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HomeMy WebLinkAbout13540-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy UPDATED C.O. No. z17136 Date July 29, 1988 THIS CERTIFIES that the building .... 0. r}..e..f.a.m. ~.l.y..d.¥.e.Z.l.~..n.g ...................... Location of Property 380 The Greenway East Marion IJl[~s'e HO: ........................................................ Street Hamlet County Tax Map No. 1000 Section . .3.0. ........ Block .... 2. .......... Lot 47 Pebble Beach Farms Subdivision ............................... Filed Map No..6.2.6..6...Lot No. !9.7 .......... conforms substantially to the Application for Building Pernfit heretofore filed in this office dated October 12, 1984 pursuant to which Building Permit No. 13540Z dated ~ 9Y.e.m.b. e..r..I'.6.,..1.9.8.4. ........ was issued, and conforms to all of the requirements of the applicable provisions of the law. The o,ccupancy fo[: wbicl,t this certificate is issuedis .,. Private one-family dwelling wztH two t. 21 aec~s ~ garage wnzcn''i's .... attached to one of the decks which is attached to the privat~ one- family dwelling. Tile certificate is issued to LEONARD & BETTY WALTERS ..................... ...................... of the aforesaid building. Suffolk County Department of Health Approval ...... 1.4.'7S. 97.2.0.9. .......................... N691471 UNDERWRITERS CERTIFICATE NO .................................................. PLUMBERS CERTIFICATION DATED: Original C.0. #ZI3558 6/25/85 K & K PLUMBING 5/24/85 Bnilding Inspector Rev. 1ia1 TO%VN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT Ct'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No 13540 Z Permission is hereby granted to: ..Z~..2~._~.. ~'..~.-~..,Z~.c~ ...~0...~..../~.. ........ 4~Z .......................... .... ~/~.-~.~.,~...~..:.~......~../.~...~ ...~...,~..~..c~.~..:.~ .~,~..~.... ............................................................................ at ~remises located at -~(~ ~*/-/~ ~~/~/~f~-~-~ ~ co,,.~ Tax ~ap No. ~000 Sec.o...0..~.0.. ....... ,,ack ....~..g. ...... 'o, ~a. '~"Z" ........ ~.uon, ,o opp,,~a,,o, dat,~ ...~.....Z~. ............................ . ,,2..~ and opp~ ~ ,he Building Inspector. Rev. 6/30/80 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building one-family dwelli:ag w/deck & Attached garage. Location of Property 380 The Greenway East Marion House No. Street Hamlet County Tax Map No. 1000 Section 30 .Block 2 .Lot z~7 Subdivision....P,e.b.b. 1..e..B.e.a. ,c.h. ?.a..r?.s. ...... Filed Map No. 6266 .Lot No. ? 07 conforms substantially to the Application for Building Permit heretofore filed in this office dated October d 2 198.~-.. pursuant to which Building Permit No. q 35~0Z dated .... N..o..xr.e.m.b.e..r..q.6. ........... 19~.~., 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 ......... .., .~..~y?.~.e., .o.n.e.r .&a~.~. 7. ~Ve..~!i~.~' .wZ~.~..e.k' .5..a.~a. e..h.e.~., .~.a.r.a.~?: .............. The certificate is issued to ......... LEONARD & BETTY WALTERS (owner,~ of the aforesaid building. Suffolk County Department of Health Approval Ig-SO.-2.09 N69q#7i UNDERWRITERS CERTIFICATE NO ................................................. Building Inspector Rev. 1/81 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ~{outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions in duplicate ~ A. This application must be filled in typewriter OR ink, and submitted, 'V, :~o' ~.he Building l nspec~- 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. Commemial 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty 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- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of ce~iafi~c~e~f. ~c. cupancY5. 0051.00 ~ew Buildin~ ............. Old or ~re-existin~ Buildin~ ........ ~fi. Vacant Land ...... ~ ..... Location of Property j~..~.~. ~~ co..,~ ~a~ ~,~o. ~000 S~,,~o. .... ~ ....... ~,oc~ ... ~ .......... ~o, . . ~ ......... .... ........... ..... ,~a~, D~,~. ~o~ .~.~.:.~. ~ ~.~ ........ ~or D,~. ~,~o~a~ ........................ Unde~riters Approval ........... Plannin oard Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $,~, ...................... Construction on above described build~g a~er~ets all applicable~s~nd regulation, ¢,¢ ,~ ~1 ~ Appl ........... FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ~uthold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANC Instructions in duplic This application must be filled in typewriter OR ink, and submitted, 'V, tor with the following; for new buildings or new use: " BLDG. DEPT. ....... ~OWN OF SOUTHOLO I. 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--(So9 form or equal). 3. Approval 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, For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: I. Accurate survey of p~operty 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 preoare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre~existing dwelling $15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 New Building ..... . .tS~...... Old or Pre-existing Building ....... ~ Vacant Land ...... .~ ..... County Tax M/~o. 1000~ ction .... ;~..~. ....... Block ...~ .......... Lot..~ .~.Z ......... Subdivision ; .... Filed Map No ........... Lot No...,,~./~. ..... Health gept Approval tH - ~ - , .~.;,O o~ App ..................... Labor Dept. royal ........................ Underwriters Approval ,~.~..V~(.V-~..~,., ..~ .......... Planning Board Approval ...................... Re uest for Tem a \ '~ q por ry Certificate ..................... Final Certificate ....................... Fee Submitted $ .._~2. ......................... Construction on above described building and.p~rm,~ets all applicablepqdespnd regulations, State of New York) ss.: County of Suffolk) BLDG. DEPT. 3"OWN OF SOUT,HOLD William H. Price, Jr., being duly sworn, deposes and says: 1. I.am the attorney for Leonard and Betty Walters and am personally fa- miliar with the facts hereinafter set forth. I make this affidavit knowing that the Building Department of the Town of Southold relies upon the truth of the statements contained herein. 2. My clients are the owners of certain improved real property located at 380 The Greenway, East Marion, New York, designated on the Suffolk County Tax Map as District 1000 Section 30 Block 2 Lot 47. 3. That in respect to the one-family dwelling with other structures lo- cated at said premises a Certificate of Occupancy No. Z13558 was issued by the Building Department of the Town of Southold on June 25, 1985. 4. My clients have contracted to sell the premises and the purchasers thereunder or their lender is requesting that the certificate of occupancy be made more specific. The certificate of occupancy currently describes the approved structures as "PriYate one-family dwelling ~/ deck & attached garage". The requested amendment would read "Privat~ one-'family dwelling with two (2) decks & garage which is attached to one'of the decks which is attached to the private one-family dwelling". 5. On July 27, 1988, I did go to the premises and, in fact, there is a deck in the back yard attached to the house and there is a deck in the front yard which is attached to the house and to the garage. Sworn to before me this 28th day of July, 1988 Notary Public / URtE F- GP, AEB ~k~.~,. State o! New York ~k~t~'Y ,~,,~,~. SuftO~k County NO.~z'"'"' per 30 1988 T~ ~ires Septem ' .Luul~ THE NEW YORK BOARD OF FIRE UNDERWRITERS SUREAU OF ELECTRICITY ~ o.L 8~ JOHN BTREET, NEW YORK, NEW YORK 1003~ THIS CERTIFIES THAT only the elec tricel equipment as described below and i~troduced by, the applicant named on the able application number in the premises of in the followlng location; ~ Basemer~t ~ 1st FI. ~ 2nd FL Sect~o~ Block Lot 10'1 was examined on ~,~ ~ ~ and found to be in compliance with the requirements of this Board. FIXTURE OUTLETS SWffCHES JO DRYERS I ~ FIXTURES INCANDESCENT FLUORESCENT RANGES OVENS DISH WASHERS EXHAUST FANS OTHER APPARATUS: ;~lm;orb 1-~/~ 11t* Zd-t-O" t0 li"~es T~ac~ ~ti~5 $ E R OF CC. COND C NO O~ HI-tLC A. WG OF HI-LEG 1 A W, G OF NEUTRAL 4/0 G- ~ ~ Electric .