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HomeMy WebLinkAbout21935-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24871 Date JANUARY 29, 1997 THIS CERTIFIES that the building NEW DWELLING Location of Property 1305 LIGHTHOUSE ROAD SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 50 Block 6 Lot 5.9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 4, 1994 pursuant to which Building Permit No. 21935-Z dated MARCH 8, 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 ROOFED FRONT PORCH, ATTACHED TWO CAR GARAGE & RAISED REAR PATIO AS APPLIED FOR. The certificate is issued to JOSEPH & SUZANNE ANDREJACK (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL-93-SO-77-NOV. 13, 1996 ELECTRICAL INSPECTION CERT. #5608 - FEBRUARY 20, 1996 PLUMBERS CERTIFICATION DATED MARCH 11, 1996- PETER SOLLAS ) - le~ i/RoKild,fng 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) N2 21935 Z Date ?/I.I-I............................., 19.... Permission is hereby granted to: ?r~~eD............:.....1 L.gd.l J~T79 L ~?v~J/ to ......sT~z.C, 4............~ ............~w .........J...?~J...?..........~/...t-..........: ~~~......./.7?y....... /!!ly .d ...(....../..wn...r/~~/~- ....................lr. W-~ -4 ...........................................................................rte . 4c~< at premises located at - . zz1v 4~'' 5' kt)7'vLr3 County Tax Map No. 1000 Sectlon ...k , P Block ©.~........Q.... Lot No. 9............. pursuant to application dated wcll........ ~T 19.../. and approved by the Building Inspector. Fee !r~•• .........,f...~.u7 / B iIG ding Inspector U Rev. 6/30/80 0-f I (Ora 1191 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT JAN 2 3 ' • ; TOWN HALL 765-1802 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 17 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, 1.957) non-conforming uses, or buildings and "pre-existing" land uses: I.. 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 Building - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $115y.0p0~, Commercial $$1155.00 Date Q~~~ . ~~7-............ New Construction... ..~.r. Old Or Pre-existin Building.......,............ Location of Property..1,3v5, i ~ qhh hao H^^d y 60a4 K.!`C-~ I House No.f J ] 1 S?rreeelty~ 4 p Hamlet Onwer or. Owners of Property. .l~ 1 h~.1y..!.•.. a.`~w1G l! .~..!.f~~ ~J..... County Tax Map No 1000, Section ...U.C50..j.~... Block.... to....../.....Lot.. P60.15 Subdivision 1U:`rr.Ojdljed Map."1.3-.I.IO. ...Lot..1P./~.57 Permit NA.1.9.~5Z.... Date Of Permit. .3.74.:1q..... Applicant ~?~5~~!7. n or + I ~1(a A «~lY~~cCfc. Health Dept. Approval ....Approval Planning Board Approval Request for: Temporary ]]Certificate........... Final Certicate...~..... Fee Submitted: AU D CA nrrr,r rnrrr Town Hail, 53095 Main Road ? nY Fax (576) 765-1823 P. O. Box 1179 -z Telephone (516) 765-1802 Southold, New York 11971 - ~i 1 •~.