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28985-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30514 Date: 10/26/04 THIS CERTIFIES that the building ADDITIONS/ALTERATIONS Location of Property: 6895 MAIN RD EAST MARION (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 31 Block 1 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 14, 2002 pursuant to which Building Permit No. 28985-Z dated DECEMBER 6, 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 "AS BUILT" ADDITIONS & ALTERATIONS TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JEAN ARENA (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 03-2588 11/24/03 PLUMBERS CERTIFICATION DATED 07/13/04 HARDY PLUMBING & HEATING //Aho zed ignature 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. 28985 Z Date DECEMBER 6, 2002 Permission is hereby granted to: VIVIAN BABINE PO BOX 273 GREENPORT,NY 11944 for "AS BUILT" ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 6895 MAIN RD EAST MARION County Tax Map No. 473889 Section 031 Block 0001 Lot No. 002 pursuant to application dated NOVEMBER 14, 2002 and approved by the Building Inspector to expire on JUNE 6, 2004 . Fee $ 1, 221 . 60 aA�t�hq��ze4,�q ature ORIGINAL Rev. 5/8/02 3 n. Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 2004765-1802 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-existingbuildings(prior to April-9,1-957)non-conforming uses,or buildings and"}ire-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$15.00 Date. New Construction: Old or Pre-existing Building: V (check one) Location of Property: [(JD q�-- -,! House No. Street Hamlet Owner or Owners of Property: J cwv reya- - Suffolk County Tax Map No 1000, Section 3 ) Block I Lot Subdivision n 7 Filed Map. Lot: Permit No. 2 `1• E .S� ate of Permit. 1002-Applicant: Ot Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted:$ 'Applicant Signature Ax- -:2— 0- C6-?-- 3os ►'� 7-77-77 KFN t ` � �F�. l" 461�� l7LM'.� C.�rtfealeNti)tftr ttu 10* r - A�unic?Fpul/ly• .9outhatcJ1'awn'�C N" yFcw'nc�al,3specto 1rsd�L�hre 1 E�?44 rs.?etllti 1r}3�ai1 h 14hicti+a tyiitf§pn ,!c04tF lEl'�1i'�`t3t i:` Feop�its Ad�r¢�s• f y ri a L ($aJ FaI..B T S T t r I T �12 k 13$st IV1ari1�}. 1 LJ35.' s s„r w 3� �+.�t.f.�Jw'43. -:+Iv o.x w a+at tea+7t'S�+��'k'"�! * �rw y�,+kG°."�,:t'f'".�n'l�l.frt�".$R-�'" �•� u.it 3r» fail 1 �1�14`1C 1 e t TK"W�•ntrt, 3. nm 3tt Alct ...... dnd'f©r# y clttlaiihc}s ciaatl ttuu� d 1V io!23u>is�u�11 3M�vru 1ve lao�lq titEt ,u t ...... Bier mfee s "S3♦ r� �+'.J9i1»Mr ioi� ,SSvvltc/t@3' .S {�'�lte�4pttt�s.} t � � i= � a ;a Seo Si t .t. ......... e.., ;�� t���.! Yt" �z:g��w�, S �e�Z {,� d"S' i � a st ..oX"4� $ S.S � �,, b t.5+�� t. f„ �, r ��.,aSN, ..�,.'�• 1 z' a •`t ' t i i S'r U9 t,,.; t as Y x a � e ft i as i}� yyy t"1 ,� � i'• , e t�;i 3 S f`..A.=i Ott �.i„�ii»f ,fit S �S Y t S.. .a ''►'`" 7s'��C"'"''' .S, � a.'�aL4,w•+.SS rSaS�.q,3�;*�� S o�'..S N ;f�i' S'«...;,+(+.bw 1 » "� ::i "rr �`." rw"'�.1`i y�'iA:r�. ✓t1sSi '.. � a .r��L'� t ".t `. "M i i'r"Lr sANN- Al ::.t � t£��� y Ors 'a''i. �'}r 'f.k Zw .Z Ls •trS 1'S., ,Sx..'4'�'Y"� .s G' �`"�: •+ ,,.