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HomeMy WebLinkAbout29232-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30153 Date: 04/28/04 THIS CERTIFIES that the building ACCESSORY Location of Property: 1095 VILLAGE LA ORIENT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 25 Block 2 Lot 9.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 21, 2003 pursuant to which Building Permit No. 29232-Z dated MARCH 21, 2003 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 ACCESSORY INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to JON ANTHONY TURNER & ANO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 50332C 03/25/04 PLUMBERS CERTIFICATION DATED N/A C Authorized nature Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30154 Date: 04/28/04 THIS CERTIFIES that the building ACCESSORY Location of Property: 1095 VILLAGE LA ORIENT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 25 Block 2 Lot 9.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 21, 2003 pursuant to which Building Permit No. 29232-Z dated MARCH 21, 2003 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 ACCESSORY HOT TUB WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to JON ANTHONY TURNER & ANO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 50332C 03/25/04 PLUMBERS CERTIFICATION DATED N/A Authorized gnature Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30155 Date: 04/28/04 THIS CERTIFIES that the building ACCESSORY Location of Property: 1095 VILLAGE LA ORIENT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 25 Block 2 Lot 9.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 21, 2003 pursuant to which Building Permit No. 29232-Z dated MARCH 21, 2003 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 NEW FOUNDATION TO AN EXISTING ACCESSORY GARAGE AS APPLIED FOR. The certificate is issued to JON ANTHONY TURNER & ANO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Authorized S' ature 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. 29232 Z Date MARCH 21, 2003 Permission is hereby granted to : JON ANTHONY TURNER 155 EAST 78TH ST NEW YORK,NY 10021 for CONSTRUCT AGCY I/G SWIM. POOL W/FENCE TO CODE & NEW FOUNDATION FOR EXISTING ACCY GARAGE AS APPLIED FOR. THIS PERMIT REPLACES BP#26921 . Two Certificates of Occupancy required. at premises located at 1095 VILLAGE LA ORIENT County Tax Map No. 473889 Section 025 Block 0002 Lot No. 009 . 002 pursuant to application dated MARCH 21, 2003 and approved by the Building Inspector to expire on SEPTEMBER 21, 2004 . Fee $ 225 . 00 ri d Signature ORIGINAL Rev. 5/8/02 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. 26921 Z Date NOVEMBER 15, 2000 L Permission is hereby granted to: E WILLIAM DAVIS & ANO 168 E 73RD STREET NEW YORK,NY 10021 for CONSTRUCT ACCY I/G SWIMMING POOL WITH FENCE TO CODE IN REQUIRED REAR YARD & NEW FOUNDATION FOR EXISTING AGCY GARAGE AS APPLIED FOR. Two Certificates of Occupancy required. at premises located at 1095 VILLAGE LA ORIENT County Tax Map No. 473889 Section 025 Block 0002 Lot No. 009 . 002 pursuant to application dated OCTOBER 26, 2000 and approved by the Building Inspector. Fee $ 185 . 00 X Authori d Signature i" COPY Rev. 2/19/98 / Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Departme�w" the following: A. 