HomeMy WebLinkAbout27996-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEP~qTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29360
Date: 04/16/03
THIS CERTIFIES that the building
ADDITION & ALTERATION
Location of Property: 1100 SEVENTH ST
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 48 Block 2 Lot 41
GREENPORT
Subdivision Filed Map No. -- Lot No. --
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 9, 2002 pursuant to which
Building Permit No. 27996-Z dated JA/%q3ARy 9, 2002
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is issued
is ADDITION AND ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED
FOR.
Thc certificate is issued to JACKSON A TAYLOR
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPRO%5%L
ELECTRICAL CERTIFICATE NO.
1044983 03/24/03
PLUMBERS CERTIFICATION D~r~u3
Rev. 1/81
[2/20/02 PECONIC PLUMBING & HEAT
Authorized ~nature
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
(THIS
BUILDING PEP~MIT
PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 27996 Z
Date JANUARY 9, 2002
Permission is hereby granted to:
JACKSON A TAYLOR
305 WEST 28TH ST -APT 16D
NEW YORK,NY 10001
for :
ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR
at premises located at
1100 SEVENTH ST
GREENPORT
County Tax Map No. 473889 Section 048 Block 0002 Lot No. 041
pursuant to application dated JANUARY 9, 2002 and approved by the
Building Inspector.
Fee $ 150.00
Authorized Signature
COPY
Rev. 2/19/98
Form No. 6
TOV*~N OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL ;
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
qhis application must be filled in by typex; riter or mk and submitted to the Building Depmlment x~ ith the fi,llowing:
A. For new building or ne,,,,' use:
l. Final survey of property with accurate location of all buildings, property lirtes, streets, and unusual natural or
topographic featm-es.
2. Final Approval from Health Dept· of water suppl.,,' and sewerage-disposal (S-9 fonn).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statemera from plumber certit3'ing that the solder used iu system contains less than 2:10 of I qb lead·
5. Commercial building, industrial building, multiple residences and similar buildings and ir~stallations, a certificate
of Code Compliance t'rom architect or engineer responsible for the building·
6. Submit Plmming Board Approval of completed site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, buildin2 and unusual natural or topo~aphic
features.
2. A properly completed application and consent to inspect signed by the applicant, it' a Certificate of Occupancy is
denied, the Building h~spector shall state the reasons therefor in writing to the applicant.
C. Fees 1. Certificate of Occupancy - New dwelling $25~00, Additions to dwelliag $25.00, Alteratiorts to dwelling $25·00,
Swimming pool $25.00, Accessoq' building $25·00, Additions to accessory' building $25.00, Businesses $50.00·
2. Certificate of Occupancy on Pre-existing Building- $100.00
3. Cop.,,' of Certificate of Occupancy - $·25
4. Updated Certificate of Occupancy- $50·00
5. Temporary Certificate ofOccupanc3 - Residential $15·00, Conunercial $15.00
,,ate. 7-0'5
New Construction: Old or Pre-existing Building: ,/" (check onel
Locatiouof'Property: -7o~x _~~.~ ~ 5/'.__ ....
}louse No. Street Itamlet
OwnerorOwnersofProperty: 7~c /q Yo~....- 'f-r4
Suffolk County Tax Map No lOOO. Section lql-g Block____.~ ______Lot q ~
Subdivision
Pe t No. ? q
Health Dept· Approval:
Planning Board Approval:
Date of Permit.
Request for: Teinporary Certificate
Fee Submitted: $ ~ ~-.
Filed Map.
Applicant:
Underwriters Approval:
Final Certificate:
Lot:
(check one)
"~Applicant Signature~'
BY THIS CERTIFICATE OF COMPLIANCE THE
NEW YORk BOARD Of FIRE UNDERWRITERS
BUREAU Of ELECTRICITY
40 FULTON STREET ~ NEW YORK, NY 10038
CERTIFIES THAT
Upon the application of upon premises owned by
G & S ELECTRICAL CONTR. JACKSON TAYLOR
BOX 215 1100 SEVENTH ST
SOUTHOLD, NY 11971, GREENPORT, VILL, NY 11944
Located at 1100 SEVENTH ST GREENPORT, VILL, NY 11944
Application Number: 1044983 Certificate Number: 1044983
Section: Block: Lot: Building Permit: BDC: NS37
Described as a Residential occupancy, wherein the premises electrical system consisting
electrical devices and wiring, described below, located in/on the premises at:
Basement, First Floor, Outside,
was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was
found to be in compliance therewith on the 24th Day of March, 2003.
Name QTY Rate Ratin~ Circuit Type
Alarm and Emergency Equipment
Sensor 1 0 Carbon Monoxide
Sensor 3 0 Smoke
Appliances and Accessories
Furnace 1 0 Oil
Exhaust Fan 1 0 F.H.P.
Dish Washer 1 0 1.2 KW
Wiring and Devices
Receptacle 14 0 General Purpose
Switch 23 0 General Purpose
Fixture 21 0 Incandescent
Receptacle 1 0 20 amp Laundry
Receptacle 1 0 30 amp Dryer
Receptacle 7 0 GFCI
Service
1 Phase 3W Service Rating 200 Amperes
Service Disconnect: I 200 cb seal
Meters: 1
1 of 1
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the lecation indicated.
