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Home My WebLink About33377-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33603 Date: 03/19/09 THIS u~KTIFIES that the building ALTERATION/ADDITION Location of Property: 7125 GREAT PECONIC BAY BLVD L~UREL (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 126 Block 10 Lot 13 Filed Map No. Lot No. Su]~livision (HAMLET) conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 11, 2007 pursuant to wb/c/1 Building Permit No. 33377-Z dated SEPTEMBER 11, 2007 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 ADDITION AND ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JAMES F DRUCK III & WF (OWNER) of the aforesaid building. SUFFOLK COD1TTYDBPARTMENT OF HEALTH APPROVAL N/A ~-i-KICAL CERTIFICATHNO. 8652 05/02/08 PLD~EBS C~KTIFIC2~TI~H~ DA-i-~ 02/20/09 GARY BUFKINS Rev. 1/81 ,, FEB 9 2O09 BLDG. I~PI. APB tOWN OF SOUTHO~9 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ,ICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: 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 I% lead. 5. Commercial building, industrial building, multiple residences and similar bnildings and installations, a certificate of Code Compliance from amhitect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildiugs 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 sigmed by the applicant. If a Certificate of Occupancy is denied, the Bnilding Inspector shall state the reasons therefor in writing to the applicant. Fees I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swi~mning 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 Constraction: Old or Pre-existing Building: Locationoferoperty: ::~-IP-~ Pe~c,~ c~ ~'<7 /~"~g House No. St{eet Owner or Owners oferoperty:"~ctw'-e4 ~¥~d~v't eM<.. ~m~-C~[ Suffolk County Tax Map No 1000, Section [O- ~, Block (check one) Hamlet e>oto Lot 013 Subdivision h .... ~ 0 Permit Health Dept. Approval: Date of Permit.c>q/]///0~ Filed Map. Applicant: Lot: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Final Certificate: (checkone) Applicant Signature Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York t1971-0959 Fax (631) 765.9502 TelephOne (631) 765-1802 BUILDING DEPARTMENT TOWN O1* SOUTHOLD CERTIFICATION Date: Buildi!ag Permit No. -~3.~ 777 Plumber: (Please print) (Please print) lead, I cmlify that the solder used in the water supply system coutains less than 2/10 of 1% Sworn to before me this Notary PATRICIA RICHERT Notar/Public, State of New York No. 30-4741154 Oucllfied. .in Nassau / Suffo~ _Countim~ Comm~ss on Expires County Feb 25 09 11:12a SBEI inc. 631 345 0457 p.1 BUREAUo~ 40 Nottingham Drive, Middle Island, NY 11953 Telephone: 631 495 8136 · Fax: 631 980 6455 - E-Mail: SBEIGS~m=il.com CERTIFICATE OF ELECTRICAL COMPLIANCE Applicant: Rough In [nspection Date: Application No.: .1 Frederick Druck May 2,2008 8652 Certificate No.: 8652 Final :[nspecUon Date: May 2,2008 Building Permit No.: 33377 Suffolk County Tax Map No.: This Certificate of Electrical Compliance is limited to the inspection and compliance of electrical equipment and/or work described below, installed by the applicant named above, located at the premise of and not after the final inspection date above: Owner: J Frederick Druck Site Location: 7125 Peconic Bay Blvd., Laurelr NY 11948 Owner's Address (if different): [] Residential [] Indoor [] Basement [] Service L] Shed [] CommercJal [] Outdoor [] First Floo~ [] Pool [] Hettub [] New [] Renovation [] Second Floor [] Attic [] Garage [] Addition [] Survey Olher: INVENTORY The electrical work and/or equipment described above were inspected and appear to be in compliance with local, state and naUonal electrical code requirements and this office. ApplicanL J Frederick Druck Inspected By: GeneSurdi Signature: J/~' License No.: Homeowner Date Of Cerlif~cate: Feb 25,2009 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. 