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HomeMy WebLinkAbout17214-z r 1 FORM NO. 4 TOWN OF 80UTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. ' CERTIFICATE OF OCCUPANCY No Z-18429 Date SEPTENBER 28, 1989 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 1328 KING STREET ORIENT N.Y. _ House No. Street Hamlet County Tax Map No. 1000 Section 27 Block 03 Lot p/o 4 Subdivision KINGS BAY ESTS. Filed Map No. Lot No. 2 conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 5, 1988 pursuant to which Building Permit No. 17214-Z dated JULY 15 1988 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 ATTACHEII GARAGE & ATTACHED WOOD DECKS The certificate is issued to KINGSBAY PARTNERSHIP _ (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 87-SO-178-JULY 18 1989 UNDERWRITERS CERTIFICATE N0. PENDING - SEPTEMBER 22 1989 PLUMBERS CERTIFICATION DATED SEPTEMBER 25, 1489-K&K PLUMBING & HEATING Building Inspector Rev. 1/81 Fosas xo. s 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) N o 017 214 Z Date .......7~:~ 19~~ Permission Is hereb gra ted ~o...... ~ to ~ . . at pr~~~ocated at .....~l.~~... Caunty Tax Map No. 1000 Section ........'~..7........ Block Lot No pursuant to application dated ...................7...~..........................., 19.d.Z1.., and approved by the Building I//nspector. Fee ~7~! ~,1( Iding Inspector Rev. 6/30/80 TOWN OF SOUTHOLD JUL 3 { BUILDING DEPART?PENT TOWN HALL TOWN OF SOUTHOLD • SOUTIIOLD, NEW YORK II971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCIIPANCY Q ,p q DATE. L.2~C~4? 1........ NEW CONSTRUCTION .!:._..OLD OR PRE-E%ISTING BUILDING...._.VACANT LAND...____. Location of Property .PoAK~!~7~u'+.~..l41~?E..,,,,, ©K.I~~VT_ HOUSE NO_ STREET HAMLET Owner or Owners of Pzoperty...~IN~'-,~,g~'`'(._~t~~?J'~R?~L~? . County Taa Map No. 1000 Section Block ....1_.,. Lot' Z Subdivision..KlNr1S.~~.~.-...,...... Filed Map ........Lot.......... Pervit No. .I~?!~,_„Date of Permit ..~~~S~g~,.Applicant ~U7r!~.T~'!~^~n,+~, IIealth Dept. Approval Underwriters Approval..._.,........ Planning Board Approval Request for Temporary Certificate Final Certificate Fee Submitted: $ APPLICANT.. ~4My~ 1_„ Q~ee •3~3 f ~ ~ ~ ~$Ha9 rev. 10/14/88 i ~ ~ :w i y „ - FORM NO. 6 ~ ' „ - ~ ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS A. 'This application must beifiled in typewriter OR ink and submitted to the Building ]:aspector with the folloying; for new buildings or new use: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Heal,[h Dept. of water supply and sewerage-disposal(S-9 form). 8. Approval of electricals installation from Board of Fire Underwriters. 4, Sworn statement from plumber certifying that solder used in system contains less than 2/10 of IZ lead.,. 5, Commercial buildings,~industrial buildings, multiple residences and similar buildings and installations, a certificate of code compliance from the 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, buildings and unusual natural or topographic features. 