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HomeMy WebLinkAbout27096-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28302 Date: 03/25/02 THIS CERTIFIES that the building ALTERATION Location of Property: 780 MINNEHAHA BLVD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 87 Block 2 Lot 43 .1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 18, 2000 pursuant to which Building Permit No. 27096-Z dated FEBRUARY 28, 2001 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 ALTERATION AND RENOVATION OF AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. NEW YORK STATE PETITION #2001-1028. The certificate is issued to J ROSS & JEANNE MCHUGH (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1037974 03/08/02 PLUMBERS CERTIFICATION DATED 03/20/02 NORTH FORK PLUMBING C 11,4t orizeY Signature Rev. 1/81 FORM NO. 3 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) PERMIT NO. 27096 Z 'Date FEBRUARY 28, 2001 Permission is hereby granted to: J ROSS & JEANNE MCHUGH 16 TWISTING LANE WANTAGH,NY 11793 for ALTERATION & RENOVATION OF AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at 780 MINNEHAHA BLVD SOUTHOLD County Tax Map No. 473889 Section 087 Block 0002 Lot No. 043 . 001 pursuant to application dated NOVEMBER 18, 2000 and approved by the Building Inspector. Fee $ 75 . 00 Au o iz Sig ature COPY Rev. 2/19/98 Form No.6 TOWN OF SOUTHOLD / BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPAN ,V .. This application must be filled in by typewriter or ink and submitted to the Building Dparten> "followmg: r X02 A. For new building or new use: �r , 1. Final survey of property with accurate location of all buildings, property lines, streets,-arid unusual natuial or' topographic features. n 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 I% 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, the 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. Photocopy of Certificate of Occupancy-$0.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy- Residential$15.00,Commercial$15.00 Date._,31,1 ?,OL L New Construction: Old or Pre-existing Building: (check one) Location of Property: 7 SO &1111121,1--H,,9,,yW ,BLYO. House No. Street Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Block Q Q p 2 Lot D 3. ao/ Subdivision Filed Map. Lot: Permit No. 2 70 yG 2-- Date of Permit. Applicant: -�� ol-llye S,ccyc7ohiS�/ Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Supmitted: $ Applicant Signature o�os�Ft:o�,��oG Town Hall, 53095 Main Road y Z Fax (516) 765-1823 P. O. Box 1179 �� r" Telephone (516) 765.1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N� DATE: t/ 90 10 Building Permit No . Owner: Int Ross the &A (please print) Plumber: Uoud!-� /� l4->l�eW—J�t. r/;74 4 �ti� (please print) 1* k1'4 ✓c.e I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. 6� Wlumbers Signature �ZFi(/ VT Sworn to before me this 020 t/. day of 17,79,e&/ 19,-2000, Notary Public, V"L1 FoL _ County " G�E NA Y A. PESTER NO Public, State of New York No. 4940985-Suffolk C 5nCommisioExxies � IN BY THIS CERTIFICATE OF COMPLIANCE THE C NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET -- NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by 5 MICHAEL J. HURLEY ROSS &JEAN MCHUGH 5 9905 NASSAU PT. RD. 16 TWISTING LANE COTCHOGUE, NY 11935, WANTAGH, NY 11971 5 5 Located at 780 MINIHAHA SOUTHOLD, NY 11971c Application Number. 