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Home My WebLink About10435-Z OF SOUTyo`o Town of Southold * * P.O. Box 1179 53095 Main Rd UNTI Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 47067 Date: 05/18/2026 THIS CERTIFIES that the building COMMERCIAL ADDITION/Alteration Location of Property: 22350 Route 25 Orient, NY 11957 Sec/Block/Lot: 18.-5-1 Conforms substantially to the Application for Building Permit heretofore, filed in this office dated: Pursuant to which Building Permit No. 10435 and dated: 10/10/1979 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: Additions and alterations for conversion of existing automotive service station to a retail candy store and candy making as applied for. The certificate is issued to: Heins W J&E M Lvng Trt Of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL: ELECTRICAL CERTIFICATE: 10435 04/14/2026 PLUMBERS CERTIFICATION: uth iz d S nature pF SO!/ryolo Town Hall Annex Telephone(631)765-1802 54375 Main Road N P.O.Box 1179 �Q Southold,New York 11971-0959 o�yCOUNV,� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICAL COMPLIANCE SITE LOCATION Issued To: W. Heins Address: 22350 Main Road City: Orient st: NY zip: 11957 Building Permit#: 10435 Section: 18 Block 5 Lot: 1 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Electrician: License No: SITE DETAILS Office Use Only Commercial Indoor Basement Service Solar Residential X Outdoor 1st Floor X Pool Battery Storage As-built Renovation X. 2nd Floor Hot Tub EV Charger New Addition Attic Spa Generator Survey Mezzanine Garage Dock INVENTORY Service 1 ph In-wall Heater Recpt 33 Ceiling Fixtures Smoke Detectors 2 Pump Service 3 ph Hot Water GFCI Recpt 17 Wall Fixtures CO Detectors Heater Main Panel A/C Condenser 1 Single Recpt RecessdFixtures Combo Smoke/CO 2 Transformer Sub Panel A/C Blower 1 Range Recpt Ceiling Fan Heat Detectors Salt Gen Transfer Switch Mini Split Dryer Recpt UC Lights Fridge AutoCover ARC Blower Heads Switches 13 Pucks Lights Dishwasher Mini Fridge GFI SepticDisconnect Emrgency Strobe 4'LED Microwave Garbage Disp. ARC/GFI ERV Exit Lights 3 Bath Exhaust Hood Dehumidifier Other Equipment: gas furnace, 8 8ft flourecents, 2 240 volt outlets for in wall ac, 10 4ft flourecents Notes: AS BUILT ALTERATIONS Inspector Signature: r Date: April 14, 2026 FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. TEMPORARY Certificate Of Occupancy No. . . . . �984+9 . . . . . . Date . . . •Jan4ary. .24. :. . . THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . .,. . . . . . . . . . . . . . . . . . . . . . . . . Location of Property . . . 22350 Main,Road,&. .55. OY.4terPonds. lane. . . . . Orient,. N.Y. House No. Street Hamlet County Tax Map No. 1000 Section . . . . .18. . . .Block . . . 5. . . . . . . . .Lot. . . . .I . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . .Filed.Map No. :: . . . Lot No. . . . . . . . . . . . . . conforms substantially to 'the Application for Building Permit heretofore filed in this office dated October 6 - 197.9. pursuant to which Building Permit No. 'l'04t 35Z . . . . . . . . . . . . . , dated . . . October. . .. . . . . . 1979. ,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 to Retail Store #Upon approval of alt.erat;Lgn ans . . . .. p�, The certificate is issued to' . . . . ' William Heins (owner;# :.. .• of the aforesaid building. Suffolk County Department of Health Approval . . .December •.3,.. 998Q, . . . , UNDERWRITERS CERTIFICATE NO. . . . . . . . . . .N. :463gQ ,. uilding Inspector Rev 4/79 *Certification that alteration meets the Energy Code FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERIC'S OFFICE SOUTHOLD, N;. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No i®435 Z Date ..................................C�.�...�....... .1? 19../.f Permission is hereby granted to: .....I./U.l..L!a.hI............... ........... .................r/./ . .�jr'.;..11(....... .7i�1=. ..,......�..,..`,L << (,(•1, 7 /Vj' // 9 1-/ L/ y ............... ....................................................'.......... _ too.. .........F0.........,q......�..X��.(.1./.,./.�.......C.AS........C.:ZA.—r.l..0.l1',....... S.k........ (1..... ....... l .` .......a::.�. DF....I.T,�...r.A?�!I'�VnL....��..f1!,Z�.1.rA7Loni.....�ANS at premises located at ..........0.2....3.. -11...14A/..rk/.......ti:m..1.7.... .......... i A ................................................................................ ................... ....................................... ................................................................................................................................................................. pursuant to application dated , f 6, �, and approved by the Building Inspector. Fee $...o�..-r..../...... Building Inspector -� f'�AniS � �i�oFF�Slonl�� C ! FP/TCA-fibAl Cr T/-/ AL7C A y/ 0A/ %Hfl T T�� I'i/OFF' l�l l-7 TN /-z/VE><�',' �'0-bt l�L/�lI/S SrT5) )N ftU ►r?C l� L;r. _��i� fl/_�� '�ic`r�/ (�j 7NF X 1f�7/A/er 13011- 6 ,1wr lS 7C:' E� FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to 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 peoperty 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 $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date . . . >r-7. .