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HomeMy WebLinkAbout11700-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED Certificate Of Occupancy No. Z14730 Date July 31, 19.8.6 THIS CERTIFIES that the building .... Pine. :~/~'qJ,~Y..clw~.l.l.i.r~g ..................... Location of Property 930 Ol.e Jule Lane Mattituck County Tax Map No. 1000 Section .... ], 1, ~ ..... Block ..... 1.2. ........ Lot..1.3...4...&..P/.O...1.3.. 3 3/7/83 Subdi~.don l Ko.~al ski).. PB..qpp r.o.v.~ ..... Filed Map No ......... Lot No..B. ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated · .M..ay..1.8. ............. 19..8.2pursuant to which Building Permit No...]..1.7..0.0.Z. ............ dated . .M.a.y..2.6. ................... 19..8.2, 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 f.a~.ily dwelling. The certificate is issued to .... q'Qb~ .~L~..~.~..n~.~..g.o..w.~.~s.k..~ ............................ (owner, of the aforesaid building. Suffolk County Department of Health Approval 13- SO- 12 N604011 UNDERWRffERS CERTIFICATE NO .................................................. Update of C.O. #11782--to reflect lot line change. Building Inspector Rw. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..~P?~ ......... Date ....... July `14- .......................... 19.83.. THIS CERTIFIES that the building ...New..lZ~e.~.LSmg ............................... Location of Property . .9.}.0...O.l.e..J.~. ~?..L.a..n? ........... · ...... Iq.a~ct ±~cuck Hou~ No. Street Hamlet County Tax Map No. 1000 Section `1 `14- ·Block `1 2 ..... Lot `1 Subdivision....0.h.~.i..s.~.5.~.~...K.~.n.~ ........... Filed Map No..! ~. 7 .... Lot No. conforms substantially to the Application for Building Permit heretofore fried in this office dated ·..l~.a. 7' .1.8. ........... , 19.8..2pursuant to which Building Permit No....~-'~700~ ........... M~y 26 82 dated ............................ 19..., 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 ......... ..... .~.ox .a...o~e...&a.a.i.~. 7..d~e..~.~.~.n.f~ ............................................. The certificate is issued to Johrr a Linda gowalski ..................... [o'~n~;','/~'dr't~.r~h~t/ ...................... of the aforesaid building. `13-so-`12 " Suffolk County Department of Health Approval .......................................... N604-0`1 '1 UNDERWRITERS CERTIFICATE NO .................................................. ~.~. Building Inspector Rev. 1181 I~ORM NO, I~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 11700 Z Permission is hereby granted t.~ ....... ~.~.,.~. ....... ~.~..~.. ...................... ........ .~,.,.~.,~. ./~../...~.,.~. ....... ~l..~ ,o ..... ~-~.-:~'~.~...._~ .... ?~..~,~'~,~.~_~ ................ ........................................... ....................... at premises I~:oted a-~/...~;:.,~.~.,~. ........ I~;)~.....~.~......~J~.~ ....................................... ...................................................................... ..,~,~.~.~.,_~. .......... E....~f~-_-_~....~.//..y.. ........... /~z.~.....~.~...~. ........... .(..... t, County Tax Map No. 1000 Sec 'on ........ i .~... .......... ~lock ....~'...~... ........ Lot No ......................... pursuant to application dated ....... ~..~.~.....~..~... ................ , 19 ........ and ~pproved by the Building Inspector. Rev. 6/30/80 NEW YORK STATE DEPARTmeNT OF E}rVIROI~NTAL CONSEP, VATION Regulatory Affai=s Building 40, Sb~Y Stony Brook, N'Y 11794 (516) 751-7900 Robert F. Flacke Commissioner ,A, CO.P,Y..OF THI~I A .UTI!OR.I. ZATION MUST BE AVAILABLE ON PROJECT... ~ohert & Ruth R. Geffk~n 56 I~2odm~nt Boad Melville, NY 11747 TWNL ~ 15275-0101 "A" TIDAL ~.~T'~UOS ~JOTIFICATION LETTER APPROVAL Dear Sir: This is to inform you that we have reviewed the notification letter (or permit applica~ion) filed on 4/28/ 1981 and have determined that it will not be necessary to file a permit application (or secure a tidal wetlands permit) to construct one-family dwelling, garage, swimming pool and associated septic syst~n on 4.1 acre parcel designated by Tax #Dist. 1000- Sect.