2. A properly completed application, a consent to inspect signed by the applicant and a certified abstract of title issued by a title company which shall show single and separate ownership of the entire lot prior to April 9, 1957. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 3. Date of any housing codde or safety inspection of. buildings or premises, or other pertinent information required to prepare a certificate. C. For Vacant Land Certificate of Occupancy: 1. M applicatiott for vacant land Certificate of Occupancy shall be submitted, and a certified abstract of title issued by a title company showing single and separate ownership of the entire lot prior to April 9, 1957 shall also accompany the application. If a'Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. D. FEES: 1. CERTIFICATE OP OCC~TPANCY - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwel xng $25.00, Swimming Pool, $25.00. Accessory building $25.00 Addition Co Accessory buildings, $25.00 - Businesses $50.00. 2. Certificate of Occupancy on pre-existing dwelling - $100.00. 3. Copy of Certificate of Occupancy - $5.00 - over 5 years - $10.00 4. Vacant Land Certif}care of Occupancy - $20.00 5. IIpdated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy - $25.00 Residential $50.00 Commercial I~ rev, t0/14 /38 PORT ABSTRACT INC. 600 OLD COUN'1'KY ROAD 21 EA6T 40th STREET' P.O. 60X 8008 NEW YORK, NEW YOKK 10018 GARUEN CI77, NEW YORK 11630 SUITE 1008 (fi18) 2'L7-2160 (212) 370-0838 . .1 718 7... _ „ _ r . t ( 87=9393 a, ~ t ~ ~ , t t' t i - (914 328 OA26 - ~ ~ ~ ~ A Date: ~O~I 10~~ ~ C ~lJ L-( ~r~ ~ Sf~U,~-h GJ ~ ~ Re:'ritle No. ~8~Q73-~j~; t.~jb q • ~ ~ - ~X ~ I /l Premises : `~`r ~Lh(~ I(,_ ! , S~u~hOld ~)l~ II_~lI r1e~+ ~1 ~ iA~ Sec: ~~"~_Blk:_~_LOt: ~ I~ Rec. Owner: \/Ci l rC~ Dear Sir /Madam: closed please find our check in the amount of $ ~,l`~ that is required in order to obtain a copy of the certificate of occupancy on the above captioned premises. Please fortaard a copy of this information to our Garden City office, indicated above. Note our reference rnunber on this copy. Your prompt attention to this matter would be greatly appreciated. Thank you in advance for your cooperation in this matter. Very truly yours, Phyllis Petillo ^b q~ s~ r~~\~ ItEPitEBEN'1'ING STEWAI;T'CITLE INBUItANCE COMPANY F'IitB'1' A'1'LAN'1'IC'CI'1'LE INBUItANCE CORP. O ~~~Fa~ COr TEL. 7G5-1802 ~l xowrr or sou~r~oa.~ ~ ~ OFFICE OF BUILDIi•IG INSPECTOR o= c3 P.U. BOX 728 ~ :'~r`~''~'`~ -e TO1VN HALL ~Z' SOUTHULD, N.Y. ] 1971 ~~p~ Yob C E R T I F I C A T I O N , Date i Building Permit No. Owner n~~ ~y (please p\rint)'! 1 (please print) -1-- V I certify that the solder used in the water supply system contains less than 2/10 of 1g lead. (plumber's signature) Swornl~ to befor= me this / 19~, otary Public Notary Public, .5 dT!°OLi{ County ENICgG'KOCN NewN MtiW Stets of New Nock No.