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HomeMy WebLinkAbout29138-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29448 Date: 05/20/03 THIS CERTIFIES that the building ALTERATION Location of Property: 1800 TOWN HARBOR LA SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 65 Block 1 Lot 3 Subdivision Filed Map No. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 31, 2003 pursuant to which Building Permit No. 29138-Z dated JANUARY 31, 2003 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 ALTERATION TO AN EXISTING ACCESSORY BUILDING AS APPLIED FOR. The certificate is issued to CAROL A OWENS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1119834 05/09/03 PLUMBERS CERTIFICATION DATED N/A Aut orizedIn Snature Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 29138 Z Date JANUARY 31, 2003 Permission is hereby granted to : \ JAMES A & CAROL A OWENS 1800 TOWN HARBOR LANE SOUTHOLD,NY 11971 for ALTERATION TO AN EXISTING ACCESSORY BUILDING AS APPLIED FOR. THIS PERMIT REPLACES BP#27022 . u " o at premises located at 1 0� TERRY LA SOUTHOLD County Tax Map No. 473889 Section 065 Block 0001 Lot No_ 003 pursuant to application dated JANUARY 31, 2003 and approved by the Building Inspector to expire on JULY 31 , 2005 . Fee $ 75 . 00 ori ed Signature COPY Rev. 5/8/02 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) n_. &c(A '2 9/39 PERMIT NO. 27022 Z Date JANUARY 18 , 2001 Permission is hereby granted to: JAMES A & CAROL A OWENS 38-31 218TH STREET BAYSIDE,NY 11361 for ALTERATION TO AN EXISTING ACCESSORY BUILDING AS APPLIED FOR. at premises located at 1600 TERRY LA SOUTHOLD County Tax Map No. 473889 Section 065 Block 0001 Lot No. 003 pursuant to application dated OCTOBER 5, 2000 and approved by the Building Inspector. Fee $ 35 . 00 Authorized Signature ORIGINAL Rev. 2/19/98 Form No.6 TOWN OF SOUTHOLD 14 , BUILDING DEPARTMENT TOWN HALL _ 765-1802 I-- - APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of I%lead. 5. Commercial building,industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For 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,building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy-New dwelling$25.00, Additions to dwelling$25.00, Alterations to dwelling$25.00, Swimming pool $25.00, Accessory building$25.00,Additions to accessory building$25.00,Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy- $.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial$15.00 Date. New Construction: Old or Pre-existing Building:�—(check one) CY,-ter Location of Property: 18-,90 n4ce �,4eeA6M House No. Street( Hamlet Owner or Owners of Property: (�f Suffolk County Tax Map No 1000, Section Y733-& Block Lot X 03 Subdivision 7 -3/* Filed Map. Lot: Permit No. Z 9/3 Z,Date of Permit. l �' 3 Applicant: ���� Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ ����� Applicant Signature a �nns�l�nsrnns��rL3ffPr lIrr�.nss�r�l�I�nnsrn��l`n�nn��s�l�n�ss�l�rr�nns�rsrs`nrns�r��rns�rs�prn�nsr�`nen o 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 BUREAU OF ELECTRICITY 5 C5 40 FULTON STREET — NEW YORK, NY 10038 rCj CERTIFIES THAT SUpon the application of upon premises owned by S 5 DOROSKI ELEC. INC CAROL OWENS 5 5 P.O. BOX 781 1800 TOWN HARBOR LANE CC5 CUTCHOGUE, N.Y. 11935, SOUTHOLD, NY 11971 5 Located at 1800 TOWN HARBOR LANE SOUTHOLD, NY 11971 c� ..