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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-20148 Date AUGUST 15, 1991
THIS CERTIFIES that the building ALTERATIONS
Location of Property 48555 MIDDLE ROAD SOUTHOLD N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 55 Block 2 Lot 7
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 25, 1988 pursuant to which
Building Permit No. 19424-Z dated SEPTEMBER 27, 1990
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 DECK ADDITION & ALTERATION TO SEASONAL ONE FAMILY
DWELLING TO CONVERT TO YEAR ROUND ONE FAMILY DWELLING
The certificate is issued to MICHAEL J. SARAGAS
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-181211 - MARCH 29, 1991
PLUMBERS CERTIFICATION DATED JULY 24, 1991-HARDY PLUMBING & HEATING
Bu' ding Inspector
Rev. 1/81
FORM NO. $
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)
Nfl C 'r Z Date
19.
117,06
Permission is hereby granted to,
. /.....9..
z 41~
~
at premises located at ..l $l J..........
. C7.":1.Pff~
County Tax Map No. 1000 Section Block ..........J.''........ Lot No. .
pursuant to application doted r~sl./ff 19........, and approved by the
Building InspectorD
Fee $20Y 'i . .f~...~.:
Bufldl Inspect r
Rev. 6/30/80
Form No. 6
K•
TO14N OP SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802 AUG - 9199)
APPLICATION FOR CERTIFICATE OF OCCUP,\NC TOWN OF UT OLD
This application must be ~
inspector with the filled in by typewriter OR ink and submitted to the building
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 archi_ect 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.
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 - $5.00 over 5 years - $10.00
4, Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date :F/ .7 2w Construction......... O1 Or Pre-e ~~4
xist~inng Building „
cation of Property.... y{/ . 4- ] ® .l°.\,l
house No. ~~i S5'..1` ...............:~4~:
Street " " '
:wcr or Owners of Property Hamlet
..M 6r, t.l L..a... ~c Yr 5.........
.only Tax Nap No 1000, Section...,S..~,'„ a
.Block...s)............Lot.... 7
bdivision.
4702~~ ...................Filed Map............ Lot........
a
:mit No.. .Date Of Permi.t.. /
...3 . f ....Applicant ....rn! c;rrL~ ~•~r~~G j..
.filth Dept, Approval....,
..................Underwriters Approval J,,,•
inning, Board Approval
:uest for: Temporary Certificate...........
Final Ccrticatc.,,l,t~~,•,
Submitted: > [:)u
CUB °~OI7 •PLICANTL~~
o~pS~FF~Lk o TOWN OF SOUTHOLD TEL. 765-1802
^Qr P vt . , < OFFICE Or BUILDING INSPECTOR
+j~413! rn P.O. BOX 728
~'1' TOWN HALL ,
D~p1 ~a~t SOUT11OLt), N.Y. 1 X971
7/14
To Whom This May Concern,
We are unable to complete your Certificate
of Occupancy because of the following reasons.
/V An application for Certificate of occupancy
is not on file.
No Underwriters Certificate on file.
The check is (c~ti- r--d/not on file.) Y7 ~S;UO
No flealt-h Dept. Approval on file.
No final inspection has been made.
Please contact our office on this matter.
Thank you for your cooperation.
Building Permit If Z
/7aG.3z
Buildin<I Dept.
***/i/ No Plumber So.ldor Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
FORK NO. a
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- 017263 Z Date 19. Ire
Permission is hereby granted to:
.-.....43-3..
.....,.....t//...................
to ~ f
at premis=ted at T.67.cY....... .
............C
County Tax Map No. 1000 Section .........c, . Block Lot No............
pursuant to application date /~r7 19.1.4) and approved by the
7~1 s~
Building Inspector.
Fee $..ITT.
a.. ector
B din Insp
Rev. 6/30/80
l
TEL. 763-1802-
V F':
r ~ l.OtY1'L? OF ..J{J.+J.~l`1TOLL': ~...........,.,,...a.,~ _ ~-,..r ..we
i:" .`c . OFFICE OP RUdLDS1IG I'ISP CTOdt Fr
}
P.O.13.0;2.a
.y.. \ T03Yre1. I::.LI FAU6 ^ 9 II ('s
d~ SOUTHOLD, N.Y. k 1971 t
~hIQ ~b BL OG . C3~F...,,,..'T..~~.,
^Zi RLC3G.
TOWN CSF SOUTHC3!_t7
C E R T I F I C A T L O, r.1
Date JULY 24, 1991
Building Permit No.
Owner CHUCK KRAUS/SARAGIO JOB
(please print)
Plumber HARDY PLUMBING & HEATING, INC.
(please print)
I certify that the solder used in the water supply system
contains less than 2!10 of 1% lead.