1037974 Certificate Number: 1037974 c S Section: Block: Lot: Building Permit:27096 BDC: NS 11 Described as a Residential occupancy,wherein the premises electrical system consisting of electrical devices and wiring,described below, located in/on the premises at: Basement, was inspected in accordance with the National Electrical Code and the detail of the installation,as set forth below,was found to be in compliance therewith on the 8th Day of March,2002. Name OTY Rate Rating Circit 13M S Additional Charges PARTIAL FINAL ROUGH ONLY 5 DEVICE BY ANOTHER ELECTRICIAN Alarm and Emergency Equipment Sensor 2 Smoke Wiring and Devices Outlet 4 Fixture Receptacle 12 General Purpose Switch 9 General Purpose Fixture 4 Incandescent Receptacle 1 GFCI 5 seal S 5 1 of 1 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. The New York Board of Fire Underwriters Bureau of Electricity is in the process of issuing a certificate of compliance for the electrical installation as provided for in the application for inspection e00C? � �&4 New York Board of Fire Underwriters Bureau r Electricity Inspection activity pursuant to Application ,v?_ -7�� � z # leted and a certificate of has been comp forth the detail of the compliance setons being prepared. ele al sy Inspector Dat Form 00(Rev.06/00) THE NEW YORK BOARD OF FIDE UNDERWRITERS PDGE 1 113510+7 BUREAU OF ELECTRICITY 40 FULTON STREET, NEW YORK, NY 10038 Date MARCH 01,2002 Application No. on ftle 14141002/02 N 587912 THIS CERTIFIES THAT PERMIT NO. 270,962 only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of ROSS & JEANNE MCHUGH, 780 MINNEHA ;k BLVD, SOUTHOLD, NY in the following location; ® Basement ❑ lst Fl. ❑ 2nd Fl. Section Block Lot was examined on FEBRUARY 25,2002 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES I COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUT= INCANDESCENJ FLUORESCENT I OTHER AMT. K.W. AMT. I K.W. AMT. K.W. AMT. K.W. AMT. H.P. 4 12 9 4 1 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS fA10,]�K:*W, OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AML AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E R V I C E METER NO.OF CC COND. A. G. A.W.G. A.W.G. AME. AMI. TYPE EQUIP. 1 12W 1 I SW S•JW 3 14W LER I OF CC.CON'. NO.OF HI-LEG OF NI-LEG NO.OF NEUTRALS OF NEUTRAL OTHER APPARATUS: PARTIAL FINAL DEVICES ONLY-1 ROUGH DONE BY ANOTHER ELECTRICIAN-1 ON AFP # 123644-01-1 G.F.C.I:-1 SMOKE DETECTOR:-2 JAMES MURRAY LIC.#3653 P.O.BOX 305 GENERAL MANAGER LAUREL, NY, 11948 Per This aeMtOCate malt npt hq altered In any manner;return to the office of The Board N Incorrect.Inspectors may be Identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. .*ELS /I STATE OF NEW YORK DEPARTMENT OF STATE `9 r 4 1 STATE STREET ALBANY, NY 1223 1-0001 C': RANDY A. DANIELS SECRETARY OF STATE ----------------------------------------------------------- In the Matter of the Petition of: DECISION John Ross McHugh For a Variance to the New York State PETITION NO. 2001-1028 Uniform Fire Prevention & Building Code ----------------------------------------------------------- Upon the application of John Ross McHugh, filed pursuant to 19 NYCRR 450 on October 27, 2001 and upon all other papers in this matter, the Department makes the following determination: NATURE OF GRIEVANCE AND RELIEF SOUGHT The petition pertains to the alteration of an existing building of Al (one family dwelling) occupancy, one-story in height, of type 5 (wood frame) construction, approximately 1,056 square feet in maximum gross fire area, located at 780 Minniehaha Blvd., Peconic, Town of Southold, County of Suffolk, State of New York. The petitioner is seeking relief from: 9 NYCRR 711.1(a)(2),which requires ceiling heights in habitable space to be a minimum of 7 feet 6 inches. [The petitioner wishes to allow habitable space located within a basement to have a ceiling height of 7 feet 5 inches] FINDINGS OF FACT 1. The petitioner proposes to use a portion of an existing basement for a recreation room, study and bathroom. 