-rte, OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE: 3-11-96 Building Permit No. 219352 Owner: Joseph T. and Suzanne Andrejack (please print) Plumber: ac ( lease print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. i gpf; °F F. T',:'%r1 (P1 e s ignature ) Hatay Pafic, Sacs a Nni York No. 47,34354 4p, "Oplan Manfierl in SuuHorac cou 31,719 1 Sworn to before me this rN day of M.4/ae- 1994 Nota~c, ~UL/C County 0000 o000000000000000000000000000000000000000000000 Q (516) 286-6642 ELECTRICAL INSPECTION SERVICE, INC. 0 0 375 DUNTON AVENUE Q ° EAST PATCHOGUE, NEW YORK 11772 ° 0 Date 2-20-96 A 560 _ O p APPLICATION Na. ON FILE p 0 0 ® ADDRESS:-13 05 Liaht HOUSe V ILLAGE_PecgrilC ___TOWN:_ Southold o ° Road ° 0 ISSUED TO: J AndreaCk O O O 0 INTRODUCED BY F.a ct Fled PcFFwer & L1IXht _LIC. NO.-' 4380E p 0 O 0 was examined on_ 2-20-96 and found to be in compliance with the National Electrical Code. O [0 LOCATION XX BASE. XX 1st. XX 2nd -3rd -Attic Pool p p RES. DET. GARAGE HOT TUB O O p 0 FIXTURE RECEPTACLES SWITCHES G. F. C. 1. DIMMERS FANS AIR. COND. 0 O p 0 96 63 74 7 6 6 0 0 DISHWASHER DRYER CLOTHES WASH. GAR. DISP. RANGE OVEN SMK. DET. Q O p 0 1.2 KW 30Amp. 20 Amp. 3#8 - 3 O FURNACE OIL GAS CIR. MOTORS BELL TRAN. SERVICE DISCONNECT 0 ° Meters m s. a e O 0 4-F 1 200 UG o0 0 1-60 Amp. Transfer switch for generator o0 0 1-6-100 Amp. Sub Panel o A.C.- Future O 0 1-20 Amp. Air Handler 1-1-30 Amp. Disconnect President O 0 1-1 HP Motor for well pump 00 This certificate must not be altered in any manner. O Inspectors may be identified by their credentials. O O O ooooeoeoeoeoeoeoeoeoeoeoeoeoeoeoeoeoeoeoeoeoeoeoeoeeo ON U ° COMMENT ° s~•- • a ~ 7OU11DATION (1st) `3C~ c\ FOUNDATION (2nd) 2. o~ ROUGH FRAME ~ Q PLUMBING 3. INSULATION PER N. Y. k In STATE ENERGY CODE !~//S+ ° C.J tom' a 4. C J FINAL eve- 2 L~ 12 ADDITIONAL COMMENTS, m x Jc x NQ~ .~f u O~QgOFF0t/t Gym W Z Town Hall, 53095 Main Road p O Fax (516) 765-1823 Telephone (516) 765-1802 P. 0. Box ewYork 9 11971 Southold, N OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD March 15, 1996 Mr. Joseph Andrejack 381 Marcy Avenue Riverhead, NY 11901 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xx An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. xx The check is not on file. $25.00 xx No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 21935-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. M-1802 BUILDING DEPT. INSPECTION G. [ ] FOUNDATION 1ST [ ] RO=LATION [ ] FOUNDATION 2ND [ ] 1 [ ] FRAMING [ FINAL [ ]FIREPLACE & CHIMNEY REMARKS: G~ 7 DATE / INSPEC M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING INAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE Z vlz~,INSPECTOR ppppp- 765-1802 BUILDING DEPT. INSPECTIO [ ] FOUND=ON2ND [ ] ROUGH PLBG. [ ] FOUN [ ] INSULATION RAMING [ ]FINAL [ ] FIREPLACE C &CHIMNEY REMARKS: DATE INSPECTO M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY j 3 REMARKS: DATE J INSPECT - 7 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] F NDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARK. ~d e~S ~/a,~,/o/sir ,~A?o~s/r 6e fps?' zaclA ` & j- Z'r , aep DATE INSPECTO° Scce IN <SA57-r se ~a~?