Loading...
HomeMy WebLinkAbout16347-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17698 Date JANUARY 23~ 1989 THIS CERTIFIES that the building. Location of Propert~ 5740 HORTONLANE House No. County Tax Map No. 1000 Section 054 Subdivision ADDITION Block 03 Filed Map No. SOUTHOLD Street Hamlet Lot 14.9 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUG. 12~ 1987 pursuant to which Building Permit No. 16347Z dated AUG. 19, 1987 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 1st STORY & DECK ADDITIONS TO EXISTING ONE FAMILY DWELLING. The certificate is issued to JOHN & SUSAN NOBILE (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 PENDING CERTIFICATE 1/16/89 K & K PLUMBING & HEATING 1/17/89 Building Inspector i~01~1~ NO. I~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. is hereby grante to: · ..!~.~..~..o.....~......~...~ ............ ~~....~.:¥.,.....~./..~..'z..t .......... , ~o ~...~.~.~, .~..~..~.....~...~....~..~....~ ..... ................ at premises located at .-~.....~..~....~......~....~. ~., ....... ..~.~ ............. County Tax Map No. 1000 Sectiotla~X..(~....~.~...~.. ...... Block ...... .O.....~ ....... Lot No..!...~..'...~.-- pursuant to application dated ...~g~.~...~....~..( ) ........... , 19~..~.., and approved by the Building Inspector. Building Inspector BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ..~.~....L~ .......... , Rev. 6/30/80 TOWN OF SOUTROLD BUILDING DEPARTMENT TOWN BALL J~120t966 SOUTROLB, NE~ YOR~ 11~1 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE ............... NEW CONSTRUCTION~LD OR PRE-EXISTING BUILDING ...... VACANT LAND ........ Loeation of Propert,..~.?~'.~....~...m~. ~.. ~.~ff..--...5~.~...~?.%.~. ............... HOUSE NO. STREET HAMLET Owner or Owners of Property...~'~.~['[. !..~..%1%.$.~..~)...~.~..~).~.~.~. ................. count, Tax Map No. 1o00 Se=tlon .0.~..~.. Block .O.~... Lot .~..~.~ .... Subdivision ....................... Filed Map ........ Lot .......... Permit No. l~.~.~.Z. Date of Permit Health Dept. Approval .................. Underwriters Approval .............. Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificate ./.. ............ APPLICANT ................... ,/~ ~/~x rev. 10/14/88 TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL soUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. Owner ~(b~¥~ ~ o%)'\ (please print) Plumber \~ ~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworp7 to befo~ me this/ Notary Public,/~ County (plumber' s signature) Quellfled in Suffolk nty Term Ex~tres Jan. 31, 1990 UNDA~_ __ _(1st). UNDATION (2nd) UGH FRAME & PLUM~I/ SULATION PER N. Y. STATE ENERGY / CODE FINAL ~NAL COMMENTS: New Building ' Old or Pre-existin9 Building Vacant Land Location of Property ...(~o. #.)..Helicon. -~Aqe. ........ Southold Hou~ ~o. Street Ham/et Owner or Owners of Prope~ ALBEA~ ~ ALBEA~SON JR County Tax Map No. 1000 Section ..... GS~ ....... Block ...03 .......... Lot ~9..0.~4, p.0.~.. Subdivision Mg~ of ~i~or Subdivision ...... ................... ~ ...... ~lee Map I~o. .Lot No...~. '~b~ Albert W. Albert~on,~r. ' ................. Permit No ........... Date of Permit .......... Applicant .............................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Unde~riters Approval ........................ Planning Board Approval ...................... Request for Tempora~ Certificate ..................... Final Certificate ....................... Fee Submitted $ .5,00 ........................ Construction on above described building and permeative codes and regulations --Fre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 ..O~tp~gU.