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HomeMy WebLinkAbout11983-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy .................. Date ..... March 1 19 .83. NoZl1508 ...... . ................... THIS CERTIFIES that the building ................................... Location of Property 755 Long Creek Drive Southold House No. b'~reet Hamlet County Tax Map No. 1000 Section . .0,5.5. ....... Block ...0.3. .......... Lot. 026 SubclJvision .................... ¥~.;~qc;ot[ ~a?k Filed Map No. :5 ...... 1.8.'(...Lot No .10 ...... conforms substantially to the Application for Building Permit heretofore f'ded in this office dated ·..QC ko.b.~ C. 35. ...... ,195~. pursuant to which Building Permit No...1.~. ~.8.~..Z. ........... dated ..... Q.c~.o.b..er..2.6. ........... 198..2., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate ie issued i~ ......... ~ ~rivate one-family .d.w.e..1.1.i.n.g: ROBERT JOHNSEN The certificate is issued to ........................................................... of the aforesaid building. Suffolk County Department of Health Approval . .1.2.--.~.0. T).0.2' ,. )/.6./..8.~.,..R..o.b.~:..A....V. ~.~.a. t P. E. UNDERWRITERS CERTIFICATE NO ......... .N. ~5.8.~ ? ~.2. ............................ ... Buildin~ l~spector Reg. 1/111 TOWN OF SOUT"0~ ~ BUILDING DEP~RTM~N~ TOWN HALL :- SOUTH'OLD, N~ Y.' BUILDING FERMI~ (THIS PERMIT MUST BE KEPT oN THE PREMISES UNTIL COMPLETION OF THE WORK AUTHORIZED) ~ ULL Permission is hereby granted to: /2 ~ ; , } ..................~<~ ........ ~..*.~., .~ .............. ~. ..... ~..~. · ..~.~z~i..~..;~L;~.r.~ ............... ~ ................... ~ ........... ":"i" ~' ' '''~ '" } ............................... '" ......... : .................................................. '"'" ":'"';Y':~7 ..... ~ '~" ': ....... r- ~s~.~:~...~ ........... ~z..: ...... ~:.~,~ ~ ....... :.~.,~ ..................... Co~ ,~x ~op ~o. ~0oo s~t~o~ ..~...~...~.. ~oek ~.,~.~. ....... :~t ~o...~.~ ........ ..... ........ ,:.: ~: ' ~ ~~.....L ' Building Ihspector. Fee ' ~'~ g~ Rev..~ 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department: Town Hell 8outhold, N.Y. 11B71 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This appJicat on must be filled in typewriter OR ink, and submitted in duplicate to.the Building Inspec. tor,,vi~h the following; for new buildings or new use: 1. Final sur,zey of property with accurate location of all buildings, property lines, streets, and unusu~i n~tural or tooograohic features. 2. Final approval of Heaith 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 building~ 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 sur*~e¥ of peoperty showing all property lines, streets, buildings and unusual natural or topograph ic 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. ' 1, Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date- .~/¢. _ ~ ~-- //¢~.¢~ .. New Building . .. /?..'~ .... Old or Pre-existing Building(Z)., ....... ~/Vscant Land -. ........... ~o~,,o, o~ ~,o~,~ .... ~,~ .... -~¢..~.. ~.~,'~.'~ .... .~?:~.~,4d. ...... Owner or Owners of Property .... e~ _~ ~ ..~.~ . . Co,,,~ ~ M~, ~od00o S~io, . .~,,%,% ..... ~o~* .... ~ ........ Lot.. ~. :~ ........ s,~,~,,,o,... Yr. ~. :e.~c ¢~.~...Pe~ ~..,,e~ ~-,o.. ¢/¢2..Lo, ,o... '/.9. ....... ~h o~t. Approval ../.~..%'F?..A?.~ ...... L~bo~ D~p;. App¢o~ . .~ .............. ,.. U,d,~,i~,~,~pp~o~. ~.~Z. 2.,~ ~. .... P~,i,g So,,d App,ow~ .................. ~.., Request for Temporary Ce(tificate ..................... Final Certificat~ .. ~'.~.(;'.~ .... ~,e fu~m~,,~ S... 5.%¢¢~... ¢ ............. ' ' Construct,on on above de,cr,b,d ~udd,ng and pe,~, aPp~bl/od,, and regu ..... ...... . ..... . ..... 