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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23309 Date OCTOBER 26, 1994
THIS CERTIFIES that the building NEW DWELLING
Location of Property 465 BURGUNDY COURT SOUTHOLD, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 51 Block 3 Lot 3.14
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 26, 1994 pursuant to which
Building Permit No. 22124-9 dated JUNE 14, 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 ONE FAMILY DWELLING WITH ATTACHED GARAGE, & TWO OPEN
PORCHES AS APPLIED FOR.
The certificate is issued to NEIL REGO
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-94-0023- Oct. 14, 1994
UNDERWRITERS CERTIFICATE NO. N-330528 - OCTOBER 19, 1994
PLUMBERS CERTIFICATION DATED OCT. 14, 1994-BERTSAND PLUMBING & BEAT.
~yy r
adding 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)
Date ...14. ° 19.... 94...
No 22124 Z
Permission Is hereby granted to:
CHARDONNAY WOODS ASSOCIATES - A/C NEIL REGO
to CONSTRDCT A ONE FAMILY DWELLING WITH ATTACHED GARAGE AND 2 OPEN PORCHES
AS APPLIED FOR.
.
.
.
at premises located at.. 465.,499 GUNDY.!gQggTx..SOU.M.OL.D
.
County Tax Map No. 1000 Section ......5 A Block 3.............. Lot No. .-,14
pursuant to application dated R.. ~k.. 19....9~t........ and approved by the
Building Inspector.
Fee $12.00........
wilding Ins ector
Rev. 6/30/80
sus-go39
Form No. 6
TOWN OF SOUTHOLD
~Pf BUILDING DEPARTMENT
OAT 2 6 E!~J TOWN HALL
765-1802
DG. DEPT.
_0?^j1~ OFSGUTHOLD 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-disposel(S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and a consent to inspect signed by the applicant.
If a Certificate of occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildine - $100.00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
J ,
Date
New Construction....:..... Old Or Pre-existing Building.. !l
Location of Property
House No. Street ` Hamlet
Jnwer or Owners of Property....... 44..~J~ckl
C~ / J
:ounty Tax Map No 1000, Section.... Block..... 3......... Lot..... 314J
ubdivision. 4:R:'r-1.f AXlljw:.o~~?jvfL,~.k~ ../.Filed Map..;!~Z~'.... Lot...~y................
,rmit No. 4( L 4.......Date/Of Pernit.l /fy1.°•.Y Applicant.~~vl<G nalnyttgyp •?5 -
,alth Dept. Approval......../ ...............///..Underwriters Approval .........yl
anning Board Approval
quest for: Temporary Certificate........... Final Certicate.... /
Submitted: $....~~:-2:1
Glec, q gb
3 3 APPLICANT
ITHE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1065081 BUREAU OF ELECTRICITY Y
r as JOHN STREET, NEW YORK, NEW YORK 10038
Date OCTOBER 19,1994 gppliration No. on file 84840094/94 N 330528
n
THIS CERTIFIES THAT ~t
only the electrical equipment w described below and introduced by the opplicont namedon the above application number in the premises of II66~EE`
SHARDANAY ASSOCIATES, BERGUNDY COURT, SEC.#051.00, SOUTHOLD, N.Y.
in thefollo.eing location. ® Basement 3 1st fl. OXJ 2nd Fl. GAR/ATTIC/OUT sce tian 81oe03.00t„t 003.0
Lens examined on OCTOBER 13,1994 and found to be in compliance with the National Electrical Code.
FIXTURE EPTACUIS SWITCHES FIXTURES RANGES COOKING-PIS OVENS DISHWASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORE5CENf OTHER wMr. I K W AMT R W. 6N f. R W PMr K.W /uM f. H P
i 35 59 43 35
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'?T TIME CLOCKS SELL UNIT HEATERS MULTI-OUTLETl I DIMMERS
TRANS. unr H p SYSTEMS ,L,wf. wwn5
AMT. R. W OIL H. P. GAS H. P AMT I NO. A W G AMr 4MP. AMT. AMPS. NO. OF FEET
1 F 2 - l
SERVICE DISC0 NKi NO.OF S E R V I C E
METER NO Op CC. COND. A. W G. A w. G A. w G.
jjj "0
I e Jw J e 9W ],I Aw PER d Of CC COND NO Of HLLEG Of MUG OF NEUi4Al5 OF NEUTRAL
AMT. AMI pPE EOUII. I F tW
1 200 CB 1 X I 1 210 1 210
OTHER APPARATUS!
