HomeMy WebLinkAbout17946-z
J
FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Ha11
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19873 Date APRIL 26, 1991
THIS CERTIFIES that the building RENOVATION
Location of Property 3130 MANHASSET AVENUE GREENPORT, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 43 Block 4 Lot IS
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 20, 1989 pursuant to which
Building Permit No. 17946-Z dated MARCH 24, 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 RENOVATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to EMMANUEL TZANNES
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-180178 - MARCH 25, 1991
PLUMBERS CERTIFICATION DATED OCT. 23, 1989 - K & K PLUMBING & HEATING
.2 _
ui,ding Inspector
Rev. 1/81
lOBM NQ
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)
0 017 9 ~ ~ Z Dote ~..L~.C~......~..~ 19. ~.I.
Permission is hereby granted to•
....Fr.
i~rkt-ri. :c-~........Y...'.~ .a.r~ra.
A,~ .
to .~~......Rnfs-ir~...4"+16. -r-s~....4-v.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .n.. . . . . ...n. . . . . . . . . . . . . . . . . . .
at premises located at ..a~. ~.t~.°.....~.4!~:1•I.l.a-4?4A~.- ~K.u?..........~151hY .
.
.
County Tox Map No 1000 Section o`f 3 , Block . n.4 Lot No g..... .
pursuant to application dated OuC~ a:~. 19~~., and approved by the
Building Inspector.
Fee $
~-c~r o.-c.
. . .
Building Inspector
Rev 6/30/80
Form No. 6 0;'~~'~!C=);~~~11~~'t' j~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT ~ ~ 21,~3'y~
TOWN HALL
765-1802
~
APPLICATION FOR CERTIFICATI: 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 lZ 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 Flanning Board Approval of completed site plan requirements.
3. 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.
G. 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 - Resident,,~~iyya~~l $15.00, Commercial $15.00
Date .9:.~~rG~..,}~., lQ~st.(
'Iew Construction........... Orl?d1 Or/~P~r~e-~existiQng Buildingp.~
Location of Property./.~dQ.. [:.t~'4lKKf~?+4~~...+: :e:....4~?,.?P2~„~ ./~-P.'~..~~4:~Y............
House No. Street Hamlet
7nwer or Owners of Property.. ~11;1n:1C1~11-t~'r~.... ~~~.Y.1CLe~
County Tax Map No 1000, Section......~/~J.....Block..... ........Lot..... t.~
Subdivision.....pp.~~.// .............................Piled Map............Lot...~..p.................
~'ermit No...~~J.K~.....Date Of Permit..~~4~.t~~•`~Q•..Applicant~C~?n~?ku444..~~.....
![ealth Dept. Approval ..........................Underwriters Approval..
Planning Hoard Approval
Zequest for: Tempora~~r''}}y/Certificate........... Final Certicate...........
Fee Submitted: $....R`.?'.~.~ .
~f r.~~
~ 0-~ / ~ ~ ~ ~ APPLICANT
C TEL. 765-1802
o Oy TO'PVN Ob' SOtiTTIIOLD
r~ < OFFICE OF BUILDING INSPECTOR
~ ,~z~,---, P O BOX 728
~ TOWN HALL
y~o~ ~b~~ SOUTHOLD, N.Y. 11971
C E R T I F I C A T I O N
- Date 1~~~~~~
Building Permit No. r~l~y~oZ~
Owner_ ~ ~Za,n`(~Ex~
(please print) ` _ 1~
Pll:mber~ ~ ~ ~~V M~ ~ ~1~ ~\e~C\~
{please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1B lead.
