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HomeMy WebLinkAbout22176-z e ~ FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24021 Date NOVEMBER 6, 1995 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 1575 LAURELWOOD DRIVE LAUREL NY House No. Street Hamlet County Tax Map No. 1000 Section 127 Block 5 Lot 10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 23, 1994 pursuant to which Building Permit No. 22176-Z dated JULY 11, 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 GARAGE AS APPLIED FOR. The certificate is issued to DAVID & SUSAN CONSIDINE (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVALRIO-94-0053 OCTOBER 24, 1995 UNDERWRITERS CERTIFICATE NO. H046522 AUGUST 11, 1995 PLUMBERS CERTIFICATION DATED OCTOBER 30, 1995 DAVID CONSIDINE ldi g Inspector Rev. 1/81 1 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) " p Date u'y............................ 79~1C[ .1...x... N2 _ 22176 Z 7 f Permission Is hereby granted to: .U1 J'R':.:........~ ^~.Ae Cd~aST,D!we..L.S2CZeslvy a Sk?. gy....:l:A..s.n1....1~.~..CQ-....... .t . U419..... k/ADJ....... N.:.Y......1..~. I fF!f~.l..!`.f ( to .........C:?.kc7..S..l...'........ /{......~c.r.N.....1,..8........ j ..............I'~.c s~.. ,.f.I.. ~.N.~.............. As....... ~ fir..?, ~..6~ .r {C ...............1.S.J...ctk..........A-A 5' hA ............9-&R-ft ..C, I at premises located at.....,~. 1~ ."..^Dr......!1.f~ (A.," . a f hrt ~ ...............~C. 2$~..... . -y....11 I.Ke............ County Tax Map No. 1000 Section ......./2.7.... Block 5 Lot No. /U.................... J ~ ~7 ..............................o`.. A........., 19......., and approved bythe pursuant to application dated ~ I Bullding Inspector. ,TO ( Fee S9 r ....................L..........~?.......................... i Building Inspect i Rev. 6/30/80 I i ~ ~ s Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT NOV -31995 TOWN BALL 765-1802 u i TOWN OrAPPLICATION FOR CERTIFICATE OF OCCUPANC$ 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. 1 B. 'Far 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 - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date 11'3-96 New Construction. Old Or Pre-existing Building Location of Property. X575 1,AU(2E( U~fh DP_ \)6.. _ AUCCI% f.....IU. j,I~'J,~, , , , , , , , , , , , House No. n Street Hamlet Onwer or Owners of Property. ~J f....................................... County Tax Map No 1000, Section ....?.........Block....:J~ .........Lot...... d Subdiviaion.~AA I WOC)1~k STPT ......,.Filed Map............ Lot...... 1 2 Permit No....Date Of Permit. Sv~.~(..