FEEDERS-2
MOTORSt4-F H.P.
G.F.C.I:-9
SMOKE DETECTOR:-2
FRW ELECTRICAL LIC.#4405-E
SERVICES, INC.
P. 0. BOX 1154 GENEW MANAGER
RONKONKOMA, NY, 11779 11 1/1
Psr_ i
This certificate most not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identifi y their credentials.
C'~REt
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
TEMPORARY
CERTIFICATE OF OCCUPANCY
No 5-23287 Date OCTOBER 17, 1994
THIS CERTIFIES that the building NNW DWELLING
Location of Property 465 BURGUNDY COURT SOUTHOLD, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 51 Block 3 Lot 3.14
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 26, 1994 pursuant to which
Building Permit No. 22124-& dated JUNE 14, 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 ONE FAMILY DWELLING WITH ATTACHED GARAGE, & TWO OPEN
PORCHES AS APPLIED FOR.
The certificate is issued to NEIL REGO
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-94-0023- Oct. 14, 1994
UNDERWRITERS CERTIFICATE NO. PENDING - OCTOBER 13, 1994
PLUMBERS CERTIFICATION DATED OCT. 14, 1994-BERTSAND PLUMBING & HEAT.
~ ilding Inspector
Rev. 1/81
x(05 -s36 8'
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
OCT 14M TOWN HALL
3 765-1802
CL UG, DEPT,
- TOWN OrSOIIrHOLD APPLICATION FOR CERTIFICATE OF OCCUPANCY
1. 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.
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.
j 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 Building - $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 ...:.n1..~Y{7./
ew Construction....... Old Or Pre-existing Building..//
ocation of Property
House No. Street Hamlet
ewer or Owners of Property..... lIb 5..... L u a I l t^O~...~'OUK ~
t(
runty Tax Map No 1000, Section ...S.1........ Black 3........ I.ot..................
bdivision.... !1t.34qV.\AVj.LVP.AA.~.•~^'.°C~i~1~Filed Map...~.~2.~..Lot.....
rmi t No 2 f /n nb n via Gvdv.JS SS-
~Z ..........Date Of Permit.4?/!l/..(......Applicant. C ..........~..........rt:...
.lth Dept. Approval........ ...............Underwriters Approval....
nning Board Approval
uest for: Temporary Certificate.... Final Certicate...........
Submitted: Q
~elt.y8~SI/ 1. P.
Tarns to t.-)S'n1 APPLICANT
TRL. 765.1$102
c~oc~FfOtK~~ TOWN OF SOUTHOLD
OFFI" OF Bulwm INSPECCOA
j" P.O. BOX 728
TOWN HALL
"O • SOUTHOLD, N.Y. 11471
C E R T I F I C A T I O N
Date October 14, 1994
Building Pemit No. 221242
Owner Chardonnay Woods Associates-
(please print)
Pluwber Bertsand Plumbing 8 Heating, Inc.
(please print)
I certify that the solder used in the water supply ;YBtWp
contains lose than 2/10 of 1% lead.
A
plumber's signatus'e)
Sworn to before me this
14th day of October ,
19 94 Notary Public
Notary Public, Suffolk County
EILEEN M. ROACNE
Notary Public. State of New York
No.4826842
Qualified in Suffolk County
Commission Expires January 31.18;75
1.. 1 Ta
I ro
FOUNDATION (15t) ~I
707 i c
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F0UNDATION (2nd) m l
2.
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DOUGH FRAME $ L
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PLUMBING
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ItISULATIOt! PER 17. Y.
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STATE ENERGY ie~`1e E
CODE
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ADDITIONAL C04MENTS: x
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M-1W2
BUILDING DEPT.
INSPECTION
[ I FOUNDATION 1ST [ ] ROUGH PLBG.
[ I FOUNDATION 2ND [ I INSULATI N~
[ ] FRAMING
REMARKS-., ~--ci -
1,7
DATE INSPECTO ,-C
M-1802
BUILDING DEPT.
