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HomeMy WebLinkAbout29022-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30503 Date: 10/19/04 THIS CERTIFIES that the building NEW DWELLING Location of Property: 805 GREENWAY WEST ORIENT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 15 Block 1 Lot 28 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 18, 2002 pursuant to which Building Permit No. 29022-Z dated DECEMBER 18, 2002 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 SINGLE FAMILY DWELLING WITH ATTACHED GARAGE AS APPLIED FOR. The certificate is issued to THOMAS & LINDA OATS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-01-0202 09/29/04 ELECTRICAL CERTIFICATE NO. 1176248 08/27/04 PLUMBERS CERTIFICATION DATED 10/07/04 M&S PLUMB.&HEATING 9 Aut o iz Sig ature Rev. 1/81 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_911957)non-conforming uses;er buildings and"pre-existing"Iand 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$15.00 Date. L'304 New Construction: V Old or Pre-existing Building: (check one) Location of Property: 5�-n s— &l-eeg C,.� W e5 Dcc Pint House No. Street/ nn Hamlet Owner or Owners of Property: 0 onOC2 i_ l ✓1 Ac" L2, 3 Suffolk County Tax Map No 10�00,Section 15 Block � Lot Subdivision � �/ c;-re 4'A I rc' -es Filed Map. Lot: � J Permit No. oCcj 0 Z Date of Permit. I o2 0 2 Applicant: 4,y1 a5 Health Dept.Approval: Underwriters Approval: Planning Board Approval: / Request for: Temporary Certificate Final Certificate: V (check one) Fee Submitted:$ Applicant Signature C o 36563 MICHAEL SILVESTRI M&S PLUMBING&HEATING 46 Cornell Lane Hicksville, NY 11801 (516) 931-3598 ................................................................ October 7, 2004 To Whom It May Concern, I, Michael Silvestri, certify that all solder used contained less than 2/10 of 1% lead during the construction of the plumbing system at 805 Greenway West, Orient,NY. -7 "4 day a LPr- Sincerely, DONNKM. SILVESTRI NOTARY PUBLIC, STATE OF NEW YORK NO. 01 S 16015587 QUALIFIED IN NASSAU COUNTY Michael Silvestri CO ISSION EXPIRES NOV.2 20 0.1� 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. 29022 Z Date DECEMBER 18, 2002 Permission is hereby granted to: THOMAS & LINDA OATS PO BOX 419 ORIENT,NY 11957 for CONSTRUCTION OF A SINGLE FAMILY DWELLING WITH ATTACHED GARAGE AS APPLIED FOR at premises located at 805 GREENWAY WEST ORIENT County Tax Map No. 473889 Section 015 Block 0001 Lot No. 028 pursuant to application dated DECEMBER 18, 2002 and approved by the Building Inspector to expire on JUNE 18, 2004 . Fee $ 1, 516 . 20 hr' ed Si nature ORIGINAL Rev. 5/8/02 a 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 NEW YORK BOARD OF FIRE UNDERWRITERS S S BUREAU OF ELECTRICITY 5 40 FULTON STREET — NEW YORK, NY 10038 5 CERTIFIES THAT 5 5 SUpon the application of upon premises owned by 5 5 SJOH LUDEMANN THOMAS OATS C P.0 BOX 621 805 GREENWAY WEST 5 NEW SUFFOLK, NY 11956 ORIENT POINT, NY 11957 S 5 Located at 805 GREENWAY WEST ORIENT POINT, NY 11957 �j Application Number: 1176248 Certificate Number: 1176248 5 5 Section: Block: Lot: Building Permit: BDC: NS11 5 5 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: 5 Basement,First