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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-23460 Date JANUARY 19, 1995
THIS CERTIFIES that the building ADDITION
Location of Property 410 BLOSSOM BEND MATTITUCX NY
House No. Street Hamlet
County Tax Map No. 1000 Section 115 Block 6 Lot 27
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 19, 1993 pursuant to which
Building Permit No. 21566-Z dated JULY 30, 1993
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 TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to JAMES & ELIZABETH CHRISTY
(owner's)
of the aforesaid building.
SUFFOLK. COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS INSPECTION SVC. 3441 OCTOBER 12, 1993
PLUMBERS CERTIFICATION DATED N/A
a4-
Building Inspe or
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 ~D 19.9
N
21566 Z
Permission is hereby granted to,
Y~o...
to . ~ ~
.........a4
21
at premises located at........//0 "!rl,.,
County Tax Map No. 1000 Section eX3......... Block 6 Lot No. ......a..^
pursuant to appllcation dated Y 19„!,,.5......, and approved by the
Building Inspector.
Fee $....Tr~~c~.
~ ....I
Building Inspector
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
r BUILDING DEPARTMENT
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 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 $ 5.00, Commercial $15.00
/ Date 7...........................
New Construction............ Old Or Pre-existing Building
Location of Property.....r?1(O_....... L63Y'O.+n.......l.. TT,~TUCK..... !v
House No. • • Street Hamlet
Onwer or Owners of Property.. 'Y-5-41n _s m . ~ T ..17:..~~:trQ.~s j
`.Z
County Tax Map No 1000, Section Block ~0........... Lot
Subdivision Filed Nap............ Lot......................
,
Permit No.. ......Date Of Permit. 7.~3~C3..... Applicant
Health Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval
Request for: Temporary Certificate........... Final Certicate...........
Fee Submitted: $
!~1 C ~G f}2C~
4~34U D APPLICANT
Town Hall, 53095 Main Road C=
COD Fax (516) 765-1823
P. 0. Box 1179 W- Telephone (516) 765-1802
Southold, NewYork 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
January 5, 1995
Mr. James Christy
Box 564
Blossombend
Mattituck, NY 11952
Second Notice
To Whom This May Concern:
We are unable to complete your Certificate of occupancy
because of the following reasons:
An application for Certificate of Occupancy is
not on file. (Enclosed)
xx No Underwriters Certificate on file.
The check is (outdated/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 21566-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
~~o~~ggfFO(~COGy
Town Hall, 53095 Main Road °y = Fax (516) 765-1823
P. O. Box 1179 .rte _ Telephone (516) 765-1802
Southold, New York 11971
y~ol * Sao
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
July 11, 1994
Sid Beebe & Sons Builders Inc.
P.O. Box 979
Cutchogue, NY 11935
Re: James M. Christy
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.p
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 # 21566-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
~o~ogOFFOCX-Aar
o ~
Town Hail, 53095 Main Road °y Z Fax (516) 765-1823
P. O. Box 1179 W- • g , Telephone (516) 765-1802
Southold, New York 11971 .j. 0!
col ~ ~a
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
January 5, 1995
Mr. James Christy
Box 564
Blossombend
Mattituck, NY 11952
Second Notice
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
An application for Certificate of Occupancy is
not on file. (Enclosed)
xx No Underwriters Certificate on file.
The check is (outdated/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 # 21566-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
IELD INSvECT1ON ~~llATE, COt`HMENTS
ro
H
FOUNDATION (1st)
c
FOUNDATION (2nd) m
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ROUGH FRAME &
PLUMBING
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3.
INSULATION PER N. Y.
STATE ENERGY
CODE
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4. ~ --J , j
Ul)e FINAL G.
ADDITIONAL COMMENTS:
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BO,1RDOF HEALTH
FORM NO.1 8 SETS OF PLANS
SURVEY SOUTHOLD U TOWN OF
BUILDING DEPARTMENT CHECK " " " " " ' . • • • • • • • • .
