HomeMy WebLinkAbout18408-z
. ,
FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 219147 Date JUNE 14, 1990
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 1050 SOUTH HARBOR LANE SOUTHOLD
House No. Street Hamlet
County Tax Map No. 1000 Section 075 Biock 03 Lot 14
MINOR
Subdivision APPROVED 4/9/90 Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 22, 1989 pursuant to which
Building Permit No. 184082 dated AUGUST 25, 1984
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 WOOD DECK AND STEPS
The certificate is issued to TOWN OF SOUTHOLD
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL S9-SO-17 JUNE 13, 1990
UNDERWRITERS CERTIFICATE NO. N119524 MARCH 20, 1990
PLUMBERS CERTIFICATION DATED HARDY PLUMBING MAY 24, 1990
~~~.4~ 4 .
Building~Inspector
Rev. 1/81
sows xa s
TOWN Of SOUTHOLD
BUILDING DEPARTMCNT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N°- 8 4 0 Z Date ..~Z.......~.:~.~ 19.~ ~
Permission is hereby granted o:
/...~l~l/..~.....~..~..~~/...~,...1..<../..G~.
. .
.
ct premises loeoted at .......~..~....l.J
................u~'~......~,~.~r,~i.GG....
................................................~..i... ...~r..
G%~~r~ -
County Tax Map No. 1000 Section ..Q..~~.... Btlock~....11...~...... Lot No........I...~~.....
pursuant to application dated ....~rq~cG~..........1.....~ 19.~~and approved by the
Building Inspecto~r.~/~
Fee $.iU!/..`.'/.l!rK!:°/ V
.
Building Inspector
Rev. 6/30/80
- TL•L.7G=-1802
.,~,'~r tp. TO,\~'I'^I S(JtJT~~~L-3).
~ r
x,_ .t . OFFICE OP B.~Ili~LD131~ IVSP£L-T;OR
O1~0 SOUTHULD, N;.Y. 1.1~97fl
Y`,0
C E R T I F I C A T T. O. Ld
Date MAY 24, 1990
Building Permit No. 18408
Owner TWO BEARS
(please print)
P1Cts`J2r HARDY PL & HTG. NORTH, INC.
(please print)
I certify that the solder used _n the water supply system
contains less than 2!10 of 18 lead.
" (plumber's signatur )
Sworn to beforepme this -
a~J day of ,/r~~~~~~
19~ ~ IJoCary ublic
Nota_^ Pc~h'ic,w~~OL/~- Coun:.y
MELANIE V. BAOHM
Notary public, Slafo of New York
No. 4908712
QuaG9od In SuibAc County C~ 1
CommNdOnBxpiro00d.t9,i9_,.
0
.
- _ - -
THE NEW_ YORK BOARD OF FIRE UNDERWRITERS FACE
1000968
®URHAU OF ELECTRICITY
85 JOHN STREET. NEW YORK, NEW YORK 10088
MARCH 2O,i99U 65030289/89 N 1.29524 ~i
J)ete Application No. on file
rHls ceRrfFlES THwr
oily the electrlcd equipment a descrihed Fxbm and introduced Fry the appNcant rtatrted on the ahooe eppliation aumher in the prentieee q/
TNO BEARS BUILDERS, N/S SOUTH HARBOR i,ANIS, 7.034,55, SOUTHOt.ll, N. Y.
ATTIC 075 03 14 e
in thefoBominR locaOQp,CN BeeeRytnt Ixt Fl. Ynd Fl. SectJon Block Lot
mae esomined on t+t+A llYYY~~ andJound to 6e in compliance with the reyuirementa of ehia Board.
l7
INi1fN! RXTURES RANOEE tXKN(Ri6 DECKS OVENS pSN WAfAMK EXIIAYST FANS
t)1BEETE AQB EYYITC11E5 INCANDeSCENi FIUdIlSCEM OTHEn AMT. K. W. NAT. N. W. ANT. K.W. AMT. K. W. AMT. X. r.
L2 as 33 iz i t~
DRYERS fVRNAC! MOTORS IUTURE AMIIANCE RWiRS fr[gAt REC'K i1ME CIOCKS REII ' UMi MA1EEf tAIATI-WiflT MMMERS
AMT. K. W. CMl X, v. GAS N. r. AM7. NO. A. W. G. M1T. AMV. AMT. AARS. TtAOK. AMT. It r. ~
~t AME. wAlTb
3 F 3 - 1 1 3U 1 Ei
SERVICE O~MCT tq.W S E R V I C G~ E
AMT. AAV. Int 1/TN 1PSW S/SW 3X,W ffM;COND. gCC.C~. NO.q MI.IEG Oi~M4~1l6 NO.gTlUTKAUi gNlVT~KAI o
t loa cB i x i 4 i 4 ~
oTtNR Af7ARATUS:
G.F.C.I:-3
SNO$E DETECTOR:-2
NILLIAN T.STUC(C LIC./889 E
1350-5 LINCOLN AVf:11UE
HOI,BRWK„ NY, 1].741 ~y~ ~
Per ~
This TxrDficaN mutt not be altered in any monnsr; return to tM offiu of the Board if itlcorraci. ImpetMn be idetNifieB ilt+tre1R{RENiok. rop
COPY fOR BW1,DIg6 DEPARTMRTJIT. THIS COPY OF CERTIFICATE MIDST NOT pt JIiLTERRD IN AIIP A/MMR. ~J
- - - Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
BLDG. DEPT.