Floor,Second Floor,Attached Garage,Outside,Attic, 5 5 5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5 S herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5 authority having jurisdiction, and found to be in compliance therewith on the 27th Day of August,2004. Name QTY Rate Rating Circuit Type 5 5 Alarm and Emergency Equipment 5 Transfer Switch 1 0 60 amp CSJ Sensor 2 0 Carbon Monoxide rj Sensor 6 0 Smoke Appliances and Accessories Furnace 1 0 Oil Dish Washer 1 0 1.2 KW SPump/Motor 1 0 1 H.P. 5 Cj Oven 1 0 40 Amps Exhaust Fan 2 0 F.H.P. 5 SPanels 5 1 60 11 Wiring and Devices 5 Outlet 52 0 Fixture SFixture 52 0 Incandescent 5 Outlet 112 0 General Purpose 5 Receptacle 64 0 General Purpose seal LSwitch 54 0 General Purpose 5 5 Continued on Next Page 1 of 2 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. C.rQ3 PQ rr= e 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 S5 SBUREAU OF ELECTRICITY 5 40 FULTON STREET - NEW YORK, NY 10038 5 CERTIFIES THAT S 5 5 5 5 Upon the application of upon premises owned by S 5 S JOH LUDEMANN THOMAS OATS c5 P.0 BOX 621 805 GREENWAY WEST 5 SNEW SUFFOLK, NY 11956 ORIENT POINT, NY 11957 S S Located at 805 GREENWAY WEST ORIENT POINT, NY 11957 5 SApplication Number: 1176248 Certificate Number: 1176248 5 5 SSection: Block: Lot: Building Permit: BDC: NS11 5 5 Described as a Residential occupancy, wherein the premises electrical system consisting of C electrical devices and wiring, described below, located in/on the premises at: 5 Basement,First Floor,Second Floor,Attached Garage,Outside,Attic, 5 5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5 authority having jurisdiction, and found to be in compliance therewith on the 27th Day of August,2004. 5 Name OTY Rate Rating Circuit Tie 5 5 Receptacle 1 0 40 amp Range 5 5 Dimmers 6 0 5 Receptacle 1 0 20 amp Laundry 5 Paddle Fan 7 0 5 Receptacle 5 0 GFCI 5 Service 5 1 Phase 3W Service Rating 200 Amperes SService Disconnect: 1 200 cb 5 5 Meters: I . S 5 5 5 5 5 5 seal 5 5 2 of 2 S 5 This certificate may not be altered in anyway and is validated only by the presence of a raised seal at the location indicated. 5 0 t] cPcJ'� cnrJJ srJ - - 1:. 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 5 BUREAU OF ELECTRICITY 5 40 FULTON STREET — NEW YORK, NY 10038 c� 5 CERTIFIES THAT S 5 S 5 Upon the application of upon premises owned by 5 55 S JIM SAGE ELEC. INC. ROBERT WALLACEP.O. BOX 38 SHIPYARD LA 5 S G EENPORT, NY 11944-0038, EAST MARION, NY 11939 S 5 Located at 295 SHIPYARD LA EAST MARION, NY 11939 c5 5 5 Application Number: Certificate Number: 5 PP 1183192 1183192 S 5 Section: Block: Lot: Building Permit: BDC: ns11 5 5 SDescribed as a Residential occupancy, wherein the premises electrical system consisting of S 5 electrical devices and wiring, described below, located in/on the premises at: S 5 First Floor,Attached Garage,Outside,Attic, 5 5 5 rj A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5 authority having jurisdiction, and found to be in compliance therewith on the 31st Day of August,2004. 