1000, Sec(t~~tiion..A/ .49...... Bluck...~ 7......... Lot...0.7 ubdivisi.on... h K F.iled Map.. 7 7 . "ermit No~ .....Date Of Permit ................Applicant.. lealLh Dept. Approval ..........................Underwriters Approval......................... 'lanning Board Approval tequest for: Temporary Certificate........... Final icate........... -ee Submitted: $ L119 4 New York State Department of Environmental Conservation Building 40-SUNY, Stony Brook, New York 11790-2356 (516) 444-0365 dMilibb.- -am FAX (516) 444-0373 ~//0 y(1 7 / Thomas C. Jorling Commissioner SCr AMENDMENT TO PERMIT Former Permit # (if any): Owner: +,E1 Ier\ Su, I l uo?r1 RE: Permit No. & Location: y739-0Q&78L0Q.0oi-v C'~y 11~3(~ c~ f 23 AA/1 her v i etA M0,;9+' Lek , 1e00-A-07-07 Dear 0 ~M Ike) you recen equest o extend ,,the abo permit as be reviewe purs t to 6 CRR, Part 21. T expiry L n da is extended t Your recent request to modify the above permit has been reviewed pursuant to 6NYCRR, Part 621. It has been determined that the proposed modifications will not substantially change the scope of the permitted actions or the existing permit conditions. Therefore, the permit is amended to authorize:- Cons~rACt 4..51115?e iI o..'a 6raZ~e Cro pes- '-k e_ (-tJtsect PIaN) 19 cc, by l=Gv.bieba /ad- rP,v,sed gIpI9if aid Stiffed iV O'0'rC 0eProved s11619~r, This letter is an amendment to the original permit and as such, shall be posted at the job site. All other terms and conditions remain as written in the original permit. Very truly yours, Deputy Regional Permit Administrator, cc: Co wmW W recycled we lELD S: CTiU;i IPAT I~ ~OMMENT° U T FOUNDATION (1st) ee~ FOUNDATION (2nd) 2. hill ROUGH FRAME & n PLUMBING 3 It, 3. C m m INSULATION PER N. Y. 3 STATE ENERGY CODE a 4. - 1 ry \ 14°' FINAL ADDITIONAL COMMENTS: ~„1 C iLAt 'F CIO, Huh O j\ m • 9 r 4 _ Z p m H y 4F Plf vile TEL', '-Idjgi YC TOWN OI' SI)OTHOLD ..y. gg OC1 tC SO V nU1LbIN(, INSPECTOR u W P.O. BOX 728 i E, ply r0 TOWN HALL SOUTHOLD, N.Y. 11971 AUG 29 1995 r °t a i C E R T I F I C A Tj O N g~ v, ~ ixS i~Date s .~I a J[~$py~~~,w~i ~ftf ~~rt 4,S;c 9 iT£ t F Mt 1 ~3 9~ Y Boiiding Patmih No. , ownar.~ t~~w c t1 p1u p k. pt n r f ~41 1 y a. IV Cage print) f ~ ~ ~C-A CA~q• ~ ~ fd y A~' . r t aottiEY that the so.tanr used in the water supply system ,,aontning 111108 :than 2 /10 o k f 1% lead. 3° x•, :bLA Y yy (plumber's aiclthatntral; k Iy PF ~ 3 4 i8wdrn tt7 :bnfat* mo this ~ .L A , s , m~ s r t ' dpy tort f~f~ ~g~ 14~( ~M~ i Not. CSI Pubi.ttn r 4 i.* R'~ tar (S ~,Ilolaty itubLld~ ount f JOYCE M._WILKINS Notary Public, State of New Yoi~a ' No. 4952249, Suffolk Co k Term Expiree,June 12.18: r 1 7r s> r yi}$t 4 rc RNFFMMM 1;~gOFF0j/( o~o~ OGy~ y x Town Hall, 53095 Main Road W- • Fax (516) 765-1823 Telephone (516) 765-1802 P. 0. Box ewYork 9 11971 Southold, N OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD August 23, 1995 Burger Construction Inc. P.O. Box 934 Cutchogue, NY 11935 Re: Joseph & Ellen Sullivan Prem: 1455 Meadow Beach Lane, Mattituck 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) xx No Underwriters Certificate on file. The check is (outdated/not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. ` xx No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 22360-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. New York State Department of Environmental Conservation Building 40-SUNY, Stony Brook, New York 11790-2356 (516) 444-0365 FAX (51616) 44 444-0373 Thomas C. Jorling Commissioner November 15, 1993 Joseph & Ellen Sullivan 82 Eaton Road Garden City, NY 11530 RE: 1-4738-00878/00001-0 Dear Mr. & Mrs. Sullivan: In conformance with the requirements of the State Uniform - procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit. Please read all conditions carefully. If you are unable to comply with any conditions, please contact us at the above address. Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather. Very truly yours, 1~4m lyW t Roger Evans Environmental Analyst I RE/nw enclosure , W4 SEP 1 L }y . 