JUL 2 y,9g3 TOWN HALL SEPTIC FORM
SOUTHOLD, N.Y. 11971
I TEL.: 765-1802 t:OTyEY : Z
l
CALL1
Examined 19 7,e-;' ~s1 TO: .
Approved ...7.30..... 19/y. Permit No. .
Disapproved a/c
(guuilding spec or)
APPLICATION FOR BUILDING PERMIT G a
Date 191.)
INSTRUCTIONS C)
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
;ets•of plans, accurate plot plan to scale. Fee according to schedule.
S. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
jr ar°as, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
-ation.
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
;hall 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
;hall 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
3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
2egulations, 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 necessa inspections.
(Signature of applicant, or name, if a corporation)
P'.0 n?..y.:119.3.s
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
............4"! r[-D!1~
\`ame of owner of premises
(as on the tax roll or 13test deed)
f ap licant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No. ~.~.~.CC.l/ffil aa lf.Z
Plumber's License No. 71a #0
Electrician's License No. .
Other Trade's License No.
Location of land on which proposed work will be done. 'u/.Q
House Number Street Hamlet
County Tax Map No. 1000 Section ~.5.......... Block 62 Lot
Subdivision Filed Map No. Lot .
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ..?l r e i - C~G~ • • • . • • • . • . .
cx a .
b. Intended use and occupancy
3. Nature of work (check which applicable): New Budding Addition ....X, Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost ..1(li.~ ~ Fee
(to be paid on filing this application)
5. If dwelling, number of dwelling 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 ...?r. Rear . S_.. Depth
Height Number of Stories ......1;1
Dimensions of same structure with alterations or additions: Front /_3 Rear ....3 .
Depth 415.1 Height Number of Stories
8. Dimensions of entire new construction: Front Rear Depth
Height NgmberofStories r.....................
9. Size of lot: Front ....IQQ Rear /P d.............. Depth 9. .
10. Date of Purchase Name of Former Owner
11. 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 JQm.4$. Nr.,'Stf . Address 61 g5SQc .1'6vVA Phone No..2 48."8:6~FA
Name of Architect MKr-K .SehwgLya?,....... Address .;ln cke L!YIP4a Av.C . Phone No..?GSA £!371.. .
Name of Contractor S, d.f3eeb?.k SONS p~~drSz SnP: Address 1)?R,AV. R.4.•........ Phone No.
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 number or description according to deed, and show street names and indicate whether
interior or corner lot.
TATE OF NEWS S.S
OUNT OF.. R7`.7.~~ ••f{e~p
j~ being duly sworn, deposes and says that lie is the applicant
(Name of individual signing contract)
iove named.
eis the
(Contractor, agent, rporate officer etc
said owner or owners, and is duly authorized to perform or have per ormed the said work and to make and file this
~plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the
')rk will be performed in the manner set forth in the application filed therewith.
vom to before me this
day of 19
itary Public, ounty
L GLEW 1. Y-W/ - riK.~ .
PkKSry Public, arts of New York
Pro, 4879 879506 . . . . .
Qualified in Suffolk County (Signature of applicant)
Commission fires December 8,19.
P
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RENO
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0P 1Merlnt
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jUL 2 ! 1993
B
TOWN OF St~a ;
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST ] ROUGH P G.
[ ] FOUNDATION 2ND [ ] IN TION
[ ] FRAMING FINAL
REMARKS:
1
DATE INSPECTO
765-1802
BUILDING DEPT.
INSPECTION
[ FOUNDATION 1ST [ ] ROUGH PLBG.
/FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS:
Apr
DATE ~ l / rl INSPECTOR
J
G
i
4
7651802
BUILDING DEPT.
INSPECTION
[ ) FOUNDATION 1ST ( ) ROUGH rLB,G.
y ~
FOUNDATION 2ND [ INSULATION
FRAMING [ ) FINAL
REMARKS:
DATE 3 INSPECTOIt~-
-
koeF5Iw4LEg'Ia I-IAru+ ° E~f• 4K4oE _ EIO Wo, oN M I/2 R
P •a IaAPIF.IG! 2.11 Ira SUL ~l/x sµT.axK
WOGE
VENT ~7 12 *-Mao Au FLUSH Cbn lcxr luUS 6
1V2 ?IC 6NItE J S (MININUM)
TA_PPP RATG ~etSi
- FFFII
i.