+ i 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ OUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: -C~p~ DATE INSPECTOR i- ~J M-1802 BUILDING DEPT. INSPECT! ON [ ] FOUNDATION 1ST A(, H PLBG. [ FOUNDATION 2ND [ ] INSULATION VAe'FRAMING [ ] FINAL REMARKS: C DATE INSPECTOR pp~ l~ M-1802 BUILDING DEPT. INSPECTION [ ] F UNDATION 1ST ( I ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: r ~ -a o DATE 5641 INSPECTOR M-1802 BUILDING DEPT. NSPECTION [ FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL r~~~ REMARKS: zil ~ v DATE INSPECTO HENRY G. BAUER INC. P.O. Box 868 WESTHAMPTON BEACH, NY 11978 (516) 288.1023 Health Department Ref. No. Name of Applicant t/ one 7~f1 61 owneer/rff or u1 r Address_n~c'~,l C. 1 tO. ir1 oa / `~i Property location, includ g tie distance to nearest cross s trt: S U Hamlet _ ~~/vl aC r~~ Township m Subdivision /D~IZJ STT ~ed S Lot No. Type of system installed: Septic Tank d (a) Volume (b) Type- Precast Equivalent Block Leachiny Pools / (a) Number Size of pools '2' "2 a"I' (b) Type- Precast c~ Blooc - All precast material supplied by y Poly pipe Nom. >r I hereby CERTIFY that the private subsurface sewage disposal system de- scribed above has been installed according to current cc teria of the Suffolk County Department of Health. ~ Signatur -~GLG/ Title Date 0 y ~3 _So_ 77 SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES 7 S '/o -17 H.S. REF. NO. COMPLETION REPORT - LONG ISLAND WELL well NO. OWNER LOG aL, 2 A S i Y Ground Surface ~d / r I y //r/© El. ft. above sea LOCATION OF WELL A rt. DEPTH OF LL BELOW SURFACE DEPTH TO GROUND WATER FROM SURFA_C.,E// TOP OF WELL It. S 7 ft. CASINGS DIAMETER In. In. In. in. LENGTH . ~S ft. ft. It. ft. SEALING CASINGS REMOVED SCREENS MAKE A OPENINGS • DIAMETER _ -5 in, in. In. in. LENGTH ~L 7 ft. ft. ft. ft. DEPTH TO TOP FROM TOP OF CASING PUMPING TEST DATE TEST OR PERMANENT PUMP? DURATION OF TEST MAXIMUM DISCHARGE days hours gallons per min. STATIC LEVEL PRIOR TO T ST In. below LEVEL DURING MAXIMUM P MPING In, below ft, top of casing ft, top of casing MAXIMUM DRAWDOWN Approximate time of return to norm I level after cessation of pumping ft. hrs. min. PUMP INSTALLED TYPE MAKE MODEL NO. /J MOTIVE POWER MAKE H.P. 1G1 / CAPACITY g.p.m. against ft. of discharge head RU~WIJOWLS STAGES /G It. of total head DROP LINE SUCTION LINE DIAMETER DIAMETER / In. In. LENGTH q LENGTH ft. ft. METHOD OF DRILLING USE OF WATER ? rotary O cable tool other j2 WORK STARTED COMPLETED /v7v2~1 21ti'S DATE 11 DRILLER LICENSE NO. ,114 +'NOTE: Show log of well - a s n untered,with depth below ground surface, water bearing beds ter levels in each, casings, screens, pump, additional pumping tests and other matters of interest. Describe repair job. See Instructions as to Well Drillers' Licenses and Reports. Pages 5 - 7. 