�q,,y„hyNy=.:.. sq,. +;11"x,. ;i+,M.�„ -hM.':. �*W � c�n 2 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR PO BOX 1179 Yr TOWN HALL SOUTHOLD, NY 11971 CERTIFICATION DATE: 1 It 3)dq BUILDING PERMIT NO. 9 5 2— OWNER: OWNER: Je 0. -A reA C', (Please print) PLUMBER: Hardy Plumbing.Heating&Air Conditioning Inc. (Please print) I certify that the solder used in the water supply system contains less than 2/10 of Mead. I also certify that I installed an anti-scold and/or thermal shock preventing device at all bathing and/or showering fixtures in conformance with part 902.6(k) of the N.Y.S.F.P.A.B.C. (plumber's sign ur ) i1 93 � Sworn to before me this day ofjl , 2004 (Not 1 MoUry�7411 INw IMk Notary Public County Qwfifiad in Nassau/ Commission Expires o�OS�fFO�,�cOG �� yam► O 1 Fax (516)765-1823 y 2 Town Hall,53095 Main Road Telephone(516)765-1800 O .lC P.O.Box 1179 Southold,New York 11971 SOUTHOLD TOWN LANDMARK PRESERVATION COMMISSION To: Southold Town Building Department From: Southold Town Landmark Preservation Commission—Herb Adler, Jr. Dated: December 5, 2002 Re: Arena Residence at 6895 Main Road, East Marion Tax Map #31-1-2, SPLIA No. EM 7 With respect to the above referenced residence, the Landmark Preservation Commission has reviewed the submitted plans. With respect to the items which come under our jurisdiction,there are no problems with the rebuilding of the porches or the second story addition, since the latter is not visible from the road. It is requested that the replacement windows be in accordance with the historic style of this house, i.e. incorporate full mullions. `;°o"► C oN 1.8 �•�-�" rn 5�•��'oO�x�� $ �'Nx 1 lo1 CONC FNC 01A 0 2 f MON W C' Z O T( w ` 21) .. lye.. SHED x ON 3.S' _ SkiED OUSE SHED CESSPOOL ON 1.6' COVER x LOT 3 LOT 1 S�E4 u N/F N/F }p3 TIMOTHY J. BELL & CATHERINE GHASSEMI CESSPOOL � + COVER I x x n x1p ICIA it D ►M O O p s'R 31 1 5 ME �• --� I V) 30.3' N p 1 Lf) N r \ z t 1 gp6N 1p 1 o � 2 3" ?_ 6200? t Permit Number MECcheck Compliance Report Checked By/Date New York State Energy Conservation Construction Code MECcheck Software Version 3.3 Release lc Data filename:Untitled TITLE: Jean Arena C COUNTY: Suffolk STATE:New York HDD: 5750 CONSTRUCTION TYPE:Detached 1 or 2 Family HEATING TYPE:Non-Electric DATE: 11/26/02 DATE OF PLANS: 1-/31/02 PROJECT INFORMATION: Addition of 8 x 10 sitting room COMPLIANCE:Passes Maximum UA=21 Your Home=20 4.8%Better Than Code Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA Ceiling 1:Flat Ceiling or Scissor Truss 80 30.0 0.0 3 Wall 1: Wood Frame, 16"o.c. 150 19.0 0.0 7 Window 1: Vinyl Frame,Double Pane 30 0.340 10 COMPLIANCE S TEMENT: The proposed building represented in this document is consistent with the building plans,specificati ns, d other calculations submitted with this permit application. The proposed systems have been designed to meet the N w York State Energy Conservation Construction Code requirements. When a Registered Design Professio 1 has tamped and signed this page,they are