~ 114, Block 12, lots ~3 and 3.4, west side of Ole Jule Lane, approximately 610' SOUth of New Suffolk Avenue, Mattituck, Town of Southold, Suffolk (20. Ass,ming you have obtained all other necessary permits, you may proceed with your project adhering to the special ccnditions (if any) found on this letter. This project must ~,~ly with all local flood plain ordinances. cc: U.S. Army Corps of Engineers NYSDEC Law Enforcement - Region Regional Permit Administrator 5/6/81 Date Issued 6/30/82 Expiration Date TOWN OF ~OUTHOLD Building Dep&i ;.iient Town Hall ~outhold, N.Y. 11971 76.5- 1802 APPLICATION FOR CERTIFICATE OF Instructions This application must be filled in typewriter OR ink, and submitted m ~ 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 disposel-(S-g 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pL"operty 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. Exist Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 $15.00 Date....7/.2.9./..8.6 ............... i--- for ~ Up_date since #11782 issued 5/82 to reflect lot line cha. nge. ~v(~ ~)~)~)4N ~)~.., Old or Pre-existing Building ............ Vacant Land ............ Location of Property .. 9AC).. 0.1 .e.. ~] U ) .e..[, Q p ~.,. ~ ~ .t.t. i 1; U ~:.lt ............................... Houae No. Street Ham/et OW ner or Owners of P rope rty ...~.q t1 ~. ?.... ~ p .cl.. ~ i p.clA..F,..Kq v/~ ] .s.k i ....................... County Tax Map No. 1000 Section .. ] .~ .4 .......... Block ...... ]..2 ....... Lot .~ .3...~. ~. P./.0..1.3.. 3 Subdivision. ! .K.o.w.a.~. s, .k.i.).P.B...aj:).pf..o.v.e.d...3/.7./.8.18ileal Map No ........... Lot No....B .......... Permit No ........... Da~e of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval Planning Board Approval . Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. Applicant.. ~. ~.'..~~; ................... Rev. 10-10-71 Survey attached. d.~, z/ %/?Sd FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy TEMPORARY No..~13 ?.0.9 ......... Date ............. Jnne..~. ............ 19@.~. THIS CERTIFIES that the building. ~ew. ]]welliug ................................ Lo~tion of l~operty .. 9~.(]. 01~ .Jula .Lana ....... ~t' .... MattLtuck ........ House No. County Tax Map No. 1000 Section ... 3 .'1.~ ..... Block .... .'12, ........ Lot ....... ~ ~.. ~.;..: Christine King Subdivision ............................... Filed Map No..~. ? ? .... Lot No....~. ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... I~Ioy..~[8 ........ , lff~., pursuant to which Building Permit No....'].~-7(~©~- ........... dated .... May 26 19 82, 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 ......... For a one family dwelling The certificate is issued to John & Linda Kowalski (owner, le~se or tenant) of the aforesaid building. Suffolk County Department of Health Approval ~] 2-oo-82 UNDERWRITERS CERTIFICATE NO. N 604-01~I Building Inspector 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 In.,pec- tot 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 dlsposal-{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-exisfi~g" 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. Dpte of any housing code or safety inspection of buildings or premises, or other per[inent inform3- lion required to prepare a certificate. ' C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.OO et land u se '~'15'~$5.00 Date ....... New Building ....... Old or Pre-existing Building(X) ......... a tVacant Land ............ 930 Ole Jule Lane, Mattituck, NY location of Property... ................................. . . , . .. ... .. .. ~... ..... ~-.... .... .. Hou~ No. Street ~ 'Hamlet Owner or Owners of Property......John and,. T.~.~;].~i...,_KOW~i~]~i . .................... . . . .. . County Tax Map No. 1000 Section . .114 .......... Block ..... ~2. ........ Lot... ~--~,4 ........ S hdv Christine Kin 1.17 4 u__ s on ........... .g ............... Filed Map No .......... lot ~Jo .............. 5/26/82 - ' R..Ge.f.f.k.e.n. Permit No. ~[70.0..~ . Date of Permit .......... Apphcant ........................... Health Dept. Approval .1~..."'..~,0. ~'~. .......... ,~W14~a~ ...................... ,.. Z.B,A. approval 3/23/83 (#3091) 3/7/83 Underwriters Approval Planning 8o~rd Approval ............. Request for Temporary Certificate Final Certificate ' Fee Submitted S ............................. COMMENTS FIELD INSF~CTIC~ 1., FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & ?LUMBING INSULATION PER N. STATE ENERGY ~ODE FINAL ADDITIONAL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY [~ 38 JOHN STREET. NEW YORK, NEW YORK 10038 o,.. t~y 27, 1983 .~ppii,,,o,.Xo.o,.me 204].S~S3 N 604011 THIS CERTIFIES THAT only the electrical equipment as described below an~ i~trodueed by the applicar~t named on the above appllcat~on nu tuber in the premises of ' John Ktrm~kL, OLd Jula ~ ~ Suffolk Ave. Y, xaus Rd., ~lacr. LCuc~, ~.