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HomeMy WebLinkAbout22354-z L FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24410 Date JUNE 10, 1996 THIS CERTIFIES that the building ADDITIONS 2330 ANCHOR LANE & Location of Property 800 BRIGANTINE DRIVE SOUTHOLD NY House No. Street Hamlet County Tax Map No. 1000 Section 79 Block 4 Lot 33 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 8, 1994 pursuant to which Building Permit No. 22354-Z dated SEPTEMBER 26, 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 AN ADDITION AND DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MICHAEL & MIRIAM LASTORIA (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO.. N372734 12/12/95 & N341889 02/07/95 PLUMBERS CERTIFICATION DATED N/A Building Inspec r Rev. 1/81 F FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24411 Date JUNE 10, 1996 THIS CERTIFIES that the building ACCESSORY 2330 ANCHOR LANE & Location of Property 800 BRIGANTINE DRIVE SOUTHOLD NY House No. Street Hamlet County Tax Map No. 1000 Section 79 Block 4 Lot 33 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 8, 1994 pursuant to which Building Permit No. 22354-Z dated SEPTEMBER 26, 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 NON HABITABLE ACCESSORY GARAGE AS APPLIED FOR. The certificate is issued to MICHAEL & MIRIAM LASTORIA (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N362377 SEPTEMBER 11, 1995 PLUMBERS CERTIFICATION DATED N/A 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) NO 22354 Z Date.. . 19.9 Permission Is hereby ,ratite,. to; o w+ 0.../ ~cSs.... , to4leo.r..1,44 +W. . A . ..4! 1414 . at premises located at..... ~P 3..~..r,.) .G. /a"e4e I...... aZL''~~ County Tax Map No. 1000 Section ~.......p/2......... Block y.5/ Lot No. pursuant to application dated ......."/./~L 19?~~.., and approved by the Building Inspector. Fee $....,x~ w T n ~ k: ..4ns a,7 uiditor Rev. 6/30/80 a c:~s Form No. 6 s TOWN OF SOUTHOLD D BUILDING DEPARTMENT U TOWN HALL 0 jyP 765-1802 3),3 3 SH BLDG. DEPT. TOWN OF SOU4p1,A ION 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 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. 0, Accessory ui ding $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 $155-.00, Commercial $15.00 db ~D tti8',t sc3 Date ...~.../.I .'-6...! . t.rB New Construction Old Or Pre-existing Building. /{tnGGar ASV!: Location of Property... 2,1 3 d La- House No. Street Hamlet Onwer or Owners of Property.... 9 lc•ia.e-1. w 1 1 t Htam, ! ~ 3 ~ • County Tax Map No 1000, Section Block Lot...................... Subdivision. .A O. °'.A ................Filed Map............ Lot...................... Permit No..Z:27.!.1. 7'..Date Of Permit..../.z 61~ ...Applicant.. 9... •s Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate..~...... Fee Submitted: 1 W-. ~~1 II (l ~ APPLICANT Form No. 6 R F SOUTHOLD „ L5 y U G DEPARTMENT WN HALL MAY 2 1 ggg 5-1802 L CERTIFICATE OF OCCUPANCY TOWN OF SOUTHOLD 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. 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 u.«- r ` 9 / Date New Construction...!:...... Old Or Pre-existing Building Location of Property.... 7.130 ............A h~~ . a ..............~2~........... House No. Street Hamlet Onwer or Owners of Property. .?S% County Tax Map No 1000, Section Block Lot...................... Subdivision........ LY.................... Filed Map............ Lot...................... Permit No.2j ......~~....Date Of Permit. V~ ......Applicant. ....1. Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate.." q, S; Fee Submitted: z 5(3 LoU APPLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE! r1000121 BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK. NEW YORK 10038 Date aT"PTFk4RER 11,'1.935 Application No. on file 8Sd11)2t?9513"5 N 362. X77 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 d- 2330 AYlchgl L_a MICRUT, MATORIA,"RDBRTGANTIMP ROAD, SOUTHOLD, ` in thefollowing location; ® Basement ? Ist FL ? 2nd Fl. GAR/OUT Seetion Block Lot was examined on AUGUS'T' 28,1995 and found to 'n co ce with the National Electrical Code. FIXTURE ECEPTAClES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER MIT K. W. AMT. K.W PMT. K.W AMT K W MIT. H P 12 5 9 1'L T E' DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECTT TIME CLOCKS EEL[ UNIT HEATERS MUSYSTEMSLTI.OUTLET DIMMERS AMT. K. W. OIL H. P. GAS H. P AMT NO. A W G AMT AMP. MIT. AMPS TRANS, AMT H. P. NO. OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E R V I C E METER NO OF CC COND A W G. A W G A. W G. AMT. AMP. TYPE QUIP 1 q ]W 1 a 3W 9 d 3W 9,e 4W PER A' OF CC. COND. NO OF HI LEG OF HI. NO OF NEWRAIS OF W 0, LEG NEUTRAL OTHER APPARATUS: PAUL, R. BURNS LTC.#3897_N FaO.HOX 1061 OUTHOLD, NY, 1.1971-0932 GENERAL MANAGER 11 Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST IWT BE ALTERED IN ANY MANNER. THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1000121 BUREAU OF ELECTRICITY 83 JOHN STREET. NEW YORK. NEW YORK 10038 Date AUGUST 31,1995 Application No. on file 88102895/95 N 362377 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 4-M7WL)H MICHAEL LESTORIA, BRUGANTINE DRIVE, SOUTHOLD, N.Y. in tkefollowinq location; ® Basement ? Ixt Fl. ? Ynd Fl. GAR/OUT Section Black Lot was examined on AUGUST 28,1995 and fount to be in compliance HWth the National Electrical Code. FIXTURE ECEPTACL6 SWITCHES FIXTURES RANGES COOKING DICKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K. W. AMT. K. W. AMT. K.W. MIT. K. W. AMT. N. P. 12 5 9 12 1 F DRYERS FURNACE MOTORS FUTURE APPLIANCE RICERS SPECIAL RWPT TIME CLOCKS east UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K. W. OL H. P. GA5 H. P. Mr. NO. A. W. G. AMT. AMP. AMT. AMPS. TRANS. AMT. N. P. SYSTEMS AMT. WATTS NO. OF FEET SERVICS DISCONNECT NO. OF S E R V I C E AMT. AMP. TIPS MROWP. 1 ,am 1 X 3w 3 / TV 3 r ~W NO.Oi CC D. A. W. O. NO. OF HI-LEG A' W. G. NO. OF NEUTRALS A. W. G. PER 1 OF CC. C D. OF NI-LEG OF NEUTML OTHER APPARATUS: G. F.C.It-1 PAUL R. BURNS LIC.#3897-E P.O.BOX 1061 SOUTHOLD, NY, 11971-0932 GENERAL MANAGER 11 Per This certificate most 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. Olt FDIt Gym co 2 Town Hall, 53095 Main Road p O Fax (516) 765-1823 P. O. Box 1179 y 0~ Telephone (516) 765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD February 13, 1996 Mr. Daniel Fischer 38785 Main Road Orient, NY 11957 Re: Michael Lastoria - SCTM#1000-79-4-33 Prem: 2330 Anchor Lane, Southold To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xx Application's for Certificate of Occupancies are not on file. (Enclosed) No Underwriters Certificate on file. xx The check's are not on file. $25.00 each. No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 22354-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. _ -If7 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAVE 1 r10001.21 BUREAU OF ELECTRICITY 83 JOHN STREET, NEW YORK, NEW YORK 10038 Date I?FIC writ 17 , iggs Application No. on file 207812495/95 N 372734 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 MICHAE1, LASTORS111, BRIGENTINE DRIVE, :SOITHOLD, N.Y. in thefottowinR hrcotion; ? Basement PX 1st Fl. ? 