TOWN OF SOUTH LD LIGATION FOR CERTIFICATE OF OCCUPANCY '
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, 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, Che 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 - $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 . ~ a - O
New Construction.....~'~, Old Or Pre-existing uildi~g.
Location of Property..,'656....~~J,~ e•f._~.~~...y~.~:.•~~~ao-.~I.~I,• .
House No. 7 ,a,/ S r eVt~ 4 Haml.`let~': d 5.,~ ,
Onwer or Owners of Property...
c~ ` -
County Tax Ma No 1000 Section.., :`s-~ „ ,,,,;1,,,
P , ....Block.. ......Lot
Subdivision ....................................Filed Map........... Lot.
CCpp
Permit No....,~g,`~,~7„~Date:Of Permit...j.:,.Cx :~y ,~,`~W ~d
.Applicant. e~d;j.Sh:.~~~yy.c}...///. 1
lIealth Dept. Approval.... , , , , ,Underwriters Approval...~..J~. a l .Y,S+'L?c'.
Planning Board Approval / '
Request for: Temporary Certificate........... Final Certicate...~:;'-,
Fee Submitted: $,,,,,,,,,,,,,;;~r~,,,`,,,;,,. +
PLICANT
_i::LO It;s:~::c:;ua ~lu~~.i; :;obK~r,ars
- - _ ~ '°OQ
1 .
o HO
yh
FOUIDATION _ (1st) ~
~ ~ D a ~ ~ _
~ C~
L ~
FOUNDATION (2nd) ¢ ~i~
2.
o
. O
ROUGH FRAME &
.PLUMBING _
r
3.
IIJSULATIOPJ PER N. Y. ' JV (~L qq~'
STATE ENERGY
CODE
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vat N ~(,1
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FItdAL
AD TIONAL COMMENT m
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765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST ~ ] ROUGH PLBG.
FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ] FINAL ~J
REMARKS: _ ~
DATE INSPECTOR
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.
.~1~orfFr ~ark~ .~ousiny .alliance, Inc.
(FORMERLY THE GREEN PORT HOUSING ALLIANCE)
~/O SOUYH STREET
GREEN PORT, NEW YORK 11944
(516) 477-1070
ADEQUATE HOUSING FOR ALL BESSIE E. SWANN. EXECUTIVE DIRECTOR
BEVERLY HALLOCK, PRESIDENT ,
February 6, 1990
Steven and Nancy Foster
712 Wiggins Street
Greenport, NY 11944
Dear Steven and Nancy:
This letter is to confirm the meeting that was held in the NF'HA Office on February 2, 1990,
regarding your letter dated January 24, 1990. At the above mentioned meeting Two Bears
Builders, Inc. gave the following responses to your concerns-
1) Floors
A!t damaged floors will be replaced.
2) Plumbing and Electrical
Rough plumbing and Electrica! work are allowed by law once a roof has been
installed. Any defects that were caused because of the methud employ?d will be rectified.
3) Deck
The rear deck will have stairs allowing entry and exit.
d Cheath;na
The exterior sheathing that was damaged by the excavator will be repaired
thru the existing sheetrock.
5) Plnvoad
Plylvood will be installed in the storage areas on the second floor.
6) ~`'indow
The broken window an the second floor will be replaced.
7) Shingles
The shingling process used by the builders was explained. Any defective ar
flapping shingles will be replaced.
FUNDED BY N.Y,S. DIVISION OF HOUSING & COMMUNITY RENEWAL, VEATCH FOUMDATION.
DIOCESE OF ROCKVILLE CENTRE AND NATIONAL GLOBAL MINISTRIES
AN EQUAL OPPORTUNITY EMPLOYER AND PROVIDER
8) Cabinets
Kitchen Cabinets eith broken drawers and crooked doors will be fixed or
replaced prior to closing.
9) Cesspool
The cesspool situation fell be assessed by the builders. One of two methods
~~ill be used to correct the problem. A smaller cover will be placed on the cesspool or grading Hill
be done to create a level yard.
10) Door
The front door is the correct door for the house, it goes with this particular
house type.
11) Plans
The builders explained the differences in the floor plan and the actual
building plans. The initial choice would have been delayed because their was no actual blueprint.
This matter was dealt with to the satisfaction of all invoked.
The builders will meet with you as agreed on Saturday, February 10th on the building site
to make sure that all concerns are being resolved to your satisfaction. If there are any further
items that need to be discussed please feel free to call us at any time.
Sincerely,
Bessie E. Swann
Executive Direct
cc: Scott Harris, Supervisor
Jim McMahon, Community Development
James Burt
TN~o Bears Builders, Inc.
