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HomeMy WebLinkAbout10624-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No... ZlO.1SO ....... Date ..... DC~O]le~ .6, ................ 19 .~.O THIS CERTIFIES that the building ............................................... Location of Property . .~7.0. Ship' s Drive, Southold~ N.Y. nguse No.' .................... 'S'~/e$i ...................... h~r~/ei County Tax Map No. 1000 Section . . ·079 ...... Block . . .0.~. .......... Lot .... 02.7 .......... Subdivision$~le~a..WOOO.~..]~s.'l;.o[te$ ...... Filed Map No. 55.2.0....Lot No....~ .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated · .~p?~.l.. ? .......... 19 .~.0. pursuant to which Building Permit No.. fi..0.~.2./~..Z. ........... dated . ~.pri.1..9. ............... 19.80., 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 ......... .... .One.. F..m~.J,!y .~.o!!.l.n.g ..................................................... The certificate is issued to . . ?.h.q.~l.~.8...&..~.8.l~..17.8..,j...Old. ~.8 ................................. (owner, ~ of the aforesaid building. Suffolk County Department of Health Approval . .~ O.-.SO.-2.O. 9/2.2/~0.-~.t}l~.~.'l;. ~,..V.i. 1..1.~... UNDERWRITERS CERTIFICATE NO ............. N./4S7.190 ............................. Rev 4179 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST ~'E KEPT ~ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) N? 10624 Z Permission is hereby granted to: ..... ...~.~y..~....~,..~.~. ~.... ........ z~.o.×......~.. ............................... ....... ....... ,o ..c~.~...~--..~.~.,.L_W...:e~__~.r..Z,;~.~ ........................................ ~ ................. .................................................. !.....~fo~ ...... .~z~',q~ ~...~...~.~o~.~,~....~'.,¢~. ......... at premises located a~..~.7~...~.~t~:~.....~./~'~-..~. ........ .~.~ .~..~t~)~:~..~'..fi~_ ......... ~,~.,..~,a..~z~...~.~: ....... .~.~.zo ........ ~..Z..~z......~. ........... pursuant to application dated ...~/~./.~ ......... ~ ................... , 19 .~4~1, and approved by the Building Inspector. / Fee $ .... · - / B~ilding Inspector TOWN OF SOUTHOLD , Building Department Town Clerks Office $onthold, 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 Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, oho unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage dlspasol--(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 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. Dote of any housing code or safety inspection of buildings or premises, or other pertinent formation 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 .......... ,~ ......... ~ ................... New Building ......~... ...... Addition ................ Old or Pre-existing Building ................ Vacant Lend .............. Location Of Property .... ..'.~..,..,".~l~..~. ....................... ,, ................................................................. Owner Or Owners Of Property ....... ~...~..C~..~'~¢~..~. ~ ........ ,~,~.~..?~....~ ................................................. Subdivision ..... .,~, ,.,~.,]ko,~.......,~,~,,)[-,~.,~ ............... Lot No...,~ ..... Block No ............. House No ............. Permit No. Date Of Permit ...... Health Dept. Approval ~.~.~:;~,~...~'~.,.~.,CJ~.~.C).Labor Dept. Approval ................................................ Underwriters Approval ..:~..~.L¥o_~.....'~.-...,..~..~..O..Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Find Certificate ...... .,~, ................................. Fee Submitted $ ...,~..,..0,,0.. ...................... Construction on above described building an~d~eet, s oil op~. c~Tz~ regulations. Applicant ................................ ..~.......~.......~.....~...~ ............. Sworn to before me this ................ day of ............................................ Notary Public .................................... County THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY~ ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 "~,~y 2~, [gao ~Ppllcati°~°'°n~"~aT0~[2 N THIS CERTIFIES THAT only the electrical equipment aa described below and introduced by the applicant named on the above application number in the premlses of %~o~0n~ Omm~ Sldp~ Dry, Nor~bside-FAd l%int, '$o~3old, N.Y. in thefollowlng location; [~. Basement [] Ist FI. [] 2nd FI. Section Block Lot was exa.,,.~d o. j%ffy 21, 1980 and found to be in compliance wtth the requirements of this Board. 18 DRYERS ~ECEPTACLES 41 FIXTURES RANGES EXHAUST FANS SWITCHES FLUORESCENT OTHER APPARATUS. E R V I C NO OF CC COND A W G W O lNG OF NEUTRALS A W G PER ~' OF CC CO~qD OFA HI-LEG OF NEUTRAL Eo:~ 215 Soutt~,ld~ N.Y. 11971 Lic.578 E Th~s certificate must not be altered in any manner, return to the office of the Board if incol FOLqYDAT I0N ( I ~>~) FOUK~DAT ION 2. ROUGH FRAME & PLUMBING (2nd) INSULATION PER N.Y. STATE ENERGY COpE 4. FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-180:3 19.?~. Permit No./~ Z c~ ~_ Disapproved a/c ......... '~- .-~.. ........... ~. ....... ./. / (Building' Inspector) APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS Application No..ff~'~ .~..¢~.. '.'~. .... a. This application must be completely filled in by Wpewriter 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 ~n buildings for nece¥[~y inspect~s. ~ ~- / · ZX ' '"~ .t ~~~t, or name, if a corporation), ~ (Mailing address o app cant) Name of owner of premises ~....4 .... ~..~ .~..... ~~ ................ (as on the tax roll or late~t~eed) V If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ....... ......~,~:~... ........ Plumber's Licensemo..~..~(...,Ml,-~..~..~~ ~ I Electrician's License No ~ 1. Locationoflandonwtuchproposedworkwillbedone.....~...~.5..,~..& ..... .... ................. .......... House Number '~ fi'7 ~d Street Hamlet County Tax Map No. 1000~ 'i~ ..~. :7.~. ......... Block .... .O.?. .......... Lot .... Subdiwsion....~.0v,~..~...~.~_~~FiledMapSo..~.~.~.~...~3... Lot ..... ~:7 ........ 02 (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy 2./'.,,~ 6~ to, b. Intended use and occupancy ..... ~ .~ .-~-~... ....................................... 3. Nature of work (checl~ which applicable): New Building ........ Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... ,/~ , i r~, -- ~ (Description) , - -', (to be paid on filing t is app ication) 5. If dwelling, number of dwelling Units ..... .~ ......... Number of dwelling units on each floor ................ If garage, number of cars ..... i ................................................................... 6. If business,'commerciai or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of ex~stlng strnctur~s, if any: Front ............... Rear .............. Depth ............... Height ................ Nun~ber of Stories ........................................................ Dimensions of same structure w~th alterations or additions: Front ................. Rear .................. Depth .................... I' ' Height ...................... Number of Stories. 8. Dimensions of entire new construction Front . .{c':,.I., .~.'.~ ..... Rear .. L~, ~:t. :. ~'~. .... Depth' ........, ,,/~..%: ' ' ~ .% ........ (~ .... Height ............... Number of Stones ........................................................ 9. Size of lot: Front .... ~. ~t,.~D.I,: .......... Rear .. ~..~:. '>: .,...q. ~ . . Depth : . . -'..,.~..~..~i,~., ..~.@ .O *. :. 10. Date of Purchase ........... l .................. Name of Former Owner ............... :5 ............ 11. Zone or use district in which pr4mises are situated ......... ~.