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HomeMy WebLinkAbout22271-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23389 Date DECEMBER 5, 1994 THIS CERTIFIES that the building NEW DWELLING Location of Property 1600 MILL ROAD MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 107 Block 1 Lot 2.5 Subdivision Filed Map No. Lot No.. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 1, 1994 pursuant to which Building Permit No. 22271-Z dated AUGUST 19, 1994 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 ONE FAMILY DWELLING WITH ATTACHED GARAGE AS APPLIED FOR. The certificate is issued to GARY & DAISI PETERS (owners) of the aforesaid building. SUFFOLK ,COUNTY DEPARTMENT OF HEALTH APPROVAL R10-94-0049-DEC. 2, 1994 UNDERWRITERS CERTIFICATE NO. N-333175, - NOVEMBER 10, 1994 PLUMBERS CERTIFICATION DATED SEPT. 20, 1994 - ROBERT BERTORELLO uil ing Inspector 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) Date ......August...19.'................................... 19.94...... N2 22271 Z Permission is hereby granted to; Riverside Homes, Inc. a/c .LAMES H. COHILL .......................................................................................... P.O. Bog 274 .......................................................................................... Riverhead, N.Y. 11901 .......................................................................................... to ..........CONSTRUCT AONE FAMILY DWELLING WITH ATTACHED GARAGE AS APPLIED-FOR.. ................................................. ............................... .................................................................................................................................................................. NOTE: LOT (SUBDIVISION) IS SUBJECT TO C&R'S OF THE PLANNING BOARD .................................................................................................................................................................. ..........................................................................................................................................................I....... D. at premises located at........1600 KILL ............MATTITUCI�,..NE61 YORR................................................. .............................................................................................................................................................. County Tax Map No. 1000 Section ........,,107.......... Block...........1.............. Lot No. .....2..5..............., pursuant to application dated .........AUGUST 1, 19 94 and approved by the Building Inspector. Fee $.. .. r. . ' .. ...... ................... Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 — 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted the Building Inspec- tor with the following;for new buildings 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 of Health Dept. of water supply and sewerage disposal—(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pm. perty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $25 . 