(plumber's signature)
Sworn to before rtrne his
ff day of
V L-0
19 61 Rotary Pub c
Nota Piik:.ic, Counl.y
. CAtNE•~~A!~ A. MAGI
Navy of NOW Y4
~1R11i11~~ Qt ~ v
THE NEW YORK BOARD OF FIRE UNDERWRITERS
14'~f>1)GF) BUREAU OF ELECTRICITY
83 JOHN STREET. NEW YORK. NEW YORK 10038
Date Application No. on file
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
14.,7,t5,ftA(d7LS, WS, Nff)))100d Itl), (TUT t)OU:,R), SO 1'}TOIA), NV,
/01,1T
in the following loco B s.~~ n ATTTC t 0 l.st Fl. 2nd Fl. Section Block Lot
~Kt$~tctH ~ 5
was examined on andfound to be in compliance with the requirements of this Board.
FI%TURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K W. AMi K. W AMi. K W AMT K W AMi. H P
34 33 ?•3 2 i 1:3,3
UNIT HEATERS MULTI-OUTLET DIMMERS
x DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIMECLOCK$ BELL
SYSTEMS
AMi. K W. Oll H. P GAS H. P. AMT NO A. W. G. AMT, AMP AMT. 11 AMPS TRANS. AMT H P NO. OF FEET AMT WATTS
f ~r f 1
'Y SERVICE DISCONNECT OF S E R V 1 C E
AMT AMP. TYPE METER 1 q YW 1 a 3W 3 % 3W 3 fS 4W NO. OF CC COND. A. W G NO OF HI LEG A W C. NO. OF NEUTRALS A. W G
_ EQUIP. PER ,e OF CC.LOND. OF HI LEG OF NEUTRAL
! 50 71a i C 1 I
OTHER APPARATUS:
:
~ k::S:LG L;ISl;C1'It:10, a(;F., 1"~C;. I,fC~dD3l.ZC
TAFT11PACF, NY, 11,714 GENERAL MANAGER
5,.1
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.
1 LD INSPECTION ~JDATE COaMMENTS
,n m
1.
FOUNDATION (1st)
m
y
FOUNDATION (2nd)
2.
ROUGH FRAME ~F s i C~t~
PLUMBING &4 94g
H
3.
m
ca
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ItdSULATSOAt PER N. Y.
STATE ENERGY
CODE
x
a
4. , y
FINAL
` z
ADDIT ONAL OMMENTS. x
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~,765-1802
I BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST ( ] ROUGH PLBG.
( ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ FINAL
REMARKS:/
171 L~-
DATE INSPECTOR
ce"' M-1802
BUILDING DEPT.
1 NSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
ll-~ -41
[ ] FRAMING [ F
INAL /v r
REMARKS::
AlVt~
DATE 'I INSPECTOR
t
l 7 ),0 3 765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ INSULATION
[ ] FRAMING [ ] FINAL
REMARKS:
DATE - ~ INSPECTOR
~1
l 7z- ~ ~
7'65-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST (PJ ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[i,j'FRAMING [ ] FINAL
REMARKS:
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DATE / 4~ INSPECTOR
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1
House renovation for Michael J. Saragas
Job location: section 1000 55, lot7, block 2
Specification and description of work for job at Middle South
Road, Southold.
No major structural changes are to be made. The wood load
bearing columns in the basement shall be replaced with 3 1/2"
diameter steel columns supported on 21-0" x 2'-0"x 1-0"
concrete piers. Temporarily support the girders before
removing any existing columns.
Repair or replace any load bearing components that have been
damaged by water or insects.
Remodel the kitchen and the first floor bathroom.
Build a new bathroom on the second floor as per plans.
Install a new heating system.
The new heating system shall be baseboard hot water
with an oil fired furnace. The furnace shall be a Weil-mclean
with a input btu rating of at least 160,000 btu/hr.
The flue for the furnace shall be a prefabricated metal
chimney by Metalbestos and have a temperature rating of 2100
degrees F.
The temperature of the rooms shall be controlled by 2
thermostats one upstairs and one downstairs each connected to
separate circulators.
In order to satisfy the New York State energy code the
following components shall be installed:
R11 fiberglass insulation in all exterior walls
R19 fiberglass insulation in the second floor ceiling
R19 fiberglass insulation in the basement ceiling
Insulated exterior doors by benchmark
Windows with insulating glass R value of 3.0
0'10W. S i0 NMOI
d3 'Da'le
l ~G/'N Fok/ry .
9 ( v1 s . ~ ~
i
CO t~ ~~V
~N of
VICTOR LESSARD
cP~ M k t r Town Hall, 53095 Main Road
EXECUTIVE ADMINISTRATOR
(515) 765-1802 P.O. Box 1179
Southold, New York 11971
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
JUNE 10, 1988
Dear Mr. Saragas:
In order to process your application for a building permit
to convert a summer residence to year round use, we will need
more detail regarding structural changes, chimney, heating
equipment and a statement from the engineer on compliance
of building to New York State Energy Conservation construction
Code regarding windows, doors, and insulation. Thank you for
your cooperation.
Sincerely,
a. 4,;;14
,---Z
Thomas Fisher
Building Inspector
TF/lmr
~e BOARD OF HEALTH 21,
3 SETS OF,, PLANS r . .
FORM NO. 1 SURVEY tiQ
+ TOWN OF SOUTHOLD CHECK D•g.°X
BUILDING DEPARTMENT SEPTICFORM
d? E1r1 TOWN HALL NOTIFY
T
P OW1 SOUTHOLD SOUTHOLD, N.Y. 11971 CALL • . .7 • • - 33./.
