HomeMy WebLinkAbout15824-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Z16637 Date Feb. 5, .1988
THIS CERTIFIES that the building ...O.q e...f.a.m.i. ,1 y..d.w..e .1.1. i. n. g.. ......................
Locntln. nfPrnn~rtv 740 Longview Lane Southold
County Tax Map No. 1000 Section O?.B. ......... Block 0,4 .Lot 50
Subdivision..M.a.p...o.f..T..ef.r.y., .W.a.t.e.r..s ....... Filed Map No. 290 1 .Lot No. 69
conforms substantially to the Application for Building Permit heretofore filed in this office dated
.... Ma. r. c b..:~ § ,..1.9. (~ 7 pursuant to which Building Permit No. 1.5. 8..2.4.Z. ..............
dated . ?..a.r.c.h...3.0.,.. ! .9.8.7. .......... 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 family dwelling and attached deck.
The certificate is issued to CHARLES &, CATHERINE ROWAN
.................... x ..................
of the aforesaid building,
Suffolk County Department of Healtb Approval 87-S0-22 Feb. 5, 1988
UNDERWRITERS CERTIFICATE NO... N84379 I Nov. 18, 1987
PLUMBERS CERTIFICATION DATED:T & F PLUMBING & HEATING 9/12/87
'" /Buldng' '-i'-i--'I~t;; .............
Rev. 1/81
FORM NO. ~
TOWN 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)
N~ 15824 Z
Permission is hereby granted to: ,~
...... ........
.... .....................
.~~...~......~.:~..:...~L.~..~..g...:
,~'-r,~_ ~q ~ ' ~ ~," ~ ~ ......
.~.~..,.....~.......?~....~ ................ ~ .............. ~ .............. ,~ .................................
at premises located at .....~...~....~.......~....~...~-~.....~..--~.....-~.-~~ .........
County Tax Map No. 1000 Section ..... ..~...~..,..~.. ..... Block ...... ..~....~. ........ Lot No ...... ~ ............
pursuant to application dated .... ....~.~......~...(~. .............. , 19~..~..,
Building Inspector.
Fee $....~...~...~..: ...~...~....
and approved by the
Building Inspector
Rev. 6/30/80
FORM NO. 6
TOWN Of: $OUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted ~I I~iiiII 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 featu res.
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. Commercia[ 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~opertv showing all property lines, streets, buildings and unusum 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.
Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00
1. Certificate of occupancy New Dwelling $25.00, Accessory ,$10.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00
4.Vacant Land C.O. $ 20.00
~ .u~t~a c.o. ~ 50 .oo Date ...~..'..?"'. :..~..~. .........
NewC OhS truc tion ...... Old or Pre-existing Building ............ Vacant Land .............
Location of Property . Xa e
House No. ~J Street Hamlet
Owner or Owners of Property ...(~)v~/~.~..'~,. [..~',~ ~..~.~-~../. '/¥..~...' .~.O., .~J. ¢~'~V .....
County Tax Map No. 1000 Section . . . ~;~ ~ ........ Block .... .~. ........ Lot ................
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No/~'~.~... Date of Permit,~,~/~O./~,, .Applicant .,~ .~,~xl. cA ./~.~l.~.~., ./.~.C.' ......
Health Dept. Approvml ........................ Labor Dept. Approval ........................
Underwriters Approval A/. ~.~,~.~t.. ~/ .......... Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $... C~.,-~: (0..0 .................
Construction on abov descmbed budding and permit meet~,all applicable codes and regulations.
Applica ..........................
Rev. 10-10-78
OU~]D A TI~_ON
OUNDATION (2nd)
OUGH FRAME &
PLUMBING
~NSULATION PER N. Y.
STATE ENERGY
CODE
. ~DDITIONAL COMMENTS
765-1802
BUILDING DEPT.
INSPECTION
[~/~OUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION ZND [ ] INSULATION
[ ]FRAMING [ ]FINAL
REMARKS:
//
FRAMING [~AL
INSPECTION
~oum~^~o~ ~ST ~ ~ ~ou~
FOUNDATION 2ND [ ] INSULATION
DATE/~,~2 INSPECTOR
~ ~NSPECTION
[ ] FRAMING
[ ] FINAL
REMARKS: o ///~ ~ ~ /~ ~
765-1802
BUILDING DEPT.