�: . . :fir � . . . . New Building . . . . . . . . . . . . . Old or Pre-existing Building . . .�. . . . . . . Vacant Land . . . . . . . , . . . . . Location of Property . . . . . . . . . . . . . . . . . �./.. . . ��. . . . . . . . . . ®I. e'?. . House No. / Street Hamlet Owner or Owners of Property . . �� °:'. . . . . .l7-� '�'.S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No. 1000 Section . . . . . . . P. . . . . . Block . . . . 5 . . . . . . . . Lot . . . . . . . . ... . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . . . .Lot No. . . . . . . . . . . . . . g Permit No. .� �y3.s Date of Permit G�� .�0.1. .Applicant . . . . . . . . !. . . . . . . . . Health Dept. Approval . . .1� . . . . . . . . . . . . . . .Labor Dept. Approval . . . . . . . . . . . . . . . . . . . . . . . . Underwriters Approval .��. yG. .�.«. 7 . . . . . Planning Board Approval . . . . . . . . . . . . . . . . . . . . . . Request for Temporary Certificate . . . . . . . . . . . . . . . . . . . . .Final Certificate . . . . . . . . . . . . . . . . . . . . . . . 0 Fee Submitted $ . . . . . . . . . . . . . . . . . . . . . . . . . . . Construction on above described building and p ' meets aij ap licable codes and regulations. Applicant . . . . . '�� "` . . . . . . . . . . . Rev.10-10-78 � � I THE NEW YORK BOARD OF FIRE UNDERWRITERS i d BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 1OC138 Date' el c1:0,17' rY 16', 1, L' Application No.on file , THIS CERTIFIES THAT only the electrical equipment as described below and introduced[byt the applicant named on the above application number in the premises of I.4 (FC?�.fY ra J^J��l'\7 •.�'�.•l kk !'1 C.1 f)'Pir7y�r'�ivy s,uJ-�6• in the following location; ❑ Basement 0 1st Fl. ❑ 2nd Fl. Section Block Lot was examined on Janaxny 15, 5,y and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENT FLUORESCENT MERCURY VAPOR AMT. K.W. AMT. K.W. AMT. K.W. AMT. I K.W. AMT. H.P. 251 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. N SYSTEMS O.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E R V I C E METER NO.OF CC.COND. A.W.G. A.W.G. A.W.G. AMT. AMP. TYPE EQUIP 1,0 2W 1,0'3W 3,0'3W 3,0"4W PER.0" OF CC.COND. NO.OF HI-LEG OF HFLEG NO.OF NEUTRALS OF NEUTRAL 130 OTHER APPARATUS: ri::�G.Y'r✓'CZ i�.,t 19 ',�,p .y •;�;�`T w.,:l�.`: c t 7 GENERAL MANAGER' Per a7 I; 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. d PY FOR BUILDING DEPARTMENT. THIS COPY. OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. laf soulyolo # TOWN OF SOUTHOLD BUILDING DEPT. "cou 631-765-1802 . INSPECTION [. ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ .] I LATIOWCAULKING [ ] FRAMING /STRAPPING FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY-INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ .} -FIRE-RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ]. ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ]. RENTAL REMARKS: &4, —Fop A4�1+AV r /�•/j r"v N — DATE y INSPECTOR lk SOUTy�Io i O 3 ��3.b,V ac v` Kok # # TOWN OF SOUTHOLD BUILDING DEPT. ^ou 631-765-1802 INSPECTION [ ] FOUNDATION 1 ST/REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] .INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL- 'j. ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ]. -RENTAL REMARKS: �7 , 1�' l OtO 1413 K,_tckev, a- work Arms 4ion :510kt a _t v,4 cAoor'- 1 �0alifl°_r q Li Of on W-ck6k*-r c_DrA_ CM 0 ro W Vic)'Pf _ �ke, co n fit. DATE a�-� a`t INSPECTOR i35 aa3� sf SOUT yO� * # TOWN OF SOUTHOLD BUILDING DEPT. courrnN�'' 631-765-1802 INSPECTION [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE-RESISTANT CONSTRUCTION [ ° ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) [ ] CODE VIOLA ON [ ] PRE C/O [ ] RENTAL REMARKS: 6af 14 5 b of(S CON rle4A z �Ljk4_k CL60kye wtojou) eGT.�tov� batow &C- nte G rd p fid o. " 4eJ OA� IA kack vl__ mk&5 r"Ir6 to,% n Ll V UI.�6�F 1],� l 1 "`2.� C� OLc�GO/In'P.�f ob Wow AkCbe'to rs" _ k��) k, o �lR r u1 0,5 DATE 3-3 1 a�P INSPECTOR JAM& -- - OF SOUTyO� �lf ag3✓ C.✓ Q 5 TOWN OF SOUTHOLD BUILDING DEPT. "cou 631-765-1802 INSPECTION [ ] FOUNDATION.1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND _ . . [ ] INSULATION/CAULKING . [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION : [ ] FIRE RESISTANT CONSTRUCTION [ .] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) V] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: DATE " l �� INSPECTOR#— V OF SOUIyOIo PT co # TOWN OF SOUTHOLD BUILDING DEPT. 