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HomeMy WebLinkAbout18492-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219816 Date MARCH 26, 1991 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 800 HALYOAKE AVE. ORIENT House No. Street Hamlet County Tax Map No. 1000 Section 027 Block 02 Lot 2.9 MAP OF SETTLERS AT Subdivision OYSTERPONDS Filed Map No. 7729 Lot No. 9 conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPT. 15, 1989 pursuant to which Building Permit No. 184922 dated SEPT. 15, 1989 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 AS APPLIED FOR. The certificate is issued to INGO & ROSEMARY SCHARRENBROICH (owners} of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 89-SO-44 FEB. 11, 1991 UNDERWRITERS CERTIFICATE NO. N147331 SEPT. 13, 1990 PLUMBERS CERTIFICATION DATED K & K PLUMBING-MARCH 7, 1991 Building Inspector Rev. 1j81 !'OHM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT 70WN HALL • SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°- 18492 Z Date 19..~~.~ Permission is hereby granted ta: ~ -y- ct premises located at ..~.f..?!..../:I..l!~....~rSr:^'i.:.......~...S.N..`:r.Y.' County Tox Map No. 1000 Section ...Oa1......... Block ......~~-.....`.,pLot No. pursuant to application dated ..~~-~:'~!.~.A....~ 19..A.y.., and approved by the Building~/Inspector. VVV Fee S...f..1.4.0~.:.. / ~ ~.Sr.`..~J?r.......~ldiny.lnspecfc Rev. 6/30/80 ' ~'x "p' Ni'3a. fi.GF~'[w."rO~t~74,~+i~~".SEC'Tf.~FdS ' `C r~ ~ tLEt~ try . , , , ~:3 ~ _ i : Ci:~f~'S`t~fiF`YC'~ P~ h't~ i~tCi•7~. ~.uacatv']'3 ~'~~,6~`- EC.~+J I30.,~'T ~.'f~^i ~E4 L_.~tr=s` • '~Y # •.W. r ~~?1Y~.. W yr a ~ _..l 4 ~ Y `YI~ ~ f4^ M ~ ~ F X69 Y ff ~ ~ a i ^n 1 / as i 'N ( j~ CSIJ f a~! '~~^',l~1rry~,,.. n`~ ~~{~}'/~',1,ry{p~~[~~}~~/~ ,.~j_ t~`S['~_ Y~~ f .•A"! ~~~y~.~1 ~I V+'Y+.r~iV 1 1 ~ 'L 'A` K'~.~lw~~}.~v~{7\R _npj ~ IY ~ V (~a1 _ ~L' hi~n~i~ ~'^k~s - +r r ..S,e. .i. pnry ' ~ E ~ r a -..Ai~~:~7.83 c~u.~aur~p~c: -3.,;( ~ ~d/?o QQ'~ ; tti sn ~9 ~ ~ i ~ I'LL' ~ 4 ~ 1 _ T t p ,l•.,~ +J ~ . N ..R,.: arts ' She ~ ,1~'ech Defiant Encore sn~e~ the up y ~ Defiant Encore® Clearance Chart urf Urfa STOVE PARALLEL CORNER PARALLEL tJpRNER CLEARANCE No HntShielda 24' 31" 24" 8" 1S" 8" Top Exit, RearHS.onlyt 24" 31" 24' S' la e" RwrExit,RearHS.only 24" 19" NA 8' tP ~ NA Top Exit, Rear&Cotmce- 24' 19" IT' B" il" T for Heat $hielda'x CHIMNEYCONNECTOR ALL INSTALLATIONS ALI.INSTALLATIONS CLEARANCE No HeatSldelda 24^ 8" Connector Heal Shields 12" 4'e COMSCSSI'1HLES 48" 5hieldtgg fire top exit stove must include s shield insert to protect the area beh1M the fluamllar. eChlavteymnnector heatshieida muatexbend exactly 28"above the flue mllarof theamve,anda24"d'umeter rnillng heatahkld must be used. Tim shield should be 24 gauge orhnvieraheetmetal, centered onehe chimney mnxctor snd be mounted on non-cominutlble spacets 1" be]ow the orillng. uJa 'si'he cellletgtuat shkkt tvquined whonchimney connector shields ana used should