INSPECTION
] FO~UNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING
FINAL
,., INSPECTOR
76.5-1802
BUILDING DEPT.
INSPECTION
FOUNDATION ~.ST [ ] ROUGH PLBG.
~FOUNDATION 2ND [ ] INSULATION
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ~ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ *~j~FRAMING [ ] FINAL
DATE_
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [ ] I~ULATION
FRAMING [//,~ FINAL
-u~/
DATE
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [/-~N~LATION
[ ] FRAMING
[ ] FINAL
DATE
INSPECTO~
765-1802
BUILDING DEPT.
INSPECTION
DATE_
765-1802 ~
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [ ~
/~SULATION
FRAMING [/~ FINAL
DATE [~; ~ ~ INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION ZND [ ] iNSULATION
[ ] FRAMING [ ~FINAL
REMARKS: _~/~c._, . ~ ~)
DATE ////~ .~,d
119~o84 THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
~g 85 JOHN STREET. NEW YORK, NEW YORK 10038
.ov~,b~ 18, 1987 ~.~..o.~o.o.~.~ ~7,/s7 N ~3 ~1
D~te
THIS CERTIFIES THAT
Ro~an, Lo~ Vi~ Lane~ VBa~iew & Watereed~e ~ay~ S(~hold, N.Y.
in the followlng location; .~ Bi,~ment ~ Ist a. ~ 2nd FI. Section Bl~k Lot
FIXTURE FIXTURES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS SWITCHES FLUORESCEHT
17 17
DRYERS
SYSTEMS
NO. OF FEET
OTHER APPARATUS:
Motors: 1.- lhp
3-G. F.C, 1. 2~-Bmoke Detectors
E R V !
AWG.
OF CC. COND ~
Schardan Electric
~ox 1077
Cutchogue, N.Y, 11935
Lie. 3540
GENEIIAL MANAGER
This Certificate must notbe altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FORiBUiLDING DEPARTMENT. THIS COPY OF CERT!FICATE MUST HOT BE ALTERED IH ANY MANNER.
TOWN OF $OUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. ! 1971
TEL. 765-1802
CE RTI F I CAT I O'N
Date 9/12/87
Building Permit No. /~4-~-
Owner C~L ~ ~OL~/~r (please print)
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
~~r [~ture )
Sworn to before me this
Notary Public, ~uK County
Notary Public
NO'f'AI~¥ PUgLIC, STATE OF NEW YORK
SUFFOI. K COUNTy NO. 'S882037
PALMER ASPHALT COMPANY
196 WEST 5th STREET
P.O. Box 58
BAYONNE, NEW JERSEY 07002
Telephone: (201) 339-0855
June 8, 1987
Mr. Jim Van Nostrand
LINCH HOMES
321 County Road 39A
Southampton, NY 11968
Dear Mr. Van Nostrand:
Jerry Kemp at the H. Verby Company suggested I contact you in regard
to the cross reference of materials produced by Palmer Asphalt with
that of Seaboard Asphalt. Palmer Asphalt, established in 1932, is a
manufacturer of cold process asphalt products used in roofing,
waterproofing and dampprofing applications. Palmer produces material
under our own BULLDOG brand as well as under private label. All
BULLDOG products are manufactured in accordance with the applicable
Federal and ASTM specifications.
BULLDOG products compare very favorably with Seaboard material.
Seaboard produces many varieties of similar mater[als under different
labels to meet a price point. Some of their materials meet a
specification and others do not. Without hesitation, BULLDOG products
will, at the least, provide you with a comparable material to that of
Seaboard.
Enclosed please find a complete BULLDOG catalog with Material Safety
Data Sheets attached. If I may be of any help, please feel free to
call or contact Jerry at the H. Verby Company (S16-585-9100).
Very truly yours,
PALMER ASPHALT COMPANY
V~/js
EnG.
· SINCE1932 ·
SYSTEM?
CONF'OR:
SOFFOL!