`~•Applicant~il7ip NSipiNi Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary ~,ennrtificate........... Final Certicate........... Fee Submitted: $......cr~.... AP L NT s , NEW YORK STATE ENERGY CONSERVATION CONSTRUCTION CODE PART 6 COMPLIANCE FORM - 6A Building Design by Thermal Rating Method (for buildings with one or two dwelling units) BUILDING ADDRESS: DATE: S 1 Z COUNTY:LK ARCHITECT, NGINE ORr~ i 4 CONTRACTOR /!1 PHONE:(31O PERMIT APPLICANT: C~AdI D =fit P I PHONI_ 1. HEATING DEGREE DAYS (Table 2-1) ? 5000 8,6000 ? 7000 ? 8000 ? 9000 II. BUILDING DESCRIPTION Building has one or two dwelling units. (Use this form 6A) ? Building is three or more dwelling units. (Use form 6B) III. PROJECT TYPE R_New construction ? Substantial renovation of existing building ? Addition to existing building ? Exempt (7810.6c) IV. HEATING SYSTEM TYPE ? Gas-fired E. Oil-fired ? Heat pump ?Electric revised 2/28/91 6A.1 V. BUILDING ENVELOPE SYSTEMS: 7815.2 Total Thermal Rating: 7815.2(a) The total Thermal Rating for this building is 93 The Worksheets used to develop this Thermal Rating are attached. A Thermal Rating of zero or greater indicates that the building envelope complies with the Energy Code. Vapor Retarder: 7815.2(b) Location Location Type Plan/Spec. Required Provided Provided Reference Walls Ceiling Floor Other Insulation Continuity: 7815.2(c) Location Required Specified Plan/Spec. Required Reference Plate lines Continuity Sill lines Continuity Band joists Continuity Corners Continuity Infiltration Rate: 7815.2(f) ff Maximum Rates Specified Plan/Spec. Reference 037 cfnift ft. 0.50 din/sq. ft. 6A-2 Joint Sealing: 7815.2(f) Joint Location Sealant Type Specified Plan/Spec. Reference Windows Doors frames Walls at roof/ceiling Walls at floors/found. Wall panels Utility entrance Penetrations Other Other Air Infiltration Barrier: 7815.2(f) Location Required? Specified Plan/Spec. Reference Walls yes / no Other yes / no Fireplace: 7815.2(g) Required Specified Plan/Spec. Reference Outside combustion air duct with damper Flue damper with max. 20 cfm, or damper and non-combustible doors Gas fireplace ignition VI. HVAC EQUIPMENT PERFORMANCE REQUIREMENTS: 7815.11 Equipment Minimum Performance Specified Performance Plan/Spec. Required / Table No, Reference Furnace / Table 4-5 Boiler /Table 4-5 Heat pump /Table 4-6 Central air /Table 4-8 conditioner 6A-3 VII. HVAC CONTROL: 7815.12 Temperature Control Required Specified Plan/Spec. Reference Thermostat each dwelling unit Shut off at each terminal unit Thermostat Required Specified Plan/Spec. Reference Minimum range 45°F-85°F Deadband range z 5° Automatic capability HVAC Reset Hydronic System Required Specified Plan/Spec. Reference Heating only a supply water 300,000 Btu/hr temp. reset i VIII. DUCT SYSTEMS: 7815.13 Category Required Provided Plan/Spec. Reference Duct z 1" thick insulation Transverse Sealed joints DL VENTILATION SYSTEMS: 7815.14 System Type Required Specified Plan/Spec. Reference Supply Damper at envelope Exhaust Damper at envelope