HomeMy WebLinkAbout15560-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Z15777 Date May 21, 1987
THIS CERTIFIES that the building .... .A.l.t, .e.r..e.x..i.s.t,i.n. 5' .o.n.e. 7.f.a,m..i,l,y' ,d,¥,e.l.l.i.n..g.,..
Location of Property 985 Bois seau A.v.e... i. Southold
House No. Street Hamlet
County Tax Map No. 1000 Section ...... .6.3 ....Block 2 .Lot 27
Subdivision ....... X .... Filed Map No. X .Lot No. X
conforms substantially to the Application for Building Permit heretofore filed in this office dated
..... p.~.qe.~.b.e.¥..1.,..1..986 .. pursuant to which Building Permit No... 15560Z
dated ..... .D.e.qe..ra.b.~.r...9 ~ . .1. 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 .........
.A.lt.e..r D.x.i..s.t.in.g one-family dwelling.
The certificate is issued to .................... .E.:, .W.A.L.D.H..E.I.M. .........................
(owner,
of the aforesaid building.
N/A
Suffolk County Department of Health Approval .........................................
UNDERWRITERS CERTIFICATE NO .......................... N8...0.8. 6......61 .............
PLUMBERS CERTIFICATION DATED: N/A
Building Inspector
Rev. 1/81
FO~v.~ NO. 2
TO~N O~ $OUTHOL~
TOWel HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
No 'i5560,z
Permission is hereby granted to:
C~.
...... ~..~..~.?..~'7.. ........................................
...~~...,,~, ....~..~.:....~..~.~ .... .
.......
__~ ......................................... "- ................. : .............. r~"-'- ....... ~'-';~"'":-: ....................
at premises located at ...Q.~..~...~.~..~' ~ ..................
County Tax Map No. 1000 Section .... .(~)..~...~ ..... Block ...... .~...~.'. ....... Lot No ..... ..~.....~. ............
pursuant to application dated ~~....! .................. , 19..~...(R., and approved by the
Building 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
This application must be filled in typewriter OR ink, and submitted ~ ~ to the Building Inspec-
tot 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 pz~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 requ ired to prepare a certificate.
C. Fees: Additions $25.00
New Dwelling $25.00, Accessory,$]O.00 Business $50.00
1. Certificate of occupancy
2. Certificate of occupancy on pre-existing dwelling $ 50. ~)0
3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00
4.woant c.o. 2o.00
5.Upda~,ed C.O. $ 50.00 Date ...........
New C OhS truc f, i on ...... Old or Pre-existing Building ............ Vacant Land .............
o, ........................ .& .....
. Street l-lam/et
Owner or Owners of Property .... .~..... ~4'~,4.~--~/') ~/'~. ~ ................................
-
County Tax Map No, 1000 Section ........... Block .............. Lot ...........
,Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No..J~/.~,' .~¢.~-d~te of Permit J, .~.~..Applicant... ~~. ,~.~. .............
Health Dept. Approval ........... ~ ............ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate ...... ~ ..............
Fee Submitted $ . .~...f.~..~.~..~..~ ...............
Construction on above described building an~/~ ~,,~i~e7 all lpplicable codes and regulations,
O~,o,~J~b ~c,~ -/~/-/ Applicant . . .%~, ~ L. ~.~ .....
_ ' ....................
Rev. 10-10-78
~.ooo~3 THE NEW YORK ,BOARD OF FIRE UNDERWRITERS
]] BUREAU OF ELECTRICITY
Hay .1 ] ,, 19~7 83 JOHN STREET. NEW YORK, NEW YORK 10038
Date ~plication No. on fil~ 474~46/~?
THIS CERTIFIES THAT N
E] Wa]dheim, 985 Boi~seau Ave., Southold~
wasexa,ninedo,t May 4 , ] 987 .
4 5
E
OTHER APPARATUS: G.F-c. I.-1
~lec. Room tleaters-4-1.OKW,l~-l. SKW,l-.2KW
~R V I C E
A~W' G' NO OF Hi'LEg r A w, G NO OF NEUTRA[ A W G.
Glenn Bradley
I~e~recJ in on)' mcJnner, return to the office of the J~oord ,t~ incorrect Inspectors~~eir~/Ima¥ be 0o.;[f ed by their cre~ontiol.
"~OPY FOR B I~DING DEPARTMENT. THIS CgPY OF CERTIfiCatE ~US~?OT BE~AL~ERE?~_~.Y ~NNER;~~--
TOWN oF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P,O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 1197!
TEL. 7(55-1802
To Whom This May Concern,
We are unable to complete your Certificate
of Occupancy because,of the following reasons.
/~/ An application for Certificate of Occupancy
is not on file.
/ ~--~/No Underwriters Certificate' on file,
/5/ The check is(outdated/not on file.)
/Z/ No Health Dept. Approval on file.
/5/ No final inspection has been made.
Please contact our office on this matter.
Thank you for your cooperation.
_Building Permit #
***/Z/ No Plumber Solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984
SPECIFICATIONS
Garage Conversion
E. ~ta Idheim
Southol d, NY
Contractor is to remove existing exterior doors and windows, interior lining of
garage, plumbing fixtures, and interior partition.
The existtng concrete floor shall be covered with R 5 styrofoam insulation, 2x4
CCA sleepers and 5/8" CD plywood.
Add to existing ceiling framing to provide sheetrock nailing 16" o.c.
Frame openings in exterior walls to receive the new windows and door.