��5 Application Number: 1119834 Certificate Number: 1119834 5 Section: Block: Lot: Building Permit: BDC: NS11 5 5 Described as a Residential occupancy, wherein the premises electrical system consisting of 5 electrical devices and wiring, described below, located in/on the premises at: 5 5 First Floor,Detached Garage,Outside, 5 j5 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was e5 found to be in compliance therewith on the 9th Day of May,2003. �5 5Name OTY Rate Rating Circuit Type 5 5 Panels 5 5 1 50 4 5 rj Wiring and Devices rj 5 Receptacle 5 0 General Purpose 5 Switch 5 0 General Purpose 5 Fixture 4 0 Incandescent 5 Fixture 1 0 Fluorescent 5 5 Receptacle 4 0 GFCI 5 5 A visual inspection,of the delineated electrical installation,determined that an obvious hazard is not present and the installation is believed to be 5 5 in comformance with the applicable reference standard for the estimated period of construction of the premises wiring system. 5 5 5 5 5 5 5 seal 5 5 5 5 1 of 1 rej 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. tPclrJ�[P[P[f[P[P[PcP[P[P[PtPr P[P[P[PrJ@P r: 101 1P[PtPrJ@11I- -EPC! C iPc jrmjj P[Jr MVI 10[PtPrJ@P[PcP 0 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE BUREAU OF ELECTRICITY 40 FULTON STREET, NEW YORK, NY 10038 .1Ft' l&7 19,3-� '8'00/r'NI 2 5:1:3£G Date `�rL.aia � 1 '' Application No. on file THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of J.AP0;S C:67FN'S, 1S101f T'_ HARBOR. LANE, SOUTHOLD, N`? in the following location; ❑ Basement ❑ lst Fl. ❑ 2nd Fl. OUT Section Block Lot l_APi'UF:PY 0"4 ,2000 was examined on and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING OECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENT FLUORESCENT I OTHER IIIAMT, I K.W. I AMT, I K.W. AMT. I K.W. I MT. K.W. AMT. H.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. K.W. OIL N.P. GAS X.P. AMT. NO, A.W.G. AMT. AMP. AMT: AMPS. TRANS. AMT. H.P. NO.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 E9UIP. 1 R RW 1 0 7W J 0 3W J 0 dW pER 0 OF CC.CONN. NO.OF NbLEG OF HIAEG NO.OF NFUTRALS OF NEUTRAL 1 2a�a cB 1. X OTHER APPARATUS: PAUL R. BURNS _ L L PO BOX 1061 SOUTHOLD, NY, 11971-0932 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. Applicant,/ p Date Owners Name�Ck^f\. P\ 47 CA, A V( _ t`,jeAS_ _ Reviewed 1111e. in0_ Architect/ Date _ Engineer ___ __ Submilled K) S('l M Il District. 1000 Secuon (s Block _. Loi Prolca � � Subdivision I )Calico -- Suigh S separate Required canif(atmrl (Yes/Nol_ Kc4 Hcy_ /Dome ),,ci 4 II of svc �uual 34�3o� lacy Req Req r (Rom Yard/VA Proposed /"0 f (Side Yard proposed f [Rear Yard Propo_,,d .«l I Project Description: Azo 4 Ae'essro ,i AGENCN'8,_ERMITS Permit REQUIRED FOR REVIEW N.A.. NO YES Number Suffolk County Health Dept. New York State D. E. C. Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation ??? ) r Flood Zone: X to -�JO.J !'rcJ'�+_jT/,, � ! t' rt �/I S/lK TO i..J'+ � l/w\^ / /_"'r15 a% "() �fff 4 LJ�'Y Or�W))i ,, WG3 /J4!/T 3 -41- 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE CHIMNEY REMARKS: °'- v DATa/91 INSPECT ql3w M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH-PLBG. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING FINAL [ ] FIREPLAC CHIMNEY REMARKS: � 2 DATE INSPE �' 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS ATION [ ] FRAMING [ INAL [ ] FIREPLACE & CHIMNEY REMARKS: C - DATE ` d ✓ INSPECTO FI-, L7 IN,"PECTION REPORT DATE COMMENTS T ell, u III-- FOUNDATION ( IST) N u I y FOUNDATION (2ND) it ROUGH FRAME 5 PLUMBING I» n l n If n n E H N II INSULATION PER N. Y. xi If STATE ENERGY II n u -- —It CODE If If I N -Ik = Lrl II II it II II JV FINAL n — —_ C 11 II AD ITIONAL COMMB S: 1 oz �H 1 "'1 V\ ttl r p H \\a ro N BOARD OF HEALTH . . . . . .. .. . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . .. . . . . . . TOWN OF SOUTHOLD SURVEY . BUILDING DEPARTMENT CHECK . . . . . . .. . . . . . . . . ... . . . . . . } TOWN HALL SEPTIC FORM . . . . . . . . . .. . . . . . . . . 