mesa the wall protector. This will / 'te trimmin the ceRin ahleldabn theltneof intersectionwith the wall totestor. rn Sample Wall Shield Sizes 11"C75) r~ ~^"J" 30" r 1" I I' ~18"~ i Z9" t r9" I ~ e 73" ' ~ st I ~ ' ~a 1 1~ ii rta^ ~ lad 4'+l i TLas' ss^ ~ ~ cb- ~ , ~ t"" ~ t" , ~ ~ PARALLEL INSTALLA710N CORNER INSTALLATION VERTICAL CHIMNEY CONNECTOR VERTICAL CHIMNEY CONNECTOR STOVE AND CONNECTOR HEAT SHIELDS Reduced side wall clearance. Wall shields are to extend Reduced rear and side wall clearances. 1 B" to the front of the closest corner. ' tf rear clearance is 15"the wall protection needs to be only 66"high, and the chimney connector and stove heat shields Fireplace Installation Clearances are not required, K the chimney rronnector heat shield is co used a ceiling heat shield must be mounted 1" f rom the ~d ceiling. Rear and side wall shields may meet at the corner. n- ~f i ~ Hearth Dimensions g I ~ Minimum floor t, ~ i 6" g ~ j ~ protector dimensions e 4' 'Measured from side ~s of door opening 8"•--?~.~. _ +--8"• e A) Mantel 39' (protected) 18"(unprotected) I it B) Top Trim 39 (protected) 18 (unprotected) 76" e C) Side Trim" 10 (protected) 8 (unprotected) ~ 39.. e "protruding 2" or less ` 'The specifications and clearances included in this tech sheet are for pre- liminary planning purposes only. Before beginning any installation, consult your local authorized Vermont Castings/Consolidated Dutchwest dealer. Tech Sheet-9 ~,FFaCK~`~ TEL. 7G5-1802 ~p OGy, TOWN OF SOUTIIOLD :.f~ t~;;~a~; ~ Ul~f~iCLOPBUILDlNGINSPECI'OR ;JCy ,z P.O. BOI' 728 ~ TOWN I?ALL ~,of/0~ ~ SOUTIIOLD, N.Y. 11971 1!1<11t[ti s, 1991 7N00 5 1~ 4fAR1[ 9lIlA1?!?J~ICH 238 WAi~&SI ST. ffit[IQd.7tN, N.Y. 11201 To 47hom This May Concern, We are unable to complete your Certificate o" Occupancy because of the following reasons. tae/ nn application for Certificate of Occupancy is not on Life. » / J No Underwriters Certificate on file. The check is not on file.) $25.00 ~ tdo I[calf-h Dept. 1lpproval on file. No final inspection has been made. Please contact our office on this matter. Thant. you for your cooperation. Bui] din~l Permit If 1 8 4 9 2 Z CcE Pniffl.Y'*-~'*?A~ Building Dcpt. ***~J No Plumber Solder Certificate on file. ( all permits involving plumbing being .issued after l,pril 1,19II4 ) .9ts~ Im~trm®©$a6.ss co ~,a ~~x s/2G/9o jc~-~~ ~~~77/d~ c.c. At3aIl~5 tt Seim I~LD is:.~.:'...:~;:: Il:in:~ I ::ii:4MENT^ t. C ; " m ~ ~ r'OUtlDAT20:1 (1 s~t) ~ ~ I© ?OUNDATIOfl (2 ) m 0 ROUGH FRAFfE & PLUMBING 2y d y 3. a IlasuLATIOr1 PER N. Y. ~ Q cl,~/a STATE EPlERGY ~ CODE 'R~ ~ - Y_ r 4. ~ a FI:]AL I _ o ADDITIOPIAL COMMEUTS: s 3 / `9+'"1°~ BLS ~ X H S ' . ~v'C~ "j H G ~ G ~ - f m _ ~ c^ r - H v m ~ ~~``~z 76'~-1802 BUILDING DEPT. 1 NSPECTI4N [ ]FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL REMARKS: DATE -INSPECTOR ~~~~v 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ) ROUGH PLBG. FOUNDATION 2ND [INSULATION [ ]FRAMING FINAL REMARKS: DATE ~ INSPECTOR- 765-1802 BUILDING DEPT. 1 NSPECTI~N [ )FOUNDATION 1ST [ J ROUGH PLBG. FOUNDATION 2ND ( NSULATION [ ]FRAMING [ ]FINAL REMARKS: - ~ r DATE ~ INSPECTO ~~~~v . 