D CS C~ C~ QMC rnon. ~~Lf
Hr,uSE: SOVTL-! Nr~2i3oR
MAY - ~"I 191 p~aE= i eF nary • ~ //go
nES:iiF'iinh' ~_t,,:;. CnM!^EWic
i. eXTFRin'n
vR=:SIWS RJJGk
:r:I4EWaY NONE -
hepF ~ ^E F 6 OfF w =
SIi~It:S ?
TRIM ?
CHIMNEY FDX ?
W.I'+~~DW WELLS (bment) N A
EkTERIGn k,TEk TAP ~ 5(D[ Po~N AR
EX.=IDR EtECT CUTLET ? ~1(~~ fl•Rcrt r'tRE~'{-
EX7. tI6~ FIk7URE(S)~ 1 Fr;oNr FbRcH,/ I 51yE PoRcN-
EwnR FELL ?
FF;~'hi Eh'TkaNCE DDOk
installed _ W~~51"~tia LOOSE ~ eocKSET" KEY 7Ur2N5 FYRUUND ~ Af~JNiJ
adjusted _
painted _ ti^r `K7~121OIQ -
• FeNF,i'SIUE FNik• nDuk
installed _ b'N" 6GI~h SGrl7trf2 rJO krGKi~(.w1ty
anjested _
painted _
FRDh'T tt1nCH lS' STF~ tcJltL I~iE ERO+~NVJ L~ZG-G ~tF7P7~ ~/N/4L 6/PGYO/Nb-
kEA6?SIRE RnRCN ~ GRUUNl~ LCUEL 141=r1't2 (--rN~'~'i ~RaOrtVL-
Si'~'pS ht'14'l1C fXWN It7LL SLN~-NT - SE'iTrGEl7
rvP t~Eo rsN r c.~v~- wrrx- nec~~e.
I
MAY ,
t t ~;`i;c., ~
r
i
' .i F ~
H;rUG_,
F'AGc ~ L~ LATE: 2
X: I
!tBCRIR~ION ipMp,TF Ct~MMcNTe
II. EiECTRICAL 's
N:TBR F'AN ?
_I!CO H00!" UP ~ •~^r •rURN~ oTt ~
?iL:pHaNE J[_ our'a'/7C (f~rlul°- (KSrO& rurRrNL
CAB! E TU ~Q
see incividual rooms for out)ets, fixtures
III. F'LU.MBING
A. SBWERA;E SYSTEN i
I. Septic TanY, ? ~
i
2. Cesspool or 2) ?
3. Inside Cennection_ tcbsC efA(AY r raaK CJ-}~T rROnr /~nA'i4c~n DUE (a A'~'ir'iU-E~
" 4, Waste Piping (~7~5 BCrfC'h' FcRS~AI rN Cr ~ E Wl4LC- RU N ~ 77Pr`'~J FdUNVr4-~f L~
,F: Well / 4.!ATEfi SUPR:1 WBcle. Wr91Ls
i
Wtr•ft-:.riven ~ - M1h 0- n! = L t
7t> lfUuSC• bne~K'v- r~°f~tss ~00~ ? ~ r :c moos
2. Water Pump r-~n nA ~"1.fNr_ ~ r.rn Fi~,rMVS~N t--
3. Electric Hoek-ao N~
4. Water Tanl: N~
r, Pipes to Boiler
(Heating)
b. Pipes to Boiler ?
(Hut Wa?er)
" 7. Fipes to Fir,tures~
(Geld Water)
~'?SPA°~~.r in=~e^t1c'~ o~~. • ir~:.~•: ~~s1 •pc^.e !nr :)ur r:. {.1'T. C~: :C-19!:.: n~'$•
N~~.~c:• So. hlt4Rfb~
o'a iiz f ~ LHTc• Z!
c
i•:_C~:... to
iIi. GiU!~IN3 ccr:tinuec
C. dEAiiN3 / HJi WA'cF
hez'er
boiler instaiied
b,'rner installed
f.'estoD sneefrecl; , ~rJFFICIGl~T TD rUe~T CrODF DOESN'/EXFF_7JD GN /{/z- S(/~l-5
OF Ft-Ut
Fuel Qil Tank
a.73nk ? •
b. r11i / Uent ~ ~IENT ~ RLL N~~~ ca~fk ne, i,vlheYe a2 ~}'IrU tD ooC~( ~ _
C. Line .o &urr:er_~ ~3' RUN ]Z~ P.oR%JER ND IN CF_711r~V7- - ~
' Pibine - Heatino _ ~uf41N(r P~rTt175 ~ooR ~efi2iNKLt~
" 4. F'ibinq-Hot k'ater
ripa
ba=_en~ent ~L ~~'1~e741~5 bK .