(S}_
SUFFOL{
SERVI~
CONSTR:
DATE-~
H. S. REF
APPROV~
SUFF(
DIST.
OWN~RS~
~ DEED: L~
TEST E:
'FORM NO. 1
:"TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 765-1803
7.
Examined . · U.~..~r.O. .,
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Received ........... ,19...
INSTRUCTIONS
a. This application ~nust be completely filled in by typewriter or in ink and submitted to the Building Inspector, with
sets of plans, accurate plot plan to scale. Fee according to ~chedule.
b. ~lot pI~n shoo,n8 location of lot and of hufld~s on pro~ises, ~ehfionsh~ to adjo~n~ ~e~isos or pubic
o~ a~eas, and gives a det~led description of layout of property must be drawn on the diagram which is pa~ of this appli-
cation.
c. The work covered by this application may not be commenced before issuance of Bufld~g Permit.
d. Upon approval of this application, the Building Inspector will issued a Buildhg Pe~it to the applicant. Such pe~i~
shall be kept on the premises ava~able for inspection ~roughout the work.
e. No building shall be occupied or used in whole et in p~t for any pu~ose whatever until ~ Ce~ificate of Occup~c~
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building.Dep~tment for the issuance of a B~lding Pe~it pursuant to th(
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, ~d otherappticable Laws, Ord~ces
Regulations, for the construction of build~gs, additions or alterations, or for removal or demolition, as here~ described
The applicant agrees to comply with all appficable laws, ordinances, bufld~g c~de, houses co~e~d r~g~latigns, and tc
admit authorized inspecto, on premises and ~ bulldog for nocossa, inspoction~ d
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
......................
Name of of premises '
owner ..........................................................................
(as on the tax roll or latest deed)
If~plicant is~ cg/p~ongsigna~re of duly authorized officer.
Builder's License No ....... ~ .............
Plumber's License No .......... ~. ~ · ·
Electrician's License No. 3 ~9 ~
Other Trade's License No ......................
I. Location ofland on which.proposed work will be done~ .b.0..A/)..~. ............................
House Number Street Hamlet
County 'Fax Map No. 1000 Section ...... ~: ........ Block ...... ~. .......... Lot .... ~.'~.0. ...........
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
ting
fl. Exis use and occupancy ................................ : ..................... · .....
b Intended use and occupancy . . . . ·..
3. Nature 6fwork (check which applicable): New Building . . .~.... Addition i Alteration
I liti ~ Otb k
Repair.: ............. Removal .............. Demo on ... .... .. ... erWor ..........
: ~ (Description)
4 Estimated Cost ' Fee
*' (to b~ paid on filing this application)
/
5. If dwelling, number of dwelling units ............... Number of dwelling ufiits on each floor
Ifgarag~ 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 I . Number 0fStories '
Dimensions'of same structure with altdrations or additions: Front Rear
Depth .~ ..................... Height ....... ............. Number 6f Stories
'- 8. DimensiOns of emtire new construction: Front ...... ~;~.~...' ..... Rear ..... o~ ...... .............. Depth .... ~..~."' '. '. '.
Height '.../g~.. ........ Number of Stories ....... ~' :' ....... ~ .... ~' 'i ......................
9. S~zeofl0t. Front ...... /.O.O.~.O. ......... Rear ..... /~..O. ...... i Depth .../~..O.:o.J .......
10 Date of ~urchase Name of Former Owner
II Zone or!use d ...... d
. lstrlct m which premises are situate ........................ : .....
12. Does proposed construction violate any zorn'ny law, ordinance or regulation: ' ' 'i" .......... ' 8'" . ..... ..............
13. Will lot be regraded ..... ' .................. Will excess fill be remoYed from premises: Yes
14. Name of Owner of premises .... Address ! Phone No.
Name of Architect ..................... ....... Address .............. t~; No ...............
Name Of Contractor .~..00. ~O/9.P-~., .~..,~..: ...... Address .~..O '//~./~°..FTC.! ."' Phone
. ... Phone No.~.~'~..x.O.O..O..~.