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST (~OUGH PLBG. [ ] FO NDATION 2ND [ ]INSULATION [ FRAMING [ ]FINAL REMARKS: . ~,r~,~~ i d' DATE ~ INSPECTO , ~ ~ C~~~fS ~ h/G,+~1S .mss J ~"Z>o~_ gyp 'c /~av, 765-1802 ~"Tr"" f BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ROUGH PLBG. [ ] FO ATION 2ND [ ]INSULATION [ FRAMING [ ]FINAL + REMARKS: (V/ ~y y I DATE G INSPECTOR~~ 7' 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING ~ ]FINAL REMARKS: DATE ` INSPECTOR .G~~ I ! ~ 765-1802 c BUtLDiNG DEPT. iNSPECTI4N [ ] FOUN ATfON i5T ( ] ROUGH PLBG. FOUNDATION 2ND ~ ~ INSULATION [ ]FRAMING [ ]FINAL REMARKS: - < DATE 1-~ INSPECTOR " t [ ~ X65-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST ( ] ROUGH PLBG. FOUNDATION 2ND ( ]INSULATION [ ]FRAMING [ ]FINAL ~ REMARKS: `2~;~ 'L- x DATE INSPECTOR ;i)fMIIiWWW11NU7NA al IIUiD11UA1)1NcRUi:W7~119)1 ~Nllclli}U~fURIIlIUB1pUI1N1i1 x y p,r F ~ c i > ri 3 ~ ~ ° _ _ C ~ 3 T S'i ..j ~ 1 ~n O o t +c n ~1 _ (~Z x ~ "a O q Leo x x Z m 3 f ~ ~ _ ~ ~ C ~ ~ a < -m 6 - ~ ,-m m° '3 c f x 5 ~0 0 to o £ o^ t 3 'bc_ m C W O > m ° ~ ~ m ~ o o. £Q P c a ?1 c 2 C T o m" m ~ N S~ `c F T 0 o n ..1 Z 2 K7 b A m v n> A ~ F C y ^ p i ~ ^E a r ~ ~ ~ -1 oc~ ~ I ~ ~8 ~ ~ a ~1~m < ~ " 2 x. o o ~ m _ ~ ~ Q £ N n s;O z S ° ~0 0 m o ~ $ ~ c m 1Ti W m a" =_f ~ m f a~ ° ~ N f41 A _ c m ~ E p C. a Z s ~ 1 N a Z m ~ m l~ R X o ~ c ~ _ ~ _ ~ ~ 3 ~ c ~ ry ~ ' Z£ ~ 1 y w _ y F m = ° q m I a S L 'v4' a D ~ D N ~ _ _ _ SvFF~~C TEL. 765-1802 z!:'~, O~y T01VN OF SOUTHOd.D /4 OFFICE OF BUILDIIJG INSPECTOR c n, P.O. BOX 728 0 ~ f ~e TOWN HgLL D //,'O ,~0~ SOUTHULD, N.Y. 11971 BLDG. DE"rT. TOWhI OF SOU7F'OLD C E R T I F I CAT I O N Date ~~1y `Q~ Building Permit No. /'8`'Fp2 ~ Owner Jn/G+s S/'/-1~R.,~B~PotCt/ (please print) Plur„5er d ~\vmh..~~ k \~,~c~,r,~ (please print) ~-J. C ef~~yL c ~ JS ~ - I certify that the solder used in the water supply system contains less than 2/10 of l~ lead. _ ~ ~ .,moo (plumber's signature) Swor aro befor:~eLthi~ s[/,,, ~ / day of ~i1'-~'jl ~ Notary Public t7otary Public, County EIMi: ~.1(OC11 pdoT h~W,lMM d NwiY6rlt Na i2,21~t100 Ou~MM~d N MAlat OMnMy Term 8r~irw.lw. r/992,' Form No. 6 TOWN OF SOUTfIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 1. 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 19. lead. S. 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. 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 S. Temporary Certificate of Occupancy - Residential $15.0//0, Commercial $15.00 Date ....~~71.~~• ;ew Construction.......~~yy .Old Or P~,r/e-existing Buildiyng .ocation of Property...Q.~p .......CC~L.1J'.~~7e~...~'+..~54' ~2~~............ House No. StreeC H~a/mlet )nwer or Owners of Property..~!~/~-D..~I.I~~.SC~`7!~`.~.f....~Cy.~'.~~j1~~2A{C!