NSPECTION
[ UNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS:
DATE INSPECTO
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
r1055081 BUREAU OF ELECTRICITY
85 JOHN STREET. NEW YORK. NEW YORK 10038
Date OCTOBER 19,1994 Application No. on file 84840094/94 N 330525
THIS CERTIFIES THAT
only the elec uipment as described below and introduced by the applicant named on the above application number in the premises of
ci A'iDO 4 U-
SHARDANAY ASSOCIATES, BgtMMY COURT, SEC4051.00, SOUTHOLD, N.Y.
in thefoNaw•inp location; ®Bosement I_T IA[ Ft. A 2nd Ft. GAR/ATTIC/OUT ,Section BIcek03-ft.t 003.0
ayes examined an OCTOBER 13, 1994 and found to be in compliance with the National Electrical Code.
RKTURE TACIK SWITCHES RXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORlSCENT OTHER AMT. K. W. AMi. K W AMT. K.W T. K.W AMi. N P
35 59 43 35
DRYERS MENACE MOTORS WTURE APPLIANCE FEEDERS SPECIAL MC-PT TIME CLOCKS FELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
AMT. K. W. Oll H. P. GAS H. P. AMT. NO. A. W.G. AMT. NAP. T. AMPS. TRANS. AMT H. P. NO. ~ FEET AMT. WATTS
1 F 2 - 1
SERVKM DISCONNECT NO.OF S E R V 1 C E
AMT. AMP. TYPE 1 / TW t / S\V S / TV 3 / AW No. OPEMI COND. OF CC. cow NO. OF HI-LEG OF HI-LEG NO. OF NEUTRALS OF ryFUTGf1Al
1 200 CB 1 R 1 2/0 1 2/0
OTHER ~ATUS:
FEEDERS-2
HOTORSt4-F H.P.
G.F.C.It-9
SHOKE DETECTORI-2
FRW ELECTRICAL LIC.=4405-6
SERVICES, INC.
P. O. BOX 1154 GMOMAS MANAGER
RommNicONA, NY, 11779 11 /
Per
p'
This ceMi - muH not be aDered in any monner; 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.
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST pq' ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS:
ww
44
I~;?~aa~ p- G~
DATE ~0 INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ I ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS: uYo u~ '3:) p /k:; 7^a oe3
DATE IN8PECT0e ~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FO DATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS: VC,
DATE INSPECTOR
76S-1102
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] RO H PLBG.
[ ] FOUNDATION 2ND INSULATION
[ ] FRAMING [ ] FINAL
REMARKS:
z2A
DATE e3h~ INSPEO'TO
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[/FRAMING [ ] FINAL
,REMARKS: GL/
Ok ~,c
DATE INSPECTO
lrL°y l
.i
f~ BOARD O Y&AYTH
FORM N0.1 3 SETS OF ~itdS . .
.
.
TOWN OF SOUTHOLD SURVEY . .
MAY Z 6 9K BUILDING DEPARTMENT CHECK ll.y 4 - - f. .
TOWN HALL SErTIC FORM _
SOUTHOLD, N.Y. 11971
BLDG. DE TEL.: 765-1802 NDTIFY
-1-V_11 F g OLD
CALL
Examined I 199 MAIL TO:
Approved , 10yPerrnit No. .O?.SK 3` .
Disapproved a/c
(Building ~ector)
APPLICATION FOR BUILDING PERMIT C
Date 19 qy
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-
c ition.
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
shdll 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 regulations, and to
admit authorized inspectors on premises and in building for necessary inspect.ions dI'
...rSC/~ v
(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.
CDJvk\:?K <.0?1,~............I...........................................
Name of owner of premises ..~/ut?ZD.D.nr~a~ ¢SSrg~latPS
,(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 .
Plumber's License No. p~. .
Electrician's License No. ..b t' /1~
Other Trade's License No .
1. Location of land on which proposed work will be done .
.........................Eau~~u.~~.y..~T
House Number Street Hamlet
County Tax Map No. 1000 Section OV- PP Block -47-300 Lot ..0. 3'.l y
Subdivision 0-m- rl- a)49 'F` SOk4O1~ p~ 2c~
D4 Filed Map No. Q Lot
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .
b. Intended use and occupancy S! h~ LP 1~ Ke S i afr e
t
3. Nature of work check which applicable): New Building Addition ....:'¢..4i . atib'n
.
Repair , bval . Demolition ..............Other Work
(j (Description)
4. Estimated Cost Fee........... I
(to be paid onif)ji%1his application)
5. If dwelling, number of dwelling units 1. .
Number of dwelling units on eaCfi Boot
If garage, number of cars , . ~L .