attesting that to the best of his/her knowledge,belief, and professional j en ch plans or specifications are in compliance with this oo/d Builder/Designer Date 1 �O • 0526 ���ss►o�' MECcheck Inspection Checklist New York State Energy Conservation Construction Code MECcheck Software Version 3.3 Release lc DATE: 11/26/02 TITLE: Jean Arena Bldg. Dept. Use Ceilings: [ ] 1. Ceiling l: Flat Ceiling or Scissor Truss,R-30.0 cavity insulation Comments: Above-Grade Walls: [ ] 1. Wall 1: Wood Frame, 16"o.c.,R-19.0 cavity insulation Comments: Windows: [ ] 1. Window 1:Vinyl Frame,Double Pane,U-factor: 0.340 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? [ ] Yes [ ]No Comments: Air Leakage: [ ] Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage must be sealed. [ ] Recessed lights must be 1)Type IC rated,or 2)installed inside an appropriate air-tight assembly with a 0.5" clearance from combustible materials.If non-IC rated,the fixture must be installed with a 3"clearance from insulation. Vapor Retarder: [ ] Required on the warm-in-winter side of all non-vented framed ceilings,walls, and floors. Materials Identification: [ ] Materials and equipment must be installed in accordance with the manufacturer's installation instructions. [ J Materials and equipment must be identified so that compliance can be determined. [ ] Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. [ ] Insulation R-values and glazing U-factors must be clearly marked on the building plans or specifications. Duct Insulation: [ ] Supply ducts in unconditioned attics or outside the building must be insulated to R-8. [ ] Return ducts in unconditioned attics or outside the building must be insulated to R4. [ ] Supply ducts in unconditioned spaces must be insulated to R-8. [ ] Return ducts in unconditioned spaces(except basements)must be insulated to R-2. Insulation is not required on return ducts in basements. Duct Construction: [ ] I All joints,seams, and connections must be securely fastened with welds,gaskets,mastics (adhesives),mastic-plus-embedded-fabric,or tapes. Duct tape is not permitted. Exception: Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in.w.g. (500 Pa). [ ] Ducts shall be supported every 10 feet or in accordance with the manufacturer's instructions. [ ] Cooling ducts with exterior insulation must be covered with a vapor retarder. [ ] Air filters are required in the return air system. [ ] The HVAC system must provide a means for balancing air and water systems. Temperature Controls: [ ] Each dwelling unit has at lesat one thermostat capable of automatically adjusting the space temperature set point of the largest zone. Electric Systems: [ ] Separate electric meters are required for each dwelling unit. Fireplaces: [ ] Fireplaces must be installed with tight fitting non-combustible fireplace doors. [ ] Fireplaces must be provided with a source of combustion air,as required by the Fireplace construction provisions of the Building Code of New York State,the Residential Code of New York State or the New York City Building Code,as