(plumber's signature)
SwornJto before me this
0/ ~
2 ~ " day of Y~
19 l'
T-TNotary Public
~ Notary Public, ~G`+~.%~ County
OC ~aawn wr+~
1~1
I
I
l,.s: ~c:,u;, pu;,:~, q ,,,;:k~~EUr~
~
a
H
- - H
r'OUIIDATION (1st) ~
c
=OUPJDATIOIJ ( pnd } m
~ z
ROUGH FRAME o
PLUMBING
H
3. ~ ~
m
n
IIJSULATIOfJ PER N. Y. 'j
STATE EflERGY
CODE I `
7 }
~ m
~ y
FI11AL 3
i
r
i , - ~
A DITIOP]AL C/O11M PITS x ~
- K~{ - 5 4f~--~=~~ O'q f) ~ e ~M l
~ w. G 7 a .-~.f?
r
iS~..
' c
Z
/L
- ~ V" x
_ ~v
H
• 9
H
H -
O i
m
5
r
H
_ 1
CS
m =
^o
H
oS~EFOIk~oG
VICTOR LESSARD ~ Town Hall, 53095 Mam Roud
PRINCIPAL BUILDING INSPECTOR = Z P O Box 1 179
~ SoutLold, New York 1 1971
(516) 765 1802
FAX (516) 765-1823
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
September 24, 1990
Emmanuel Tzannes
229 Washington Avenue
Garden City, NY 11530
Dear Mr. Tzannes:
We have received your request for an extension of your
building permit # 179462 dated September 18, 1990.
Please be advised that your new expiration date is:
March 24, 1991.
Thank you for your cooperaiton in this matter.
Sincerely yours,
Southold Town Building Dept.
>
h
YORK STATE ENERGY
CONSERVATION CONSTRUCTION CODE
PART 5 COMPt.IANCE FORM:
Bulld[ng Design by Acceptable Practice
BUII.DING ~n{
ADDRESS: I~0 MA~'NA?~SE~ fd~i; DATE: I' Zr`~ -~t~'
toP.r~cl•~~G7~. /J• it ~'3'Q' COUNTY• sJ~"~'OLK~'
ARCHITECT, R OR
~OAA~bke'POR: p~~ . K*OS1~S G-e PHONE: ~ C - b 2 f - ~j (4~ 7
1. HEATING DEGREE DAYS (Table 2-1)
? sooo ®6000 ? 7oao
? sooo ? 9000
II. BUtLD[NG DESCRIPTION (Pre~uat[fying Condtttons)
If the building does not meet all of the following pre-qualifying conditions,
Part 5 of the Encrgy Code may not be used.
Building is residential, heated aadlor cooled;
or building isnon-residential, heated only.
Building is less than 5,000 gross squaze feet
Building is three stories or less in height
Ratio of glaang azea to gross wall area is equal
to or less than: -
24% if 5,000 degree days
23% if 6,000 degree days'' Actual Glazing Area
20 0 egree ays ~~qo
189'o if 8,000 degree days Actual Gross Wall Area
16%if 9,000 degree days
lll. PROJECT TYPE
? New construction ? Substantial renovation of existing building
Addition to existing building ? Exempt (7810.6c)~
N. HEATING SYSTEM TYPE
? Gas-fired ? Heat pump
Oil-Erred ? Electric
V. BUILDING ENVELOPE DATA (Table 5-1)
Envelope Value Value
Component Required Provtded
Roof/Ceiling Up = ` Up = . O r>
FIOOf Uf= ~ Uf=
GAUrr
Exterior W all Uw = , Uw = , p
Glazing Ug = . S °v TJg = • c~
Entrance Door Ud= 4'o Ud=SP , ~
Slab Edge Insulation R;= A R;=
' Basement/Cellaz Wall Uw= P Uw=
Insulated Depth Below Grade D = ~~P D =
Vl. VAPOR BARRIER: 7814.2c
' Location Location 'lope Plan/Spec.
Required Provided Provided I Reference
~ Walls f~'~=~! ~ k,~AU.S ~or~ Fin ~ S'~~.
Ceilin
g t~~r~t ~
Floor (~AA"fr~~~f~.S
Vtt. A[R LEAKAGE: 7814.3 (7813.5}
infiltration Rate
Maximum Rates PlanlSpec.