•2182100 ty ~Gx~??essk .81,1980 ~a•^ZrJrr ~ rI:L. acs-l sm 05,,,E ~c, To~errr or sou~o~.>7 ~~~~~H :..,R76u:~;~~ Y•u ...c Ol~f'ICIi OP BUILDING iNSI'ECTOR ^li. ,A~' ~~t; ~ 1'.O. BOX ] 1 7 9 ~ ;w ~ TOWNiiALL ` O~ SO(JTIiOLD, N.Y. 11971 September 21, 1989 ELIZABETH THOMPSON RINGS BAY PARTNERS 316 NOTT ST. APT. 3B NEW YORK CITY, N.Y. 10012 RE:RTNGS BAY PARTNERS 'Po Whcm This May Concern, 1 4.e are unable r.o complete your Certificate of Occupancy because of the folloc•~ing reasons. 11n appl.ic.ation for Certificate of Occupancy is not nn fi].c. No Undert~rrit-crs Certificate on file. / 'I'hc chec:F; .i:: on file. ) D:o itenl.th Dept. Approval on tile. P:o final inspection has been made. Please contact our office on this matter. - Thank you for your cooperation. Ilu.ildir:q Pcrm.it: i! 1 7 2 1 4 Z Duilc3inq Dupt. ttk 'k/~tlo Plumber ;;older Cert.i L-icate on file. ( al.l ponnits involving plumbing being .issued after ,1pri.1 1,1984 ) :~1::LD It:SPEC;iU.d ~~llATE ~ COMMGNT° ~ ~o m ~ H i _ - H FOUtJDATION ( 1St) I~_' d c ti FOUNDATIOtJ (2nd) _ _ - ~ z. a z \ o ~ A.a ROUGH FRAME & o0 -PLUMBING ti 3 . x' m ~ / ~ IIJSULATION PER N. R. y Q> STATE ENERGY CODE m ~ 4 . ~ G dK.r•~. - 1 F I id A L 4/r ~f~l.c..-- ~ ~ o z ADDITIONAL COMMENTS: x H a H H~ 2 i [T1 OQ A • r i H ~ ' S d ~ C+1 (y~y H 'U ' ELIZABETH THOMPSON n ~ ARCHITECT 316 Mott Sireei • 3B New York, NY 10012 2 2 Jnly l£~,ig88 Mr. Tom Fisher Res 'Kings Bay Nstates Southold Town Building Dept, Building permit Southold Town Ftall Southold, N,Y, 11g'71 Dear Mr. Fisher, This letter is in response to our telephone conversation on July 15th in which you requested verification of an 18+ foist span in the living raom of the above referenced house. IEve enclosed photocopies from two ~Hifferent sources to show the data used in determining the allowable span, Since the exact information needed is not supplied by any table, it was extrapolated in the following manner. At modulus of elasticity 1.~ and 40# Zive Load: Allo, w• Span A, 2x10 Joist @ 24" O,C, I4+-7+' 2x10 Joist @ 24r' O,C, 16+-3++ (w/ 3/4" glued plywd,) B. 2x10 Joist ~ 16"~~O.C, 16+-g'+ 2x10 Joist @ ~.6" O,C, = (w/ 3/4+' glued plywd.) ' Using proportional fractions, the unknown allowable span should be 18+-8". Using simple addition, the 3oist span increase at A is 1+-8++, Adding that to B makes the unknown allowable span j 18+-g". By either method of calculation, the 18+-0++ span shown on the drawings is within the allowable distance. Lf you have any other questions, please do not hesitate to call. 4 Sincerely ~~~L-1 Elizabeth Thompson+ A,7,A, I ~s~~ Floor Joists: 30 and 40 Ib Live Load 303 1)%':IGN CRITERIA $1RENGYN: Live load of 30 psf plus dead load of 10 p>Idetermines the required fiber stress value. DEFLECTION: For 30 psf live load. Limited to span ' ~ m htthoy divided by 360. FLOOR JOISTS-30 LB LIVE LOAD i _ ALL ROOMS USED FOR SLEEPING gREgS AND ATTIC FLOORS ~ _~f -/0117 (IN.I MODULUS OF ELASTICITY, E, IN 1,000,000 PSI xIl C9PACING 0.5 O.fi 07 0,8 0.9 1.0 1.1 1,2 1.3 1.4 L5 1.6 8A 8-6 8-11 9.4 9-9 1,7 1.8 1.9 - 12 510 570 640 700 750 8 01 860 910 960 1010 1060 1100 1150 12 0 1240 - 2x0 18 560 630 800 770 830 890 9 0 7000 1060 1110 1160 1920 12701 1320 11-4 ~ 24 6-4 6-9 7.1 7-5 7-9 8-0 8- 1360 640 720 800 880 950 1020 1080 8150 8210 1270 7330 7390 7450 7510 7560 12 10.7 11-3 11.10 12.4 1210 13-4 13-9 142 14-6 14-11 15-3 157 15-f0 - 16.2 510 570 640 700 750 810 860 910 960 1010 1060 1100 1150 1200 16-6 s-i 1os 1o-s laao 3x B IB 560 630 700 11-13 11-8 12-1 12-6 12-10 13-2 13-6 13.10 142 14-5 14-e 15-0 770 830 890 950 1000 1060 1110 1160 1220 ))1270 1320 1360 fi40 720 800 - 24 B-5 8-11 9-4 880 9 02 1020 1080 11 0 1210 1270 1330 1390 14450~~ 1510 1580 12 13.6 14-4 15-1 15-9 16.5 17-0 17-6 18.0 18.6 19-0 195 19-10 20.3 208 21-0 's~ 510 570 640 700 760 810 8fi0 910 96Q 1010 1060 1100 1160 1200 1240 ~^~~`°7e 10 16 12-3 13-0 13-8 14-4 14.11 15-5 15-11 16-5 16-10 17-3 17-e 18-0 18-5 18.9 19.1 --,u. 560 630 700 770 830 890 950 1000 1060 1110 1160 1220 1270 1320 1360 ' r~' 24 10-8 11-4 11.11 12-6 13-0 13-6 • 13.11 14-4 14-B 15-1 15-5 15-9 16-1 16-5 16.8 ,e~r~ 640 720 800 880 950 1020 1080 1150 1210 1270 1330 1390 1450 1510 1560 - 12 18-5 175 18.4 19-2 1911 20-8 21-4 21-11 22-6 23.1 23-7 24-2 248 251 25-7 510 570 640 700 750 810 860 910 960 1010 1060 1100 1150 1200 1240 `G'~~ x I1 ~ 18 14.11 15.10 16-8 17-5 18.1 18-9 19-4 19.11 20-6 21-0 21-6 21.11 22-5 22-10 23-3 560 630 700 770 830 890 950 1000 1060 1110 1160 1220 1270 1320 1360 13.0 1340 14-7 15-2 15.10 16-5 16.11 175 17-11 18-4 18-9 19.2 19-7 19-11 20-3 24 640 720 800 880 950 1020 7080 1150 1210 ' 1270 1330 1390 1450 1510 1560 ~~'VF f)TE: Tha required extreme fiber stress in bending, Fe, in psi is shown below each span. tias~r:. f~. ~y0C81GN CRITERIA ~TRENGTNr Live load of 40 psf plus deed load of 10 'aprMl determines the regWred fiber stress value. 'i-.DEFlEC710N: For 40 psf live load. Limited to span sy+jM1 Inches divided by 360. -'.KLOOR JOISTS 40 LB LIVE LOAD , "'ALL ROOMS EXCEPT THOSE USED FOR SLEEPING AREAS AND gTTIC FLOORS r`10197 (IN,I MOD ULUS OF ELASTICITY E, IN 1,DOG,6G9 P51 ZI;[ SPACING 0,5 0.8 0.7 0.8 0.9 1.0 1.1 1.2 1.3 1.4 1.5 1.8 1.7 1.8 1.9 12 520 590 660 820 880 8 0 890 y a 10-0 ;10-3 10-6 10-9 10.11 11-2 114 990 1040 1090 1140 1190 1230 1280 -2x0 16 6-7 7.0 7-5 7~9 8-0 8-4 8-7 8-10 580 650 720 790 860 920 980 9-1 9'4 9-6 9-9 9-11 10-2 10.4 5-9 1040 1090 1150 1200 1250 1310 1360 1410 24 660 50 830 900 980 1050 1120 1190 1250 8310 8380 8440 8500 8550 7610 12 520 590 660 720 780 830 8906 9400 13-2 136 1310 14-2 14.5 14-8 15-0 - 2 x 8 8.9 9-3 9-9 10- " 990 1040 1090 1140 1190 1230 1280 16 2 10-7 11-0 11-4 11-8 12.0 123 12J 12-10 13-1 13-4 13-7 _ 580 650 720 790 850 920 980 1040 1090 1150 1200 1250 1310 1360 1410 24 660 850 830 900 980 7050 7120 1190 1250 10-9 11-0 113 115 11-8 '11-11 123 