~r~r~m~r~ra~r~ra~rmPr~r~r~r~r~Jr~-IrJ~ ~-[Jr~J~r-J-~J~@Ir~irJ~ir~r~irair~ir~ir~~~~
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Fax (631) 765-9502
Telephone (631) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATION
Date:~__
Building Permit
(please print)
I certify that the solder used in the water supply system contains less than 2/10 of 1%
lead.
Sworn to before me this
day
Notary Public, ~L~.~, ~,~(D I~..~
O O (Plumb~ Signature)
VIC~I L. LOPER
Notan7 Public, State ot New Ym
No. 01L08070081
{i~alfl~ in Suffolk Counl~
FOR:
]~NERGY CUDS CALCULATIONS
[For Non-Electric Heat)
Design Criteria 6,000 Degrem'.nat,~
O.A. 10"f' i.A. 7U"F
DSSIGN '£IlMRMEL REMARKS
- SUBSYSTEM AREA "U" RATING
t::xterioc Wail~ (Opaque) ~ ,0~ + ~
Ceiling/Roof (Opaque) 17 0 , o~ o
Gkyligh ts . %
f,loor ;7 ,O 0 5 0
~ounda tlon Walls
Slab Insulation
TOTAL ~ ~
Uuildlug Z'.welope S~'stems to meet require,l~ent~ ~£ 7815.2
IIVAC Squipement to mee~ requirements of, 7815.11
llVAC Systmus to mee~ requirements of 7~.15.r2
Duct Systsms to reset requiremehts of 7815.13
Ventil~tiol%s Systsms ~o meet requirmuents of 7815.14
Insulation of Piping Systems to meet requirements of 7U15.15
Ssrviue Water Heating Systems & Equipment
SlectrJ. cal ~ Lighting Systems & Equipment
to meet requiremmits of
to mee~ requirements of 7UJ, 5.31
To the best of my knowledge,
belief, & professional
judgemel~t, these plans are
compliance witix the code.
BUILDING PERMIT EXAMINER CHECK LiST
AP P LIC ANT NAME :i~fleC'~ od--[g,~toK
SCTM# DISTRICT: 1,000 SECTION:
STREET: 90-2 (a,~,~,/~'r
PROJECT DESCRIPTION: ~bU/~c~ -t~
ESTIMATED PROJECT COST:
DATE REVIEWED: / / ~ /02
DATE SUBMITTED: ! /~ /02
SUBDIV. NAME:
ARCHITECT / ENGINEER."~-~o.--~ ~ cc
FAST TRACK?
SINGLE & SEPARATE CERTIFICATION-REQUIRED? b/O NOTES: ~-
LOTS 40,000ST -100-24. Lot recognition.(CREATED before June 30, 1983), UNDERSIZED LOTS FROM JAN.1997 100-25. Merger (A nonconforming at any time after 7/11831
ZONING DISTRICT:
REQ. LOT SIZE:
REQ. FRONT
REQ. REAR 3
CONFORUINO? #0
ACT. LOT SIZB:~ REQ. LOT COY. c:~
PROP. FRONT 4~t.'f t.~Q SIDE
PROP. REAR ,_g57,3
WATER FRONT? /v' o DESCRIPTION:
PANEL #: I~ FLOOD ZONE: ~ ,
ACT. LOT COV.
ACT. SIDE
APPROVALS REQUIRED
SUFFOLK COUNTY HEALTH DEPT: YES o~(BED #): DTE:
TOWN SEPTIC RECEIPT: Y or N
NEW YORK STATE DEC: PRE-DEC9/1/7$ YES (~
SOUTHOLD TOWN TRUSTEES:
, YES o
TOWN ZONING BOARD APPROVAL: YES or'(~
TOWN PLAN. BOARD APPROVAL: YES orr~~
TOWN HISTORICAL PRE (SPLIA): YES oi~.Q.d
NYS ENERGY:~,~aRNO : 4-5~
EGRESS (18 H m~n.. 4 sq total) ~ VENT (SQ. FT. k 4%)
BU1LDING PERMITS OPEN/EXPIRED: BP
HAVE PRE CO'S: Y OR N BP
NOTES:
PERMIT #:R10-
/
/ LIGHT (SQ. FT. x 8%)
-Z / C/0 Z- ,
-Z / C/0 Z- _,.
FEESTRUCTURE:
FOUNDATION: SF
FIRST FLOOR : '-/o,9,.q SF
SECOND FLR: SF
TOTAL: 40~- SF
1NIT OTHER TOTAL
FEE FEE FEE
rOT( /1/.2o/ SF)-( ,---- .SF)= / SFX$ y =$ -/ +$ /r'o+$ ~ =$ / ~
765-1802
/~BUiLDING DEPT.
/ 4NSPECTION
[ //]' FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[[]] ~iRR~;pI;;cE&CHiMNEY[ ] FINAL
REMARKS.' ~
DATE
765-1802
BUILDING DEPT.