5 Name OTY Rate Rating Circuit Tyne 5 5 Appliances and Accessories 5 5 Exhaust Fan 1 0 F.H.P. 5 5 Wiring and Devices 5 SOutlet 18 0 Fixture 5 5 Fixture 18 0 Incandescent 5 Outlet 36 0 General Purpose 5 L5Cj Receptacle 17 0 General Purpose � Switch 23 0 General Purpose 5 Dimmers 2 0 5 Receptacle 1 0 30 amp Dryer 5 5 Receptacle 5 0 GFCI 5 5 5 S 5 5 5 seal 5 5 5 I of I 5 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 a o��S�fFO��-cOG o� y� CA Town Hall,53095 Main Road v, Fax(631)765-9502 P.O.Box 1179 Gy • �� Telephone(631)765-1802 Southold,New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD July 11, 2003 Thomas Oats PO Box 419 Orient,NY 11957 To Whom It May Concern: Your most recent amendment to permit#29022Z, has been approved. No fee is due and no further action must be taken. Please keep the enclosed set for your records. 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 4:00 p.m. Respectfully Yours, /c//Z--- IF Damon Rallis,termit Examiner 112 TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER —STREET VILLAGE DIST. SUB. LOT a ma s Lir ; (005 C 1-i e-., W-i Westy S� FORMER OWNER 5019h`,e Cram 1rC4) N E ACR. r !1 C � �J— . —s+3 S W TYPE OF BUILDING �r RES. SEAS. VL. FARM COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DAT REMARKS '�` �� �-� cr"✓d'% �� fat ov- To ? 73si,. �i�. a e�-�c i,chSo DI) AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre Tillable 1 Tillable 2 Tillable 3 Woodland Swampland FRONTAGE ON WATER Brushlond FRONTAGE ON ROAD House Plot DEPTH BULKHEAD Total' DOCK Town Of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 12/06/02 Receipt#: 0 Transaction(s): Subtotal 1 Septic Permit-Construct- Resid. $10.00 Cash Total Paid: $10.00 f� Name: Oats, Thomas& Linda P O Box 419 Greenway West Orient, NY 11957 Clerk ID: LINDAC Internal ID:64493 CHICAGO TITLE INSURANCE COMPANY ` "SEE KEY CONTACT SHEET ATTACHED FOR ADDRESS/PHONE" VARIANCE SEARCH TITLE NO. : 3802-95392 COUNTY OF SUFFOLK } }SS STATE OF NEW YORK } THIS IS TO CERTIFY THAT THOMAS OATS AND LINDA OATS ARE THE OWNER(S) OF RECORD OF LOT 13, MAP OF GREEN ACRES AT ORIENT, FILED 4/13/62, MAP NO. 3540. DIST. 1000 SEC. 015.00 BLOCK 01.00 LOT 028.000 THAT THEY ACQUIRED TITLE THERETO BY DEED DATED 2/12/99 RECORDED IN LIBER 11947 CP 624 ON 2/25/99; THAT WE HAVE MADE A SEARCH OF THE RECORDS OF THE SUFFOLK COUNTY CLERK AND/OR REGISTRAR'S OFFICE, AND THAT SAID SEARCH SHOWS THAT NEITHER THE SAID OWNER NOR ANY PREDECESSOR IN TITLE OF THE SAID PREMISES OWNED CONTIGUOUS PROPERTY AT ANY TIME SINCE 1/1/97 EXCEPT AS FOLLOWS: NONE THAT THE APPLICANT HEREIN DOES NOT OWN ANY CONTIGUOUS PROPERTY EXCEPT AS FOLLOWS: NONE THIS CERTIFICATION IS MADE WITH THE INTENTION OF THE RELIANCE THEREON BY THE BOARD OF APPEALS AND/OR BUILDING DEPARTMENT OF THE TOWN OF SOUTHOLD. THE LIMIT OF LIABILTY UNDER THIS CERTIFICATE, FOR WHATSOEVER, WHETHER BASED ON CONTRACT OR NEGLIGENCE, SHALL NOT EXCE $25,000.0 AND SHALL BE CONFINED TO THE APPLICANT TO WHOM THIS CERTIFICATE I ADDRESSED, OR THE COUNTY OF SUFFOLK. CHICAGO TITLE INSURANCE COMPANY BY /V 1112�9 JLV1� AEXANDRA . BOSSUN J (631) 284-2462 SWORN TO BEFORE ME THIS 5TH DAY OF NOVEMBER , 2002. u , NOTARY PUBLIC, SUFFOV'\ COUN Y, N.Y. CAWL0. ftW"P*ft�olftw" VARSHCT N&47=W 00 11 il"Ellpim Nm Sk SM VARIANCE SEARCH (Continued) TITLE NO. : 3802-95392 SUBJECT PREMISES: DIST. 1000 SEC. 015.00 BLOCK 01.00 LOT 028.000 DEED GREENWAY