Loading...
HomeMy WebLinkAbout12062-z FORM N0.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.. z'I,'162'I......... Date A1~z~i~-. .15 19.85 THIS CERTIFIES that the building .New,Dla;el~irg,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, Location of Property ...250. Victoria, ,I~rjve, , , , , , , , , , , , , , , , S.4td'(=hA.l,d............ . House No. Street Hamlet County Tax Map No. 1000 Section ...~78......Block ....09.........Lot ...0'JO-.Q`].:i..... . Subdivision ...............................Filed Map No. ........Lot No. . conforms substantially to the Application for Building Permit heretofore filed in this office dated , , ,November , , , , , , . , , 19 ~.2 pursuant to which Building Permit No. ...:12Q62Z.......... . dated DeC ember. 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.Alew. Rv~rellang The certificate is issued to ....~Ioseph. Mary..Kilksxrny....... . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ~,?-so-138 N549789 UNDERWRITERS CERTIFICATE NO . Building Inspector Rev. 1/81 e x TOWN'OF ~OUTHp4D,t BUILDING ~DEPARTM~N~ TOWN' HALL - ~ SOUTHOhD; N. Y.' BUILDING PERMIT (THIS PERMIT MU5T BE KEPT ON 'SHE PREMISES UNTIL ~ULL COMPLETION OF 7HE WORK AUTHpRIZED) N° 12062 Z data ~C~"i-J'l,~±"EiF" 19..`~ ..y"r. i x Permission is hereby grouted to-" ro of premises located at ~,.~(~.........f'EC~~~ ; : 3'`~., /U County Tox Map No. 1000 Section Block ' Lot No. pursuant fo application dated " 19......;.; and tspproved by the Building Ins~p+ecto~r. ~ Fee S, ~GY I " ' i . G i ~ 9. i ~ ~~y~® Y k /~NY~~...... . ~ iT .uo.u. .u..... .u..uo......r... Building ;InspectoF E Rav ;6/30/84 t ~ ~ s ~eE ~ ~ . ~ . r FORM N0. G 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- torwith 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 Depx. of water supply and sewerage disposal-iS 9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, tndustria! buildings, Multiple Residences and similar buildings and installa- tions, acertificate 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 wrvey of property 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 oiherpertinent informa- tion required to prepare a certificate, ~ C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling o land use$!S`' $5.00 3. Copy of certificate of occupancy $1A0 p Date ~/:<n~~0~~- . . . New Building .............Old orPre-existing Building(X) . z Vacant Land Location of Property 7~` D U',~c ~O,e;~ , ~r~;v . House No.' Street Ham/ef Owner or Owners of Pro erty .:~.or°%~ ~ ~~es~ ~ % p y ......f~.//!..... County Tax Map No. 1000 Section O , , Block - A, Lot ,o w. O?/ Subdivision .................................Filed Map No. ..........Lot No. , Permit No. l.zd . Date of Permit /.'.'~?f ?!..Applicant . ~~°v 4 ~ ~ ~k~-'^' j Health Dept. Approval . ...............Labor Dept. Approval . Underwriters Approval . .......................Planning Board Approval • Request for Temporary Certificate .....................Final Certificate - Fee Submitted $ Construction on above described building an ermitmeets all appf{cable~odes and regulations. Rev. 70-7078 J.'