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Home My WebLink About12308-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z12156 December 23 83 No. ............................. Date ..................... 19--. THIS CERTIFIES that the building, lxt~' D~I41h~N6 Location of Property 365 R'AB, PE~ ROAD WEST SOUTffOLD House No. Street Hamlet 1363 07 0&8 County Tax Map No. 1000 Section ............ Block ............... Lot .......... .....,.- -~ S-- HAR/¥EST I30ME~' ~TATE~ 5337 008 uDuivision..'... 7.. ,; ........ ' .............. Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated AP~Y~ 12 19.8..3pursuant to which Building Permit No. 12308.Z dated '.~.p~'~. lQ ................. 19.8.3., was issued, and conforms to all of the requirements of the applicable provisions of tile law. The occupancy for which this certificate is issued is ......... 'For p, ney,! o.n,e fp~rn,i,,~Ly, The certificate is issued to HR, & ~S, JOSEPH BRA'J~UKA . (owner, le~see or tenant) of the aforesaid building. Suffolk County Department of Health Approval 1.3- s.,o~48. UNDERWRITERS CERTIFICATE NO ..... ~[$.~.~.G ...................................... Building Inspector Re~. 11Sl 12308 Z Permission is hereby granted to: 'TOWN 'OF S~OUTHOi~i) BUILDING DEpARTMI~N1 TOWN HALL $OUTHOLD, N. ¥. ~BUILDING: I;ERMIT (THIS PERMIT MUST BE KEpT ON, !H~ PRE/~!IS~S UNTIL ~ULL COMPLETION OF THE WORK AUTHORIZED) ' Dote ...... , ....................... at p~emise$ located at , , , ............. ; ........ ,~...~.. .................. ~ ........................ COU~ ToX Mop No. 1000 Section ............ BI~ .~. .......... ot No ......... pumbant tO application dat~ ... ~....;.~...~...~ ~ .......... , 19.~ and appr~ by the BUilding I~spector. ~ ~ ~V. ~/30/~80 ~ ~ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, 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- tor wlth the following; for new buildings or new use: 1. Fina~ survey of property with accurate location of aH buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approva~ of electrica~ 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 P~anning 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 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. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C.: Fees: 1. Certificate of occupancy $5.00 / 2. Certificate of occupancy on pre-existing dwelling/ land use --?re-2:× ls t, lng C. 0. $1 5.0 0 3. Copy of certificate of occupancy $1.00 Vacanf, land C.0. $ 5.00 Date...~:..( ?./....~.~'.'~. ..... New Building.....~... ~.Old?r Pre-exist~ B. Location of Property , House No. ~ _ /~,~¢, l~treet ~ · I Hamlet uwner or uwners ct Yrop rw .................. ~-. ............ V .............. County Tax Map No. 1000 Section ............... Block .......... Lot .............. .Filed No ........... Lot N,o ............ Subdivision ............................ ~). Map Permit No. 1o¢.~, ?. ?..~Date of Perm,(~ ...... 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~m ~ it meets ail applicable codes and re§ulations. Applicant . .~,[,/,r~ ....... Z '~'' ~'i ........... FIE~D %~SPECTION COMMENTS FOUNDATION F·OUNDATION 2. (2nd) ROUGH FRAME & PLUMBING // INSULATION PER N. STATE ENERGY %ODE FINAL ADDITIONAL COMMENTS: · The wator ~uppl9 mad sewage disposal zoooT THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICtTY ~ 85 JOHN STREET, NEW YORK, NEW YORK 100:38 THI~ GERTIFIE~ THAT only the electrical equipment as described belo~ and int~duced by the apphcant named on the above applwation number In the premzses of in thefollowing location; ~ Basement ~ 1st FI. ~ 2nd FI. Section Block Lot was examined o~ ~]~ ~8, ~ ar~ fou~ to be ~t comptlance w~th t~e requirements o~ this Board. FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FA~ ~/ 42 35 27 3 F I 20 3 F 1 ~0 1 150 cb X 1 1 1 1 3~.F.C.I., 1-.~ Det~t~ GENERAL MANAGER/' Thiz certificofe must not be o]~ered in uny monner~ return to the office o~ the Board i( incorrect. Inspectors mu~ be i~enfified by their credentials. ; COP~ FOR B,UILDII~G DEPARTMENT. TM S COPY OF ~ ~' / TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapproved a/c ............. ~ .......... .("~ ....... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No.//.~-- f~. ~. ...... Dat .. '.., 19 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 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for nece,~ ..a~tmspecti, ons. (Signature of applicant, or name, it~a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, phunber or builder. · If applicant i§ a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No....