REALTY CORP. TO MARTIN GRAMLICH AND SOPHIE GRAMLICH, HIS WIFE DATED: 11/25/76 RECORDED: 12/3/76 LIBER 8152 PAGE 245 MARTIN GRAMLICH DIED NO PROOF OF DEATH IN SUFFOLK CO. DEED SOPHIE GRAMLICH, AS SURVIVING TENANT BY THE ENTIRETY ✓✓✓ TO / THOMAS OATS AND `// LINDA OATS, HUSBAND AND WIFE DATED: 2/12/99 RECORDED: 2/25/99 LIBER 11947 PAGE 624 LAST OWNER OF RECORD PREMISES ON NORTH: DIST. 1000 SEC. 015.00 BLOCK 01.00 LOT 027.000 DEED GREENWAY REALTY CORP. TO NICHOLAS BOLLETINO AND GENEVIEVE BOLLETINO, HIS WIFE DATED: 6/12/73 RECORDED: 7/10/73 LIBER 7437 PAGE 151 LAST OWNER OF RECORD PREMISES ON EAST: GREENWAY WEST LAST OWNER OF RECORD VARCONT - CONTINUED - 2 VARIANCE SEARCH (Continued) TITLE NO. : 3802-95392 PREMISES ON SOUTH: DIST. 1000 SEC. 015.00 BLOCK 01.00 LOT 029.000 DEED GREENWAY REALTY CORP. TO MARTIN GRAMLICH AND SOPHIE GRAMLICH,HIS WIFE DATED: 7/2/68 RECORDED: 7/5/68 LIBER 6376 PAGE 378 MARTIN GRAMLICH DIED - NO PROOF OF DEATH IN SUFFOLK CO. LAST OWNER OF RECORD PREMISES ON WEST: DIST. 1000 SEC. 020.00 BLOCK 01.00 LOT 003 .007 DEED ORVILLE H. TERRY AND RHODA T. TERRY TO /DAVID W. TERRY DATED: 9/11/11 RECORDED: 9/16/11 LIBER 781 PAGE 218 DAVID W. TERRY DIED 12/21/53 ORVILLE W. TERRY DIED 12/24/ 6 DEED JOYCE P. TERRY TO SUZANNE M. EGAN DATED: 1/30/01 RECORDED: 2/14/01 LIBER 12102 PAGE 372 LAST OWNER OF RECORD VARCONT 3 - CONTINUED - BUILDING PERMIT EXAMINER CHECK LIST DATE REVIEWED: ►a/I8 /0a APPLICANT: DATE SUBMITTED:a/fL/0Q SCTM#DISTRICT: 1.000, SECTION: _, BLOCK: , LOT: STREET ADDRESS: _ CITYcha SUBDIVISION: 64�29X6 PROJECT DESCRIPTION: L 6a2ft ESTIMATED PROJECT COST: oak ARCHITEC R: ���` FAST TRACK?jJf1 SINGLE & SEPARATE CERTIFICATION-REQUIRED? NOTES: p L .'l LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZE LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at any time after 7/1 ZONING DISTRICT: CONFORMING? /l(a REQ. LOT SIZE: �Q�ACT. LOT SIZEQREQ. LOT COV. __ ACT. LOT COV. ✓ REQ. FRONT 4 PROP. FRONT�U _REQ SIDE jt 3� ACT. SIDE ✓ REQ. REAR 0 VSO PROP. REAR TJ REQ. HEIGHT PROP. HEIGHT WATER FRONT? AM DESCRIPTION: PANEL #: FLOOD ZONE:_, APPROVALS REQUIRED SUFFOLK COUNTY HE H DEPT:<&or NO, (BED#):-�—DTE: 1Z / Z / Z PERMIT#:R10- 0/'C4:PUa TOWN SEPTIC RECEIPU- IRE-DEC or N NEW YORK STATE DE 9/1/75 YES o SOUTHOLD TOWN TRUSTEES: YES o TOWN ZONING BOARD APPROVAL: YES or TOWN PLAN. BOARD APPROVAL: YES or TOWN HISTORICAL PRE (SPLIA): YES o NYS ENERGY YE R NO : v EGRESS (18 H muL.?4 sq total) VENT(SQ. FT. x 4%) ' LIGHT(SQ. FT. x 8%) ' BUILDING PERMITS OPEN/EXPIRED: BP -Z/C/0 Z- , HAVE PRE CO'S : Y OR N BP -Z/C/o Z- , NOTES: Z� FEE STRUCTURE: FOUNDATION: I M 5 SF FIRST FLOOR: 4P-554 SF SECOND FLOOR: G r SF OTHER: SF INIT OTHER TOTAL TOTAL: ) D SF FEE FEE FEE DD 1. ( j`fey SF)- g( SF)= y� SF X OL _$ X366 +$ roD +$ _ $ 15It 2. ( SF)-(SF)= SFX$ =$ +$ +$ =$ -jaz2 ,:-,,� 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REM RKS �IC =pJ. zz OF DATE2/)/61,5--�MPECTOR 4��4XOII� 765-1802 BUILDING DEPT. INSPECTION [ ] F NDATION IST [ ] ROUGH PLBG. [ XFOUNDATION 2ND [ ] INSULATION [ ] FRA FlNAL. [ ] FI PLACE & C MNEY REMARKS: DATE IN8P M-1 BUILDING DEPT. INSPECTIO [ ] FOUN TION 1 ST [ ROUGH PLBG. [ ] F NDATION 2ND [ ] INSULATION [ F G [ ] FINAL [ FIR LACE A CHIM Y—ke' REMARKS: 77, Ciao 4-t, 7, J-1-5 DATE �� INSPECTORS C ok 1 BUILDINGDEPT. INSPECTI N ] FOUNDATION ROUGH / • 1 ] INSULATION INSPECTION RE lARKKS: Z'��_��4� /3j , / 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [e�IFISULATION [ ] FRAMING [ ] FINAL [ ) FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: �l at6 6WA, C .