~-~ ~ ® 7m ~ ` W• f'• - l c•k ~ Zooot22 THE NEW YORK BOARD OF FIRE UNDERWRITERS i1B BUREAU OF ELECTRICITY ' ~ 85 JOHN STREET, NEW YORK, NEW XORK 10038 L+ ~.y p~ M"... Date ~ ~ t APPlication No. on file '~'g~~1'~~$~ N «g Jy ~ g{ r,.g THIS CERTIFIES THAT v °R v ec only the electrical equipment as described below and introduced 6y the ap Licont named on the shove application numher in the premises of .7oseph Ki.7.kLATtny, 7`i0 Viotor~.~ I~r. , 5ou1~taolc~F i1.X. I in the following lomcionl ©Basement © 1st FL. ? 2ad Fl. Section Block Loc I was examined on ~'~yy~j ~y Z~ t ~9~~ and found to be in compliance with the regnirements of this Board. FIXTURES RANGES COOxING DECKS .OVENS DISHWASHERS EXHAUST FANS HXTURE RECEPTACLES SWITCHES me uxr OUTLETS INCANDESCENT FLUORESCENT VAPOe AMi K W AMT. K W. AMi K.W AMi N W. AMi H P 41 5~3 43 G~. 1.2 :i DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS gElt , UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMi. K. W. Oll H P, GAS H. P AMi NO A. W. G AMT. AMP. AMT AMPS TRANS. AMi. H P NO. OF FEET AMi WATTS 4 F 1 50 1 i SERVICE DISCONNECT NO.OF S E R' V I C E ' AMT. AMP. TYPE METER ~,9 YW ~ ~ 3W 3 d 3W 3,e' AW NO OF CG. COND. A W G. NO. Of HLLEG A G' NO. OF NEUTRALS A. W. G EQUIP. PER ,e' OF CG COND. OF HbLEG OF NEUTRAL s7 OTHER APPARATUS: k~vtors a "1-E'. 1-i~,1~.T. ~ 1-G.~.C.1. 1-Smoke lleCL~CCfr { Track2i~,kLtiTa~a4-0", 3µiita~. .I Paixl. $L1$418 Town Harter I.r1aTr .F SOUttL01d, N.X. t ~.~'7.a. L3.c.~28Z ENERAL M NAGER ~ a F A Per r"= ~ This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be iden Ted their credentials. C PY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST] NOT BE ALTE ED IN ANY MAN ` ~ .,'.n a.>i ~ nw i ~ ~ ~ x.t,~, t., FIELD INSPEC%f°ION~ DATE COMMENTS } ~ Q ~o cJ 1 3 R _ y N FOUNDATION (1st) ~ FOUNDATION (2nd) ~ _ - 2. z _ V R, ROUGH FRAME & Q, PLUMBING _.r-~ R e H 3 . ~y t~ INSULATION PER N. Y. / y STATE ENERGY ~ ~ !.'~µZ .~d CODE x ~ ~1 ~ l ~ ld 5p H 4 . FINAL C~ i o z c~ ADDI ONA COMMENTS: ~ ~ ra ~v H 77 \ H H O Z . ~ x ~ ra . r H ~ xO') d rn -d \ H W i _ . _ _ ` 6 4 °~l ~rT.J yGd ~ ~ - C~>vi- ~/J; u c6riuti vh c~t'_ by ,2,~-- off' ,~,y„v~.~ v~~" s~-~u d ~G~ ~~-'~."17 i ! - FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 f7 TEL.: 765-1802 Examined ,~:./.~i.L~...~~ry~.... 194~?~ / Application No.~~Q . Approved~E.G.../ 190°.~Permit No.~~~/.4~~ Disapproved a/c , . . (Buil g Inspector) APPLICATION FOR BUILDING PERMIT Date ..~4' 19 ~Y INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for Che construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordi nces, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for n essary inspections. ~ ' /i.,~ ~ (Signature of~applXCant, or na~m~, i~corporatio (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .............CY-Rim?~!`'~..................................................................... Name of owner of premises ~'''.c':e~-.'e..~ . Ka . /.~T.~.,,1:?.... ~ ..'