6D p imed on recycled pacer X N O ~ J m f0 z CD 0 CD =T c O O_ ~ (O CD 3 CD =3 0- 0 - 0 CD ~ N CO 07 '-r 0 0 =Y' C: Ito 3 -CD -s CD V n C O CD ? O Cl) O n w O w N 0 r+O +mm 0 Q- O o CD Q -fi m o no<_ Z m ~~CD0 MCD C-D 0 CD 3 C S o ~ -v = x m~ . M m O o CD < CD r-F. v; Cl) C7 O-r C/) O z O O O Cn :3 O CD cD 3 r-+ CD ~ + O -n.+< ~U O '-r Sv 0 CD 3 o O ~CD s -0 0 vac) O CD M -0 CD CD CD -a 3 C] CD (0 o CD m m CD n CD 3 O COD. < C . cl r* o = N 3-~-tocn O. 3-p3 Ito r o Or 3 CD l< =3 CL NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION i DEC PERMIT NUMBER EFFECTIVE DATE ' 1-4738-00878/00001-0 November 15, 1993 FACILITY/PROGRAM NUMBER(S) PE MIT EXPIRATION DATE($) Under the Environmental Conservation Law TYPE OF PERMIT a New 0 Renewal ? Modification 0 Permit to Construct ? Permit to Operate ? Article 15, Title 5: Protection 0 6NYCRR 608: Water Quality ? Article 27, Title 7; 6NYCRR 360: of Waters Certification Solid Waste Management 0 Article 15, Title 15: Water D Article 17, Titles 7, 8: SPDES 0 Article 27, Title 9; 6NYCRR 373: Supply Hazardous Waste Management 0 Article 19: Air Pollution 0 Article 15, Title 15: Water Control ? Article 34: Coastal Erosion Transport Management 0 Article 23, Title 27: Mined Land 0 Article 15, Title 15: Long Reclamation 0 Article 36: Floodplain Island Wells Management ? Article 24: Freshwater Wetlands ? Article 15, Title 27: Wild, 0 Articles 1, 3, 17, 19, 27, 37; Scenic and Recreational Rivers a Article 25: Tidal Wetlands 6NYCRR 380: Radiation Control ? Other: PERMIT ISSUED TO TELEPHONE NUMBER Joseph & Ellen Sullivan ADDRESS OF PERMITTEE 82 Eaton Rd., Garden City, NY 11530 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER Frederick Weber 41 E. Maple Rd., Greenlawn, NY 11740 NAME AND ADDRESS OF PROJECT/FACILITY Sullivan Property - Lot 23 Harborview LOCATION OF PROJECT/FACILITY Mattituck COUNTY TOWN WATERCOURSE NYTM COORDINATES Suffolk Southold -7 OESRIPTION OF PU1H331M ACTIVITY Construct a single family dwelling, deck, driveway, garage and septic system. Fill and grade area of dwelling construction. All work shall be in accordance with the-attached NYSDEC approved plan. By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, the General Conditions specified (see page 2) and any Special Conditions included as part of this permit. REGIONAL PERMIT ADMINISTRATOR: ADDRESS Robert A. Greene Bldg. 40, SUNY, Room 219, Stony Brook, NY 11790-2356 AUTHORIZED S[GNAT RE DATE / November 15, 1993 Page 1 of 5 GINT AL. 03DITIGS E Inspections 1. The permitted site or facility, including relevant records, is subject to in- inspection at reasonable hours and intervals by an authorized representative of the Department of Enviromrental Conservation (the Department) to determine whether the permittee is complying with this permit and the ECL. Such represen- tative may order the work suspended pursuant to ECL 71-0301 and WA 401(3). A copy of this permit, including all referenced maps, drawings and special conditions, rrust be available for inspection by the Department at all times at the project site. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. i I Permit Changes and Perv3mis 2. The Department reserves the right to modify, suspend or revoke this permit when: a) the scope of the permitted activity is exceeded or a violation of any condition of the permit or provisions of the ECL and pertinent regula- tions is found; b) the permit ms obtained by misrepresentation or failure to disclose relevant facts; c) neN rraterial information is discovered; or d) environmental conditions, relevant technology, or applicable lanr or regulation have materially changed since the permit wes issued. 3. The permittee rrust submit a separate written application to the Department for renenel, rrndification or transfer of this permit. Such application crust include any forms, fees or supplemental information the Department requires. Any renam 1, modification or transfer granted by the Department rust be in writing. 