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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-23374 Date NOVEMBER 29, 1994
THIS CERTIFIES that the building ALTERATION
95 PRIVATE ROAD #4
Location of Property 20615 MAIN ROAD/ROUTE 25 ORIENT, NY
House No. Street Hamlet
County Tax Map No. 1000 Section 17 Block 3 Lot 10
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 11, 1994 pursuant to which
Building Permit No. 22003-Z dated APRIL 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 ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR
(SUN ROOM).
The certificate is issued to DAVID SILVERSTONE
(owner's)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N328329 SEPTEMBER 27, 1994
PLUMBERS CERTIFICATION DATED N/A
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) ynl'G/
Date j...~/........ 19....1..E . .
N2 22003 Z
Permission is herreeb'y~ granted to:
/f!~~y.. . .....J.........2~sr77
Arq..,.... /°Xix.... /x/1...
to t
9 I ~ ?V
%~r-?
at premises located aT.............So.i............... °
Q
I
County Tax Map No. 1000 Section Block Lot No. Aa...............
pursuant to application dated 19 9 and approved by the
Building Inspector.
Fee
Building Inspector
Rev. 6/30/80
Form No. 6
Dale
TOWN BUILDING OF SOUTHOLD DEPARTMENT
'IdOC!~OCilz3
TOIM HALL -
P!f11/ 1994 765-1802 Gt/~6661 8 L 11UiV ~ u
BLDG DEFT. APPLICATION FOR CERTIFICATE OF OCCUPANCY
TOWN _OFSOUTHOIn 0
1~°-
W 0
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 Buildina - $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 ,,,.November 280 1994
New Construction.......... Old Or Pre-existing Building
Location of Property ?0615 Main Road Orient
House No, Street Hamlet
Onwer or Owners of Property..,, David.& Caroline $ilverstone
County Tax Map No 1000, Section Block 03 ,,,,,,,Lot....... . 10..........
Subdivision ....................................Filed Map............ Lot......................
Permit No.,,22003Z ....,Date Of Permit :11.1.1./?4.. Applicant. C:A;Strang for $ilv..... e
Health Dept. Approval...... N4A ................Underwriters Approval. .i s ued, 9/27/94
Planning Board Approval...., N/A
Request for: Temporary Certificate........... Final Certicate..... XX
Fee Submitted: $,?Sr 00,.,..
J 1'7 APPLICANT
oaf
OgpFFO(K~OGy
Town Hall, 53095 Main Road °y x Fax (516) 765-1823
P. O. Box 1179 v~ Telephone (516) 765-1802
Southold, New York 11971 O!
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
July 11, 1994
Mr. Garrett A. Strang
P.O. Box 1412
Southold, NY 11971
Re: David & Caroline Silverstone
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)
xx No Underwriters Certificate on file.
xx The check is not on file. $25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 22003-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING V'FINAL
REMARKS:
INSPECTOR
DATE
424 /
i
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1$;T
[ ] FOUNDATION 2ND INSULATION
[4fRAMING [ 7 FINAL
REMARKS :
r
k
2.
DAT ~S INSPECTOIkf
76S-1802
BUILDING DEPT.
INSPECT ON
[ ] FOUNDATION 1ST [ ] OUCH PLBG.
[ ] FOUNDATION 2ND [ INSULATION
[ ] FRAMING [ ] FINAL
REMARKS:
DATE 4-14q( INSPECTOR
. ? j 1. J i• H . ~ U.J II ~ f] 1 u II . y]w']i• _i^"~~ ~ i ~ ar v'.!Y.T^.Y~
COCiMGNT°
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FOUJJDATION (1st) - -HiW
FOUNDATI011
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) ti~
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2.'
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ROUGH FRAME
S
PLUMBING
ly
3. Al daL . O a y
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x
9 P7
INSULATION PER N. Y. a~ M
H
STATE ENERGY
CODE
4.
