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HomeMy WebLinkAbout15392-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z15853 June 16, 1987 No .................. Date ................................ THIS CERTIFIES that the building .... p.n.e. 7.f~a.m. Jr .ly' dwelling. Location of Property ..... ..1.1.2.2.7. ...........S. 9.u.n.d.y .i.e.w' .~. ¥.e.n.u.e. .......... S.o..u.t.h.o. 3:..~... House tvo. Street Hamlet County Tax Map No. 1000 Section ..... 5..4 ..... Block ........ .6 ......Lot ... p./.o...2.,.2. ..... Subdivision .................. X. ............ Filed Map No....X. .... Lot No .... conforms substantially to the Application for Building Permit heretofore filed in this office dated ·..O¢.t:p. ber..7, s. 19.8.6, pursuant to which Building Permit No. 15 3 9 2 Z dated ........ QcLbb. e.X. 9.,..1. 9 ~3.6... 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 ......... New one-'family dwelling with attached two-car garage. ROBERT JOHNSEN The certificate is issued to ..................... ?o'~n'e;','~f~'~j~q ...................... of the aforesaid building. 86-SO-75 ' Suffolk County Department of Health Approval .......................................... N810846 UNDERWRITERS CERTIFICATE NO .................................................. 6/9/87 PLUMBERS CERTIFICATION DATED: Rev. 1/81 lvO~ NO. ~ TOWN OF $OUT~OLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDiHG PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~' 1539~ Z Permission is hereby granted to: ...~.~....~~.~....~..,.. ~.:.~:...z.:..~.z./. ...... ~....~. ........ : ......................... ~' .................................. ~"~ ................. i .......... ot prem,ses located at ..~J........~...~....~ .................................. 0 · ~* County Tax Map No. 1000 Sect,on' ..... 0.~..~. · ...... Block ........... ~D ..~. ....... Lot No....7./.9. ............... .;Z., ~ pursuant to application doted ..... .~....~.,.~.....~. .................. , 19~)..~., and approved by the Building Inspector. 'J~ilcJing Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department · Town Hall '~ Southold, N.Y. 11971 765- 1802 TION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m ~ 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. For existing buildings '(prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property 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 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15o00 NewCons trhc tion ~ ·. . . Old or Pre existing Building ............ Vacant Land ............. Location of Property ......... .7.., ..... ' ..................... Hou,~ No. Street Ham/et Owner or Owners of Property ... ~X,¢,~, ,e,~.~... ,~,~,J h .~,~ ;~,~ ................................ County Tax ~ap No. ~000 Section ...q ~.~ ..... ~,oc~..~ ~ ......... Lot..~.. ?......::k... $15.00 Date .... ~, ."7.',~. ~,. 'T, ,~,,':. '~. ..... Subdivision ................................. Filed Map No ........... Lot No .............. PermitNo... ~ Date of Permit .... Applicant 9,~,e,¢, Health Dept Approval ~ Labor Dept Approval Unde~riters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate . .~ .................. Con,ruction on above deseribed building and p~¢~e~ll ap~able codes and regulations.~.0~ ,~ ~ ~~: ·. y ............. Memorandum from ~. :, ~ __ · ..' ;2: ,~gg~ ~..~sn~ BUILDING INSPECTORS OFFICE TOWN OF SOUTHOLD Town HALL, SOUTnOLD, N. Y. 11971 765-1802 BUILDING DEPT, INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING REMARKS: FINAL DATE /~-~///,~ , I .$PECTOR///~-,~,~(~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] IN/SULATION FRAMING ~ FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] R..