•�ol'i-r1 ,- �ILLGB2l lGG�-1P�G�:�ZE ZtA 000r Coe �ISdP X30�.�r —az" DATE l � INSPECTOR 22 4-- 7765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUG [ ] FOUNDATION 2ND SOLATION [ ] FRAMING [ ] FINAL [ ] FIREPLA RIMNEY [ ] FIRE SAFETY INSPECTION REMARK I!�� DATE � INSP � �L 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ DATION 2ND ] FOUNDATION INSU N[ [ ] FRAMING NAL [ ] FIREPLACE 8 CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: V4�✓ DATE � o INSPECTOR �J' � 76s-1sos BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. � [ ) FOUNDATION 2ND [ ] IN LATION [ ] FRAMING [ FINAL [ J FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: 12 DATE ?11-310 INSPECTOR ^�'�j F�i,� � G//iLas�� ✓%�L /i .�/�i��ice. � '" �.j�,i�_ . , PLUMBING rug - INSULATION PER N.Y. STATE ENERGY CODE , 10 JIF W qml- v C TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION•CHECKLIST BUILDINC,-BEPARTMENT Do you have or need the folio ,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 X43 sets of Building Plans TEL: (631)765-1802 Planning Bow approval FAX: (631) 765-9502 urvey www. northfork.net/ uthold/ PERMIT NO�Nn� &/Check _ _11�jt KSeptic orm N.Y.S.D.E.C. /� Trustees Examined / 20 Contact: Approved 120__2___ Mail to: Disapproved a/c Q Phone: aQ 7— GG Expiration �J ,20 Building Inspector Fill, nc , 7 2002 APPLICATION FOR BUILDING PERMIT Date 920 OLD 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 waterways. 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 a 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 what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date.If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize,in writing,the extension of the permit for an addition six months. Thereafter, a new permit shall be required. 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,ordinances,building code,housing code,and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name,if a corporation) % /box yt? ©aeo, ' /% 11957 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder Name of owner of premises 5 4 G(Va ._ OCV+) (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. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: G-f t ,✓+- House Number Street Hamlet County Tax Map No. 1000 Section ] S_ Block C Lot 2r Subdivision f=ree, Acren, ro. OiTo�T Filed Map No. 35'-q0 Lot 13 (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy j.acoA Lo F-- b. Intended use and occupancy to 3. Nature of work (check which applicable):New Building f Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost 9a)000 Fee (To be paid on filing this application) 5. If dwelling,number of dwelling units 1 Number of dwelling units on each floor If garage, number of cars ` 6. 