'oum, 631-765-1802 INSPECTION [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING/STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [A ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ]. RENTAL REMARKS: A5 -T�� 6\ -lamt, [tot) DATE 41 a F a INSPECTOR oFsouryO� 16Y3 5 aa35o kT aS # # TOWN OF SOUTHOLD BUILDING DEPT. °`y�o�►�� 631-765-1802 INSPECTION [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [fd ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: V A C w� ift <2 li EO r - tAZ e wV e v, �&,O tVL ui r@Q 6 o-cl ,� V10,451 DI'04LAIPPA, DATE INSPECTOR 0E50UTyOlo 1 a a3o_ TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 INSPECTION [ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] .FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) A ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ ] RENTAL REMARKS: v �� s _ l \. DATE J r �o�' INSPECTOR AA J FIELD INSPECTION DATE -COMMENTS Ll FOUNDATION (1st). o N FOUNDATION (2nd) n 2, ROUGH FRAME PLUMBING CQ CD C+- INSULATION. PER N.Y. STATE ENERGY CODE x w VA ,a ni FINAL I� . co ADDITIONAL COMMENTS: - -i .a �1eG�r�e- 23 C+ I 0 0 N 1Y d � m cr C c) i\-A tj T 5 :x 7 Z. 7F ell- Ci Fz 'V C— F-- i A 62 e12 A. -1 A U C 0 /--A /J� I\j -FZ V r �d, T ;� D Sj y Southold, N.Y. 11971 HENRY E. RAYNOR, Jr., Chairman TELEPHONE FREDERICK E. GORDON 765-1938 JAMES WALL BENNETT ORLOWSKI, Jr. GEORGE RITCHIE LATHAM, Jr. February 1, 1980 Mr. William Heins Main Road Orient, New York 11957, Dear Mr. Heins: The following action was taken by the Southold Town Planning Board at a regular meeting held January 29, 1980. RESOLVED to approve the existing parking and screening at the property of William Heins located on the corner of Oyster Ponds Lane and Main Road, Orient, subject to a one-year review because of .the undetermined use of the addition to the building. Yours truly, HENRY E. RAYNOR, JR. , CHAIRMAN' SOUTHOLD TOWN PLANNING BOARD By Muriel Tolman, Secretary Copy to George Fisher, Sr. Building Inspector ✓ Charles Grigonis, Chairman, Board of Appeals - ACTION SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES CONT ❑ CHGE ❑ PAGE NEW ❑ DELT ❑ FOOD ESTABLISHMENT INSPECTION REPORT OF -� ESTAB. I.D. SANIT- ESTAB, / ESTAB, c r N NUMBER (1-5) AREA (6) CLASS(7) (8) NAME (9-28) /' J i� FILE (- ESTAB. �] -y (�� v / ACT PERMIT VOLUME I ADDRESS(29-50) �l - ! ( - — / ✓� � DATE (52.55) RESTRIC. (56) CODE (57) LETTER OWNER'S / 'l��Q� I� COR NAME NAME ION PHONE REINSP. (N ,v CORPORATION ZIP WATER SEWAGE i FROZEN PRE HRG, p ADDRESS SUPPLY(58)1,�-1 DISP. (59) DESS.(60) + ORIGINAL=1 REINSPECT=3 ILLNESS=S INSPECTION 0 TIME OF l AM FOR.HRG. PURPOSE PERIODIC=2 COMPLAINT=4 (6) DATE (7.12) ✓ V INSPECTION �%� PM DESCRIPTION Item X DESCRIPTION Item X c. Food Mgrs.Certificate - J 13 WATER Water source,approved,adequate,safe,hot"&cold under pressure 43 MGR {/ GENERAL CERT y SEWAGE Sewage and waste water disposal approved 44 Valid health permit 14 No cross-connections,back-siphonage,backflow 45 PLUMBING Economic Violations 15 Installed,maintenance :' 46 Approved source,wholesome,non-adulterated 16 Adequate,convenient,accessible,designed.Installed 47 FOOD &LET Original container,properly labeled �` 17 TOILET SH Toilet rooms enclosed,self-closing doors, proper fixtures provided,good ` p Potentially hazardous food meets temp. requirements during storage, FACLTS repair,clean,hand cleaner, sanitary towels;approved hand drying prepar., display,service,transport 18 devices provided. '; 48' Adq.facilities to maintain product temperature 19 GARBAGE Approved conatiners or receptacles,covered,adequate number,insect/ Thermometers provided&conspicuous 20 & REFUSE rodent proof, frequency,clean 49 FOOD Potentially hazardous food properly thawed 21 DISPOSAL Storage areas/rooms,enclosures properly constructed,clean 50 PRO- Unwrapped& potentially hazardous food not re-served 22 TECTION Food protected during storage, preparation,display,service, INSECT- Presence of insects/rodents-outer openings protected. No birds,turtles, transport 23 ROD. CTRL_ other animals (except: police/guide-dogs) 51 Handling of food (ice) minimized 24 Floors: covering installed,constructed as required,good repair,clean, Food FLOORS r` (ice) dispensing utensils properly stored 25 dustless cleaning methods used 52 Toxic items properly stored,labeled,used 26 WALLS& Walls ceilings attached equip:construction,good repair,clean surfaces, t: CEILINGS 27 dustless cleaning methods used. 53 c Personnel with infections restricted 4t PERSONNEL Hands washed & Clean, good hygiene practices 28 LIGHTING Adequate lighting provided as required 54 (;- Clean clothes, hair restraints 29 I ` - --�-- VENTLTN. Rooms and equipment-vented as required 55 Food (ice)contact surfaces: deslgne t onstrE ucte aintained; installed,located 30 DRESS RM Rooms adequate,clean,lockers provided,facilities clean 56 e Non-food contact surfaces: designed,constructed, maintained, Complete separation from living/sleeping quarters,laundry 57 (- installed,located 31 Clean.soiled linen properly stored 58 L Single service articles,storage, dispensing 32 ISC- premises: free of litter,maintenance, unnecessary articles,cleaning, No re-use of single service articles 33 maintenance equipment property stored 59 FOOD Dishwashing tacitities:approved design,adequate,constructed, The items above (x) are violations found during an Inspection of the operation and facilities in this. f, EQUIPMENT maintained,Installed,located 34 establishment