13-0 138 14-4 14-11 155 1511 165 16-10 17 3 17 8 18 0 18 5 18 9 1610 12 520 590 660 720 780 830 890 940 990 104D 1090 1140 1190 1230 1280 x 10 16 580 11-10 12-5 13-0 13-6 14-0 14-6 14.11 15-3 15-8 160 16-5 16-9 17-0 174 650 720 790 850 920 960 1040 1090 1150 1200 1250 1310 1360 1410 24 9.9 104 10-10 11.4 11-10 12-3 12-8 13-0 13.4 660 750 830 900 980 1050 1120 1190 1250 13-8 140 14-4 14-7 14-11 152 14~ 11 154 0 168 17-5 18~ 1 189 19-4 19-11 1310 1380 1440 1500 1550 1610 12 520 590 660 720 780 830 890 940 990 21.0 216 21-11 225 22-10 233 2X 12 16 13.6 144 15-2 15-10 16-5 170 17J 18-1 18 7 1040 1090 1140 1190 1230 1280 580 650 720 790 860 920 980 1040 1090 1750 12 0 12501 1710 1960 1410 24 11-10 12-7 13-3 13-10 14-4 14.11 154 15-10 163 660 750 830 900 980 1050 1120 1190 1250 16-8 170 17-5 17-9 181 18-5 NOTE: The required extreme fiber stress in bending, Fp, in psi is shown below each 1310 1380 1440 1500 1550 1610 span. aftlonal Forest Products Association; Washington, O.C. l~~.ct~, r~~.~un~^~ ~=l,.w~ra~ih~c~ ~~°~~~~~k~ y,, f' S. Department of Housing anti tJrhan pevelopment t~ QMice qt Ply pevelopment and Reseafch , . h r , , . _ ~ ~ ~r~ R., ucing Home Building Costs with f w.v ~ O~/E Design and Construction ~ * ; ~ w G ideline 5 ~ . . " j. ~ ~ ~ ~ 4 ~ , V. i 1•. ~ •x.:. k n i~ . ...v f. .aF.v ' ~ M. f, - I 4.~1 ~ ' 1 • t a oiP s. ` ~ 1 f- ~ ; I _ rt L F... I l ~ 4y 4 . J,, ( j ~ 1 ! i'1 I ~ { ~ h: 1 f , shy i. d; i s to ;rP 4` ~ r ppti 3 ls: F . `R _ i~ { ^ ~i i, 1. _ g 41 ' ~ ~ ~ ' , , i ~ i / ~ r •3L \ ~ i . i ~ 1~ 1'y's~~'kF' r tx ~ ~ •,I ~ ~ ~ z~ ~ ~ is a t e - s ~ ~ ~ 4' ~ nr ~ r ~ i~ ~ 1, r i~ ~ ~ ~ I M~11 4 I ~ j. ~ , ~ ~ ~ `1 w, P ~ ~ ~ ~i r ~ - f'~ ~ cam,. ~ ` m k e'4 "'R.XY ~ r' eY ~ ~ r ~ ~ f . • I G ~ ys~1,.,~?Y ,~w"v ~ Jh •'NI ^1 IMr.4 ,v ?MY S f r t"Y ,4 "!T'~: /dw w.k,~. MK` ~nc~ e ,d ~ a f ° !i • - - _ - 1 TABLE 4-4. Allowable spans (f t.-in.) for 24" o. c. joists with 3!4 glued plywood floor j {i Joist Joist Modulus of Elasticity, "E", in 1,000,000 psi* Size 0.6 0.8 1.0 1.2 1.4 1.6 I•~ 1.8 2.0 40 lbs. per Square Foot Live'Load S-t 8-8 9-2 9-7 9-t1 to-z to-6 10-9 2x6 1100 1270 1415 1545 1655 1755 1855 1950 to-3 tt-o It-7 12-2 12-7 13-0 13-4 t3-8 2x8 1025 1180 1310 1430, 1535 1630 1725 1810 ~ 12-9 13-8 14-4 15-0 15-7 l6-tll 3 6-6 i6-lt j 2x10 ' 970 '•.1110 1230 1345 1445 1535 1625 1710 i ~i 15-2 16-2 17-1 17-10 18-6 19-1 19-8 20-2 2x12 ' 925 1060 1175 1280 1380 1470 1560 ~ 1640 ~ 30 lbs. per Square Foot Live Load 8-11 ' 9-7 t0-1 10-6 l0-)1 11-3 11-7 1t-10 2x6 1340 1540 1715 1865 2005 2130 2250 2360 ~ 1 11-4 12-2 12-10 13-4 - 13-10 14-3 14-8 15-0 2x8 S 1245 1430 1590 1730 1860 1975 2085 2190 f ~ Y 14-0 t5-0 15-10 16-6 17-1 17-9 18-2 t8-8 2x 10 1170 1345 1495 1625 1745 1860 1970 2070 16-8 17-10 18-10 19-7 20-4 21-0 21-8 22-2 2x12 1120 i28o 1425 1550 "1670 1780 1890 1985 i NOTE: Associated minimum required "f"-value for repetitive members shown ` with each span, s See Appendix A for strength properties of different species and grades ~ of lumber. ? . Source: Performance of Glued Single-Layer Plywood-To-Wood Joist Floor Systems, ; NAHB Research Foundation, Inc., for HUD, June 1973 t t ~ 55 • _ l7y/~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ) ROUGH PLBG. [ ] FOUNDATION 2ND l!