6. If business, commercial or mixed occupancy, specify nature and extent of ea h type of use V .
7. Dii mensions of existing structures, if any: Front Rear Depth ...'~A , .
Height ...............Nu berofStories........................................................
Dimensions of same structure with alterations or additions: Front Rear
Depth Height . . . Number of Stories
r2 2 /
8 Dimensions of entire new c Nutruction: Front ....Co. ~ Rear ...~n. Depth
Height .2 .
per of Stories .
9. Size of lot: Front . , J3 Rear .....~H7`27 Depth .
10. Date of Purchase Name of Forrpgr Owner
11. Zone or use district in which premises are situated ~ . .
12. Does proposed construction violate any zoning law, ordinance or regulation: 6
13. Will lot be regraded . 4 -*A Will excess fill be reprgved from premises: Yes
14. Name of Owner of premises ..°~`ttNddresAdl T" t' LyW... Phone No.73)."YY3.3
Name of Architect Address Phone No....... .
Name of Contractor k, , , , , , , , , , Address Phone No.- A5.-:
.
15. Is this property within 300 feet of a tidal wetland? es........ No..y_1
*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.
a4 ?"Po" S"Alt"I
STATE OF NEW YORK, $.S
COUNTY F. ~
(Name ofTTindividu ' ' ' ' ' • • • • being duly sworn, deposes and says that he is the applicant
contract)
above named.
He is the O441rxer~
(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.
Sworn to before me this
467.,: .....day o 119.9y
Notary PublZ~ X50, ...County
HELENE D. HORN
* Now York
No ary Public, State of E
No.4951364,
Qualified in Suffolk Bounty ,,,;;~,5- (Signature of applicant)
Commission Expires May122, A
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SURVEY NO 89-070
5e~ m/o Ch mlo Chardonnay Woods @ Southold
Filed 5, Filed September 28, 1989 as Map No. 8822
10T M \ N. 69.46'29" E.
1947'
PARCEL ZONED for rs AREA OF PLOT Z ZONED -E' RESIDENCE OF PLOT ^i S. F,
PROP, 15t FLOOR 15t FLOOR / 35P S, F,
2nd FLOOR iaoo S. F,
SAACE 4 27 ~Oa1~ PROP, BASEMEN T SASEMENT in So S,F,
OPEN \ PROP. GARAGE GARAGE Gno S, F,
NED DATUM,
30•• E ASSUMED DATUM,
o fj0 THERE ARE NO 'E ARE NO SURFACE WATERS 7N 300 FEET OF THIS PARCEL,
N ~0 WITHIN 300 FEE.
OO THERE ARE NO N E ARE NO WELLS WITHIN 100
C ~O FEET OF THIS P, OF THIS PARCEL,
4 A0 S. y o ~ ~N
Y AREA = 40.001 S of 40,001 S.F. or 0.918 ARCES
Fy t yz s y C). Uc"'etreranan o' r e s a ~n S"urveyor's So Seal rs a of violabon 5 ,it alteare, or addition to a survey map bearing a Palessonal Land Seal s avia/abort olSecnan 1209, Sub-S ecuoo $ o/the New York State
qG.d Ly*a~p aLt Etlucabon Lew D
X93¢ Geamnrapsarcerbhemmiet"drn e c efio existing oCoing "Code0a ohrereoPracctice" oce'Polyi thaf Land d Surveep ys adopted Surr ptped by by the
v V ccordence with the existing "C. with h the Me fb State Association of PrOlessronal Lend Surveyors" i-artlguannter, is
° p?a 0 aN we fee ,,mollm,mclymthe both m the 1111A company, goI he b0er amnlym [M1overearnirl a,a th y e ndlendngansed,eadon his
V ° C hereon end the assignees of theI S gg. tl j \ not rrenslerah/e to additions/ m, the assignees of the lending institution Gue amiss or cert ficatons are 'able to additional institution or subsequent owners
QC~ wu Copies from the"ORIGINAL" of to ,the"ORIGINAL'otth,ssurveym7, fmarkedwilhen"ORIGINAL"at
LOT/! V~~v afabeead Suva er sopRED INK£O' rve,or's"REOINK£O"seelar'EMBOSSED" seelshellnotbecansldered d true cop,
10- 83.5 R= 50.00' W' S 5 00'A"' E.
p. saw,
~~'9 • / 132 -
c
%.FbP Wila Loc s.a v ro vs aoc ewe oprze/9i
C uc COUNTY TAX MAP NO.: /000 - IAP NO.: /000 - 051,00 - 0300 - 003014
dT0' CERTIFIED TO
` R
NAME L JNIY DEPT. OF HEALTH SERVICES SURI SURVEY OF LAND AT.