L-~ 110
Wpm^5"AKFS - II ON I/2 rK F-*r y=~
Wof ftMI2 6'51415 61 - . w/I/G SIAr IPK iG i9P cp Ex~q. csck
MATGH E41C~ ((._2atD'R 1L~o4 'Q T , / sx4-6" _ - -
7 2 I'•T..sIL., ~ I i I
'SILL. =EA6i1¢, ~ rr~M~1~ sl,a.
.P _ Ova."swsa+vmww,rs
II V~J'~1~ O° ~f4'n,lloa- OCCUPANCY CR
jlp I ' 'i l_GN lwpUT CERTW KATE list is
o' i OF OCCUPANCY r-_. _
x
r ~~f1 iG
15 T UNDERWRITERS CERT;*J~
f I _ $V)L.TwI ~ ' h
M r ~
THE 6FAPI APPROVED AS NOTED APPROVED AS NOTED
ZK 9.@~11oa. n ~ M veclc m I I 2~g412 SHArkS- - ~ LLi-
f F4007t .1a1 FTS I' 3 'Y.NEZT A+7pTfr9N A'S REW'0 ~ M~ScH FYI' Srr~wer. - DATF:-------'_B.P.#-~
n
bll---- "oI 6u' a -ewr FT%V Zell 7.95-1502 S AM TO 4 I'M FOR THE
(xsllNfi 4NSPECTIDP,hS:
FFDi7NDAf,oN . T`.Nf?k1EClUIBEU (',DNCRETE
`!FAT t cS I h A6T SNO WA" R~IyIC.E.s _ FHA114iNEi & PLUMBING
• Y~ I,'- s• a y iGdSL11~A71{)?4
ynl , DNS I F]GNSTftUCTiGNINUST
Z- fie(, I TIE bEA14 ~ . nav'd. ~ Re~arrt I ' µt !'V7N3PV..F:TE FGFi GA.
rf_ I ~K"~"~~at(S~' ~+i1/JbIW ~55kIW?N .y,- _ ,miS. C%GPu:STkiUCTI®N S14ALL MEET # ENERGY
BE(lUIBE(MIENT T
STfiTE
2-zr4 _ Y lµ \y CODES. NOT RESPONSIBLE
1=11 j ~ ~ I r --V41 ~ i~ DESIGN OR GONSTRUGTION ERRORS
Lrr UpsEf Hffjul JP ~ ~ F4u511 celadu O I~~(''~~~ - lfp WALL _ I .Y,
I~ _ o
t:fvl ~`••-AT1aN talAN GENERAL Nib fE$ w. e. DONOT.W^ZOMWINCIS•
1. ALL WORIK MATERIAL„ Np EOUIPM N7 SHALL BE IN SHALL BE IN 9. DESIGN CONSULTANTS OR RECOSD ARCHITECT.ENGINEER ARE
ACCORIOU WITH THB' W~I(~~~YORK NTA~„UNIFORMn CBUILDING D THE l - - - Ex, FAMiLh CODE, ANNDI LOCAL EW Yd L°BATE ENERGY C1DNSERVATION "M BUILDING NOT REEP`01yBIBLE FOR THE INSPEOTON', SUPERVISION, OR
tKI1TING fY137'~ I~uJ D'CN9SERVATION APMINIBYRATIDN OF THIS CONSTRUCTION PROJECT.