( J n.q. :ounty Tax Map No 1000, Section... ~'7........Block.... Z .........Lot....: ! subdivision ....................................Filed Map............Lot...................... 'ermit No..~ ~.7.~ ~!.Z...Date Of Permit.. ..........Applicant (ealth Dept. Approval........~~:5... ~Z:~/9~..Underwriters Approval... ~ Tanning Board Approval equest for: Temporary Certificate......... Final Certicate.... ~ee Submitted: $.....G.~'.:°??....4C'~ :.7 3~a~/y/ C d Z~ J~~~ ....APPLICANT.... .y<~. 1 NOTE~• SUFFO ~Q~j~~.~f~~ .APPROVAL I Li)S P,i~~ I~t.t F_{~ TCaMFaF' :,F F'T"! I F'i~¢ ` {It[%;.(ti(0'~~\1WT'•~ r Ai .Y ' '"'L;.'. d i.:: ` FILEii t N 1'Nt~ _ ;~_t ~ _ ~ ! ~ ~ SUFF. t,~ Cl.r~i~i.' ` :1FF tC C A~ MAG NJ 772, va~"n,>.I? _ AUG 21 !98g ~ fi+=ELEV. 13.0 FT. gSOVEMfrANSEAL_EV~L. -_.___1.^--- r r ~ ti , r . ~ .C. DEPT. OF ~3 I a i / j, 1, ~ j, 180.;.' i . ~ \ J . ~ v ~ C < ` 1 , t _ ! ~ c,,.. Y ST NTENT - i _ _ _ { _ta - - ~ 25 r'y' y+ ~ ~ ~ - ~ THE WATER SUPPLY AND SEWAGE DISPOSAL ,.p-~ ~5,5~I2 E. P~ o ~p ~ , I ~ ~ i t_ ~ SYSTEMS FOR THIS RESIDENCE WILL cy Q" o.°~' t10~8 If1 ~ ~ CONFORM TO THE STANDARDS OF THE ,ti, ~ ~ A_• SUFFOLI1~~~~O. ppEPT. O H ALTkLSERVICES. g "9i~ ~ G i F=~ f .i (sl (h„1.,c5~ Q1 ~ ~1 ~•`~,S - - PLICANT t(7~- I7O~ ' " - ,t - , : c7 n1 d~l~' i ~r .iJU I l ~ ..1...L', t 1.Y. SUFFOLK COUNTY DEPT. OF HEALTH x ~~y \ 5ER V ICES -FOR APPROVAL OF r~,N ~ ! CONSTRUCTION ONLY v r " jr R O r-- ~ ~ DATE: A~JG L J IJ Q ~ v'J 7 Q H. S. REF. NO.: S~ ~,i ~ _ V ~ . ~ v; APPROVED: ~ ,p j, ~ / ,~J~ 8 SUFFOLK CO. TAX MA? DE ATION: l~' vt. V~`~; ' C~?.:.. JSO.C < r ~ ~O ,t' - . ~ DIST. SECT. BLOCK PCL. ~ taJO Q27 2 2~ Ata : Kbi.iy0 ,J ~ ,rt t ~ ~ ~ SCAL.i` IOO= I OWNERS ADDRESS: A' 5.G18-T AC. I ~ P,T4~~r',~~. a o m , 's 4 \ o Pif~E~ - - 62001L1..YN, IV.Y. IIZDt Vl FT I ~ I ~ ia217- Jk ~ i~ 8 9$~y ` \ A--TAGiCED H_U~- il rI _ stxr.~ - ~ ~ (7EL.118-576--t22'T} t v2«•. ~vRG _ ~ DEED: L.N~A P. 1~ ~ N ~ ` rza~. tao.o SINGLE FAMILY DWELLING ONLY TE AMP . ~ ~ n~c a-. ati 9 EXPfRES TVJO YEARS FROM DATE OF APAR0I~L; -Y If 1 C _[h.:'~zC-` sRa a'~on or aGd+tion } l ~I T LE. ~ ` ~ • .~,;'F~ ~ ~ ~ ~ ~t at o fztaw. ttre Naw \corA Statt / t^.^ C l-\ I' ~ W J V Yv l• i V; II ~ ~ tso this s•¢vW ma not bearing .LS I - ra M s rvnYa s ~ aa'~ o. ~ ` Z td bu0 ih M onnsi :erect 1. A 1 ` 9 . pnaed Seai 3F.a1' nol ~~I' W lj1 a~ LtJ y Q C~ to a valid trua cnoY ~ Q H •h.+ L~ G aranteas inilice•.~`- h^r¢on he ~i ~ ~'1 ` N t O ~ ` ~ ~ Y t0 tha Yr 9t Or h ~5 - - - tV LLI ~ ~ s reuar d ;;,o ' rc 't~a u .v and 'v ~ b ~ MAP AfriENC~~p - NOV.8,1988 ~ ~ Z' ! CrJ n m ' n I a ~ ~ _ . ~ V Q t the , onalA rS 6 R ens r s ''s Q aCC t \ ~ tJ.gcf 17 20 W. vo~sa3 ti" 1 Z SEAL ~ C ;~A,iV Tt`t'~~ ~ N~' S~! ~TI.'! ~ N, Y CK q O pp l e Y~ ~yJ \4~t r f N ~ LICQNSED LAND SUR YORS ~r 20 ~'4 d GREENPORT NEW YORK is ~ F"IA;VD, J. . T[1EOYNE It]fT N81]~9 i `t> SUFFOLK CO. HEALTH DEPT. APPROVAL l.~L~r, ,~iCJ.~ ftE=E=~&? TO MAC OF~ET i lrC.2.. i ~C~I~1~~, _ - ~3 n( r; ~a(~~Ht~~"" ~I~~G_iri ~ MAP C,~F- f-~f?O~'E~ ~tT.Y' FEB 131990 - _ - ~(,}Ef C.C! CI.E{t!