ADDRESS O O ROVAL OF CONSTRUCTION ONLY NORTH VI H, S. REF, MT' A14- ORTH SOUTHOLD
CITY PHONE < ) m SG TOWN OF
THE WATER SUPPLY AND SEWAGE DISPOSAL n SUFFOLK COUNTY SOUTHOLD
SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS AND SPECIFICATIONS OF OUNTY NEW YORK
YR SUFFOK COLINTY DEPARTMENT OF HEALTH CMABL/S PATH l hereby camry mar the. m+p we me de Edward u,,Smr k, A. Bullock, Jr. BY' E. A.S.
2 boom .n ectuel surveycompleted ey me on pmtessianel Lend nd SUrveynr&En SERVICES a7-.lam-fi and SurveMr & Engineer DRAWN: /.P.S. 02114189
w IfNtAiwr UEt * wt,' kffrm S1e7m SCALE: 1" - AO'
APPLICANT'S SIGNATURE G c~we"`Q 1 Art Affrm stamv N YS. PL.S No. 49214 NY //TIN y 11776 FILE NO.:
N.Y.S. PE No. 63675 576-47J-$1.8 6...70-$,~,p /000 - 5/ - 3 - 3/4
' NASSAU SUFFOLK OLUEPFINTINO
ROBERT HIGGINS ARCHITECT
G John Street
Shoreham, NY 11786
516 821-9847
1. These drawings have been prepared by the architect end to the best
of his knowledge, inFormation and belieF, meet the requirements of
the New York State Energy Conservation Construction Code,
2. The data provided below is solely based upon " Part 6 - Building
Design by Thermal Rating Method" as outlined in the New York state
Energy Conservation Construction Code dated 1 March, 1991.
3. Design Data;
Heating Degree Days 5000
4. Envelope Components;
Value of Net Component
U component S.F, Thermal Ratings
ROOF/CEILING , 0 357 -5 75 SKYLIGHT GLAZING
NET WALLS d52, 2l01~~
GLAZING J L. 3 Z z• rj
- 23
DOORS tea 7 70
FLOOR p Lt lj 12 5,j Q
FOUNDATION WALLS
SLAB INSULATION
TOTAL THERMAL RATING
OF BUILDING 2~Q' ) 0
d7 ...I WT ayQ':
SAP. M~~L ' If ~if F k,
L ~ 0 `y4~ dpi
r I " c+
- -
uA~
f= TYp
12 ~I x;11
-
IIA
IFaR[ -
~J
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I I, ~ , I I~ I f
I kl`Nj{
a ~ j
I
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I F-+
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f - fi J
i-' T ,
_
I I
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r7l
i
i 7 211, o" 2 ry', $ d ' ~1 X11 ~ f
Y° WZ 2 ~ ~A{e
c'I CO rl iii 11 II IGN Eg~
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0 = T-/P, FT- I ~r
y ,-1\ , i I - I yP nom/ N J-- i 2b M7 il71i M' y
e p rr nle p rr 16
q
" , ~ - 2, x I o P, ~ f (off °fL U GCSA~G. : ~qI
T { 5 s - _
v_ Ier-e- RATeo C3 0 p
1. ( ~ F CrHFEK _L1,dbL5
x u'
r~ iv:t'~o rcn:- " C:oNV, c~6.faw5 v r' N
ac if eopW tubing is used PLUMBER CE Imt.,rn~ ~ti n PLUIllmolle
''a MLp11 Y111~01 for water distributing ON LEAD CO O C . CCUUPANC PANC rY -I rte JS-r - M I
''h", " rYtg611M IUD system; piping shall be CERTIFICATE OF Y ~ -GIs r ~
7Bg1M10b10111COVER" oftwiffloo SOLDERUSEDI R y~+ a{
SUPPLY SYSTEM C CANNANNOT I, of _ C 'f'a F-rt~ y u _j
EXCEED 2110 OF 1% LEAD.