10. THIS DRAWING IS AN INSTRUMENT PREPARED TO FACILITATE
2- ALL CONCRETE SHALL BE STONE AGGREGATE WITH A MINIMUM PITH A MINIMUM CONSTRUCTI AND SHALL HOT BE CONSTRUED AS A
28 DAY STRENGTH OF 3000 PSI CONTRACT BONEEN BUILDER AND OWNER.
CI+ANgE EaOZi. ' WeR 5•.IINGi w"F EaOZT. k Sw.N6~ 3. ALL LUMBER SHALL BE OF STRUCTURAL GRADE X2 OR BETTER X2 OR BETTER, 11. SEWAGE DISPOSAL SYSTEM AND FRESH WATER SUPPLY SHALL
< DOUGLAS FIR • LARCH. BE DESITED,AND BUILT IN ACCORDANCE WITH THE SUFFOLK
COUNTY ,NPARTMBNT OF HEALTH.
\ Pb - 1460 PSI E - 1,700,000 PSI 12. THIS STRUCTURE HAS, PEEN DESIGNED IN•ACgOR, q-q NOE WITH
4. PROVIDE DOUBLE HEADERS AND TRIMMERS AT,ALL STAIR AN[ .ALL STAIR AND 11HENEW YORK STATE ENEROMCONSERVA' CODiF.
F- r FLOOR OPENINGS. POSTS AND PARALLEL PARTITIONS. 'IONS. 1B. IT IS 4MOBSTEO THAT 'A CONSTRUCTION BUDGET NTINOENd I FLOOR BEAMS. OR INEVITArLY OF E ERIVE (5) E CENT B A QED TO ACCOUNT
- - S. BRIDGING TO SE PROVIDED FOR ALL JOISTS AND FLOOR BEAMS
SPACING NOT TO.EXCEED 8,0 FT,
S. ALL DIMENSIONS AND GRADE CONDITIONS TO BE VERIFIED S` BE VERIFIED BY 14. ELECTRICAL AND MECHANICAL COMPONENTS TO BE DESIGNED TRUCTION AND AND SPECIFIED BY OTHERS.
CONTRAOTOR(S) PRIOR y. 10 START OF C.GNBTRUCTION AM ORDERINp OF MAT RIALS. THIS FOUNDATION HAS BENI ON HAS BEEN 15. ALL STRUCTURAL STEEL TO BE ASTM ASB WITH+ONE COAT
DESIGNED FOR A SOI~ BEARING CAPACITY OF TWO (2) TSF ANI 110 (P1 TSF AND VERIFY THAT EPOXY'PAINT. ALL FASTENERS TO BE ASTM A-325 BOLTS, 314'
-N GRADES,1EBB THAN MA. CONTRACTOR SHALL VERIFY THA' THROE CQNDITION$ ARE MET. ALL FILL BENEATH CONCRETI A qTH CONCRETE DIAMETER.
VSITY. 16. CONTRACTOR SHALL OBTAIN ALL PERMITS AND INSURANCE
F_y, IIVIN R•H. wa1244C SLASS TO BE COMPACTED TO 25% RELATIVE DENSITY.
7. ALL HEADERS 0 FT IN LENGTH AND OVER TO BE SUPPORTEI BE SUPPORTED NECESSARY TOP.ROTEGTTHE ENGINEER AND OWNER.
BY DOUBLE UPRIGHTS, 8.0 FT AND OVER BY TRIPLE UPRIGHT: ALL HEADERS TO BE MINIMUM OF 2.20 OR AS SHOWN OI IIPLE UPRIGHTS. AS SHOWN ON 17' DDYO NOT INSTALLATION K14L AGAINST FOUNDATION WALLS UNTIL FLOOR
DRAWING. SS COMPLETE.
MA-r 7r, 17V 1A•r 7 1vv3 GEIRIS"f`( 1 ~ 1cE-a~l-nol-,s - -
ANn AuTEYLA7I0fAS TO
i ~rL w1,9r1 A_ R C.l1 I T E C T ( A7nTUCIC ESTATES; NLW'10IZK
al R~~e~alderifl Conmerciai
Industrial
RAN S, eLAF-uA7oNs, Norer
- - t o~ c
Q So275 cl o w"'A~"m 1 Mark SSchwariz. A.I.A.