L=t fieor nkRU
I__
~~Ft. ~r2 CLOSET = f~'0 ~Pr~~- 0~-~')-KS
2nd flocr _
zttic ~ /lit~c~~yf.01.iJ7ti l.~liGL'` - i1.L0 GY.~(,PA~J
E. Faseboard kadiaticn bleed
length end caDS valves COmment5 i~
1st floor
N~-
living rnnn~ ~DY ~3~ No
-Tm;~
kitchen Nl~, - O- ia~v3'nU~ 4CL~ -Pt~f~ ZF CIVINI> ??h~t .
tat#troort:~i i
bedroon _ !-Yi'Y g~ NO ~rtNO ~?orvr C~OO~re
2r~d floor
hall ~ y
tathroon~ _ i~' NO '
bedroom of S~N1JT" C/N !2/rS5/N6~'.• /JNE OFF
_ ~Y ~9 ~ NO
7. The~nrostats
1st floor ? location UVIN6 Rn~. F
2nd floor ? lnczticn
1
HGUSc~
F'A~ ~ o~ ~ PATc: ~ '
y
:c5~ni"~IDN CG!1P!cTE CDt!eENTE ~
'tV. «SEt"cNT
STAIki.A'v _
:lairs ms:aliee P~7zryl n~f/~ Sr(-f'[ f2[3~ ~ Rsr [4A'~ S5"
sheetrvcked
sheetrocr; pa:ntec+ 6
!:andrd!15 DNC 5~:7r nNLY~FboR' /NSfxl StkOVLD Fi b BGlT{ 5l/7~3
headrnnp; ~r[ !PN'£Si Cle ararlCe _ F.Att'I sfa ES 61'1 ~ f
witlt^ f°: wall to h3PC.^cil
stairway iitlht ~ f..OCr3T(Oti[ r°?r9/J - O[? u~[~ ~ :Barn 77JV
burner switch ?
sc,oke detector _
INSU! AT1DN ?
Eik!rFS ?
f!UDk JD?STS y/
LAL1Y CDWNN5 ?
kAL! 5 ?
=IDGk ~ I
viiNGGWS ? (b )
I
tr'AS~iEk HGD!'-UN
water ? I ~
electric ?
D"Kick HDGi[-UP
electric
EiECTkiC i
circuit box ~ G?CVi/7 rN
other lights ~ 3 '
ether outlets ? /
CG>riNENTS I I
I~
I
I
i
' i
PASc ~ Oz f~ DATf: Z
X. I
I'SS~.kIFTICrN CUKn'LcT_ CUMMeNTS
VII. i;ITCHEk
CcI.INS, k'ALLS
eheetrnd;ed ~o~ ;~~a-//'g - Ra~rcr~ /~/ct7d e%eet^r`~ book/;r~
gainted,~ ~ ~,ia /~/~'S
FLLORS
na}: flooring _
finished
0.'INDGWS
installed ~ )
painted
INiERIQR LsUR(S)
installed
painted
lnckset=_ _
TRIM '
windgw _ ~rniic~n/ ~'/ni r n~~ ~ t CpU/y1~74/7J NO 5/(i~"/-h'OCK dN/.~~?NE71~` i
door ?
baseboard ~
pained _ Tl?/H4 NL~'r3> /~'f'~~ Go/4 /
EL'eCTRIC
overhead light ~ _,L~) GCOF'iC- A(o'~ /~5?~-~~
nutlets_ -s/~o,/d/~eCGIC /14t6fK~JE° /?fJd9/ (=n/2 l2GFF4/06E=sZ
ground fault nutlets fa ~ j
teleahnne jack
TV cable jac};
CLDaeT
• sheetreckedL1/~
painted ~
clothes pale
sheif
A~+PLINNCIS
stove /J~7_IUEI?e"1~
range hoed ~ ~
da=_hw~asher _ N NDO{t~17' U/~
refrigerator ^
CH&It;ETG
baet' ^.agi'teLS _ ~Rn//~ fay pij/hw~s/~'R Nnr s~ei~/a~ ~o ~f
counter too _ Lff 5//JE
/X~7' SELsU/PE-79 77J Rf15E
wali cabine*s
sinl: i
faucets --1G
water cnnnec:ion=_. ? ~
drain connexion
HUJSE: _
PAGE ~ DF ~ DATE: Z,_,
R=
?ESCfiIF4ION COMPLETE COMMENTS
fR. EEUkODM, ~rFloor
CE]lIN6
sheetrnched ?
painted ?
k'ALLS
sheetrnel:ed ?
painted ?
FIDDFS
oak flnaring ?
finished
FiItiDOU5
installed ~ /79~L. / SiNG[C -
painted _
INTEkIDR LCDk(5)
installed ?
painted C/rxr,f /xvv vIG~Pd~ a-G1olI~8? CLt~-
loc)sets
TkiM
wir~dew _ 5/!-~ LU!'alPP/NL>- (/'Lf//GG/oN~
door
baseboard
painted _ ~/vrJ COsa/ /V~~77~D
ELE::TfiIC
overhead light ~//`I'
outlets N
telephone jack ,LV~
TV cable jack
C.OSET
sheetrocked ?
painted ? ~nvLO />SL~ ~uGffrli~.
clothes pole
shelf ?