2. The ceiling height in the basement is generally 7 feet 5 inches and is acceptable for the bathroom and recreation room which are non-habitable spaces. However the study/office is required to have a ceiling height of 7 feet 6 inches. 3. If this was a conversion, Section 1233.3(b)(4) of the Uniform Code would have allowed a ceiling height of 6 feet 8 inches. 4. The proposed recreation room will be provided with sliding doors for an opening for emergency use as required. 5. The petitioner proposes to provide a window in the study/office area which will comply with the requirements for an opening for emergency use as pert 9 NYCRR 714.1. WWW.DOS.STATE.NY.US • E-MAIL: INFO@ DOS.STATE.NY.US RECYCLED TAPER Petition No. 2001-1028 Page 2 6. The petitioner has proposed to provide electrically wired smoke detecting alarm devices that will be installed throughout the building as required by 9 NYCRR 721.1. This will provide ample warning to the occupants in the event of a smoke related emergency. 7. The petitioner has proposed that the habitable space in the basement will be provided with natural light through windows having a minimum area of 10 percent of the habitable space, and will be provided with natural ventilation through operable windows having a minimum opening area of 5 percent of the habitable space which will exceed the code requirements for natural light and ventilation. 8. The local code enforcement official has been consulted in this matter and does not object to the granting of a routine variance under the provisions of 19 NYCRR 450.6. CONCLUSIONS OF LAW Strict compliance with the provisions of the Uniform Fire Prevention and Building Code would produce a negligible additional health, safety and security benefit to the occupants of the building. DETERMINATION WHEREFORE IT IS DETERMINED that the application for a variance from9 NYCRR 711.1(a)(2), to permit habitable space located within a basement to have a ceiling height of 7 feet 5 inches; be and is hereby PROPOSED TO BE GRANTED with the following conditions: 1. That electrically wired smoke detecting alarm devices shall be installed throughout the building in conformity with 9 NYCRR 721.1 and shall be interconnected with similar devices in the basement. 2. That that the habitable space in the basement be provided with natural light through windows having a minimum area of 10 percent of the habitable space, and be provided with natural ventilation through operable windows having a minimum opening area of 5 percent of the habitable space which will exceed the code requirements for natural light and ventilation. 3. That a window be provided in the study/office area that will comply with the requirements for an opening for emergency use as pert 9 NYCRR 714.1. 4. That the recreation room will be provided with sliding doors for an opening for emergency use as required. 5, That the alterations conform in all other respects to the applicable requirements of the Uniform Code. This DECISION is issued under 19 NYCRR 450.6. Unless objected to by the petitioner in a writing received by the Department, the decision shall become FINAL after fifteen days of receipt of the decision by the parties. This decision is limited to the specific building and application before it, as contained within the petition, and should not be interpreted to give implied approval of any general plans or specifications presented in support of this application. Petition No. 2001-1028 Page 3 • sty George E. Clark,_•Jr: Director, Codes Division DATE:l RAS:sg Petition No: 2001-1028 