4. The permittee crust submit a renenel application at least: a) 180 days before expiration of :permits for State Pollutant Discharge Elimination System (SFCES), Hazardous Vbste K/bnagarent Facilities (IWff), major Air Pollution Control YAPC) and Solid V%bste Nbnagement Facilities (S/VVF) ; and b) 30 days before expiration of all other permit types. 5. Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms, conditions or requirements contained in such order or determination. Other Legal Cbligations of Permittee 6. The permittee has accepted expressly, by the execution of the application, the full legal responsibility for all damages, direct or indirect, of 'whatever nature and by MaTever suffered, arising out of the project described in this permit and has agreed to indemnify and save harmless the State from suits, actions, damages and costs of every name and description resulting from this project. 7. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the irrpaim-ent of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. 8. The permittee is responsible for obtaining any other permits, approvals, lands, easenants and rights-of-way that rray be required for this project. Page 2of 9520-6a (7/92)-25c ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (Title 5), 24, 25, 34 and 6 NYCRR Part 608 ( ) 9 That if future operations by the State of New York require an al- other environmentally deleterious materials associated with the teration in the position of the structure or work herein authorized, or project. If, in the opinion of the Department of Environmental Conservation 13 Any material dredged in the prosecution of the work herein permitted it shall cause unreasonable obstruction to the free navigation of said shall be removed evenly, without leaving large refuse piles, ridges across waters or flood flows or endanger the health, safety or welfare of the bed of a waterway or floodplam or deep holes that may have a the people of the State, or cause loss or destruction of the natural tendency to cause damage to navigable channels or to the banks of resources of the State, the owner may be ordered by the Department to a waterway. remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State, and If, upon the expiration or 14 There shall be no unreasonable interference with navigation by the work revocation of this permit, the structure, fill, excavation, or other herein authorized. modification of the watercourse hereby authorized shall not be com- 15 If upon the expiration or revocation of this permit, the project hereby pleted, the owners, shall, without expanse to the State, and to such authorized has not been completed, the applicant shall, without expense extent and in such time and manner as the Department of Environmental to the State, and to such extent and in such time and manner as the Conservation may require, remove all or any portion of the uncompleted Department of Environmental Conservation may require, remove all or structure or fill and restore to its former condition the navigable any portion of the uncompleted structure or fill and restore the site and flood capacity of the watercourse. No claim shall be made against to its former condition No claim shall be made against the State of the State of New York on account of any such removal or alteration New York on account of any such removal or alteration. 10 That the State of New York shall in no case be liable for any damage 16 If granted under 6 NYCRR Part 608, the NYS Department of Environ- or injury to the structure orwork herein authorized which may be caused mental Conservation hereby certifies that the subject project will not by or result from future operations undertaken by the State for the contravene effluent limitations or other limitations or standards under conservation or improvement of navigation, or for other purposes, and Sections 301, 302, 303, 306 and 307 of the Clean Water Act of 1977 no claim or right to compensation shall accrue from any such damage (PL 95-217) provided that all of the conditions listed herein are met 11 Granting of this permit does not relieve the applicant of the responsi- 17 All activities authorized