~ a JFf tCC A5 MAF NG•772y. ~ ' % ELE`J. 13,0_-FL_ t~8O1/E MAN SEA LFsV~L. BLCG DEPT. _ 70WN OF §DUTHDLD ~ ' ~ r ' ! ! • _ _ STATEMENT OF INTENT ~ ~ t __~o_ ~ _._r~ - THE WATER SUPPLY AND SEWAGE DISPOSAL _ - ~ x i { 1 - ~ ~ ~ > SYSTEMS FOR THIS RESIDENCE WILL ' 1~ ?o_ - : ~ - ~ _ . _ CONFORM TO THE STANDARDS OF THE by ~.ao IIfl38 A,T' SUFFOLK CO. DEPT. OF HEALTH SERVICES. 4rr~,: ~ , Ot~IE=~P.iT (sl APPLICANT ~+rxi~ !~U O T~Wiv ilE"' SUU}(-i~L.??, Pti~Y. SUFFOLK COUNTY DEPT. OF HEALTH „ ~ „r ~ 6 ~ SERVICES - FOR APPROVAL OF ~ ii CONSTRUCTION ONLY Ci ~I r~ ~ c-- a DATE: iI ti ~ Q H. S. REF. NO.: ~ e~,:, v _ r? APPROVED: ~ 4)f ~ ?r N.~ - - Ili ,,~I/~ • ~b ~ ~ ~ T ~ 7~ Q -t- 8 SUFFOLK CO. TAX MAP DESIGNATION: 0 ~i ~ . 4i, ~'v' ~ "r ~ VA - ~ ; - DIST. SECT. BLOCK PCL ~ ARC~IGi.~J t~,~\. . `1~ ~ ~ tsx:o J27 ` i ~ rtj;`•- ~ ~ • _ 3. , V~ SCP1,L~ ~ 1C~' I OWNERS ADDRESS: ' r' s~ w' ~tiK Af~/A. ~ S,UI$~i A~ • 2.38 WAfLfi.Ehl 9'i: 4 r PLAT i _ I ~o ~ 4=TAGi'GED HUB rCvr'.t1 ,o ~ ~ ~ t!7EL.-118-5~o--if2-T) ~ ~ ~ ~ _t"___.- r15t - / DEFD: L. OLA P. STAMP I ~ t•' ` I2A0- I OO. Q GQFiC~. FdUNG~.. ~ Y ~ i; ~ ! t Vin.. •,~,:r,.,,.~ ettx+tion or adistion i I ris a rJ z +on' ~ •af the Aaw YOr%State ice. I Q T(l-l,~ NG 6U5"7'3Jt~E3 ~ soon taw. _ mep not bearing ~ oP rh,s s!meV i~•' L~ Cj ~j i~~~~S~7VCVC~~ ^Coh,.a~e•,d survaYOr ,n"ed saa4a y_i \ y - e,~ ~s>d sect ariaff not tre considered i „p L^ ~ avafid VUe coGfi• tU i, s O N : entaea indicated hereon shaft run _.'t ~ .N r cn to the person for wham th0 survop and on h~ baheit to the Q -L ys raper 3 o~ernr.an al aerw and -N 4 tit cr+ a~/ 8 and .J Y1 ~ hereon I y , ution lets e~ t,. - aes -i the Sand,n9 ins:i- MAP AMEND~C- NOV,B E98$ . N©~/• $ 1989 the N . 1 - , -ar;,aas era not transferuhN _ t wn G4 Z ^ ` r a t,,,pnal ins:itauona or subaeau~ ars. ~ e_~.-_~~~_ ~ SEAL r ~ N'Q VA..'~t•i i ~~T TEEDTU~ r 9 17 ?A W. ~ I I SAG ~ f~i~l TI`G$ErvBANtc~;•, n i ~ ul ~ ~ ~ O .ICI A`t ~i'3' ' i AN YL, 2 ~ ~ z ~ ~ . ' i. ~ f., ; ~ ~ LICENSED LAND SUR EYORS ~ ~'$j~^ ~9 i't GREENPORT NEW YORK _ ~ - _ - f - - - SUFFOLK CO. HEALTH DEPT; APPROVAL REaf TQ_ 1v7A~' OF 5E..:~ L~~~_ ~ ~r~~~f~.."r,~~~~iL~t~ trJ-t`u~. ~ ' ~ -MAf~ Q~" ~f~~`1~'~ ~g ` n - ~I-C~ °.l` <tfF~ 1~,:~ X~~ ~l~t ` !~3 ~'7T Z~. V,u~ APJ'. ; . _ - - - _ - ti Fvi~.._ C SUkd , rr s. t~ ~"1' .9~v'~ :?_^^Etrt 5f^A I...~VEL,.. ~a - _ 1 ~,,~F,~;. ~ ~ >6o.v ~ ! i `~(~::~"t ~.hw ~ t . 1 t , a, f ~ATEMHt~T OF ti"tTENT .y.`~ " `,~Qyy,~ -i ~y~~y~ ~~~''~'i~ ~ { ~ C ' ' ' i ' -j t- r^ THE WATER SUPPLY AMD SEWAC+E bISPOSAL ~ i.~~ ~~f"I~~"`t~~: t~C ~ .r~~.~~~{•,,,/ll~.,_,i•~~ SY5YEM5 FOR. 1'MIS RESt~ENCE WILL `J~v t?, s'°- _ _ ~ _ . ....._u. NFORM TO THE STANDARDS OF TWE ~ i~ ~ d~' SUFFOLK C.O. DEPT. OF WEALTH SERVICES. ~Of ~ , ~ ,i .~E ; ''"4444; ~p ~ ~ _ . ti.?t~''v~ 1 (s~ a1+PlICA\NT Y~. b-~`wwt. ~O ~O ~`sY1ft'~t C~~ 1'~U ~ `i:.31, t t .:.Y, SUFFOLK COUNTY QEPT. OF HEALTH ~ ~ +ti SERVFCES -FOR APP/20YAL OF SUFFOLK COUNTY QEPARThfL-N; Ct f!