/) INSULATION [ ]FRAMING ~ [ ]FINAL REMARKS: ~J~t~~~(' ~ , DATE 023 INSPECTOR ~ q G L ~C., ~ L 765-1802 BUILDING DEPT. INSPECTION [FOUNDATION 1ST ( ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [)FINAL REMARKS: ~iL2~ zi DATE (2 INSPECTOR ~~;,~,,~Q~ w~ ~ T65-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION iST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INS CATION FRAMING [ FINAL REMARKS: ~ - ~ ~ ~ ~ DATE ~ 0 INSPECTOR ~'v~"/ r ~~z.t~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ) ROUGH PLBG. [ ] FOUNDATION 2ND [ )INSULATION ~RAMING [ ]FINAL REMARKS: ~-j-- DATE 1' ~ ~ INSPECTOR 172 ~ 765-1802 BUILDING DEPT. INSPEC7'IAN [ ] FO DATION iST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: DATE ! ~.f INSPECTOR - ~ .~.-~e~,~_~,. ~ ~ T6S-1802 H BUILDING DEF~'T~ INSPEC ION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING ( FINAL , E ARKS: ~ ~j 'mod ~ ~~~e r~~- ° ,tee., ~ DATE ~ G~ INSPECTOR .^,r..,,.~r ~,,._„~e_,.,_•.,_.~~,,,.,m BOARD OF HEALTH V ~~F~~a„~~~~,(_l~rl,~ 3 SETS OP?PLANS . J• • - • FORM NO. 1 SURVEY • . ~Q TOWN OFSOUTHOLD CHECK ~.7Cx/ BUILDING DEPARTMENT SEPTIC FORM - . - • • - • • • TOWN HALL NOTIFY F3LCG. DEi'I. SOUTHOLD, N.Y. 11971 CALL TOWN,UF SOUTMOLD TEL.: 765-1802 • • • - • • ~ • ~ • • • • - ' MAIL T0: Examined .~~~.r 19 g~.~ ')YV~r~ei J •y1LG~~i,G.t.v" Approved 190 Permit No.~.~~./~ ~ WAR, Q'uc-A-~ ~,UvY~-+~• Disapproved a/c ~i~g Ir~tor) APPLICATION FOR BUILDING PERMIT I Date VV!•:~{..r-.i..-....., 19~p 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 whote or in part for any purpose whatever until a Certifcate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Depaztment 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 build~m s, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply witty 1~T~~p-,~~t~ laws, ordinances, building code, housin code, and regulations, and to admit authorized inspectors on pr . i~e,~.an~hn-l~ciil~ g for necessary inspections./,/////~ ~(J~`~~7~~/////A ~y~ ~ N m& .x _G~> g , ,~hzd. 3~,4 ~ ~ (Signature of applicant, or name, if corporation) „ ~.i`~r... ~ 3/6 M.oT( ST• /?p~ 3>S N-`f . N`( toot.Zr. is ~ ~ (Mailing address of applicant) State whether applicant is owner~~~; ~h chitect, engineer, general contractor, electrician, plumber or builder. V. lV.N.4~L.I...I~tR-21;NTEZ!~ . Name of owner of premises 1 N.~S ~A:`.{....p8K3:N.E~ . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No . . Plumber's License No.~,:E: S \.~.~.~y~//~1.N.~ Electrician's License No.~~C~.~~f.~~:.~ ~--~-C - - Other Trade's License No . . 1. Location of land on which proposed work will be done . . ..:~..1.3~.