supply on/off switch L Exhaust on/off switch 6A-4 SUMMARY OF TOTAL THERMAL RATING If the total thermal rating below is zero or greater, the envelope portion of the building is in compliance with the energy code. TABLE THERMAL A. WALLASSEMBLY AREA U VALUE. USED RATING Al. Net Wags Aw 1,0`11 Uw .0 5 "I F ZZ n A% Uw rQ -1 5 A2 Glazing ~ Ug 113 A3. Doors Ad 107- Ud ~ -I e -23 Ad- 0 Subtotal Thermal Rating for Section A (Al +A2+A3 -i-Z~ B. ROOF/CEILING ASSEMBLY B1. Roof/Ceiling Ar 1232 Ur 1015 (0-3 l~ Ar Ur B2. Skylights Ag_ I D Ug, 3 b 6-3 0 9 SubtotafThermai Rating for Section B (B1 + 82 75? C. ENTER DATA AS APPLICABLE (Either C1, C2, or C3) Cl. Floor At (23& Lh .05 (0-3 C2. Foundation Wag Wag Perimeter ft. Above Grade Exposure ft. Insulation Der 24 8 84 8ootQt e Footing Perimeter RValue C3. Stab Edge Insulation e Subtotal Thermal Rating for Section C ( C1 +C2+C3 D. TOTAL THERMAL RATING (A+B+C) .x.193 PARnWO JUN 17 '94 15:04 N F PRESS 51647715590 P.1/1 RODERICK VAN TUYL 4LS.1 COLINVANTUYL RODERICK VAN TUYL. P. C. Licensed Land Su.viyors 218 FRONT STREET GREENPORT, NEW YaRK 11944 (5161 477-01 70 June 17, 1994 Judy Walter Smith Finkelstein Lundberg Isler Yakaboski 456 Griffing Avenue Riverhead, NY 11901 Re: Considine Dear Ms Walter: This is to certify that the property of David Considine on Laurelwood Drive, Laurel, is over three hundred feet from wetlands; in fact,600 feet from Brushes Creek. ~I Very ttruly,.yours, 1994 P JUN 23 L BLDG. DEPT. TOWN OF SOUTHOLD COUNTY OF SUFFOLK O~.G+pv OF ROBERT J. GAFFNEY O SUFFOLK COUNTY EXECUTIVE DE MENT OF HEALTH SERVICES MARY E. HIBBERD, M.D., M.P,H. COMMISSIONER PERMIT, THE ATTACHED PLAN, WHEN DULY SIGNED BY A REPRESENTATIVE OF THE DEPARTMENT, CONSTITUTES A PERMIT TO CONSTRUCT A WATER SUPPLY AND/OR A SEWAGE DISPOSAL SYSTEM FOR THE PROPERTY AS DEPICTED. CONSTRUCTION MUST CONFORM WITH APPLICABLE STANDARDS INCLUDING THE STANDARDS FOR CONSTRUCTION OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES AND STANDARDS AND PROCEDURES FOR PRIVATE WATER SYSTEMS. THE PERMIT (PLAN) EXPIRES THREE (3) YEARS AFTER THE APPROVAL DATE. ANY MODIFICATIONS WHICH MAY AFFECT THE PROPOSED SEWAGE DISPOSAL SYSTEM OR WATER SUPPLY REQUIRE SUBMISSION OF A REVISED PLAN AND ANY ADDITIONAL FEES, PRIOR TO CONSTRUCTION. NO INSPECTIONS WILL BE PERFORMED BY THE DEPARTMENT ON EXPIRED PERMITS. PERMITS MAY BE REISSUED UPON THE SUBMISSION OF NECESSARY APPLICATIONS, PLANS AND FEES, AND WILL BE REQUIRED TO MEET THE STANDARDS IN EFFECT AT THE TIME OF REISSUANCE. A PERMIT MAY BE TRANSFERRED INTO ANOTHER PARTY'S NAME UPON RECEIPT OF WRITTEN PERMISSION FROM THE ORIGINAL APPLICANT AND THE RECEIPT OF ANY REQUIRED TRANSFER FEES. IN THIS CASE, THE PARTY PAYING THE ORIGINAL APPLICATION FEE WILL BE CONSIDERED TO BE THE ORIGINAL APPLICANT. WWM-058 PAGE I OF 2 DIVISION OF ENVIRONMENTAL QUALITY COUNTY CENTER RIVERHEAD, N.Y. 11901.3397 852-2100 18-380..12/92 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 watt supply facilities prior to backfilling. 