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HomeMy WebLinkAbout14469-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Date July 14, 1987 THIS CERTIFIES that the building .0.~.~..F.A..M.I.L.Y...D~.E.L.L..I .N.G..W..I.T.H..4T.rAq~..~p. & WOOD DECK - Location of Property .. 1. 8..2.0..L..i .t.t.l.e...N.e.c.~..Rp.a.d. ........ .C.u.t. 9 .hp.g.u..e.,' .N.e..w..Y. qr..k ..... House No. Street Ham/et County Tax Map No. I000 Section . . .1.0.3. ...... Block . . .0.4 ........... Lot ..... 0. ! .8 ......... Subdivision M/o Moose Cove . , .Filed Map No. 3230 .LotNo. 018 conforms substantially to the Application for Building Permit heretofore filed in this office dated N o v.e mb e r I 3, I 9 8 5 pursuant to which Building Permit No. 1 4 4 6 9- z dated ...D.e..c .e.m.b. e, r...1.2.:..1 .9.8. 5. ..... 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 WITH ATTACHED GARAGE & WOOD DECK AS APPLIED FOR The cextificate is issued to SCENIC HOMES EAST, INC. (owner, ~e~FeY~.~DX of the aforesaid building. Suffolk County Department of Health Approval 14 - SO- I 13 UNDERWRITERS CERTIFICATE NO N 8 I 70 15 PLUMBERS CERTIFICATION DATED: July 8, 1987 Rev. 1/81 FORM' NO. 8 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HAL& SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 14469 Z Permission is hereby granted to: ..... ..-,.,.,.,.,.,.,.,.~_~.t.c..~l.~.~-~...~.J ......... .... ~..z ~o,.. .~ rc ~. . . .Cr~. . .~.~¢. .. . . ~... . . ......~crr:r..~.c,o...-...~......~.. ....... ,~.l...q...7...I ,o ........ ~..~ ~ .T. F~.~..~-T... ...... .(2. ~::~c~....~.-7~. ~.t,,..~.....i¢-,,~.~.~.1 .~ ................ t ~ o /_.l cc ~.~...~. ~_o..~.~ .............. ot premises located at ............. .~. .................. ~ ............................................. ....................... [-' ........ i ......... L" ........................................... .C..~.~..~.v..e....~.~.~. ............ ................. .......................... ......................... County Tax Map No. 1000 Section .... L~..,..~. ...... Block ...... O...~.. ...... Lot No...~...]...~. ........ pursuant to application dated .~'J~O~......]L...~.. .............................. , 19..~...~.V"nd approved by the Building Inspector. Fee $....Z,..~.~:~ Building Inspector Rev, 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 TOWN OF 'SOUTI~OLD APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted I~==maa~ 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-iS-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. B. 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~"operty 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: Additions $25.00 1. Ce~ificate 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 occupanc¥ $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .., J.~. ,~. 9 ........... ~-:~T~, ,L, ,'~,...~N~. House No. Street Ham/et Owner or Owners of Property . .~0~C~.~.[..C--....~-~.O.~¢,-.~...~. ~::~.~.'.~. .... ~. tNl.(~_ .~ ......... County Tax Map No. 1000 Section .... ~..O..~ ..... Block ...... .~ ....... Lot ..... {.8 ......... Subdivision. :~('~1,O.O. ,~.~,.. ,~..~. ,~.~, ......... Filed Map No. ,~. ,~, ,~. ~..Lot No .... .~.Q ..... Permit No, i..~.~.9...-~-gate of Permit .......... Applicant...~..~. ~'~.t ~,,..~,'"~,~,~%~.. Health Dept. Approval .j..~...~.~..Q)...~-.. j.[.~ ...... Labor Dept. Approval ........................ Underwriters Approval ,tN[..