¥. in the foliotving location; ~ Basement ~ 1st FI. ~ 2nd FI. Section Block Lot teas examined on ~y 19, ~L~ and found to be in compliance with the req,drements of this I}oard. FIXTURE OUTLETS ItECEPTACLES SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS ~,7 ~ 30 DRYERS FURNACE MOTORS FUTURE APPUANCE F~EDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SERVICE S E R SYSTEMS NO. OF I~ET V I C E 2/0 1 2/0 OTHER APPARATUS: 1-G.F.C, I. 1-Sauke De~cU~r UJ. chard t~.ys~ P. O; ~.372 / Per i :redentials. This certificate must not be altered in any manner; return to the office of the Boq~d if incorrect. EPARTMENT. THIS COPY OF CERTIFICATE MUST NOT g BUILDING DEPT. INSPECTION []FOUNDATION 15T [ ] ROUGH PI~Q. []FOUNDATION 2ND [ ] INSULATION []FRAMING ~] FINAL REMARKS: 7GS-18e2 BUILDING DEPT. INSPECTION [ ]I:~)UNDATION ~ST ~ ROUGH PLBG. [ ]FOUNDATION AND [ ]INSULATION  FRAMING [ ]FINAL ./ - ./. ~L~ O,eV~LIAT ¶ TAX FIA~'~ o[~t~]'~0W M~,TTrl'd~, H-'6 1 J,.,,, ,. U"~ ARCHITECT 275 IIIO&DHOLLOW 10AO MIELVlLLE JEW YOlK 11147 SIS. 293 4778 TOWN OF ECXJTHOLD BUILDIN{3 DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapproved i/c APPLICATION FOR BUILDING PERMIT t= ~.= ' ~o -~ Applicatio~ No. ,//.Z .O~.. ........ - INSTRUCTIONS- , a. This application must'be comple,tely fille-,d in by typew~i,',~r ,~r ~.,ink, a~,d. submitt,edin triplicate to the Building Inspector, with 3 sets of plans, accurat~ plot ~ tO SCale. Fee ac~di~g to schedule. b. Plot plan showing location of lot and of~b'~lldings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drown 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. Upoo approval of this application, the Bu/ldin~ Inspeotor 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 Cerlificate of Occupancy shall have been ~ranted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Depadment 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 ,Iterations, or for removal or demolition, as herein described. The applicant a~rees to comply with all applicable laws, ordinances, buildin~ 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) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . ~..L-~...~e.. ................................ :~ ................................................ Name of owner or premises . ~I~,,~.~.11t. ./~,~.'~1/(... ~:',~..~.~ .................................. (as on the tax roll or latest deed) If app~corporation, signature of duly aut~,orized officer. . . . ..... ....... (Name and title of corporate officer) TO RFJ~OVE ro~,t,~: Builder's License No. ~.~.../~.~. ............... Plumber's License No.. 2~. ,.. , .~e~.., ......... Electrician's License No. ~ .~.alsMIr~ ....... ABOVE pRF.~ISES FROM R. EGRADING LOT -- -- ~C CONST~ Other Trade's License No ...................... 1. Location of land on which proposed work will be donee. X~, ~, ....... ,g~.~~,_, ,,, . ........... ....... ' ............ House Number ~5~'0 Street Hamlet County TaX Map No. I000 Section .. Il .~. ........... Block .../~. ........... Lot./~.~.~'. {.~. ¢.~. .... Subdi, on. .... ....... -- Map ....... .......... (Name) , . 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... ', .1~..~. ~.~...'~.. ..................................................... b. Intended use and occupancy ... (:~J~ f .... ~: ....................... 3. Nature of work (check which applicable): New Building .......... Addition ..: ....... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... ~'- (Description) 4. Estimated Cost...~/~ ......................... Fee ~/.~.~..~. ........................ / (to be ptdd On filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars ~ 6. If business, commercial or mixed occupancy, specify nat~ and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories: ....................................................... Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ..... : ................ Number of Stories ...................... 8. Dimensions of e~nJir~p.n, ew construction: F~o,n,t c ""~' ~'~-' P' ~.t.. Rear ..; .~. ~.../.--~ff.... Depth .-~..-.~..~. ..... Height .... M'...~". i .'~ .'.. Nur~'l~e~'of Stdries':...'.. ~.. ~'..,.%. ~..' ....... · ................................. 9. Size of lot: Front ..... ~..~. ............. Rear ...... ~..~ ............. Depth ..,~/~. ............... 