by this permit must be in strict conformance bdity of obtaining any other permission, consent or approval from with the approved plans submitted by the applicant or his agent as part the U.S. Army Corps of Engineers, U S Coast Guard, New York State of the permit application Office of General Services or local government which may be required. F. Weber 12 All necessary precautions shall be taken to preclude contamination Such approved plans were prepared by of any wetland or waterway by suspended solids, sediments, fuels, on 8/8/93 solvents, lubricants, epoxy coatings, paints, concrete, leachate or any SPECIAL CONDITIONS 1. During construction, no wet or fresh concrete or leachate shall be allowed to escape or be discharged, nor shall washings from transit mix trucks, mixers, or other devices be allowed to enter tidal wetlands. 2. All necessary precautions shall be taken to prevent contamination of the tidal wetlands and/or waters of New York by silt, sediment, fuels, solvent, lubricants, epoxy coatings, concrete leachate and any other pollutant associated with project work. 3. Any debris or excess material from construction of this project shall be completely removed from the adjacent area (upland) and removed to an approved upland area for disposal. No debris is permitted in tidal wetlands. 4. The storage of construction equipment and materials shall be confined to within the project work site and/or upland areas greater than 5o linear feet distant from the tidal wetland boundary. 5. Prior to the ultimate expiration of this permit the permittee will cause all fill and exposed faces to be vegetated to prevent erosion. IJEC PERMIT NU.x10ER _ O PROGRAM/FACII.ITV UMBER Page _Z_ of~ 95-206f (7/87)-25c NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION ~S SPECIAL CONDITIONS For Article _ 25 Tidal Wetlands 6. A row of staked hay bales or approvable erosion control devices shall be placed at the landward edge of the buffer area at commencement of regulated activities and remain in place until project is completed and all disturbed areas stabilized with vegetation. 7. All areas of soil disturbance resulting from this project shall be seeded with an appropriate perennial grass seed and mulched with hay or straw within one week of final grading. Mulch shall be maintained until a suitable vegetative cover is established. 8. To protect the values of the tidal wetland, a permanent vegetated buffer zone shall be established. There shall be no disturbance to the natural vegetation or topography within an area extending 30 linear feet landward of the tidal wetland boundary. 9. Driveway and parking areas shall be constructed of pervious material. 10. Roof runoff shall be directed to drywells a minimum of landward of the tidal wetland boundary for immediate on-site recharge. 11. Dry wells for pool filter backwash shall be located a minimum of 100' landward o the tidal wetland boundary. 12. There will be no draining of swimming pool water directly or indirectly into,tidal wetlands. 13. Project must comply with all local and federal floodplain regulations. 14. All fill shall consist of "clean" gravel and soil (not asphalt, slag, flyash, broken concrete or demolition debris). Supplementary Special Conditions (A) thru (F) attached. DEC PERMIT NUMBER O L OD©'^Q FACILITY ID NUMBER U PROGRAM NUMBER X. Page ~ of SUPPLEMENTARY SPECIAL CONDITIONS The following conditions apply to all permits: A. A copy of this permit, including all conditions and approved plans, shall be available at the project site whenever authorized work is in progress. The permit sign enclosed with the permit shall be protected from the weather and posted in a conspicuous location at the work site until all authorized work has been completed. B. The permittee shall require that any contractor, project engineer, or other person responsible for the overall supervision of this project reads, understands, and complies with-this permit and all its general, special, and supplementary special conditions. Any failure to comply precisely with all of