1 Of 2 18.1359:7/86 Well Yield: g.p.m. Casing: Type of Material A/C- Drop Line: Type of Material l Y. ps; p~> If plastic, was torque arrestor used? 3/16" S.S. cable installed? Sanitary Seal: Type Used Ipti" Storage Tanks: Size /4U gals.; Type ~t4E~h_ Inside Material NDJl - CirYlnat Type of Tank Drain Pressure Gauge Installed Shut-Off Valve Prior to Tank Sampling Tap Provided _ A Shut-Off Valve With Bleeder Line Installed on Outflow of Tank Method of Disinfection: LLd203,4 77~~ Well Lateral: Depth Below Grade Material T Water Treatment Equipment Installed For Treatment of Make Type _ Model Number Well Driller's Signature Print Name Print Company Name Mailing Address Telephone Number 18-1359:7/86 2 of 2 CO EST LABORATORIES, INC. ENVIRONMENTAL TESTING 377 SHEFFIELD AVE. • N. BABYLON, N.Y. 11703 • (516) 422.5777 • FAX (516) 422-5770 LAB NO.C960775/1 03/08/96 John W. Hallman Limited P.O. Box 423 Shelter Island Heights, NY 11965 ATTN: SOURCE OF SAMPLE: Andrefack, J.*, 4193-SO-77 COLLECTED BY: JH/EcoTest DATE COL'D:02/29/96 RECEIVED:02/29/96 SAMPLE: Water sample, c.w.tank, untreated** ANALYTICAL PARAMETERS ANALYTICAL PARAMETERS Benzene ug/L <0.5 Manganese as Mn mg/L <0.02 Toluene ug/L <0.5 Nitrate as N mg/L 11 Ethyl Benzene ug/L <0.5 Chloride as Cl, mg/L 35 m + p Xylene ug/L <0.5 MBAS as LAS mg/L <0.1 o Xylene ug/L <0.5 pH (lab) units 6.4 Styrene ug/L <0,5 Ammonia as N mg/L <0.05 Isopropylbenzene ug/L <0.5 Spec. Cond. umho/cm 480 n-Propylbenzene ug/L <0.5 Copper as Cu mg/L <0.02 135-Trimethylbenzene ug/L <0.5 Zinc as Zn mg/L <0.02 tert-Butylbenzene ug/L <0.5 Lead as Pb mg/L 0.004 124-Trimethylbenzene ug/L <0.5 Iron as Fe mg/L 0.10 sec-Butylbenzene ug/L <0.5 T.Coliform, 100 mL Absent p-Isopropyltoluene ug/L <0.5 n-Butylbenzene ug/L <0.5 Aldicarb sulfoxide ug/L 6.1 Aldicarb sulfone ug/L 5.0 Aldicarb ug/L <0.5 cc: .REMARKS: * Lighthouse Road, Southold. **Pump ran 1 hour. Pump rate = 21 gpm. Total Aldicarb exceeds NY State guideline for potable water. Nitrate concentration exceeds NY State and Federal standards for potable water. All of r values are within limits. OR rn= 3722 NYSDOH ID# 10320 41 0 EST LABORATORIES, INC. ENVIRONMENTAL TESTING 377 SHEFFIELD AVE. • N. BABYLON, N.Y. 11703 • (516) 422.5777 • FAX (516) 422-5770 LAB NO.C960775/1 03/08/96 John W. Hallman Limited P.O.'Box 423 Shelter Island Heights, NY 11965 ATTN: SOURCE OF SAMPLE: Andre3ack, J.*, 4x93-SO-77 COLLECTED BY: JH/EcoTest DATE COL'D:02/29/96 RECEIVED:02/29/96 SAMPLE:, Mater sample, c.w.tank, untreated** ANALYTICAL PARAMETERS ANALYTICAL PARAMETERS Dichlordifluomethane ug/L <0.5 1122Tetrachloroethan ug/L <0.5 Chloromethane ug/L <0.5 123-Trichloropropane ug/L <0.5 Vinyl Chloride ug/L <0.5 Bromobenzene . ug/L <0.5 Bromomethane ug/L <0.5 2-Chlorotoluene ug/L <0.5 Chloroethane ug/L <0.5 4-Chlorotoluene ug/L <0.5 Trichlorofiuomethane ug/L <O.5 m Dichlorobenzene ug/L <0.5 1,1 Dichloroethene