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 Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear '6epth 7 '6 Height Number of Stories 9. Size of lot: Front 1 �� S-S" Rear Lrb Depth L44eJ -47 V', -AD,09 tJ_ 13141 10. Date of Purchase I� Name of Former Owner spo�l e, Grrti"I(Cll 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO / 13. Will lot be re-graded?YES /NO Will excess fill be removed from premises? YES NO .J p 14. Names of Owner of premises` j+LuadCa SAddress��%14 Orj41' Fs`7 NAY Phone No. 63/ AO %1/8- Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO—Z * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale,with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below,must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OFA � 1 Dltif4S �Q' /� being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the Ao'q&e (Contractor,Agent, Corporate Officer, etc.) of said owner or owners,and is duly authorized to perform or have performed the said work and to make and file this application; 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 before me this 10 1�7 day of Pc�iu�Pr 200 y - I Z&� - Notary Pub Signature of Applicant JOHN E FIT ALD NOTAPY PUBLIC STATE OF NEW YORK NO.01 F16013847 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES 09128/200(p ENERGY CODE CALCULATIONS CHAPTER 5 SECTION 501 Detached One and Two Family Design Criteria 5750 Degree Days (For Non-Electric Heat) Zone 11B For: TM Per: P, 4,.� R 2 1 f Dated: 2 o L DESIGN CODE DESIGN CODE SUBSYSTEM AREA _ «U„ «U„ UA UA Exterior Walls 263E o.ld8�� 0.14 2 66.3 / 3 LG°•yy Ceiling Roof 153V 0, 0 3 0 0.031 Floor Over Unheated Space /5- 3,50 0 , os' 0.05 74.70 -76.70 Heated Slab On Grade 6.5 Unheated Slab On Grade 4.5 Basement Wall 0.1 Crawl Space Wall 0.06 NOTES: S 2.7-3 Construction shall comply with 502.1.1 moisture control and 502.1.4 air leakage Building Envelope Systems to meet requirements of Section 501 The mechanical systems and equipment including: HVAC Equipment,HVAC Systems,Duct Systems,Ventilation Systems and Insulation of Piping Systems to meet requirements of Section 503 Service Water Heating Systems&Equipment to meet requirements of Section 504 Electrical&Lighting Systems&Equipment to meet requirements of Section 505 o• y To the best of my knowledge, �' w belief, & professionaljudgement, these plans are in compliance s�oP oss�s4 with the code. 'OFESSIQ%1P ANY AE TIMI OR: R ABDfT;;: TO T1RS lWWV IS A VJM ATOW S U F I t_fi C N T Y c�.>�ce'L TN �T tW>� .wja�r VOCA t rL 401"f� LTJ '' J J 'Y zooz NOV 2 7 a� . s ''TNIS A* AW oNL+� r 8' g2 SAID 11A15. 1EAR TNr- AES1E9 SEAL Dir Ti+e strvcraa AT ORIENT W� s�»T� APPEARS MER[flN • - LOD � �WA�TEWAT�R MGM7 c ALL TO W ap S ��� LOT NUMBERS REFER TO 'MAP OF GWEN SUFFOF}' �O j j� /"� !'j , YK ACRES AT ORIENT' FILED IN T S!#�'I'�"OLK LK v +t✓ Q COUNTY CLERK'S OFFICE ON APRs. 13, 1962 low ' 1,5-91-28 0" AS FILE NO. 3540. � . 