00 -- BUSINESS $50 . 00 2. Certificate of occupancy on pre-existing dwelling $ 50 . 00 3. Copy of certificate of occupancy $ 5 . 0 0 , over 5 years $ 10 .00 4 .Vacant Land C.O. $ 20 . 00 5.Updated C.O. $ 50 . 00 Date . . . . . . . . . . . . . . . . . . . . . . . . . . NewConstruction , , , , Old or Pre-existing Building . . . . . . . . . . . .. Vacant Land . . . . .. . . . . . . . Location of Property . � . . . . . . .! �� : . �. . . . . . . . . .0,47 House No. Street Hamlet Owner or Owners of Property . . . �! . . ./.41. . ��. F�.S. . . U! S. .'".:���,. . . . . . . . . County Tax Map No. 1000 Section . . . . . . . . . . Block . . . . . . . . . . . . . . Lot . . . . . . . . . . . Subdivision O. -74 1.7kG-K . Filed Map No. O .Lot No. . . . ... . . . . l 1ie� Permit No.?:?.���?: Date of Permit �����y. .Applicant �1 �L�?z�.��. �'�•���5 . . . . . . Health Dept. Approval . . . . . . . .Labor Dept. Approval . . . . . . . . . . . . . . . . . . . . ... . . . Underwriters Approval . . . . . . . . . . . . . . . . . . . . . .Planning Board Approval . . . . . . . . . . . . . . . . . . . . . . Request for Temporary Certificate . . . . . . . . . . . . . . . . . . . . .Final Certificate . . . . . . . . . . . . . . . nV Fee Submitted $ . �� . . . . . . . . . . . . . . . . . . . . . Construction on above described building and per ets all applicab a codes and regjations. Applicant . . . . , . . Rev.10-10.78 &3 RIVERSIDE HOMES, INC. o 9,33Ff �, o��S�FFO(��oG y� Town Hall,53095 Main Road y x Fax(516)765-1823 P. 0. Box 1179 W- Telephone(516)765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD November 30, 1994 Riverside Homes, Inc. P.O. Box 274 1159 W. Main Street Riverhead, NY 11901 Re: James Cohill Prem: 1600 Mill Road, Mattituck NY To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons : xx An application for Certificate of Occupancy is not on file. (Enclosed) xx No Underwriters Certificate on file. xx The check is not on file. $25.00 xx No Health Department Approval on file. No final inspection has been made. xx No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 22271-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. JOB NO. 1188 Date q �9 y Building Department Town of Southold Town Hall Southold, New York 11971 Re: Building Permit No.: 22271 z Owner: Peters (was Cohill) Gentlemen: I hereby certify that the solder used in the water supply system for the captioned job contains less than 2110 of 1% lead. Very truly yours, BERTSAND PLUMBING AND HEATING By Sworn to before me this 070'``' day of S��tr_�,��-s-, 1999. 