2nd Fl. Sertion Block Lot was examined on UE -F."I' BER 07 , 1.995 and found to be in compliance with the National Electrical Code. FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W AMT. K.W AMT. KW. MT. K.W AMT. H.P 9 11 3 6 9 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECPT TIME CLOCKS BELL UNIT HEATERS MULTI.-OUTLET DIMMERS AMT N. W. Oll H. R GAS H. P. AMT. NO A. W. G AMT. AMP. AMT. AMPS TRANS. AMT. H F- NO. SYSTE OFMFESET AMT. WATTS SERVICE DISCONNECT NO.OF 5 E R V I C E METER NO OF CC. CONE A. W. G. A W. G. A W. G. AMT. AMP. TYPE EQUIP. 1,P TW 1,e 3W 3.e3W 3,e AW PERe OF CC. COND. NO.OF HbLEfi Of HI-LEG NO. OF NEUTRALS OF NEUTRAL OTHER APPARATUS: PADDLE FAN,;i- 2 1`10TORS;2...F 11. P. PAUL, R. BURNS LIC:. #31397-E P.0,B0X 1061 SOUTH01,D, NY, 11.971°0932 GENERAL MANAGER 11. Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. r THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGN 1 10001.21 BUREAU OF ELECTRICITY F 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date PFBRUARY 07,1995 Application No. on file 06878995/95 N 341 389 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 MICHAEL INSTORCA, 2.330 ANCHOR LANE, SOUTHOLD, N,Y. in the following location • Basement I lat FL ? 2nd Fl. ATTIC /OUT ? sement L"S Section Black Lot was examined on EE~BRUARY 02 ,1995 mad found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES INCANDESCENT FIVORESCENT OTHER T. K W. PMT W. AMT. K W. AMi. K. W. AMT. M. P 10 7 9 01 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS S?ECIAI REC'PT TIME CLOCKS SELL UNIT HEATERS Ml! TI.OUTLET DIMMERS TRANS. AMT H P SYSTEMS AMi WATTS WT K. W. Oft H. P. GAS H. P. AMT NO A W.0 AMT. AMP. AMi. AMPS, H6• WFEET SERVICE DISCONNECT NO. OF S E R V i C E AMT. AMP. TYPE METER 10 ]W L % DW 3V! 3p. AM, NO, OF CC COND. A. W G. NO. OF NIAEG A. W. G. NO. OF NEUTRALS A. W 0. EQUIP. PER O OF CG COND. OF HI L OF NEUTRAL OTHER APPARATUS: MOTORS t 2--F H. P . G,F.C.It--2 PAUL R. BURNS LXC.#389749 y P.0.80X 1061, SOU'THOLD, NY, 11971-0932 GENERAL' MANAGER 11 Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified" by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. M-1802 BUILDING DEPT. 1 NSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INS ATION [ ] FRAMING [ INAL [ ] FIREPLACE & HIMNEY > REMARKS: !G°~ /17oz Z) DA INSPECTO ell 7 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] R GH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL [ ] FIREP"-A E & CHIMNEY REMARKS: w DATE B Y INSPECTO M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. F DATION 2ND [ ] INSULATION [ FRAMING Q Q [ ] FINAL REMARKS: DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ) ROUGH PLBG. [ ) FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS:d~f i DATE INSPECTO M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ )ROUGH PLBG. [ FO 2ND [ ]INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACES CHIMNEY REMARKS:_ d~c C C.O r DATE I~ INSPECTOR 'Y"-1802 BUILDING DEPT. INSPECTION [ ]FOUND ION 1ST [ ]ROUGH PLBG. [ ] FO DATION 2ND [ ] INSULATION [ RAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: / - DATE INSPECTOR M-1802 BUILDING DEPT. 1 SPECTION [ J F NDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ J INSULATION [ J FRAMING [ J FINAL REMARKS: t DATE / I i 765-1802 UILDING DE C' IN ECTIC [ ] FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOU TION 2ND [ ] INSULATION RAMING [ ] FINAL REMARKS: DATE INSPECTOR aM-1802 B ILDING DEPT. INSPECTION [FOUNDATION 1ST [ ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARK T l~ 60 DATE G~ INSPECTO 1ELD OOMMEN FOUNDATION (1~ FOUNDATION nd) 2. Imcl) z~ - o ROUGH FRAME & 'PLUMBING* / o ~ ~ C l 3. my INSULATION PER N. Y. STATE ENERGY CODE 4. ~ r !GL ©r c°Z~P FCC/ d7.fE.e°N FINAL f d~~ y ADDITIONAL COMMENTS: now s r VgZg 5e,zvo 't1 X H 6x~,. m , H m ^v • y ! I i I I .