10. Date of Purchase . .. ......................... '.... Name of Former Owner ............................. i I. Zone or use disfrict iN which premises are Situated~.:, ;': .................................................. 12. Does proposed construction violate any zoning la~;, ordinance or regulation: . ~ .......................... 13. Will lot be regraded ... ~ ..................... Will excess Cfll be removed from premises: Yes ~ No 14. Name of Owner of premises/~a~. ~,~;g~'.. Address ~'~. ~Oz~tlt~o~7'..~hone No. ~'2.~./..,~,~ ..... Name of Architect .......................... Address ~/d/1/~. ~h~.u~e:... Phone No. Name of Contractor ~r~,./t~r~_~,.' . . . . .~j~. Address ~.~ ...... Phone No. ~.~. ~d~i i i PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK. COUNtrY OF.. .... S.S .... ?~/r.o. ~. ,~r. ........................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is ....................................................... (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 f'rie 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 f~rth in the application Cried therewith. Sworn to before me this ............ /..~. .... dayof ...... ~...~. ......... 19~..~ (~ ' ~i~.~S~ ~ (Signature of applicant) -/ This sheet may not be duplicated without the architects written consent. ARCHITECT ANALYSIS & NOTES FOR COMPLIANCE O1:x THIS STRUCTURE WITH THE N. Y. S. ENERGY CODE Name of Builder Name of Model Plan File N~o. 1. Analysis of the "U" values of the wall, roof and floor assemblies are as per the "standard" diagrams shown in the code and are rounded to the nearest 1./100. 2. Slab edge insulation to be provided in ail living areas as shown on plans. The "R" value of insulation is to be g=5 for unheated slabs. 3. Glazing to be either insulated glass or storm windows, U=. 69 (including frames). 4. Exterior doors to be urethane core or wood with storm door, U=. 40 (including frames). 5. Window & door manufacturers to provide certification of compliance - including. infiltration loss per E402.4 of the N. Y.S. Energy Code. 6. Calculation of heating loads to be by others. Design of mechanical system to be by others in conformance with sect. E403 of the code. 7. Domestic hot water to be as per sect. E404 of the code, Manufacturers c~rtificution to be provided, as required. If the space heating boiler is also used for domestic hot water, the standby loss of the boiler may not exceed: 13.3 (PMD) + 400 = BTU./hr. Max. standby loss. No. of Baths PMD Max. Allow. standby loss No. gal/hr BTU/hr i 29 2656 1½ 30 2699 2 42 3240 2½ 42 324O 3 45 3375 *n - assumed at . 296 Boiler manufacturer to certify compliance with the above per sect. E404. 3 (al . 8. All exposed hot water piping and ductwork in unheated basements to be insulated as per sect. E403.9 & E403.10 of the code. 9. Fireplace units, ff provided, to include a tight fitting smoke damper, tight fitting, heat resistant glass enclosure doors, & a duct for outside combustion air, fitted with a closeable damper. 10. The design basis for heating analysis is as per code, as follows: Outside design temperature = 10 (Suffolk County Airport) Inside design temperature 72 floating Degree Days = 6000 11. The design wi//be predicated on Par~ 5 - Generally Accepted Standards. The design as reflected in the above notes and calculations and attached construction plans is, to the best of my knowledgn, in conformity~andards' of the N. Y. S. Energy Code. ~~~, Architect. BLOCK OUTSIDE AlE KIT INSTALLATION SIDE VieW Jl II FRONT I ,~H1M Nt' :REAR ELEVATION 'RIGHT ELEVATION ,'[E! LEFT SIDE EE,(VATION t ,I FLOOR 'PLAN i¢ ¢. ,4.'~¢'L LAg SECTION A-A L T~'irl, FA:5~IA/ I I F :I I I SECTION ':4 ]4~ q5 I~" SECTION E-E HKD: PLUMBING H~ ~ALE KITCHEN C A"BINETS . '~/~'"-I'-~'" DIAGRAM' HOg, AH qALITE'L LIqH-~,~4Zgg' E~UAL, >~- r~,,- ..... , 'r- ~)" -7-- / ..... /'~, P-90 ~? "Jr should be ,noted that s~nce thins J~'eperty is Iomted in an agHculturoi area~ the possibJ~ty exists that the water ~upply may contain trace amounts of pesticides end/or n~trates, Special anaJysiS ~/~ required. · . JXCAir I'II]Ii SUFFOLK CO. HEALTH DEPT APPROVAL H. S NO, STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THiS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOL CO DEP F EALTH SERV CES APPL ~cA N~.,~ SUFFOLK COUNTY DEPT OF HEALTH SERVICES - FOR APPROVAL OF CONSTRUCTION ONLY DATE, H S REE NO IC'~ I APPROVED' SUFFOLK CO T~X DIST SECT BLOCK PCL ~WNE~DDRESS: DEED L tO~4 P. ~,~E~ (~_~'.') , TEST HOLE STAMP SEAL l