2h Notary Public EILEEN M.ROACHE Notary Public,State of New York No.4826942 Qualified in Suffolk County Commission Expires January 31,19.1& THE NEW YORK BOARD OF FIRE UNDERWRITERS PACE 1 ®3501E fBUREAU OF ELECTRICITY F 85 JOHN STREET, NEW YORK, NEW-YORK 10038 Date- NOVEI,MER 10"' 1994 application No.on file 85948094/54 N 333175 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number,in the premises of I(000 PETERS, S/W/C/ MILL ROAD & GRAND AVENUE, JOB-1188, MATTITUCK, N.Y. in the following location; ® Basement ® lst Fl. ❑ 2nd Fl. GAR/OUT Section Block Lot was examined on NOVEMBER 07,1994 and found to°be in compliance with'the Nattipnal Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENT"FLUORESCENT OTHER AMT. K.W. AMT., K.W.. AMT. K.W. AMT. K.W. AMT. H.P. 10 30 14 10 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. K.W. OIL I H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS 1 P Z 2 3 —. SERVICE DISCONNECT NO.OF S E R V I _ C E AMT. AMP. TYPE METER EQUIP. 2W 10 3W 3 0 3W 30 4W NO.OF CC.COND. A.W.G. NO.OF HI-LEG A.W G. NO.OF NEUTRALS A.W.G. EQUIP. PER AY OF CC.COND. OF HIAEG OF NEUTRAL 1 100 CB 1 X 1 4 1 4 OTHER APPARATUS: MOTORS:2.-F H.P. G.F.C.I:-2 SM01ME DETECTOR:-1 PETER CHARBONNEAU LIC.#2697-E \\ 35 SHEPPARD LANE "15TTHTOWN,s NY, Z 1788 GENERAL MANAGER 11. _ Per This certificate must not be altered in any manner; return to the office-of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. 765.1802 BUILDING DEFT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. ( ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: � o DATE 765-1802 BUILDING DEPT. INSPECTION [ ] F NDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: C DATE � d'� INSPECTOR BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST L,,r ROUGH PLBG. [ j FOUNDATION 2ND [ ] INSULATION �MING [ ] FINAL REMARKS: c6) DATE �� / ! INSPECTOR suiLDiNa car. INSPECTION [ ] FOUNDATION 1ST [ ] ROU BG. [ ] FOUNDATION 2ND INSULATION [ ] FRAMI C ] FINAL REMARKS: DATE / INSPECTO � M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [o FINAL REMARKS: Lie l 6 ! DATE ;� INSPECTORS BUILDING DEFT. INSPECTION [ ] FOUNDATION 15T [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATION ( ] FRAMING 10 INAL REMARKS: DATE_� 1 �'� INSPECTOR_''` / FOUNDATION ( 1st ) FOUNDATION ( 2nd ) _ _ _ _ m 2 . rr� z o � ROUGH FRAME & -PLUMBING 3 . rn INSULATION PER N. Y. I y STATE -ENERGY CODE 4 . a y v !i 119 vc� FI41AL �s ADDITIONAL COMMENTS : 9,3 x a • y �ti. r - y 'M 516 727 3411 P01 Cerponte Offices 2596 RVAO 112 fie,New York 117ae (toleloss) ON s FM o ea!-OW M !!A N !iaiill--i�o•j •Y1�! November 19, 1994 TnWn of Southold Building Inspector itc Building Permit 022271 Beet isle�:Yif4rn BOI dens-Lot 011 ft8 To Whom It May Coaoen+, .� We have Inspected the repair to the floor Wilt located under the bathroom, In the house on the above referenced lot. We certify►"that this repair was done oorractly And in aocOrdence With the detail which we supplied to the build*r• 9W Since Y, � 'N®lf ' 1 �. 