[~Lc 5?5 E OENI:RAI,~ANA~E~ Per 11 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. .... CP"hF°." SM'O "? OEe~"TME"~ T" S~CO~ P~C~"T F~,C~W~,~q~T ~OT ~E~T~eEO '~" ^"V MA""E" TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. Owner ~ ~/~/~D (please p~ri~{) ' -- Plumber ~ /~ (pi-ease' print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber' s signature) Sworn to before me this ~y day of ~.· . , Notary Public ,~County iBC'it ry' L. WALTIER~ I~OTARy Pt/BLC, State of t/e~ York ~1o. 5,~-4147350, Suffolk ~ F. xplr~ Uar~ ~0, The sewage direful a~l wster aul~l~l¥ facilities for ~bJ.~ looation ~ve been inspected b~ this do~rtm~ut ~ found Services FIELD IN~FECS*ION COMMENTS FOUNDATION ( 1 st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY QODE FINAL ADDITIONAL COMMENTS: (516) 298-4817 North Fork Drywall & Insulation Co. P.O. Box 1230 Mattituck, N.Y. 11952 ~.~ I SWORN TO BEFORE ME THIS 13th day of MAY 1985 76S-1802 ·, BUILDING DEPT. NSPECTION FOUNDATION IST FOUNDATION 2ND [ ] INSULATION [~RAMING [ ] FINAL RE:MARKS= 0/~/ DATE INSPECTOR ~/~ 765-1802 BUILDING DEPT. INSPECTION [ '1 FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION []FRAMING /[~/~ FINAL /, (Building Inspector) APPLICATION FOR BUILDING PERMIT 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Received ........... ,19... Date.. ~.../-~.. ..... 19gY INSTRUCTIONS 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. ' ' e. 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. blo 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 Courtly, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolitinn, as herein described. The applicant agrees to comply with all applicable laws, ordfnances, building eogl~, housing code, and regulatigj3s, and to admit authorized inspectors on premises and in building for necessary .... inspecti~./~d~ '~WY~- _ ..~.~_~.~'"~"" .......... (~tu~eof applicant, or name, if a corporation) ' . - (Mailing address of app~ant) / State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... D:... ./:(. .-% .................................................... -: ........ Name of owner of premises . ~..~6~..0..~.~Z~. ,ff....J-..f~..'~..~2fl..~ ~ .................................. (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 ............ '..: ........... Other Tmdc's I. Location o~land on which proposed work will bc do~c .......... ~ ...................................... House Number -- Street Subdivision . . q~ ......... Filed Map No ............... Lot .......... / (Name) : .... 2. State existing use and occupBncy of premises and intended use and occupancy of proposed construction: ~, ~x~stin~ use and occu?ancy .......................... . ~.. nten e us cupanc ................. ,~ ......................... ~.,. 3. Nature of work (check which apphcable): New Building ....... Ad&hen . ~, ........ Alteration .; ........ Repair ........ ' ...... Removal; .............. Dgmolition .............. Other Work ............... ~ .~..~.~. ~ (Description) 4. Estimated Cost ...... ~ ~~.)~tJ~0:~O. · ................... Fee ........................ (to be!paid on filing this application) /. Iii 5. If dwelling, number of dwelling units ............ Number of dwe ng 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 ' Depth Height Number of Stories Dimensions of same strUcture with alterations or additions: Front ~ Rear Depth ...................... Height ........... ~ .......... Number ~f, ,~ories .......... ac. ,~ ...... a. DimensionsofentirenewconstrUction:Front ..... ~t~.'~.: .Rear.. ~....Depth....~E..... .... Height ............... Numbet' of Stories,..,~..~..~..~ ..... ' ' ' .....-......... 9. Sizeoflot: Front ......... 2?/. ........ " "', .... / ............i ....... , ~ .... 10. Date of Purchase ../~.~./~ .................. Name of Former Owner i ........................... 1 1. Zone or use district in which premises are situated 7~ ................................................... 12. Does proposed construction ~'iolate any zoning law, ordinance or regulation: ~ ........................ 13. Will lot be regraded ............................ Will excess fill be removed from premises: ~ No 14. Name of Owner o remises . · . reds .............. ; ....Phone No.. .':' ..... Name of Architect ........................... Address ......... ~ .... i .... Phone No .............. Name of Contractor ~.