~.[ ,tT',O. J.,~, ........ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Rev, 10-10-78 Construction on above described building and permit meets all applicable codes and regulations. TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date 7/~?~ Permit No. !~, ,~ Building Owner ~0A~ C 1~%~ (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber'S ~ignature) Sworn to before me this ~ day of .~ Notary Public, County 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ~NAL BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION FRAMING , [ ~L DATE ~/,/~//~ ~ INSPECTO ,.R~/~~ ~.~ 765-1802 ~~ BUILDING DEPT. FOUNDATION 2ND [ ] INSULATION 765'1802 BUILDING DEPT. INSPECTION~ [~ FOUNDATION 1ST [ ] ROUGH !PI-BG. ,,, FOUNDATION 2ND [ ]INSULATION [ ] FRAMING REMARKS: [ ] FINAL DATE INSPECTOR 765-~802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ~ FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION ZST [ ] ROUGH PLBG. FOUNDATION ZND [ ] iNSULATiON FRAMING [ ] FINAL REMARKS: ..~ ~AT~ ~l~ ~~SP~CTO~ ~ -- ~ COMMENTS FIELD INSPECT ~N _. (1st). FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: yOP..K~ SC/-/tEHY--E ARCI4~'rECTS- EH[IR6~ COUPE ~ A~//J YAL~E 6AEC~LATI/O~qS ' CEILING SECTION CAVITY ~ FRAMING , OG . ~ ~. oo ~. s~ (~ STU~ . ~5 . ~ ~ 0.07 ,= ~. ~ _CAVITY ~ F~A~ING 2 AlP- P IL,qX . OAF.. FLOOP.. · I~'~' ~=ELI' . OG ~V~' IN~UL~TIO~ ~. oo AI~ FIL~ · TOTAL" ffOTAb" ~" WAL~ ~ O. 07 .~A, Lb.SECT/ON CAVITY 7~ Il O0 = 0 ~07 .7~, , OG , G~.-' 0.1¢- ..ACTUAL WLNDOW ~ OF- OV'E-.~ALL WALL AREA. yOIZK ~L SC/~F_./qKE AP. CHII'E-. CTS YAIL JE AILC JLATI/O $ C.I: ILING SECTION i.C, AV'ITY P... FRA,~ING/2,. l?-..' 'INSULATION 'ToTAL"E VALUE--' --' '5~J.G7 = 45 · IoTAL" U" ~'ALUB' = WALL .OUTS(DE ALP-.. 'FILN% 4J' gTO~ta or liS~,lc~, I "A~ g~Ac~ ~" P~ WOO~ ~/[ INSULAT I0~ ~2"G'/PSU~ WALL~A~D TOTAL" ~' VAL'Ub TOTAd' U" VALU~ FLOO~ SECTION OVER UN~EAT~D C[LLA~ ALP,, F I LJY', I~'~' FELl' ~';2-" PLYWOOD 3~/~' INSULATION AI~ FIL~ TOTAL" ~" VAbU~ ~OTAL" U" · I? ~. z~ . OG 11. oo =. fi-. z~, CAVITY R ; 06, ,r_,'2. lI.OO ,iff .Ge, 7.Gl 0.15 FRA~ING ,;,.WA ]L/..' .SECTION OUT.51u)r= AIR, FIL/% ?z" PQ' 5Y&" INSULATION V2.u O"/PSLI/1A WALLDOAR¢) !,NSIDE- AI~.. ~'IL/V~ /To TAL"/2..'[, VALLJ TOTAL" U VALUE--- 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examine~..t..-~. ...... ,19 .~..~'~ ApproYed~.. {.7-2. ....... 19 .~..~ermit No. TOWn-be S-OU'rHot0 ,,, Received ........... ,19... Disapproved a/c ...... ~ .......... ,~ ......... %~~,~ ....................................... //fY/ ..... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . Il /..I.$ 19~.~'. INSTRUCTIONS a. Tins 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. 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 code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ... ,~.¢ ~, ~ .~.c...BO.[.~ t-~ $...~,A.S .'C ............. (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 .. ~.c..~. ~t .~ ~. ~-~ .o..[yfl..k~. 5...~.1~..~ .WT. ........................................ (as on the tax .roll or latest deed) If applicant is a corporation, signature of duly authorized officer. .... .......... (Na~e and title oi~corporate officer) Builder's License No .......................... Plumber's License No...2..~.~. ~..~ ~ ............ Electrician's License No. ]."[. I[.~. U..~. ........... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. [louse Number Street Hamlet County Tax Map No. 1000 Section .... !0,3 ......... Block ....... .