the terms and conditions of this permit, unless authorized in writing, shall be treated as a violation of the Environmental Conservation Law. If any of the permit conditions are unclear, the permittee must contact the Division of Regulatory Affairs at the address on page one or telephone (516) 444-0365. C. If project design modifications become necessary after permit issuance, the permittee shall submit the appropriate plan changes for approval by the Regional Permit Administrator prior to undertaking any such modifications. The permittee is advised that substantial modification may require submission of a new application for permit. D. At least two days prior to commencement of the project, the permittee and contractor shall sign and return the top portion of the enclosed' notification form certifying that they are fully aware of and understand all terms and conditions of this permit. Within 30 days of completion of the authorized work, the bottom portion of that form shall also be signed and returned, along with photographs of the completed work and, if required, a survey. E. For projects involving activities to be undertaken in phases over a period of more than one year, the permittee shall notify the Regional Permit Administrator in writing at least 48 hours prior to recommencing work in subsequent years. F. The granting of this permit does not relieve the permittee of the responsibility of obtaining a grant, easement, or other necessary approval from the Division of Land Utilization, Office of General Services, Tower Building, Empire State Plaza, Albany, NY 12242 (518) 474-2195, which may be required for any encroachment upon State-owned lands underwater. DEC Permit No. Page 5-0f TRUSTEES SUFFO(,S SUPERVISOR John M. Bredemeyer, III, President %k® SCOTT L. HARRIS Albert J,, KTupski, Jr., Vice President ' M d, Henry P. Smith Town Hall John B. Tuthill 53095 Main Road William G, Albertson P.O. Box 1179 Telephone (516) 765-1892 Southold, New York 11971 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD S.E.Q.R.A. NEGATIVE DECLARATION NOTICE OF NO SIGNIFICANT EFFECT ON THE ENVIRONMENT APPLICATION NO. 1000-116-7-7 Chapt. 97 - Wetlands NAME: Joseph & Ellen Sullivan Chapt. 37 - Coastal Erosion DATE: December 7, 1993 RESOLVED that pursuant to Article 8 of the Environmental Conservation Law, State Environmental Quality Review and 6NYCRR Part 617, Section 617.10 and Chapter 44 of the Code of the Town of Southold, notice is hereby given that the Southold Town Trustees, as Lead, Agency for the action described below, has determined that the project will not have a significant effect on the environment. Please take further notice that this declaration should not be considered a determination made for any other department or agency which may also have an application pending for the same or similar project. TYPE OF ACTION: Type DESCRIPTION OF ACTION: to construct a single family dwelling, deck, garage, sanitary system and fill. LOCATION:SCTM #1000-116-7-7 REASONS SUPPORTING THIS DETERMINATION: 1. An on site inspection has been conducted by the Board of Trustees. 2- An environmental assessment, submitted by the applicant and reviewed and completed by the Board of Trustees, has indicated that no significant adverse effects to the environment are likely to occur should the project be implemented as planned. cc: CAC SEP 1 1994 t~.., i M-1802 ~3~ ~ ssza ~ BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: C c z-12 k- DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 LATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE / INSPECTO M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ) GH PLBG. [ ] FOUNDATION 2ND INSULATION j ] FRAMING [ J FINAL REMARKS: , , _ DATA" " hI~NSPIEC.0 11 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ OUCH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ING [ ] FINAL REMARKS: r-- DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOU ATION 1ST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION 4 [ ] FRAMING [ ] FINAL f REMARKS: -T i I ` DATE