2'1i. �Iaherty BLDG.DEFT.Thomas . �,�TOWN OF SOUThIOLD��,'""'µ Executive Vice President Riverside Homes, Inc. a b% 2id" P. O. BOX 274 - 1159 West Main Street Riverhead, N. Y. 11901 Phone: 516 - 727-3395 -' ly 29, 1994 11994 1 To OF OAF gpuPl' TMOLD Building Department Main Street Southold, New York 11971 Gentlemen: Enclosed please find application for building permit, together with our check for the fee. Since lV. Cannazaro Eli Enclosures �QCIATIOq yM o Y MEMBER o o �_ Fn— f• ' `LONG BLAND 1 S� � REos its ,N� 8Nl��sIS 'S 516 727 3411 P01 TRIANGLE BUILDING PRODUCTS CORP. 25"RovrE 112•MEDFORD.NEW YORK 11763•(516)654•35W•For(516)634-9204 November 17, 1994 /0199 . , 4 1 0� '` Town of Southold utoLt, Building Inspector Re: Building Permit 22271 East Isle Cuotom Bldrs. Lot#I ISO To Whom It May Concern: We have inspected the repair to the trusses which we supplied to the abuvc refcrenced job. We certify that this repair was donc corrcctly and in accordance with the detail which we supplied to the builder. Sincerely, -�z 0- 9�f — THOMAS J. FLA,HER'TY EXECUTIVE VICE PRESIDENT 516 727 3411 PO1 Riverside Homes, Inge P, o. sox 27e - 1159 West Main Sheet Riverhead, N. Y. 11901 - Phone: 516 - 727-3395 ,.- ortober 13, 1994 Southold Building Department =-- ATM: JOHN BOU>rIS OCT 131994 Re: Permit No. 22271 Attached please find information explaining the areas of the truss cut that you questioned. The truss is manufactured as sham in the attached truss design. If you need anything further, let us know. Sincerely, S rao P esidpnt c Enclosure �3 �f 0 r 1011EBW� YnO6 uamu,e s 1 A. (ISLE--EAST ISLE. INC EAST ISLE) / R24 THIS 04, PREPAAEB FROM C011MEIR INPUT WMA0S S 01119610M511 SUIM11TE0 11r TRuai W6 TOP CHORD 2x4 SP 02 (A', IX4 13 HEM-FIR DA BETTER CONTINUOUS LATERAL OWING TO s N 801 CHOAD 2x4 SP Of :B2 2x4 SP 92: BE EQUALLY SPACED. ATTACH WITH (2) 8d NAILS. BRACING ;;;.c WEBS 2x4 SPF 13 S : W5 2x4 SP 12. MATERIAL 10 BE SUPPLIED AND ATTACHED AT BOTH ENDS-TO A L - �" SUITABLE SUPPORT BY ERECTI10`1 CONTAAMR. " ftn 4X6(R) T •y-y , 1.5X4 X9 • v .SX4 L• 4X5(81) (A) -a 4xox4 4 h VS 4x :f1 12-0-o 0-9-0 ' -1I-oil L 22-9-0 ' f OVER 22SUPPORTS R-16601 w-5.8 R-14510 H-5'8 PT TYP - APNE - pew 17,211 a o o Q Ca o +xIMPOATANT�w'\'"�'""K151' IelomlclA "'� WARNING""%I N:1d"1N"'CAN IC LL 30.0 PSf, B101L Mt Elivo>•na.1 la 1/{l I■ nuaLllq [KCT Nor ANY c� o a o oil 1Aua1I w I■il alual a IMw HIC1,MAIM& a al WINO, IlL 1111.1 Of IPI. B8 1196 K1511 1C OL LO.0 PSP G O O O pV14041 l0 VAW NIB 11\46 1■CWWNN"■I Ili YBIM of IN. 100/OWllMa wUTAL K■1■ILMI&"lli IN, per, C O Q CM Y'IIL GION"TWO MIL 01BI OF ZM W►Y,Bill►MUIN ALAI 6ABRAXIB,MUlk OIILWIIA{Io1L1{L{\ fur BBC QL, 5■0 p AM404 24mal 0 \o la■uapf H$rill.wfty CWLCIOi IL LAOI IMX m LIYIO W4\IN Lam"o awwo■ll11"Oslo fI� !, e '= ALPIN C= lam Me ULM BlmmlY LBCU{B a 1■IB NOVA Walla ►1 .11•OLB ftim I BIc11111w. WIIM owe fir. LL 20.0 P.7� w J'`nK,�y G CO a1•Ltlall p,■0•►1■11F I 41 L f• 6 I BIBIUI oOLMLO■IB ■1111•IYM1ILI X MU ■IF QY Ilr•• \\\ TOT,LC. 65.0 PSR C= TRUSS o �1\«i,l u�,0�.iui w►iii n 1114 ca OF 4Mioi i wl`CKt a MA awl.Iw<11:11CA1190.FUNNIM:1ow'10a 1 1IMY N aua1rrAc. i. 15 C= O L= Q Q I. V W1. 110\I.1\L NOT Y R\IIO IaIO. IN/111■TMA Yl. 011141 10 IK IM■f IKC110■CYII IrCIM. A0 .