=.",~T!! Sr}>y;;,~ CONSTRUCTFON ONLY N/ i - u ~ 7 x"' n Stfiul.E FAM.itY DYlta_t I~'G 4``~ v OATg: I ~ ~ x ~ DATfFB_],.1_]~..91H a: Rf F t,G H. S. W~F NO ~ . , ~ V The sewa4e d „no e~~' s~afar si i r °e,~ s i~rThis APR}t~lVED: ~ ~ r 6'}. r,. IOCatiOn ti ,f 'Jc~ (a~~~,G b i4 ~c ' - ~ ~ ~ - t y ~e ~e~ a .i;. and/or ~ ~ v~ ~ other a nc~efiand fo}+~d tq~p~a6s r . +r ~r x , • H tt a 8 ~ ~ ~ ~ U l~^='•t'-~ y 5131' L~+b FAQ #i L'~G3~(GNA O Q~ • [!ate ~ VAC'r~, : _ Chef Bureau of Wastewater Management ~1iST. SECT. -ft14, PEE.. Afi~i~ =iC~i.tyJ ~s'i, ~ ~ 45' ~.[..s~ ~ t~f3G3, . a~ [ ~ , O ~ ...:ALE.. t~ f OWNC ADORE _ ~ h j` ~ ^~1'..~t, . 1 A f`;A^t SNtta ! A~ , Z~ ~n/AGZV.#t+1 ~T: 1- "'rS~' ~ o- Pt+~ - - B~CC.Nh;. f*t.`4' ~ lk". ! .PEAS T ~ F`r ~i9 ~ I ' ~ ~ - "~lsGiC~l~ ?IUes_ Qt'~tiF~ -tee - i,sr4ev ~ (`fEL.'718-5`~b-:'t2G"i} t - . t u~.v'~}~ 2',tUTLV FR.HO - at64- .3a. ; _ D'EBD: L.t+ifA P. R 7 1vV:N Y if Ii! ~ AQ'`s8?.@~? t5rorzv ~?,r~-. ,l~i~ r ~ E L AMF S " ~ /1 ~i1 1 I'ltfVT!i 1kA ~I.OM1 OI QMCb/1 F s l: > u-rc ~C'~I' ,V5 ``~.M .o . v__^' n . ~ ~.lo.. ~t . { v T[[ r? T J ~ L. ~t 4' ~ Y tPe P.ew 1'~:t StsN blgn LMW ~ ~ ` a .A. ~ ~ ~ 9 , 3 605 ~ 5 _766 ,r 3,., + ~ 4I ~ - r Ma i i ~ A ' t ~.1 8 -n MApAMtr~vr~G•N©v.8,t~. NOV.81989'AUG7f t..Lw~„'6y..~ _ i ~ ~ [d,4q°t~ 7A W. ^,~2~•68 ~ VA~,~. r y : FE 7C5 ~i ~ ~ ` ~ ` fU ~ ~ l~f~;~YL a`s pp 41C~N'SEb LAh1D STIR YOBS _ _ 4 GREENP@RT NEW-YORK ~ - • ~.~E. ~ SUFFOLK CO. FtEALTti OEP7, APPROVAL tr_~ ~t.~.~,.F~~~ryTpu~h~'~~5F?'~t.~l~~_ ~ H•s. N0. ~ ~S'J~~ . ~~E i>r~' Ac i"3t~1 . N ~ 77'~ , V~: AF~1;'; - ~~f~ . ~ C'~'1''~ ~n S'+5.f ^u+^~ Y l tf~:(: , J 1 - ~ ~ , ~ `~f ~ I ~r~~, ~~e' ~ ~ . j I "'u ~ - - ,_....,..~_.-~.w. ._.._...._~...,rw S?ATEMEf~T OF tNTfNT Gsti~-°' ~ ~c°~' L. ~~D ~ ~ i-•, .ror~' ;,d r r-; - . r,..,, , THE WATER SUPPLY AND SEWAGE bISP06AL ~ ~ ' _ ~ ~ ~ ~ ~ . t ~ ~ STEMS FOTt TWIS RESIDENCE WILL :;7,~ ~ ; o,- • - " ~ ~ ~ ~ . . .CONFORM TO THE STANDARDS OF TWE ~ SUPFQLK C.O. DEPT. OF f~EALTH $t~RVICES. i, ~ , V~~ ~ ~ ~ ~ ~ G~'fE: ~ ~ ~ AM~r:CANT LSD G . F, ~ .~tIbTJI~1G~s~~waaL. ' ~ ` c7~ . ~ ' x ~?`u~1F~'J ,.1~.,. ~ ~-1°,r~l~~?, :I w`Y`, SUFFOLK COUNTY DEPT:. QF HEALTH . r1 ~ '~f' r, r SUiFOIK COUNTY DEPARTh'.r.N i ~x „'4!~ ~a cr S E (t V I C E 5 F O R APP R 0 Y A L Of I a` ~ ~j, ~ ~ Z 1. ,•5* l~ : SlNG1f FAh;it.Y DWCtI,I~C Q,u " ,,c4;Vi;, CONSTRUCTION ONLY ~ ti s . DA ~S y ~I ~ ~ T`~~ Y ~ .DATE: ~ w.;`'r'•~ ~ a ' ~ ~ ~ J ~ ~ ~ tt:S RAF. t~v. $ ~Y,••~~ H. S, RE`F. NO d T ~ ~ ~ the sewage d~~~n ~l a!t uahrs~,~~r r a .•^s.i r # V D. . - ~ w o'J L.~li -r.r 7 ~y t: $ ; } ° this pl'RC? £ - i4..~~.. ~ is \ OCation i, f~ 'BC,t` ~ ( ,,i,~L', ?il!~/0( ~ ~ \ others _ 4~, ~ ~ 1 nsie~and fo}~'.d iq~b~atis(~ ry• r - ~ c~ ~ ~ $ ~.,.~itt~~•~~ UV Ltr'~w1 i'~ 3ElP'FOLrMC CO.OAK MAP 1~51~NA~'tON: ~ r - ~ ~I~r~: ; Chief b~ Bureau of Wastewater Mana e~me~ nt~ ~ ~ X17 • h$~ ~ ' . J ti B aiST. SEtT. ~L PCL: y i ~ ~ ~ ~ ^r.A~.