~>,a.~,~g~... ~/.~Fe~-4- ..... Address ...... ~¢2:.-~.~..~... Phone No. 7.~' ~.. ~..~..~. PLOT DIAGRAM Locate. clearly and distinctly all buildings, whether existing or proposed, and. ifidicate all set-back dimensions from ~roperty lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ./ COUNT F ...... ~'~ ~- . q ;~.~d,~'e,~,,~ ~,,~ ~/ ......... (Name of individual signing contract) , above named· tte is the ........................................ ' ............................. (Contractor, agent, corporate officer, etcl) of said owner or owners, and is duly authorized to perform or have performed the !said work and to make and ~e 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 · ·. ~ ~t0~('~.f~ ~t0t~.day of. · ~ ..... ~ g~'4147350, Suffolk CounJ~ ,**~*:-. -~ ~ .//., ~ Not aryl~ub~c*,# r.~ ~. ~ ~-~..'~,Z... TH.C-- ~ FOR APPROV~L OF CONSTR~JCTION OF . . Singl~ Family Residence Only /~ ~. t~%X r~,,.., State of New York) ss.: County of Suffolk) William H. Price, Jr., being duly sworn, deposes and says: 1. I am the attorney for Leonard and Betty Walters and am personally fa- miliar with the facts hereinafter set forth. I make this affidavit knowing that the Building Department of the Town of Southold relies upon the truth of the statements contained herein. 2. My clients are the owners of certain improved real property located at 380 The Greenway, East Marion, New York, designated on the Suffolk County Tax Map as District 1000 Section 30 Block 2 Lot 47. 3. That in respect to the one-family dwelling with other structures lo- cated at said premises a Certificate of Occupancy No. Z13558 was issued by the Building Department of the Town of Southold on June 25, 1985. 4. My clients have contracted to sell the premises and the purchasers thereunder or their lender is requesting that the certificate of occupancy be made more specific. The certificate of OCCupancy currently describes the approved structures as "Private one-family dwelling w/ deck & attached garage". The requested amendment would read "Private one-family dwelling with two (2) decks & garage which is attached to one of the decks which is attached to the private one-family dwelling". 5. On July 27, 1988, I did go to the premises and, in fact, there is a deck in the back yard attached to the house and there is a deck in the front yard which is attached to the house and to the garage. Sworn to before me this 28th day of July, 1988 Notary Public NOTIFY BUILDING 1, FOUNDATION - TWO REQUIRED ALL CONSTRUCTION SHALL MEET THE REQUI?EMENTS OF THE N, '0 0 0 I , . _ .............. -- ..................... d ~-Ummtlhoriled-m or i the', Nev~ York State EducatiOn Copies, of this document not beari~!g the enginee/s inked ~eal or embossed seal shall not be~ comsidered valid copies. ¥~\0 .,~ oO , : addition to this document is a violation of section 7209 of fhe New York State Educmtlon Copies of' this document not bemring the enginee/s inked se~l or embossed seal sh~Jl not be considered v~lJd copies NOmESi 1. ALL-WOP/~ SHAL~ COMPLY WITH THE NEW ¥0EK STATE L~6IFORM lPIl~ P~VENTION AND BUILDIN~ CO~S, 2. ALL ,LINTELS SBO~I ARE }IINIMUM. 3. DOUBLE JACKS FOR ALL OPENINGS GREATER THAN 6 PEET, 4. D~UBLE FLOOP JOISTS UNDER PARTITIONS. 5. DOUBLE RAFTERS AT SKYLIGHTS AS APPLICABLE. THE NEW YORK STATE ENERGY CODE SHALL BE COMPLIED WITH ON BASIS OF PART 5 (ACCEPTED PRACTICE AND IN PARTICULAR A~ ~LLOWS:) 7. PROVIDE SEPARATE HEATING ZONES FOR FLf DE. FIREPLACE DAb, PER SHALL HAV~ A LEAK BAT}~ OR BE FITTED WITH A GL;tiS DOOR & HE FIT"ED WITH AN, E~TERNAL COMBUSTION AIR SOURCe. NON-VENTfNU. ALL ~HTIN~, ~OT w~TER, AND WI~H Tlil~ NEW YORK ~AT~ CON~RVATI~N . INSULATION SC~DIILE 0,40 r additiom fo this document i~ a 425 %'~1 -i Un.uthorized alteration or mddltlon to th~s document ii · violation of section 7209 of the New York State Educ~tlon Cop~es of this document not bearing the engineer's inked ~eal or embossed seal shal~ not Un,uthorized alteration or ~ddition to this docUmeM ii violation of section 7209 of the New York State Edu¢,tioil Copies of this document bearing the engine,/s inked se~l or e~lb~ssed se~l shall nat be considered valid copies.