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HomeMy WebLinkAbout15918-zFORM NO 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-16330 Date October 26, ]987 THiS CERTiFiES that the buildmg ADDITION & DECK ADDITION I 9135 Mazn Bayview Road Southold, New York Location of Property H~se 78 9 65 County Tax Map No. I000 Sechon ...... Block .......... Lot ........... Subd~wsion ............... Filed Map No ..... Lot No ............ conforms substantmlly to the Application for Bmldmg Permxt heretofore filed ,n tins office dated Ap r i 1 I 3, I 9 8 7 pursuant to winch Building Permit No. 159 18 Z dated April I~ , 1987 ...... . ........... was msued, and conforms to aR of the requirements of the applicable prowmons of the law. The occupancy for which tins certificate ~s issued is ADDITION & DECK ADDITION TO EXISTING ONE FAMILY DWELLING I GEORGE & The certificate ~s lssu!d to ......... of the aforesaid bmldmg Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO PLUMBERS CERTIFICATION DATED: CORLA D. DOUGLASS ............ N/A N834506 October ]6, 1987 / Bmld~ng Inspector Rev 1/81 FO~3~[ NO. ~ TO~VN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS pERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 15918 Z Permms~on is hereby granted to: · ...... ...... .............................. ...~.......~...~.~.....u~..~.~;... ,,-q ,o ~.~...,....~.........~.~.~....~.~_........~....._4~ ........... ~'"'": .... :'_c ':"TZ: ........ ;'~ ................................................ ot p,mi,, ,~ot~ ot .,..~.~.~.~.....~....~..~..U. .............. .~......~ii.~... County Tax Map No '1000 Section ..... .(~..-'/..~ ....... Block ...... .(~..~ ....... Lot No .....t~,.'~"'~,. ....... pursuant to app icatio? dated ......... ~..~;3~ ............. , 19~..~.., and approved by the Braiding Inspector. Fee $..~.....:..~.. ' Building Inspector Rev. 6/30/80 FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions Thru apphcatlon must be fdled in typewmter OR ~nk, and submitted .m ~ to the Building Inspec- tor w~th the following, for new buildings or new use 1. Final survev of property with accurate location of all buildings, property hnes, streets, and unusual natural or topographic features. 2.Final approval of Health Dept of water supply and sewerage disposal--(S-9 form or equal). 3Approva~ of e~ectrica{ installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Remdences and similar buddings and instaila. t~ons, a certificate of Code comphance from the Architect or Engineer responsible for the building 5.Submit Planning Board approval of completed rote plan requirements where apphcable. B. For existing buddings (prior to Aprd 1957), Non-conforming uses, or buddings and "pre-existing" land uses: 1. Accurate survev of p~operty showing all property lines, streets, buddings and unusual natural or topographic features· 2.Sworn statement of owner or previous owner as to use, occupancy and condition of bu ildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepa[e a certtficate. C. Fees: Addztions $25.00 1. Certlf[cateofoccupanCv New Dwellzng $25.Q0, Accessory ,$]0.00 Business $50 00 2. Certificate of occupancy on pre-existing dwelhng $ 50.00 3. Copy of certificate of bccupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ?.~.... NewConstructzon .... t OIdorPre-e×lstmgBuddlng .......... Vacant Land ............ County Tax Map No. 1000 Section ............. Block ........... Lot ............... Subdlvlmon ....................... Fded Map No ........... Lot,~No.. ............ Permit No./.~..~. ~ ~.,.. Date of Permit I . .Applicant .. . ~ .................... Health Dept Approval .... ./ i ................ Labor Dept. Approval .................... .... Underwriters Approval J~. ~ ~ '~--/¢-5 ~ ~ Plannln oar roval ....... · · · ................. g B d App ........... Request for Temporary Certificate ................... Final Certificate Construction on above descrl Rev 10-10-78 ,ed building an~it meets all ap~. code~n~ons. Applicant . ,~) ?.~.....~,...,¢?..~.:",).. (~'..~ .................... FORM NO 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A Th~s apphcatlon must be filled ~n typewriter OR mk, and submitted m ~ to the Building Inspec- tor with the followmg, for new buddmgs or new use: 1. Final survey of property w~th accurate location of all buildings, property lines, streets, and unusual natural or topographic features 2 F~nal approval of He~alth Dept. of water supply and sewerage disposal--(S-9 form or equal). 3. Approval of electrical mstallat~on from Board of Fire Underwriters. 