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 1%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 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- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00,Commercial$15.00(/ rL Date. New Construction: Old or Pre-existing Building: (check one) Location of Property: Ut 0 Qy t/4 t¢ hn pwt House No. ��, p �,,� Street Hamlet Owner or Owners of Property: Z& A: Atry Tt>V2 46 V' O��L�'� �6pik Suffolk County Tax Map No 1000, Section �7 M I Block 2 r Lot —2- Subdivision 2Subdivision Filed Map. Lot: Permit No. 2�'Z7J�` Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) d Fee Submitted: $ C 30 Applicant Signature 5-20-03; 10:5OAM;J TORTORELLA FOOLS ; 75372637387 # 3/ 4 1 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. 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 1%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 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- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00, Commercial $15.00 Date. rj I�q O New Construction: X Old or Pre-existing Building: (check one) Location of Property: t-:--,) \_ 1' House No. Street — Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Z S Block Z Lot 9 .dOL Subdivision Filed Map. Lot: Permit No. A09 Z ( 'Z Date of Permit. 1 �tT, Applicant: I j y -a L 2a—Is 29-2--s-72- Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate:— (check one) Fee Submitted: $ '/10,2 Applicant Signature ONO W.AM Electrical Inspection Certificate Issue Date Electrical Inspection Service, Inc. Application " 3/25/2004 375 Dunton Avenue 50332C . East Patchogue, New York 11772 (631)286-6642 Issued To: Margaret Helfand Street: 1095 Village Lane Village: Orient Point Zip: 11957 Town: Southold Section: Block: Lot: Contractor: Ridge Electric Lic. # 1895 Was examined and found to be in compliance with the National Electrical Code. .:�,a ❑ Commercial ❑ NV Defects X Pool F1 1st Floor ❑ Indoor LI Basement IXl Hot Tub '•-;'�� o{; •�� xO Residential ❑ Det.Garage ❑ Attic ❑ 2nd Floor ❑ Outdoor Ll Addition U Survey Switches Receptacles Fixtures GFI Heaters A/C Fans - _= 5 3 2 y Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Microwaves � �y Furnace Oil Gas Circulators Smoke Detector Bell Transformer Meter Amps Phase UG/OH Jacuzzi Television CO Detector .v j Bldg. Permit: 26921 ti %f Other Equipment _ 100 amp pool panel -20 amp specialty outlets --` -20 amp breakers (3 pumps, 1 blower) Hugo S. Surdi President 14r i d� Rough Inspection: •moi %� Inspector: Final Inspection: 03/23/2004 Inspector: John McMahon III This certificate must not be altered in any manner. Inspectors may be identified by their credentials. x 5-20-03; 10:50AM;J TORTORELLA FOOLS , ; 15312837387 YF 4/ 4 r•"i 1+. .i i p3• �,,�A� C .' '.S:i..�.iK .:i" . •.r�..,�j'',h'•*�f >`','+., ; •Z*'w? < },�Jy� `7+'•F ti aq�,❖r h� -rimit )�C' 1r. ;3'• x t+�• •^y5 i{•M'%�"Y 1 •}�� ': 4 .lo♦��tr t�._:• ! •5 .� Y.b \L j•, ,Y?a .SaS, •� ' .•`l" �t:�'�. \� \.t,. � i•.. 3/ i\\•Sa � =t y�}.j�:•A -rti.• ,.,�#��• �'''�''rt'ss€�tti,rTrr� � ii• i �' t l e �:�' Jtl�`' t •%� =i •3,., :fid • �•%j:',.?i. ��•ss� s•: % �=�t .j�t�'t;:':--• IV .F{• �� Electrical Inspection certificate Electrical Inspection Service, Inc, i :. • '""ter 375 Dunton Avenue tf '. • r w East Patchogue,New York 11772 ;,1 i (631)286-6642 1�` •t Date: 4/4/01 Application No. . 50332 n - Issued to: Margaret Helfand Street: 1 095 Village Lane � •�'_--�_��_-� ±tr Village: Orient Point Zip: 19957 Town:Southold ;t } Section: Block: Lot: I F. s ? - �=z Introduced by: James T. Ridge Lic.# 1895-E r •rf a was exdWred and found to be/n camp/lance with the AW/Ona/E/eCtr/Ca/Cad ? �- ❑Attic ❑1st Floor ❑indoor © Residential ©Pool ❑ Det. Garage %'.