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FINAL I -
o
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ADDITIONAL COMMENTS: cq
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THE NEW YORK BOARD OF FIRE UNDERWRITERS PACE 1
1001071 BUREAU OF ELECTRICITY
F 88 JOHN STREET, NEW YORK, NEW YORK 10038
Date SEPTEMBER 27,1994 Application No. onfile 06454094/94 N 328329
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 SILVERTONE, MUNN ROAD, ORIENT, N.Y. 17 3' I l7 n-C.e - q
in thefollowinp location; ? Basement ® 1st Fl. ? 2nd Fl, Section Block Lot
was examined on SEPTEMBER 22 ,1594 and found to be in compliance with the National Electrical Code.
FIXTURE ECEPTA[lE5 SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT OTHER MU K W. AMT. K W. AMT. K.W AMT K, W. AMT H P.
2 . 4 2 2
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECPT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
AMT. K. W. OIL H. P. GAS H. P. AMT. NO A. W. G AMT AMP. PMT. AMPS TRANS. AMT H P SYSTEMS MIT WATTS
NO. OF FEET
SERVICE DISCONNECT NO. OF S E R V 1 C E
AMT. AMP. TYPE METER 1,e' 4W 1 ,R 3W S,e' 3W J p tW NO. OF CC COND. A. W. G. NO. OF HI-LEG A W G. NO OF NEUTRALS A. W. G.
EQUIP. PER 9 OF CC.COND. Of NbIEG OF NEVTRAI
OTHER APPARATUS:
ELEC. ROOM HEATERSt1-2,0 K.W.
G & S CONTRACTOR LIC.#578-E
~t l
BOX 215
SOUTHOLD, NY, 11971 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.
F COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIJ~ICATE MUST NOT BE ALTERED IN ANY MANNER.
BOARD OF HEALTH
FORM NO. 1 3 SETS OF PLANS
TOWN OF SOUTHOLD SURVEY
BUILDING DEPARTMENT CHECK
TOWN HALL SEPTIC FORM
SOUTHOLD, N.Y. 11971
TEL.: 765-1802 f70TiFY~
~p/ CALL
Examined , , , 19 / MA I L TO
Approved 19/X: Permit No... . . .
Disapproved a/c 11, u
~n
APR- 6
K............
1
uilding Inspector) G3&tC.se'i. I
TOVY19F SCi1'feaLU.
APPLICATION FOR BUILDING PERMIT
Date ...Apr.i.l. 5.r..149 } 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 areag, 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 inspecti s. _
(Signature of applicant, or name, if a corporation)
P.CI .Box. .1412.,..Sou.t.hold.,..NY...1.1273........
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Ar.chitest......................:........................
Name of owner of premises ..Do.v.id.and.Cax.oline..H..S.ilver.stona
(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. n o.t . s e l.e.c t e d.........
Plumber's License No. ,rot„ s e l e,c t e d, , , , , , , , ,
Electrician's License No. not, , s e 1 e. c t e d, , , , , , , . ,
Other Trade's License Non o.f s . e.l.e.c t . e . d
1. Location of land on which proposed work will be done. ....Mai ri..Road,,. Orient . . . . .
Main•R•oad,..Route•25,.Or.ient............................
House Number Street Hamlet
County Tax Map No. 1000 Section ..17 Block 3............ Lot .....IQ........... .
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 ..............Sing e..F.ami.l.y„ Res,i,depce,,
r.;a
Si,n e F mil Residence " ,
b. Intended use and occupancy
1
i
3. Nature of work (check which applicable): New Building Addition Alteration A
Repair Removal . . Demolition Other Work
(Description)
4. Estimated Cost ..AjJI r_ Fee $7.5.09.......................... .
(to be paid on filing this application)
5. If dwelling, number of dwelling l. Units Number of dwelling units on each floor
If garage, number of cars
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .
7. Dimensions of existing structures, if any: Front .....5,3 ! , , , . , Rear ..53. Depth 35.1....... .
Height .23 Number of Stories .....1.:1 /2.' .
Dimensions of same structure with alterations or additions: Front ........53 Rear 54 ' .
Depth ......35..........
Height ........23 Number of Stories ...1-1 /.2 . . . . . .
re new construction: Front ................Rear Depth
Height sions of Number of Stories .