~1 o 4n as ~rrv4 i~ Mir ° I r y~ r fill ONO !@ e 8 ;roi r~.a t i, n -9 I alo m Fn J J' neJa ca \ f;. ( 1 ( f { r t ~j I ! 1 I ~I ICU i if } 1 I I I' ~i I i , I I I I ~ I q's { { j m I I ~ ~ I , ~ diN ~ i 1 I ~ ~ ~ o. o ^ °o Id I , Y I~ I~ i I i lr I , i I I I I LA 1 ] Fl~ =;aaCs~',: I - - rIA ~.r J y ~ op J Y o ~ ~ b Ih lI i ~ LT- i i I ' IN . I {I ~ ~ I i 1 I Y~li ~~"f ~ f~"'! 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LLB jC. racPa pfd tC r' i `'~1i?' , - - :j ,y' MfC7f~IG1S ~ J ilk :3Aft14 fit 4 7-1 ui:3n~~i' `Ft'~SY 1 7y+r-+.'t i ~l emu' 0'.x'3 Yl~o a$" oli= T!jt'1; e g y N' c N z CIx..E 6 rrt / :1R? -q 11 • p Mc r1Y'Q11 ,Y~ e~l,G~S •d 6' (pa~i`~,' +'1 ~!''P~... ,.x- rtr,.'y}H t: i 1,. lexa J// r t; ga Y-Yi nY.~ .g•y W.l r, Ir. !•H t:. ''~.a~ . . _ ~ ' e~ ~Z r"; rn• ne~0 .',~nZ .Q' ,r• ..i' •!r~1 n 1"' 'i.' 1~ 1•'S o•'^~yF ~QR' ,=,i ~ T .,FV .ta, .,r '~''F ;k,• '_l. , E~.. BOARD OF HEALTH FORM NO.1 3 SETS OF PLANS TOWN OFSOUTHOLD SURVEY SEP $ BUILDING DEPARTMENT CHECK TOWN HALL SEPTIC r•oarl SOUTHOLD, N.Y. 11971 A41 TEL.: 765-1802 t:oTIFY's ~a3-~~4 GG~~~~ C CALL Examined . P........ , 19!. "F~'L* To Approved 19f.ermit No.. Disapproved a/c (B ldi nspector) APPLICATION FOR BUILDING PERMIT f p// ' Date 19. / 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 c de, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspectio (Signature of applicant, or name, if a corporation) ~"~8S~9c2irr / 6to( Di-/enf /yy ll ft7.. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (~~n r2~ Car/fra~ aY..................................................................... Name of owner of premises ~~~rla... . . .S.~.d/. . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corpora'tte officer) Builder's License No. .9`~ Plumber's License No. ..2~~. Electrician's License No. Other Trade's License No . 1. Location of land on which proposed work will be done . House Number /Street Hamlet ~j County Tax Map No. 1000 Section 7.9.`.......... Block . J/ Lot : Subdivision Filed Map No. Lot .,!5/ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy i IC /e J A' " esi e /A'e . b. Intended use and occupancy r~!?~ 3. Repair Re air . of . . . . . work (check which ch applicable): New Building Addition Alteration . ,loval Demolition Oth rk /frfeht~ tx?etisiey, and open dee-k /Z x// d rf escription). 4. Estimated Cost . Fee . (to be paid on filing this application) If garage, number of cars g units Number of dwelling units on each floor S. If dwelling, number o ial or e min . 6. If business commercial xed occupancy, specifypre and extent of each type of use . 7. Dimensions of existing structures, if any: Front . . . . . Rear 4 Depth `J~~....... . Height /16 Number of Stories . Dimensions of same structure with alterations qr additions: Front uhchary?~l , , , , , Rear ! 'OA, , , , Depth " `P . , , . , , , Height , , , , Number of Stories 22.......... t sion Height of ientire new construction: 9. Size of lot: Front ,f ~Y: on: Front Rear . .......Depth lp of Stories . ~ . . . . l a/~~,v,~~ ,/si c•Gr~i/~r p~,en .~e.f~C............ . Rear Dept 10. Date of Purchase . 