Frame walls for the closet and bath.
Insulate the ceiling with R 19 fiberglas batts, and the exterior walls with R II.
Apply I/2" sheetrock to the ceiling and 3/8" to walls.
Install wood double hung 6/I windows with Elmont aluminum combination storm and
screen units.
Install a Benchmark exterior door with El mont VIP aluminum combination storm and
screen door.
Interior trim shall be Ix3 common pine.
Door hardware shall be by Kwikset.
Exterior walls shall be patched with new asbestos siding as necessary, and caulked
at exterior openings.
The closet shall be fitted with built-in shelves and three drawers, and clothes
hanging rods.
Interior doors shall be I 3/8" flush lauan hung in pine jambs.
Sheetrock shall be spackled 2 coats.
Ceilings shall be prime painted, and finish coated with Devoe dead flat paint.
Closet interior shell be painted 2 coats flat.
Other interior walls shall be papered with Sanitas or equal wallpaper.
Interior trim shall be painted 2 coats, giving a semi-gloss finish.
The windows and door shall be painted 2 coats premium acrylic latex paint.
Electrical work includes 7 receptacles, 4 switches, 3 fixtures (allowance $75),
GFCI circuitry in bath, and $630 for electr'ic heat.
A concrete st~p shall he installed at the door.
Bath fixtures shall be American Standard for the toilet and t7 x 19 oval vanity
sink, and a Fiat "Seagull" free standing shower stall.
A vanity shall be built in with Formica top, 2 drawers, and sliding doors .
An allowance of $800 is ingluded for carpet and floor tile.
A bath fixture allowance of $40 ls included for towel bars and a paper holder.
A plate glass mirror 24" x 48" shall be installed over the vanity.
ContracYor shall provide a building permit and Underwriters certificate.
Owner shall provide insurance on the buildtng and ma'~erials stored for use
thereon during construction.
765-~.802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION ZST [ ] ROUGH PLBG.
FOUNDATION ZND [Z~SULATION
[ ] FRAMING
[ ] FINAL
RE:MARKS= ~/~~
DATE: /'/~/~//~7/
INSPECTOR
OUNDATION
(1st)
OUNDATION . (2nd)
OUGH FRAME &
FLUMBING
iNSULATION FER N. Y.
STATE ENERGY
CODE
ADDITIONAL COMMENTS
FORM NO, 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
COUTHOLD, N.Y. 11971
TEL.: 765-180:3
Approved .~..~...q...., 19~..~. Permit No..I.r*.~..'~. · .O..'~.
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING'PERMIT
INSTRUCTIONS
a. Tkis application must be completely fill~d 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.
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 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 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 cod/~, 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 add~g~s of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises ....... .~.~.:.../'~..~...~.. ~..~. ............................................
(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.. I..~:..~.7.~... ~'{' l .........
Plumber's License No .............. - ...........
Electrician's License No .......................
Other Trade's License No ......................
l. Location of land on which proposed work will be done .................... ,q .............................
House Nmnber Street Hamlet
County Tax Map No. 1000 Section ...~. -- ... Block .................. Lot. ----..
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 .......... .iD./x(:-~., ·/I../X~,~ - .~/'~. 7~- .................................
b. Intended nsc and occupancy
3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .~..\ ......
Repair .............. Removal .............. Demolition ............. Other Work .............
i~..~..~) (Description)
4. Estimated Cost ........................... Fee ......................................
(to be paid on. filing this application)
5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................
If garage number of cars
6. If business, commercial or mix'ed occupancy, specify nature and extent of each type of use .....................
7. Dimensions of ex,_sting ~tructures, if any: Front ............... Rear .............. Depth ...............
·. Number of Stones ........................................................
Dimensions of same structure with alterations or additions: Front ................. Rear ..................
Depth .................. i · · · Height ...................... Number of Stories ......................
8. Dimensions of entire new construction: Front ............... Rear ............... Depth ...............
Height ............... Nfimber of Stories ........................................................
9. Sizeoflot: Front ..... ....~ ............ Rear ...................... Depth ......................
10. Date of Purchase ............................. Name of Former Owner .............................
11. Zone or use district in which premises are situated .....................................................
12. Does. proposed construction vilolate any zoning law, ordinance or regulation: ................................
13. Will lot be regraded ....... ! .................... Will excess fill be removed from premises: Yes No
fp
14. Nam~ of Owner o remises . ~ .................. Address ................... Phone No ................
Name of Architect ........ i .................. Address .................... Phone No ...............
Name of Contractor . .Tt~... ...... Address Phone No
15. Is this property loeate~ within 1~00 feet of a t±da3, wetland? ~ Yes ..... No .....
~ If yes, SouthoJ. d Town Trustees Permit may be requ±red.
i PLOT DIAGRAM
Locate clearly and distinctly ~11 buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
STATE OF NEW Y~;r~-t~
COUNTY OF .... 4~.CY!?..~:..~. ~"~
.............. ~ ...... .-.~~ .......... being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named·
He is the ~'f/~P~
] (Contractor, agent, corporate officer, etc.)
of said owner or owners, and is d'uly authorized to perform or have performed the said work and to make and file this
application; that all statements cohtained 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 :
......... day ~f..~.~5.~ 19 .~
Notary Public ................ ~..
'
' UNDAJ. CO0 , /
Notary Publlo, 8tMe of NewY~/
! Term Expires De~ 31, 18.~,.V--o
(Signature of applicant)