9. Size of lot: Front ....95.1...1........... Rear 95 Depth . . 222. ~
Name of Former Owner .
101. Zone or use district in which premises are situated .
12. Does proposed construction violate any zoning law, ordinance or regulation:
13. Will lot be regraded . . . Will excess fill be removed from premises: Yes No
14. Name of Owner of premises Address Phone No............... .
' • • • Address Phone No............... .
Name Name of of Architect Contractor • ,Address ...................Phone No................ .
15. Is this property within 3
00 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 dumber or description according to deed, and show street names and indicate whether
interior or corner lot.
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STATE OF NEW YORK,
COUNTY OF .......S u f f .0.1k S,S
• • • ......GAR.RETT. A.. STRANG.I being duly sworn, deposes and says that he is the applicant
(Name of individual si ninlg contract)
above named.
He is the..'I A.gent.............................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly lauthorized 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
5th ............day of. I!. ?A.r is 19..9.4
Votary Public,
5Vf.f.czlk.. County
NOTARY
No. 473o09S~J 1~do Vwk . (Signature of applicant) .
mkaIoria 7n Suffolk 'co,,,,ry (Signature of applicant)
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Alnl T J 5 E>cl~~'iNCa o~oA~ c~nwra REQUIRED (a ~ N e, FZ-A i r`1 O } E ~p
oo~~ I 401~Wi4 NO , ANIO VAOE
Il f `.p. WAU oatR~~j USE ~o APP
t• m~r~JLAfIoN av~t Ao{°~ }o Flr o ~GrA IN • IN~~A~ N P APP¢0 ED AS P.If NOTED
OIrIING~ db - ° m e'7A~¢• JNIft,R IoN o ~~TT YZ 19)c hIOWIJ. Im 40H4 MIwHU~ Qp.-,,Z 6 q,, IP y/ yL DATE:z Wr)c ~I+1(V'b.~a 44A 1 141 IiGI~M '!42 (I"II) ~A'I f . 0 lJ-. DATE: 5<~~ 9s~ ? r-v3z B.
la Ft~ I"s~ (4'I~ICQI. Or!"61-A trt~ (9 011,, Ir~nta l.A'~aN, (+-(P) FEE: FEEt0 2f-,0V BY: _-9 Contractors work is to conform with all local
D_ ~aFit I io ~rww p~ y yam`' / NOTIFY BUI (Ir1 IF 11001NG N GE~A,rAIG 'l ll..~ L ~'yIG?~G'~/ WUI`I 765.1802 B NOTIFY BUILDING DEPARTMENT AT ordinances i New York State building and energy 7651802 8 AM TO 4 PM FOR THE conservation codes, latest edition.
FOLLOWING INSPECTIONS:
~iFI~J}Ir~G~C~R~ { NG~ C~R~ f'?E I GG rr FOLLOWING ~p"~',J~.~ v~ M r I 1. FOUNDA 1. FOUNDATION - TWO REQUIRED Electrical i Plumbing work shall be governed by all
(,eN o , o LAC? U. COIApJ iODUO plip"IN ML61 (010 O GI- - - FOR POU FOR POURED CONCRETE National, State and Loral codes, latest edition.
Ali io III g~ppEMAN~IJrI 9JNOA{'IM cil _ NwN 7i41I ~oN~Jt~~ s suw 2. ROUGH - FRAMING & PLUMBING Contractors shall verify all field conditions i 3. INSULATION dimensions, and will be responsible for same. Any
4. FINAL - 4. FINAL - CONSTRUCTION MUST discrepancies shall be reported to the Architect
BECOMF I (yJ o?E EKI '~ING1~ ALL CONS' BE COMPLETE FOR C.O. immediately.
ALL CONSTRUCTION SHALL MEET
r~~p ~DIED'~ (+'~j~IGAL/ rf, THE BEQUI yP (itGH r oNIEO - STATE COP THE REQUIREMENTS OF THE N.Y. Contractors will cooperate with all other trades a STATE CONSTRUCTION & ENERGY complete their work in accordance with the beet
CODES. N CODES. NOT RESPONSIBLE FOR standards and practices.