Element R~gate~s / Provided I Reference
Windows Olin. ft: , ti:.n
Residential Doors`
Sliding/Patio OS A ~ ~
Swinging 1.0 ~
Non-Residential Doors
~wtn~~ Sliding 11~
evo g
'Vestibule or revolving doors are required for residential buildings
other than one- and two-family dwellings.
Flreptace ~r A
PlanlSpec.
Required ~ Specified I Reference
Outside Combustion
Air Duct with Damper
Infiltration Control:
20 ctim flue damper, or
non-combustible doors
Joint Sealing
Joint Sealant Ptan/Spec.
Location ~ Type ~ Reference
Windows at Exterior Zp gU~,,J
Doors at Exterior
Walls at Roof/Ceiling
Walls at Floors • ~
Wall Panels r
Utility Entrance
Fenetrations t, ,
Other
Other
Vtll. HVAC CONTROLS: 7814.13 (7813.13)
' Thermostat (7813.13a)
Type Range I Provgided Refes~iice
Heating Only 45'F - 75•F ~ L •
Cooling Only 70°F - g5°F ~KC S~ ST
Heating and Cooling 45'F - 85°F
Humtdistat (7813.13b)
Humidity Provided Plan/Spec.
Type Setting Settin Reference
Add Moisture 30°.6 RH max.
Remove Moisture El1°!o RH mia. ~
Temperature Zoning (7813.13c)
Required Locations Plan/Spec.
.Type Locations 'Provided Reference
Thermostat Each HVAC
system
EU~Dwe!ling
Thermostaz Each Zone" iJf w Zo~E. S`(c.C,
Shut-off Each Zone
Shut-ot[ Each Floor
or story
• Applies to one- and two-family dwell'm~.
Does aot app}y to one' and two-family dwellings.
Control Setback (7813.13[c][4]) •
T e I P
ovided Re~rence
Manual or Automatic ~ ~p~ ~7~~ cwC fc.~ ~C
Mechanical Ventilation (7813.16)
Location Location Pian/Spec.
Required I Provided I Re€erer;ce
Shutoff damper at eavelope 2 S
Volume wntrol t,}~ou~
tX. PtPtNG fNSUlATtON (Heating and Cooling): 7814.1 (7813.19}
System Type Tem~ranmire Range I Rleference
Hot Water/'5temn 4~~5'(
C~~~d Water
Thielmess' Pipe Size
i ~ Runouts 1" and 1 1/4" 2 1/~" 8" and
~~p less to 2" ' to 4 5"- b" more
(T~ab~e 4d5)
Provided
~latg/S~ec.
e er nce
• at R = 4.0 to 4.6 per inch of thicimess
X. DUCT WSULATION: 7814.14 (7813.20) N~p.
of =Duct air temp. -Surrounding temp.
st = •F
Requued Value Plan/Spec.
of ( Value ~ .Provided Reference
52S°F or less R = 3S min
Greater than 52S•F R = of min.
15
X[. DUCT CONSTRUCTION: 7814.'!4 (7813.21)
Duct Pressure I Requirement Scheduled/Spec.
Low I Joint sealing ha57rc ~r~l s~ .
S
Xtl. HVAC EQUIPMENT PERFORMANCE REQUIREMENTS: 7814.12
(781323)
. Equipment Perform
nce Ptrfor
Hance Refes~nc~e
Furnace
• Gaa-225A~ Btu/hr oz less 7096 AFVE
• 0~7-225,000 BEnlhr or less 759b AFUE
AIIOthera 7596 CE -
Boiler ? - - -
1 l~
Gas-300,000 Btvlhr or Jess 7096 AFUE
. OS-300,000 Btulhr ar Jess 7596 AFUE
- -
- All Others - - 7596 CE
' Heat Pump -Air Source
Cooling - -
I` tJ~65'000 Btv/hr. ss SHER
' z~ch~
,ooo Bturhr. ~ E>~
tS~OSO BtuJJu, and over 73 EEFt -
Hcatiag - -
high temp. (4TF) 2.6 COP I -
Lowtemp. (17•F) L8 COP -
• Heat Pump -Water Source
Cooling -
?
