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HomeMy WebLinkAbout11237-zFORM NO. 4 TOWN OF SOUTHOLD · BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No. Z10683 Date ...Sep.t~embei~..1.4.,. ., 198.1. THIS CERTIFIES that the building ................................................ Location of Property/:/~ls~/0o0'. G.l.e ~. lt~a d .~ ......... S ~3~/et;~ o 1 d.,' .N ew..~o }' k ........ h~t~/ei County Tax Map No. 1000 Section .. 97.0. ...... Block .... .0i2. ........Lot .. 0..3.3 ............ Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... .d .u.n.~. 3. ......... , 198. !. pursuant to which Building Permit No ...... 1. 1. ¢.3.7. 2. ......... dated .... J.u ~ ¥..~ ................. 198.1., 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 ......... Addition Second Floo~? Loft ano~ Insulat¢~ C~ll~ng' ' ' ~, The certificate is issued to . . . ~Jl.l~ 1~ I ~t..1~, . ~.Y.~¢ I(~.l~ .................................. (o wner,7~~ X of the aforesaid building. Suffolk County Department of Health Approval .... N./.I~ .................................. UNDERWRITERS CERTIFICATE NO. R/.I~ ............................................. Rev 4/79 Building Inspector Permission: is hereby granted to: BUILDING ~P, ERMiT :, (THIS PERNtlT MUST BE KEPT ON ~-LE PP~I.< COMPLETION oF THE WORK AUT, RC~-IZED)~ ot p~emiseS at ..~.,.~.,~., · Cg~ty To~ Map No. 1000 Section BIO~ p6rs~ant ~o application dated .~ REV. 6/30~80 : ~: t · 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 buiidings 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. Approva~ of electrical 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 Planning Board approval of completed site plan requirements where applicable, Bo 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, occupapcy 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date .... c~,//,,.~ ............. New Building ............. Old or Pre-existing Building .. V Vacant Land Location of Property . ./.~'~, .~..O. ......... .~..~.~.../~..~p~'. ...... .~..q ~ ~ ......... ~ ~.~ ~.~ House No, SCreet Hamle~ Owner or Owners of Property ~., ~ ~~ ~ County Tax Map No. 1000 Section . .~ ......... Block ..... ~ ....... Lot, ~ ~ Subdivision ~;~f...OY.4.~...~~..Filed Map No. 3.~Lot No... ~.7 ........ Permit No. /~ ~ ~ ~Date of Permit . ,Appticant ......... Health Dept. Approval ........................ Labor Dept. Approval Underwriters Approval ........................ Planning Board Approval .............. Request for Temporary Certificate ..................... Final Certificate ... ,'~". ......... Fee Submitted $...~.~ .................... Construction on above described building and permit meets all appli~t~le codes and regulations, Fi~L~SPECTiON COMMENTS FOUNDATION (1st) FOUNDATION (2nd) 2 o ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY G,ODE FINAL Y o ADDITIONAL COMMENTS: uses Decorative, tackable Burlap paneling is used in both residential and non-residential building. It is an especially effective den, hobby room or family room paneling. Burlap adds warmth and dignity to offices, reception rooms and studios. It is an attractive wall paneling when used with contrasting materials in dormitories, motels and apartments. advantages Burlap paneling is a completely finished, structural panel. On-site surface treatment Is not required. It is lightweight, easy to work with, and the surface is unique and exclusive. Burlap is noise-deadening and provides extra insulation when used to panel peripheral wails or ceilings. The tackable surface conceals tack or pin-holes. The substrata will not crack or splinter, it is moisture resistant, and protected against termites, rot and fungi. Homasote black or white trim and joint molding is available. material composition N.J., and installed in accordance with current Homaaote instructions. general conslruction data Illest rs!ed mstatlatio n ms~;~ ~ given in Homasote Bi~lletin~ This bulletin detaitsthe Homasot~ ~ ~:approved.installati0n ~ ~tep-by-ste~ pr6aedureJ The f611owingg;~{ ~ infor=ationjs fo~'produ~~ Construclion Site Storage--Protect Burlap Panels, as any valuable building product, from inclement weather by storing Indoors or on a dry platform under shelter. Keep wrapped in packaging until ready for use. If no shelter is available, stack panels o~ skids 8" above grade and cove~ with polyfilm or other device. Panels must be installed in a d~ condit~on'only. Burlap paneling is composed of three basic elements: heavyweight fabric surface, bonding adhesive, and substrate. The bond is r~adc with a waterproof adhesive applied to the substrate in a continuous, uniform coating. The substrata is structural Homasote Insulation Board made from 100% recycled, all wood fibre material. It is a homogeneous composition, treated for resistance to moisture, protection against termites, rot and fungus and compressed into high density, structural panels, 15/32" thick. standard sizes* (nominal) la/e2" 4' ',' J finishing *Lengths of 10', 12' or 14' available specifications (substrate) Density, Ib./ft.