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HomeMy WebLinkAbout10524-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building .............................................. Location of Property ...~.~.0.. ?.h.~.. ~..h.O.~.~...L.~.. ?. .................. ~. ?.87..1~. ?.~.~.o.n. ........ House No. Street Ham/et County Tax Map No. 1000 Section ...0.~.0. ...... Block . .2. ............ Lot....~ ............. ~:'~' ~Pebble Beach Farms Subdivision ............................... Filed Map No.'~. ....... Lot No.7 ............. conforms substantially to the Apphcat~on for Building Permit heretofore filed in this office dated .. P???.m?.r..~°.0 .... ,197.9.. pursuant to which Building Permit No. '105214.Z dated .. ?.~.c..e.m?.e.~...]..7. ............ 19.7.?, 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 ......... ...o.~?:~+~.y..Fray??. ~?~37...,,~3.~...~.,.~.~. 9.a.~.a...~.~?.~. ?: ................... The certificate is issued to .T.:..G.,...M:..C.O..n.8.~.r: . .C.o..1Up? .-.D..~..l?.~..ff.:..B.o.¥9 .............. ~¢,~v *. ' (owner,/osao~or-tono~t~. of the aforesaid building. 9-S0-113 Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO.. N679160 Building Inspector Rev 4~79 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S Ot=FICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 10524 Z Permission is hereby granted to: ...~~,~...~.,~.: ....... zz~, to .... O~.~G.C.~ ........ /.u~ ....... O~ .... ~ ..... .............................. ~ ................................................................................................ ~..:~.: ............. '/~~...~~..~0~ ......... ~ .............. Z~..~...z ....................... Building Inspector. Fee *..~.:.'~ ..... 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 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 disposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buitdings, industrial buildings, Multiple Residences and similar buildings and instalta- 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 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. Co Fees: 1. Certificate of occupancy $5,00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1 .O0 $5.00 Date .......................... New Building ../. ........ Old or Pre-existing Building ............ Vacant Land ............. Location of Property '.~...~...c~..: .~./..~.-..~..~/..~..~: .~..../: .~..~: ......... ?~.~:...~..,~..~/. ?../~.: ......... House No, Street Hamlet Owner or Owners of Property ~.t..f~..~..~ .~,.t.. ~....~, .~.~. ,, .................................. County Tax Map No. 1000 Section . .~--~.../'~.. ........ Block ....~. .......... Lot ..~. ............. Subdivision ~.~.~.~..~.'~..~. ~.~.<.'~...C~~. ~.~.?. ' . .Filed Map No ........... Lot No.~. .7 ......... Permit No/.C2.~. ~.~..Tm,. Date of Permit ,~.?~"~..".~'~..Applicant .(~..~..~.q... ~?..~..~?.~..~ .o~ .~,,. ..... Health Dept. Approval .~. ~.~.~.~..~./! ~.~. ............ Labor Dept. Approval ........................ Underwriters Approval ~...~?..~./.~?. ............. Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate . L//, ................... Fee Submitted $ .