~tl
awn
65,000 Btulhr. 83 SEER
~t~65,000 ButThr. ~ 3~• - - - I -
• 65000 Btn/hr. and over 73 EER
I
- Iicating ~
AII - 3A COP ~ - - I - - _ -
Heat Pump -Packaged Terminal
Tieating 2.6 COP _ -
~ EER 1- - 1- -
Central Air conditioner ILXtS'tpo ~i~,9 t'~ - -
l.~~cl~bsaoo Btu/hr. 9S sEER - -
N tt ~
t
~WIM1M1I B~ W 44. _ KO ~
r' 6500 Btnlhr. and over 73 EER -
- - ~ Packaged Tertniaal A/C 6S EER
AFV E - Annual Fue! UiiliLhoa Ffficeacy CE -Combustion Effieienry
SEER -Seasonal Eaerd9 Eliydenry Ratio EER -Energy Effideacy 12atio
COP - Cdeil-ident of Performance
5
R i
. .
~ Xtll. SERVICE WATER HEATING: 781427 (7813.31.7813.39)
Pertormance Requirem~e~nts ~ ~~gS~-~~~G p
Water Heaters Performance Perfor anre Refes~nce
US DOE Covcrcd
Electric Storage EF x.93 - .0013V
Gas-Fired EF x.60 - .0019V
Oil-Fired EF x.59 - .0019V
All Others ,
Electric Storage SL s 4 watts/sf
Gas-Fired TE x75%
Oil-Fired TE x 75%
Gas-Fired Storage SL s23 + 67N
Oil-F'ued Storage SL s2.3 + 67N
Combination Service/ SL < 13.3 pmd +400
- Space Heating' n
'Must also meet performance requirements listed in XII.
EF -Energy Factor TE -Thermal Energy
V -Volume pmd -probable maaumum demand (gph
SL -Standby Loss n - fraction of year when mean temp. > ~.9° F.
f Ptpe Insutatton* ( h
Insulation Pi a Size
Runouts to 2" i" and Less 1114" to 6" 6" or More
Required 1R" 3/4" 1" 11/2"
Provided
~la~/S~ec-
e er nce
"1Kot required for piping 1" and less in one-and two-family dwelling units.
i ~
t Hot Water Conservation ~
i
Required Contr 1 p1 Spea
Cate o Control Provi~ed Reference
Residential Temp. 14Q'F max. setting F,CtS-(rt~6
Electric Water Htrs. Shutdown switch
Gas/Oil Water Htrs Fuel shutoff valve
Circulating System Pump shutoff Z st
Fixtures
Pubtic Lavatories OS gpm and 110• F. max.
Other Lavatories 3.0 gpm max. at 60 psi S
Showers 3.0 gpm max. at 60 psi
Swimming Pool ~ p
Temperature 80• F max. setting
Heating System Shutoff switch
XtV. ELECTRICAL POWER: 7814.31 (7813.51, 7813.52)
la~~//S ec.
Category Required SpeciSed efer~nce
Power Factor 85%a min. r-ei~ ~t4uq-~ ~~9
Voltage Drop 3%max.
Lighting Switching
Local Switching Required (~~,p,,~
Illumination 50% min. if over
Reduction 500 sq. ft.
Electric Meters Ea. Dwelling Unit ,~~i5
~ _
XV. UGHTlNG POWER BUDGET': 7814.31 (7813.53) +.1~A
Design Lighting Power shall not exceed Lighting Power Budget.
Design Lighting Power
Lighting Power Budget
'Not required for residential buildings.
~S~EfOLK~OG
VICTOR LESSARD ` Town Hall, 53095 Mam Road
PRINCIPAL BUILDING INSPECTOR = z P O Box 1 179
~ Southold, New York 1 1971
(516) 765-1802
FAX (516) 765-1823
OFFICE OF BUILDING INSPECTOR
' TOWN OF SOUTHOLD
September 24, 1990
Emmanuel Tzannes
229 Washington Avenue
Garden City, NY 11530
Dear Mr. Tzannes:
We have received your request for an extension of your
building permit # 179462 dated September 18, 1990.