•``»�' Basement 2nd Floor Outdoor Commercial `= ❑ ❑ ❑ ❑ ❑ Hot Tub ❑ NV Defects >_ Switches Receptacles Fixtures GFl Heaters A/C Fans Dishwasher Washer/Amp Dryer/Amp Oven Range/Amp Garbage Disposal 'rr Furnace Oil Gasr. •���.,'-. Circulator Smoke Detector Bell Transformer .,�z�•:>>:� �•-�''-'?fir. r" Meter Amps Phase UG/OH Telephone Television Carbon Monoxides mag: ❑ 1 •_�r Other Equipment. � _�"�: • poo/,vane/ -` �- Hugo S. SurdiPresi liar. V dent •• RRSS• Building Permit No. 26921 This certificate must not be altered in any manner Inspectors may be identified by their credentialsWM .:•: s�;y rte' 'fU�ii ^!' ..^: -moi•..,L!� r\ •t .t •/. rt.` -� -.�7F�`Ft• l t 7 'fi{fc \• '•i r 'rr •i/i �t ,��../�57.. .r ..j�.::p::. >.'�`Yi'[}•�/.. 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J�j'!•' •`�•����17f� '•rS'✓.fi�•;•: � �i3• .i•'. .. ••i'i1• '�. r Will!", ♦�, 'si �`�i Si � .�YSi ifi� �• a \•tiMi',f �y 11;t�:�•. 'h / ) =t e! n' t Ti� :» jb��''i1• wfylf' �,1� 'it r I �w .44 h '.�'R.•��,f 4 rr ;M• '•ki w.•,'.ir.'S•�'. n. �Y:i� ,��w a Rt•:d,N:�,.4\\, t�? r.d x•`oi . :! :;�;E',,. IN `'',.,!i';•'•..t ii.+Ike, t..\;2,.,.�'.,N;.y.\�.;5:•.trq,i•.nj.•;:Y:�N.:':•...�\`•..;t'v:;.'' n.\,::._.�•% f r•:; 8`L,t r..,Lf ' Y�, .! :i i SZS LY i�tot;; 5yt. f%•get )Rtf Electrical Inspection Certificate Electrical Inspection Service, Inc. 375 Dunton Avenue East Patchogue, New York 11772 ;a ` _ (631)286-6642 ° Date: 4/4/01 Application No. : 50332 { •rN�>. .w SLS: Issued to: Margaret Helfand �?> •N�JNA Street: 1095 Village Lane Village: Orient Point Zip: 11957 Town:Southold Section: Block: Lot: : •w� yy�w��i, �N,.Y�31t Introduced by: James T. Ridge Lic.# 1895-E •lir` .'y •� •<: was examined and found to be in comp/ionee with the Notiono/E/eetrico/Code =fes ❑Attic ❑1st Floor ❑Indoor 91 Residential © Pool ❑ Det Garage ;,- :• IW��sN/ ❑Basement 0 2n Floor L;Outdoor ❑ Commercial ❑ Hot Tub ❑ NV Defects Switches Receptacles Fixtures GF/ Heaters A/C Fans :N»' 5 3 1 Dishwasher Washer/Amp Dryer/Amp Oven Range/Amp Garbage Disposal ::yf•':fly -- r''- Furnace Oil Gas Circulator Smoke Detector Bell Transformer Meter Amps Phase UG/OH Telephone Television Carbon Monoxide =V; ''•l. Other Equipment: .4 poo/pane/ `s .00 Hugo S. Surdi =• President This certificate must not be altered in any manner : f sti Building Permit No. 26921 !: t Inspectors may be identified by their credentials' lf�''^• *�r� `!e.•2 � . 2 1 '•'a.1\i .;b..J:::, ,Zi {tf t: ..L i �.•..,.�•:g .t•Z: 'S�i. +ii`.:.i t. i'► � �:.�.t ! ':.:�"i�d::.•. ;.:vf:�:•. �.:y,:✓•.'.::T+ 2� � ''&•:\L �\i ;�.dr' i� ft-.:1 N`\i�vi%f 'if Z�. isf'•,"R"• \\i .d�iv{:.. `1•i £.:<''i}^:L\. t,/.• !.it;�i..L{ .ff/s.,• •.L\v/�f i^y::.••\VS,I. v1 f .•. �\`:7.f. .i\�.�.. �i '•�?`� Z 4•y. :nS• •a .•r •kti�y';..:a t' .,�,•,.,\�`\ �'T i •tX''r'.,.rvd..ii:l�t' •`•t%'. 'f.{ti„•�;,� c,�..'�'''.' e a s.�!”�ti �,,. .. ... f, .� ,@ .e fM1�� i � „ ,� li �"�� r''��i�f�y',..�••�N� tht•r 4 .n 7=.t\�'�i s K� ,�'tiiiSi•' � �../��'��'�� � � ..s•�t.� Lt��t� 'moi` •��`�'�.1�. �� ' �•' 's•�k,_.,�;1 o�OS�fFO(�-coG 0 N Z Town Hall,53095 Main Road 0 • Fax(631)765-9502 P.O.Box 1179 y 0� Telephone(631)765-1802 Southold,New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD March 6, 2003 John Turner PO Box 300 Orient,NY 11957 To Whom It May Concern: It has come to our attention that building permit number 26921Z, for construction of a in ground swimming pool and accessory garage at 1045 Village Lane, Orient, Suffolk County Tax Map Number 1000-25-2-9.2 has expired and you are in violation of Southold Town Code. In order to rectify this matter, the following is required: 1.) Immediate renewal of permit number 26921Z: Please submit a check for$225.00,made payable to the Town of Southold, noting the original permit number on the check. 