The persons below are advised to TAKE NOTICE of the attached document. The attached document pertains to a petition for relief related to code requirements. If there are any questions, call (518)474-4073 and ask for the Variance Unit. Please refer to the petition number in all related conversations or correspondence with us. JOHN BUFUS TOWN OF SOUTHOLD BLDG DEPT PO BOX 1179 SOUTHOLD NY 11971 JOHN ROSS MCHUGH 16 TWISTING LANE WANTAGH NY 11793 MICHAEL VERITY ✓ TOWN OF SOUTHOLD BLDG DEPT PO BOX 1179 SOUTHOLD NY 11971 02/12/2001 14:15 5168269785 CORI'S FAX PAGE 01 FAX TRANSMISSION DATED 12 FEBRUARY 2001 FROM: J. ROSS MC HUGH TELEPHONE: 516 826-0255 16 Twisting Lane Wantagh, NY 11793 RE: 780 Minnehaha Blvd. TO: MR. EDWARD FORRESTER, Director Code Enforcement Southold Town Hall Southold, NY 11971 Dear Mr. Forrester: Concerning our application for a permit to finish a- portion of our basement at the captioned location, please be advised that we have eliminated an oil-hot water heating system with chimney and tank. Having recently retired, we find the cost of installing this new system ($8,000 - $10,000) prohibitive -- almost double the cost of the whole job. As we use this house only during the summer months this is too much to spend at this stage. For the past 14 years we have been coming out from June through early September. We are not selling our home in Wantagh as originally planned. We are in the process of renting part of the Wantagh house and we urgently need to empty out this space and remove the household items from there for storage in the area we are trying to finish in Southold. The delay of this process has already created a financial hardship for us as the income realized from the sale or rental of the Wantagh house is a vital part of our retirement . If, based on the above, we cannot obtain a permit for this small project, I urgently request a meeting with you in order to determine exactly what we have to do to effect this. Thank you for your consideration. Very truly yours, d• J. ROSS MC HUGH 2-12-2001 4:34PM FROM C2CE P. 1 LICENSED PROFESSIONAL ENGINEERS NEW YORK NEW JERSEY Cronin and Condon Consulting Engineers, LLP 1755 SWbse Road Phos«631-734.7250 MaNuck,New York 11062 Fax .631-734.7014 FAX TRA MIMAL Date: Febn.Wy 13,2001 To: Ed Forrester Company: Southold Building Department Fax Number: 765-1823 Phone Number: 765.1802 Re: McHugh House. 780 Minnehahe Blvd Southold (SCTm#1000.87-02.43.1) From: Mark K. Schwartz,AIA—Architect Number of pages(includn9 this one). 1 Comments: Ed: Amide 10, Part 1000, page 12,369—1000.1 b indicates that d residence is not used from September 15" thru May 31", no heat Is required. Please Wow and comment Thank you. MCHUgh3.d= 2-09-2001 8:27AM FROM C2CE P. 1 LICENSED PROFESSIONAL ENGINEERS NEW YORK NEW JERSEY Cronin and Condon Consulting Engineers. LLP 1753 SWJM Road Phone:631-7366-7250 Mamtudc,Nsw Yofk 11662 Fax :631-734-7014 FAX TRUMIT 'AL Date: February 9, 2001 To: Ed Forrester Company: Southold Building Department Fax Number: 765-1823 Phone Number. 765-1802 Re: McHugh House 780 Minnehaha Blvd Southold (SCTW 1000.87-02.43.1) From: Mark K Schm*,AIA—Architect Number of pages(including this one): 2 Comments: ownw will not heat this tower levier space. Please call when you have had a chance to review. My dint line is 749-3289. Thank you. Mdiugh3.doc 2-09-2001 8:28AM FROM C2CE P. 2 LICENSED PROFESSIONAL ENGINEERS NEW YORK NEIN JERSEY Cronin and Condon Consulting Engineers, LLP 1756 Sipcbee Rodd Pho w 631-734-7250 MaMd6 New York 11952 Fax :631 75�-7014 January 10, 2001 Southold Building Department Main Road Southold, New York 11971 Atte: Mr. Gary Fish Re: Alterations to McHugh House 780 Minnehaha Blvd Southold, New York SCTM#1000-87-02-43.1 Dear Mr Fish: I have been to the aforementioned property to obewve and measure the existing conditions. The enclosed plan indicates existing conditions as well ars this proposed alterations, Please note the proposed new al tank, boiler,and new chimney have been omitted. The Owner had planned to replace existing electric hest system with naw oil fired system, but has decided to leave as is. Also, no heat will be installed at Basement level. Please call this office if you have Questions or require additional information. My direct line is 749-3289. Very truly yours. Mark IC Schwartz.AIA-Architect MdiughlAw SURVEYED FOR:- , OSS _IAE�4A./ LOCATED AT L.D4/Gf11A./G G ,4TE.e �S'ECT/ON' ONE , TOWN OF %.50C/7y'/4044;pSUFFOLK COUNTY N.Y. LOT OFFSETS FROM STRUCTURES MAP OF TO RELATIVE BOUNDRY LINES, CO. CLK. NO. FILED SCALE 1" _ Q" ON SURVEY, ARE FOR A SUFFOLK CO. TAX MAP DATA:- SPECIFIC USE ONLY, AND 'SHOULD NOT BE USED FOR DIST.1404; SEC. Od7.DO CONSTRUCTION OF FENCES BLK. Oa?UO LOT ,0.43.4201 OR OTHER STRUCTURES. Ex.Dwc �, r t C_ �v/F MEAGY EX�ST��� ��oE fc•io•o � T-.,G+ 77 'Q sz (D EQ, s �c.A7.o Jai 0 nJ• � � y GU4,e,4A1 TEEO •' r A Q%� G2oCi vp !�f/4TEfc' 1A O T r, .4CLJ7QTL� L�ST,�.tJC'T Ca2�? a r VA /.c/�'V.P�l�c.�G-E C. O.�',.t/EH/J/�.E'.0 /E�. na���J , •/�.G Gia O/' � �O ..-a" .s`.__ Q5Y i"���E�.��'S cv�1C �c ►rio,v. /ocr i✓-��87 7'iTGE fib. G3o-S-OS99 S l�'44 C.� gA �!/NG7Al/oIV Lc._/Gluey; l7/ /9d7 f SURVEYED . 1UGY 3, 19466 BY WILLIAM R. SIMMONS JR. P/O BOX 377 JAMESPORT, L. I., N.Y. 11947 TE.-t"ooc L(fCLG �o�AT?'©iv,_ 8Y�Gc/^!E�_ C.o"vT�P�4cTa,Q FILE NO. /O,.�SG�B PAGE 2,3 GRID H--;t/ BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ,DATE INBPECTO M-1802 BUILDING DEPT. INSPECT=PLBG- FOUNDATION [ ] FOUNDATION IST [2ND [ ] INSULATION [ j FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR BUILDING DEPT. INSPECTION [ ] FOUNDATION iST [;7NSULATIION O PLBG. FO ATION 2ND [ [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY R ,AQ DATE � � �� IN8PECT0 ��� C ?� suiLDiNa uEP`r. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INTION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS• C ?Ilt-27- � DATE 1/0 )/"*`iNSPECTOR G FIELD INSPECTION REPORT DATE _:, .. ; COMMENTS ssa=xasaxax==xaaaaxaxxxxa�x=aaaaxafm==csxsa=xxaxaaa=aaax=aaa=ax==xaa==asaaaa==x====aaaaaaxa y FOUNDATION OST) I I11I,, If II II b FOUNDATION (2ND) ------------------------- -------- -----=------------------- -------------- 00( �t-Gr/JC �I I� 1 I c �► ROUGH FRAME & PLUMBING N r _/ loll I saa==as==aaaaaaaa—axxa a---= — 1 — amaaaaa=a=axxa— � 7 ii- INSiTLATION PER N. Y. GGCC�� H STATE ENERGY CODE N sty . loor 6x=M=e==aax=a¢aa—a===aa 1 — —a��aaa—max—s-----x=aaraa—a--=ss=x=axxa=axxax=m=—aas;x v``� I M U I II ' FINAL 11 a =aaa=sa=aaa=-xasa---xsaax as-r--�-Baa----s---- a------ azsasaFtsxaaaxa=a=a--ssaaaaa \ ADDITIONAL COMMENTS: ssaaas=c✓-m==aaxaxaaa=axaaaxaaaa�xs----��xsse-- -. s-�`-,-a aaa=aaxar-Stam=x= � l c �^n l� ro H BOARD OF HEALTH . . . . . . . FORM NO. I " " " " � SETS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOUTHOLD --SURVEY BUILDING DEPARTMENT CHECK TOWN HALL SEPTIC FORM SOUTHOLD, N.Y. 11971 DEC TEL: 765-1802 TRUSTEES . . . . . . . . . .. NOTIFY- Exam ined..... I. ......., 294f. p. . . r-._, MAIL TO: . . . . . . Approved...... . /+moi Permit No. J.©[.'C'. 4! ............................... Disapproved a/c .................................. .................................. ...................................................... (Buildi tor) APPLICATION FOR BUILDING PERMIT Date. . . . . . . . . ., 2G.