~.r .~.7 ................ Plumber's License No...~.c~..~}.~.-~t~ ..... Electrician's License No .................. Other Trade's License No...~7-. '.¢~..G.~ . . ~..~7'~ 1 Locationoflandonwhichproposedwork~illbedone. /./. ~ ~f~ ;~ se Nu~r ..................... ]~ir'eet Hamlet County Tax Map No. 1000 Section ................. Block . Lot. ~.. ............... Subdivision. t/~..6~..~/~....~...~..~... ~. Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of p~~ded use and occupancy of proposed construction: a. Existing use and occupancy ...................................................................... b. Intended use and occupancy .... /.~.. ~ .................................. ' JAddition 3. Nature of work (check which applicable): New Building .................... Alteration Repair .............. Removal .............. Demolition .............. Other Work ............... (to be paid 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 nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. l~epth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................. ~ Height ..... .._~. ~, .......... Number of Stories .............. 8. Dimensions.of e~ntire new construction: Front.. ~.'.5.. ....... Rear...~...~'..~ ....... Depth . Height .. ~/'7' .......... Number of Stories ..... [ ........ ~, ............................................ 9. Size of lot: Front ~_..]./~.t.... i. ,,.,~,, ..... Rear .... ~/t.~. t. ? ........... Depth .~../~.,..~.~...~. ........ 10. !)ate of Purchase ,.~-, ...... ~..~4[t~.. ........... Name of Former Owner ............................. 1 1. Zone or use district in which premises are situated ........................................... 12. Does proposed construction violate any zoning law, ordinance or regulation:-- . ................. 13. Will lot be regraded ........ : ................... Will excess fill be removed from premises: Yes 14. NameofOwnerofprem~ses*~.~.fl,.~...~ ......... Address .t~J~.t~P~Z~.~...~./?PhoneNo ................ Name of Architect ........ ..~. ...... : ....... Address ............. :. Phone No ............ Name of Contracto~r~'~///~/~..~,~./..2~.~..~... Address ~..~.~..~q~./~. r.~.. ?..'g'Phone No 7~... PLOT DIAGRAM Locate clearly and distinctly ail! 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~ORK, ' ~ :S - ~c ......... being duly sworn, deposes and says that he is the applicant [,~Name of individual si~n t) above named. He is the ...................... '.....~...2'.".. ~ ................................................. ~ (Contr~ent, corporate officer, etc.) of said owner or owners, and is du.~.au. ?dto 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. Sworn to before me this ~ ....... / .~"~':-:":'~' .-~..day ofi..~;~ ...... ,19¢ Not u. blic ................. . ~ ~ ~ ELIZABETH AflN NEVILLE nature of applicant) I~OTARY PUBLIC, State of New York ~[10. 52-8125850, Suffolk C0unt~ Term Expires March 30, 19..~,~ OCCU?J NC'/ AS NOTED LP. :~ ~ D~p i~V~E N T 1-1802 9 AM TO 4 PM FOR THE FOLLOWING IN?ECT ONS: 1. FOUNDATION ' TWO' REQUIRED~ FOR POURED CONCRETE 2. ROUGH - FR!~MING &,pLU~I~ING 3. INSULATION 4. FINAL ' CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRU-TION SHALL MEET THE REQUIREMENT'S OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. IlC copper tubing for water distribu~inl system} piplr of types K- 0 r L SLAB INSULATION Degree Days Min. By Zone R Value 5000 5.5 6000 5.5*/ 7000 5.5 8000 5.5 9000 5,5 The insulation must extend at least 24" under the slab or at least 24" below grade down the foundation wall, FOUNDATION ~ALL The insulation is installed on the inside face of the foundation wall and provides a thermal break between slab and foundation, code location compliance slabs OUTSIDE FOUNDATION WALL The insulation is installed on the outside face of the foundation wall and provides a continuous thermal barrier at the slab edge and foundation wall. All exposed exterior insulation above grade should be covered with a protective material. ~rotective 9 over insulation copper tubing is used ~or woter distributing sys~em~ piping sba~J be o~ types K or L only NOTIFY BUILDING DEPARTMENT AT 765-]802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: .1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4, FINAL - CONSTRUCT/ON MUST BE COMPLETE FOR C. O. ALL CONSTRUCTION SHALL MEE~ TH~ REQUIREMENTS OF THE N.Y. STATE CONSTRUCT/ON & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. q II