2.) Inspections required: Once you have renewed the above referenced permit, it is your obligation to schedule any required inspections and submit any required certifications. 3.) Certificate of Occupancy required for the expired permit: Once you have passed the above referenced inspections, you may apply for a certificate of occupancy. Without a certificate of occupancy from this office, any use of your property is a violation of Southold Town Code (45-15) and New York State law. If you have any questions, please feel free to call this office at(631) 765-1802 between the hours of 8:00 a.m. and .m. Re ectf illy Y urs, uthonz i ature C . e J. TORTOREL" 6 (631)283-7373 SWIMMING 1764 NORTH HIGHWAY FAX(631) 283-7387 SOUTHAMPTON, L.I., N.Y. 11968 www.tortorella.com POOLS INC. GUN/TE POOL BUILDER October 31, 2000 Southold Town Building Department P.O. Box 1179 Southold, New York 11972 Re: Building Permit Application Submitted 10/26/2000 Margaret Helfand Gentlemen, In reference to the above, please accept this letter as an explanation of the wall that we have on the plan which will be used as a barrier to the pool. The wall will be constructed of solid stone, with no foot-hole areas. It will be 4' in height. If any further information is required or if you have any questions, please feel free to call me. Sinc ePy, eborah Byrne Executive Assistant MEMBER -M� NATIONAL SPA i POOL INSTITUTE BUILDING PERMIT REVIEW CHECK LIST DATE REVIEWED: /26/06 APPLICANT NAME: DATE SUBMITTED: /a:4 PROJECT LOCATION STREET: /O 9S c), /�a� L CITY: +- SUBDIV. NAME: ARCHITECT/ENGINEER: FAST TRACK: YES OR NO SCTM#--- DISTRICT: 1,000 SECTION: BLOCK: .2 LOT: 9.,2- ZONING: •,2ZONING: ZONING DISTRIC :�R4O80 AC CONFORMING: YES oR T�O REQUIRED LOT SIZE: ¢GiL SQFT. WHERE ACTUAL LOT SIZE FROM? ACTUAL LOT SIZE:34614 SQFT. REQ. REQ. REQ. FRONT: -f O'PROPOSED: YD:S'/ ' PROPOSED: '/ REAR:S6 'PROPOSED: ' LOT OVERAGE: AL/LOWE % EXISTING:,_sf % NEW: sf % TOTAL: sf % /,-, = Se S,4hacc CORNER? YES o N WAT ER FRONT? YES o DESCRIPTION: SINGLE & SEPARATE CERTIFICATION-REQUIRED: YES OR NO NOTES: LOTS 40,000SF --100-24. Lot recognition. (CREATED before June 30. 1983). UNDERSIZED LOTS FROM JAN.1997 100-25. Merger. (A nonconforming at any time 1 y ori PROJECT DESCRIPTION: ADD,ALT, cc R N/D: Poat .w� Nk P AGENCY PERMITS REQUIRED FOR REVIEW NEEDE TOWN SPETIC PERMIT: YES o SUFFOLK COUNTY HEALTH DEPT: YES or BED NEW YORK STATE DEC: PRE-DEC 9/1/75 YES oO ( � S SOUTHOLD TOWN TRUSTEES: YES or 1 J TOWN ZONING BOARD APPROVAL: YES or TOWN PLAN. BOARD APPROVAL: YES or NO FLOOD COMPLIANCE ZONE: PRE-FIRM 3/18/80 PANEL #: NYS ENERGY: YES OR 0 EGRESS: VENT: LIGHT: NOTES: A3K��1 Fsn T�+c �` S7a�r tX� 71 k /1l,eA1,6�_ FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR SF SECOND FLR SF INIT OTHER TOTAL TOTAL: SF FEE FEE FEE TOT( SF)- ( _SF)= SF X $ =$-+$-+$-=$ ve/r Av�,- BUILDING DEPT. SPECTION [ FOUNDATION IST [ ] ROUGH PLBfi-.