~. ......... Lot ..... 1.~. ........... Subdivision...1¥) .o..o..~..~...~.G~b,( l-~ .............. Filed Map No..' .~.~...~..(~. ..... Lot ....~?. ......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed donstruction: a. Existing use and occupancy .... .'M. & .~../.z~ .17t .T? ....................................... ; ........... 3. Nature of work (check which applicable): New Building . . . ..~f. i'... Addition ......... Alteration ........... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost ...... ~' '~' t ............. ': ........... 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 .......... I ................................. '.. i ........................... 6. If business, commercial or mixed occupancy, speqify nature and extent of each typel of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear ........ ! ...... Depth ............... Height ............... Number of Stories ............................. ! ........................... Dimensions of same structure with alterations or additions: Front ............. i ....Rear ........... '. ...... Depth ...................... Height ...................... Number of S~ories ....... . ............... 8. Dimensions of entire new construction: Front . 5..~,. .......... Rear .5'..~., .....i ......Depth ~.,[. i ......... Height ..... [2~. ....... Number of Stories ........ [ ..................... i ........................... 9. Size of lot: Front ./I.3..'..,..~., .......... Rear . l l~., .. ............... Depth .. 17.7. ................. 10. Date of Purchase ..... IQ./. 1.~/./~.1~ ............. Name of Former Owner . .,~ .oB lq...W.~.L.KFA/~ F.E .... 11. Zone or use district in which premises are situated... ~ .~.,~ .1.0..~ .~..~. 1. .~..[_. ....' ........................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ....HO. ......................... 13. Will tot be regraded ........ ~l.,t~ ................. Will excess fill be removed ifrom premises: Yes 14. Name of Owner of Pre, mis, es ~. ~.~t.c: 1 .g~.~ .~.S. L~/2~ ~.~ddress ~.o..~.T.B.c:?.~. ~. .....Phone No. ~{~ ~ .~.zl .q.[. Name of Architect q. 9.~.. I.~. 0 M 9. ~.¢.1.4 ~.~ }q~ ...... Address ~. ~.Q~.lq .~ ~ 1 X. ~}q. ,. Phone No. 7..~-.2..-. ! '.'(..~.O.... Nmne of Contractor~q~l~;.q..Bc-ciV/l~%. k~C~&T .... Address ~ .°.~...'E. B..c-,,fi.~..t~,... i. · · Phone No. 7..6b~. .'~.~1 .~.i.O.. 2.. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blfck number or description according to deed, and show names and indicate whether inte.rior or corner lot. [BLOC. F.. STATE OF NEW YORK', S.S COUNTY OF ......... . ........ ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. 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 ~e this application; that all statements contained in this application am true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application flied therewith. Sworn to before me this t,.~ .~ .~..0~.. ' 19~..~? ~i~''~ ................. day of .............. , ; ~' ', o~1~' ' ~ r~EE Z ~tCK VAN TUYL, LICENSED LAND SURVEYORS SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. 