4 1K?...... . , . , Name of Former Owner 11. Zone or premises are situated . . 12. Does proposed construction violate any zoning law, ordinance or regulation: 4.0 13. Will lot besregraded i which Will excess fill be removed from premises: Yes No ~3~oR/B Address . 4r~cr»irJGD Phone No. 71 r 6a1.... . 14. Name Name of of Owner Architect of premises t~ Address phone No....... Name of Contractor krscyGrz Address~97B5ilain piirvht phone: 15. Is this property within 300 feet of a tidal wetland? *Yes........ No..„ *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all !buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block h! umber or description according to deed, and show street names and indicate whether interior or corner lot. 11.2leatre Jee X i ie-e j"e , ~L%C.G~GGG ~y I I I STATE OF NEW YORK, S. IS COUNTY OF 1) hr r c L - Y I B e ?f Eri , , , , , being duly sworn, deposes and says that he is the applicant (Name of individual si nin~ contract) above named. He is the C G r ~p G4 C Y; t? . (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 U.. .........day of. . I 19 Notary Public, I County r LINDA.). COOPER Notary Public, State of New York (Signature of applicant) No. 4822563, Suffolk County r G Term Expires December 31. (7 OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY Now ePPV NOTED~3DATE : P. N T FPAR T AE - - UUU %65 1802 9 AM TO 4 FOLLOWING INSPECTIONS: 7. FOUNDATION - • TWO REQUIRED - ~fl FOR.POURED CONCRETE # t 1 2- ROUGH - FRAMING & PLUMBING " 3. INSULATION ar` PROVIDE OPENINGS FOR IPERINGS FOR 4. FINAL - CONSTRUCTION MUST RE COMPLETE FOR C.O. EMERGENCY ESCAPE AS CY ESCAPEAS ALL CONSTRUCTION SHALL MEET !Y PART. 714 OF THE REQUIREMENTS OF THE N Y. _ REQUIRED BY PART:7140 N.T. STATE BUILDING CODI STATE, CONSTRUCTION IN ENERGY WILDING CODE CODES.. NOT RESPONSIpFILE FOR I i, DESIGN- OR CONSTRUCTION ERRORS,' I I~' p. k - S OF NEW y . b•C P~pCE . TG M' ~{I~Ir a y" - ;20 'A . ~ - t - idt- 16,114 ~P > pep r _ ~ r wJ e...~ R n ~~.rs .v n . a~. a.1..Y 1 n .Y-r . c- .l-. .h v. ~ - _ c W i ~ w ~ 7L 4 F Y G Y 1 1 Aye ~1 _ .I 1 p• u" AS 1'1`77" G - is W b Ai 41 s k c~ t1 of ^vL { i I 72 .t Q id C3 Z OF NEW k i w( wl 1~jiY'~w*~~( t sti -NCE r~r 91' I ~ r W + ~G C co, n FT - RpFESSl94dP k ~ v g] L.r~ tr i +a f v PARTII r,ar1~ _ Ft saqf-,~,r EWE11cy ~nuE nEV1R ' (non-electric) ' ' 7014 (1'nrt 5) 6,000 degrao,alnys Pur_ l.~d`~ UVI t Per Uwys_ V f~ Dated S/'F~„7y+,~/~~/ l? Guvelo f.'oniWOnpuC It-Value - kxLerlov Wall R-lll Itoor/celling II-19 Floor I1-19 Eoundnllon Wall II-IC Slab Edge Insulation n-lu Clarl n9 It-1. 7 EnLrance Doors H-2.5 All IIVAC Equtpnm,t Lo uwet toyulremm~Lo of 71114.11 ~t Jam) """•ti-yr All IIVAC ConLt01 Systems LO Meet tequlremenln or 7014.12 I~~F"x~•~~~1~~5_. L tiJ~5~a~~.~fl t~av~r~ All Uuct Syntcins to n,eat requirements of 7014.13 Ir, All VeotllnLLlg Syntelln to Imet requirements of 7014.14 All Plplog lunulation to meet requImnenl.o oC 7014.15 All SerVlee WnLar. Ileatlug Syntenao and Equllxneut Lo meet 'F I requ/l~teimito of 7014.71 All Electrlc oynLemg to met Lequirements of 7014.71 y;` ' 14 To the best of my knowledye, ~ . - - p be119E, and profesalotial V judgement, Lileae plans are In conllliance with the code - - - - 'j ~ p,~EOarlElvy 4 l.. * R F Ex1TkL~G ~ A. P. 6kk Do ^ AR i i r~~FFu9' ; 9Pa' i El D Teco ,q PIZ S a.p, I TO tai .k ~ r l { ~PnL 14 'x'srS'!7t".fir vim i i of NEW ~ ~ Yp _ LA v k t, . ~oft5S1'7=So- ~ - VE - / d - - l ! ! I i ! { { - r - T E ~.nl.«....a.~~•w--.-+. ~ . . - - - - - ~ tirnr,~..wY.w~.- ~ Imo. . 'y RkcaAT iW4 f' 12 ,[~,~ryt ~ i . ~ iw-;..,_