~ ......................................... 12. Does proposed constlmctlon vioiate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ...... ~¢'4 .......... ~ ....... Will excess fill be removed ~fr, om,premises: Yes No PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and~ indicate all set-back dimensions from property li~es. Give street and block number or description according to deed, and show street names and indicate whether interior or co~ner lot. STATE OF NEW YORK, COUNTY OF. ,;~tt.F. ~.~:~ ~ . ~.c ...... , S.S (Signature of applicant) work will be performed in the mannelr set forth in the applicationfiled therewith. Sworn to before me this .. .................... day of ...... d · ........ , Notary Public,./ y ~?.'~,. ./. . /'~, ~ ., ~ t ......... County ·../'c .. ~,.~ ~/...('. .... '., :..~/.-9 ,i.~".*.fl ................ being duly sworn, deposes and says that he is the applicant / (Name of individual signing contract) / . above named, i He is the 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 contgined in this application are true to the best of his knowledge and belief; and that the water supply & sewage disposal sys- 79- 52 - 24690 SUFFOLK CO$NTY DEPARTMENT OF HEALTH SERVICES FOR ~ ~W~.~ OP ~IRNCTIO~ ONLY SURVEY FOR THOMAS W. gl lAURA AT BA¥ VIEW TOWN OF $OU~HOLD SUFFOLK COUNTY, N.Y SCALE ~ I"= 40' MARCH 2, 19;'9 REFER~NC~ ' M/O BAiitVlEW WOODS ESTATES FILED S~PT. 9,1970 ;AS MAP NO, 5520 USCIFE ~ITLE INSUffANCE COMPANY OF NEW XORK 79-52-24690 4 ,> Unauthorized alteration or addition to this survey lea vlolatkm ef section 7209 of the New York State Educati~ Law. Copies of this survey mop not bearing the land surveyors InJ~ld seal or embossed seal shall not be considered to be a valid copy. Guornnm~.s or certifications indicated hereon shall run o~ly to the person fo< whom the survey is prepared, and on his behalf to the dlle compony, governmental agency and lending institution listed hereon, and to the ossignees of the lending institution. Guamntee~ or certifications are not transferable to additional instilutions ~, subr, equent owners. SURVEY FOR THOMAS W. El LAURA G. JA~ AT B,4YVlEW T0~ OF SOUTHOLD SUFFOLK COUNTY, N.Y. SCALE; I"' 40' M,4RCH 2, 1979 ,,~JG. 19, 1980 M/O BAYVlEW WOODS ESTATES FILED SEPT. 9,19?O AS MAP NO. 5D20 ~IARANT~D TO ' USLIFE TITLE INSUR4NCE COMPANY OF NEW YORK THOM4S IF** ~ LAURA ~. JAMES LAND EUItVE¥O~I New Residence Mr. ~ Mrs. T. James Southold, N. Y. ~New York State Energy,Conservation Code Requirements. teat Loss ]Design Perimeters: 6000 D. D. Floor area : 1776 SF To : 10° FDB Glass area = Z00 SF(ll. 6~0) Ti = 7Z°FDB Summary Heat Loss (BTU/Hr) Allowed Design Component U Loss U Loss Wails .07 6,166. Z7 .069 6.,078.20 Cl~. .05 5,505.6 . 05 5,505. 6 Floor .Z ZZ,0ZZ.4 .Z ZZ,0ZZ. 4 66.6 Slab edge . Z 66. 6 . Z Ir~filtration 10,050. 7 10,050. 7 Totals 43,811. 6 43,723. 54 Boiler Size % (43800) (1. ZS) % 54,750 BTU/Hr Net Output (Per Code) 1. ) All insulation and mechanical equipment shall conform to New York State Energy Requirements. .~. ) Perimeter insulation shall he as follows: walls R 13 (3~ ceiling R 19 (6") ~lmb edge R 5 (1" styrofoam) 3. ) Fireplace shall be fitted with outdoor air plenum ~vhich contains an adjustable damper. 4. ) All hot water pipes shall be insulated to value of R -' 4. 6 5.) Domestic hot water heater shall conform to Class I as defined in Section 404.3 of the code. 6. ) Heating thermostat shall he capable of setting between 45-75°F. r r APF' ED NOTED NOTIFY BUILDING DEP/SRTMENT AT 765-1802 9 A~ TO 4 P~ FOR THE FOLLOWING fNSP~TIONS: L FOUNDATION . ~O REQUIAED FOR POURED CONCRETE 2, ROUGH - FRA~ING & PLUMBING 3. INSULATION 4, FINAL - CONSTRUCTION ~UST ~ BE COMPLETE FOR C. O. ,ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY COD£$. 'NOT RESPONSIBLE FOR DF-SIGN OR CONSTRUCTION ER, P-.ORS. f --..1 F il L.