~ ..................... 25 Hardness (Janka Ball) ............. 240 Tensile Strength .................. 550 Mod. of Rupture, psi .............. 550 Mod. of Elasticity, psi ............ 69,000 Shear in Plane of Board, psi ........ 125 Lat. Nail Resist., ~/~" from edge .... 150 lb. Water Absorption by volume ......... 3% Conditioned Moisture Content ..... 5-8% Expansion from 50% to 90% tel. hum.. 0,25 Thermal Conductivity {k factor) ...... 0.42 R value .......................... 1.11 architectural specification (short form) All ...... as shown on drawings shall be Burlap Panels as manufactured by the Homasote Company, West Trenton, ~ATED Burlap Panels are completely fipished and do not require surface treatment. The colorful, naturally textured surface will last for many years without noticeable deterioration. Homasote joint and trim moldings in Iow lustre black or white are available for a neat, professional finish. These moldings include: cove, cap, inside and outside corners, and "H' for butt joints. maintenance The natural surface does not require painting and its appearance can be kept fresh and clean with negligible maintenance. Soils or grime can be removed by brush-vacuuming, or with soap or detergent and water. Do not flood. Use a wet (not soaked) rag, sponge or soft bristled scrub brush. Remove soap or detergent using a clean cloth ~r sponge wet with clean water. Do not flood. Exposure to u/v light will cause color shading, institutional, affended faei burlap, added tothe natural struct strength, high insulation value~ sbund · deadening and moisture resistance ¢ Homa~sote 400, makes Class ~ Panele an ideal interior panel for any appliaation. - .. availability This is a Nova product, Samples and literature are available throughout the United States and Canada from local building material dealers, if a local dealer is unable to serve, write direct to Nova Sales CO., P.O. Box 240, West Trenton, N.J. 08628. 4 090 2 PRINTED IN U S A~ February 1978 ~br~.ryl~ ..... ; ........ RO 3F LOUVER  ~' ' 50 SERIES - 77 SERIES Square hood design for effective/ ~ [ weather protection and maximum/  i~for duct outlet in kitchen and · - ' ~ l bathroom exhaust fan Installa- tion. Can be used on any styl or pitch roof. Stack Flashing ; FraeArea Diameter Dlmen. HI. Model No. [Sq. In.] (In.} [In.] [In.] i R-50A (Aluminum) 50 8-718 14t/2 x15~4 4 R-50 (GaN. Steel) S0 8-718 f4V2x15V2 4 R-~0AD (Alum· Dampered) 50 8.718 14V2 x 15Y2 4 R-77A (Aluminum) 77 10-718 17x17 5 ' " eRA SERIES provides maximum ventilating area on I~steeper roofs. Rec- ommended for roofs with 4/12 or greeter · pitch. 8h~eof Op~nlng AIrDuct Dimensions [In.] Area FreeArea [In.] ModeINo. Width ! Height ; [Sq. ln.] (Sq. ln.] Width I Length eRA-10 x 3 10 3 30 18 14V2 )6 eRA-20 x 3 ~0 3 '60 35 24V; 16 SRA-2S x 6 20 6 1~0 51 26 203~4 eRA-40 x 3 40 3 120 70 44 V= 16 Note: eRA designates eRA Series Louvers are patented under one or more of aluminum the Iollowlng U.S. Patent numberS: 2,300,842; 2,382,076;  i PLAS-T-VENT® ROOF ':2~:, : . VENTILATORS Low profile ventilator con- structed from th~rmo- formed ABe plastic faced with Korad® for maximum durability. Resists dents ~ ~ and hail damage· Will not rust or stain shingles. Available in white or black. ; Model No. Flashing Dimension (In.] F'ree Area [Sq. In.J ' p40.W (white) 15x15 P51-W (white) A.Z~ 17 , / ~ '://~ PLAS-T-RIDGE® ROOF ,~;~"> ~'~/ Ridge ventilators designed .~'~; ~ ~/~/ highest point in attic. Con- ~/ ' ~,~1~ ~ structed from ABS thermo- ~ ,~' ,~. facing. In four foot sections '~-~' ',// ' for individual or continuous ~,'~ / installation. Sturdy rein- '~'~/' forced design. Will not rust " or stain roof. Model No: !Free Area {Sq. In.J Pit,h* Length [Fl.] pR-4B Black 72 2112-8112 ~ 4 pR-4W White 72 2112.8/12 4 iEREAVE LOUVERS AND 3/8" SOFvent® Formed aluminum in eight foot sections for flush or recess mounting. Available in Iouvered or 118" per- forated design requiring no insect screening. Available in mill finish or white painted finish. Overall Net Free Width Area [l~.