applicable. Service Water Heating: [ ] Water heaters with vertical pipe risers must have a heat trap on both the inlet and outlet unless the water heater has an integral heat trap or is part of a circulating system. [ ] Insulate circulating hot water pipes to the levels in Table 1. Circulating Hot Water Systems: [ ] Insulate circulating hot water pipes to the levels in Table 1. Swimming Pools: [ ] All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. Heating and Cooling Piping Insulation: [ ] HVAC piping conveying fluids above 105 OF or chilled fluids below 55 OF must be insulated to the levels in Table 2. 1 � s Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes. Insulation Thickness in Inches by Pipe Sizes Heated Water Non-Circulating Runouts Circulating Mains and Runouts Temperature(F) Up to 1„ Up to 1.25" 1.5"to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes. Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Ran e F 2"Runouts 1" and Less 1.25"to 2" 2.5"to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant, 40-55 0.5 0.5 0.75 1.0 and Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD(Building Department Use Only) PROFESSIONAL ENGINEER 1725 HOBART ROAD/PO Box 616, SOUTHOLD, NEW YORK 11971 TEL 631-765-2954 • FAX 631614-3516 • e-mail: joseph@fischetli.com Date: July 7, 2004 Reference: Arena Southold Building Department Main Road Southold,NY 11971 Dear Sir, The chimney flue for the Arena residence at 6895 Main Road, East Marion is adequate for use as an oil fired boiler flue in accordance wit NY State Building Code Section 1-7.1 pf NEWY fr%SCly�r'0,9� tio. o62a�° Joseph is 1, P.E. PROFESSIONAL ENGINEER 1725 HOBART ROAD 1 PO Box 616, SOUTHOLD, NEW YORK 11971 TEL 631.765-2954 • FAX 634614.3516 • e-mail: joseph®fbchetti-com Date: March 24, 2004 Reference; 6895 Main Road /Arena Southold Building Department Main Road Southold, NY l l 971 Dear Sir, I inspected the sanitary system for Mr. Arena on 6895 Main.Road in East Marion. The sanitary system consists of a 1000 gallon septic tank and 2 eight foot diameter leaching pools eight feet deep. This type of system is designed for a four(4) bedroom home. The addition of the pool house with one lavatory will not add to the flow.requirements for this system. The system is functioning and is adequate C ed use. P F�acN�lroq� R LU 2 ES31 Joseph Fischetti, P.F. C: Arena At"-WORMAJon of IVAUn doc BUILDING PERMIT EXAMINER CHECK LIST DATE REVIEWED: (114/02 APPLICANT: DATE SUBMITTED:T/ /02 SCTM#DISTRICT: 1,000, SECTION: 1 , BLOCK: I , LOT: STREET ADDRESS: � � CITY: �, � �-, SUBDIVISION: PROJECT DESCRIPTION: p�sj��j ESTIMATED PROJECT COST. ARCHITECT INE -, �, FAST TRACK /�1y SINGLE & SEPARATE CERTIFI ATION-REQUIRED (o 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 after 7/1/83: ZONING DISTRICT: ;?