Please be advised that your new expiration date is:
March 24, 1991.
Thank you for your cooperaiton in this matter.
Sincerely yours,
Southold Town Building Dept.
ti~ ~ sEa 2 a ~~u
BLDG DEFT
TOWN OF SOUTHOLD
September 18, 1990
Southold Town
Building Dept.
P.0. Box 1179
Southold, NY 11791
To Whom It May Concern:
I, Emmanuel Tzann__=s of 3130 ~Nanhasset Avenue
Greenport, have a building permit that expires on
September 24, 1990. The permit number is 179462,
an extension on the permit is necessary. If you
need to contact me, my business number is 516 538 2576
or send written notice to: 229 Washington Avenue
Garden City, NY 11530.
Very Truly Yours,
Emmanuel Tzannes
THE NEW YORK BOARD OF FIRS UNDERWRITERS ~Ar,E i
10007.66 BUREAU OF ELECTRICITY
85 JOHN BTREET. NEW YORK. N!W YORK 10038
k Date NARCH 25,1941 Application No. on ftb 63348189189 N 180178
s THIS CERTIFIES THAT
only thI ebetr4al equipment N daecri6ed 6abro and Jnen]ducsd by tM app/bant named on the ehooe appBcation number Jn the promLp of
MR E TZANNES, 3130 NANBASSET AVF.,, GRE~~yE.•NPORT, N.Y.
in thefelbloinp loc~}t~;~y~ g~q~gnt ~ Ist Fl. U End Fl. ATTY./nUT ~,ti~34 eloek2~ Lot 7k8 =
was examined un '"_""CN ~8' 19y1 and found to 6e in compliance with. the reyuircmenta of this Board.
RXriRE RX11BlEf fbORN16 RECItS O DISH W BXNAYST FANS
twTl/2Tf AClE6 fYY1TCN6 Ctf[EM rlUCt[KEM OTHEn AMT. K, W, AMT. K. W. AMi. C.W. MIT. R W. AMT. M. r.
58 48 37 55 1 6:87 1 7.4 1 1.2 1 F
DRYBRS RIBSIAC! MOTORS IIITUtl A!lt1AlICR RRiRIf SMgM RK'K TIAAS t,YOaf AML {IMT.:. lEef CIIt11AERS
~E AMr. K. W, ql X. r. GAE X. r. AMT. NO. A. W.O. AMT. MV. AMT. -MVS. ~RM'tS. AMT. N. r NO. a REI AMT. WATTS
] 1 6 600
? SRRVIOT OBCONNECT NO.M S 'E R V I C p~ E
' AMT. AAV: TYrE 1 / Tv 11 TV ] 1 ]W ] / eM K~CECdM. ~ A.~ NO. OP NFIEG OI ~KLLO 1q. p mlmAls -
' 1 200 CH 1 X 1 3/0 1 3/0'
ortm ArrAUTUS:
2TON A/C UNITS-1
2.5TON A/C UNITS-1,
G. F.C.I:-5
SNAKE AETECTUR:-?.
COR&REY ELECTRIC L.T.C.{17.04-E
294 JERUSALEN AVE.
NENPSTBAO, NY, 11550 aBKItAt~
11 t s`
~0 F';rf
Per
This artificaH must not ba alHrad in any mann?r; return to fhe offiu of tlr Board ff iTMOrnct..lnspeclort. ba idaMffiedby Is. N,
_ _
DOPY Fqt EWLDINf. OEPARTMlNT. THIS CGrY t9F ClRTtRICA~E-ASIST NOT ~ ALTERED IN ANY M111Mdt.
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T ( ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ] FI~NA_L~
REMARKS: d ~ ~s~~,~
G~~
~ ~
DATE lNSPECTC~f~
raj ~ (~f X65-1802
! ! (Q BUILDING DEPT.