~..' i.JQ' i dWNti ADDRES~: _ K: ~ _ o ~ r - PtF~ Bt~JC3I~CYIJ, u.~ I1?~! . ~ ~ ' ~ pE,~~•~ ~ ti)iA ~ ~ti\'~ Q-'TAGiC.r~lJ EAU ~ ~4J~€: io4r~ --IB7 - w._ ~ ~mttY ~ ~ ~ i7EL.~118-~'~o-:~t>2%`t} . ~ ~,r 1 ~ . ~:r2A~.' IC?(7.Q 25'Ir~f2Y iR.HO ~ X65. 3{:. .._I ` DE$D: L.tti]l~ P. i'`t ~ • i.5TaTLY ~,r w} E HOL AMP ~K V ~ ~ ~ ` ~ . ~"`ir.. ~ ~ ~ ~ L ! I i~w. ~ T 7 I L I tP :l+ li 111f 4iEK 1`JI'. Ff1aN y~ ta~t~ G~1"~41L ~`tTl.~~,1' ~~~•~`.~~a ~~ar~nk=,rr~•~:~~u~~, ~ _ _ . ! ~ ~r +Mr~t.W~vkx xaey~,neir~u~n! ~ ~ ~ ± ~ 9 ' ~ 6Q~~5 • _~bb 4. ~ ~ ~ , !Rj u~ ~ - C I ~nl+,n e. ~.A thkl!'nin i A li h ~ ~ M. n1 ~L~t ~ iV F~ 1 Q ` ~ ' q MAIr AM E P.t~.?E~U - NOV. B, f~$ NOV ~ ?989 A!;lG.7 t r = E ~5, ~J- 1.. ) a ,;~..`ir~~t~M~nFtKh'JVr,~~91`:. ~ ; ~ ~ ,~r • AUG. 3t?, ~0, ~ l tj ~ ~ ~ Q ,~BA~NtC; ~ ~ p' t a, S 1 i ~ ' ',.,....,..~Y ~ ~ , • LICENSED LAND SUR EYORS ~ FREENPDRT NEW YORK . mt~+rnt psi ria~zzv r 4 ~ ~ SEr^^--v77-'69 12:55'ID:'rinNOLD ARKS TEL. N0:?12-535-2590 #7?5 FU1 ~+~w I 1 , r i :f ~ 1 i rr ~ ~ r ~'SY r 1 ~ r •a 1 1 1.. .,tea ~ ~ ~ ~ ~ ~ 3 ~ ~ } V \ 4 V Q ~f. _ +'l t ~ ti ~ L ~ 1 O Z~ ~ , 1 ~ . , ~ r W oO \ '1. ~ ' ~ r l 3l \ .`1 o N a ; .J~ , _ qtr , ~ ,.t,. V ~ r r'fi i~ ~ ='y~ I . rE,~ , r r.. I • t j ~ 1 { f v, ~ i t ' ~ ~ w, 'S, r ..~j , ~ , m ~ ~ ~ ''`r' ;7 t . ~ ~ 1 ,r .ft-~~i ! 1 I tt. I / BOARD OF HEALTH 1~' / 3 SETS OF PLANS C).1~„ . I1 PI UU 1VJ FORM NO. 1 SURVEY - P• • • . TOWN OF SOUTHOLD CHECK ......:~:.65`f.~...... . r ~ • ~ BUILDING DEPARTMENT SEPTIC FORPI ...Q•1::....... . TOWN HALL rr i" , SOUTHOLD, N.Y. 11971 NOTZFY ~~6i.Jj F~.~E' FC+~tr7f U~PSU n ~,p TEL.: 7G5~1802 CALL ~7.7.7.7~ . ~~n~/?-c.. ~.5. 1949. MAIL T0: P~. Qok b`7~ Examined • . ~T,N. \pPrave~) S 19?39. Pcnnit No. ~ Y".7 ~ ~ /1944-' Disapproved a/c ' '%'1 . . U ..~....J . (Building Inspector) APPL{CAT40N FOR BU{LD{NG PERMIT n Date .l7.lJlx-i.~I......, I5^ INSTRUCTIONS a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, wit 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 str_ or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this ap 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 per 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 Occupai 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 Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance- Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describ The applicant agrees to comply with all appiicatile laws, ordinances, b ilding code, housing code, and regulations, and admit authorized inspectors on premises and in building for necessary infections. (Signatur of applicant, or name, if a corporatton) • (Mailing address of app icant) State whether applicant 's owner, essee, agent, azchitect, engineer, general contractor, electrician, plumber or build Name of owner of premises !4!1-0. ~`J.~lt.~S~!'Z~?~?,-J.' • u.C~91.2~,~?.Q~l.~i~. • . • • • • • . • (as on the tax roll or latest deed) IC applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No . . Plumber's License No. M) ~'(E .