~.....~ .................... Construction on above described building and permit meets all applicable codes and regulations. Rev 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICiTY~ ~-- ~)Ht 85 JOHN STREET, NEW YORK, NEW YORK 10038 was examined on ~z~ ~ * ~ ~ O ~ and found to be tn compli~e w~t~ the requlrerne~ts of this Board. 1 ,[00 cb ~ 1 4 1 4 ~u~ure Appliance Feed3r/ l ~S~e De~ec~or This cert,f,cate must not be altered in any manner, return to the off,ce of the Board ;f ,~cor~ect. Inspector~ may be ~dentifled by th edentiol~% COPY FOR BU?DIHG DliPAI~ME.~. THIS IN ANY FIELD IN~PECTION 1. COMMENTS FOL%W-DATION (1st) FOUNDATION 2. ROUGH FRAME& PLUMBING INSULATION PER N.Y. STATE ENERGY COpE 4. FINAL ADDITIONAL FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765~180;~ Examined ~.tf...-] ..... , 19~7...~. Approved .g . .'~q<. · · ./.-~ ..... , 15.~. Permit No.~. · .~. · .~.°.~.~ ............. · ~ · ,f./c~(B~"Z ~. ~ ' ' ~ '"" .... APPLICATION FOR BUILDING PERMIT Application No. ZO.~.~. / ..... Date· .].~..../... :7 ..... , 19].~. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 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 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 buildings for necessary inspections. (Signature of applicant, or name, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. k -~- · .~...4..x.~..~.. ~ .. ............................................................................ Name of owner of premises '..'-~.. ~ .~......cO., ~.3..x:.r F:.....~. &?. .................................... (as on the tax roll or latest deed If applican~t is a corporation, signature of duly authorized officer. (Name and ~t)6 of corporate officer) Builder's License No ........................... Plumber's License No..:~..~.'. Electrician's License No.. ? ./.~.'....g~ ........... Other Trade's License No ..................... ,. ~ ~ 1. Location of land on which proposed work will be done. .~.~'.~. . . . .~. ',g. . . .E~¢?. .~i?. . .~.~ .¢'.c-~. !~.~.-t57.~... ....dq.e~..o. ....... ./.-ZT./q.~.-. ~¢drt../¢F7.. d .~.?~ ........... ~.~¢..5;C..~..~ iz.:? .~?. ................... House Number Street Hamlet County Tax Map No. 1000 Section .LO..~.O ............ Block~ .'o~. Lot .... CC. ............ Subdivision. ~.~.5'~>.~. ~1.'¢... ~.~./.~.0(4.. ~A..~...~x. '.~ ..... Filed Map No ............... Lot...,%:~c...'7. ..... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..t.~..~. e.-.0' Q.'T'....L: .~..~...~. ............................................ b. Intended use and occupancy ~a~.. [.~. ~ .... ~.' ~..t'fS.~ .~..~ .... ~.~.~. ! ~. ~.~. ¢. g. ....................... 3. Nature of work (check which applicable): New Building ....... Addition ......... Alteration .......... Repair .............. Removal .............. Demolition 2,~ .......... Other Work ........ . ....... , ,-.~- ,t //_ (Description) 4. gst~nated Cost .... ~-~.'. ? .... .i .......................... Fee . .~. ~ ............................ (to be paid on ~ing this application) 5. If dwelling, number of dwelling units .... ~ ~.~ .... Number of dwelling units on each floor ................ If g~age, number of cars .... ~ ......~ ~¢~ ........................................................ 6. If business, commercial or mixgd occupancy, speedy nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ O~ensions of same structure With alterations or additions: Front ................. Rear .................. Depth ................... i. ·. HeiSt ....... ~ ............. Numberer Stories ....... 8. D~ensions of entire new construction: Front· .~ .......... Rear .~.~ .......... Depth ~ ]~( Height . [.~ ........... Number of Stones ... O ~ ............................... z ................ 9. S~ze of lot: Front . .~.~ ..... ............ Rear...7.~ ................ De~th .~f.~ ................. 10. Date of Purchase .. '/~2~'' ~ ................... Nme of Foyer Owner ~.. ~{t. ~: .. 1 1. Zone or use district in w' hich premises are situated· O .~.~..~.~.[~X.. ~t.O~.~.q~ .................. 12. Does proposed construction vi61ate any zoning law, ordinance or regulation: . ~.~ ........................... 13. Will l°t be regraded ........ ~ .......... ; ..... Will excess fill be removed from premises: Yes N~ 14. Nme. of Owner of prem,ses ~i ....... ~..~ ...... Address r~ .... , . . . ~. ~.: ,, Phone No.~ .............. Nme of Architect . W.' .¢. '..~:~D 2[ q r ¢ ....... Address .~:~.Y/.~.q[~...g.'Y.' Phone No.~ Nme of Contractor ~& m.,.P~.~,*.I ~.'. ~ ~'. Address . ~.ff~ ~ :.. ~, ~ 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 bloc~ number or description according to deed, and show street names and indicate whether interior or corner lot. k ~ STATE COUNTY .. ~..~. · . ~.. ] ~ .I/5 .~...¢~ D ~.t3,,%; ................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is ddly authorized to perform or have performed the said work and to make and file this application; that all statements con~ained 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 ...... gr., TITLE NO. IO~GI-II OBSERVATIONS AND OR FROM DATA OBTAINED FROM OTHERS WILL CONFORM TO THE STANOARD$ OF THE SUFFOLK COUNTY o~ ~^~. S~RVlCES APPLICANT: ADDRESS TEL Lot 17 ~ vOCor~f LOf 16 vocOnf N. 85° =41.6 e1=41'8 Lot I§ vocon! Lot 6 vocOfl~ AreO' 26' 8015q'fl' Lot8 voCO~f el = 40.0 N. i3°, NOTE: · = I~ONUI~ENT SUBDIVISION MAP FILED IN THE OFF/CE OF TNE CLERK OF SUFFOLK, COUNTY ON ~dUNE II, 1975 AS NO 6266. LANE YOUNG & Y 400 OSTRANDER AVENUE, RI YOUNG JRVEY FOR: J, BOVE No. 7. ",,,EeeLE eEAc. EAST MARION ~rowN o~ SOUTHO£D SUFFOLK CO., N.Y. GUARANTEED TO: CHICAGO TITLE INSURANCE CO. EQUITY FEDERAL SAVINGS ~ LOAN ASSN. ~- 1"-'50' DATE AUG.$O, 197G TIT£E NO 10991-11 THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FtELD OBSERVATIONS AND OR FROM DATA OBTAINED FROM OTHERS Lot 16 voconf f=416 el: 41 8 Lof 15 rocor! SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES DATE FOR APPROVAL OF CONSTRUCTION ONLY .s REF. NO. APPROVED, Lot6 voconf Lot 7 Area= 26,801$q'ft' LOt8 voCOnf el:400 S, 76*~ ~,00 e1~39.7 NOTE' ·: MONUMENT SUBDIVISION MAP F/£ED IN THE OFFICE 0~ THE C£ERt¢ OF SUFFOI i¢ COUNTY ON dUNE II, 1975 AS FILE NO 626~. , 7 HE vacOnt 'REVISIONS LANE DANIEL ~ BOVE &OT NO.~ "PEBBLE BEACH FARMS," EAST MAR/ON THE TITLE GUANANrEE CO, o~ SOUTHOL D , SUFFOLK CO, N, Y, II AP?~©V~D AS NOT_ED DATF~/~B.P :~ IO5 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: ]. FOUNDAT[ON- TWO REQUIRED FOR POURED CONCRETE 2 ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL CONSTRUCTION BE COMPLETE FOR C, 0 ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N, Y. STATE CONSTRUCTION & ENEPGY I ti i I CODES, NOT RESPONSIBLE FOR ill "J-~,---I~- DESIGN OR CONSTRUCTION ERRORS. ;j~.~ ~< ~ ~ = foundation 7 floor lan plan front ii rear elevations right side 'left side elevations I GENERAL NOTE ~11~ ~ (~?' A MINIM~ CO~SSI~ ST~NGTH OF 2500 PODNDS PER 2. BOTTOM OF ALL FOOTINGS S~L BE~ ON UNDISTU~ED SOIL ~ ~ ~~" ~ HAVING A MINIM~ BEARING CAPACITY OF TWO (2) TONS PER 3. PROVIDE ~E WATERPROOFING AT EXTERIOR FOUNDATION ~ I~ ~. ~ ~ ~u~ ~ ~t~ AS ~LIEVING T~E CONT~CTOR FRO~ EXECUTION OF ALL ~ ~ , .- 4. NO NOTE OR DETAIL OR LACE THEREOF S~L BE CONSTRUED 5. F~ING LUMBER S~L ~E ST~SS ~TED DOUGLAS FIR OR SOUTHERN PINE ~TR~SS ~TED 1200 POUNDS ~ER SQUARE INCH MINIMUM FOR ~ENDING' (fb) FOR SINGLE MEMBER USE, ~ AND 90 POUNDS PER SQUARE INCH MINIM~ FOR SHE~ AND HAVING A MODULUS ~ ELASTICITY OF 1,500~000 ~~ ~ UNLESS NOTED OTHERWISE. V~UES A~ FOR SU~ACED DRY ~ ~1~ ~ ~ ~'4~ ~,~ ~ ~ LUMPER ONLY USED AT 19% MOISTU~ CONTENT. ~J DOUBLE ALL FLOOR JOISTS UNDER PARTITIONS PA~LLEL TO ~l~lD I~ ~LOOR JOISTS ~D OVER 6'-0" LONG. ~ 7. ALL PLUMBING WORK TO BE IN STRICT ACCO~ANCE WITH ~4I~ ~ ~ __ ~ LOCAL TO~ ORDINANCES. ~ ~ ~ ~% ~'"'% ~1~, ~T P~, 9. CURBS, CURB CUTS AND PAVING MUST CONFO~ WITH ~L F~ PT~ ~~ ,.~ ~ REGULATIONS AND REQUI~NTS OF THE DEPARTMENT PUBLIC WORKS. section 'a .... ~ ,,~- ' OWNERSHIP OF DOCUMENTS . THESE D~WINGS AND SPECIFICATIONS ~ INSTRU~NTS OF SERVICE AND SHALL ~IN THE PROPERTY OF THE ARCHITECT ~ETHER THE PROJECT FOR WHICH THEY A~ ~DE IS EXECUTED OR NOT. THEY ARE NOT TO BE USED ON ANY OTHER PROJECT EXCEPT BY WRITTEN AUTHORIZATION OF THE ARCHITECT. ~ ~ ~,~,. ~**~** *'*'~,.,.** ENERGY CONSERVATION NOTES ~ ~ ~.~,~,~ 1. CO~Y OF ~ . PERCENTAGE OF GLAZED AREA IS ~,~=,~ =~ ~1 LESS TH~ % OF TOTAL WALL A~A. DEGREE DAY EQUAL FOR COUNTY. ~T~J~ , ~,,~(~ 2. THE FOLLOWING VALUES OF THE~ T~NSMITT~CE SHALL ' .- BE MINIMUM VALUES FOR USE IN THIS PROJECT: J ~ ROOFS & FLOORS EXPOSED TO j _, ~BIENT CONDITIONS .................. Ur~ .05 ~Jl~ J ~ ~ ' ,w~ ~ ~, 1,1~ EXTERIOR WALLS ...................... gw= .08 ~ ~(~ ~.~, ~-~.~ G~g;~g ............................. gg= .69 / - -~~ ~ ~, ~.~,~ ENTICE DOORS ...................... Ud= .40 ~-/- ~.~.~ I , I.l~ ~ ~ ; FLOeRS OVER. OR ABO~ G~DE BASE~.T P~ ~ j I J SL~ EDGE INSU~TION UNHEATED S~B .. Ri= 5.5 ~ ~1~ ~ ~ '~ Ri= 8.0 ~,~/~ ~1~ ~, ~,~1 HEATED BASEMENT / CELLAR WALLS HF~ATED BASEMENT / CELLAR W LLS (BELOW GRADE) ....................... Ri - . , ' FIREPLACE CONSTRUCTION SNALL BE IN ACCO~ANCE W~TH THE PROVISIONS OF SECTION E - 402.4 OF THE N. ~. ~L DOORS AND WINDOWS TO BE DESIGNED AND CONSTRUCTED TO LIMIT A~R LEA~GE IN ACCO~ANCE WIT, SECTION E -