1 NS~PECTION
[ ]FOUNDATION 1ST ( OUCH PLBG.
[ ] FOUNDATION 2ND INSULATION
[ ]FRAMING [ ]FINAL
REMARKS: _
,l'L ~ ~ -
J~,_
DATE ~ INSPECTOR
1 7 ~ 765-1802
BUILDING DEPT.
t NSPECTION
[ ]FOUNDATION 1ST ( ] ROUGH PLBG.
[ ] UNDATION 2ND [ ]INSULATION
[~RAMING [ ]FINAL
REMARKS: ~
DATE INSPECTOR vC~
B0~\RD OF HE.\LTH
3 SETS OF PLANS ...k!......
FORR1 N0 1 SURVEY
TOWN OFSOUTHOLD CHECK .........r!:..........
QUILDING DEPARTMENT SEPTIC FORM
' 70WN HALL
SOUT110LD, N Y 11971 NOTIFY-J~i_~-~~
nn q TEL.. 7651802 C~1Lti
Exanlincd . ~~Cnn~1 arrty 19~gI. rinlL TO • MM
~pprovcd ~GuCf(I..~'i , 19g t Penntt No ~ ? R.~~ ~ k
tt .t
I I
Disapproved a/c ~1~ 2 ~ ( '
~i ,
-.,•r•.~
UUU (Buildmg Inspector)
APPLICATION FOR BUILDING PERMIT
Date Z ~ 19 g
INSTRUCTIONS
a Tlus application must be completely filled m by typewriter or m ink and submitted to the Buildmg Inspector, with
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 ad~ommg premises or public stre~
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of ttus app
cation.
c. The work covered by this apphcatton may not be commenced before issuance of Buildmg Permit.
d Upon approval of this apphcatton, the Budding Inspector tvdl issued a Building Permit to the applicant. Such pent
shall be kept on tfte premises available for inspection t}troughout t}te work.
e. No building shall be occupied or used m whole o: m part for any purpose whatever unfit a Certificate of Occupan~
shall have been granted by the Buildmg Inspector.
APPLICATION IS HEREBY h1ADE to the Buildmg Department for the issuance of a Bwldmg Permit pursuant to ti
Buildmg Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances .
Regulations, for the construction of buildings, atldihons or alterations, or for removal or dcmohtron, as hereut describe
The applicant agrees to comply wdh all applicable laws, ordinances, building code, housing code, and regulations, and
admit authorized inspectors on premises and in betiding for necessa~nspecUOns
(Sicnahue of applicant, or name, i a corporation)
~?9.V,IIts~tiuc:,~?ra I~~~....~~k~G°1y....
• (hlaihng address of applicant) j~
State w'~hether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde
...~1.4%?lt.E Q. GG
Name of owner of premises 4-:'~ M {aN J fc,i, , .~~-1LF.r.N fe S •
.
(as on the tai roll or latast deed)
If applicant is a cotrnrn},poration, signature of duly authorized officer
(Name and title of corporate officer)
er s License, . .
3
Clciln'c i irrncP Ny'. .
Other Trade's License No .
I Location of land on which proposed work will be done , . , . .
House Number Streets Hmn[et
• •
Subdivision ~ Fllcd Atap No Lot .
(N.une)
Z State e~istmg use and occupancy of premises and intended use and ocpc~up~ancy of proposed construction
a. Existing use and occupancy . ~t ~~S--f • t • ~{'`f • • •6~xz-~~,~r~•-}~
iA", 8:°.r.5~ .
b. Intended use and occupancy • • • • r '
•s<• ~
3. Nature of work (check which applicable) New Butldmg Addrtion Y~ ,'Uteratron .t-'.'... .
Reparr .Removal Demolrtron Other Work
(DescnpUOr
4. Estimated Cost . Fee
([o be pard on filing thrs apphcatron)
5. If dwelling, nurnber of dwelling units ~ Number of dwelling units on each floor , k~k... .
If gara^.c, number of cars . C~
jJa . , , , . .