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 filial grading. Other inspections may be required. Following satisfactory construction and inspections: 1. The applicant must submit 4 prints of an as-built plan (up to and including 11"x17"), by a licensed design professional, of the subject property showing the following: a. the lot location and dimensipOns; 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 dimension 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. i 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 Ilthe potable water supply, the applicant must submit a current well water analysis (within one year) and a well driller's certificate. If the well or water quality does not conform 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. I~ SUBMIT ALL NECESSARY FINAL PAPERS AT THE SAME TIME. PHOTOCOPIES OF DOCUMENTS WILL NOT BE ACCEPTED. WWM-058 PAGE 2 OF 2 18-380-12/92 aim N N F 3Z T ~ "O ~ Q O <O V 04 i a W v N C W ~NW J ~ T 1.1~ ~ ~ ` V 3 Y ~YD OQ y N a G tl ~ N~ W (y~~ C W' x C Gq m H~ F Z H m tr d w'a t!W m ~q s S <g a' a 4 1. ~ W Y W ° U a O 7. ° W o o 4* O 'o° z O^ E r u 3. o d, r ~O If7 H C 8 f a, e U.W N D' E 3~ v LL zz a 3' i « c f N J 0 p U X q p , (9 r ° ao LL {L Q , b. K 6 W 0 O O W Z N "N . N 3 a N Us V a,Z ; ch a; 06 W Q ~W a H® tl N m C q o Z` o m F Q 3 S m O 0,' m W LL ~ QN c 4 VAC) 7' L ~d W ti n 3 i i aN H c E. '45 F" W U2 5 ] < d g F$ ra z w = y e N ~s7 I... r.~ F• a H ~ W rc i r Ll ~ h N A e a W ' c. W Y v IL $ d 0~ N Q W E ~ m S ,a h o c 3 0~ rc 'o W m ~ yW1 c} O U q ",x Y n1 W Y V V N ~l r7 u m h F °f ~ ~ + H o Q C y ¢C h~ z r NOV - 3 1995 Jj B4UG. P q -f 4 TQVVN JF ~+G i 5-10 zz 1LP THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 8049676 BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK. NEW YORK 10038 Date AUGUST 11,1995 Application No. on file 85x'57794/94 N 046522 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 J CONSIDINE, 1575 LAURELWOOD DRIVE, LAUREL, N.Y. in thefollowinR location; F Basement A Ist FL ® 2nd F1. GAR/ATTIC/.OUT .Section Block Lot was examined on JULY 31 , 1995 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 AMT. K W AMT K W. 11 AML K.W AMT K.W MT. H P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIMECLOCKS BELL UNIT HEATERS MULTI -OUTLET DIMMERS AMT. K. W. OIL M. P. GAS H. P. MAT NO. A. W. G. W. AMP. AMT AMPS. TRANS. AMT H P. SYSTEMS AMT. WATTS NO. OF FEET SERVICE DISCONNECT OF S E R V - I C E AMT. I AMP TypE METER 10 2W 1$ 3W 3 0 3W 3 0 AW NO. OF CC CONO A W G. NO OF HI LEG A' W. G. NO OF NEUTRALS A. W. G. EQUIP. PER % OF CC. COND OF HI LEG OF NEUTRAL OTHER APPARATUS: 2d '7 