33377 Z Date SEPTEMBER 11, 2007 Permission is hereby granted to: JAMES F III & WF DRUCK 7125 PECONIC BAY BLVqD. LAUREL,NY 11948 for : CONSTRUCT AND ALTER AN ADDITION TO AN EXISTING ONE FAMILY DWELLING AS PER ZBA/ # 3210.THIS PERMIT REPLACES BP # 15104 at premises located at 7125 GREAT PECONIC BAY BLVD LAUREL County Tax Map No. 473889 Section 126 Block 0010 Lot No. 013 pursuant to application dated SEPTEMBER 11, 2007 and approved by the Building Inspector to expire on MARCH 11, 200~9. Fees 170.60 ~~r~ ~~ ____~ed ' Rev. 5/8/02 ORIGINAL PO~ NO. · 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) 15104 Z Permission is hereby granted to: ......%. .............. ....... .... .~...~..~..~...~.....~...~ ............... ................................................ I.L.~..'L.~. .................. County Tax Map No. lO00 Section ..... )...~.J~.. ....... Block ........ /....~.. ....... Lot No....l..~, ............. pursuant to application dated ..... ...~...0/~....L~...~...~.?[ ............ , 19.~...~., and approved by the J Building Inspector. Building Insl~:tor Rev. 6/30/80 3.3.~ 7 7 7_ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSULATION [ ]FRAMING / STRAPPING ~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS:~ ,~ ~~ ~~ - ~-~, ~/ DATE "/",-~ ~'- o 8 INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING / STRAPPING FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] INSULATION ~FINAL [ ] FIRE SAFETY INSPECTION ] RRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: 765-X802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ]~OUGH PLBG. FOUNDATION ZND ~ INSULATION [ ] FRAMING [ ] FINAL ~/~ ~/5REMARKS: ~~~~ ~ ~ INSPECTOR~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] .OUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION [~FRAMING [ ]FINAL REMARKS: ~ ~ /~ 7GS-180~ BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL RE:MARKS:~~ ~ /~ DATE FOUNDATION 1st) FOUNDATION 2. 2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ To ~...,"~(-~,~.."~'.'.. ~'~/"~.~..~. · .~.".. . .~...~ ...................... .. ~~ ~.. ~:.~ .... //.~.~ PL~SE TA~E.OT~CE t~ ~o~i~a~ion Oa~ ... ~~W .... ~.~ .... ~ ~ for p~it to const~ct ~~~~ ................................ at ~cation of ~op~Ry ~:o~ ...... ~~' ~t~d '~ ....... County T~ Map No. 1000 Section ../~ ....... Block .../.~ ....... Lot .~/~ ....... Subdi~on ................. FRed Map No ................. ~t No .................. is mtum~d h~with and disapproved on the follow~g ~o~ds'~~./~. ~.~ .//~..~ '~/~.. ~~.~. ~~. ~..~..~ ~Z. ~~ ~. ~ ~ RV 1/80 FORM NO. 3 I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL PLEASE TAKE NOTICE that your application dated. ~Z./J(q~ ~ .... ./...~ .... , 19 .?..~. for permit to ~ ~9~. ~. ~~..~ ~~.. ~ .... at ~cafion of ~operty . .~.(~..~O lC. ~ ~..w .... ~~..~ .... Hou~ No. St~t Hamlet co~.~ ?= ~=. Ho. moo s=~tio~ ../~ ....... 8]o=~ ... d~. ....... ~&~4~. ........ Subdivision .... ' ............. Filed Map No ......... : ....... Lot No. is returned herewith and disapproved on the following grounds .~. ~'q/,d~.. ,~... CD.-. . ?~6 z . ?./.~. ~. . .:~. ,~ . .:~,va. . . ~. 5.o. ~. . . ,z~-z. .~ . . .~r_m~ . . . (~ . ~.Z. qq r. ~-,'(qa ~ . . ~. . . ~2-,cavT ~.~ec. . . ,,~ r,q/.~. ~ . / ~ ~ ~ ~ ~.~7~ - . ~~. Wr~. :.. ~v/~Z~q~. z~ ............... ~ . . ~. .~r~ . .~a . ~~. . . ~.q(~ ................ Southold Town Board of Appeals ACTION OF THE ZONING BOARD OF APPEALS Appeal No. 32]0 Application Dated January 24, ]984 TO: Mr. and Mrs. James F. Druck III Box 355 (Public Hearing held 3/2/84 & 4/5/84) [Appellant (s) Laurel, NY ll948 At a Meeting of the Zoning Board of Appeals held on April ]9, ]984, the above appeal was considered, and the action indicated below was taken on your [ ] Request for Variance Due to Lack of Access to Property New York Town Law, Section 280-a [ ] Request for Special Exception under the Zoning Ordinance Article , Section ~ Request for Variance to the Zoning Ordinance Article III, Section ]00-3] and Article XI, Section lO0-ll8 [ ] Request for The public hearings on this matter commenced March 2, 1984 and was recessed until April 5, 1984, at which time the hearing was then declared closed after receiving testimony, pending deliberations. Upon application of JAMES F. DRUCK III, Box 355, Laurel, NY for a Variance to the Zoning Ordinance, Article III, Section lO0-31, Article XI, Section lO0-118, to alter and construct addition to a nonconforming second dwelling exceeding 50% of fair market value and leaving insuffi- cient sideyards. Premises: 7015 Peconic Bay Boulevard, Laurel, NY; County Tax Map Parcel No. 1000-126-10-013. The board made the following findings and determination: By this appeal, applicant seeks permission to construct and alter an existing second dwellin9 by extending a two-story addition at the rear (north) end by 36' by 19' (inclusive of an existing 10~ by 13' area)leav- ing a setback from the easterly side property line of 23.7 feet, as shown on the building plan prepared by Wooden Environments, Inc. received January 24, 1984, and by survey prepared November 2, 1981 by Donack Associates. The building has been a two-story frame garage with living quarters, with approximately 614 sq. ftl of livable floor area. The total area of the one-family, two-story frame dwelling/garage will be approximately 2,260 sq. ft. compared to the existing total area of approximately 1,228 sq. ft. The premises in question contains an area of approximately 24,100 sq. ft. with 60.27' frontage along Peconic Bay Boulevard and 60.07' frontage along the rear property line. The premises are improved with the two-story frame garage/cottage in question which has a setback from the westerly property line of 1.69 feet and a one-story frame dwelling set back approximately 47 feet from the front property line presently used as a one-family dwelling. For the record, it is noted that an affidavit of Albert S. DeClue, sworn to on the 9th day of March, 1984, has been submitted attesting that the residence building in question has been occupied as a one-family dwelling for over 30 years. In considering this appeal, the board determines: (a) that the relief requested is not substantial; (b) that by the granting of the requested relief, a precedent has not been set and therefore will not adversely affect the character of the neighborhood; (c) (CONTINUED ON PAGE TWO) DATED: May 24, 1984. Form ZB4 (rev. 12/81) CHAIRMAN, SOUTHOLD TOWN ZONING BOARD OF APPEALS Page 2 - Appeal No. 3210 Matter of JAMES F. DRUCK III Decision Rendered April 19, 1984 that by allowing the variance, no substantial detriment to adjoining properties would be created; (d) that no adverse effects will be produced on available governmental facilities of any increased population; (e) that the relief requested will be in harmony with and promote the general purposes of zoning; and (f) that the interests of justice will be served by allowing the variance, as indicated below. Accordingly, on motion by Mr. Goehringer, seconded by Mr. Douglass, it was RESOLVED, that Appeal No. 3210, application of JAMES F. DRUCK III for permission to alter and construct addition to existing building, BE AND HEREBY IS APPROVED SUBJECT TO THE FOLLOWING CONDITION: That the addition be'no closer than four feet to the west side line. Location of Property: 7015 Peconic Bay Boulevard, Laurel, NY; County Tax Map Parcel No. 1000-126-10-013. Vote of the Board: Ayes:' Messrs. Goehringer, Doyen, Grigonis, Douglass and Sawi:cki. This resolution was unanimously~adopted. JGERARD P. G~OE~RINGE~, CHAIRMAN May 24, 1984 J/ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved . .~.. l .~.., 19 g..~. ,..? X3 ¢'~ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... 19... 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 diagram 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 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 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 regulation_s, and to admit authorized inspectors on premises and in building for necessary, inspections. ,,~/..