6. If business. commercral or mixed occupancy, specffy nature and extent of each type of use ~~(fa............
7. Dmtenstons of existing s(ructures, rf any Front ; : . ; :Rear Depth . i s , , , ,
Fletght , Number of Stones , ,
Dtmensr~ort~ of same struciur~wrth alteratrons or addrttons: Front ~ju',..~ ~F44!%!K.... Rear 3Z.?7, .~,e~
Depth n~.i ./~~.6(~C~iv.. Ilerg}tt .~r.~%,.~ Number of Stones ..fir
Drmensrons of entire new constructron Front y!/.Ja... Rear Depth .
Herght ..Number of Stones .t....... P .
9. Srze of lot Front .52-.?:v...... Rear .5C) De th 11.4-..:r.......... .
10 Date of Purchase . ........Name of Former Owner
11. Zer.e cr use dtstr,~t which premrses are sttuated .
12. Does proposed construction vtoJate any zoning law, ordinance or regulatron. ..~C~ .
13. 1Vd1 lot be regraded r3t?..... . ~ .
J
f Nrll excess fill be re~oved fro~ry,~remrses ~~A Yes
14. Name of Owner of pr~e/mtses~~`~ .)'1::~ ~ ~1r r s~~rtw Address ~R h ~.<°vt . ~`:E~C:~ Y~:uli3ione No. ,
Name of Archr[ect . MI U-If~G.I•s (".C.$?h,~~ Address"~L~!`~t ~1~~.~,.~: ~I)~tc~ne No . r.5!
Name of Contractor ..........................Address .............Phone No............. .
15.Is this property located within~00 feet of a tidal wetland? *YES....NO....
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and duttnctly all buildings, whether exrsting or proposed, and mdtcata all set-back dunenstons fn
property tines. Give street and black number or descnptron according to deed, and show street names and indicate whetr
tntenor or corner lot.
S~~ F1'(~~Ct~tt•? t7itifa~~,J6
STATE OF tiEN YORK, S.S
COUNTY OF ~1I' ~J
• ,~.h?.t'r?ot9 AILf~ ~/L'~!".'~~, bang duly sworn, deposes and says that he is the appltca
(Name of mdmdual srgnmg contract)
above named
Eie rs the C:4 J/~~~C.~.~{~,.~. .
(Contractor, agent, corporate offrcer, etc.)
of said owner or owners, and rs duly authonzcd to perform or h.tve performed the Bard wort. and to make and file t,'
apphcatron, [hat ail statements contmnrd m this applrcghon are true to the best of hrs knowledge and belief; and that t
work wdl be performed m the manner set forth m the apphcatron fled therewith
Sworn to before me tats
...day of.. ~~r~~.....,19~
Notary Publrc . ~~,~r`~-:...... County
Et.lA$JAQNAa .G~~'ZZf''.°`~~'~i,/~~a~d~...~.
Nate-4804732anr1Rorit (Srgnature of applicar
Quafiflad in Nassau CasMY
Term Expires August 31, f 9_.1 G
F
t
V
/I '
, H ?'_H-u,q
- /
~j
b :J
7
[e'd~ ~ -, ~. --1 F-I
~Z
-/~1//
.MIChAeL KOSINSK~,
3~ SPRIi,TG HILL ~OAD
EAST HILLS, N.Y. 11577
i' 5 o"
ARCHITECT
COPYRIGHT (O~ 1989
TEL. 516 - 62P- 5141
CONSTR fL,TI~N THE PROPENTI oF.
EA@~%ANUEL TZANNE~
3130 ~%Alh~dANSET AVENUE
GREEI, JPORT, NEW YORK 11944
FOR TIIE OWNER:
EM~/iANUEL TZANNES
229 WASHINGTON AVENUE
GARDEN CITY, NEW YORK 11530
PLANS
ELEVATIONS
SECTIONS
~OT~S
REV.
DATE
PRO~ECT:
SCALE
DWG.