I
I;
I`
NuI~S I
t,c 7 ~
ic5'Cr,!pTION C07pli7i C2MMcN75
I
V, Si~.iRwrY (tn second floor)
SiF:1f.5
insaiieq ~j- /~57~p fQ15~ ~I'/t`~ - REST ~Re SJ~hF"
painted irisers) ~B/.dy~=?1
fini=_~ed Itrezds)
WNitS, C.iIL1N'u
sheetrna;ed _ ~r t9Y STS?!RS NE~'DS Re?~AiR
pointed _ 1cY/C~`v/~~
HpllidtAILS
installed ?
finished
fiiADRQON ~1~ lowest clearance
N
WIUTH .33 frt will to handrail
II. L14'iNS kODM
1
CEI!IN;
sheetrocl:ed ? ;
pa±nted ?
Wr:! LS
sheetrocked ?
painted
fLOGRS
nal: tinnrinq ?
finished _
WIN90WS
installed ?
painted ~ oZ.~,c,1,1 Go?t~/" .r~/
I!ITiFIQF' DOGS(5)
installed
tainted
lncl;sets _
TFIN
window ~SlLLS /Vr77" ?rCC~l1~iL[= - CUT //Y /ft9LF
poor %
baseboard ?
painted _ !~iy'//I~"7J - NEE-lJ5 ZN~ Cor?-T
E! ECiF.IC
ovsrhezd light N A ~
Outlets _(p '
grauno i?alt outlets Ntq
4~~
HCUSE:_~SOO. f{~'vIjUY _
RAGE ~ OF ~ DATE: Z/
X . 8'
DESCfi1RTIDN CCMRLETE COMMENTS
X, HALLWAY (Location ,~it~. )
CEILING
sheetrccked ?
painted ~G
WALLS
sheetroel;ed
painted ?
FLCCFS
oak flooring ?
finished JG
WINDOWS
installed 1(1~h
painted „~V~I'
TFIM
ce:ndew
door
baseboard _
painted _ t,~.~ /J
ELECTkiC
overhead light ~ dW.r..O~L
ftii
outlets
telephone jack ,~/L1"
sr~ol:e detector
CLOSET
sheetrocked ? ,
' painted _ NO
clothes pole 1l(~{,
shelf ~ r~i.l.P.~.~e~
d/1FjY.-.~ rCOZu~f-v/ ~ ~~/GC(~Lfib-~'
~I
li
1`
I~
ii
HOUSE:.SD. /fFiR~R
pASE ~'DF f7 DATE: 2
x. y ~
PESCF'IFTION CONFLETE CONMENTS
VIII. B?TNRODN, „~~Floor
CEllINu, WAILS
'rccked, painted
f L OD'riS
tiled
grouted
WINC~OWS
installed ? ~~~:rf - ~N~ ttRNULE ~ ~
panted
IN?E~IOk DOOh(S)
installed
painted _ ~NI? CD(gi" NE~nE~l
locl:sets
TfiiM - WHOP
window _ 1~~k
door
painted _ ,?NO Ux~~ I~OE~
TF'IN -TILE
window ffiq
baseboard
grouted _ 1J~1?~ 77XXt!-U
TAP & SHOWEP,
walls tiled _
snapdish installed
tilt grouted _ ~~~1~5 TDtzt(yP D:4 CAtI~-K
shewzrhead _ ,
faucet
water controls ? ~
drain connection
' curtain red _ 1JDNC
ACCfSSC~fiIES
soae dish _ _ i nu!~
teothorush holder _ ~ODSC ~
tewei h.ar _ /f~
tissu_ holder _ LnoS~
~ed_cine cabinet _ S1DN~
WATEk CLOSET
installed
water connections
dram connzctien ?
VANIP'
caoinet toe BOTTOM 'rleJ li1~'tki/ ~R 'YaP
sini: JL
faucet V
waxer evrmzctiens ~G
dra l'i .cnne^:'ien
EL.:?F:IC
.Ye"nE3d i'_L~it III L'~l
PAGE ~ DF LATE: Z + ~
X : ~o
lESCRIPTICN COMPLETE COMMENTS ~ ~
p95f
I%, bEDkOCM, ,~~Floor
CEILItiG
sheetrocl:ed
painted ! f,~¢Q.y1'+~F4'e2G~~d
ed
~Ltf'[~
W4~L5
sheetrocl:ed JG
painted _L/
FLOCKS
oak flooring J~
finished ?
WINLDW5
installed
painted _ .~.-ttd' .out.fi~~
INTERIOR LCCR(S)
installed 1/_
painted _ Gto9Cf D~~i/P5 /N5/OC DNLV /w«~
locl.sets _
TRIM
Y'lridoW ~ /71UL, L~/N~o1U 5/Ll G(~T /N ff79LF /~0/- /!ftCEF°/7~'/.~L=
door
baseboard ?
painted ! aN~9 CDi4~ /JEP7.7E~
ELECTRIC
overhead light f~1+4-
OUtletS / fj/ ~
telephone jack ~t/~ I
TV cable jack „/V~H'
'CLDEFT
sheetrocked ?
painted ? YD~GfK~/A3 Nk~7lED. ~ ~
clothes pole ?
shelf ?
HCNISE: moo, kar~t~
PAGF DF ~ UATE: yj2 / ~
: / /
CESCRIF'TICN COMPLETE COMMENTS ~
fY.. Prt~Dft, ~~Eloor
CEJLING
sheetrocked ?
painted ?