~UGH PLBG. ./ [ ] FOUNDATION ZND [/-/]'INSULATION ,, _( THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY ~'~',~ 20:, ~,.~7 85 JOHN STREET, NEW YORK, NEW ,,.t. N 10846 THIS CERTIFIES THAT only the electrical equlprne~t,? described below and introduced by the a~ppllcant ~lamed on the above apFlication number in the premises of James P. Bnn~er, als Sound View Avenue RoO~I. ~ouchold,~ in lhe followlng location; ~ Baseo~ent ~ Ist FI. ~sexaminedon ~ay 14~ 1987 [] 2nd FI. Section Block and found to be in compliance with the requiretnents qf ti is Board FIXTURE FIXTURES RANGES OVENS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT DRYERS E OTHER APPARATUS: Motors: 1.-3/4hp 1-5 Ton A/C Unit, 2--C,F.C.I. 2-5moke De~ector~ R V I 2/0 C E A w G. NO OF NEUTRALS A, W G. OF HI-LEG OF NEUTRAl. 2/0 EECO Electric Corp. (Cliff Cornell) 325 Willlw Point Road Southold, N.Y, 11971 Lic, 2816E GENER~ MANAGER i~ This certificate must not be Qltered in any manner; return to the office of the Board if incorrect. Inspectors may be idenfifed b their credenhol - FOR~BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE ~UST NOT B~ ALTERED IN ANY ~NNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Plumber Building Permit No. / (please print) (please prSnt) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this ~ day of ~/~ Notary Public~~_ County Notary Public FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE ADDITION~ ENTS: Examined .~..~..~q~q.... ~ .... , 19~. .~. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1803 Approved ~*,-~ .~. · . · .q. .... 19~. .k. Permit No..) .~..~..~. ~ ..~- Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... Date.../IQ...'7..7 ....... 19~..~. INSTRUCTIONS a. Titis 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. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy ihall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the iss~ance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New y4ffrk] and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or/for ~moval or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, bui/Vding/eode, hou~g code, and regulations, and to admit authorized inspectors on premises and in building for necessary insfl~~ (S~nature of appli,~ant,, or name, i.f a corporation) ..... I I.,~ , ....~..~ .o.. 9...':qq,. u?..~.v.: .e..,.u....,~.o.g. ........... ' . .... ....... ~ma±L±n~ address of appl±cant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......... .... h. ............................................................. Name of owner of premises ...... .~.~. l ........... ?. 5. e .;'1 ............................................. (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. 2 ~,~e Other Trade's License No ...................... Location of land on which proposed work will be done ................................................... .................. .7. ..... ....................... House Number Street Hamlet County Tax Map No. i000 Section ... ~..~. .......... Block ....~. ............. Lot ~.°~.~.~."~2...~.,.~. .... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: '7- a. Existing use and occupancy ............ ,: .t...?~. .................................................... b. Intended use and occupancy . . . ./-/.. ~./4d.... ~..~ q~:~' ............................................... 3. Nature ofwork (check which applicable): New Building ... Addition.. Repair .............. Removal .............. Demolition ........... 4. Estimated Cost ............ 7.