3 3 vtg"1fri s"OCCUPANCY OR z~ r
iCY OR
USE IS UNLAWFUL .AWFUL I ~ ~"7
ITHOUT CERTIFICATE 2TIFICATE A I 1';od ~1 p• : N p f
OF OCCUPANCY Lit ?ANCY - i/Yl-br ' I
mld - , Y 1
(L 11 X11 211, f 21 2" ~2., 1 2,1 A oR ED AS NOTEdD
- - - I t
BY: f FE
t 4v _ -ru& sA W P1_ I . . _ rum c .1,AV !IC tI ES ,L 1G DEPART F77 AT L' J 10 F,J, fall __2x 10-F..-l~ -214
f n- If3tY1 , AM TO 4 I'M FOR THE
it - - __.4 I %2n I n'J LoWSNfi INSPECTIONS!
1. FOUNDATION nNO REQUIRED IA 3.1 - FRAIL7NCRETE
-ty 1L n FOR POURED ROUGH 2u
3 ? FPANIING & PLUMBtNG 4 RNA INSULATION
_ Fi~d:;1. CONSTRUCTION MUST' t1 RE COMPLETE FOR CA. II ~i I ~ ~e ty~
ALL CONSTRUCTION SHALL MEET II I 11 jYj Y ~ih,wl ~rI 3
WG THE REQUIREMENTS OF THE N.Y. T I o-~2xco crr ~p P PVT
STATE CONSTRUCTION & ENERGY PI?aN "To OG~1~2. ~ ~ ~ ,
CODES. NOT RESPONSIBLE FOR w. zw plc z„1 przoP Taw actin, yP
DESGGN OR CONSTRUCTION ERRORS )a 24 Oti!' 24"x 29"K /2" = 5 ~ r-laas Y~E s, Y~EG a Fn rc VGnY2S. '1' i
-V - URDER KM YGAMWATE REQUIRED 75r~cat. f .2 t x f io ccq f - - -
_ _ X111.
411 O v
e : - 4n
x + 7 i.h
H _ 3tl~~~~pS HIG~TF~A ya ru W:y c ,;4g ~ s
ca, 2 o 41', Z
4-~Z) e r~r~i~+a,a.1
' n Oy 1 o r ~ i f I
~ 'T G!H'~ r^{~~
p ~ DO NOT PROCEED u9 i T,-,I h p e m 1 rj &
~ UNnLad SURVEY OF a
FOUNDATION LOCATION HAS BEEN APPROVED
I
a[, 99
s ~..~..m I er4u i x~'r_•u i~....~1~ .~..~V' ~~,i.ild iY~ ~i.( ' ~
it
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1. 44i w0grk shall' conform to New ~YOak 5tjtan Local, 0cunty TI - - - - laill ip '41114 tgniog Codes A41 much Codes shall duper- a~ r1
I i{ the_dbi'Yi,flllt cdl - - - - - .i~ -12),'h0'r~_cl'.2"1?l~ 3a'rx92'I al-I "G21.310" _r_ 422 rr
'•2,-:1VCiktbiiiminai~Pae •aati fiavr ryri}cadaque Ol"i'scs1a7-: `InFRes d _ Ang4+ahala A9f!k-'Rr#iiiti#de. over ti.