DESIGN OR DESIGN OR CONSTRUCTION ERRORS All dimensions are nominal and take precedence over
Note: co~t~aoto~ r0 vg iF~ wlNOOw <O~B ~~,2.'~ scale. All abbreviations are standard.
OPENIN(ayI to INO{7AlLAtION. AMIN(a MIN (a ~ II ~-~~~N~ hq~j~lU~i All items of work on the drawings ¦re new, unless
IAN N r Co oN R r°`~ a CAIN OCCUPIW OCCUPANCY OR otherwise noted.
I r (4N~ro coFlfi~ coflfi) Vpi mIse +rv)
41 ~K ~IarNra GANG. w~~zl~ USE IS UI USE IS UNLAWFUL Proprietary names identifying items of work are ~p~n used solely to prescribe standards of construction.
oFol. MAp WITHOUI WITHOUT C61USfICATE Items of equal quality may be submitted to the Architect for consideration.
OF occu OF OCCUPANCY ill wood !came construction shall conform with the
American Institute of Timber Construction's "TIMBSR CONSTRUCTION MANUAL" latest edition.
~E ~~rG ~DiNG All wood framing members shall have an allowable
i ~-(oND extreme fiber' stress equal to or greater than structural grade Douglas Pic;
Pb - 875 psi Py - 95 psi E - 1,600,000 psi
Provide solid blocking on all joist spans in excess
of V-B".
~xNI~C~CI~ I o P
?Er/tAiN All headers and girders with a span in excess of five feet (5') are to bear on a minimum of 2-2x4
or 2-2x6 Jack studs with double floor joists
- - Gaclcatir.lr, FlvirUA - 6~lnv_ unlnaa nn"nd nYA-....1-- •w.. J,._.a
Provide 5/S" fire code•gysuum board~on~walls and
etA~u r~erAl~o`~o ~~aIN _ _ E~I~I~~(7 ceilings of garage as required by code.
- a A All firestopping shall be of an approved non-
combustible material and installed in accordance with all applicable codes.
wall insulation shall be 3q" (R-11) kraft-faced
MF batte with vapor /bparrier facing warm side of building. Coiling/Roof insulation shall be 6-1/2"
(R-Y2) kraft-faced batts with vapor barrier facing
i warm side of building. Crawl Space ceiling
insulation shall be 6-1/2• (R-22) kraft-Paced batty with vapor barrier facing warm side of building.
All windows and doors to be insulated "low-6" glass
vinyl clad with _ _ screens and operating
hardware as manufactured by Andersen. Contractor le - - to confirm operation, style, finish, color and Mfg.
with owner prior to placing order. owner shall
provide safeguards, planters, shrubs or other
T protective measures to prevent injury caused py
contact with open casement or awning windows. These
types of windows are recommended only if these - - conditions are complied with.
All windows a exterior doors to have aluminum or
wood drip caps.
9 Contractor to install all interior and 'exterior
trim to match existing.
Id,dntractor is to clean all door a window glass, as
4iv~~DO f FR~ 'wall as leave all floors, walls and ceilings free of debris immediately prior to final completion.
Aq Lvoo ~
~?~I~'~ING~ 2"~~ ~ I~~}ALL NEW O~L~( LAIYIGE '~'O N~A~G+I IDiDN~6N {m rfo~AIKI --..-t COf INCA AR
E~~fi~~ca EI-10 1,4(1 oHlrjaLI?~ 61r,
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to rHl;
Si pASTggryCS GARRETT A. STRA TRANG Qii~l~~ervlbrJE r~iot:NOe
LOCATION 010, inl R-~/'~~
architect + QK-IENi', N2uJ Yotc GALE ~ r101 p.~a 11E VISEO DRAWING N^
Main Road P.O. Box 1412 Southold N.Y. 1197 Id N.Y. 11971 ~`VV io FPS 'Y4 - guASM~rrro FOR a~n DATE II cJAN. ~~n! ~L ~ I '
015244 F 516 - 765 - 5455 DRAWN Rr m.~ ~ \
slATf OF NE`N y00 AROJECT RE ~4/^:~ I OF