ug/L <0.5 p Dichlorobenzene ug/L <0.5 Methylene Chloride ug/L <0.5 o Dichlorobenzene ug/L <0.5 t-1,2-Dichlor.oethene ug/L <0.5 124-Trichlorobenzene ug/L <0.5 1,1 Dichloroethane ug/L <0.5 Hexachlorobutadiene ug/L <0.5 2,2-Dichloropropane ug/L <0.5 123-Trichlorobenzene ug/L <0.5 c-1,2-Dichloroethene ug/L <0.5 t-1,3Dichloropropene ug/L <0.5 Bromochloromethane ug/L <0.5 c-1,3Dichloropropene ug/L <0.5 111 Trichloroethane ug/L <0.5 1,1-Dichloropropene ug/L <0.5 Carbon Tetrachloride ug/L <0.5 1,2 Dichloroethane ug/L <0.5 Trichloroethene ug/L <0.5 1,2 Dichloropropane ug/L <0.5 Dibromomethane ug/L <0.5 112 Trichloroethane ug/L <0.5 Tetrachloroethene ug/L <0.5 1,3-Dichloropropane ug/L <0.5 Chlorobenzene ug/L <0.2 1112Tetrachloroethan ug/L <0.5 cc: REMARKS: * Lighthouse Road, Southold. **Pump ran 1 hour. Pump rate = 21 gpm. All values are within NY State and Federal standards for potable water. . DI R - rn= 3721 NYSDOH ID# 10320 _ July 19th, 1 994 L l Southold Town Building Department Town Hall Southold, New York 11970 Re: Building Permit No. 21935Z Attention: Gary Dear Gary: In connection with the above-captioned building permit, please find attached the following items: 1. Under-construction survey; 2. Amended house plans showing the following changes: a) smaller window over kitchen sink; b) larger sliding door in dining area; c) eliminate basement window in crawl space; d) reduce size of garage from 28x26 to 26x26; e) chimney stack relocated; f) footings for possible future fireplace; g) smaller upstairs bath window (relocated); h) 2x4 exterior walls. Please let me know if there is anything else required as we hope to start construction at the end of this week or the beginning of next. Thank you. Sincerely, u Suzanne Andreja BOARD OF HEALTH FORM NO. 1 3 SETS OF PLANS :f TOWN OFSOUTHOLD SURVEY MAR - 4 BUILDING DEPARTMENT CHECK ..i~ TOWN HALL SEPTIC FORM _l' L SOUTHOLD, N.Y. 11971 t:OTI<FY; Sue Andrejack TOWN OF uC>v'~ t TEL.: 765-1802 <w.+..w. 7 2 7 .7114 _ _ pp Examined 3/(/ , , , , , 19p 1. CALL MAIL TO M/M Andrejack Approved 3/~ , 199 Permit No. al.p. zg. 381 Marcy Avenue _ . . . Disapproved a/c Riverhead, NY 11901 (Bu' in. Inspector) APPLICATION FOR BUILDING PERMIT Date March. Ath...... 19.94 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, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. C~I t~GU)Vll Q U.1.YIl ~f . (Signature of applicant or name, if a corporation) 3A I . RArgy. AV9Uue,. , R1V2;11ead.t , NY ,11901 , . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..........QVIIAX .Suzanne Andrej ack Name of owner of premises , Joseph. T.. .and. (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 . Electrician's License No . Other Trade's License No . 1. Location of land on which proposed work will be done. •Lot • 3•,• .SUbdi Yes ion, Map , of, Too Bee Realty - )30$,>i,ghthouse,Road~ Southoldr,New York 11971 House Number Street Hamlet County Tax Map No. 1000 Section .59 Block 6......... i Lot 54~ Lot. Subdivision Too. Bee Realty at Southold . , , Filed Ma No. 9396 Lot . p/o Lot 5 (Name) 2. 