arekr i iad~{ft; ' a. ' All _1' - - - a
R,,. grgda . 00 wing Ar aaa elulll ae Vcrilixd bN of t ' - -
the; ~pt1 *W %g twdaatupt en AA+t dmiL&igR6 the or at y Ao Cii~e'a Ca tr oa i%ign• rriau drawl `1 - O] Ll1( oN i Sl
nae pmaam 4 J : AWCi} a 4({ ' #r}e Im fore by th !111 - -
44Y 0 a4edidy"dX'ml ' '~^ARTibgqpp0.,- 1. 'bdati"a a tar ~M^•raT? made in .'Aix in - 7,p_r,7~)
L'1gtElldf' Orr lit
SbCRm. FOdb X Y 1^ FlrepSii l 1!- - _ - - GLG. f. / f3 TN
aSJpAOeaa''ya~~+ ~11a +Fiun - - . Prov - .YpgeSdkWfd'o s} ibiiity 0 ilrN
Sslliry I {lbt All vl
a fir At ' isetWr itlz t construgeton All inabi ead
iigea+ ieyuMA~{,fr.Cx f!cod`rdur#0 'oz "scare sha~-- + .;tot wt~tpz.)iaaf,!•ip6l"d'epd'gC{igraa!a man caahatr ttA with the -
t Zia reeybm i,1 Kok 7YkS;+ ataatars - All buildii ' -
-".fai'Y' a'%i4 Faa}y! pwpo,tfti• xrrt 'fle a, aC1r.-.q_k4a protegbeI a - - _ ~ - ''$oaat a lipkaYltllQa. Y'!tie Arghit 0 1 ktdt be of the insu, - Lo ptl qll sv" d- b' Sr. PlIr D /
iaep0lfi bla ode Oho tone er anivadond o do4ractoror 4ias'r perrotl "Oto Ells vark Insulation 0,,
7 ;At togtintm 1A "aY oxP wigginr 4 ad1,i with continuity o M1 F 1/k~ fY~ t'z121ZF 1 ~ II M 1/piz f l ` n D119
%fiai'ni4o Capa'tY of .A, %0iytK4' 4 YLggt Joists apd:e - - ,gi'~pp fir, 1ga d+i.'i~#lyb- nA}ayA -
'9a 'Ai} Cd Cai ~yTj` ma aVi a+i u l6at$~Caa4+ H aar*not Floors cede-u _ . , 2 x 8 c J 1 r> ° °i~ Iza I L• I F Jta ~ Na-rc.H V N
2; all 11Mi4r Hin In¢uiata dul. by tfie Energy beer - LC.,e>9pwx~i+'1,bitol - r ''Al"ew. - y 4~
add,p¦n'as~ghddwallaAtt7:1 ' fizFS yt AC1F-{rrf}i'aR #^,ia7 pmaca All Dom.. tic hot rater setting at 140 Y Max.
11.1- fit; gFFa R,a qW 1YSOi m Pboka 0tiWits pad. To be 'tilled ' ablid wi'Sb'C[fACaata - c .
i2: "tiaaA KY~`jainbs W"kw:ce}Iottrbr abgN wogA fFpminR• 21. Architect, bat net lwen. reEalPed-for Site, const cucc.orn x N 1Z. x8 ILGI-2.'f +wa Gde N
13., i•ilsa dp'1#tl_4~aty Mitdt hedge afiA p9pWiFfO >ro#p, hglee,„Max. 5upgivie3pn, or fol' inspections. ~'i '/.we coi~ *-*`_t" ra4}er--,, 0,0 excel' igtc JAhgb6914 il brick 22. These Sete of plank, contain all the necessary information ~ J 10 q9°roL 9e^~4"°
*ir^*^ t O PC ay9 Rfiird row. to vbtiala a huilding permit. ALL OTHER WORK and information le.;blaah IC#u4k ins ad~~'3 fa il'fygi'kiMt?ja i ' iiyia.Ia~Mrlae rF,.'1rIhI*Ung including vpecificiltions and materials are the responsibility ul 0 1 1
,t
briauble able frame tuba 1. ro1pafiaf;a aIh, n ,;ai}h -nigal larghYng, of the Owner, and unAa; ba er, hot t ttbisr m a openigs,., hndaz .ddrallel..psrtitio is 1 ' t~
16:: Joist bdngarr required, at ail hush structural load" i
'hearing bond atone ^TERg or ,agdayy 17, All iueber lptall ba.Ei tie fbi 5o singleembe;, gj m _ _ 4.2x8 i a~ 0 0 _
- the S4sp;gppe%i!!W manse 9f,l.7, 10. ill baamr,rpd. pird#rr~ihail bave.,4'1"bearing minimum. - N S u r
19. Minima-aeiidana"Cydr 4011 And %iIdowdl'2-2x12., - - 12 nl r a
20. pzovidq aq le at one Vihddi each apace.,exeept kitchen. sad' Baths thrt conform to the N. T4. egress- hods. dp¢nable' ri I~)I 9° ~dn:1 qp 2~ 11 41 4 ov 141,411
wlndoVi t,P' bfiVS-!G+}i pg: Vt. ' man. area, with 1'e" minimum
diaurrion,,,Vikh bongs of gi}¢Tind'Fo higher than 3 feet 6 dnei above ~tinish floor. in all abpvigrade stories, and cQ ~ 9 ~ (71 M Q
Ae'bigheo'_ tapn-4 Idiot"6;lncbea where regyirgd in basements.
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