- Ko CONFORMING? //y REQ. LOT SIZE:ct�ACT. LOT SIZE REQ. LOT COV. p902 ACT. LOT COV. REQ. FRONT PROP. FRONT ✓ REQ SIDE / ACT. SIDE REQ. REAR--_,�J PROP. REAR REQ. HEIGHT PROP. HEIGHT WATER FRONT? /D DESCRIPTION: PANEL #: FLOOD ZONE: , COMPLIANCE: APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DST: YES orT�, (BED#): DTE:—/—/_ PERMIT#:R10- TOWN SEPTIC RECEIPT: Y o NEW YORK STATE DEC: PRE-DEC 9/1/75 YES or O SOUTHOLD TOWN TRUSTEES: YES or TOWN ZONING BOARD APPROVAL: YES o TOWN PLAN. BOARD APPROVAL: o TOWN HISTORICAL PRE (SPLIA): or NO NYS ENERGY: YES OR NO : EGRESS (18 H min.? 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: FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR:13?P _SF SECOND FLOOR: P SF OTHER: SF INIT OTHER TOTAL TOTAL: _ SF FEE FEE FEE 1. � ASF)- SF)= 1�� SF X$ 3d =$ A)+$ /�o +$ _$ D _ -I i d 2. ( SF)- SF)= SFX$ =$ +$ +$ =$ /"zo 7 1302 I/,n✓� ►�,,�o �V suILu�N 2Et) INSPECTION FOU ATION 1ST [ ] ROUGH PLBG, [ ] NDATION 2ND " [ ] INSULATION [ F ING [ ] FINAL [ (REPLACE & CHIMNEY REMARKS: C Q�t�. —��r� .to e»..,��.e,-✓, 9`� D G IN8PECT0 suauiNo DE". INSPECTIO [ ] FOUN TION iST [ ROUGH PLBG. [ ] F NDATI� 2ND [ ] INSULATION [ FRAMING � c [ 1 FINAL [ ] FIREPLACE 8 CHIMNEY R ARKS: 91 vc�A, � J i DATE / 0� IN8PECT0 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSULATION ] FRAMING [ ] FINAL [ ] FIREPLACE CHIMNEY �- REMARKS: �^ z L-4z DATE � �� INSPECTOR W BUILDING DE". INSPECTION FOUNDATION IST RO FOU TIONINSULATION RAMING FINAL FIREPLA CHIMNEY Z&-a� DATE INS ECTO �, �i PIP : , BUILDING DE". INSPECTION FOUNDATION IST • PLBG. FOUNDATION 2ND INSULATION FRAMING FINAL `� ✓� / / i DATE INSPECTO j! �./ 7es•isos BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS TION [ ] FRAMING FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION RP-MARKS! Ad Al&�� TE / � INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ) FOUNDATION 2ND [ ] IN ATION [ ] FRAMING [ FINAL [ ] FIREPLACE A CHIMNEY [ ) FIRE SAFETY INSPECTION REMARKS: o� r3) r DATE INSPECTO ag 98.s2;:- X65.,802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 SOLATION [ ] FRAMING [ FINAL����) [ ] FIREPLACE & CHIMNEY [ ) FIRE SAFETY INSPECTION REMARKS: DATE d&4 � INSPECTOR��� FOUNDATION PLUMBING INSULATION PER N.Y. STATE ENERGY CODE ,s ����//yam � L..•. 2,i �� �i���!-�� ,-' I � --- ADDMONAL COAWENTS A • 1 ,IC 1i G , a - TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CtECYIIST BUILDING DEPARTMENT TOWN HALL, Do you have or need the following,before applying? SOUTHOLD,NY 11971 Board of Health TEL: (631) 765-1802 3 sets of Building Plans FAX: (631) 765-9502 Planning Board approval www.northfork.net/Southold/ PERMIT NO. 26993F:�--, Survey Check Septic Form N.Y.S.D.E.C. Examined 20 1j Trustees Contact: Approved v G20 ' Mail to: Disapproved a/c Expiration Phone: ,20 �----- -- _ _ ildi spe APPLICATION FOR BUILDING PERMIT _- V 14 Date OV 14 20 orL 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 Ins issues a Certificate of Occupancy. pector 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,i a corporation) (Mailing address of applicant) IV, State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder 14Gi palu r Name of owner of premises u/P—,4 /V A RF NA (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: House Number Street Hamlet County Tax Map No. 1000 Section 3 / Block Lot Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy 1,-)EA17-114 L b. Intended use and occupancy IQ 3. Nature of work(check which applicable):New Building Addition Alteration Repair Z Removal Demolition Other Work (Description) 4. Estimated Cost ��, 000 . Fee (To be paid on filing this application) 5. If dwelling,number of dwelling units 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 �v Depth Height ';�3 Number of Stories 2 i Dimensions of same structure with alterations or additions: Front Rear Depth 53 .F5 Height ;�)8 Number of Stories 2 8. Dimensions of entire new construction: Front Rear 4 Depth �© Height -M 33' Number of Stories 1 9. Size of lot: Front 1017 Rear ! Depth ' 10. Date of Purchase Name of Former Owner 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 X Will excess fill be removed from premises? YES NO >c Alllv'rlivn 14.Names of Owner of premises i EM A-OeYA Address �3 3 C61 67 Phone No./2./,2- Name o✓L,2- Name of Architect .Jojr-p/, ' Address k, J77/0e—iD Phone Nom 6 _ Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO.)( * 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 OF /?/G f,/k,"1�2/] / 4 �'A ll being duly sworn, deposes and says that(the is the applicant (Name of individual signing contract)above named, (S)He is the �L1�//T (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 day of 20 Notary Public Signature of Applicafit EDEN S.SANTORA NOTARY PUlUC bt=New Ypk CesAaisriox Qusllfkd Ie Expires r- w or N4O7 .' GoMvu� u>iYt all Ng-86 9 YC7uw 01970AA- CEnT1�rc�i�c�� rss y 8e PROVIDE SMOKE-DETECTING UNDER,J^•TrRSCERTIFICATE REQUmo ,�✓r � . r , �_, � ;- L[C( E ALARM DEVICES , � IZU AS TO ART. 721.1 14 r,L,.- crh .rc''? � sF� - - - - - -- - N.Y.S UILDINGCODE. APP DAS NOTED p. D NDSv��C6Dl4�lf#M / 21dB ''�I P W . • , ;g. �� 1 L.IEL.I" - r - FRAMIp�!!±±�� T Y BUILDING DEP EN AT CHlh�ue-r' )' \ •- G�wIIN•j . IJllR�B7f. 7 2 Y AM TO 4 PM FOR THE - ' OF FOUNDATION CATION FOL WING INSPECTIONS: HAS BEEN APPROVED. t FOUNDATION • TWO REQUIRE13 9 _ FORPOUREDCONCRETE Is eki. u�l,� i iLG'Ie�' _ 8 ROUGH • FRAMING 6 PLUMBING A 2 �` 2 l / S INSULFINAL TION { 7 N h \ OCCSU NLA DR FUL BE COMPLETE FOR C.O. ION MUST T CERTIFICATE FI ATE ALL CONSTRUCTION SHALL MEET VUANCY THE REOUIREMENTS OF THE N.Y. T CONSTRUCTION A ENERGY ------ STATE C N CODES. NOT RESPONSIBLE FOR �� — ,! /-- -� - _� // -- -----1 DESIGN OR CONSTRUCTION ERRORS -- tJ ]RIE R FORRGENC S PLUMBING -BY Pk . A WATER LINES OF ALL PLUMBING TIT NEED N.Y. STATEBULLDINCODE, TESTING BEFORE COVERING - ROVIDE ANTI-SCALD AND/OR LI PENTINGTHERMAL5HOCKPREV 2Y' I=, ro- DEVICES AS TO PART. 902.6(K)��r f N.Y. STATE BUILDING CODE. �4 PLUMBER CERTIFICATION ON LEAD CONTENT BEFORE 7 - CERTIFICATE OF OCCUPANCY °I SOLDER USED IN WATER SUPPLY SYSTEM o CANNOT I I EXCEED 2/10 of 1 /o LEAD. �- f---- gis Er dis" used j --for�lit8 iC-via:oY,�,yo;g; g 1 t—� •-�_ _ -- . sy rn;�a; PfP!Pg shaN b- , 4' Ir or L _ L I v (2 r'I ! � I _.-- l,.- —------- - "- " - I L--- ---- --_~ ._�_ UNBcR CERTIFICATE REQUIRED � I I -- __ - - �i Z „ e— � ,Jrk+.TNr?