5 U SOUTHOLD, N.Y. 11971 DEC . TEL: 765-1802 TRUSTEES . . . . ... .. .. ....... . . . . L NOTIFY: q /3 8 W`k9rcp CALL . . . . . . . . . . . . . . . . . . Examined... ............. 29.°L. MAIL TO: . . . . . . . . . . . . . . . . . . . Approved....,!/. ........ 7-0°l. Permit No. .4�7�a��% ................................. Disapproveda/c .................................. ................................. . . .... . ....... .............. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date. . . . . . . . . . . . . . .. . 2C. . . . INSTRUCTIONS a. This application not be completely filled in by typewriter or in ink and submitted to the Building Inspector 3 sets of plans, actuate plot plan to scale. Fee according to schedule. b. Plot plan sowing 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 meat be drawn on the diagram which is part of this application. 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 whale or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICUION IS TEEM MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Tone Ordiof thhe Town of Southold, Suffolk Canty, 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, o s, building code, housing code, and regulations, and to admit authorized inspectors on premises and in builid for necessary i Vons. ( upguhattse of applicants,, or name, if a corporation) �0„OCJ �C+JfI/%//fK$ ,La.............. (Mailing address of applicant) Soo 7 P 4 0 Nyt. /t91/ State whether applicant is wiper, lessee, agent, architect, engineer, general contractor, electrician, plumber or buili --...caw.lVF..f .....-.�............../.�..... n............y.............. ........................................ Name of owner of premises .V�1��%�../C. YIIt�P�...l?•<...®Wie'r�:?................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ......................................................... (None and title of corporate officer) BuildersLicense No. ......................... PlumbersLicense No. ......................... Electricians License No. ..................... Other Trade's license No. .................... L location of land on which proposed work will be dam.. 4 4 5AI..44................ ...................................................................................................................... House Number Streetrr hamlet Canty Tax Map No. 1000 Section ...�.�........ Block/��.t......1....... Lot X......5...... 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 ......rl.'.19:XA4. L. /....................................................... b. Intaded use and occupancy r/.-A.gAf�(S.; =.......... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ... v Repair ............ Removal ............. Demolition ............ Other Work .ADS?....IWI- 6W ..L1�y .04'. A/ (Description)Nrpv ap0(25 4. Estimated Cost .....C�.��I......... fee .............................................. (to be paid on filing this application) 5. If dwelling, cumber of dwelling units ............ Number of dwelling units on each floor Ifgarage, cumber of cars .......//............................. 6. If business, commercial or mired occupancy, specify nature and extent of each type of use...................... 7. Dimensions of existing structures, if any: Front... .. Rear .Z Y..,s..... Depth .Z Y... Height ..... / // ....... ..�...... ..... Number of Stories .... j.. .o ......... s[ructhhre.. Dimensions of same with al[era i Front �. or additions: Fnt ... y ....fes... Rear ...4?. .. .... ... Depth ....Z•s/ r .. Height. ��.. Number of Stories �.... . 8. Dimensions of entire new construction: Front ................ Rear Depth .............. Height ......Ir 1./p1./1......t Number of Stories .....�..pp............. ec 9. Size of lot: Front ...I0Q.