~RCo B y - , • , • , , . c Electrician's License No. G{.-~..~c~I ~'r.. . Other Trade's License No . t~4 Q A 1. Location of land on which proposed work will be done. .....~"./7'~L-!;1Q!-~,;~~", 11 ~'1 c~ I{ouse Number Street. Hamlet ~ County Tax 01ap No. 1000 Section ~ z7. • • • • • • Block Lot y~..... . Subdivision Filed t<tap No. Lot . (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . y~ b. Intended use and occupancy ...~/N~'•"~~...n'r''M/~,y...~~$'f,/~,~TvC~ 3. Nature of work (check which applicable): New i3uilding 4!...... Addititn Alteration . Repair Removal Demolition , Other 14ork , . s (Description 4. Estimated Cost ~ 1.~~f,DO~ Fee (to be paid on tiling this application) 5. If dwelling, number of dwelling units I Number of dwelling units on each floor . Ifgaragc.numbcrofcars 6. If business. commercial or mixed occupancy, specify nature and extent of each type of use . 7. Dimensions of existing structures, if any: Front . Rear Depth . Hcigfrt Number of Stories . Dimensions of same structure with alterations or additions: Front Rear , Depth lIcight ......................Number of Siories ' 8. Dimensions of entire new construction: Front 4~0 Rear ....~:~4.°....... Depth ,~f ~ , , , , , , _ Hcigltt Number of Stories 9. Size of lot: Front .....8.3r? Rear ......~P.+~s3~ Depth 10. Date of Purchase :T~`t4G... ~Q,~.7 Name of Former Owner G~/~e~/P'.L~. /Y.~J/t'Ot?/T.,~.~.. 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zottirig iaw, ordinance or regulation: .../y.Q . 13. )Vill lot be regraded .....,.f~~s \Vill excess fill be removed from premises: Yes 14. Name of Owner of premises .~'CN~,P,~7.?,132e~~.y, Address . ~$d''/•c/?t2!?~!.f'T.. Phone No:?l$'rS9N:: 7.a .]~ar~rtreEz'crcltite'ct ...............Address .~2?~'~4~,/V..~•... Phone No............. L~tame-of-6ontractor s~ ~i~ ......:........Address R/, ........Phone No...~......... IS.Is this property located with in 300 feet of a tidal weCland? *YES....NO.? *If pes, Southold Town Trustees Permit may be required. PLOT DIAGRAhI Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions fr property lines. Give street and block number or description according to deed, and show street names and indicate whet interior or corner lot. STATE OF NEw YORE, S.S COUNTY , , . . 1~.-d'! being duly sworn, deposes and says that he is the applic Name of individual signing contract) above na d. Eic is the , ..../1Y<<ATrr~+~'~~" . . ontractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to mane and 61e application: [hat all statements contained in this application are true to the best of his knowledge and belief; and that work tvill be performed in the manner set forth in the application Filed thcrewitlt. Swam to before me this yr Notary Public, , ~.iLI.C..°!.~... ~jdt~~" . " _ounty • . • . h • `!~f~ . . HElENKOEVOE (Signature of applic, NDYIUtY PUtiL1C, State of New Yak Tam Exp~?MiScb~30k Imo may/