~ d~O ....................... Fee .......... . Alteration ...... ·. Other Work .............. (Description) (to be ~aid on filing this application) 5. If dwelling, number of dwelling units... ~;:~; N . I ...... umber of dwelling unit~ on each floor... /... If garage, number of cars .............. ~ ~-... t~.7~.ag./~.e~. .... : ............... i... i i i :i. 6. If business, commercial or mixed occupancy, specify nature and extent of each typle of use..~ ............... 7. Dimensions of existing structures, if any: Front ............... Rear .. i Denth Height . ~ ......... Number of Stories . ' ........ ~ ............... Dimen~s of same structure with alterations or additions Fro~i ................. ~:.' .................. Dem~fi ........ · ........... ~ ... ,~, ........ ~rm ...................... Height ....... Num bar r~' .q~,~qoo ' ...... D~menmons of entire new construction Front ~ o~'.0- Rear ~ ~, t~ ~ -- ~ I ~,t ..... ' .................. ~ ...... tJepm .. ~... 71 ...... Height . .. I~--.~ ........ Number of Stories ..... //" '~' ................. t ........................... 9. Size of lot: Front ....... ~t~- ..... Rear · ...~.~.~. . . Depth / 10. Date of Purchase ]~. 8] . . " . .'i~a~o~'~ ' '~ ........................ ............. ; ...... ~ · cermet Owner . i ........................... 11. Zone or use district in which premises are situated ..... /~'~ ............... ~ ........................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .. j~.0 .......................... 13. Will lot be regraded .... ~VO. ,. ................... Will excess fill be remove4 from premises: Yes 14. mame of Owner of premises . .]~. ,~,~>~.~ 4~., Address Phoneme ~..~L/~,~...'~. Name of Architect ........................... Address ................... Phone Name of Contractor .... ]~ .~.h/X~'.q ......... Address .............. ,. Phone No ................ 15. Is this property located w±th±nl00 feet of a tidal wetland? &'¥e~'. .... No...:.;>.,~ ....... ~ If yes, Southoid Town Trustees Permit may be required. PLOT DIAGRAM . Locate clearly and distinctly all buildings, whether existing or proposed, and~ mdleate all set-back dimensions fl~om property lines. Give street and block number or description according to deed, and show and indicate whether interior or corner lot. ~ _ .TATE OF NEW YORK, S.S :OUNTY Ob ..... ~ ......... ........ [.XO.[e,q. ~ .... ,.~']a.U .~ ~n ................. being duly sworn, deposes and says that he is the applicant (Name of individual sign~g contract) hove named. e is the (Contractor, agent, corporate officer, etc.) f said owner or owners, ~d is duly authorized to perfom or have perfommd the saic work and to m~e ~d file this )plication; that all 'statements contained ~ this application are true to the best of h~s knowledge and belief; and that the ork will be perfomed in the m~ner set forth in the application filed therewith. ~om to before me this ............... ~ta, Public ........ ~'. ~: ~.. County .... . .............. ~ ~ (Signature of applicant) SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO.~G- STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DIS~SAL SYSTEMS FOR THIS ~ESIDENCE WILL CONFO~ TO 'TN~ ST~ND~D~ OF TN~ SUFFOLK CO. DEPT. OF HEALTH SERVICES. A~LICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF ' CONSTRUCTION ONLY , DATE: . ''~ .--" ' S~FOLK CO. TAX MAP DESIGNATION: , ~._ OWNERS ADDRESS: ~ DEED: L. P. ~ TEST HOLE STAMP VAN TUYL, ~.C, k~ND SURVeYOrS ~N~O~T N~W YO~K RODERICK VAN TUYL, I. ACENS£D LAND GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FO.,J~ THIS RESIDENCE WILL CONFORM ,,~ /'J'HE STANDARDS OF THE SUFFOLK/~:)F~T~C~F/~E;~LT" SERVICES. ~LICANT q - SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONL~ D TE: a IF S~FOLK CO. TAX MAP DESIGNATION: DIST. SECT. BL~K ~L. OWNERS ADDRE~: DEED: L. P. AVE ~cc~, ' , . - , ~.