~6 ~9.84 . Date .. . ~ FORM NO. TOWN OF SOUTHOLD Building Department Town Hall ,~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY ,, Instructions , A. This application must be filled in typewriter OR ink, and submitte~to the Building Inspec- 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. 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. B. 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 owne~ 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 / land use 3, Copy of certificate of occupancy $1.00 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION :)ND L ~,SULATION FRAMING [/] FINAL ,~.~,KS DATE I / O~/l~ INSPECTOR ~ F ?~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. / FOUNDATION 2ND [/INSULATION [ ] FRAMING REMARKS: ,r. ] FINAL 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ~ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING [ ] FINAL REMARKS: INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [~/~RAMING [ ] FINAL REMARKS: 765-1802 BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS-' [ ] FINAL DATE N 20~ joHN A'_,..~oSKI suS,~N joHN $EpENOSKI A. FHD ~'EL 44 8 LOT Ogle MAP OF' AT SOUTHOLD TOWN OF SOUTHOL $ UFFOL K CO,. COUNTY 'H FAMILY H.D. REF. DATE T HE SI~AGE DISPOSAL Ai~ LOC,~J'rlON HAVE FOUND TO BE Chief of pOLE DEPARTMENT ~LY Sectio~ FOR ~' i4,,4~. /'" $OUTHOLD SX~V/NG$ BANK PECONIC ~BSTN~CT ' ~ N~SSOSE7 · JOHN A NOBILE SUSAN uNoel&fi seolond surveying a engineering pc. 40 west moin street ri verheod, new york 11901 (516)569-1717 OCT..6, 198~ JobN~85-347c 1~0-054~3 ~14~, Scole: I"- 60' 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1803 Examined~/~ .~..l ~., 1982 1957. Permit No.] Approve~,~./.¢~., · .(q.a.~..2. ?' Disapproveda/c ............................... f~.~ · ~ ~~ ................................ ...... z (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... CHECK .......... SEPTIC FORM ............. NOTIFY CALL Date INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the BuildLng Inspector, v;ith 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 issued 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 ~t 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 building for necessary_inspections. ~ ,~ ....................... /(Signature of applicant, 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..dOt~. ~.-. a~C{..~t.,5..'(2..,?7..., ff..~('/.~. ............................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... Plumber's License No ......................... 'I~ Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done...~.?. ............................................ 57 o e .... ' House Number Street Harfilet County Tax Map No. 1000 Section . .(~. ~q'-~)(.~ .e~ ........ Block . .c?.,3..~.4 ......... Lot...dP.../i~./.~.ff~. ...... Subdivision ..................................... 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...C~../? .4~..L~./.~..L/.y' .~..O. ~.~..~./.~.....d~..g...~. (./~..'.~. ?..0.t?.4,..~.~ .~ ...... b. Intended use and occupancy 3. Nature of work (check which ap~plicable): New 'Building ' Addition .. t/ Alteration Repair .............. Removal .............. Demolition .............. Other Work ............... i (Descrip~tion) 4. Estimated Cos .......................... Fee ....................................... ,~ ' (to be paid on filing this application) , ./ $. If dwelling, number of dwelling ~nits .............. Number of dwelling units on each floor ..... ~. .......... If garage number of cars ~ ~ . 6. Ifbus~ness~c~mmercia~rmixed~ccupancy~specifynatureandextent~feadhtype~¥use..,..