$~............oFF..k~NU. sTeee~ ..................4a~ENr..........:............. House Number Street Hamlet ,1 County Tax Map No. ]000 Section ..OZ 7............ Block ....3 Lot . ?.j.`LCI'.~~.°. Subdivision ~LW.IBS...p?~°!'~...~ST19.~~a........ Filed Map No . Lot . (Name} 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~•`??1>ENTIt4L.. f .~~f~lG!~.4T4r.W?',l' . b.tntendeduseandoccupancy ....~`?tDElUT11'k~,,,,,,,,,,,,,,,,,,,,,,,•............._,.,,,,,,•..,. i 3. Nature of work (check which applicable): New Building ...X , Addition Alteration . e ov Re~air ~I . Demolition ..............Other Work . S OC1L7 , - (D se~riplion) 4. Es imated Cost ~ ~ , • ' Fee...................................... ` (to be paid on filing this application) S. If welling, number of dwelling units Number of dwelling units on each floor . If arage, number of cars Z . G.!4.~ . 6. If usiness, commercial or mixed gccupancy, specify nature and extent of each type of use . 7. Dimensions of existing structures,',if any: Front Rear Depth . Height ...............Number of 5tories........................................................ De th , , , , , • • alterations or additions: Front Rear . ~4 1 Height Number of Stories . 8. D~lensrons of entiresnewtconstnzotion: Front ..~4. r......... Rear ..$V.'.... , , , ...Depth . E{O. r......... . Height ...3.~ .........Number of Stories . 9. Siz of lot: Front ...~9P ~ Rear Z.q4. ~ Depth , 790 1 1. Zo ~ e or use district in whi~h rem ' ' ' ' ' • • • Name of Former Owner . P p b ises are situated (Lesi P:~4 • . 102. Do s oro uosed construction olate any zoning law, ordinance or regulation: .Nq . 13. Wil lot b@ regraded ....N.p Will excess fill be removed from premises: Yes 14. N e of Owner of premises . K~N',c,S.&RY.~~gr?~:?'S. AddressA~~ Ky f ~ IvdIL. ,phone No. Z.rL-9uGe-~Kgy. Na e of Architect ..E~r?%iq:r$~;7N, .TtK?Mpso~./, ..Address .....lr4AME~........ Phone No....(S!Fwe~, • . I!'iG-C.~Su~ .....Address SE.o. A~Har~6K:R... Phone No. ~'1t.-765-5$4,'7, p p y I 15. Its thisCororaerotr located within 300 feetyyof a t__gqida'1°w'et7an$~''Y*Yes No ~G... *If yes, Southold Town Trustees PermitpLO'1'DIAGRAMed. Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block nu~rrber or description according to deed, and show street names and indicate whether interior ar corner lot. 5&6 SITE P.aN I I 'i STATE OF NEW YORK, S.S, COliNTl~ OF ..~g~~~~ ~t~S411J ~1~$~k1!~R1~ ...`Ul being duly sworn, deposes and says that lie is the applicant (Name of individual signing contract) above na ed. He is the r-F.~"'~`'7 . (Contractor, agent, corporate officer, etc.) of said o ner or owners, and is duly authorized to perform or have performed the said work and to make and file this 'applicatio ,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 efore me this t,, Notary P blic, ~ .Yf (.,J,~J~. L County V V l I't. ~ . NONo~47 78 BK~t of Idew Yait . 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