DAVID J CONSIDINE 9 R, 17 JUNARD BOULEVARD PT JEFF STA, NY, 11776 GENERAL MANA01it- 11 ...w x~ ~ 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 NOT BE,ALTERED IN ANY MANNER. { INSPECTORS pfyS>3fF0 , SCOTT L. HARRIS, SupeTOisor o w4 Thomas Fisher Southold Town Hall P.O. Box 1179, 53095 Main Road Building Inspector Gary Fish Southold, New York 11971 Building Inspectors Fax (516) 765-1823 Telephone (516) 765-1800 Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE: Building Permit No. 12-:2 1-76 Z Owner: - please print) - `3 Plumber: uAQ_ID~". f^,~1Si111Ni (please prints i b_;:s~ ~ d I I certify that the solder used in the water supply system contains less than 2/10 of 12 lead. (Plumber gnature) Sworn to before me this ,30 96 day of D 1996 Notary Public, County Not ublic e eCGe/ MAIGt/ERITE C. FEIICE Notary Public, State of New York No. 52-1169275 Qualified in Suffolk County n/ commission Expires February 28,19.Q,~ s l0 ry t rA en 'a :4 Pj Mm y; ~a < rn k m w N cl) h1 °s f N N Nm p m° W '0 ° k0 UJ N O i 4 q O 3 K7 b H OW M N 2 N ° CO a Z m GO HJ~i~MH n H $ N IV OH C ~7 N ro w ~Z ;y E O? 3 D _ m ieo ,d ~'f z SU ~ r Hz 6 R} ~ v N m 0'~ Q, W ~~yC} t~ ~ N m r '4 Zm a p f E z "tl ~s "D N J 2 > Yi A CJ i Z ° Z N W m c -1 M oo t R 9 c a ~a ZC ° ~p T 9 3 71 m ?J Z A C JJ b r Q O Q !t N '`t'GY1 x n 111 a ns A S f O ".rJ `3'.r ^ Z U 3 f m- j co N ~ 8 s x H Ln rn "J 0 'S ZP N p ~O v a N z m b =F : ~ E n7 } p r~ y m I I C m Onr N , R Ln/~ 6 ~ ~ TmC x N ~ ~ A eP V• c m~'~ f ~ ~ a f,1y mA y ~n N Y ~ h S N ~ W a x n SR ~a ° >y, 9 Z V N MEW um I 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 ULATION [ ] FRAMING FINAL [ ] FIREPLACE & CHIMNEY REMARKS: _ F V j DATE / /3 h S INSPECTOR i 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] RO GH PLBG. [ ] FOUNDATION 2ND [ INSU TION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE J INSPECTOR 765-1802 BUILDING DEPT. NSPECTIO - [ ] FOUNDATION 1ST [ ~ ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ RAMING [ ] FINAL REMARKS: DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ XFODATION 1ST ] ROUGH PLBG. ION 2ND [ ] INSULATION [ l FRAMING [ ] FINAL REMARKS: Cam/ DATEV Y' INSPECTO M-1802 BUILDING DEPT. INSPECTION [FOUNDATION 1ST [ I ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE INSPECTOR .......__L,_. CO fmENTz m \ OX (1st) y a 'el r'OUIIDATI061 (2nd) _ m 1~:j 2. o, \ TOUGH FRAME • r` A ; •PLUFIBING •r,:.s ; `U( t -1ISULATION PER N, Y. I M R STATE ENERGY CODE I } P• FINAL ADDITIONAL COMMENTS: • x H H • O N !ts+riG.'.~ a...-...~. z...:ai.1i :w r r :tiii:• .,a , _ H ~ :,~fA[~ w D' `y 0 BOARD O NS FORM N0.1 3 SETS O OF F PLANS TOWN OFSOUTHOLD S WtlIY P 31994 BUILDING DEPARTMENT CHECK _ . TOWN HALL SEPTIC FORM 6LDG DEPT. SOUTHOLD, N.Y. 11971 ?OWN OF OUTH LD TEL.: 765-1802 N 67 I FY 9 ALL k515)423:~~79 Examined 19 C ! MAIL To: • • • • • - / Q DAVID J. CONSIDINE Approved 19 /Permit No. q?a 7 17 *JUNARD Bf vb' Disapproved a/c PORT JEFFERSON STA. . NEW YORK .11776 (Bung Inspector) LICATION FOR BUILDING PERMIT Date , JUNE 23.... 