which must be corrected by the date specified. Failure to comply with any time limits I, & Pre-flushed,scraped,soaked, racked 35 for the correction of violations as noted in this inspection report may result In appropriate legal action [; against this establishment as provided for In Articles 2 and 13 of the Suffolk County Sanitary Code in- UTENSI LS Adequate thermometers provided,dish racks,it used 36 eluding a hearing,possible suspension of your food operation,and/or publication of the violations and fines. Wash water clean,proper temperature 37 ` If, Sanitization rinse clean: (hot water-chemical) 38 , Reinspection 1st n 3r Y Date t Wiping cloths: clean,use restricted 39 Si nraturl f P' so Reg Ivi ort Title Food contact surfaces of equipment&utensils clean 40 1„? •� 1r% i• Non-food contact surfaces of-equipment &utensils clean 11 41f San'tari ! - Tit 1 Clean equipment/utensils: storage,handling 42 �. � p FC-1 5/79 // U 8.519, 1 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 /� to Examined . . . . . . �? . . . ., 19 .� Application No. lQ1/. . . . . . . . . . . . . . . Approved . . . . . �a., 197' .. Permit No. . . . . .. Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �a . . . . �`�: (Building Inspector) APPLICATION FOR BUILDING PERMIT October 6,1979 Date . . . . . . . . . . . . . . . . . .. 19 . . . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS 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 buildings for necessary inspections. ROBERT HLITvS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . pi�,( L� (Signature of applicant, or name, if a corporation) _ J116 Main Street Gnpt. ( ! 9 Lf-. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. AGENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IS Name of owner of premises . . . . . . . .i'. . . .IA. .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License No. . . . . . SELF Plumber's License No. . . . . SELF Electrician's License No. . . SELF. . . . . . . . . . . . SELF Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. ORIENT POINT NONE � �h 5� 0` .5.��,�ivt5 MAIN ROAD ORTLNT House Number Street jj Hamlet II County Tax Map No. 1000 Section .Q. . : 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 . . . . . . VACANT. SEnVICE STi..TION b. Intended use and occupancy . . . . . . . . .. CANDY SHOP . . 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . :Ys-= . . . Alteration . . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . . . . . . (Description) 4. Estimated Cost . . . . . . . . . . . . . . . . . . . . . . . . . . ..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 . . . .I . . . . . . . . . . . ..... . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 . . . :a ;t�:'. . . . . . 'Depth .; :$ _:s. . . . . . . Height . . . . . . . . . . . . . . . Number of Stories . . . . .:. + . . . . . . . . ..... . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front P` . . . . . . . . . . . . Rear ='.�:�? . . . . . . . ._ - Depth--.-. s . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . : R 8. Dimensions of entire new construction: Front . .i i.4. r' . . . . . . . Rear . . _ ,3 E C) . . . . . . . Depth .1.? °? Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . 'D lk:: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . `.... 9. Size of lot: Front . . . . . . . . . . . . . . . . Rear . :. . . . . . . . . . . . . Depth . .r.w . . . . . 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: .y-W. . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded . J2` ,0. . . . . . . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes No 14. Name of Owner of premises I'e.b;l: . . . . . . . . . . Address': -t n . . Phone NoZ2'1 ,.. 7. . . . . . Name.of Architect �. � :77, . . . . . . . . . . . Address r o,.t:- r. . .- .- . . Phone Nor 5. . . . . . . •t'ai .' •.L M ,, .1. .t i•.••O• 'V i..�• tJ:YV:4 Name of Contractor . . . . . . . . . . . . . . . . _ . Address,rt; i, -ra .��, Phone No k-- 7. . . . . . 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. girl. j i17 CAP ` y kt STATE OF NEW�ORK' S.S . COUNTY O),. -.✓. ,q ,�`�. . ' �.�,,.�;. . . . . . . . . being duly sworn, deposes and says that he is the applicant Na e ofindividual signin Contract � g above named. Heis the . . . . . . . . . . ��. . P,. ?-/ , r?.�` .. . . : . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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-t:-.ue 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 . . . . . . . . . . . ;f.u i . . . . day. of. . .�.�' G,�?�t.. , 19`? Notary Public /.d. . . . . . � �„��-� `County '��,,,fs.-G'�•��/�•v�`�'f_J i,�A..f,�.f}'�r. h /' �..��i-LJ'� t•� �� c;.�sG-� "4 . ' ' ELIZABETH ANN NEV LLE (Signature of applicant) NOTARY PUBLIC, state of�New York No. 52.8125850, Suffolk Cou Term Expires March 30. 194 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . .11'``' . . Alteration . . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . . . . . . (Description) 4. Estimated Cost .81.;.000;I .0 . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) S. If dwelling,number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . ... . . . . If garage,number of cars . . . .3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .C. i if. , • . • . • . • 7. Dimensions of existing structures,if any: Front . :P6 t.6..`. . . . . . . . Rear . . . " . . . . Depth . . .t. ; 11. . . . . . Height . . . . . . . . . . . . . . . Number of Stories . . . . :� sF:. . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . Rear 3 �.�?. . . . . . . . . . . . . Depth . . .4-1 .�Q?, II. . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . .021 E. . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . 3 t:E?ql. . . . . . . Rear . . .ZO!06?1. . . . . . . Depth . .414ii . . . . . . . . Height . . . . . . . . Number of Stories . . . . . . . . (XF1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of lot: Front �J€ e Ci'(. . . . . . . . . . . . . . . . Rear .88;al . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . 10. Date of Purchase ,a:;:xil. 20.,1.9W` 9 . . . . . . . . . . . . . Name of Former Owner !�.1b��,��. Ce-rpl . . . . . . . . . 11. Zone or use district in which premises are situated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . 12. Does proposed construction violate any zoning law, ordinance or regulation: .1`1O. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded . . .V9. . . . . . . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes No 14. Name of Owner of premises Y-r?t RPA • . . . . . . . . . . Address a:' rrl . 41.9 : . Phone No.L k3. 7. . . . . .. Name of Architect 7gc. -All-IC;•rs . . . . . . . . . . . Address 546,5E Phone No.`l :i �v• Name of Contractor .Self. . . . . . . . . . . . . . . . . . . . . Address l?ai--i . .�. .l}r• e.nt Phone No.via>'� ti_'�'. . . . c5• r' . 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. ,3 AID«✓1066. , �lg Z► a Fro v J � s � .., Min t o Ll t � 7)- 1 STATE OF NEW ORK, S.S COUNTY O . . . . . . . . . . . . lgni . . . . . . . . . . .. being duly sworn, deposes and says that he is the applicant (Na e of individual s g contract) above named. Heis the . . . . . . . . . . r . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. (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. . .(�,/.� '-� . , 19`.7 . Notary Public, . . . ... . . . . . . . . . .. . . . . .•County , ELIZABETH ANN NWLLE (Signature of applicant) NOTARY PUBLIC, State of New Y h No. 52.8125850, Suffolk County Term Enlres March 30. 195ab FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL - SOUTHOLD, N.Y. 11971 TEL.: 765-1802 _ Icy 7/ �o�� Examined;...: . .: , 19 :�. Application No. . . . . . . . . . . . . . . . . . 113,5 Approved . . . . .�� (�., 19' . . . Permit.No... . . . . . .. .. . . . Disapproved a/c . . . . . . . . . . . . . . . . . ..J_._. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . (Building Inspector) APPLICATION FOR BUILDING PERMIT dctober, 6,3979 Date . . . . . . . . . . . . . .. 19 . . . INSTRUCTIONS a. This application must .be completely filled in by--typewriter or in ink and submitted in-Ariplicate 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 issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e.-No building shall be occupied or used in whole or in.part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS 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 buildings for necessary inspections. (Signature of,applicant, or name, if a corporation) LLT ;, 1116 t,'Ilain,' St r e t Cu.,A. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. AGi ltT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .;. : . . . . . . . . . . . . . . . . . Name of owner of premises . . . . . . . . .l':�s:LU�r.�.' N�� ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . .. . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License No. . . . . . . .SELF. . . . . . . . . . . . . . . . . . Plumber's License No. . . . . . . .. . .. . . . . . . . . . . . . . . . . 8. Electrician's License No. . . . .. .'ri`. . . . . . . . . . . . . . . . _.. Other Trade's License No. . . `.'...f. . . . . . . . . . . . . . . . NT 1. Location of land on which proposed work will be done. ORIENT NU S . . . . . . • • • • • • 0 S� OY5 hid i i.�TdJa. . . . . . . . . 3S. . . . 11AIN Rom. L'. . . . . . . . : . t)RI-:1� '. . . . . : . . . . : . . . . . . . . . . . _ House Number Street Hamlet County Tax Map No. 1000 Section . . . . . . . . . . . . Block .. . . . . . . . . . . . . . Lot . .I . . . . . . . . . . . . . . . . Subdivision . . . . . . . Filed Map No: . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: z ra, n r� a. Existing use and occupancy . . . . . . . VACANT U :4 ��.'�; .`�.... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . . . . . . . . . . . . . . ....... . . . . . . .. . . . . . . .. . . C. ..h IDLY 1.:1? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . SMITH, FINKELSTEIN, LUNDBERG, ISLER AND YAKABOSKI ATTORNEYS AND COUNSELORS AT LAW 456 GRIFFING AVENUE,CORNER OF LINCOLN STREET "P. O. BOX 389 HOWARD M.FINKELSTEIN F " ? .1! - PIERRE G.LUNDBERG _ .. RhVERHEAD, N.Y. 1 FRANCIS J.YAKABOSKI ! " `y IIJI U FRANK A.ISLER FEB - 4198I (5,16) 727-410 EGINALD C.SMITH SUSAN POST ROGERS ; 1926-1983 I � � 1 SUi�iiVISORS OFF rcF February 2, 1987 Francis J. Murphy, Supervisor Main. Road, .State Road- 25 Southold, New York 11971 Re: Town of Southold v.