-1011 • MM A11i II6IIIu1L IIa• Itll 1•.1101.Y 011W Ul'CI1ICA1I■t lul w•11 WC.1Ml1{Iw 24.00 1 . SUFFOLK CO. HEALTH DEPT.APPROVAL H.S. NO. r OCT -5 1 994 STATEMENT OF INTENT All I—L QOAD _ � BLDG.DEPT. THE WATER SUPPLY AND SEWAGE DISPOSAL TOWN OFSOUTHOLD SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE N. :%0�06 �f!" — 1SO.0 _ SUFFOLK CO. DEPT. OF HEALTH SERVICES. APPLICANT ...._ •, . . -__ -- --_ 'I _ I _ O COUNTY DEOF HEALTH PT. FORAPPSERVICES R O VAL FOR t-- � i : .._ _:'1—_ i'/ ,'�'L^-!r' l..•r L., .�`.1-'�'�+r�. � CONSTRUCTION ONLY DATE: n _ -- r - < 4,f,0 �� coNCR v� I t SUFFOLK CO TAX MAP DESIGNATION: e`) FQ 1NUA. I q i _ /fir;?=�7 7'17-CJC; DIST. SECT BLOCK PCL. J U�Z-YF SAC LJ �D(Z Y OWNERS ADDRESS: l C DEED: L. P. • 6. _ TEST HOLE STAMP oC•a.._,.ro,.• rcCJ�"...c"::- .., ....... .. 'o'.- 1'6.J c:Jr.'t":1� �7;':IC: i�.-_,_ c'i;::�� i`'+,• '�'t I � !-. - c.. I ... • OCT.-,1994 j r, A I SEAL ---------— - - RODERICK VAN TUYL,P.C. ,�: >„�. _ , ....._-:Q J � �. `Y-�.M--tom • � LICENSED LAND SURVEYORS GREENPORT NEW YORK : , . .}. FORM NO. 1 } { TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Received. g Examined ,. ... . . .,. . . ."' . . . ., 19 �� . . . . . . . . . . , 1 . . . . Approved " . .. . . . ., 191/permit No. .' z 7�X01 Disapprovedw ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . a 1-1 1994 . . . . . . . . . . . . . ... . . . . . . . , u (B ilding ector) gi.DG.DEFT TOWN OF SOUTHOLD APPLICATION FOR BUILDING PERMIT Date . . . . . . . . . . . . . .. ... . .. 19 . . . INSTRUCTIONS a. This application must be completely Filled in by typewriter or in ink and submitted to the Building Inspector,with 3 sets-of plans,accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and,giving a detailed description of layout of property must be drawn on the.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 regulations, and to admit authorized inspectors on premises and in building for necessary inspections. RIVERSIDE HOMES, :INC. : ...; (Signature of applicant,or name, if a corporation). PO Box 274, 1159 W. Main St. ,. Riverllead 11901 /'' . .(Mailing address of applicant) . . State whether"applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. `builder/agent . . . . . . . . . .,.:.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner;of premises . . . . . . . .James.H, .Cobi lI. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is.,a.corporation, signature of duly authorized officer. I`lti,Y . i4�4' E (NA '�e d ttitle off co at officer) Rrdon, Pres1 ent s`License No. . . . . . . . . . . . . . . . . . . . . . . . . . Builder' _, .. Plumber's License No. . , , . 1487P. . . . . . . . . . . . . . . .Electrician's License_No. 2697E Other Trade's License,No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SWC.Mill. Rd. �pd,Grand,Aye. . . . . . . . . . . . . . . : . . . . . . . . . . . .'iHouse Number Street Hamlet :County Tax Map No. 1000 Section . . . . . 107. . . . . . . . . . Block . . . . 1. . . . . . . . . . . Lot.. . . .2 5. . . . . . . . . . . . Subdivision . . . . . Mattituck, Creek Estates , , , , . Filed Map No. , 9209, , , , , , , . Lot . . . . . .5. . . . . . . . (Name) . . . . 