WALLS
sheetrocked ?
painted ?
kLOCkS
oak flooring ?
finished _y/
WINCCW5
installed ?
painted ? ,
INTEkICR UCCR(S)
installed ?
painted
loc6sets
TRIM i
window _ !!2rrf/.c~c~2 L_VN_i.Ein,07.r/.sG~f.GP_ C1,Lf" ~ 1?.C~ Q tLGLD~~P .
door ?
baseboard
tainted _ (.!J
ELECTRIC !
overhead light
outlets ~
telephone jack t4
TV cable jack NR
'CLOSET
=_heetrecked J/ I
painted
clothes pole
shelf
r
HGUef~ Sn I~ikRRL1Q
X . ~7^
Df&CFIFTIGN CUNN~fTf L'GMMENTS
xI. Ai7IC AkfA
ACCfES: 5cuddle Hale _
er
ACCfS~: k*~eewall Laar 1~ 77f~6.'OJbH- GrN~T ~"nk2x~IM CLO°~1~
iN5U~ATIGN
i;neewall
floar
overhang Ul^7JT'-i t7b yu1llC,fP ~ ~(touLr/ f3c /N5UU3~7J f~f#47714iLV
FLOUR DfC1;INn lI2- W~, TU El4'U~
LiSNTI!i, hNE [a6ffT (3V 19008
Ne~n~ m PrC ~N~ Z9 oro7'
I
pp0
- R
• PL ASE NOTE M pIN S R a5 ~
Requires septic tank
cover to grade. N o
uSE POBLiG WAiERI A
l
GOLDEN ~
Ol F JEANETTE
N J 209 40 fnd F'
~ t rnnn. o ~
0
~ 3 0 „ E ~ LI'N el. 19.7 Uf (
o C
9 I .
I',~` N 79 ~ 5 en~~ -
c ~ ~ ~ m .,r) ~ ,
r
~ JoiW rvcr '
I 0.3E °
i Pr~P' W I f o \
~ e1. 2x of//ve WOY LT v k ('f
npn 40'
E ~ V' 13i PROP P~OtR'erllhe 1A m ,~QJ~~ v~l\
' ~ 1n, i-I s E -o cP m J ~ LJ ~T'
N
O l0 p Q y
~ _ ~ aoP sEVr/o ~ m
E 40 ~ ~ti
f ~ ~N r
a O -p - H D
a O O ~ ~ e11ao r ro
y IE o '
` ~ j ~ , bj~'eEPt ~
I n,on !
u. rn 2p9 3 S
~ Z a1. x1.B ~ 50" W .
z o 26 (~ACANTI AND
;nd g.77
Mon. ZEBROWSK( /
~'apE, ROWgKI {
t N/O/F STEFAN ZEB- '
I Fee $ uses
SIRf(~L~ F~~~fLY f~3'~JEa~fafi`! ~ ~ D
~Xf~fRf~S l"'b~/® Y~AFi:i FFf~`VI C),~"3v~ (7r N~Fj~r~VA~ ~~~'v~
s
• AREA = 23 , 566 SQ.FT.r-'
I, SURVEY OF PROPERTY
{ THE WATER SUPPLY AND SEWAGE DISPOSAL A T SOUTHOL b
FACILITIES FOR ALL LOTS IN THIS DEVELOPMENT
COMPLY WITH THE STANDARDS dREDUIREMENTS
OF THE SUFFOLK COUNTY DEPARTMENT TOWN OF SOUTHOLD
OF HEALTH.
M ~ SUFFOLK COUNTY , N.Y.
I 1000 4 075 - O 3 14
SCALE I" = 401
SUFFOLK COUNTY DEPARTMENTOFHEALTH SERVICES NOV 3 , 198 6
FOR A PPROVAL OF CONSTRUCTION ONLY I am familiar Wlih the Starxlards f~r~,
CCpp I Construction of Subsurface ~eWa a D'is Dsxal S
DATfF4D ' ~ ~ HS EF. N0. " _ l1 far SinNle Family R
seR
Itlenc~s aXr ~d ~bI by t e„
condtfions sOjfnrfh
4h®ret~
&nd . 8
APPROVED eonstrUCL BROWN SILTY
. /'WIC ,rru. ,;~.D~~,a. ~-,a€ 1.8'
s"'C'--MZir~ ~ E BROWN
~ COMMUNITY DEVELOPMENT OFFICE LOAMY SILT 32'
G TOWN MALL PALE BROWN
i ~rQ ~ ~~uiy1` SOUTHOLG• NEW YQI(7~( 1 ~O) COARSE SAND
~ 0~G . Y . S. L IC . N0. 49668 WATER IN PALE 15.6
BROVHE.COARSE
SAND
- I SU~ RS a ENGINEERS, P.C. I~
i ~ I ~ 4t~0 0
I MAIN ROAD ELEVATIONS ARE REFERENCED
~ SOUTHOLD ,N.Y. 11971 TOrASSUME,D DATUM REVISE 10-17-33 (PROP HSE)
~ ~ ~ manta)
aop°
Mp~NsR.251 ,
o I
w
A
GOLDEN 1
JEANETT E _
N / D ~ F 209 40 fnd N
1 ~ ° ~
c , ~ o
I o~ 5, 3 0' E I i.)'N el. re.7 N- C
;1,~ N . 79 ~cc 9
~s ~s"k wcY~ 11 ~ s ^ _
I a3•E. A
bjj~ W f
el. 22.1 i~ 'i
- 1 4l.~~ 0
Q 1 0 T
IA E~.d - i
,,I m ~
o to VV ~.oua _ ; Q>f
~ VV _ _+s~_ - O
o ~ 11 ~ ~ 7C
s 3 __3~.z-_---
_ _ ~ _
r
o :o _ - -
0 o i
I~ o
a M 1 ~
~ c ~ m.