1 JAN. • t�ch 2002 "*rof 1 SUBJECT TO COMVcNANTS&RESTRIMOMS LIBER ,a oon Max 4�, 20 p�......E � ;, . m .Q. 4 • SC[�1i.S Rot# RIO-01-0202 LOT 1 cD�LI 4tz EL 19.1' C7 147.89 EL. 19.1' � f^ .. r- ci _ � v EL, 14 4 PROPOSED DRIVEVAY N lob e,to t*1 ti. < LOT 13 n � _ z. TEST 1*XE r� rris l ' i DA4K AMIJVN SIL T Y LOAM OL h Del LEMMY SILT ML 172' 3' tj1 ,I� 1 E1-• / 1 AMOW STt,Tr SAND WITH VERY ; 134.00' WAVY GRAVEL SM � O PAIS BROWN FINE l0 COARSE SAWD S EL 0 W YELL 1►. .,,,,Tdrd � Bd d df RE eW S / LOS 12 determination dated 2s o Z WATER IN PALE BROWN FINE TO / cDVELLi '> COARSE SAND SV ✓ Q P"N r' {� >I. pwxmv MAE Is, O YELL NOTE, SEIV AGE "OSAL $ TE#d Alm `--' 1 14-M 113.0 � ►. PROPOSa WELL LOCA"W5 AIV DFS1SN POMWMR AAIB BASE L~ suFFaK COUNTYART DE'T TM. 1 SER � STA/�ARRS � r FISCtIETTI, AMxDpT ROAD ' HwesT VMcM water MAM 1e" CL eo tom! INS- _ mur NA 7FlM+►L AAY7t+IMD ALL POpI.& SUFFOLK.COUNTV D �RTN M OFtA HEAL t of MEAN BAND t V�Y. PERIVIIT FOR OI3 AP>aR VAL OF CON�'TRUCTION FORA IDENCE ONLY EXCAVAT{ON INSPECTS E ? SINGLE ii�A*ILY RES FOR SANITARY DATE 3 o S .Nd iPA - o/- 0920 z BY HEALTH DEP tornrn APPROVED C:)p..d �Il TSE ' OF g..BEDROOMS ' am familiar with the STANDARDS FOR APPRO\ 3= " AND CONSTRUCTION OF SUBSURFACE S WA6�CPIRES TfiREE FROMDA'TEOFAPPRt3VAL �P��pE NfW y M c DISPOSAL SYSTEMS FOR SINGLE FAMI Y RESIDENCES S t.Met O,P and wilt abide by the conditions set forth therein on the permit to Construct. The toCation of welts and tcesspoots shown hereon are i Nt - LIC. Na 4961 ' from f'wid observations and or data obtained from oth rs, C •y P.C. C 9t9 f x(630 7765-1797 €tev*.titins are refer>-erticed to Q aSs4+rred datum. SET S.F. Poe *--PIPE ,►c P z SM k- 7 7T7 -7.11,7 7-11 ",lop C SUR Y SM 'Off. mwv Arl • ORIENT, -P jr 411-It IV=-11-11 jp 4cku. 10 11 M, 745-01 28 At IL 14 ac *30 J0. 22 ZOW WWI* �ffir w 14, tval'** #10-01-ezo LOT a. 46 O S/ 0 < OT --4 0 TEST *k%X eras - A"w AR"w S It TV L UAM 0- yen%* til SILT W X-SAW WITH VUY Sm To- 0 WATER IN PALE F-1W TO COW:�E $AND S V 23' PLM $so= 4"W k4u, NO TEI SEWA6E DISPOSAL S*MW AAV PROP0.1" #a L Lf "n"q AAV K". tam DESOV-P9WW TVX M . Tx vw sr-A fi- mowsr momno 410UMMAM Jv AW ML A* A" SAM I ars f6miflar , with th STANDMD� FI {2 APPROVAL F AND CONSTRUCTION OF SUg..SU1;W-ACE T A -S 01 DISPOSAL, SYSTEMS PEW SINGLE FA41LY RESIDENCES T. and wiki QiWole 1c)y the com%tb set forth t#qerej" and .on the pOrmit to construct. The toco'tion of 'weits and cesspockis sbown hereon are from field observatioris and or data obtained from othlr-s. C E(evation5 *ry r a *Ference-d to ap asswM60 014 t Lm. M 'Avi q WAX: 1030 'TRAV-CLER '4-w1rr I p*'Y' PIPE 'tvv" �Q&' L .1 7 iMrN G►'�hi to ('Ot{( /+O TLU ANY AL TERATMN OR ADDITION To TwS SURVEY Is A VIMATIOV , 'T T �. ' ' PROPER ' p 23` COUNTY OF SECepT As w cep rr,E NEV YQtdc is*TAX z. ALTIOtt rjr UR ExcEPT As �r srcrrary rem-suil�vls�0�► z. ALL r�.ttTtr•ICATIaws Id. HEREIN AM VALID FOR THIS MAP AND CORKS rHEWff 12%Y N ORIENT '39 WAHOSE S14MTt1 C APPEARS HEREON.J9 OW 1W COPIES KAP THE NER£SSLB SLAL OF THE SUP VEYOIP TO WJE OF SO U'THO Q WELL SUFFOLK FFO T y /� �"t TY -�� y`�� �1' LOT NUMBERS Rt FER TO 'MAP OF GREEN �.7 i.! IILLZ V (,,i ,i 1 l 11 ACRES AT ORIENT' FILED IN THE SUFFOLK 1000--15-01 _28 log. AS FILE eNO.83540.FFICE ON APRIL 13, 1962 Waw`: 1 =30 0 1 AN. 22, 2002S IS Mach 139 20002 mkiw out yoMvi wait Aorp 1,14, ?,ras (aVic A:s c } Aro s'ldvd lc�+x.fire !A 2004 %W) A4y. 2W4 tedi0ims) A . SClal'6 Rel# RIO-01-0202 LOT 14JL4 �cv� Et ta,r n e 147. a+ r' N 80'36` € o t ' � tti v7 � ,44' Z >9 _ o O \ t./�� • sr -­\-sr 6I' .TV , T .SSB — bLOT 13 RCA well 30 r� 0-4 ArST HOLE -_...... .•......�-,.c--._.+ter--.. •-.