15. Is this property located within 300 feet of a tidal wetland? *~es ..... No ,~...
*If yes~ Southold Town Trustees PermitpE~be required.
DIAGRAM
Locate cl arly and distinctly ~1 buildings, whether existing or proposed, and. indicate all set-back dimensions fro~
property lines. Give street and block number or description according to deed, and show street names and indicate wheth~
interior or corner lot.
STATE OF NEW YORK, S.S
COUNTY OF ................. '
........... : ...................................... being drily sworn, de'. ~oses and says that he is the applica~
(Name of individual signing contract)
above named.
/
He is the .......................................................................................
(Contractor, agent, corporate officer, et~.)
of said owner or owners, and is duly authorized to perform or have performed thel said work and to make and file thi
application; that all statements contained in this application are true to the best of his knowledge and belief; and that th~
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this~
.............. ...... ..... .......
~. 4707878, ~ ~ ~ .....
(Signature of applies-t)
%.,
SUFFOLK COUNTY DEPA,qT~Dqr OF
. SINGLE F~,~.ILy DWELUNg ONLY
The ~' ~= . , . ..... ,.
R~.[;)EF~ICK VAN T,~U.YL, P.C.
LICENSED LAND SURVEYORS
GREENPORT NEW YORK
SUFFOLK CO. HEALTH DEPT. APPROVAL
STATEMENT OF INTENT
THE WATER SUPPLY AND SEWAGE DISPOSAL
SYSTEMS FOR THIS RESIDENCE WILL
CONFORM TO THE STANDARDS Of THE
SUFFOLK CO. DEPT. OF HEALTH SERVICES.
ts)
APPLICANT
SUFFOLK COUNTY DEPT. OF HEALTH
SERVICES -- FOR APPROVAL OF
CONSTRUCTION ONLY
DATE:
H. S. REF. NO., ,..~"7- ~0-~
APPROVED:
SUFFOLK CO. TAX MAP DESIGNATION:
DIST, SECT. BLOCK PCL,
OWNERS ADDRESS:
TE~T HOL~ ~TA~P
SUFFOLK CO. HEALTH DEPT· APPROVAL
fo~ 70
.SU._FFOLK OOU~i ,..
mYER" ~:~'~,N, ,~,~'OMES
INC.
,..'r. ~1901
sour~m~, ~Y ~8
(516) 203-0009
LYNCH HOMES INC.
COl tn,TV ROAD 39A
:?'::'
~ .58
LICENSED LAND SURVEYORS
gREENPORT NEW YORK
STATEMENT Of INTENT
THE WATER SUPPLY AND SEWAGE DISPOSAL
SYSTEMS FOR THIS RESIDENCE WILL
t CONFORM TO THE STANDARDS OF THE
UFFOL CO. D r¢:
(s~ ~, ~'/~r~ t//7/~
- I- ~PPLICANT
SUFFOLK COUNTY DEPT. OF HEALTH
se.vic~s - ~o. ~..ova~ or
CONST R ~t~¢~
DATE: kd~O~?. /
SUFFOLK CO. TAX MAP DESIGNATION:
DIST. SECT. BLOCK ~L.
OWNERS ADDRESS:
DEED: L.~gO~ Pm
TEST HOLE STAMP
A,~PROVED AS NOTED
NOTIFY BUILDING DEPARTMBNT AT
766~1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
FOUNDA'rlON TWO REQUIRED
FOR POURED CONCRETE
ROUGH ;RAMING & PLUMBING
3 INSULA*FIOr,;
4. FINAL CO~J~TRUCTICIN MUST
BE COMPl ETI: l~OR C 0
~ QON,~*I RUCTION ~HAcL ~EE'F
THE REQUIREMEN'r$ Of' ~ N~Y
· tAI"E COI~TRUC*'n~ & ENERGY
~PANCY OR
USE kS UNLAWFUL
~ CI~'I'I~TE
OF OCCUIliIiIOY
,/
-f
PLUMaER CER~'/F/CA ~'ION
O,'V LEAO C0~£#~. a£FORE
~Oi. oER U$,EO /,4/
I
4\
Jl
II
'L
~i' I O,J
/--IT
II
IL____
! .