~ ~ 209 3 6
50 VI
Z o 26
d. 5.77 pN0
I BROWSKI
,'aii~ F pNNp ZEZEeR01MSK1
I N~0/ STEFpN
AREA = 23,566 SQ.FT. ~I ~~yOF~~
SURVEY OF PROPERTY
A T SOUTHOL d
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
(;~]~p TQ, 1000 f 0T5 - O3 - 14•
SCALE I" 40'
NOV. 3, 1986
Sspi. 11. 1988(found. loc.1
d Nps
v ~8 A ~ G,9L
* ~ C N.Y.S. LIC. N0. 49668
l:
P .I~ ~U ORS a ENGINEERS, P.C.
(~I B~ 20
P. 0.
MAIN ROAD ELEVATIONS ARE REFERENCED
SOUTHOLD , N .Y . 119 TI TO ASSUMED DATUM pEVisE io-n-ee (PpoP. nsE)
8fi - fi20B_
Wpfe/
V `I t~ . ~ ~o-
RO
~~a~~~,.R• 25 ~
!
~
\
0
w
A
TE GOLDEN ~
0/ F' ~ ~EANET -
N / ~ 209..40 tnd
,.1 md,, o
~ ° ~
I1~~ 79 a 3 5 ~ 3 p E, , t.rN eT. lay y ~
~L,,• N once- ~ ~
'b i~. rvaYc
'Q,e -
o
W o
fem. al. 22 • T ~ WOO~K CT i
_ ~ 49.4 ~ Q "f,
> ~ - "~W`/~ ~ In
{G
~tlFFOLK COUNTY DEPARTMENT OF HEALTH SERYICFS w ray ~ ~
ty nrE 9.rr. ~ g m ~
SINGLE FAMILY DWELLING ONLY &,a~. „s6. ~ i ~4. _ -
z ATE~U~I.S. REF. N0. -`7.52_!7 g ' Pr ~
~ L ai p
~ sewage disposal and water supply facilities for this i aD
~ anon have been inspected by this Department and/or 1
' o ' s nd touppqq to sfa r
D i d.1e.a ro
gtidl Bureau of Wastewater Management ~ nd 1 °
/
' ° 209.3 $
w OT ~ ,
O ~ u W •
Z a''e 7 ° 26~ 50
S ~ AND
~"c¢r ~poWSKt.
I~ic N/D/ F ANNA AN EZEBROWSKt
I STEF
AREA = 2$,566 SQ,FT.
SURVEY . OF PROPE~tTY
A T SOUTHOL ~
° TOWN OF SOUTWOLD
` ~ SUFFOLK COUNTY, N.Y.
~CT
ORQTlTLE7GUARANTEE COMPANY10o0 SCtA LE5 I° 40.3 - I4 •
` NbRTH FORK BANK & TRUST
$OU'TkOLD SAVINGS BANK N O V,. 3 , 19 8 6 ,
STEVENN FbsrER dept. 11, 1989(fo~nd. loc.)
NANCY FOS1`ER
~'eb. 13; 19E0 (FINAL)
APRIL 9, 1990 f wafer llnel
t'r;:ixl~ed in accordance wiTh the minimum I
v ~ sten?ards to iitte surveys as established by
_ ~~qN S, rho L. L A. L. S. and approved and adopted
c~ ro 9 for suc}r use b~~.rNew York State .Lane
Uk+'~Qy~P f CF~.L~~ ~ Title AssociaTio >~`"~1;„,y~
~ ~ ~ - " ~
p', s
* Y . S. L IC . N0. 48'668
MqY 2~ >
e - ~Q....___ QED
YORS
( l6) 7 - 5020 ~ '
ii~°t 4~ '
P. 0. BOX 9 0 9 '
M~11 N ROAD
EIEVAT10N5 ARE REFERENCED REY/S,ON 2-''>3=~~4 ~"~"10Ln
SOUTHOLD ,N.Y. 11971 TD ASSUMED DATUM gpy4gE 10-17-8.$ (PROP.HgEj
~ c
§ _ ~ .
•
BOARD OF HEALTH
3 SETS OF PLANS
FORM NO. t SURVEY ~ .
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FORM
' TOWN HALL
SOUTHOLD, N.Y. 11971 NOTIFY
• TEL.: 765.1802 CALL James. (1st~ahpn.....