4 Commercial buddm~s, Industrml buildings, Multiple Residences and similar buildings and instaila- t~ons, a certificate of Code compliance from the Architect or Engmeer responmble for the building 5 Submit Pianmng Board approval of completed rote plan requirements where applicable. B For existing buildingsI (prmr to April 1957), Non-conforming uses, or bufldmgs and "pre-existing" land uses' 1. Accurate ~Jrvey of 'property showmg all property hnes, streets, buildings and unusuat natural or topographic features~, 2Sworn statement of 6wrier or prevmus owner as to use, occupancy and condition of buildings. 3. Date of any housm~ code or safety inspectmn of buildings or premises, or other pertment reforma- tion required to prepare a certlfmate. C Fees Additions $25.00 1 Certificate of occupancy New Dwell [nf; $25 00, Accessory ,$ ]0.00 Business $50.00 2 Cert~flcateofoccupancyonpre-existlngdwelhng $ 50 00 3 Copy of certlflcate olf occupancy $ 5.00, over ~ years $10.00 5.Updated C.O. $ 50.00 NewCons truc t:~on . Old or Pre-existing Building ........... Vacant Land ............ ., Street Hamlet Subdw~s~on I ...Lot No Health DeOt A~proval ................. kabor DeOt. Approval ....................... Underwmters Approval .................. Planmng Board Approval ...................... Request for Temporary Ce~ td~cate ............... F~nal Certificate ................... Fee Submitted $ .............. Construction on above descmbed budding anc~perm~t meets all a6~mable codes and regulations. Apphc .......... iOUUi~L THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY THIS CE~IFIE5 THAT ~trlc~ ~t~n[ ~d~_mtL~uc~ ~ t~ ~cant ~ on ~he a~ ~phcot~ numar m the p~m~s of FIXTUEE I I li DRYERS I FURNACE MOTORS FIXTURES I RANGES ]COOKING DECKS OVENS 'D~SH WASHERS ] EXHAUST FANS Illin'il [ I i i.2i FUTURE AI~LIAHCE I~ED~RS/SPECIALREC'PTJL TIMEC~KS~[ UtE UNiT HEATERS MULTI-~T~T DIMMERS I ~ [ 2 600 S E R V I C E Z~'2W L,E3W 3~'3W 3.8'4W NO OFpE~C~COND AWG OF CC COHO A 2~G.F.C.I. PAul t.aAr ~ z'/o Toga tfar~or La. ~UthOld, 1~,.¥. llt)71 GENE~A~ MANAGI~ // 'his cerhhcate must not be altered m any manner, return to the off;ce of the Board ~f tncorrect Inspectors may be idenhfted by the;r credenhals COPY FOR BUILDING DEPARTMENT THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P O BOX 728 TOWN HALL SOUTHOLD, N Y 11971 TEL. 765-1802 CERTIFICATION Date Building Permit, No. /~-7 / ~ Owner D6~q}Q~ (plea~°e print) Plumber ~0 [' ~ac~ ¢~'~ ~]~ (please print) I certify ~hat the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before' me this /~ ~ Cay o~ ~ ~ ~ Notary Public, (plumber' s s~gnature) Notary Pub ry u=,c, ~tateof New York No. 52-8125850, Suffolk Cou Term Exmms October 31, 1,~ TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because.of the following reasons. /Z~ An application for Certificate of Occupancy is not on file. /_~/-- N~_/ Underwriters Certificate on file. /!/ The check is(outdated/not on file.) No Health Dept. Approval on file. /5/ NO final inspection has been made. PIease contact our office on this matter. Thank you for your cooperation. Building Permit # ~ 5 ~ -1-.~ Z Bui tdiqg Dept. ***/_~ Lo Plumber Solder Certificate on fl!e. all permits involving plumbing being issued after April 1,1984 ) OUNDATION ( 1 OUNDATtON (2~) OUGH FRAHE ~ FLUHBING NSULATION PER N.~f~. STATE ENERGY CODE o,4. FINAL , ADDITIOn;AL CO~HENTS: ig ,,4 1 t } 'I JUN 5~9~ tl TOWN O~ SOU i'HOLD 'T~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING REMARKS: ROUGH PLBG. I~SULATION [~J~INAL DATE 765-1802 BUILDING DEPT, INSPECTION FOUNDATION 1ST FOUNDATION ZND FRAMING ROUGH PLBG. INSULATION FINAL DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [,/]ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND [ ] FRAMING REMARKS: ROUGH PLBG. [/'~SULATION [ ] FINAL DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ]/FOUNDATION ZND [ ] INSULATION / [~ FRAMING [ ] FINAL DATE Examined ~ Approved . Disapproved a/c ·. ) '~ ,'195 ?. Penmt No (Building Inspector) BOARD OF HEALTH . 3 SETS OF PLANS [[ .z~.'.. FORM NO I SURVEY . . &'. ..... · TOWN OF SOUTHOLD BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL NOTIFY ~UTHOLD, N.Y 11971 CALL TEL. 765-180~ MAIL TO: APPLICAIION FOR BUILDING PERMIT Date ........... , 19 INSTRUCTIONS a. This apphcahon must be completely filled m by Wpewnter or in ink and submztted to the Buidmg Inspector, wO sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of bmldmgs on premises, relationship to adjoining premises or public str, or areas, and gtvmg a detailed descnphon of layout of property must be drawn on the ~tagram whtch is part of this ag catmn. c. The work covered by flus application may not be commenced before issuance of t~ufldmg Permit d. Upon approval of