• Heins Dear Supervisor Murphy: I enclose herewith statement for services rendered in the matter of Katherine Iieins and William Heins v. The Zoning Board of Appeals, which Article 78 proceeding has- just been ruled upon. by Judge Doyle in a decision dated January 20, 1987, a copy of which is enclosed. A copy of the decision and of our statement of services rendered has been forwarded to the Chairman of the Board of Appeals and the- Town Attorney. Very t my yours, F CIS KABO KI FJY:knm enc . v/ ;., MEMORANDUM 4 SUPREME COURT, SUFFOLK COUNTY SPECIAL TERM PART II In the Matter of the Application of , KATHERINE HEINS and WILLIAM HEINS , BY DOYLE, J. S. C. Petitioners, For a Judgment Pursuant to Article 78 DATED January 20 1987 of the Civil Practice Law and Rules , , VS. INDEX NO. 86-21779 GERARD P. GOEHRINGER, Chairman, CHARLES GRIGONIS, JR. , SERGE DOYEN, JR. , ROBERT J. DOUGLASS and JOSEPH CDISPSJ H. SAWICKI , constituting the Zoning Board of Appeals of the Town of Southold; etc. , Respondents . A14TH014Y B. TOHILL, P.C. SMITH, FINKELSTEIN, Attorney for Petitioners LU14DBERG & YAKABOSKI , 12 First Street ESQS. P .O. Box 1330 - Attys . for Respondents . Riverhead, New York 11901 P.O. Box 389 . Riverhead, N.Y. 11901 In this Article 78 proceeding petitioners seeks to reverse and annul a determination of respondent, Zoning Board of Appeals of the Town of. Southold, which denied area variances_ to petitioners . The petition is dismissed.. Petitioner, Katherine Heins , is the owner of land situated on the north side of the Main Road at Orient Point in the Town of Southold, New York . The property is approximately 48 , 800 square feet and is improved with a one and a half story frame house, a garage, a shed and a cottage. The property is located in the A-Residential/Agricultural zoning district which requires minimum . lots of 80, 000 -square feet, with -frontage of 175 feet and a depth of 250 feet. Petitioners ' property was purchased- as two separate parcels . One was purchased in 1962 and the second parcel was purchased in 1964 . Petitioners , for the first time in any proceeding contends that these parcels are two separate parcels because two separate Suffolk County Tax Map designations are maintained for them. Respondent asserts there Was a verger of tr,e property in 1964 upon the purchase of the second parcel . PAGE 2 HEINS V. GOEHRINGER INDEX NO. 86-21779 The Court concludes that merger did occur by operation of §100-31 of the Zoning Ordinance of the Town of Southold which exempts lots held "in single and separate ownership" prior to 1971 from the new one acre area requirement. Since petitioners parcels were purchased in 1962 and 1964 , merger occurred in 1964 . Nevertheless, on March 22, 1985 petitioners were issued a building permit by the Town of Southold' s building department to construct a single family residence on a portion of the property consisting of 18 , 894 square feet with a lot frontage of 88 . 11 feet. Apparently the building permit was issued on the building inspector's' mistaken belief that the property consisted of two separate parcels . After receiving the building permit petitioners assert they expended approximately $15, 000 clearing the land and having a foundation excavated. ' On December 24 , 1985 respondent revoked the building permit finding that the lot area on which the new residence was being constructed was insufficient . On February 28 , 1986 , petitioners made an application to respondent Zoning Board of Appeals for area and lot line variances. • Gn October 12 , . 1986 , after having previously held a public hearing, respondent denied petitioners' variance requests finding that a r.ajority of the parcels in the area are much larger than petitioners ' parcel; the relief requested is substantial in relation to the requirements; the difficulties claimed are not sufficient to warrant a granting of the requested relief; the character of the area would be adversely affected, as would the safety, health, welfare, ccnfort, convenience and order of the Town. Petitioners contend this determination is arbitrary, capricious , illegal and against the weight of the evidence. In reviewing a decision of a board of zoning appeals , the court presumes that the decision of the board was correct. Falvo v. Fernes, 222 A.D.2d 289, 225 N.Y. S . 2d 747 . To obtain judicial relief it is necessary for petitioners to overcome this presumption . See, Revorg Realty Co. v. Walsh, 225 A.D. 774 , 232 N.Y. S . 