19 94 r 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, housrn code, and regul^tiens, and to _ admit authorized inspectors on premises and in building for necessary inspections. o i....... (Signature of applrcantname, if a corporation) 17 JUNARD BLVD PORT JEFF. STA. N.Y.11776 (Mailing address of applicant) State whether applicant is owner,.lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. OWNER/ GENERAL CONTRACTOR Name of owner of premises , DAVID J. & SUSAN A. CONSIDINE `j.2- ~l (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.3 , 242 HI DIRECT CONNECTION CONSTRUCTION Plumber's License No . Electrician's License No . Other Trade's License No . 1. Location of land on which proposed work will be done. LOT # 1.2. OF. LAURE. LWOOD. .ESTATES . . . . . . . . . . . . A.K.A. 1575 LAURELWOOD DRIVE LAUREL N.Y. 11948 House Number Street Hamlet County Tax Map No. 1000 Section . , 1.27............ Block 5........... Lot .....10........ , . LAURELWOOD ESTATES 5595 12 Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy , VACANT LAND PRIME RESIDENCE b. Intended use and occuppncy .................................................................o.. 3. Nature of work (check which applicable): New Building Addition . , . . Repair Removal , Demolition Other Work 4. Estimated Cost $..110, OOd (Description) Fee (to be paid on,fil ng-th#s §p 79 atio ) 91 5. If dwelling, number of dwelli 'units Number of dwelling units on each;fJoorYe9EE ,Z,,ANS If garage, number of cars . , , 6. If business, commercial or mixed occupancy, specify nature and extent of each e of use , . • ' ' ' ' ' 7. Dimensions of existing structures, if any: Front .N/A . , , ..Rear MAP , . Depth , ,NIA . . . . . Height . NIA Number of Stories . . . . . . Dimensions of same structure with alterations or additions: Front N/.A , , , , . . . . . . . . . • • • , • , Rear , N~A Depth N/A Height ; . , Number of.Stories ..N/A* 8. Dimensions of entire flew construction: Stories FroML22.' ~ .2 °±R27,' 10"Rear ..50., , , , , , , DepthL34'..lk 9V 4 Num ' • 9. Size of lot: Front ..140-.-Q Q . Rear 1 4 0. ' . of . 10. Date of Purchase 6/?jq/94 DepthL288,.25 R287.08 , Name of Former Owner DAVID & JAVICE SZCZESNY 11. Zone or use district in which premises are situated ,$4Q , , • , , • • . 12. Does proposed construction violate any zoning law, ordinance or regulation: NO 13. Will lot be regraded . , ? ES Will excess fill }}~~e rett~ veet~from premises: Yes Rio 14. Nam Name Name of of Owner Architect of prePmE.isePLWAOWn , J . CONS FAddressl7 TUNARD HoI.. Phone N4.5.1.6 ) 473.