100].071. THE NEW YORK BOARD OF FIRE UNDERWRITERS ~:~' BUREAU OF ELECTRICITY ~- 85 JOHN NEW NEW YORK 10038 STREET, YORK, .l..u.ry ].3,~.9a3 A,,,,,,c..onNo. on/l,. ].949r~..82 N 589752 THIS CERTIFIES THAT only the electrical eeuiDinent_ os described belo~v and i,~tro~uced by sh~ gl~pllcant naro~pd on t~he abo. veg~ol~catio~t· number in the -l~rernlsez Bob Johnsen, Long C~ee~ w:. n/$~xa~ay~ ~outl~o~a~;~. in the followilt~ lo tiorz; ~ ~ wosexaminedon 2~a~n, ]. ~r~,tt ~ lst FI. ~ 2,~d Fl. Section Block Lot and found to be in compliance with the requirements of th~s Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS 22 23 DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS: 1 GFI, S E R V I C NO E~C~COND, OF ~C, COND. OF HI-LEG OF NEUTRAL 2/0 i 2/0 I smoke detecto~ hot wate~ hea~e~, l-4.Skw. Hea~ pump: 1-12.Skw-- G & S Elec. Box 215 SouChold,N.Y. 11971 lic. 578E must not be altered ' ~y manner; return to the office of the Board ,if incm'rect. Per_ may be identified by their credentials. COPY THIS COPY ANy.MANNER. FIELO INSPE'CTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: [~W YOP~ STATE, DEPAP~NT OF ENVIP~L%~NTAL CONSEllVATION Regulatory Affairs Unit Bldg. 40, SU~ffY--Room 219 Stony Brook, iIY 11794 (516) 751-7900 L~ar ~ ifc '. A review has been made of your proposal to: Location: b~ Stff~ OV ~g C{~C~/ 10~t2~ O~ New York State ~part~nt of Environmental Conse~atlon has found , parcel ~ project to be: Greater than 300' from inventoried tidal wetlands. Landward of a substantial man-made structure greater than 100' in length constructed prior to September 20, 19M7. Landward of 10' contour elevation above mean sea level on a gradual, nat- ural slope. Landward of topographical crest of bluff, cliff or dune in excess of 10 feet in elevation above moan sea level. Therefore, no permit under Article 25 (Tidal Wetlands of the Environmental Conservation Law) is required at this time since the current proposal is beyond State mandated Jurisdiction pursuant to ~ts act. However, any additional work or modifications to the project may r~quire a permit. It is your responsibility to notify this office, in writing, if such additional work of modifications are contemplated. Very truly yours, Daniel J. Larkin Regional Supervisor of P~gulatory Affairs DJL:RNT:cz FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1802 Examined~.~.~/ ..... ,1 .9~..z'~- Approved(~... Disapproved a/c ..... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted.~:5~i_:,_?_~ 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 com~nenced 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 pnrpose 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, build~,~ code, housing/code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inj(oectjons. (Signature j ..~..3..q.q..~.~.q~.d.w:e~.. (M ailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... . .(~...c~.. ~ .c.t.~ ............................................................................. Nameofownerofpremises ...~..~.b.e:.~.!.'~..~.~ ¼m.~e~-x. .................... (as on the tax roll or latest dee~~ If applicant is a corporation, signature of duly authorized officer, pErMiT U, .ICLUDES App~OVA~ r .... ,:<c FILL .............................................. (Name and title of co~orate officer) F~'LO~ Builder's License No. ~.~.~ ................ ~Gr, t,?Y ' ,,_'.C'~ Plu ,bers License No. ~.~T~e. f~ om b ,'~¢ CESSv ............ CELl ;',,' Electrician's License No. Other Trade's License No ...................... ~. ro~afio~ of~d o~ w~ioh p~opo~d work win ~e do~ ..... ~.er&. ~N~..~ ~..2 ~. C~ee.~. ~'?:~... ... ~7~ ................... ~e~..Cn,~. [~.. !~ r.,'~.~ ..... ~ r*~.4~ ...................... [louse Number Street Hamlet co~ty ,~ ~p ~o. moo S~cfion .... ~.~. ...... mo~k ... ~..e. E ..... rot ....... ~. 5 ........ S~di~ion....ye.e.~.e.