141 . The Court will not substitute its judgment for that of the board of zoning . appeals in the absence of an abuse of the board's discretion. Greiaura .v. Board of Appeals, 57 N.Y.2d 865, 450 N.Y.S. 2d '39. A use of land established under an illegal permit does not gain--- for the landown_.er a right of non-conforming use. Conger v. Mongin, 87 A.D. 2d 932, 450 N.Y.S .2d 81 . However, where a large sum of money has been invested in good faith under an illegal permit, such may be considered when determining whether an-'-applicant has suffered unnecessary hardship. Jayne Estates , Inc. v. Raynor, 28 A.D. 2d 720, 281 N.Y. S .2d 644 , aff 'd 22 N.Y.2d 417 , 293 N.Y. S. 2d 75. ~ PAGE 3 HEINS V. GOEHRINGER INDEX NO. 86-21779 i Here, petitioners have invested a large sum of money after receiving a building permit. However, petitioners represented to the building department that they owned two subdivided building parcels, a fact that was not so. It also appears that petitioners had applied for identical variances in 1983 which were denied by respondent in 1983. Petitioners, knowing the status of their parcels, as is evident from their 1983 variance application, cannot now contend they started construction in good faith. Thus, in this instance, unnecessary hardship has not been shown. The Court finds respondents ' determination to be neither arbitrary nor capricious , illegal' or against the weight of the evidence. Accordingly, the petition is dismissed. Submit judgment . J. S.C. Riverhead...........................� N. Y.,. February. .......... 87 .......... TOWN OF SOUTHOLD, COUNTY OF SUFFOLK, N. Y., Dr. 'I`O..SMI'I'H,.FUU STEIN, LUNDBERG,' ISLER. &.YAKABOSKI . ' .Claimant 456 Griffing Avenue, P.O. Box 389 Riverhead New York 11901 Address.................................................................................. 1 Fed. I. D. No. 11-199-3737 ..................... Re: Town of Southold v. Heins or Soc. Security No. ......................... " For all services rendered in a Heins v, Z.B.A. - 66886 of the Town of Southold; including initial conferences .. with:secretary.c er _. o e zoning , recei f 'petit ion and su ortin a s review o a own tiles re a ing fo tile canplained of, including files dating back to a pri application for similar re—lie in ; pVaration o response and return, telephone calls with Chairman of Board of Appeals and attorne or e n s• re aration of memorandum o law, r I&t and review of es nsive doc uments ran , oners counsel anrd suomssion or all documents to the court for consideration a 11 e g0�o1987 ation of the Court dated January dismissing the petition. All of which encompused approximately 20.5 hours-"of attorneys time L$ 2,562 .50 The undersigned Claima t) (Acting behalf of above named Claimant) does hereby certifythat the (Cross out one) foregoing claim is true and correct and that no part thereof has been paid, except as therein stated, and that the balance therein stated is actually due and owing. Dated ,......February..2...........'......, 19..87...... .. .......... . ............ ............................... Si tur FRANCI J. OSKI : ............ .......................... �.......... 8.7... TOWN OF SOUTHOLD, COUNTY OF SUFFOLK, N. Y., Dr. TO...,sr??:? i,.ER-117ISM { LIT�IDBERG, ISLER & YAKABOSKI ; . .........Claimant 456 Griffrig�F,venue,�P.O.�Box �$9� Riverhead, New York 11901 Address.....................................................................:........... 0' Fed. I. D. No. 117199-3737 RA• Town of Southold v. Heins (con't) or Soc. Security No. .......................... #66886 DISBURSEMENTS: Pip Printing $ ,46 1.43 Postage . 4 1.80 TOTAL: The undersigned (Claimant) (Acting on behalf of above named Claimant) does hereby certify that the (Cross out one) foregoing claim is true and correct and that no part thereof has been paid, except as therein stated, and that the balance therein stated is actually due and owing. Dated ....FebruarX. ............ 19..87...... ........ .6. .......... natur IS J. YAKABOSKI SUFF o ..AUG 1 4 2024 BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD B6lding DepartmentTown Hall Annex - 54375 Main Road - PO Box 1179 .y down of Southold Southold, New York 11971-0959 y�0 ao! Telephone (631) 765-1802 - FAX (631) 765-9502 1 iamesh southoldtownny.clov - seand(a_southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: Company Name: Electrician's Name: License No.: Elec. email: Elec. Phone No: ❑1 request an email copy of Certificate of Compliance Elec. Address.: JOB SITE INFORMATION (All Information Required) Name: C171 Address: Cross Street: Phone No.:ZZI- Bldg.Permit#: 104Z email: Tax Map District: 1000 Section: Block: -5- Lot: BRIEF DESCRIPTION OF WO(\K, INCLUDE SQUARE FOOTAGE (Please Print Clearly): may- o1� bw cal--ems 'ate CA) d,..P�V_�40U Square Footage: Circle All That Apply: p� Is job ready for inspection?: ❑ ES _ NO ❑Rough In ❑ Final Do you need a Temp Certificate?: ❑ YES Issued On Temp Information: (All information required) Service Size❑1 Ph❑3 Ph Size: A # Meters Old Meter# ❑New Service❑Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead # Underground Laterals 1 2 H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION 43600 )06P ��/ q---)4 r2t C�, ! o �-123 PERMIT# Address: Switches '' *444%, 1 t Outlets G F I's-� -'��, � �p Surface ) t Sconces t I H H's UC Lts Fridge HW _�(60 POOL V Panel Fans Mini Fr. W/D Pump Exhaust Oven Sump Heater Trnsfmr Smokes DW Generator Salt Gen. Carbon � Micro GrbDis Water Bond Lights Heat Pucks ERV HOT TUB/SPA Inst Hot ' DeHum Transfer Disc Combo Cooktop Minisplit Blower AC ' AH.