~ "A" ~Sq. tn.! 2-5/8 76 2-5/8 52 3-1/4 129 2-518 52 2-5~8 76 Model Size Fees Area NUmber [In.] Finish [Sq. In.] Type EA16-8. 16x8 Aluminum 56 Screened E~ 16~6 16 x 6 Aluminum 40 Screened EA 16-4 16x4 Aluminum 23 Screened EA 24-8 24x8 Aluminum 82 Screened EA48-8 ' 48 x 8 Aluminum 168. . Screened ES 16-8 16x8 Galvanized 56 Screened ES 16-4 16x4 Galvanized 23 Screened E-20. 16x8 Aluminum 47 Unscreene, E-10 16x4 Aluminum 21 Unscreene* E-20W 16x8 WhlteAlum. 4T Unscreene, E-10W 16 x 4 White Alum. 21 Unscreene< *E-20C 16 x 8 White Alum. 47 Unscreene~ VENTILATORS Surface mount soffit vents de- *Counter display carton - 72 pieces Leslie-LoCke... manufacturers of high quali¥ ventilation hardware and a full range of home environmentol products. FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined J~.. ,,~.... ~. .... , 19 ¢ ..~., Approved J(.W..~./....?..., 190~[. Permit No.-~//~' .~. 7 ''~-' Disapproved a/c ....... . .~......~. .......... .~:} ......... / APPLICATION FOR BUILDING PERMIT ............. 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 necessaw inspections. (Signature of applicafit, or name, if a corporation) .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .... ./?..' ....~.'~ ............................................. ~ (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. ~'~--~'"~ Plumber's License No ......................... Electrician's License No. ~-- F Other Trade's License No ...................... I. Location of land on which proposed work will be done .................................................. ../..~.¥.¢ ..... .G. ~ ~...~. .... /¢. o.,~. r>. .. House Number Street Hamlet 7Y County Tax Map No. 1000 Section .................. Block Subdivision. ~.~ ¢.~..C~...~ ~. ~5 ..... Filed Map No. ~ .~ .~.~ .... Lot... '( .~ ........ (Name) 2. State existing use and occupancy of premises and intended use and 6ccupancy of proposed construction: Existing use and occupancy ~.t.~ .[~ .... . . .,4 .............. b. Intended use and occupancy ... ~..~. ................ ~ ,~ ........ 3 Nature of work (check which applicable): New Building Addition Alteration Repair .............. Removal ..... , ........ Demolition .............. Other Wor1~ .............. : (DescriptionJ 4. Estimated Cost ......... ~.~...~. ..................... Fee .................................... I (to be paid on filing this application) $. 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 .... .q'.~ ....... Rear ... $'..~. ...... Depth ...~. %'-:. ........ Height ..... ~. { ...... Number of Stories ....... .,~ ............................................... I)imansions of same structure with alterations or additions: Front ..... ¥..~ ........ Rear .... (..~-/ .......... Depth ...... Z, ..~. ......... i' · Height ....... .~r.t ............ Number of Stories ..... ~ ............... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth Height ............... Number of Stories ................................................. 9. Size of lot: Front ...... t ~. · .......... Rear .... ~.~. .............. Depth iiii ~ .C~Z ~.~..~..~. .... 10. Date of Purchase . ¥...t:. {,. p ! ....... Name of Former Owner . ~....~. .... t~. t ./~. ~ io~. ....... 11. Zone or use district in which premises are situated ................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... P/e~ ....................... 13. Will lot be regraded ....... ~ .O ................. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises . . t~,...LV.~.< C-/::~.lcAddress . . I.S'.q'-~...~... Phone No. .7. Sf~-. ~>.~..~.. Name of Architect .......... ~ ................. Address ........ ~.. Phone No ............... Name of Contractor ......... i ................. 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 interinr or corner lot. STATE OF NEW Yr'IRK, / ........ ~;......,~,. .... ~ being duly sworn, deposes and says that he is the applicant (Name of individual signing contrac~ above named. He is the ...................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is du!y authorized to 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 Notary Public, ........ ~ ..... i'--~ County _. . . __..-_ ~/., ,- ..... ': NOTARY, PUBL{C, Stat0 of New York ~"- ~ ((Signature of annlicantY I 765-1802 9 kM TO 4 PM FOLLOWING INSPECTIONS: FOR POUF ED CONCRETE 2. ROUGH - :RAMING & PLU 3. INSULATI( ~N 4. FINAL ~ I~ONSTRUCTION BE COMPUETE FOR C, 0 ALL CONSTRUCTION SHALL THE REQUIREMENTS Of THE DE.~IGN OR CINSTRUCTION ~"~,o. . j, -]