2. :State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy vacant land b. Intended.use and occupancy single family dwelling ." : . 3.. Mature o(work (check which applicable): New Building . . . x... . . . . Addition . . . . . . . . . . Alteration . . . . . . . . ... Repair , , , . . . , . . . . Removal . . . . . . . . . . . . . . Demolition Other Work . . . . . . . . . . . . . . . . . . . . . . . . (Description) 4. Estimated Cost . . . (�i.(�. ._.�.�. . . . . . . . . . . . . . . . . . . . . Fee • `. . . . .(to .be paid on filing this application) . . . 5. If dwelling,number of dwelling units . . . . . 3.. . . . . . . Number of dwelling units on each floor. . . . . . . . . . . . . . . ... Ifgarage,number of cars . . one. . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 .W. �..�. . . . . . Number of Stories .;a . . �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimension's of§W'61structure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . Depth . . .-. .. . "-",. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . "" '":",'""' - Height Number of Stories . . . . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . 54.1 . . . . . . . . Rear . . . 54 . . . . . . . . . Depth .241 Height .16�. . . . . . . . . Number of Stories . . . . ?. . . . . . . . . . . . . . . . . . . . . . . . . . . .: . . . . . . . . . 9. Size of lot: Front ,. . .�,54'. . . . . . . . . . . . . Rear . . . 210.49.T. . . . . . . . . . . . Depth .200;, : . . . . . . . . . . . 10. Date of Purchase , ,3/28/85 , , , , . . . , , . , . . Name of Former Owner , , Joseh�Kru�ski and Anthony ,,,4 ;•+• �Rrupski. . . . . . 11. Zone or use`district in which premises are situated . . . . . . . . . . . . . . . . . . . . . . . . . . . F, . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . no. . .'. . . . . . . . . . . . . .. . . . . . .Q 13. Will lot be regraded ,. . . .fires . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes 14. Name of Owner of premises .J--Rqg 9 , Cohill , , , , Address , c/o builder, ,Phone No. . . . . . Name of Architect ,Richard Wandoloski . , , , , Address Box 971, Riverhead phone No. 727-3395 Name of Contractor Riverside Homes,. Inc. , , Address box 274,, Riverhead,phone No. , 727-3395. . . . . 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. SEE ATTACHED SURVEY • {u64�� i y N I �ob+� � p ,�" STATE OF NEW YORK, CO1,NTY.OF .j�S.iJFFOLK. . . . . . S.S 9`t C i4,4?� '`Gc/-1 BOG o$lGt. . . . . . . . . . . . . . . . . . . . . . . being duly sworn, depose's and says that he' s the applicant (Nanpe:of individual signing contract) above n4Med., HeiS thy;. . . .. . . . . . . . �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 cont aine in this application are true to the best of his knowledge and belief;and that the work will'be performed in the manners t forth in the application filed therewith. Sworn to.before�ma a this • , . . . .day o . . . . . . . . . ., 1 y/ Notary li County r ! /` .HUBU a. a-of Yank Qin Suffolk County . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . No. 5a-a 60iss4 '(Signature of arr, cwmdsdm 6xpir ff 7 3j��( SUFFOLK CO. HEALTH DEPT. APPROVAL i H. S NO. t . L MIL.. ,r2QAp Ef��y J STATEMENT OF INTENT z' f THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFOR HE STD S OF THE S U F F P - - -- A P ICANT SjJ FOL .K COUNTY DEPT. OF H'ti ` rrw E - TH Or 1 I SERVICES — FOR APPROVAL FOR Z 1 M "f ` -~4 CONSTRUCTION ONLY AP OF tin -- ---.50 j DATE. H. S. REF. NO APPROVED _ SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL. fi C� SUfz-v4!5 YOD F100 tests ` `1 �-/ j_/ OWNERS ADDRESS: D�y 1 f ,,,_S 1 14. t"/ _������ ei� c%"V6 r-.1 i Kie :y't�vPlrl.:�� i e- ' �? G. 6OX .Z 74 71 N ts,3 � .��;�,'iG� ' �l0 =/"' � 7•ut,'. 7,�? -•33�5 Q Q �'J"G` a : 36, 4Z6 S� DEED: L. N/A P. TEST HOLE f) �; r�rr✓er ,lwrsea a�er�:M: Or a C, —to. r ;r;:4C r-'atq !C.CA be COns,00red � __ •�'�/ �'�' ' to be a valid true COPY Guaru;tees Indicated LOMOn sl-A run r^tt1�!t E only to r c+,for whom th�s arvey Ls pr , :,h,s C hs'f to the i ,i 1 .=�tTr�ts`G1apc t��1f1G z ' �r�'l514 Wec,i jcaaW nd :..ld.v.:a..,..^....- ..,..�•r.v.,..r;:i.-...R.� a... - ----___.........«,.......�..,,....,.... I � � IC(id r j.. , .fG..n f7lid SUFFOLK COUNTY DEPARTMENT OF HEAd.TH SERVICES a?o;'' tu to . - drag Instl- i tuLon ::,...... -�uttcsnsferable to FOR APPROVAL OF CONSTRUCTION OFn®rs SINGLE FAMILY RESIDENCE ONLY %U " G� duarc.•� .'S <u SEAL ©A40 2 2 04 f �� d , f:'crt�e A�r>f�r�:y1S�rc7;'. ;••; atr�� �'o � �+ ' p� p'�Y APPROVED c;ark J t~+!1.`:i ,,s , f' 7�`err•S r V. TG y EXPIRE YEARS FROM DATE OF APPROVAL r RODERICK VAN TUYL, P.C. `�F, �\ ° 5J LICENSED LAND SURVEYORS S° .ANO BLDG. DEPT GREENPORT NEW YORK i TOWN OF 36 THoi n TELEDYNE POST N8132Q SUFFOLK CO. HEALTH DEPT. APPROVAL 1 H. S. NO. ( 1, � OCT 5 1994 STATEMENT OF INTENT ` BLDG.DEPT. THE WATER SUPPLY AND SEWAGE DISPOSAL TOWN OFSOUTHOLD SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE `�r'. h % SUFFOLK CO. DEPT. OF HEALTH SERVICES. r; (S) APPLICANT i SUFFOLK COUNTY DEPT. OF HEALTH SERVICES .- FOR APPROVAL FOR �• ��` �p p `y f r. ;- -' ;� '. w' CONSTRUCTION ONLY DATE: H. S. REF. NO.: ry _-`'7"'' "-- - `' �'� .i eti iJ--y rI _Y�-- �t--�1 - --------t .{a✓p��_. -F-M-tn.--- ----4—`- —~`-C._�-----' 5 u `"='"• APPROVED: S .4 - .CQNCR. ? �` i �1 'Ilf l�✓:: <,e". e` T, .'G' �`eiG;�t: a. ` FOUNDA +I , SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL. 1 ( - . OWNERS ADDRESS: 8f'� , J i � . � J � / t•• J Y• r .''• ,� ' -t 1 t � 7r l — �T' •�' J ' <<'fl .� �=� ,F^ . . :.. i „`%P:_ '.r ? i . DEED: L. `'' r/ ' P. y f TEST HOLE STAMP OCT 3/ 1994 ` • _.. I ( 'UYddCilbu..;.:..i a-._.W�.:u:f'Gd,�^r.n;�F.S� ,rJ •:'. 1, t', ,,, .; r;. ;' .I SEAL Q;rr ( l9 t�i r':'S: /•t t`, a.., Y...T i! --'x' - e - , I nyl�`w ,�Y� tv °�S'i INX i RODERICK VAN TUYL.jP.C. " '� ;; fG ,�- �,-••- A �d30d[3 LICENSED LAND SURVEYORS GREENPORT NEW YORK TELEDYNE POST N81329 _ , SUFFOLK CO. HEALTH DEPT. APPROVAL ,istar a H. S. NO."