TEL.: 765.1802
MAIL T0:
Examined°~ 19
- ~
Approved 19 ermit No/. " `i"
1 N
Disapproved a/c
APR 4
BLDG. DEPT.
V02 f...... TOWN OF SOUT1iOLD ,
(Buil g Inspector)
APPLICATION FOR BUILDING PERMIT
Date Mareh 1988.
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-grayted-bytthe---13uilding-Inspecto-r- - - -
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
;i 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
•1 admit authorized inspectors on premises and in building for necessary inspections.
(Signature of applicant, or name, if a corporation)
......z?.
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
..qwner
Name of owner of premises . Michael. as.
J. S.....a.rag....................................................
(as on the tax roll or latest deed)
Jf applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED
Builr
__..der's Lic°nse No.
Plumber's License No. ........1........~'..''....... .
Electrician's License No. ....3.I u.1,....55 Iq, G~tCh
Other Trade's License No .
Middle Rd. Southold
' i. Location of land on which proposed work will be done .
House Number Street Hamlet
2 7
County Tax Map No. 1000 Section 55............ Block
Lot...................
Subdivision Filed Map No. Lot
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
e
a. Existing use and occupancy Summer use sin l
milt', ggqXPAnoy, , , , , ,
fa
b. Intended use and occupancy YeaY, round„gCCLipB>1Cy .
3. Nature of wort k which applicable): New Building Addition Alteration
Repair . Removal , , . Demolition Other Work , .
L W *A&pSion)
4. Estimated Cost ...$25t000- . f Fee
j ; . d~.• , , ,..•,_as
` (to be pai on J4~{', p is ti9n1
4 BR. .
5. If dwelling, number of dwellin nits Number of dwelling units on each floor
If garage, number of cars
6. 6. If business, commercial or mixed! occupancy, specify nature and extent of e c tyRe gf use ,
7. Dimensions of existing structures, if any: Front ....23 ` ,Rear Y . ? , 3 . , use Depth 4 . . . . .
Height
Dimensions'of same structure with of Stories r adds ors: F .
Num h alterations or additions: Front • Game
Rear
Depth , j . Height Number of Stories
8. Dimensions of entire new construction: Front Rear Depth ;
- ,
Height . . . . . . . . Number of Stories .
1109 9. Size of lot: Front 9. 9
. , Rear 711"'-'789
10. Date of Purchase 5~16-~j Name of Former Owner , Di!'Ai . ' ' ' ' ' ' ' '
11. Zone or use district in which premises are situated . , .
.
12, Does proposed construction violate any zoning law, ordinance or regulation: No
13. Will lot be regraded No Will a ss b o from premises: Yes No X
14. Name of Owner of r es Michael 0 Saraga ~~-9
Name of Architect p %ddress Phone No. M:n274r24Q$.
'ol~n ~60i •e-P'.'E:.. Address I.T.C'.N:`I:
...5.. . Phone No. ~16 7~9^33?.
Name of Contractor . KRMA $ 1,1.1¢, QkWoodwackIddress . t4A/ Phone No. P4.4119.1 C%97--/'
15. Is this property located within 300 feet of a tidal wetland? `*Yes No .X...
*If yes, Southold Town Trustees Permit may be requMed.
PLO
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.
t
I
STATE OF NEW YORK S
COUNTY O V.
s1....
(Nam/ individual 'R R S being duly sworn, deposes and says that he is the applicant
contract)
above named.
He is the
(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 t s day of,
~(xse EvWX..& 19'~K.
Notary Public, County
Nom PEubbli 8~ N$tl~ Y6Fad .
No. 2"8441~~50
coax nj ( nature applicant)
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OCCUPANCY OR
I
USE IS UNLAWFUL
Y
WITHOUT CERTIFICATE
OF OCCUPANCY
If copper tubing Is used
APPR VEDAS NOTED for water distributing
7sSQ /7- 62 DATE: B.P. N system; piping shall be
YO,
BY: types K or L only FEE: 177 NOTIFY BUILDING OEPARTMMEENT AT
765-1902 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWOREGUIRED PLUMBERCERT/FICAWN
FOR POURED CONCREN
2. ROUGH - FRAMING & PLUMBING ON LEAD CONTENT BEFORE 9. INSULATION CERTIFICATE OF OCCUPANCY
4. FINAL - CONSTRUCTION MUST
Be COMPLETE FOR C.O. SOLDER USED IN N647ER
j' ALL CONSTRUCTION qK#U MEET
TIE REQUIREMENTS ~~y~M ~y~OF TFIE N.r. SUPPLY SYSTEM CANNOT
STATE CGNSTRUM a ENERGY EXCEED 2110o/1%LEAD. JoTES, CODES, Nor POWONME FOR
DESIGN ORCONSTRUCT= ERR0110 I. OjkL-D OUT E>'T`.VV40R W^~-`s ~~yyHL° .C
N&GEsaF,;,4,,S" A' W-U, LAT~ W/RV4 FItE2-
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