- [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REM(A�RK X2:0 ,DATE l � IN8P �6 M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING A [( }'FINAL [ ] FIREPL E & CHIMNEY REMARKS 6- 45' 7&(94ot� 26—"1-t__ DATE � a1-710 1 INSPECTO BUILDING DEPT. SPECTION [ OUNDATION IST [ ] ROUGH PLBG. � [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: rlo � T ,DATE ( �� INSPECTOR 29x32- ✓e�vrer� M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN ULATION [ ] FRAMING FINAL [ ] FIREPLACE & CHIMNEY REMARKS: 7�0 - DATE � �� INSPE cl ce- M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [JQ FINAL [ ] FIREPLACE A CHIMNEY REMARKS: IC16 a C'c �<4 g O e" 7t�/ /Cc e'e-41 / ro Je- C S S ac LttG . DATE / 2Z 0 INSPECTO 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS TION ( J FRAMING [ INAL [ J FIREPLACE & CNI 1 REMARKS: 6L DATE 4/ IN8PECT0 A ELD IWSPECTION REPORT DATE COMMENTS ►UIIDAT I ON ( IST) ijf or qs )UNDATION (2ND) _ u ----------------------- II )UGH FRAME & ;��1 PLUMBING ii ii t Wo/. , l� J /vim � cn ,SULATION PER N. Y. n v o/ STATE ENERGY ,- CODE p1 `jC it __ ubxxx=====__ - II /j__ c II���r�.5 U C �L vv��, � Icsfc• F�j��r/ `G r� /c4 A.o,.. FINALNi��ti IIJon "9DITIONAL COMMENTS: G tw i l � a z � r rzl =� H � Q .. (� ! BOARD OF HEALTH . . . . . ... . . . . . . . FORM N0. I 3 SETS OF PLANS . . . . . . . . . . . . . . . .4 TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . DEFT. BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . .. . . . . . . ,. TOWN HALL SEPTIC FORM . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY:// Z� CALL Examined...... 19.... MAIL TO: . . . . . . . . . . . . . . . . . . . . Approved....113 ......,39G�2 Permit No. ......... .................................. Disapproveda/c .................................. .................................. .................................... ................ ........ ............... . .. (Buildi•• tor) APPLICATION FOR BUILDING PERMIT a 000 Date. .1.11 .1_o. �. . . . . . ,1-9. . . . INSTRUCTIONS a. This application must be eampletely filled in by typewriter or in ink and submitted to the Building Inspector w 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 application. 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 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. APPLICATION IS HERM WE 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, ordis, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildi or neces inspecLIULIS. '.. ......................................... (Si ••t e.of applicant, or rime, if a corporation) 117 (10.r+h 04K.��J • (Mailing address o applicant) •6`� �•�9cp State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde .. 0 e rt.e K AIL- .0R►.�.e Ifo ...:..`-5 . --T-o r_-ro 0 e c;�A...PO 0 i.�?.C: ..................... .... ... ............. .....r. Name of owner of premises .f�..2C?. ........�..F....t��...�.::S�4.N E2...................................... (as on the tax roll or latest deed) If i t is7aXr ' sigpature of duly authorized officer. ....... ..... (Name and title of corporate officer) I. Builders License No. f 7�.... 0vU� Plumbers License No. �.9 P...... Electricians License No. ...... 95- ......... Other Trade's License No. .................... � .�. 1. Location of land on which proposed work will be done. ... N p U ............ ...................................�. 10 q 5- Vi 11 AG E L-A k) E D e b C-K-r' ....................................................................................................................... House Number Street QHamlet County Tax Map No. 1000 Section ....�.,�........ Block .... ......... Iot ...!. -21 . ............ Subdivision ...................................... Filed Map No. ............... Int ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: .....A E� ' r-)C- 0w n12 a. ExisCing use and occupancy ...... ... ........ b. Intended use and occupancy ...................................................E tk► DE to L ryvy k q.!...