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 , one-family„dwg 1,] i ng ire of work (check which applicable): New Building X...... Addition Alteration r I I dr Removal Demolition Other Work (Description) 4. Estimated Cost 90 , 000 7..1 do, 000 , Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units .........one... Number of dwelling units on each floor If garage, number of cars . . . . . ............two . . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories , , . Dimensions o same structure with alterations or additions: Front Rear Depth Height...................... Number of Stories...............!...... 8. Dimensions of entire new construction: Front 82 . , Rear ....82! • •8'1 • • • • Depth 441• -4 11 • • Height ...?4.'.-25.'....Number of Stories .QAe,.alla,•a,half 9. Size of lot: Front .....104r A Rear J e.4 , 0............ Depth .451.a8-,453,5,2 10. Date of Purchase September. 2.7, .1.9.93 . Name of Former Owner . TA.o .Bee..Rea.lty. Inorp,... . 11. Zone or use district in which premises are situated . . 1132.. Will Does lot be proposed regraded ar construction ound, violate any zoning law, ordinance or regulation: ...ntorne .known dwelling......... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises d, IS.. Arndre jack.. Address 381. Marcy.,.inm Phone No..7.27-.7.114..... Name of Architect . Ge..rge. F.i.sbex........... Address .$4ut.hQ10. , , , , , , , , Phone No. 7155-36 $4, , , , . owner Name of property within Address , Phone No 15. Is this proo ert within 300 feet of a tidal wetland? *Yes: No......... *If ype 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. I gp~ ~N N 001 9 "T 0 fy a 00' 0 Z s ° ISe2LI NTOuse a tin: 50 Block: 6 Lot: pro 5 1305 Lighthouse Road, S uthold, New York 11971 STATE OF NEWO COUNTY OF IU ~IC....... SS ..................unne.rx~re.(~AC~........ , being duly sworn, deposes and says that he is the applicant (Name of individual signing con act) above named. Ile is the 6?•-~rt~-, 44, . (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 !Y. ~M .......day of Atnti 4".441...., 19!1.5/ Nota ublic,~..... County ELIZ E7hi ANN NEVILLE /VI Notary Public, State of v-ivv York (Signature of applicant) No. 52-8125850, uuffolk Cou Term Expires Octabor31,1S i (VACAtiTI _ gyn, 71 i { r - 'n rri .F a~i's D C.. - , tr ro - - r ro _~wM. POOL, A= -7 Al (T) I ~ P _j - ' r7 i ~ : ttl ~ nl r tl rn n G; 1' ,.VAS. ~nrl m Z. . c7 - i r ~ N ~ (MC7tJSc 11 r ::0 (WELL a SF~'TIG • LOGAT;On! , C;NAVAI! 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L-- Qi 60' eZ8 _ - ~ ~ ~ I ~ .~q.._ _ t I 4t a .p t t i x -1 Qj W~' as, Li' u~i ( Ly t L I_ { ' Lt l Q Yb .i iyf. Q;w l 1rltl. - L a _ . r Lo 'Al h! y I y ~I 141P.Ittly CODE ItLvll.,tq ' loon-el ectrlc) 7514 (PAIL 5) 5,000 degres Jaye ror_ J q A dNG' I (yC~Fer. Iriryv ~ ?