�ll INSTRUCTIONS a. Ibis application mist be completely filled in by typewriter or in ink and submitted to the Building Inspector n 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan suing 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 application. c. The work covered by this application may not be camienced before issuance of Building Permit. d• Upon approval of this application, the Building Inspector will issue 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. APPLICATICN IS HEREBY MAIL to the Building Department for the issuance of a BuildingPermit Building Zone Ordinance of the Town of Southold, Suffolk County, l pursuant to the Regulations, for the construction of buildings, New ons, and other applicable Laws, , ash herein or additions or alterations, or for removal or demolition, as herein described. TIS° applicant agrees to comply witb all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buis. lding for scary ins /.C�.:6r y _•�• �. fit...................... ignature of appli t, o name, if a corporation) .......................................... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build ........................ Name of owner of premises Q .!1� ' l Q'� S d�t TSA ti/1�� (1J M.:-A J 6 (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ............................................ (Name and title of corporate officer) Builders License No. ?7.7� �/•• �/ Plumbers License No. ......................... Electricians License No. Y"?-X../!6:jr Other Trade's License No. .................... 1. Location of land on which proposed , work will be done... ......... .............. U. '. �.��...n�.. /.... ............... House House Number Street Hamlet County Tag Map No. 1000 Section .....FS 2...... Block ....Z........... Lot.. Subdivision ...................................... Filed Map No. ............... Lot .......... Nam.) 2. State existing use and occupancy of premises and intended use and 0 "vd 'on: a. Existing use andoccupancy ...... 44 b. Intended use and occupancy .......Q) ........................................... ".,Luce " "U" kubMik wilful apprrcaute/: New Building .......... Addition J Repair ........... ...... Demolition ......•... Alteration - Removal ....... ............ Other Work Estimated Cost ... (Description) Esti !1?,,.f Q ........ ..... fee ............. .......... ....................... (to be paid on filing this application) - If dwelling, number of dwelling units ............ limber of dwelling units on each floor ................ If garage, number of cars ._..... ............................... If business, commercial or mixed occupancy, specify nature and extent of eadi type of use.....,,,,,- Dimensions of existing structures, if► Height any. Front................ Rear .... .. Depth ............ g ....'.................... Number of Stories _...... __ _ Dimensions of same structure with alterations or additions: Front Depth ......... Height ......... Rear ............... �•�-�-��••� ••••••••-•. Nmnnber of Stories ........., - Dnrensions of entire new construction: Front ,,,•, Rear ............... Den Height ......................... Umber of Stories .......... Size of lot: Front .................... Rear .............:...... Depth I Date of Pur dmase ..................... Name of Former Owner ..... 1- Zone or use district in whidn premises are situated ............. ..................... .................. Does Proposed construction violate a rry zoning law, ordinance or regulation: ........ 3. Will lot be regraded �-.......... "............•••... Will excess fill be i c removed from premises: YES i. p �- �/ ^^ 'ON Nares of Owner of pr�enrse :':!h11oSS�Jgq✓in�_ M. 