-53 n9 MAN • . Address ,NOT ADVALABLE • Phone Nd 516 ) 567-1432 Name of ContractoDIRB.CT. CO~NNEC,T,IQN, CQNSTAddress 1,7. JUNARD BLVD, , • phone Nd . 516) 473-5379 .V' 15. Is this property within 3po feet of a tidal wetland?. *Yes • „ No,.X',..... *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or Proposed, and, indicate all setback 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. SEE ATTACHED SURVEY BUILDING PLANS i i i STATE OF NEW YORK, S.S COUNTY OF.. SUFF.QLF...... . . . *C*ON DINE • • , , , being duly sworn, deposes and says that he is the applicant (Name of . individual . signing, g, contract) above named. He is the.,,,,, OWNER / GENERA CONTRACTOR (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 se 't forth in the application filed therewith. Sworn to before me this .....day of ..al'JUNE ..••.,.....,,1994, Notary Public, County ©~Sui X[ZpN 9. YOUNG 1k N46, rv 11O ' • • • • • • • , . sf=,fa of New York. (Signature of applicant) Suil Ik Gomrty, Na, hG 3562///YYY81 • A•r-run~dnn E'roires g n Tt c I r j dl0HInOS 40 NMOI 6 1" 1d30'~JOl9 T g m~ Z I U r, ti661ZZ J(Itl N/F 2A5WEILE2 < 91 C - w m 27 C) (n _ i Q rn -n 1" T I -A A C_ o o N. 22 4100 W. 140,01 -n kj) C) i T I U) ~7 Z n - z C c_ m re c,> m all T"~~ / < 1 t- 8 t £ ri R C C_ q Z rr3 ICIi ~^~I1ir~ C7iC7 G~ m rm, ~I plp ~ n~ II, {T t~_ poi m I r~ ( € 3(r C7 ! 0 r p I 010 C J [11 ~j fuq 'rA -_7 S w j -r: - - - ~m m FTI , CANCR,POUN~ r ! ` / it .C7 _ - ~ rn I ! ~b "~.~`.23 og 5f3 E. -140 ()o 123.02 TO W00051DE LA CURS LNE LAUf2 IN }C3C) IJk~€Vfa N n a~ I I r o <q-I_< rnn 2 o a D r, ;u z (71 z p O I - m a P ~m z o rn F~ v o nxpn~u --mnu, - - - - - -i m f _ w -V - > 0 c c 0 xn to umi O W mm m~mLn l 'n mm~ m NOT REQ U. -SEE FILED MAP = r- to (A 9 o O m 71 c n < 7 O o ~ u3 -Di o W 0 y 9 D r p z n m > 9 m N r m y qJ A n O O N O r,°- n0 O O D n m m 0 Z l c rt p ;u C m p y O " -4 z -4 3 x m r m m t, s z O i -i m + m `n.: a c; r 1 r~ CFI y X r a: z U) r § co o E'fu - ' r~n1 'Dp . 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L. y, Sr~aPlcarlo yGl ~ LAtIOAI<j, G l-k`^. % to O° ° hdL imp u A"Lme*p, Ar A RS,¢, huger ro A&TIUAL -ref v lrcAfaJ Frt)or- -ro co~l~(u7~1IOU cs( f~fr-- ~JprAl tr~pJfazal- LGn1?Rlc~'G2 orb '6uILC~R... ~~P 41ALLs rOO° ALLIrlgh S{hLL rA~ oN UtiIDIeTvab~ S011- GpLWt>o (n0° 0 ALL tL sgaw f5~ A,b•'; N1. A-36O S1.FALL GoNfm2M rb k•Z, h,6. '~BU~I(~kl"IOtiI'~ Q02. r0- '17;;514r11 PA'U'R.ICAI,10I.I '_I~Da ~ 9~G?'I or.1 O~ " IZ.V~IN" ILIhLL= (00° . ~Pz~ruzAL L fMfz bwLDwc h ~ t,Atgv~r *%01)00. ~ ALL IuMr~f~ rrom rf-AMwy SHALL Vr A MiOIOUM T 0 2 HSM-t'12 (kW1 r4) A'~ ?e-V ---rArIDAKTYj 'f~V2 ZPAIJ5 oP 6rg0e- or- SriZULtURAL I.UNIb~R- ~1'1 12.av 7i•I. NAIrJIPAOIA V il",h hpSOI~eD O YLWISG. PLUMBING J-~f wnw= 60 ° ALL R I~000L- ALL ~Joltrh VOPO-2 ?ARAI.LEI. Fi,~n04~S A";' Arlou"C' ,ALL oFe4mky, P<UMBMG