~-h.c ~ K~~ ! k9.!i.n!, . 4 y .x............ (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. . . Plumber's License No. Electrician's License No. . Other Trade's License No. . 1. Location of land on which proposed work will be done . . ' ` ,a -7SO y ; C ~'J ~ / . D/' ~'c' c~ ~ GEC .......1 ~.....1..................... y.................... House NumberS7treet q Hamlet -7 County Tax Map No. 1000 Section ........1. Block Lot r. O 7 ~ . - ~ 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 ....V..i}-c, !-...h.~ ~ r . b. Intended use and occupancy .....k s v ~ ~ 4.~ ....6~?'S-~~~.... ~ . 3. Nature of work (check which applicable): New Building Addition Alteration . Repair Removal Demolition , .....Other Work . r~ ! ~ ~ (Description) 4. Estimated Cost ........J._~c~a~r.,:n? Fee % . . (to be paid on filing this application) 5. If dwelling, number of dwelling units .....?~:'f ~ Number of dwelling units on each floor . . If garage, number of cars . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . 7. Dimensions of existing structure's, if any: Front ..•-r.-':'........ Rear ~ Depth r.:-':': Height .............-.::.Number of Stories " . Dimensions of same structure with alterations or additions: Front Rear . Depth .r':....,.. Height ...t:':................. Number of Stories . 8. Dimensions of entire new construction: Front 3°~... , Rear .....:@r°....... Depth . Height Number of Stories v. ~K-.............................................. . 9. Size of lot: Front Rear /:Z ~ Depth . 10. Date of Purchase ! /:.?'7.-:,. (9?.~............ Name of Fo er Own ~ ~'.c 11. 7oneorusedistrictinwhichpremisesaresituated............~;,,..,,.?-~,.',,,,,,,,,,,,,,,,,,,,,,,,,, 12. Does proposed construction violate any zoning law, ordinance or regulation : . 13. Will lot be regraded .......Will excess fill be removed from premises: Yes No 14. Name of Owner of premises K. ~ l~€fI~ ,Address 5•-• 3~/ .............Phone No.?.~. Name of Architect . . . . C„ Address ...................Phone No............... . Name of Contractor ...........................Address ...................Phone No............... . 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. i I STATE OF NEW O S.S COUNTY OF (Name of individual si ni ~ ~ ~ • ~ ' ' ' ' ' ' • ~ being duly sworn, deposes and says that he is the applicant g ng contract) above named. He is the (Contractor, agent, corporate ofTicer, 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 mannejr set forth in the application filed therewith. Sworn to before me//thi, s ~ ~ e Notary PublicG~~~?~~~.-:~. County JUDITH T. TERRY ~ yE^?~% d~ l `••LiL%~P Notary Puhliq State of NeJa York No. 52-0344963 Sufiolk Couny~~ ~i ~ v ($lgri ure of applicant) Commission ExpireaMarch 30, 197. - i ~ o i 8 n' l~ C; Beoih?ca$ ±T ~gS.taevi9ug ieaaua~ So SoTR~ b py 1' 1 ~ vr' ?V . \ Y e„.' 