NSPECTION
[ 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLA~'~HIMNEY
~REMARKS:
DATE
INSPE~~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ~/OUGH PLBG.
[ !/~UNDATION 2ND [ ] INSULATION
[ ~FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
//-REMARKS: ~
7GS-z802
BUILDING DEPT.
INSPECTION
[ ] FOUN/~ATI~N 1ST [ ] ROUGH PLBG,
[. ~OUNDATION 2ND [ ] INSULATION
~/~ [~/] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH~P_J,BO~
[ ] FOUNDATION 2ND ~]~t~ULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLAC~H~I,~/~EY
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [, ]_~TION
FRAMING [~']" FINAL
FIREPLACE ~CHIMNI~Y .~
DATE INSPECT(]
-I
~ON PER N. Y.- · ·
· ~AT~EhKRGY
CODE
:,, (/- -
TOWN dF $OUIltOL9
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: 765-1802
Approved
Disapproved
//////'r'~ 20 o ·
PER_MIT NO...~ ~fi'~'-
BUUI)ING PERMIT APPLICATION CHECKLIST
Do you have or n~ed ~ following~ before applying ?
Board of Heakh ~
3 Se~ ofBtdld~g p!an~
Survey '
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
~ to;
Phone:
Building Inspector
APPLICATION FOR BUILDING PERM1T
Date /-- 0a~ - ,20 Oo~
INSTRUCTIONS
a. Tkis application MUST be completely filled in by typewriter or in ink dud 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 pubhc streets or
areas, and watm-ways.
c. The work covered by thi~ apphcation may not be commellcecl before ismmuce of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building P~mit to the applicant. Such a penmt
shall be kept on the premise~ available for impection throughout the work.
e; No building shall be occupied or used in whole or in part for any purpose what-so-ever until a C~dficate of Occupanc)
is issued 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, Ord/na.uces or
Regulations, for the construction of buildings, additions, or alterations or for removal or &anolifion as herein described. The
applicant agrees to comply with all applicable laws, ordinances, building code, homing code, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
(signatu~ of app/~aat or, e, if a corporation)
z eD.., 5'o ,/4 Y. /,
(1V~aillng addr~as of apphcant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No.
Plumbers License No. ~ (IJ'-~
Electricians License No.
Other Trade's License No.
Location of land on Which proposed work will be done:
House Number Street
County Tax Map No. t000 Section
Subdivision
(Name)
(as dn the tax roll or latest deed)
/ Hamlet
Block O.2,.,
Filed Map No.
2. State existing use and occupancy of premises anti. intended use a~d oceup~cy of Pr°p°sed construction:
· 5,'.., ie ~o ,-, ?.t ~o..,,~/I,'.., ,'
a. Existing use and oCCUpancy / /
h. t ded e docm y S, , / e ,
/
Na~e of work (eh~ w~ch ~hcable): New B~l~g Ad~fion
R~ R~ov~ D~olifion O~ Work
Alteration
4. Estimated Cost ,~
- /
5. If dwelling, number of dwelling units
If garage, number of cars
Fee
(Description)
(to be paid on filing this application)
Number of dwelling units on each floor
6. If business, commercial or mixed occupancy, specif3z nature and extent of each type of use.
7. Dimensions of existing sumcmres, if any: Front ,Z. oc (~ Rear Z &, 6 Depth.
Height ~" Number of Stories ¢
Dimensions of same structure with alterations or additions: Front ~5'~ ~
Depth -3 y' Height '- Number of Stories
8. Dimensions of entire new construction: Front ~ Rear ~ .Depth
Height ~'- Number of Stories /
9. Size oflot: Front /o0 Rear ~O0 ' Depth 6P0, /"~7 /
Rear
q
10. Date of Purchase
Name of Former Owner
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zomug law, ordinance or regulation:
13. Will lot be re-graded
Will excess fill be removed from premises: YES
Name of Architect
Name of Contractor/A/, /
Address ~0f-~/~ P,2~c ~'~,1, Phone
Address Phone No
AddressY'~Z,~,,,.~.-;f~gr, ,2~ Phone NO. s-o,. .'q..o Ic~.X/, ,"',//~ 71
15. Is this property w/thin. 100 feet of a tidal wetland? *YES NO ~
o IF YES. SOUTHOLD TOWN TRUSTEES PERMITS MAY BE RE(~U-~D
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
STATE OF NEW YORK)
SS:
COUNTY OF )
LO ~'1 !; c' v~- ~ t~(~ f 5~ 0 ~ b~g dMy sw~ d~oses md says ~t (s)he is ~e a~hc=t
~me of M~d~ M~g con~) above
(C~r, Ag~t, Co~omte Office, ~c.)
of said owner or owners, and is duly authorized to perform or have performed the said work dud to make and file this appl/cation;
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 tc~before me tl~ ~
~? dayof /]-~ , 20c9..~
Notary Public
HELENE D. HORNE
Notary Public. State of N~ York
No. 4951364
Qualified in Suffolk Counbc~
Commission Expires May 22, ~x~:9'O_..~
Signature