¢,~.. ~..~..~..~ .m~... ................... ~/ (Signature of applicant, or name, if a corporation) ..... .~..~...~...~7.....~..~,..~ ~..~.~ ~ .¢~. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... ~.~q .~.~R .................................................................................. Name of owner of premises... ~J~C/~...]~-......~../~...B~......~....~.. ~ .......................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) , setrr Builder s License No .......................... Plumber's License No. .5£ i'~ Electrician's License No .... . ."~..'..~.....~.. ~)/.~. ! .~ Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. . . . ~¢. ~ .................... ~¢. . ~x. . ~/. ~ ............. . .~. ~,.,,.~l .................. House Number Street Hamlet County Tax Map No. 1000 Section · · .~.~...~.; .V. ~,ock ....... /..C). ....... Lot .... .'/..~ ............ Subdivision ...... i .............................. Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: · . -' 7~' a. Ex,st,rig use and occupancy...~..'' '~' '¢'7''' '~''' '~J~''''...elf~...~%.~.t~...A./?..~..C¢../o..a~.~'../.¢./7..~.. ~..~0.~. ~,,./'~.~ b. Intended use and occupancy 3. Nature of work (check which applicable): New Buildio$ .......... Addition .......... Alteration .......... Repair ...... ~.. Removal ....... ..t-rf77~..... D~91ition ........ Other Work ............... ,~. (0/. "~ (Description) 4. Estimated Cost ~ ............... Fee ...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ../.... bet 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 ..... ~?,,~t.".O.~... Rear ...~.~..1~..~ .... Depth . .,~..~.'~.. ? ..... Height ..... [.~..~ .......Number of Stories ....~..1'~.0 ................ ~ ................. ~t~ ........... Dimensions of same structure with alterations or additions: Front ...... ~ ........ Rear ...~. ............. Depth .... .~./ ................ Height ........ [~.). ........... Number of Stories ...... .~'../~/? ........... 8. Dimensions of er/tire new construction: Front ...... ~'~.' ..... Rear ...... ?.~ ..... Depth . ./.~.t. ......... Height .... ./?.~ ........~lumber of Stories .... . .'7~...O1 .............................................. '9. Sizeoflot: Front ....... ~'.0'.~.'~. ' ... Rear ...... (~.°.:.O.?t ......... Depth_..,~..O./..~ ............ 0q 10. Date of Purchase ..... /~. ........ I..~../. .......... Name of Former Owner ..... ~./.t4.~- ................ 11. Zone or use district in which premises are situated... [~-~...t...L~...'~...~.. .................................. i2. Does proposed construction violate any zoning Dw ordinance or regulation: . .~. ~'-.~. ....... 13. Will lot be regraded .... .~. ....... ': ............. Will excess fill be remov, ed from premises: ~ es 1~ 14. Name of Owner of premises ..~. g .L[~,..~...~ .F..,]..~ddress .~.~....g2~'...IS..~.r.~.~.$.~... Phone No..,-?.q:~. ~5'.-.~'.~../~.. Name of Architect .~.~ .$..Cq, ......... i ;... Address . ~r.r.~.~...M...P..e~c.,;q~..~ .l~Phone No ................ Name of Contractor .......................... Address ................... Phone No ................ 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. STATE OF NEW Y(3~,_K,.~/( ~ o o C O_[.kNT Y OF c~-t,...)~ ~.a /~,A.__.__,~ '~~'.~..