'fttaa:J~r.itii~tl$ 0~ 0`3 r punol putt acowa.tttdep eYka d; 7oaoodsu; -uacSp-~€sseu-uIIiasooi-sS~:~si:,S--d~FaliY u Siddsts aoaA~ puu issodaip o3snt3s,®q1 O ~ VIC'CQ1"<i'_IFt. ~7~'9~t'~;~ ~~°"'~~61P0 3, i~ !n~ SSG. ~ e~ ~~~v~xt~ x tktRai x7.oa~n9 _ o ~T___~~___ ___o . >~~.c~ . m 2z; m . ~ d ~ o I a+a n; ~ - w. L87~1! FR.HCT, N_ (ia' : ~ ' +'sl p ~ 1 ~ ~ ~ I ~ I h ~s ~ ~ ~ ~ i C~ ~ ~ E .w~ ~ ~~~.c~ t s.~s r~ ~ ~°r~.~ i t nn.~n r~ F ~ wC~~.~.}R'e G.~~F ~4~~d~~~ N , ~ ~-.-..w.. ~ ! ~ f r ( _ ~ SJ f s M rtl` ~ { i ~d • 1 ~ <J _ 1 . , ' ~ 4 ~ v ~ r'`/ f ~3 = ; t'~,'3 ~ 1 , A ~ w ~ ti ~ ~ ~t E~a ~ ~ 4 cca . , ~ , F 't t . t. try r E ~ ~ t, 2 t ~ v ~ ~ O r , _ ~ ~ ~«t - ~ p ~ . ~ ~ , s nor Shoo°~ =~m~ ' ~ ~ ~ y ~ ~ -'°r ~gz<$z cam , x ~ ~ .V }~,m € ~ a~~ ~ a ~ ~ i~~ ~ QQ e ~ p ~1" i & O Si ~ n t'~ (",j~~ t ~ r ~ £ b ~ - ~ .~i, iY• R~ ~ • } c ~ 0 ~ ~ ~ ~ I . . 3 _._.__.f_.,.~_..___..__r___._.-._ `a. SY rc p~ ..1 . ~ ~ _a....~_........_.._~..c~.... T~~~_~~ O :J'..}«~; ~I ~ W ~ I_ ~ iii { ~ ~ ~ ~ ~ ~ ~S ~C~. ~ 'mil .5.. ~ -1~ ~ r 1~~ ~t;~.7~ ~ 1. ~ _ ~i.2~°~ ~ ,i ~ ~ ~ j ~ ~ ~ ~ i { c~ rv i - { j Ja _ ~ !!i MR ~ ` r _ ~i I• t 1 i ~ ~ ~t'E~~',.~ s t~., ~ ~~_.,F - t• ~ i ~ ) ~ ~ ~ ~ yyt` t d.;t ~`y tt7 ~p~~"~ti,Ti t..~ ~tt }'ag,~ ~~,t~ { f~,s~ ~ N t jt ...g ~ j 1 t ~ 5 ~ ~ a ~ l ~r` ~ ~ ~ w -i ~ ~ p f] 4~ , I ~l I`ni t ~ ~ F~ ~ t 'G 'f ~ t _ ~ o a z v n m a m n~ ~ ~ 2'^~pttt vin~ZmCrf ~ z~m ~ tfi ~j ~ ~ ~ t ~ ~ M ~ ~ .Zl M 1 < Q In p 0 m $ ~ ' y pia ° r y m <m ~ -r r ~3D m i 2' ~ i o xa D O~ m C n x x 3 cn m O u o~z ~ 0 0 D o c o °LOs"~~~(~p~'~v a~r£ $,~"o~ ro xk ~ ~ ~ r ~ ~ ~ ~ z ~ rT m Z fl v ti> N 1 N y o Z M ~ ~ !r \ ~ ~ v O 'l N~ o i 2 N jLY, to ~ ~oo~ ~,p= fo_, (S w ~ Gp ro D y ~ ~ ~ ~~~m x 1 A ~ v D m Y x~mNs~a~ °a ~ ~P ~ 0 0 i v m 41 Z D ~g m ~.in O ~~bo~~ S~ ~ ~C~ z r m < '3R ro 's m is ,.'d' r a~ m r ma mrrD- 8 ~/xTura~ [ c,' 91' /:2 12 t t, SECT.' Cei[in~ 2 ........... ,' ? PJ~P.S..F. : Living Area~F a~,r,. ........... 40 P.$.F. ., All ~ncrefe u~ed IS ~ develop a mm~um ~mpr~sive ~frengfhdn 28, d0~ a5 fol~o~: Footings and Wa I~ - ~ P,S.I. Garage Fl~r and'~oops,- ~ P ,S.I. ' Using a minimum 5 bag ~x p~r cub~c~yard, All 2"x6" and larger framing lumber sp~ns ore ~sed on the ~5~ o~ No,. ~ Douglas Fir Larch (Noffh) 9r equal havens a modul~ of ~la~flcD~ aT 1;7~ and a ~al ~duraf,ion d~ign value of (~1~0) wlf~ ~ mai. not ~ exceed 19 percent. ~., '5. D~uble floor i~B~ under all parallel ~6.' Use ~-2x12 hea~e~ over all e~eri0r 16ad b~ng~openlngs Unless o~e~isenoted~ 7. D~ine the exact cabinet size 0n the iob~ ' '~ffer the Wall finish has been applied'; Ex~rJo~ wall dJmensJon~ are to ou~ide~of '~'shea~ing.' Interior' d~mensmns' ' ~ not include d~waH, r 9. ~11 ~rs and jnterlo[ openings are 6'8" - Unl'ess othe~Jse noted. O, Cgofo~ ~ oil dimensions ~ndt~t~d ~re~ere~ce to scaled d~men~lo~s from ~the '~lueBri~.. , ' , - Wh1'Je. ~v~y attempt hag':been made m the pr~ar~hon 0F this plan ~ avoid m~ :~ mq~r cannot ggarantee ~aJ~s~u~p ~error. ~e.cp~tractor ~ ~e lob m~t, ail ~mensm~s an~ d~talJs and.m~s~be ,~ ~ ~rbund' f~uJt 'clrc~it pmtechon~ for ail el eGtrl~al.outJ~. l_e- "'/' J h __? '1 -22'/0 ,2" SPILL PY~LirJ ,s' CT/O,V- '5]-c , Z, ~L~j¢ TILt~ TO gJm? FIT 3'-/5 '; I