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, APPLICANT SUFFOLK COUNTY DEPT. Of HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY DATE: H- S. REF. NO.: SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL TEST HOLE STAMP SEAL RODERICK VAN TUYL, ~-~. ~/~.._ . ..... LICENSED LAND SURVEYORS GReENPOrT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H S. NO. SUFFOLK COUNTY DEPT. OF HEALTH SERVICES - FOR APPROVAL OF CONSTRUCTION ONLY ~/ SINGLE FAMILg-D~E~ 0~ SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL. OWNERS ADDRESS: II TI~s+ HOLE zz STAMP SEAL . t d , · 45 OCCU?A~CY OR Ua B Wl ll/ :f C[ I1FICATE OF' OCCUPAN,C¥ L.l'vnv~ ASNOTE~ ~ 302 9 .AM TO 4 PM FOR THE qNG INSPECTIONS: NDATION - TWO RBQUIRED URED CONCRETE - _ FRAMING & pLUMBING 3. iNSULATION 4. FINAL - CONSTRUCTION MUS~' BE C©MPLFTE FOR C. O, ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS- OF. THE STATE CONSTRUCTION' & ENERGY CODES. NOT RESPONSIBLE DESIGN OR CONSTRUCTION lilY,AN H. YOP, F,,. P, AYh~OKID LS£LIiNE[. PLAN ~-~ tV L RLVI$10NS: · OAT[.: T~-~c~ ~L+~ ~v~ 0/4 ' 4.-Q 2z'. f ?el" I& T/OH I.II:RMAN A IL c 14 qO-O4, 161 'STKEtl ONE fAMILY II. tS ~' "f~ CoNe. Fps. R~.v)slOH$: -Ho ~'CA~ ~ FLoox YascS, Zz : vxx/o v: C~ Nc . EEN. ?~ LL.n .,~_ d--* So/l_ ~A/UNe C~ppc/ry DST~,~i,~I&O /~r ~T~ ,' GLA~S IN HAZARDOUS LOCATIONS TO ~E OF ~AFETY TYPE APPROPRIATE TO USE. I.II:RMAN 14. YO~E. I),AYMOND [..SCI.I[NI~L PLAN A IL C 14 ' I T £ C T ~z DRWO. 161 $TR.[~.I J&MAICA NLW ¥OR, E 114 I:AMIL¥ ~1:$ D I~ NI 0-i I ._C'c,~L~ Y~"= /Lo' -- I 4-- I TON j ~ ONe I~AMILY F,o.o~ to,'~ o~ ,I /2 . I ; YORE' ~AYMOND L.,SC~[N~[I~L~N ~z~r . .1 NOTES 1. ALL WORK SHALL COMPLY WITH THE NEW YORK STATE UNIF0 PREVENTION AND BUILDING CODES. 2. ALL LINTELS SHOWN ARE MINIMUM SIZES. 3. DOUBLE LINTEL JACKS FOR ALL OPENINGS GREATER THAN 6 4. DOUBLE FLOOR JOISTS UNDER PARTITIONS. 5. DOUBLE RAFTERS AT SKYLIGHTS AS APPLICABLE. 6. THE NEW YORK STATE ENERGY CODE SHALL BE COMPLIED WP THE BASIS OF PART 5 (ACCEPTED PRACTICE AND IN PARTI, AS FOLLOWSi) ?. PROVIDE SEPAP~ATE HEATING ZONE CONTROL 'FOR EACH ~LO0] FIREPLACE DAMPERS SHALL HAVE A LEAK RATE OF LESS TH~ O~M OR BE FITTED WITH A GLASS DOOR & FITTED WITH AN COMBUSTION AIR SOURCE. 9. THE KITCHEN EXHAUST gAN SHALL BE FITTED WITH A DA34P1 BE NON-VENTING. 10. ALL HEATING, HOT WATER, AND ELECTRICAL EQUIPMENT SE~ AS APPROVED BY THE NEW YORE STATE CONSERVATION CODE~ INSULATION SCHEDULE (MINIMUMS) CEILING ~=~ WINDOWS - u ~ 0.69 WALLS ~[~ DOORS - u ~ 0.40 FLOOR ~j L~ HOT WATER PIPES - R ~ 4.6 SLAB EDGE - ~ [~ AREA GLASS DRAWING # 211o[~&-- R!VEREEAD, NY 11901 I {5161 727-74~1 IF copper fubing is used for water distributing ~ys em; piping shall be of types K or L only / 2.1 ~o .A.,,P~ROYED AS NOTED NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 ~M FOR THE FOLLOWING INSPECTIONS: J. FOUNDATION - TWO REQUIRED FOR POURFD CONCRETE 2. ROUGH - FRAMING & PLUMBING ~. INSULATION 4. FINAL - CON'STRUCTION MUST BE COMPLETE FOR C. O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE DESIGN OR CONSTRUCTION CERTII~'CAZ~ OF OCCUPANCY .~ ,./- SOLD,~3 USED IN WATER , ~: /// ,~. SUPPLYSYSTEM CANNOT ~'- X~ -'/ ,, - EZCEED 2/10 of 1% LEAD. /,/ . ~ .... T'-~,:-; ~. ~ ~ ~ · ~ ~ /' ' SOUTHAMPTON LU,q(BER CORP, :, -~ ................ ~-: .... ~-~ ~ A~ATTITUCK, NEW YORK 11952 Unaufhor~zcd aJterahon or ~8 -47J I " ' DECK -~' 5 I D E r.: L F: V ~':' 0 h' FOP~ jONN I-IAA2. O05 E. f i'~;.T I o:,.~. ,, ,< , i-:L./5 , ,:'.:--mx :~, . . X In~uthonzed alteration or · th s docum nt not I ,ring tho eng: iiI. × DE-c~ ~J ,J ,SOUTHAMPTON lob3: ' J o P<_EA~ FE, LEVAT ION ~> "C, U' A 4 x, b ° FOUNuAT ON ,5 ECT, A-A. · ,~ M,U L.T