INSPECTOR e , THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1001071 BUREAU OF ELECTRICITY F 85 JOHN STREET. NEW YORK. NEW YORK 10038 rv Bate SEPTEMBER 12,1995 Application No. on file 87094+495/95 N 363289 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 JOE SULLIVAN, MEADOW BEACH LA., MATTITUCK, N.Y. in thefollowing location; ® Basement ® 1st FL ® 2nd Fl. GAR/ATTIC/OUT Section Block Lot 23 was examined on SEPTEMBER 06,1995 and found to be in compliance with the National Electrical Code. FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K. W. AMT. X. W. PMT. K.W. MIT. K. W. AMT. H. P. 52 55 66 50 2 1 4.0 1 6.8 1 1.5 8 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS PMT. K. W. OIL H. P. GAS H. P AMT. NO A W.0 AMT AMP AMT AMPS TRANS. AMT H. P SYSTEMS NO. OF FEET PMT. WATTS 2 F 2 - 1 SERVICE DISCONNECT NO.OF S E R V 1 C E MIT. AMP. TYPE METER I p' ]W I ,e JW 3 $ 9W 3,E 4W NO.OF CCCOND A.W G. NO. OF NHEG A W ~ G. NO OF NEUTRALS A. W. G. EQUIP. PER $ OF CC.COND.. OF . G. OF NEUTRAL 1 200 CB 1 X 1 4/0 1 4l0 1 OTHER APPARATUS: PADDLE FANS-3 MOTORSt2-F H.P.,1-3.00 H.P.,1-5.0 H.P.,3-F H.P. PANELBOARDSt2-1 CIR. 60 G.F.C.It-10 SMOKE DETECTORt-5 G & S CONTRACTOR LIC.#578E BOX 215 SOUTHOLD, NY, 11971 GENERAL MANAGER per. This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST,OT BE ALTERED.IN ANY MANNER. A 8IJAKU Ut tALALi11 , . • FORM NO.1 J SETS OF PLANS TOWN OFSOUTHOLD SURVEY PUILDING DEPARTMENT cilm. _ . _ ,y TOWN HALL SEPTIC FORtt'._...,•, SOUTHOLD, N.Y. 11971 1A 1~ TEL.: 765.1802 t1 0'i i FY ; - CALIL~ Examincd" 19 MA I L TO Mil Approved . / , , 19?Wpermit No../~~J? . te, . Disapproved a/c . I , (B ' din" pector) APPLIC ON FO BUILDING PERMIT Date 19 . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with sgts of plans, accurate plot plan to,seale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises of public street or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli .ation. 0. The work Covered by thls 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 >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 .hail 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 3uildin- Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or, tegulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. 'he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for necessary inspe ttotts. (Signature of applicant, or name, if a corporation) g.Z.. Gq/ Ci1roY IIa3o (Mailing address of applicant) state whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Joe,EpOi , .`?U I'v . ow ? lame of owner of premises ..a? , ~U-l~/?~ . . (as on the tax roil or latest deed) f applicant is a corporation, signature of duly authorized officer. v (Name and title of corporate officer > to ;1 Builder's License No. • ~ 1 p~ :t ~w + 1 SEPI Z 1994 Plumber's License No, . ~IQ4 , , , • . . , g _ f Electrician's License No, • • • , Other Trade's License No. Location of land on which proposed work will be done.- . , - House Number Street Hamlet County Tax IMap No. 1000 Section 1(°....... Block '.....Q~..... , . Lot ©1 Subdivision CtV4• •~1 t MCI Filect Map No. Lot 23 (Nantc) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy w74 Lo'T , . . b. Intended use and occupancy ~N(~LL%r, , ,k2~ ~b?,? . _ . 4 f y~V J~ ~ A 3. Natuliz.ofwork (check which applicable): New Building X...... Addition Alteration Aep&ir Removal . Demolition Other Work . (Description) 4, Estimated Cost... 3 )OQJ. .............I.......,. Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units . • • ~J:.. , , Number of dwelling units on each floor If garage, number of cars ...:4: CAA, . ,(51AitA4PE , , , , , , , , , , , , 6. If business, commercial or mixed occupancy, specify n lure and extent of each type of use " . 7, Dimensions of ext. 'sting structures, if any: Front CW04)........ Pear . . . . Depth , , . , , , , , , . Height . . . Number of Stories , Dimensions of same structure with alt .rations or additions: Front C1hl~,~ , Rear Height , , Number Of Stories , . 8. Dimension of entire new construction: Front . j Rear ~',51; Depth Im . Height ..