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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)
16802 z
Permission is hereby granted to: ~ .
.............
............
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ot ~rem,,,,ocate~ ~,.~.V..~ ...... .O.'~......O,~.,,L~.e., ....... ~..~...~ .......
County Tox Map No. 1000 Section .............. ~ ...... Block ....... ..(~. ........... Lot No ...... ..{~.~. ...........
pursuant to application dated .....~..~~.....~. ............... , 19.~...~..., and approved by the
Building Inspector,
Fee $...~?...*.....~.... .......
Building Inspector
Rev. 6/30/80
FIELD -,'~ ~r ....
FOUNDATION (1st)
FOUNDATION
2.
(2nd)
ROUGH FRAME &
.PLUMBING
INSULATION PER N. Y.
STATE ENERGY
CQDE
FINAL
ADDITIONAL COMMENTS:
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 765-1802
BOARD OF HEALTH ......
3 SETS OF PLANS .......
SURVEY ..........
CHECK ..........
SEPTI9 FORM .............
NOTIFY
CALL ................
MAIL TO:
Examined..'~.~. t.I ..... 19~3. ' ' ~ ,, ,
.....
Disapproved a/c ................................... ~ ~ ~ ~ F~t~
..... ................ ' ............ .......... [.j --
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
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 diagrmn 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 pemfit
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, ordinan~building code, housing code, and regulations, and to
admit auth°rized inspect°rs °n premises and in building f°r necesT~~..*,...~3. ~ .............
_ (Sjzpmturet~f_alpolicant.x~r name,if a corporation)
.. 1 .~..e~:>...t~. ~. e.L . .39~,.., ,~. ,V,~ ..................
. (Mailinz address of a~vlicant)
E,oMo roi r4 ,, 7,,.-~ ,W.
State whether applicant is owner, lessee,~gent, architecgengineer, general contractor, electrician, plumber or
builder.
Name of owner of pre,nises ..~...~.. ?.,..1~.'['..'.~. &..~ I.k.).~.. ~.~ ~. ?:,..~... [.,{,~.W...~...~..~.~...$. ............. (as on the tnx roll or latest deed)
If applicant is a corporation, signatnre of duly authorized officer.
.gg .644..~...(3~...c~..: .t:P..~..~.O.
(Name and title of corporate officer)
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED
Builder's License No ..........................
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
1. Location of land ou which proposed work will be done ..................................................
House Number Street Hainlet
County Tax Milt, No. 1000 Section ..... .~. ~.~. ....... Block ....... ~ ......... Lot .... .'/¢.1 ...........
Subdivision ,C.~/~..O.l.~..~..}.}~.~....li~..~....~.~T./~/.'"[.~..~. Filed Map No...~..¢--:'T.I .O..}.~.. ! Lot . .7.. ............
(Name)
2. State existing use and occupancy of premises and intended use aud occupancy of proposed construction:
a. Existing use and occupancy ..... ~¢.~! .[?.~....t~'...~.¢..~.J...~..~,~.. ~..~..[~..1.¢.~1' ......................
b. Intended use and occupancy .... ~. {, .l~.~..LS.~'. ! ~ L...~t ~-).~..~.~. ~:~..~..l(~..t .~..~. ......................
3. Nature of work (check which applicable): New Building ..... ' ..... Addition ., . Alteration ..........
Repair .............. Rfmoval ! .... l ......... Demolition ........... e Work ...............
~ ~ i{Z3C~O (Descriplion)
4. Estimated Cost. . .....' ......... I ...................... Fee .................................. .. ..
i ~' (to be paid on filing this application).
5. If dwelling number of dwelling uniti .... (~3..~.~. ..... Number of dwelling units ou each floor
If garage, number of cars ...I-~.!..~..tg.~.~...~. .................................... i~., i iiii ¢ii ....
6. If busin~ss,..~gm, mercial.or, mixed occupancy, specffy.~n_,attve a~d,extent of eac_h t_ype of_us.~ ... b~r/~_ ·. ,t ....
. :' .4 .... ~ -. ,, f:~ '.- " '
7. D]mensto~l${Of~x~tmg structures, fi. any: Front ..... '.~....[4. ~ . Rear .... ~ .... ~.~.. Depth . .~.....'l .....
Height .~.~, ¥.~. ~.~.O-. [~.T.,Number iof Stories .... Dt~ ~ ................ ~t. ................ I.. - Il .......