~ .9~.. f?~ ¢% ......... ~it~a m~ ~o...~l&7. .... lot...7~ ......... (Name) 2, State existing use and occupancy of premises and intended use and occupancy of proposed construction: a, Existing use and occupancy ................................................................... b. [~te~ded use a~d occupancy .... ~. ~... ~.~ ~ .... ~ ,/ . ...... ~. C ........................... 10. 11. 12. 13. t4. Nature of work (check which applicable): New Building ....~..... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work .............. i ~_2o (Description) Estimated Cost ....... 1. .o. ~ .................... Fee .......................... ' (to be paid on filing this application) · ' ' / N fd it h fl If dwelling, number of dwelling Units ............ umber o welling un s on eac ocr .~7~..' . .......... If garage, number of cars . ./ ...................................................... If' business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... Dimensions of existing structure§, if any: Front -- Rear w~.. Depth --- Height ~ Number of Stories Dimensions of same structure wRh alterations or additions: Front ................. Rear .................. Depth ;..: ........... Height~ Number of Stories Dimensions of entire new construction: Front .... ,,5-,.~ ....... Rear ... ~.. ~-~ ........ Depth . ~7~ ~. .......... ~2.<> Number of Stories o~ Height .................................................................. /~.o. ' R /~..c>. / .......... Depth ~ .~'?. Size of lot: Front ....... i. ear ............. . .......... Date of P chase .. ~.~.~o/ . Name of Former Owner ./?~ ~ q/~,~ / 4"/. ur ......................... = ......... Zone or use district in which premises are situated ......... ~ Does proposed construction violate any zoning law, ordinance or regulation: ./{gO ........................... Will lot be regraded ... ~.~..,, ................... Will excess fill be remov, ed from premises. ~ N Name of Owner of premises ./~.~..~6ee .~, ,~..o/i.~. ~.e~. Address .ff&o.q .~.o. 0.~..~i,~ .e .,0. 4~t4~hone No. ~.d/,.C...//~..~....o. Name of Architect t, 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. STATE OF. NEW(~Y~RK,, C. ?.U..N~..Y.~~. ~1, I~..~ ~. m ........... being duly.sworn, reposes and says that he is the applicant ~ (Name of individual signing contract) above named. He is the (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 confained 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· Sworu to b~efore me this ~/ ~ PU!~LIC, Sta~e of NeW Y?I~ / (Signature of an~licantl SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. J'~: STATEMENT OF iNTENT THE WATER SU~LY AND SEWAGE DISP~AL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARD~ OF THE ~FFOLK CO~ DEPT. ~ HEALTH SERVICES. ~OLK EGUNTY DEPT. OF HEALTH ~%~ VICES -- FOR APPROVAL OF' DATE: , ...... ' ...... ' .... : ' , ...... ........ ,,, ,~ ,' ,, NEW YORK EXCAVAT[J N ROD~ lek .VAN T...~U:.,,YJ,., P.e. , L'C£NSEO LAN'::' suRvEYoRs GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL h S. NO. STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FO~-~ THIS R/)ESI DE NC E WILL CONFORM T~ //THE STA/~DARDS OF THE (S) ,t/,~,~<~.~/, .~PLICANT SUFFOLK COUNTY DEPT, OF HEALTH SERV'CES - FOR APP.OVAL OF CO.NSTRUCTION ONLY _ H.S. REF. NO.. /~ -~E-/~ /~ ~/ SUFFOLK CO. TAX MAP BESI~ION: DIST. ~CT. bL~K ~L. TEL,~ 'rEST HOLE P. STAMP SEAL ¸It !I of types K or L ollly t t / /?? ~, /' Z 0'..¥'~; '"Z :4/v ¸It !I of types K or L ollly t t / /?? ~, /' Z 0'..¥'~; '"Z :4/v ' Sys em; pl~A. g ~hla ! bc of types K oP L billy : 3. INSULATION 4; FIN/~L - c©NSTPU%TION MUST BE C©MPI F~F FOR CL O. 'ALL coNSTRUCTION SHALL MEET THE REQUIREMENTS OF T~E, N. Y- STATE CONSTRUCTION & E~ERGY S NOT RESPONSIBLE FOR CODE . _~,,~m ~CTION ERRORS. D~SIGN OR U~l~