~. · ~. · --~ .... being duly sworn, deposes ~d says that he is the applicant (Name of individual signing contract) above named. (Contractor, agent, corporate officer, etc.) of said owner or owne~, =d is duly authorized to perform or have perfo~ed the said work and to m~e and file this application; that all statements contained M this application are true to the best of his ~owledge and belief; and that the work will be perfo~ed in the m~ner set forth in the application file~ewith. __ Sworn to ~efore me t~ ....... ........... / ..... [ ...................... f'~~' ' / ~ (Signature ofapplica;; Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: $.C.T.M. #: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM-WATER, GRADING, DRAINAGE AND EROSIOR CONTROL PlAN CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK, Item Number: 2 3 4 5 6 7 8 9 (NOTE: A Check Mark (~) for each Question is Required for a Complete Application) Yes Will this Project Retain All Storm-Water Run-Off Generated by a Two (2") Inch Rainfall on Site? v/' (This item will include all run-off created by site clearing and/or construction activities as well as all Site -- Improvements and the permanent creation of impervious surfaces.) Does the Site Pian and/ar Survey Show All Proposed Drainage Structures Indicating Size & Location? This Item shall include all Proposed Grade Changes and Slopes Controlling Surface WaterFIow! Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel? Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (5,000) Square Feet of Ground Surface? Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction or within One Hundred (100') feet of a Wetland or Beach? Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen (15) feet of Verfical Rise to One Hundred (100') of Horizontal Distance? Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Storm-Water Run-Off into and/or in the direction of a Town right-of-way? Will this Project Require the Placement of Material, Removal of Vegetation and/or the Construction of any Item Within the Town Right-of-Way or Road Shoulder Area? (This item will NOT include the Installation of Driveway Aprons.) Will this Project Require Site Preparation within the One Hundred (100) Year Floodplain of any Watercourse? No NOTE: If Any Answer to Questions One through Nine is Answered with a Check Mark in the Box. a Storm-Water, Grading, Drainage & Erosion Control Plan is Required and Must be Submitted for Review Prior to Issuance of Any Building Permit! EXEMPTION: Does this project meet the minimum standards for classification as an Agricultural Project? Note: If You Answered Yes to this Question, a Storm-Water. Grading, Drainage & Erosion Control Plan is NOT Requiredt Yes No STATE OF NEW YORK ..... couNw ........... That I ................................................................................. being duly sworn, deposes ,'md says that he/she is d~e applicant for Pernfit, Name of ind[vid ual signin9 Document) CONNIE D, BUNCH Notepj Public. State of New for~ A~d flrat he/she is the ................................................................................................................... ,~...~0..~1~U6185050 .................. Owner an~or representative of dae Omler of O~er s, and is duly au~orized to perform or have performed ~e smd wCr~d to make ~md file fl~is application; that fll statelnen[s contained in ~is application are true to die best of his ~owledge and belief; · at fl~e work mil be performed in tim manner set forfla in fl~e application filed heremfl~. Sworn to before me dais; .......... ...................... ....... / I Iiiiii i DINNING ROD M LIVING ROOM, uTILiTY. Rr:o01~ ~ ' _KITCHEN J JOB NAME & DRAWN BY ~ DATE ~4 J BATH ROOM] BATHROOM iBE. DROOM~ IB£D.ooMi, 19' TITLE JOB NAME & NO ~ ment~*=,I1"~ DRAWN ~Y DATE PLUMBER CERTIFICATION ON LEAD CONTENT ;EFORE CERTIFICATE OF OCCUPANCY SOLDER USED IN WATER SUPPLY SYSTEM CANNOT EXCEED 2/fO of f% L~AD. If copper tubing, is uaed tor water dlstnbut nO - system; piping shall bo of types ~ APPROVED AS NOTED ,~ V. _, ~{~'IFY BUILDING DEPARTMENT AT -~65-1802 9 AM TO 4 PM FOR THE F-OLLOWING iNSPECTIONS: 1 FOUNDATION TWO REQUIRED POR POU~ED CONCRETE ~ ROUGH ;f~AMING & pLUM~tNG 3 INS JLATlOi'~ 4, FINAL. L:DN-C=TRUCTION MUST I B?. COM~_E~'E FOR CO, ALi. ~ONST~uCTtON SHALL MEET ( r THE REQUIP, eMENTS OF THE N.Y ST.~TE cGNSTRUCT~ON 8; ENER~t~ CODES NOT RESPONSIBLE FOR rtESIGN OR CONSTRUCTION ERRORS, ! / ',% P r~ r ~ i r