/O $74-o0.f-9 SUFFOW COUNTY DEPAFI'WENT OF HEALTH SEM 10S °Yarr-vrr SINGLE FAMILY DWELLING ONLY Apt of Commxadwoft - .9.Fri. `> i �OEC 2 1994 � The se a disposal and waW sup � at this to ;tQs have,a�6nn In9�and/Cf h• certified by thlis Dspaf burnt or other a STATEMENT O F INTENT M1t. L. 'C7R1J and fwjndtobesaaiilsfac4ar: HE WATER SUPPLY AND SEWAGE DISPOSAL YSTEMS FOR THIS RESIDENCE WILL ONFORM TO THE STANDARDS OF THE tV, -70` 06'41••t', � /�Q. � St phenA.Costa,RE•, Cf>tlef I UFFOLK CO. DEPT OF HEALTH SERVICES. _ T_-�__ �---- Offloe of water and wastewater f3As�lna S) APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES - FOR APPROVAL FOR `` CONSTRUCTION ONLY DATE I /' _ H. S. REF. NO : �� '94 . G� S fr I ,t � 1AI 7-T �i.�:d I'e- CzeEg. E57rq l- E .�. APPROVED ,... �.� ..7p -- �3 _.. _ _ ti 1 �1-4 SUFFOLK CO TAX MAP DESiGNATiON: r. : '� 1 �!• ;VIA 7-7-/ 7 .1C .., _' DIST. SECT. BLOCK PCL. i OWNERS ADDRESS. ` fw AlJfi .. ����`�'' .._ �%... A l s� t-7, il. ,�ET,� r�.5 � `�a ,�'s ;,ig r•�s/c�8 ti',�prre�,s, Ir�C. _.__ _ o. esox Z 74 •�1. . \+ \a �.�r DEED: L. P. TEST HOLE STAMP WON " .1 eY Ya1•J{9 LY 0 COW ���, �/97(311 srSCto��Fr Zy �1.,�d oct. s, i994; :. ,-u - •• KEY.3)D1 gg4 C., A47 G'0%R Al r9-Ywry SEAL !•r"dme ��rrriMj3�p��"?G+.*s .errs �"O -- ._ _ cs'nr'r� ,J. dC CQ1Si tl..5 . �'ef�r•� RODERICK VAN TUYL. P.C. ,- LICENSED LAND SURVEYORS GREENPORT NEW YORK TU7YNE POST N81329 a_ ' ~ C?~x~~cyFrar~,#h!,~';Tmn!S•rrzV7aUi':?*.'~,^~ti"4;'; ° i I 2 7/ r ) 'l v Tr. ;i r C..OAJ,TIN S '~"IgrGrC's Ir N rct~ r T 24o Asptkk+ r f E i QIPYL, - sIOIM+4 ~ 120.E - i I. VIP L~m „ I F y G S;.DF.J'~11-!?~J SC C+lY ~~IJ'(r ''i ice', 1 r- Z~}o~ASt NaU~ 'IVA I I , A Y fl v~~Y~ `fJ^!i?I nJ 7~ a -74 a _ 1 It p ~y by y k w. Fy~ N ~ ALL i ".~`.~4~% a.+.uraiwroun~ eeaavraov -ORECOVERM ~Lm co v aNwnu. rawn.rdNk r'. 54 a o.,a. I 3r G C... el TIA 10 47- 3040 x M~ 2ova~yza p4 jv~ AS NOTED X1:8". - wSUF2h•~6G~ DATE: 998.P.# r •,~~f~,n'~A.b$~u 40 :r+'~. ~ fir. areru pv-.a-d ~ eaR'+~ww~ rvsw..~ xi.dr.~.,y x i ' ~ - mDTVFYBUIDEPART AT 765-71802 9 AM TO 4 PM R THE, OCCUPAI FOLLOWING INSPECTIONS: USE IS UN OCCUPANCY VOR 1. FO>UNDATION - TWO REQUIRED, USE IS UNL,4WF'~L 'W, ~ u 'N~ M 1 Q -i 1 FOR POURED CONCRETE WITHOUT CEI VITHOUT CERTIFICATE N iaF a ~~Gs 2. ROUGH -FRAMING &,PLUMBING OF OCCUI OF OCCUPANCY 1 I I p- 3 INSULATION 4 - i Y 4, FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O. I ~ l I ALL. CONSTRUCTION SHALL MEET _ _ - ~tt pad THE REQUIREMENTS OF THE N.Y. 0 STATE CONSTRUCTION & ENERGY I ' G L. L~~ fil 2~ ~r tuaw 0 ~,c C OiE5. N RESPONSIBLE FOR D SI NY3FNSTRUCTION ERRORS f ~ e f I LLI w~~Drw~O~~ N~O~T SU IOCEED RVEY OF PTf~ ED /,J f / Y OF I i FOUNDATION LOCATION MON 1 c HAS BEEN APPROVED WED l y+v f~ f - i t { & I ~ ~ y ~"x s~~•" PIS vlaL,L.~ , c~.l h wl~ bras -1 c- Prxa. _ I i 40 I sr, I i { il f 1'x 7 q ~ 1 J r ! n~~ A N ~ I 40 ~ ~ r r +7 t opB 5 fait x _ '.rLL. _r I ?a ~ .a, ,y, .I _._wx ....nm •.::~+W~tl'~Jn SnJ`Y~rv ,o-