� Hood Blower Service Amps Have Used Sub Amps Have Used Comments ' T � 4 1414 U SU;=F ' AUG 1 4 2024 BUILDING DEPARTMENT- Electrical Inspector TOWN OF SOUTHOLD 5WIding DepartmentTown Hall Annex - 54375 Main Road - PO Box 11.79, . ® � °n of Southold Southold, New York 11971 095'9= : o Telephone (631) 765-1802 - FAX (631)'765-9502 ` jamesh(a�southoldtownny_gov seand(a_southoldtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: Company Name: Electrician's Name: License No.: Elec. email: Elec. Phone No: ❑1 request an email copy of Certificate of Compliance Elec. Address.: JOB SITE INFORMATION (All Information Required) Name: QnL/D(. 4 (4_eln,5 Address: r Cross Street: Phone No.: - Bldg.Permit #: J042$9 email: Tax Map District: 1000 Section: Block: -5 Lot: BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly): 5 ' /SM L--Le Square Footage: Circle All That Apply: �J�,� �' j Gam,' Is job ready for inspection?: ❑ ES NO -]Rough In ❑ Final Do you need a Temp Certificate?: ❑ YES Issued On Temp Information: (All information required) Service Size❑1 Ph❑3 Ph Size: A # Meters Old Meter# ❑New Service❑Fire Reconnect[:]Flood Reconnect❑Service Reconnect❑Underground❑Overhead # Underground Laterals 1 02 D H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATIONoC� Memorandum from . . . . BUILDING INSPECTORS OFFICE TOWN OF SOUTHOLD TOWN HALL, SOUTHOLD, N. Y. 11971 765-1802 c x 44 l LL Vl ----—i 1, n, 11 1::).TIC — •r , 06 I - W 3 1 Gl co 1 UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VJOLATION OF �--i Lij SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. I COPIES OF THIS SURVEY MAP NOT BEARING �� > ! TH� SU.VET'O,'S IN::D SEAL OR -�' MBO'SED SEA!SHALL t•;:,T GE CONSIDERED TO BC A VALID F;.UE COPY. 1co oN ��- 0k4c- ' e9.1 7UARANTT:S !!,Zo!CAT:C I!:C:'?N SHALL RUN J ')NLY TO I:!_ ,E. Ft::. ,i;iCi A THE SURVEY IS FkGA.AL), A.:D 0:-li,i G:HAIF TO THE I / t, (� ��' TITLE COM A`:Y, G0V,:,iJMLNiAL AGENCY ANII -p I I.:SIiTU"iIO:J L:SI.D HLREON, AND } TO THE ASSIGNLES CF THE LENDING.INSTI- TLT;OhJ. GUARANTEES ARE NOT TRANSFERABLE 4 i �CJ"' 10 ADDITIONAL INSTITUTIONS OR SUBSEQUE14 OWNERS. J AT ,.- V l OAK r_.. /V1/I _ t i L 1. l a �. GH t h N r"+✓ +tea t , , __. 3"'fi1Zu � � G•to'_,rG.►� OHDQ T -7 co T i ? �� • I��w A�Rrt cs c.� 1 C7f�..• � >r•.,. ► I i ?W Ct fg 4 i Jf4ncry LYC4JfF'- d( l�2VCla C t'btiJe ? ! 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' 3 G,i.SP.l3!-'ta ..�C,lJU� ?�3I U C= ad 3t0-- a ,.^,�.��,a� # AMF -�S.T , G2 vCCi0e�ei- F•-?X'ru r~;;#5F'�J S'fiIA. .... . . d ' �;'` FEE: �S° BY MCCUPANCYNOTIFY BUILDING DEPARTMENT AT OR _ .t,000E:� } r�p� r- ��** a�"• 765 1802 9 AM TO 4 PM OR THE C.o E !lei a F ME I � �� ••';a, FOLLOWING INSPECTIONS: UNLAWFUL '! 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE �� 2. ROUGH - FRAMING & PLUMBING CERTIFICAN NIL . 1�,!�.t�EG �it�c`� N�;t� 3 t{.c��!_s�.' k„ 3. INSULATION f 4. FINAL - CONSTRUCTION MUST F OCCUPANCYBE COMPLETE FOR C. O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N. Y. ,. CONSTRUCTION ONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. �� _ a-e'er— t , aL9 ARC tip FROJ CT:_# .14.79a2 ScAt�• : ,�►5Sk w E � �, E� �� K Architect and Engineers Seal and {` .,/�' t V tJ."C L. AT C N S ALB ERT A. SACC+O, ��ca r C�QQ°° '.', '+AI#eratton of this Oocurt�ert except eft Signature only goad for initial use of ' ' DRAWN $Y �44A� 1 by an Architect or Lice% skl Profes- AND GORDO�I . AHLERS .� swing. Changes, al#erations ar re. j } L-L �Y 10 t y �► `Y P .S CT 10 N C u c K Y, , 3 sional l~ngineer, is illegal visions to or re-use of drawings with-. _-... .:. .. a 'i''• ARCHITECTSvrl� IVGINEERS T j c 9�' H. a ' Section '7Z09, Sutxlivisiart ?.� /� tom, ^ �t - ' D A -�- �4� out Architect or Engineer's Approval A-D D I T(0 I V .T ': J' or 5"55 MAIN ROAD SOUTH4lD, N.Y. 11471 - N.Y. State Education Law, '' ^ =, PI+AN, �N p �L;V5 ,SIDI= l:L&V.;4TYR SECT. AUDITION r vr�ids Seal and Signature on same. �. V ' �. 1' '., �,'' . ToGQRAGjsrwry. 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C Nlr t,K E.t> t3'� - vision's to or reuse of drilwings with- ARCHITECTS & ENGINEERS • Section 720), Subdivision Chi l 2 '�!�'T' a 10�1��7� out Architect or Engineer's'Approval .N. Y. State Education Law. G A r p souTH®>b; N:Y. 11971 vOWs Seaf and Signature on same. 54555 MAIN R��iS M. r-, :1 {�S 11 ` :`T�. �frY� L DD auc ?024 BUMDING DEPT. TOWN •)F SOUMol Broadair AC Manufacturinq. PO BOX 40696 Houston, TX 77240 \ MFD. 0212022 Model# BCSO-14D322G48S1R8 Serial# 8228084317 Factory Charge 0.0 oz Power Supply(VlPhIHz) 230/1f60 f ' Compressor 230/1/60 { 27.9 RLA 137 LRA a n Fan Motor 230/1/60 ~ y: 2.1 FLA Design Pressure(psi) r f High:300[2068kPa] ( Low:150[1034 kPa] ,r Minimum Ckt.Amperage Max FuseAlax Cki.Brker, (HACR type recommended) 60 .. CM ni�T rvo i.cc ILCr�; ID J AUG BUTLDING DEPT. TOWN .)F SOUTP CT "