Examined 19~~ MAIL T0:
Y..., //JJ Town Hall, Main Roan
Approved 19r~.PennitNo.`~ 1~~~ S'o ld, New(n1Y~o/rkF~ b1971
Disapproved a c D ~ ~ ~ Il U L~
~q,t!
JUN 2 2 1999 ff
(Building Inspector) ~~y~~y~~~,
APPLICATION FOR BUILDING PERMIT a.~, rt-r-~ '3
' Date .May, 8,,1989•,,, 15...
INSTRUCTIONS
a. Tltis 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.
Town of Southold - Community Develop.
(Signature of applicant, or name, if a corporatton)
Town Hall, Southold, NY 11971
• (Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
OWNER
Yameofownerofpremises .TOWN..OF. SOUTHOLD .
(as on the tax roll or latest deed)
ff applicant is a corporation, signature of duly authorized officer.
James C. McMahon, Administrator, C.D.
(Name and title of corporate officer)
Builder's License No . .
Plumber's License No....~5~/.J. ~ .
q i
Electrician's License No.
Outer Trade's License No . .
Location of land on which proposed work will be done. , , ~
. . . . . . . . .
~
...................SoN}I~, UAr~io+'..j,ANQ; ,JV~o~aC......................
House Number Street. Hamlet /
County Tax IvtapeNo. 1000 Scc[ion ~7 ~ • • Blouk 0~, ,q, , , , , , , . Lot ~ .
Subdivision .NIr7.......... F.i1cJ l,fap No./~/'........... Lot~~~A .
~(Nante)
State existing use and occupancy oC premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy VACANT
b,lntendaduaeand®c~upanCy , Single'Family Residence
~s~? _ ~~3~77"l~f~
r ,
3. Nature of work (check w•hichppplicable): New Iluilding , x,', , , , , Addition Nteration .
,Repair . . Rc'ptoval Demolition Other 1Vork .
• • . • , . • . , _ (Description
4. EstimatcdCost. ~•1 Fee. W,~iyed,,..Town.Pro~ect
(to be paid on filing this application)
5. If gdwellin number of dwelling units ..........1 , Number of dwcllin units on each floor . , jJ,/ A
s. g
If ara~e, num bcr of cars N (iA " " • '
6. If business, commercial or misted occupancy, specify nature and extent of each type of rise . N./,A .
7. Dimensions of existing stiuctyres, if any: Front . N./•A . .Rear . N(/t, , , , , , , , , , Depth . Jy/, A
Height N /A.......... Number of Stories „N %lt ' • " ' • • , ,
Dirensions of same structure with alterations or additions: Front . N.i 9 ~ ~ • • • • • ~ • ~ '
De tlt : .Height . Rear NIA..........
P •NlA . . N/A ~ , , , . , , , , Nuntber,of Stories . N/A '
8. Dimensions~f colic knew cons'tnrction: Front , •3Q , , , , , , . • Rear , ,,3.~.......... Depth .a~~,
Height e7•~, g/r7 Number of Stories .
9. Size of lot: Front . ~0~`~~~~ld.... , .......Rear ..~/!a ;SSA. Dc~.....?lQ9i ~ .
10. Date of Purchase ~ , , • Name of Former Owner r~l~.
1 I. Zone or use district in wlticlt premises are situated . • ~ ~ • • • ~ •
12. Does proposed construction violate any zoning law, ordinance or regulation: .NO .
13. Will lot bere~raded
P ' ' ' ' ' ' ' ' • • • • • • • • • • • • • • , • ....Will excess fill be removed from premises: Yes t
14. Name of Owner of remisesT.o,wn.ra,f••$putshQ~d,AddressMp}n';Rd, Southold
Name of Architect ..NSA... • • • • • • • • • Phone No.74~-1&92, • • •
Address N,i9 . , . Ptaq~~.N~A
Name of Contractor .TWA..Qg,ars Bui•l.ders~, •IrABdress P.O,,QpK, 27x17, Amagp o.329rgg3p..:
15.Is this property looted. within 300 feet oP a tidal wetland? *YES....NO.X...
*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 fro
property lines. Give street and blocl~ number or description according to deed, and show street names and indicate wheth
interior or corner lat.
SEE ATTACHED SURVEY
~j/f
STATG OF NEW YORK,
COUNTY OF $.S •
. J ame s• Cr : McMahon a • • , . • . • • • , , , , being duly sworn, deposes and says that he is the applicant
(1\amc of individual signing contract)
about named. I
t[cisthe.,Community Development Administrator '
. • . • • • • • (Contractor, agent, corporate officer, etc.), , , , , , , , , , , , , , , • , " " " '
of said owner or owners, and is dulyi authorized to perform or have performed the said work and to make and Gle this
application; that all statements contai~ted in this application arc true to the best of his knowledge and belief; and that the
work wlll be performed in the manner'ICet forth in the application Cilcd therewith.
Sworn to bclorc me this '
~~p~~~ ~f
Notary Public, ,,,,Suffolk 41':,..,e G~County
HELEN K. DE VOE
NOTARY PUBLIC, State of New York . , , , , , • • . • • , • • •
No. 4767878, Sutfolk CountY~/
Term Expires Mcrch 30~ 19_.~.F (Signature of applicant)