this application, the Building Inspector will issued a Budding Pe~nnit to the apphcant Such pe~ shall be kept on the premises avgdable for mspechon throughout the work e. No budding shall be occupied or used tn whole or m part for any purpose whatever until a Certificate of Occupa shall have been granted by the Bmldmg Inspector APPLICATION IS HEREBy MADE to the Building Department for the issuance of a Btuldlng Permit pursuant to Building Zone Ordinance of th6 Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance Regulations, for the construction of bmldmgs, additions or alterations, or for removal or demolition, as hereto deserit The applicant agrees to comply with ali apphcable laws, ordinances, budding code, housing code, and regulations, an, admit authorized inspectors on premises and in budding for necessary lnspetex'~o ,~ /~) (Sign:fflire of apphcant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buil, N meofownerofpremlses. ........... the' tax roli o; iat;st 3;id) If applicant ~s a corporation, mgnature of duly authorized officer (Name and title of cbrporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .... t Plumber's License No . Electrician's License No · Other Trade's License No. Location of land on which proposed work will be done House Number Street County Tax Map No 1000 Section Block Hamlet .? ..Lot. Subdwimon Filed Map No Lot ~ (Nan~e) State emmng use and occupancy of premises and intended use and occupancy of proposed construction a. Exlsnnguseandoccupancy © tO~ ~ l ~/ ~ .~-Lt. .~t~ ....... b Intended use and occupancy ........ 0~- ~ mx[ '~'~Jb.3.~ ................. 3. Nature of work (check which applicable) New Budding Repoar ... Removal . . Demolition 4 Estimated Cost .... ~fi~ cl~ t~ ..... 5 If dwelling, number of dwelling units · Add~tmn ....... Alteration ..... Other Work ....... (Descnptmn) .......... Fee ........................ ~ (to be paid on filing this application) ....... 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 .... Rear .. . Depth Height ...... Number of Stones ........................ Dimensions of same structure with alterations or additions Front ...... Rear .. 2. l .' ....... Depth . .. / ~ . Height .... Se.' ..... Number of Stones ................ Dm~ensiogs'~nj~v constmctmn Front .. Rear ......... Depth ......... Height ....... Number of Stones 9 S~ze of lot Front .... Rear ............. Depth ............ I0 Date of Purchase .. ......... N~e of Foyer Owner ...... 11 Zone or use district m wh~c~ premises are situated ............................. 12 Does proposed construction vmlate any zoning law, ordinance or regulatmn ........................ 13. W~I1 lot be regraded ............ WxI1 excess fill be removed from premises Yes N 14 NmeofOwnerofprem~sesl~*.7. ¢~u~x Address mn,~ ........ Address ............... Phone No .......... Nme of Architect ~ ...... ~ [5. Is ehzs property Zocated w~thSn 300 feet o a Y ., ...- *I~ yes, Souchold To~ Trustees PermSCpmay beLOT DIAG~MrequSred' Locate cle~ly and d~stmctly ~1 buddings, whether ex~st~ng or proposed, and lndmate ~1 set-back d~ens~ons fro~ property hnes G~ve street ~d bh ,ck number or descnptmn according to deed, ~d show street nines and indicate whethr interior or corner lot. STATE OF NEW YORK, S S COUNTY OF ........ (Name of individual signing contract) above named being duly sworn, deposes and says that tie is the apphcan He is the (Contractor, agent, corporate officer, etc ) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file thi application, that all statements contmned m this application are true to the best of his knowledge and belief, and that th work wdl be performed m the manner set forth m the application filed therewith. Sworn to before me th~s .../~...-g~ ....... day of. ~ ....... 1¢t~. Notary Public .... ~ ........ County Notary pubhC, Stateof New ~:~t~ FJ (Signature of apphcan~ 4022563, Suffolk County ~,~ ~oo0 /%, ,~-.~ O.A..' /o°,~' 2.,4.: 7o',r 1) HEATING EQUIPMENT TO MEET 7813.23 - 75% EFF. 2) HEATING CONTROLS TO MEET 7813.13 RANGE 45 TO 75 DEGREES FAHR~IT. 3) WATER HEATING PER 7813.31 THRU .38. 4) PIPE INSULATION 7813.19 5) WINDOWs - ~OUBSB GLASS. 6) CONSTRUCTION TO MEET N.Y~S. ~%TERGY CODE. TO THE BEST OF MY EAKY~LHEGE, BELIEF, AND PROFESSIONAL JUDGEMENT THESE PLANS ARE IN COMPLIANCE WITH THE CO[~E. ,IN A.~'IOVED AS NOTED 7~5-1~2 ~ ~M TO 4 ~M FOR THE OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY soLDER uSED IN wATER SUPPLY SYSTEM CANNOT EXCEED 2/10 of I% LEAD. PLUMBER CERTIFICATION ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY If eel~ber tubing is used !~ water distributing W~tum; Idplng Ihall be of tl~ea K or L only. 9F