�'='I-i ' F-'-TJ F{IGI� i�iK'GcC�r-ll�l-�GY= AJC+tl-.c Ilc^y�-- � I�JAtJ_ [ f „�rery rwFca j ��i N��„ G'' (`nLU H'V�- LI 1�F'iC'Ff'c'c1n�.,s.t"�' tom:Cs•++ . - - i.:"� - I f � ' 1� _ U! � rIrGV — .-"H •-Pu_— u _ T S P-IOW" ;q�.w ;p�.11C 'I� �II'E F'LAC.E Of.l ra 41Tj",' FL.-X- q G�. '-7:�rJPR;= }=PaIN1r,r I'.."2G'L?�-I I� °UF_W"µ�- 'L2 X�IrJ� ✓IC;LT`?� 1 u ATI i (� OF NEIy ro 03 t * O A SCALE! ipAPPROVED BYDRAWN EYt7trwfm v W HOU F, , I='. tV T�r 1rV(a •�M�I�F�.Iu slo�+t` 2fJDhiGRf ACXJITIcI . pm > . 22 ugvl �'ILO oIJ7 2RAKr NA Iu DRI1w,NG NUMBER/ ;r� I 11 _ 41.1E W -- -- --------- �Ipu j i T,,-� 1 � - I � 2, � 2 Hawn %r'`". \ Sulo rzlru;I� 01 I � ^��"• - ---- � � I 2z8 �F- ',r; a � � I � Fx�"u "/' 2.X�";,��� �Yf�>� Ila°c.�.. 1- 6' < 1,•C— _-9'• F✓ I 17 � f� , - ---- ---- p- \\moa' I '`:..: �;..C.xz..i, _' ,_..:_2 XI > IC�IIpp _ .' xu°> i _�i IL.I I..�i✓1 V rLln -- I �^ j I G '%:y�r10 _.,>ilu L-IU Jc1``='(•_ /' - - I i V it .. IE�T'c.P �;' � t' ILI:VLC+ IOIJ Y2- �i'OII-��7c a.G'r It^I� uv , I —_� �irir PT-1 — fl i � \,,�, ! wry 2x tc' ria.-,^f: ._k^q��r�a�•�ls•Ic�; j LO � i � 1 �I.1�4J (2. 301nJ2�iG�lU• �`' i ' � � i �IyrU L,�'•"l�Ji --------- ' , I I loll ZS52 i I I 22 '. of. NE OSCly cl l A2tsfJA L �9� D ` . !...IA R'1 f NT SCALE. V4L IlesI APPROVED 9Y' ' OXAWN EY�"„y.�.lY.�r DATE, S - G4L.0 ��V"s IlO^ -052 _ FE3510 ' DRAWING NUMBERI A(Y i I •r cr I"1[-`•hy - `-a. `! IEGI,'I I.IU ?1 JI�� S 163 p 4x4� ecr. �-raw.-- � ' �. �' • U�d' l�L� Px"'�T' � F IbMCCL F� i. L2'u9 'f')( � 4 LA l _�_.__. _._.._ .__ ._✓OGLE %4'� !1C'' � s/G,c�l.-I= ���GI--I t4c,v H FLCCOP P.L&N l�pF NE k J E1 h f+Ru N A y.�P Fiscit, �0,. [0!L'CA .7D MAI},j 12Tj ', HARI DN N•Y. SCALE 1/4"- I'D,, APPROVED BY GR/.WN aYr�YNI� x w DATE 10. 1 . 02 `O N0. 0526NO 1 - FESBIO�'u� i DRAWING NUMRERWz �O ✓ 1cc V,, �,'U ` MAY f � �t r- � u 2 2nm �IJJ vi q,r4' („4� _ GEl rrar - - - - - ` i i I } f - : — pr - O�PTO Dy _ - � ,-I � , I I�_a J. \ _ — Q I T II I I I ' 1 I 1 I i, r I Jeffs H r Ic r eY�?r rk� iGtF _ deft r: !�.�d� R'' �iC !F.I�Jc��t .! i ♦J 6 Iu �1'ap"�'r,'LG.F'4^1�L.1... 12-el Px iTpv5l-Q 1R^XX-t-� CI �i br 4."f.•afi l.J " 1-I •` r `.."m.. 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"1/��., r� �{✓�\ k ' �� fn, f t-I<._.:�,rlvl�,l - I E I+JS siv . s __ � � � � u � i _ �� �'Ct✓ j rLK p;- t'"!1',"'� �'q°'"-'j""a�'�;d'c;G, --____ � � �'� ` I -' __. ---_—_ ,. �_����Sc7f-.+("iJ 2uCC;�F.��;, ICCI_G�'�,`(�C''<i':'•a,:• ra _, , I "d I � I rel�•T �, { , I �,J�r2 2852 2852 _k.-._._....._, __.. 22 '_ 5" - lr I „ . PERM HAce ErW .L.I�:' Gl 2 SIIt I "Xq /0 wL Inl kli�lu OF Nts EIyY tSCALE' II/Q , e�" APPA V90 EY II ' ORAWNBYE,rfVC�� u' L.rral�' V4' I.IDx 2 CATE: I• f'4•tJ�a ~�• 0525�� ?� FESsilo ONAWINO NUMBER,.1(1 2 �•�� YL I � G F I pctST'rn 2XIil P,J • �4p _ � u��w crucF" uueerz � 2- 2,k;0 pr ( "x � " cit aI NAS"'� • x I ff I _l�Ili I � I OF NE K r Jtsui /s V4A r7 Fps r�9 IDQA a HJ811.1, RD £ . MAZIW4 QY CC sols: y^�e t,•b ri APPdbM¢O tlV: ONAWN dY tr. W QAre4.=23. 4 3 � � � �'�, . 'yO.�o626+O �?o �^.{��.Jt✓A"E"t�Jl.f� FAN �ossto�� - - MMAWINQ NUMMA .,