/"IS {I P., -o- hal:e_d 2-fvl 65Velole Calluonent 11-Value Pxlerlot Wall It-111 Itoof/calling A-0 rloor It-1v F'oUndaLloll Wall It-]() Slab 1'alye 111eu18Llot1 It-10 alazinq It-1.7 ' Rntrance Doors 11.2.1 All IIVAC Squlptxmnt to IIMoI: raqultemeuta of 7014.11 All IIVAC Control, Syst:elna to meet tequlrelnenta of 7014.12 All bucL Syat6la9 to nwat requlrellq?nle of 7014.13 All ValltllaOng Systel6a to ,net requlretaenL_1 of 7514.14 All Ill big lnsulatlrnl to alet raqul temento of 71114.15 All servlca Wa Lat IleaLbly AyntemA poll Ggll l lmmoL Lo meet tequlrelnent:s of 71114.21. All 14lecktlc SyaleRL9 to meet regnicenlentn of. 11114.31 ` To the WsL of pry knoWleclyel b"llor, atld profesaloual JSdgexxaht/ thene plalLh Are LI calpllellce Will, Lhe ccxle Of INEWy 1 I~ i I i I --F7 L - - L NI FKONT E-v'AT.IOf~ II Isb OCCUPANCY OR i USE OUT LAWF CERTIFICATE - - wi - ~'N OF OCCUPANCY ~ =1 li I Mlw, ~ - I 1 Y~ Sorb I _ I I LEFT DE H I FIDE UNDERWRITERS CERTIFICATE REQUIRED DO NOT PROCEED UNTIL 2nd SURVEY OF APPROVED AS NOTED FOUNDATION LOCATION HAS BEEN APPROVED -r- 1\ DATE: B.P. # av I FEE: NOTIFY 6lALDINC DEPAHTM NT AT 765-1802 9 AM TO 4 PM FOR , , - T y THE PLUMBING 1 ~ P rULLUWINU INSPECTIONS: ALL PLUMBING WASTE I I. FOUNDATION - TWO REQUIRED & WATER LINES NEED 1 ~_'~_1J f S~pF NEW YO FOR POURED CONCRETE TESTING BEFORE COVERING ~ 2 nOUGii - FP.A~FING & PLUMBING ~ ,1P ENCe TG 9q. - INSYiLRtUOfd P F INAL CONSTMICRON MUST If copper tubing is used F COMI1. ere FOR c Q. for water distributing Yf ~ w ?.11 CONSTRUCTION SHALL MEET system; piping shall be liF 'FOUIRFMENTS OF THE N.Y- Of types K or L only Cnfl)E CONSTRUCTION & ENERGY _ - _ 1 _ _ 0]_2541 S NOT RESPONSIBLE FOR D' S!-PJ El FS? OFl CONS rRUCTI V i '~FESSlpt~P rRUGTION E ERRORS PLUMBER CERT/fICAT/ON ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY , % _t SOLDER USED IN WATER SUPPLY SYSTEM CANNOT RE-1,7 l y L 1- L TI ON I~I'R9'J~ EXCEED 2110 of 1% LEAP. Q o' - -PLAn~S Fck -JfE R EVE PmrAC JACIG PRE Una lunx+Y _ ~_°~~:~jY3i GeoegE n r_^__eiZ o~n r'c e,roH 5u 1U5 b54 3 NOTE F ftL51, i \ GEIl~K \ C ot FICA' 5".eel rw TECG . K ~ x I ' nir ~~~rr iI L F ~ 6 CRAWL - eflze zsz ND W 2fi zn Fu,e prl n ri ire;_ Tyl;. 3_0 IFEATCfL ~ I~ ~ WGOD' GIRhLk DFS~GNn 1- io", j T? ' o BI LC ,'C„ I Npjk "t 1LP7ronIA[ C, IRD FRS \ Amen n2 STIZEL ~nio {2' EX7L=N 510 ~I U'. I , CCn 2t C ` CLLLA R, %aucpolc k N ~N M1{, {u i~ -BOt_rs - a "~g'x ft'n Frot-IgA-tinni I~' ~ I 4 _ I ~J 5 5 KI - 16 B FIITIIIr -u~ , I . I6_ZTIn-1600 '"~B I DBE i i 8 i I , ~ I I TS C Irtn ~us• IH 30 30 _ .uY P+E°n1_C 1~ i ~ li SI ~ w ~Ok la _tr,o 16'rc Lower FOR jf, GmR FRAME j a ~ I Q - tia,~e : m~ Q~ ~I ~ 3 c r- ,I 904,15 AD Ic I D A% f0 Lml ~ lc l0 2z f i, ~ a,c GR,A W L Aw it _ I I I i _1d I i I to l UHEXCAVA -reD ~ , i IJN E XCA VA TED i i J~g I 444 ~LL~~;;~STFP ?C4 EF K5 ; i ~OF NEW 1, yA, ONCE TG N9fi DA-F OFESSIqVq ~ "STEEL"G47C1"/< DR Sr f. 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