Dimension,'of s~ll~t~tar~o~w]th alterations or additions: Front ...~..~ ~ .. . Rear . ~ .~d?.... ~. ........
Depth .~, i. '[~:~..~..~.I.~ .... Height . .[.~ .~O...~...1~... ~...'[',.. Number of Stories .... ~..~..~. ............
Di]nensioo.~s of entire new construct[on: Front .... ~ .... ..... Rear ......... ; .... Depth
Height' ..... .;. :. ...... Number~of Stories...: ..... ':... ~ ..........................
9. 'Size of l~ot: Fi0nt .... 1.,. [ ..~...,... P, ear .... ~'~iI.. , ~ .......... Depth . ~,N/... i{
10. Date of Purchase ...... .~.': [ .~.!: .~..~".. ......... Name of Former Ortner .............................
1 1. Zone or use district in which premises are situated .... [:~ ~,%| II~..~i..k3..T).r'4.[- ..................
12. Does proposed construction violate iany zoning law, ordinance or regulation: ..... ~1.O. ........................
13. Will lot be regradefl ..... ~ ., ................ Will excess fill be removed from premises: Yes I~ No
14. Name of Owner of premises .l~-~.'J: .~.. ~..'I'.~.~1.... Address .l~.~k, ............... Phone No ................
Name of Architect ~Y,~,~ .... ~..C:I. ~. .1'.~.~...i.~...~. ,Address ................... Phone No ................
Nmne of Contractor ........... ~ .............. Address .... : .............. Phone No ................
15. Is this property located within 300 feet of a tidal wetland? *Yes .~.. No ..... · If yes, Southold Town Trust~es Permit may be required.
,' PLOT DIAGRAM
Locate clearly and distinctly all bu.~ildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
STATE OF NEW YORK, S,!S
county OF .................
.... ~ J,,~..~...~. O...~..:. ~ .~...t~..~ ............ being duly sworn, deposes and says that lie is the applicant
(Name of individual signing contract)
above named. ~ ·
tie is the...~.~..'T ..........
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed tbe said work and to make and file this
application; that all statements contai aed in this application are true to the best of his knowledge and belief; and that the
work will be performed in the manner '~et forth in the application filed therewith.
Sworn to before me this "
........... : .... ,2.$, i...d y o;.iI. . ............ ,
Notary Public, ............ . ,~)~..~..~... County
NO!'**~ ~UeUC, s~.~ o~ ~,~ Y~ ..............
No. 47078'18, Suffolk .CAu_ ntYT,,',9~
-Term £x~ires ~.h ~,l~-l,/ (Signature of applicant)
~Y
I
If copper tubing is used
for water distributing
system; piping shall be
of types K or L on![
OCCUPANCY OR
USE IS UNU WFUL
ITY 0UT CERTIFICATE
GENERAL NOTES
ELECTRICAL
1. GENERAL NOTES 1.
a. All work fo be done in accordance with New York State Building and Energy
Codes and those of any local govern nD authority.
b. Sot] bearing pressure assumed at 4000 p.s.f.
c. All footings to rest on undisturbed soil.
d. Provide all steel lintels, bolts~ plates, girders and fasteners as
required. Shop coat ail steel 2.
e. Structural steel shall comply to the specifications for design, fabrication
and c~slructlon of steel for building of the A.I.S.C.
f. All framing and connections shall be in accordance with the Idlest edltlon
of the National Design Specifications for Stress Graded Lumber and its 3.
Fastenings as published by the N.F.P.A.
g. Double joist under partitions which run parallel to floor jolsts~ and
around openings.
2. SITEWORK 4.
a. Contractor to clear and grub slier strip topsoll in building limits.
b. Surplus excavated material to be used as backfill against foundation wall
and/or removed from site.
c. Contractor to strip~ stockpile and respreod topsoil for use of lawns and
planted areas.
d. Landscaping by Owner.
3. CONCRETE - ]000 ps at 28 days ASTM 94 ready mixed concrele.
4. STEEL BAR REINFORCING - ASTM 615 welded wire fabric - ASTM A-lBS.
5. VAPOR BARRIER - ASTM E-96 Polyethylene film 6 mi] thick.
6. CONCRETE BLOCK ~ ASTM C-90 mortar Type N -- 8" x g"x 16" (NOM.)
7. LUMBER
a. Douglas fir - No. 2 Grade with Fb = 1700 psi crud E = 1,700,000, 19~ M.C. 5.
b. Plywood
1) SubRoor - 1/2" th., T & G, C-D interior APA with exterior glue.