I~/rp/ OR AP R JB,P. AS NOTED GWr /ao ° ° WABM gg^~,1~dn^I ,p~~a(Y OR rM~ WAMN LINES NEED "'°'°JU li tl R Q& DATE: # a ~o . ° V~dP4E Aw .IOI• j AT• 6'-e A(i, MAX, (MID-SgW TESnNGBEFORE COVERING USE g~YY619lrG IS UNLA'v'FI FEE: JNLAVVFUL N(7fpFY B JILDING UP ME T AT L~tl PLUMBER CERTIFICATION d mr ON LEAD CONTENT BEFORE U A I T HOUT CERTIF 802 1802 9 AM TO 4 FOR THE 600 Wn9v LIIJlrl- Ie (Ukiiw,S hPeuvi~ oFlEewts )..CERTIF/CATEOF OCCUPANCY Ncoppertubingis uW .%19 btl 9~~ryy WING INS f ftry~~,p~~I~ 1( O TWOREOUIRED Ltl bi'id l FOR POUhF-, CONCRETE Z) Z>< q-" SPAN In 5'-0' SOLDER USED IN WATER for water distributing B NI 2. f, D'i ~i ri;lf, I; PLUMBING 3 2"x G" r,' o" SUPPLY SYSTEM CANNOT ly9te N Piping shall be EXCEED 2110 of 1 % LEAD. Of types K or_. Lonly TERS i i?IONMUST ZRS u u ~••-O,. Z'X ie I. 11 5,-0" DO NOT PROCEED UNDER REQU RED CERTIFICAT RITERS CERTIFICATE N SHALL MEET REQUIRED THI- fa r;'n;.f nn(-ttl5 OF fHE N.Y. II Tf"'C :::'?'7;pN & ENERGY Z •'x IZ• „ IO%o" UNTIL 2nd SURVEY OF " ()NSIBLE FOR 1.9Y>Lfi Lt ro I ipL7fCh1 of Wp{lurt ~t MJaJt fb.. )K Wa7D LInITG~L ~il,~iP,PJL>; -rOrt hl&.laLg "51-oFCUNDATIONLOCATION ~ Of A fSiU1W1r1 r-r~~'~I RHA~BE6NNCPPRIDlIEDrp?eR rrirhr ~'D2 A;LL ofil+ ~lI. U , "ONSIRUCTION ERRORS W"f",s -wNr'-D Ah FOR- IJ.i~fRA. \40aD Srrj~VRAL prrmaI6r1 DADA AuvloFZ OT4r-z Ar5jockrSLr-- cork,,. UNTIL LIIU 6u"VdY Ur ° '~LA/If M'r~{AL MIP GLAS<-FlrJtt oVO/iZ AI-I, ~-1Kjtwjo?- WIOPOLJ'J Y veop•S. FOUNDATION LOCATION HAS BEEN APPROVER ALL rozv-:~, r0 4AR44f- AAA 1 zoM Wtt-zIUR_ WvIIJ41 SPACV SLIP LL 1~O -Y4 HtOur- U, L. 5.LF 6A OSIAI(j ( oiki.) . 7Z4,'WIIN4> 4JIAV>i ° Uhp 6/3' OY(Q T:217. Of? k-Mali- 1~y Al,- "41K~ IAPFi" '!/f I40U2 RA?t=Tn G'h? 61;1. r~K. PATZAcr~, c}(IL IT-( rZM., ArJD ,,JCiP AL Vy LSF-EI.I t~EPA'e~-.D IF.I eJ° z aL 6DIf 5 Ah P~2 A aP-Dl.NC 7}} IJEkI (oR SrATe; FDU oN '~,fA1V LOaAL• LoDej, ° f wlv; W4rG IZO~I-WrAQr 6r q?. t',D. MID OXrMWrt r ZAOG .9L~ UjGInD W ALL A2Et5 ISlE[T ro f-x c5uzp- To 6J4rErt of 1"FiZ OP. n^DIS•I'URB, 6,~PSE OF NE~Y ° Tex DRMJINC,`~ J M1H 5P$GIPICATI~ l5 ARIi II.I&RJMGI.1r'i op -zpNICB -HA-.L r~r 4- l -4r-- P~RoPGR T-f or 114e ~ I rl IC Jew r~R wH~~ TIC,( opicE F A{(6D is ~xe:curov op- Nor.... ~ t4iit.L uar W "o r-oP ati t oP+ RzW~t E' P2o,1~r.T I,~I~Iout ~?!~It'.~tJ y` .~sr~ mt~DycU~TIkoKIZA-111ar.1 ?1.y11%9F'~pIr1~1~Z,. AL1O2 TThS Klo-r to., KE1' 00" 'l 101 =Q49- oR_ GOQjlAKVQ To RO/iF-+ti1 oft IQOPV, 51'7r,' --r 4A-r 1 V -r4A-r r4jty, 'P2oJ~T is N - ~z yIt~~y51 MOT- 06 AV A"U"I*-6 ND 'RG~~.1S1'UII.I'I"1 Or S~tj,JLi'UR.41i D~IC Q TD 114PK.OFOtea0 SI'(E .I t\JDll 1%rv2 Joy t v2 v4o~ ~~I~v2 o~ E5 a I rt .0 OIow"kgS pop yawworcllms a wof,Per.1 W AQle D0625E 00164, o2Dlalar.Y Arles LAWS APPIASWOW. 'LIC-h6LE Ar -r4r-- .Sj-pr,_ OFFSSIO.VP1.'~. 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