~P.f.......... Nuin er of Stories . 4. Size of lot: Front . 150: Rear . ,~,591,t;; t . 11 Depth .344 ~ . ~q80 fi 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated ' 12. Does proposed construction violate any zoning law, ordinance or regulation: . . 13, Will lot be regraded X~? , , , , , , , , , , , , , , , , , , , Will excess fill be removgd f -n prenlisas. Yes No 14. Name of Owner of prerpises;19c.AN f ~A*4 81AVIAWN. , Address&'VloN p!Drr t 1(- P . t'GPhone No. TA1 Name of Architect fr R,gvewttek,•,~;1tVfet IM , , , , . , Address4J x."14 RIp~ i.%hone No. 2fa6 ~Q~',~ Name of Contractor . LS°pNDlN~+, Address Phone No.. . 5. is this property within 3i feet of a tidal wetland? *Yes., X No....f *If Yes, Southold Town Trustees Permit may be required. `C,ofl Or- KOVAL ~a1G1 o5L PLOT DIAGRAM p Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from )roperty lines. Give street and block number or description according to deed, and show street names and indicate whether nterior or comer lot. • w t LATE OF NEW YORK, S,S OUN'1Y 01 ...k~ r RN?~ 1 _ OS e . t~ , u~ l i J Kl t!~ being duly sworn; deposes and says that he is the applicant (Name of individual signing contract) We named.. eisthe.....~ ~.~~.G Al (Contractor, agent, corporate officer, otc.) said vv'-rier a QvTtlei ~ and is duly authorized to perform or have performed the said work and to make and file this -plication: that ail S'41tcrnents contained in this application are true to the best of his knowledge and belief; and that the ork Will be iicrfor_ncd.ln %ile manner set forth in the application filed therewith, '~omto beNre.ne:lhia 71 ~...da of. 19 nary Public, County PHYLLIS S. COTSIS Notary Public. State of New York , G ' , , . 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NE OR/?EWAY j ,1g.~ \ Yn LLI W l~ O / W / QTS Y - N 27°3g 00 o 147 y _ 77' w I ~o x E- O ww y'o - I O N 3: L(i d N O I 0%, oo haw, k i p In N ~R S Z LL, M w a w d3.q N w\ I I I I ~C~ CYD 0) 00, C\2 O ~ Q q O •o 0) oN a iA,~~ of <CoWHcnZ Y> ?/1110, C~ so So ~ C-) O 0 ova ` y P y~ W n U Z N Q m °m ,~fi bdUs i OD 3: Z O JO C) La LL- F+-'I W N ~o 0 ~LUI-~~INCi Sc.l-~~MQ-TAG.. ~43x II~3° JL3 ,L3 PLUMBER CERTIFICATION ION /1n ON LEAD CONTENT BEFORE FORE _ I I CERTIFICATE OF OCCUPANCY ANCV TER I2'h° 2" I I' a 12 I I i"z^ I I SOLDER USED IN WATER SUPPLY SYSTEM CANNOT NOT EAD. M. C t H I I2 y" 2/2x EXCEED 2 10 OF 1% LEAD. I PLUMNNG iNWMLNUMM q I'~i Ire 1" 1° 1ESMGSEFOR 6OVENO kl ~IV. LauuoaY jv" II'M" I2/i, 1"IL Is used p H copper tubing `ThF I LO1^~ for r Water dno*h ti b Af/ DO NOT PROCEED r" ~~fl RI Io~ l sIS`r /1)( system; DIPhW shell be UNTIL4WSURVEY OF D 01 bw w f PA, oftyppsKorLen FOUNDATION LOCATION NDEIMRI?ER COMFICATE X57 p~R HAS BEEN APPROVED REQUIRED 2 2n lihu 3u 2u 3u I,/Ln G.I. MAO HoUSrT tom, SGDOp H.5 ~PITcH 'C{° ~E:R FT - MIN. TAP ~I°P2ovEb t.W-rA-aY SYSTt:m /0~6/9'l 60)R~- BG~ 1 o .r .,v L1T.,ar~ ny.~, is aYUBinJ i(PUBEU ViN' FTE P 0L?Cii, - FC'.~C'i l;kli .W Fb_tFV3~l.Vi af~ M'! ~ULAMON +'v PICvr+.d. - COWSTl2UCYP0N 14fi1S'I' BE COVOPLETF FOFi C.C. r Ail CONSTRUCTION SHALL 61CL1 7 THE REQUIREMENTS OF THE NA~ C STATE CONSTRUCTION & ENERd_Y -tNEM1GY C4)b6- r CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS (hr I S - Fwwlu(q PL5ou RY 4cce LF PRA ICZ) GTRdDETATWIJ ~yR~ r~YS - lQOOa 'L~.lJ IDMIRD F Di'cl I(~b,)'? buo t~~w S'GonrFol)R ~7 4 OCCUPANCY OR bE, WN TWP = -IL 'F INO~RS, (o F,~vrT.woRS~AT=(-rF 6mvio<~p ARr,& 1sT 2'ISL USE IS 1M%-VFUL 2µo /~822 to 8 7 5 4 3 ~ i i r I 1 A WITHOUT CERTIFICATE ~A4 L9s~ s,fl ~ I i 1 1 v IZ I j i I I 1\ ~ OF OCCUPANCY I t I ~ 1 FWNp \ 1 V~coc I I S ~"190'1~ SCI ~ I j 2bo,7I~ lYr+~IZ wa t v' Fa. &kM FIC) I 117 f I I ~ , 5.4\ /~I~I~JIeq (o° FCC &k f (WO.) rQ'WlnVows- Clout-E~ FNncoe~nx 2~ R19 Lc;T \ bl~,awlEdGq= r 7j WWI 3 s Sl i"E P I:. 1 \ 1 i 1 SY N ' \ L A4-LEl UIPMIF.,~JyT~, INs-rAu.&Tl°ti TCp N5RucTwnl GFtALL' W~RH -ro T1tE NYZ taJEQ(ey (PH6txtV6oo C9u5TRucTIo14 19 42 II 1 ~ I2~ E Fv ~ke~ ~ ~ Av SO -S IT/6--Fly SY s r E I CI iw 1 fy pu l tom. 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