'r!�ss,�.l:(!'?t1.>L�R�R-/�,f, — ....... Phone Name of Architect .......... No. fie ........ ........... Address Phone No. ...... ........................ Nate of Contractor .. .¢.. %4l nn tl# ..... Q !6 ........ Ll . ..a.. ...... Address ... ' 7........Phone No� - �7 i- is this property within 300 feet of a tidal wetland? * YES ........ *IF YES, SOUIIM 1UM TRUS`rEEg PUMT MAY RE ROWIM. ND ....... r 1 qs Y PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions rom property lines. Give street and block ember or description according to deed, and show street names and indicate ietber interior or corner lot. n1T: or ww Yom, SS wry or ........................r...............................bei duly are of individual signing contract) OR1' deposes and says that he is the applicant ove named, / is the (Contractor, agent, corporate officer, a c.) ......'........••- said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this )lication; that all statements contained in this application are tone to the best of his knowledge and belief; and it the work will be perfonmeri in tine manner set forth in the application filed therewith. mrn to be re me this day of W/).V........ .20, fotary Publ' _ ELMASETMASTATHIS NOTARY PUBLIC,State of Newyork &itlffetf-4At can N0.01 STSM173,Suffolk Courdy Tenn Expires June 8,20J?,2; F LOT 2 x y � 16 u 0, C, (epINF ol✓E S/pe GIuE tf,41t, 6 t TMCC/✓ 2 K y T"&- ST Y gor NES 01NK g� b N Fblf ESS v w kqon OFf/Ct- .� S Xh r LES 'IA FLOOR o PVC 711E5 n u � � IN s ox O a r Fri r QSEMENI- 5' ,o oN 0/L ��'� 6uRNER 13 -10014 �V L e- � l/0 � A ql lot/ _ - - _ _ _ _ . - _ _ _ _s. - fig: • ;�., yt. �r _ - in_ y.._,-i - F/14T 7aoL` IG" 0.C, D6TWEEN 2xy TSG ` 25TWFoAM 0' S ' Nor- T tANg , Ross MC H UC-H PRInr IN6 yiC-Hr of ;�:(' Cr/��y(,-,' '7'S" . SizE `1$0 M I!v NH HI}Nh SGvD. �__- SOvTHoL,.D ,NY //971 F7- a -913./ o - i i r i I i i s r i i _ I C l L r kjo't[{+� TEA 0167 R 055 M cHvU�-1 '780 MI NWPHAHA 13LVD I SOUTHOLS iNY �I X71 d 1000 i✓ W 4,mt , =5 o (' 89Xh T j °cam N f yc TI 1E i a , VZI �I cn �I �OfNGZ.rp SF � O 0 Z i ti O N 77 ` 2.X8 G i►2aF92 N t. Alf,PJ mac- � O/L � _ -� _ •0 Fr �//ae/✓tK -- /l yti _ g' �o'' -- r 'z�r -- ,,«- .- , .,,. .� .\ 1�-_ . .►-\ 4. a \•-..- -\�. _. •- \ _-c. . __-_ 5 :: .-.�..,y.w. t '-'/r•- - 'r>�_ Com'<� s ,y"'� . �. -1 a� a^. . as ♦\ • .__ fs+` ., .,a . 5; LRT 2x� b gra „ r DErh/EFW Trr.d,G- J EA NNS , >✓Oss Nt C N tIGLI OIC Koff - DRESS TF}NK O ASIM l- NQ iNG DEP Pvc FOL AYE FOp �yxh .o� Ti SES 1� FLOOR I. FOUNDATION - TWO OCCUPANCY OR �yC TI IES " FORFcwwCDNIxIEm USE IS UNLAWFUL ' a ti 'm x o Siu. I ROUGH • FRAYING a PwMel WITHOUT CERTIFICATE - �„ I o tiG: �5F S INSULATION 4, � gx ` � �� P 4 FINAL - CONSTRUCTION MUS , - ; OF OCCUPANCY BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL ME � � ��/ •' --� , �, � n�� �' THE REQUIREMENTS OF THE N. STATE CONSTRUCTION a ENERG A S E f1 Ell Cj CODES. NOT RESPONSIBLE FO — DESIGN OR CONSTRUCTION ERROR r NE Nl _ ROVIDE SMOKE-DETECTING _: --- ALARM DEVICES � OCL 9 TO PART. 721.1 � r�oo� > _ N.Y.S BUILDING CODE. vkj , VZ�� 8vX go UNDERWRITERS DRTIFOR n Z q' lo`' 4 �! 817 - - — PROVIDE ANTI-SCALD GAT 2X siYa�Ye M �6" O.C. 1 - EVENTING _ DEVICES AS TO PART. 902.6(K) ' �Erh/EEA✓ 2xy Taf G \ N.Y. STATE BUILDING CODE. 2 0' 5TyK0A4 P1 ; z � � 022 � �0 � Au PL t> vw87E _ COMW tubing Is USW &WATER LINES NEED for WOW disNrib dnq TESTING BEFORE COVERING sf 4V"�K._.a't on�a PLUMBER CERTIFICATION T E A NAIe , u DSS M C H L)CrV' ON LVAD CONTENT BEFORE slnE CERTIFICATE OF OCCUPANCY USED IN WATER ;NY UPPL Y SYSTEM CANNOT EMCEED 2110 of 1% LEAD. 0 c — o � I i .Y 0223 -� !F-A r7 SO tL3 1 II(M A 100