`..3.3 .[.!.l.... Rear ...�� /N/..... Depth 10. Date of Purchase ..Z1-1-2/9.7... Name of Former Owner .....$rj?/yrF....................... 11. Zane or use district in which premises are situated ................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ..../•Q ... .............. 13. Will lot be regraded .......... Will excess fill be removed from premises: YES �/ _-e� 14. Names of barer of premises �a'VaG.5..,,ry��A&lress .lA-0©.!04W.A Prone No�6� ./.�9.3 Nene of Architect .................................... Address .............................. Rene No. ............. Name of Contractor ................................... Address ...............................Prone No. ............. 15. is this property within 300 feet of a tidal wetland? * YES .......... NJ .. ..... *IF YES, SOD M TOWN TRUSIMS PM41T MAY BE RE pRED. PLOT DIAGRAM Innate 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 chanes and indicate whether interior or corner lot. SI'A1E OE Nyl YOM, SS OOIINIY OF . .. ........ .... . .. ..'.. ' ...being duly sworn, deposes aril says that he is the applicant (Nave of i ideal signing contract) above nnmecl, Ile is Une ...................C`C�C1��i' e—[.—_...................................................... (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. 9worn to be re me this 2 .5.............day of Oc 0 Notary Public ................... . . ../� ? / HELENE D.HORNS Signature of Applicant) Notary Public,State of NowYhtk No.4951364 / Qualified In Suffolk Co Commission Expires May Z2, O. N �A O IV. SURVEY OF L O TS 17 18, & 19 ind O "JONATH.�N T. OVER TON" fLED JAN 4,1932 AS MAP NO. 10.55 V0'� O a�'°` . O A T SOUTHOLD TOWN OF SOUTHOLD Za •� SUFFOLK COUNTY, N. Y. S. 88.35'00' E �R Og 1000 - 65 - 01 - 03 36er /' f : y°' �� "'w_ Scale: 1" = 40' 136:7'Map) �d . • O'\ i. b .�P5 i b,;,/ $ 2 Jan. 10, 1997 W 0� too Irl _ � ,\ \ J� cp.Ilk O) ! �Q � V c AREA = 34,304sq. ft. ' CERT/FIFO TOS vwk JAMES A. OWENS 5 �arN hod �1 CAROL A. OWENS CHICAGO TITLE INSURANCE COMPANY * ♦c PECONIC ABSTRACT, INC. w ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW, EXCEPT AS PER SECTION 7209-SUBDIVISION 2 ALL CERTIFICATIONS N LIC. NO. 49618 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONL Y IF 6 SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR ECONI C. WHOSE SIGNATURE APPEARS HEREON. (5/6) 765 ADDITIONALLY TO COMPLY WITH SAID LAW THE TERM 'ALTERED BY" P. 0. BOX 909 MUST BE USED BY ANY AND ALL SURVEYORS UTILIZING A COPY 1230 TRAVELER STREET OF ANOTHER SURVEYOR'S MAP. TERMS SUCH AS 'INSPECTED' AND SOUTHOLD, N.Y. If 97l BROUGHT-TO-DATE" ARE NOT 1N COMPLIANCE WITH THE LAW. APPROVED AS NOTEDe�. C DATE: / ° B.P.# 70 I U L VIF L FEE: DE m l �� E �`I CK F E t NOTIFY BUILDING DEPARTMENT AT �_;� 765-1802 9 AM TO 4 PM FOR THE �r HOUT GER FOLLOWING INSPECTIONS: F CAb 41CY 1 FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING UNDERWRITERS CERTIFICATE 3. INSULATION REQUIRED 4. FINAL - CONSTRUCTION MUSTf BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOP DESIGN OR CONSTRUCTION, En4�`r ST�FZ L �tlS T 5 l fj0L) r�gp�R ' _ l I10 2X `� Hyl s flF_ W NE w p D n FZ 2x q poo ft ��, 2X y ,� �L Z ' aG 1` oG �r a� ac, i i9 r � .rs 2Xy Sic c, SEIN�- Dp�D fo �`k/Sfir>Gr 2X `� 514,L leaoweo. v VV / 1r 011 i - 71,, 41 r, It i . gy 2 xy ST�p� 2X IO pW /�F e i ee-flIf 2 ' 69 i s r_X s i x�SI iAN6, rL�T &Oiv rEe /fit&G 1 --- Nrw y ,ry s7400sc c;, C, X, pouCt �Mr�ypr i -r l 3 yi s t rlV �, 2,yy 4.L e' o0 2 � W 1 p � p 2 / 0 (:, 1G o� Iw7Y '. - - 1 I \ fs fcw �� - z%la RlDbfi ' ,/ ` iXg RAF EPa nJ Ih + �HFAT I NL cD'.AP w/ IS �. f54T z ' — T&�. 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