~.~.~.~::..'. ............ .... I . ~, tt ' 5" ~ O" ~.g,,~ ,v 7. D~menmons of exmt~ng structures, ~f any Front.. b.~ .,.q .... .. Rear . ~...~ ......... De~pth..~. ¢ ........ Height . . f.~. 9. ........ Number of Storms ... 2P~.. ........ ' , . , ......... · . ' ...... ;' ri ........ , " ¥" ''~ ' ' Dnuenmons'of same structure with alteratmns or additmns: Front . .~. ~...o. ......... Rear ~.~...o. .... Depth . .~. .... ~, ............ ;.. Height ... ~.~.. ~. ............. Number of Stories ...q:2 .~/.4~. ............ .... 8. Dimensions of entire new constructmn: Front . [-% z~ ,~ ........ ' ..... Rear .../.~. f. o" Depth ...~..~. ~ ~ Height '~..~ ~..~.'f ...... Nunlber of Stories ~?,,-c/~ . .... · . x-o '":' ..................................... 9. S~ze of lot. Front . ,~... · ....... '..~.. ~ Rear . . .,. :. , Depth. ~ ....... 10. D, ate o£.P,u¥chase, ...~..~.¢...t~..~.~.~.. f?.~..-~. ....... Name of Fonner'6~Vn'e;~f~.e~;?.~'~/~6¢~?t~i~.' ~,~¢i i i i .... 11. Zone or use dmtnct ~n whmh pr~mises are situated .... t~q~.,.d..~.... ~ ................................. 12. Does proposed construction v/io!ate any zoning law, ordinance or regulation: ..~..q ...................... 13. Will lot be regraded .... ./k'...'¢~.i .................... Will excess fill be removed from premises: Yes ~ 14. Name of Owner of premises'-,},Pb.rl ~,~q~r~?.. l~l~.. &.tl.e,.. Address .W.F:..qo...7~..~?.~,j'qo0tPhone No..'?..~J-. 7~q.~..~. Name of Architect .......... ! ................. Address ................... Phons No ................ Name of Contractor ...... -'7.. 'i ................. Address ................... Phone No.~,;.~ ........... 15, Ts th,is property locatediwithi~ 300 feet of a tidal wetland? *Yes ..... No-. .... · If yes, Southold Town TrUstees Permit maybe required. ~ PLOT DIAGKAM Locate clearly and distinctly all! buildings, whether existing or proposed, and, indicate all s~t-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interi )r or corner lot. 5/~ ii [a,~ olc' ~-Fe e t4 ~c~a~'[- ~t~C/4-toT- _~,,<-(~, O/ ~ STATE OF NEW YI~RK, ~.. , ~ ~ COUNTY OF ..... ' ........... }~ ~ is the applica~ff / ~ake and file this · .lief; and that the ................................................ being duly sworn, deposes (Name of individual signing con~ above named. He is the ..................... J ............... I .......................... (Contractor, agent, corp~'~te-of~cer, etc.) of said owner' or owners, and is duly authorized to perform or have perfonn~said application; that all statements contained in this application are true to the best bT~h.k, work will be performed in the manner set forth in the application filed therewith. Sworn to before'me this c,~-~ .............. · ~ [ ....... day of ...... ~ ........ , 19~ Nota~ Public,.·~...~. ~ttt~ K. DE rOE NOTARY pU6tlC, S~te Ol New York ~. ~nature of applicant) N0. 4707878~?ug01k Term ~xpires ODE £XT£~.I~,~. \VALL$ z¢ oo %0 0./? o. o5' /2°0 0.58, 2 / g o OZ/O 0.0~. 11 7© o.o$ II 7° 1) HEATING F~OIP~TEN~ TO MEET 7813.23 - 75% EFF. 2) HEATING CONSOLS TO MEET 7813.13 RANGE 45 TO 78 DEGREES FAi-A~HEIT. 3) WATER HEATING PER 7813.31 THRU .38. 4) PIPE INSULATION 7813.19 5) WIb~DWS - DOUBLE GLANS. 6) CONSTRUCTION TO MEET N.Y.S. ENERGY CODE. TO TEE BEST OF MY K~C~gLEDGE, BELIEF, AbD PROFESSIONAL JUDGE~NT THESE PLANS APsE IN COMPLIANCE WITH THE CODE. If eel)per tubing Is used for water distributing ay~tem; piping shall be o~ ~a K or L only SOLDER USED IN WATER SUPPLY SYSTEM CANNOT EXCEED 2/10 of I% LEAD. PLUMBER CERTIFICATION ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY NOTIFY BUtLDING DEP~RTMENT ~T