(PL-500 glue down with nailing) with I/4" A.C. plywood overlay.
2) Wall Sheafing - 32/16, I/2" th. C-O exterior APA.
3) Roof Sheathing - 24/0, 5/8" th., C-D exterior APA. 7,
c. Connectors - Teco Co., or equa all to be galvanized.
d. Sills - Southern Yellow Pine f} 2 or better, CCA treated. (KDAT .40 pcf) B.
8. ROOFING - To match existing, Class A or approved equal. Color selected by
Owner. [nsta]l over 301/ building felt.
9. SHEET METAL FLASH[NOS AND ROOFING - Shall be lead coated copper at all roof
penetrations and wail/roof intersections, and roofing, I 6 oz. min.
10. TERMITE SHIELDS - Shall be .019 . Provide sill sealer (polyethylene) under 9.
sill plate. (Aluminum typ
11. FASCIA AND WOOD TRIM - Clear cedar - Shiplap o11 joints verticality at butt
condition type to match existing.
12. SIDING 10.
a. Cedar to match existing, over Tyvek non-corrosive nailing (zinc coated)
13. WALL BASE - 3/4" x 3-1/2" height pine with 3/8" radius at top edge. Mitre oil 11.
corners (clear)
14. SKYLIGHTS - N.I.C.
~3, INSULATION - Fiberglas with fuji-faced vapor barr~r by Owens-Car,lng. 12.
Thickness as follows:
a. 6" - between rafters (vent space above) and Roar j0lsts
b. 3-1/2" - between studs (4" partJflons) 13.
c. 3-1/2" + between adjacent rooms
16. DOORS AND WINDOW5 14.
a, Interior doors, 1 3/4" and 1 3/8" raised panel, solid fir, primed, segled
and twa coats polyurethane.
b. Windows ~ Andersen Co., perma-shieJd - white. Ali with screens to match.
High performance glozing.
c. Door Frames - To be made up from 5/4" pine with integral stop and
interior trim made up from ~/8" x 3-I/2" pine. Mitre oil cuts.
17.
18.
d. Window Trim - Interior 5/8" x 3-1/2" clear pine, Colonial
CAULKING: One part acrylic ferpoiymer *'Mono" as manufactured by Tremco Sealant
Systems~ Color to Match adjacent materials.
ADHESIVES: PLS00 as manufactured by contech Brands (to be used in adhering
plywood subfloor to floor joists.)
GENERAL - Furnish all labor, materials, equipment, plans, toob, and services
necessary and required for proper and complete instgJlation of all electrical
systems and related work to include, but not limlted to, wiling, lighting,
services, feeders, grounding, and irfcluding all connections a~nd devices within
the scope of the work as shown on the applicable drawing~ and os normally
specified in this type of project,
CODES - ' All work shall conform to the requirements of the New York State
Uniform Fire Prevention Building Code, New York State Conservation Construction
Code, requirements of the Suffolk County Department of Health, and the National
Electric Code NFPA No. 70-1984 (NEC).
CIRCUIT BREAKERS - Single pole 15 and 20 ampers circuit breakers shall be UL
listed as "Switching Breakers" at 120 V a.c. and carry the SWD markings.
Circuit breakers shall be UL listed. Single pole breakers with handle ties not
acceptable.
CABLE AND WIRING
a. Branch Circuits (interior) - Type NM or NMB
b. Service Entrance (Direct Burial) - Type USE
c. Feeders - Type NM, NMB, or SEC
d. Underground Distribution (Direct Burial) - Type UE
e. Conductors fo be copper.
f. Insulation (&O0 volt) fllO AWG and smaller, - THWN/THHN, ~f8 AWG and large~'
THN, THWN, XHHW (PVC for NM or UF cables).
g. Neutral wire shall have a white outer covering throughout system.
Equipment ground wi~e shall have o green outer cove£1mg throughout system.
Mark cables or wire without color coded jackets with non-fading co[or coded
tape at terminations and other accessible locations.
RACEWAY - Raceway to be rigid or metal conduit or Schedule 40 PVC (where
permitted by Code)~
OUTLET BOXES - Outlet boxes dry concealed locations in woad frame
to be PVC wail boxes installed in baseboard and noryi ceiling boxes. [n exposed
locations, use 4" square cast aluminum boxes and finished covers.