°..^.ct..�).p '' s•"' • t 4� �.D (Des�riptio�,) Ui12F r�CE 4. Estimated Cos a. .......... fee ..................... ..... (to be paid on filing this application) 5. If dwelling, number of dwelling units .....�...... umber of dwelling units on each floor ................ Ifgarage, number of cars ...................................... 5. If business, commercial or mixed occupancy, specify nature and extent of each type of use...................... 7. Dimensions of existing structures, if any: Front................ Rear ............... Depth ................. Height ......................... Nulmber of Stories ...................... Dimensions of same structure with alterations or additions: Front ............... Rear ...... Depth .................... Height ... ... .. Number of Stories ... ..... .. ..... ... 3. Dimensions of entire mw construction: Front ................ Rear ............... Depth .............. Height ......................'... Number of Stories ..................... hh QQ 1. Size of lot: Front .�� :.0'..1....... Rear .�.�Q:.�:7......... Depth o Y(4: 13.' .... CA A (St l(a 5•F i 10. Date of Purchase ..................... Name of Former Owner ........................................ II. Zone or use district in which premises are situated ....i.:.4 v................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ... ................ 13. Will lot be regraded .................... Will excess fill be removed from premises: O Nd 14. Names of Owner of premises ........................... Address .............................. Fhone No. ............ Name of Architect .................................... Address .............................. Phone No. ............ Name of Contractor ................................... Address ...............................Phone No. ............ �15. Is this property within 300 feet of a tidal wetland? * YES .......... ......... ������' *IF YES, MMD IUA IR1MMS PEEaIIT MAY HE MWIM. PLOT DIAGRAM Locate clearly and distinctly all buildings, 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. UAIT Or Nil YORK, ITS J(D[ 17 Cll1r__. ...I..... _..,.... I / �`....I.i'�.!^...... C $ 1 I....................l i ie ng duly sworn, deposes and says that he is the applicant ;Name of individual signing contract) above named, leis Lime ......... .. ................................................................................ (Contrac agent, corporate officer, etc.) )f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this rpplicatiom; that all statements contained in this application are true to the best of his knowledge and belief; and :fiat the work will be performed in the manner set forth in the application filed therewith. lworn to before me this ..t ......day of ...v� . ;.......t�°20' .. Notary P lJbl is ......... •.•••'.• Si re o pplicant) UNDA J.COOPER Notary PubllgM State of New York No.4£22563.Suffolk County Teras EApinn.Decoodw 31x49..Q26 G 0 „1,,,.. .... C�L9 APPROVED AS NOTED DATE: I ' J FEE: 6S BY. S,,tRED AI?Cll ��L�'6 t I%J, �J- NOTIFY BUILDING D�BY: AT 765-1802 9 AM TO 4 PM FOR THE 1, 1 T!-�,- a ,FOLLOWING INSPECTIONS: 1 FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 4. FINAL - CONSTRUCTION MUST r, 3qO'4 BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET t OF N0 THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY "IMMEDIATELY" CODES. NOT RESPONSIBLE FOR ENCLOSE POOL To CODE DESIGN OR CONSTRUCTION ERRORS WON COMPLETION BEFORE"WATEV �reb WD MIME -STrLv;r ry15T5 W17 6005 :P'L � 1:1L— j r L V% V. sLA� 17"a 0 SEL T� b0e7 TLjP!fAElZ' �'��= mm�rosEp 1099-) viuA&E, LANE-1 or-St'i-r, Njy O SL*ZvlEy 01= 3ERTr ispu4ls OPJEW Tor" SOUTHO W 4= N 9MMIX CAAMY,W w E 00.4mw 0-4-30— L CAPtTWUP IQ JON A&#P4KWr WLA%4M Nsu%.&w IWANNIM :. . low^01511CAM Me molobAPIC4 CAM A -410 41 too. 5' re 'tet 10 IV. Zri *4P co Plop"C"T ro" 137� a AAWA W ON WW AGM5 v n f . 30liN C. EHLERS LAND SURVEYOR SRAST&dAAXSTZM 4= 10:2!/20ad 1::3: 6P17651495 GRAYF4'iWNRY 3 Concrete Orad* Stabs 11 Stab-on-Ground Coustruction: Floating Slab Foundation road frame construction Conatruetionm 111matrated an for ' r fl�sAtnO---� wood iranse buildings with heights ssbe,tae i _pertene4or, Aee1G�g duct, if used .112.[04 maximum groin Root to car++ent wnaret+4+6 care and 20-foot maximum from boord stsei rsiaforccrosnt now to gable p++b• i' .r�,-,•:; -�++T'.. 4"n+in. For concrete and concrete 1416.g r• :- ;,. , feteement requirements, see test .r �� t�''?'''.�' f►•• 4"min. entitled. "Nonerete," past 3, yip Brad . 16. and Reinforeed Concrete," ,;' , '•,' 04 bortp an b.page 39. I to 14 —_moisture barrier For anchorage of wood sill to compacted, foundation,see illustration entlilad. :� rigid r graded grovel 8R or "Anchors and Mailing for EAcrlee { insub• ' J crushed(tone Stud Wells."part ,.page?l. a L r, ties, R2 4'•min..6"n+u. - Protection Against Frost Ac- tion—The ation—The adjoining ground h to 1/1.,retrad R 2 insulation spaced 2 incNst+A•r-f slope away from the foundation la • &124"Banters to form concrete lays .'�.'�• ba,, ?6• -D- for bearing oil directions, and the undetlying ii o.a., tAreugh dab r•lntere•n+snt soil should pstferably be sand or concrete gravel to reduce to a minlmute i� bsys .11".J heaving due to frost aetton. Silty i •:• '' ' / L[ •, sand or Clay moll should b.avoided. 11`2„ •;,•.,.. •� r i�. a o•1 •���It For perimeter wall foundation, . min. ,�,• bottom of footing is to be below tn011tur+ frost line. 1t necessary. footing 'f �- - , bottler drslns or other meant that would bars �" , rtduoe height of water table below ry, . W,min. the slab may be Installed. Fat foot• l: etber notes and d',n+ensiord Ing drains ate illustration entitled. i' not shown•same as in rp g e 11. „•: n.. r Foundation Dampproofing sed drawing above Wale roofin M part S. gag Note As two 04 bats for wood fit. _relnlaud bearing partition it out story,two - any wood bearing concrete slob $5 berm for Mood bearing partktion partition or rnssonry rnaistwa if t.+o sturies and for masonry Ynonbearing partition benisr nonLeming partitions; r+rasonry ;:_ • - : . ! 4"oils-' bearing partitions arc to be stip• . ported on separate foundations. rule. 'k �.•' i i sea nets A rot additional requirements. see • I 4" rnln., lest entitled, "Concrete Slabs on oempseted, 6" Was. 9o11."part 8, pact 10. unlfortrdy graded Brushed Ston. 11',Mtn tl"min. 1"min. or Ira Vol IM CODE MANUAL __t_0 'd 6£178 1117 9TQ 'NOHliWOW Wly ZQ: 80 00—CZ-170 OR ENT SUFFOLK CCL*17Y, NY 9,RvErrcn 50#FFCL K Gomyy TAX a `�'•�L CERWIJED TQ: cv ee FIRST AAWER G,aNTITLE H►+-WRANiG; W s �� ` go Sri, A. Rio _ _ sqqLcxr yv lot Aw sy flet l 1J �4 7-10 AN i y ! `.�ir' .rte �'�`•J��}- �1.. \` 1 �' � L Ce C17 1, < Z 4 IC c /� 4. Q JyJt s Ta•i l Yy r > R rtp!v '1 � Crer FG.T+D .. . . 'a ,psi +_aw ..r.•• sa- •a.tf ClwJas wya7•w.•n AREA =M 34 bl� � OR O�' J+GRG � -- JOIN C. E HLERS LAND SURVEYOR I s4AP:�G 5GALE I"=?p' ��1 -� 6 FA&T 1�f�l N&-M6T XY,S.I._NO.mm tw�+o BNF�I�,�D.iY.Y. 11901 E— 3>1 -026A Fay 36944 REF.-t1Hy xcvectid�P7i01�'a�39-Pc� o — a _ a- -