«,/'--_—'_"' n„ tit MJ• DARK BROWN SIL TY LOAN IX I' BRAWN LDWY SILT NL �+ 3' L L b 1b•8' BROWN S4 1Y SAND WITH VERY • it HEAVY iW4VEL SM 134 PALE BROWN FINE TO COARSE SAW S EL 9.1' ' ��i�• W VEU. - 16' f S 601 1 Lot 12 WATER IN PALE BROWN rL E TD C13ARSE SAND SW (D�/ELLIhIW 23" 145E GAMOM P"N Foom dluff is, O WELL NOTE' SEWAGE DISPOSAL SYS AAV `__r _ � ii ra � i3'�.as A� ►' PROPOSED WELL L OCA � AAIfl DESIGN PERAW M AW SASE LPON Wry SUFFOLK C"" Aj?r*lVT OF MEAL TH. L.P. .7. SERVACES STAM &V DESIS D BYE .119SE0w FISCME Tr, P.E. 1 x'21 1*%W r ROAD SOUTHOLA K /l9•TI Iwr=r�cry Naw WATER Jr Jim aro 763- t9� +/ — --- 'v REWVE ALL 14"K WU MATENAL AROCAW ALL POOLS •y BACK FXL WITH 3' COLLAR OF CLAN SAAV 4 GRAVEL F FOLK COUNTY DEPARTMENT OF HEALTH SER1/10ESAPPROVAL OF CONSTRUCTED`FORKS FOR a® SEP 2 04 I `'. E+ �.j lo-'01- 0010'a—, , NT T11@ SBNI'Sg@ di:�kYSn� c h 1t: S � � � 5{C+'�P30fl h'8Y0 b/N!' I ars farlitiar with the STANDARDS FOR APPROVAL bnpacwanNorcerftrc-. �,y+: AND CONSTRUCTION OF SUBSURFACE SEWAGE I�salswixryFOR AMAX!Mi'A,':0 _c _ ;K=OROOMS. IIISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES and will abide by the conditions set forth therein a on the permit to construct. ' Waiter J.Hilbert,P.E.. ie a Once Of Wastwdater M The location of welts and cesspools shown hereon ar h•. 9 fr6n field observations and or data obtained from oth rs, 3�, CONIC -AWE YORS, .',devotions IJ-* referenced to an assumed datum. (631) 765 - 5020 FAX:(631) 765-1797 LE 1230 A 230 TRAVEOX LER STREET AWA—Z.3.2%' S.F. ILEI ` A l F SOU 7HL7L D, N.Y. 11971 02~-- 7 fl If copper tubing is used DO NOT PROCEED WITH PROVIDE ANTI-SCALD AND/OR f3 y, jyeF #a iT v { t for wamrdisvributing FRAMING UNTIL SURVEYTHERMAL SHOCK PREVENTING rrf'°v sy. -ora, piping sBa'Al be OF FOUNDATION LOCATIOICEVICES AS TO PART. 902,6(K) L S�,y. xp'v, Rf lypcic F'. cr U oily 44 g' � HAS BEEN APPROVED. N.Y. STATE BUILDING CODE. t I ApHMANM L UNDERWRITERS CERTIFICATE t ��� I I • 29a7» REQUIhPr^,ONTO[ OPF.PvlP'1G$ FOR ED ELEVATE HEATING mo_ APPLIANCES 1 PLUMBING REQUIRED BY PAA RT.T. r NOTIFY BUILDINGAMT DEPARTMENT A ALL PLUMBING WASTE EFfEP,f>FNCY ESCAPE AS 717,3 e 4 OF FOLLOWING f NS TO / PM FOR THE RE a N.Y. STATE BUILDING CODE. L FOLLOWING INSPECTIONS: &WATER LINES NEED QUinLd BY PART. 7ITS OF - 1 FOUNDATION • TWO REQUIRED TESTING BEFORE COVERING h Y STATE BUILDING CODE. ++ FORPOUREDCONCRETE ! ROUGH • FRAMING t PLUMBING J W i INSULATION UNDERWRITERS CERTIFICATE - FINAL • CONSTRUCTION MUST PLUMBER CER T/F/CATION SH REQUIRED y 12 la SE COMPLETE FOR CON LEAD CONTENT BEFORE ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE NCERTIFICATE OF OCCUPANCY - - .Y. STATE CONSTRUCTION A ENERGY SOLDER USED IN !MATER -- -- -- \ CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS SUPPLY SYSTEM CANNO EXCELD 21l Of 1% LE D. PROVIDE �/ HR. FIRE RATED SEPARATION TO12 PROVIDE SMOKE-DETECTING PART. 717.3 (f) (1) OF ALARM DEVICES N-Y, STATE BUILDING CODE. AS TO PART. 721.1 N.Y.S BUILDING CODE. OCCUPANCY OR ---- --- - - USF IS UNLAWFUL - -- `(TkOUT CERTIFICATE OF OCCUPANCY - � --- - _ IL ic - - - _ > r _�T, -- _- ii _=_41— L ' I N 4F �t ih Hyl, AL•- \ t l)I rifUL ! 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