~~flageu,~,~ 7~ ~~K C0; DEPT. OF HEA~TH SERVICES. ~R ~ CONSTRUCTION ONLY ~ AP~OVED: , , , ,' .... ;~, , ,, ,: ' RODE~K VAN TUYL, PC , LICENSED LAND SUR~YORS ~ ' ¢~ ? ~ dlst~ OR¸ IS UNLAWFUL CERTIFICATE '1! 5: FEE'. /I~- c/ LIV/N5 AP. ~ AS NOTED ._~£AL.E Ii l.J. YOP, K ' ,P, AYMOND £. I.I I T P.. "~*x Io - tC¢ o,C. c T .S DR.W5. Io~? I//-2.¢¢ G?PSU~ ~' GI~DF=.P... F/OTE ©P FLANGE 7o UP WlT~ EDG& o~ STUDS /~..2'= / ~-o ¢AMPE££O DLIc7 7b OUT$t~ I:AM LV Itl: $ I D,[NC [ ~tVIS lO'N?.: : VgNT '~A,LL SECTION' ' 4~"'¢--.TORE' ~ ;'AI~ S~A6e. ONE I: A~l LY' 1~ ,- ,¢-' ~ ~- ~' I ':T': DIZW6:' :] f'-' . 1 A IL [, 14 I,'~ DATL: : ' G~NgRAL MOTES ~~~~ ~r6 ~t~d~"~re continuouS~o~er three or ~re, ', All Federal,, State and local ~odes, ordinancd's, regulatlonm, ~tc; shall, be considered am part ~u~r~m, ,jointl 1~ joists arm to, ~ l~mted ~t~en one .~x~, sad one q~t~r the apl~ length / .,specifications for this buxld~ng and shall take preference ow, er anything showh, described br ,~r~. an ~n~e~dtate ~p~t. Ro t9o adjotnin~ Jetsam, nor ~re than ~e.~h::trd the total nuwber. , ~ plied where variannes occur.* .'~ ' , :, mF~f to ~'joieted on the ~ side bf the sup~rt. . : ,~ ' . ' .Contractor to verify all dimensions and make work agree. ~." : , ' · ,' ,' , ~i,~'," ~,,giF~rs are to ~ ~ailed ~roa ~e side with lOL~nn~ nails, teo,ee]rr each end o~ each -Insulation Indicated on plans may vary from l~cal requirements. Insulation (R value) .able ~nftltratton rates to comply with latest regulations of ~h~: l~cal u.ti'litv company, h' ,, ~ieee. ot~ e. tR.~gered with a dietlnce of 16 inches between natla in a ~Ori~ntal '.lies. top and' ..All p~Bred concrete wall and column footings to rest on undis~'U~rd wit.gin soil... ''k r · ~t~om; e~ g~r~e'~e tO ~ n~lled: f~em each 8tdmrWl~b lO-peee~ nai{i, t~e ~ar m~eh end of each Sail bearing capacity determlne~ at site. Footings are deai'g~ed for a minimum soil bearl,g ca~ , :~eSet o~ mtalwered with a dtat~nce ~f 3~ inc~m ~'tveen emile tn a h:~i!~t~l line top ~nd ',mCt~y of 4000 lbs. per square foot. If soil bearing capacity iS less than this minimum, ~t:t°m, , ' ' ' , i[~ are to be redeai&ned by m professional engineer. , , , ~hfme-~/eC'e W&rderm l?e to;~' naile(i with ZO-penny nails on each side wtt~, t~eo ~at each end 0f All structural lumber to be Douglas ~iPaHemlock structurally graded with minimum allowable stresses 'eaCh piece, tnbludt~'intm~diate }ointm, and wit~ the others sta~ered?tt'[~ a dimta~ce of not ' as foll~, or aw indicate.d on plans, ,, ,, , ' ~ , ~ thl~/~ ~nehes ~tw~ flail! tit A horizontal line. top and bottom. : :,:j ,- 1400 P.S.I. extreme fiber ia bending F~ , ' ,F~-'pi-iee[ g~rs are to ~ natl~,with ~O-~nny ~11 as specified for ~elthree-~tece gt'r~r. 1,500,000 P.S.i. modulus of elastici~tF E ~/ ~ / Retn[orce ~11 concrete slabs am indicated wi~h 6x6 No lO Welded, Wire Mesh~ Ot~arl ~e te"~ securely aechored to ~aonry piers, nailed to wood ~ete o~ bolte~ to steel coleene. :Double all floor joists' tn parallel with ~rtitions above or aa,,indi~cat'ed, 'on pla~s. I p Glass in hazardous locations, to be of safety type approp'rtate'~o, uae. , Provide amoRe detectors, number and location ss required by the local building~code and i as' per ~anufacturers lost'ructions ' instal, l'ad ,, PLAN D W6 CEILDJO JOL~ ~a~t.n'~¢ TO C/la ,117~' 7/12 ATTIC, ~ a--toaI h ti 1~. YOP, E ', P, AYMOND k. SCl-I;[Nldk: 14 I T E C .T 5' , ON[ I:AMIL¥ PLAN It ~. $ I D;,;LN