SWITCHES - Switches, 15 amp. 120/277 volt, back and side wired. Single pole,
double pate, three-way dimmer, as required.
DUPLEX RECEPTACLES - Provide 15 amp 125 voit back and side wired duplex
receptacles on all multi-receptacle 15 and 20 ampere circuits. Provide 20 amp
125 volt back and side wired duplex receptacle on ail single receptacle 20
ampere circuits. Groundfault circuit interrupting - 20 amp 125 volt with
indicator.
PLATES - Provide plates for aU outlet boxes (receptacle, switch, telephone,
blank or combination). Smooth plastic urea (ivory color) unless indicated
otherwise. Multi-gang switches, receptacles, etc. shall be in a common,
one-piece plate.
LIGHTING FIXTURES - Lighting fixtures to be approved by owner prior to purchase,
HALO ar equal.
FIRE PROTECTION -
a. Fire - photo-electric type stat located at the first floor and the basement
storage room.
ELECTRICAL EQUIPMENT - All necessary wiring, controls, switches, motors, and
other electrical equipment required by other trodes, shaU be provided as
necessary for a complete operational system, as show~ on drawings and specified.
CABLES - Coordinate telephone and cable TV connections and operational checks
with the respective companies.
POWER INTERRUPTIONS - All required power, telephone, and cable TV
interruptions shall be scheduled with the Owner and the local utility company.
As requisite for final acceptance and poyment~ deliver fo Owner twa (2) copies
of a Certificate from U.L. and local authority, showing acceptability of work
done under this Contract.
19. HARDWARE
a. Locksets - Schlage, Series F, Plymouth, 605 Finish
b. Hinges - Hager or equal (Bronze) - removable pins.
c. Miscellaneous - Stanley (door tracks, cab, pulls, etc.)
d. Stops - flush bolts~ pulis, bumpers - Ives.
20. GYPSUM BOARD
a. Interior walls and ceilings, 1/2" thick, tape and spackle all joints.
21. PAINTING
a. Exterior Wails
1) Wood Siding to match exisling. (Slam) two (2) coats
2) Exterior Trim - to match existing. (Solid staln, 2 coats)
b. Interior Walls - One (1) coat sealer, two (2) coats fiat - color as
selected
c. Ali Woodwork One (1) coat sealer, two (2) coats satin Bnish, color to
match walls.
22. Kitchen Cabinets, and counters provided and installed by owner.
23. Vanity supplied by owner, installed by contractor.
PLUMBING
I. GENERAL - Furnish all labor, materials, equipment~ plans, tools, and services
necessary and required for proper and complete installation of ail plumbing
system and related work, to include but not be limited to, water supply and
distribution piping, drainage piping, plumbing fixtures, valves, traps~ waste
and vent piping, including all their respective connections, devices,
appurtenances within the building lines of the premises.
2. CODES - All work shall conform to the requirements of the New York State gnifor
Fire Prevention Building Code and the Suffolk County Department of Health.
3. PIPING - Cold and Hot Water, Type L Copper tubing (ANSI H23.1) with solder type
fittings and joints mode with 95/5 soft metal solder. Below ground piping to be
Type K copper tubing. Risers and mains to be 3/4 inch, all branch lines to
fixtures to be 1/2 inch.
4. DRAINAGE AND VENT PIPINg - Above ground drainage and vent piping to be ABS
plastic Schedule 40 or PVC with corresponding fittings and joint cement.
5. SANITARY PIPING - Below ground sanitary piping shall be cast iron soil pipe
(ASTM-A-740) service weight.
6. FLASHING - Flashing materials to be lead 4 lb./sq, ft.
7. HOSE gIBBS - Hose bibbs to be non-freeze type with interior shut-off valve.
8. PLUMBING FIXTURES - All fixtures and fittings selected and supplied by Owner,
installed by Contractor.
9. VALVES - Valves to be brass/bronze body - 125 psig.
]0. CLEANOUTS - Cleanouts to be full size of pipe with threaded brass screw plugs.
PLATES - Plates for finished spaces to be chrome plated spilt brass.
12. PiPE INSULATION - Pipe insulation to be cellular foam of thickness required by
Energy Code.
drawing title:
drawn Dy: checked by:
scale:
drawing number:
ret no,:
NASSAU SUFFOLK BLUEPRINTING
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drawing title:
drawn by: checked by:
d~te: sc¢le:
drawing number:
ref, no.: