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HomeMy WebLinkAbout10200-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No.. Z98~0 .......... Date ..... J.~r~ua~.. ~.~ ................ 19 80 THIS CERTIFIES that the building ................................................ Location of Property . 2{0~....West;..Cedar..Poirt't; .D~£v.e ............ SOUthold~. N. Y.~ House No. Street Hamlet County Tax Map No. 1000 Section ...090 ...... Block ... 2. .......... Lot ..... 22 .......... Subdivision. C~.~12. B.eaoh. l?.ark ........... Filed Map NO ......... Lot No... 1 ./4~. ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated. · ?.p. ?.i.1. ?..8 ........... 19.79. pursuant to which Building Permit No .... 1..0.~.0.QZ. ........... dated .... l~&]r..9 .................. 19 .?9, 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 ......... ............... ~ri.v. ate. O. ae. F.e~il~. ~ellin~ ................................. The certificate is issued to ...... (]}ler~. F,. Hei~lll~rlll ................................. (owner,~ of the aforesaid building Suffolk County Department of Health Approval .~tg.-S.()-. 2~i .... '1/.1.8/80 .... [~,. A,. IJ'121.1a.~.. UNDERWRITERS CERTIFICATE NO .......... ~1../4.~.08~ .............................. Building Inspector Rev 4/79 *"Private well with high niyrates - see Health Department note on final survey.,, FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10~00 Z Permission is hereby granted to: .-~ . ~ / ........... ...... Z,~.~....//.~.-~ .............................. ~.r~/~.~,/~. -- ~- ..~.. ............... ~o ....~'.o..~...s....z~r,~..u..c~ ~ ~.~.£~.a.~.~7~ ..... o..~.~ ..,~.~..,..~..~......~..:.~..~-....x...Z./~..,~... o, ~re~ses 'oeated o~ ..¢ .......... ~......~.~ ...................... ~....*..~.Z~....~.~...~...~ , Building Inspector. Fee $.J..~....~ ..... 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: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features, r 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. Commerc al buildings, ndustrial buildings Multiple Residences and similar buildings and.,,installa- tions, a certificate of Code compliance from the Architect Or Engineer responsible for the bu!ldi~g, 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 featu res. 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- t~on required to prepare a certificate. C, Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date.. '.~..~..~..~. ,~..,.!9..~. ·~, ..... New Building V/ Old or Pre-existing Building Vacant Land Location of Property ~)~/' ~'~.~ .C.~I~?~.(;~ .~.~;.~..~t'~.~)~i~.~=::--~') House No. Street Hamlet Owner or Owners of Property . .~. ! .~. ! .~,'~.l...~., .[~..~..t~...)..~ ~,~. ,~.~....?.. ................... County Tax Map No. 1000 Section ............... Block ............... Lot....~, ,~.~ ........ Subdivision...~.~.~)..~, .~.. ~ .~..~. ~.~). ........ Map No ............... Lot No. t ~c .~ Permit No. ~, .(~. ,~.., .(~.(~.. Date of Permit 5.-.~. :.~..~. .Applicant ..~...~, .~..~..~.. fi...~..~'.'~.~, .~. · ,~..~..~. · .f~ Health Dept. Approval .~t~¥1.(i'.~ ·O. .~ 7 .~.O.: .~.~. .Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate "-"-' ...Final Certificate ,~,~ ~ Construction on above describedApplicantbUilding ~and permit meets ~]~ .... '. Rev. 10-10~78 :able codes and regulations, FOR~ NO. 6 3'OWN OF SOUTHOLD Building Delmffment Town Clerk~ Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building Inspector 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 buildings, Industrial buildings, Multiple Residences and similar buildings and installations, 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-existing" land uses: 1. Accurate survey of property showing aH 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 in- formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 (~ertificate of occupancy on pre-existing dwelling or land use $5.00 opy of certificate of occupancy $1.00 Date ...~..a..~..?..a...z..~... ~ ,2..:....~ ?. ?..0. ...... New Building X Old or Pre-existing Building Vacant Land Location Of Property ~.~..O...~.~!~C`.e.~a..~?.~`.~?`~.``~?`~`~e`~`~``?```e~`~`~`/``~~L.~ ........................ Suffolk Co. Tax Map~ 1000-92-2-25 Owner Or Owners Of Property ..G.~.e...q..~..~....~.e...&..c].~.m...a.D...~. ............................................................................ Cedar Beach Park -- 148 Subdivision ................................................................ ~o~ No ............. 81ock No. ............ House No ............. Permit No ..................... Date Of Permit .................... Applicant Glen F. Heidtmann Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .............. ~ ......................... Fee Submitted ..Z..:..O...O. ......................... Construction on above described building aj~d~'p~rmit meets all qpplic.c~91e codes and regulations. Z ) Ku~oiph ~[. Bruer; ~ttorney rot Appl~can~ Sworn to before me this / ................ day of ............................................ (stamp or seal) i~ FO~M NO. 3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. NOTICE OF DISAPPROVAL Fde No ................................................................. Date ........~..~.~.. ~.,~ ................................... , 19..,7,,9 .......... 5 .o..u...t.b.o...z. ~.,... ~,... ~.~ ................................ PLEASE TAKE NOTICE that your application dated ...... .AP..~.~.$....J..8..~ ...................... , 19.~.9... for permit to construct .p..~.$.Y...a.¢..e....~W..e..~..~..:~:PJ~at the premises located at ...... .D~..e.....~..e.~..~ ................................. Street Southold, N. Y. Map .....C..e, ~?.....~...e..~..~..~. ...... Block .................................Lot ............ J~f) ............................ is returned herewith and disapproved on the follow, ng grounds .....C..0.~qS.J~.~Q.~.:~O..~..P.~..~,I~8 ............. ....... s..~bm .i..¢.t.e..d ...~.~ .~...~.o..~...o..o.~.p. 1.~. $.e... ~n d e.t. ail....do...n.o..¢...fu~.ni s h ...................... ...... .s...qf~$ .q..J,..e. n .¢.....J,.n~P.~.a..t S.9.~...~.q~....e. ct~ $.~m..e.~.~... hc ~n g...~.~ ~...~... ~.~n~z .......... with N.Y. State Ener~r Code. ~/~¢~,b ...... SEE.. RZI)F~.. ~.d.. &...~.2...a.~t at c h ecl..h e~.ew.i.~hF.~ .................................. ~Buflding Inspector Glenn F. Heidtmann Spec. #6 Cedar Beach Southold, N. Y. COMMENTS Drwg. #1 Foundation Plan (Slab) ~.~DNo detaili~ for concrete slab on exterior, raised, flush, footings, foundation). rwg. #2 indicates 'deCk or slab' - require ~ details for both to be approved. ~o footings for bearing ~artitions are shown. '~/No details of plumbing given, (soil lines under slab, location of house trap, e~c.). Drwg. Drwg. #3 #2 First and second floor plan .~nte~ior stairway does.n~t show size in width, or give riser and tread details. Open or close sides, handrail details.. ~/Detail of balcony railing not shown. 3. Collar ties for living room required if cathedral ceiling. ~/No Smoke Alarm Detectors shown for the sleeping areas. ~/Kitchen is incomplete, sink, cooking range, re- ~ frigeration, cabznetry not shown. ~/Dimensions for exterior deck not complete. Front and rear elevations· Roof at chimney requires ,cricket. No spread footing for fireplace foundation. Rider Sheet, cross section. No detailing for .~air flow to control conden~ion. reas of walls, ceiling, rafters to be insulated not shown. Drwg. #4 Elevations, north & south Concrete stoop & step, no foundation and footings shown. Detail of risers and tread for step not shown. RIDER #2 PLAN REVIEW: Glenn F. Heidtman Spec. #6 Cedar Beach Southold, N. Y. COMMENTS Mew York State Energy Code 1. Type windows to be used, (wood ar aluminum frames) 2. Type exterior doors being used, (insulated, wood panel, with storm doors)? 3.Service water heating equipment, classification, rating for efficiency.' 4. Detail for fireplace air supply. 5. Details for slab insulation not clear. Memorandum from .... BUILDING INSPECTOR'S OFFICE TOWN OF SOUTHOLD TOWN HALL, SOUTHOLD, N. Y. 11971 765-1802 LAWRENCE M. TIJTHILL April 27,1979 Chalet - Spec # 6 Cedar Beach , Southold Design temperature - ~nside Design degree days 6,000 Insulation "U" 70°F Outside ioOF Area Loss .... sF Walls R-!3 I07 1,026 4,300 R3of B-19 .05 2,304 6,920 Slab per~,~r R 5°0 Factor 35 x 124 If 4,350 Windows dbl glass .69 208 8,600 (thermal) Door aS per code .40 18 430 i~ lilt ration ( volume ) . 018 12,168 .13 , 1.CO~ 37~700 Per cent of glass 17% Exterior duct to be provided fro fireplace Heating & service water oioes to be insulated as per code Thermostat as per code Weathers stripping - all windows and doors Caulking as per cod~ E~etric heating to be used COUNTY OF SUFFOLK DEPARTMENT OF HEALTH SERVICES DAVID HARRIS, M.D., M.P.H. The attached approval was issued subject to the notation contained below our approval st~,~o. Would yon please type the foll~.~ing condition of approval on the fUmal C of 0 as bi-&is will ensure that any Future oWner will be made aware of the nitrate problem. "Private well with high nitrates - see Health Depar+.ment note on final su~'ey. Thank you, Robert Ao %"~lla~ P. Eo FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined...~..-..?..~ ...... 19.7. ? Approved.. ~.?..~."~ ........ 19.7..~Permit No../..Cfl.~.~ ~--~ Disapproved a/c ............................... ./ (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No.../.~.'..~..~..~. ...... 197~ 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 dia,'am 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 nmne, if a corporation) (Mailing address of applicant) -- State whether applicant i's owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ....... ~//.~f.W~. ........................................................... (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 ..... ?.0 .................. Plumber's License No.. ~.~. ~?...~....~.4.~. ·~. .... Electrician's License No..~.~.?...d~...~..~..~./2/O Other Trade's License No ..................... 1. Location of land on which roposed work ~will be done...~'.'.~"f'.O.?~.~.'~...0~'~-~. ~~ .......... .................................. ii ;;i 7 .................... ...................... House Number County Tax Map No. 1000 Section ...~.~ ........ Block .... O.d ......... Lot .... ~ .......... Subdivision...~. ~C~ .............. 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 ..... ~ ........................................................ b. Intended use and occupancy ..... ~'/.~..~¢ .~q~ .............................. 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............. .I ~30 -'~ ~O ~ (Description) 4. d Cost Estimate ,~ ~ ........... ....... : ................. Fee ..................................... (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 structur.es, if any: Front ............... Rear .............. Depth ............... Height Number of Stories Dimensions of same structure w~th alterations or additions: Front ................. Rear .................. . Deptt~ ...................... Height .................... :. Number of Stories ...................... 8. Dimensions of entire new construction: Front ...... ~ ....... 'Rear ............... Depth ............... Height ..... [~,~ ....... -Number of Stones ..... [. ] ................................................. · .F - D . .. 9. S~zeoflot. ront ....... .~.(:~.~ ......... Rear ...................... epth .... ~...~...~ ......... 10..Date of Purchase .... ~'] ~('"Y~' I '~'Q'xl' '~ ......... Na_me of Former Owner ..... [.,....~.~_,~.~.~ .k~ ........... 11 ,' Zone or use district in which premises are situated ~'.~ ).~ ............................. 12.~ Ooes pr'o~osed cofistruction vi41ate any zoning law, ordinance or regulation: ...t, hr.,D ...................... 13. Will lot be regraded . . . ,~...~.. ...... ,, ........... :. Will excess fill be removed from premises: Yes 14. Name:of Owner of premises ~oJ: .~.o..o.~ tq)T(~ 00'Address ...-~9.~ ~... Phone No....~.. ~?A?.~..~. Name of Architect . .' .x~..0~:~.W~..~..t~ ~.C~ K ~.. Address ...~.O .~.xo~ o~ ~.. Phone No ................ Name of Contractor ~.~1~3~.~).~° ~ ~o~.3 Address . .~.~.~,~.~$.O.q~9.-~,. Phone No..~.~.,P-: .~..'~.¢.(~. PLOT DIAGRAM Locatel 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, S.S , (Name of individual sigdng contract) above named. (Contractor, agent, corporate officer, etc.) of said owner or owners, and ~s duly authorized to perform or have performed the said work and to make and file this application; that, all statements cont[ined 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 ELIZABETH ANN'NB/ILLB ~ (Signature of applicant) NQT~,RY PUBLI~, State of New Yol~k No 57-8125850, Stfffolk Cou~lty form Exmres March 30. 19d¢~ . Breparat{o~ of baby for~la or co~sumpt:o~ "' ~' by infants under 6 mos. of age. ~FO~K CO. OE~T. O~ MEALTN ' : ' ~' " ' ' "" ' ' ~ ~FF~K cOUHTY DEPT. OF H~ALTH : SERVICES - FOR APPROVAL OF ~ ~OVED ~ ~' . ................... ' SUFFOLK CO. TAX MAP . .~"" ,. ' .' ' .. . ~ ' .. ~1~ ~ ~ ~ TEST ~LE ST~ .. ~ . ~ ~ . ~ . ~ ., ~ · ~ ~. ~ ~/~ . , ~[.~,,..,.,... ,..,-~.,.,, ~o..~ ~T,:~ . -. : :. ... ; - ~: · . . . ~ .;~- · , , · . . ~ ,. ~ ' ~, ~~~ ~, . :~. ~ ~ - , . ~ ,_ ~ ~ ~ .., .. . , % ., .~.,:. ...~ :'~ ~ , - .Q_~:. , . ..~ ~ .:. . - .. ~ . , · . ~ r~ ~ ~. .. . . . .~.,., , :. , . ,, X .. . · . e .~ . .. · :., ~ .:h' . ....'~ ..... . .