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HomeMy WebLinkAbout13952-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18394 Date S~ER 20~ 1989 THIS CERTIFIES that the building Location of Property 51435 MAIN ROAD House No. County Tax Map No. 1000 Section 69 Subdivision ADDITION F~JTI-IOI~D ~. N.Y. Street Hamlet Block 3 Lot 6 Filed Map No. ~ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 9~ 1985 pursuant to which Building Permit No. 13952-Z dated MAY 17~ 1985 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 ADDITION TO REAR OF D$~3~.TNG & DECK ADDITION TO ~WrSTING ONE FAMILY DW~3J.TNG AS AppLTF. D FOR. The certificate is issued to of the aforesaid building. SUFFOLK COUNTYDEPARTMENTOF HEALTH APPROVAL RUSS~r.T.E. & JOAN A. MANN (owners) UNDERWRiTers CERTIFICATE NO. N-592567-2/8/83&N-849104-1/7/1988 PLUMBERS CERTIFICATION DATED I/9/1989-MA~'rlTUCK PLUMBING & HEATING CORP. Rev. 1/81 X~O'W.'~ WO. I~ 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) 13952 Z Permission is hereby granted to: ~~~..~~...~...,.../~.,,,,.,,~,~ ~..~.~/..~.~_.~..,~,~ ., ,..:.~.._~.....,...../z...,z...z/ .... .............. ~ .......... ~.~,;~.C~..~.-- .......... at.remUs ~d ~ ~Z...~.~..... ....... ...~.~....F&.~ ................................... ........... ~.....~/ ....... ~.~..~~ ~ ................................................. ~un~ Tax Mop No. 1000 Sec,o. '£'"7' .......... ,,o~k ....2 ............. Lot No ...... ~ ........... ~o~ ~o o~,,~o,o~ ~o~ .............. ....~..~ ........... 7........ ,~...z~.~ o~o~ Building Inspector. 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 A. This application must be filled in typewriter OR ink tot with the following; for new buildings or new use: 1. Final survey of property with accurate location of alt buildlngs, 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 bui'ldings and installa- tions, a. cert f/cate 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 property showing all property lines, streets, buildings and unusual natural or topographic rfeatures. 2, Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3o 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 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling. S25:00, Agcessory.,.$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0 ~ , 3. Copy of certificate of occupancy $ 5 4.Vacant Land C.O. ' ~ $-~0'~-~6 5 Updated C 0 $ 50 O0 Date NewCOns truction ...... Old or Pre-existing Bu}lding Vacsnt Land Location of Proper ....... ... - ........... .... · ~ ....... d :.....~..~.~ff. Coun~,Ta, MapNo.,OOOSect,o, .... ~.'.f. ...... B,oc~ ..'.3. ........ ,ot..~ ............ Subdivision ............................... · · Filed Map No ............ ' Lot No .............. He-~lth Dept. Approval ........................ Labor DePt. Approval ......... ' ............. ........ Planning Board Approva ..... Request for Temporary Certificate ' Final Certificate Fee Submitted ~ .,,,t.. ,~.. ................. Construction on above described building and permit meets all applicable codes and re ulation. TOWN OF SOUTE[OLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Owner (please print) ,Please prin%) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. - ~Plumb'er' ~ si~ sworn to before, me this . Notary Public No. 4920756 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~- 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CE~IFIES THAT o~dy the electrical equipment as described below and Dst~duced by t~ appfic~t ~med on the a~ application number in the premises of in the flollowlng locatlot~; ~ Basement ~ Ist FI. ~ 2t~ FI. Sect/on Block Lot was exa~ni~d on ~ ~ ~ ~ and found to be itt compliance with the requirements of rhis Board. FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS FURNACE MOTORS TIME CLOCKS MULT[-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE OISCONNECI' S E R V I ' C OTHER A~PARATUS: 1-Smoke De~ector i-G,F.I. Rulaud Ele~. Co. P.O, Bo~ 1~3 ~tituok,N.¥. 1195Z Llo.24~E s certificate must not be altered in any manner~ return to the office of the Board if incorre~. Inspectors may be identified by F~)R DEPARTMENT. THIS COtaY OF a~uv ~a~ez> THE NEW YORK BOARD OF FIRE UNDERWRITERS ~-~r~ 8,5JOHN STREET. NEW YORK, NEW YORK 10038. ~uazell ~nn, n/~ ~n Kd,, w/o ~zck~z La., ~uthold~ inthe]ollowlng h,cation; ~ Basement ~ Ist.. ~ 2,,d Fl. S~tl,m Hick Lot examined on ~C~b ~ 2~ s ~ ~ ~ attd found to be in compliance wlth the requiret~te~ts of this Board. FIXTURES RANGES DRYERS FL~RNACE MOTORS FUTURE APPLIANCE FEEDERS EXHAUST FANS TIME CLOCI(S UNIT HEATERS MULTLOUTI-ET DIMMERS SYSTEMS NO. O~ FEET SERVICE DISCONNECT S E R V I C E H~wa~d Dilli~gham ~ox 574, Mah~ Rd. Laurel, NaY. 11948 COPY FOR E iic.#756-Z GENERAL MANAGER Per___ certificate must not be altered in ony manner; return to the office of the Board if incorrect, inspectors may be identified by their credentials. ,IG DEPARTMENT THIS ~OP~ MANNER. ~LD INSi~ECTION FOUNDATION COMMENTS FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY FINAL ' 'FORM NO. 1 · ~ TOWN OF SOUTHOLD ,4 BUILDING DEPARTMENT .~,, TOWN HALL ., ~OUTHOLD, N.Y. 11971 ~' TEL.: 765-1803 Exami?d.../F~/.7.., '~ ...'~/V...., ~9~..~.~; No 1 5.~..~.,~. ~ Approved Disapproved a/c ............................. /~. ...... ................................. ,~,...~ ..... ;~,. · ~/ .~ APPLICATION FOR' BUILDING PERMIT INSTRUCTIONS a, This 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 a~eas, and giving a detailed description of layout of property must be drawn on the diagram which is'part of this appli- cation. 9. The work covered by tlfis 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 "~ihall b~e kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or hi 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 insp~,tions. (~re Zapplicant, or name, if a corporation) .... ~j.~. .~. .z.~. ~. ~:. ~, ~./~. (Mailing address of applicant) State whether applicant is owner, lessee, ~agent, architect, ea~neer, general contractor, electrician, plumber or builder· .~..~.~... ¢~ .... Name of owner of premises .T(4..g.s.C.(/...~...¢, Jd(c~..~.%9.. ~....~fl:..g?.~. ............................ (as on the ta~ roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ...... .~..~..~....~.. .......... Electrician's License No .... ,.,, Other Trade's License No ..... ~ .......... Location of land on which proposed work will be done ..................................... ~/~., · · .67..l.qd..J57.. .............. /.~/z~.~....~o.~ ............ ~,,. ............ t:;.~ ....... House Nam ber Street Hamlet County Tax Map No. lO00 Section .... .~.'..~,. ....... Block ...3 ............. Subdivision ................... Filed Map No ........... ' : Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~ ....... .O.Oq..~. .....'' I b. Intended use and occupancy .I property lines. Give street and block hum interior or corner lot. Nature of work (check which applicable): %w Building ..... ' ..... Addition .. .4~..,., Alteration .......... Repair ............... Removal ..... ,, .......... Demolition ~ ........... Other Work ............... 'ff'f.f : .... ' .... Fee ' <Description) Estmmted- Cost. . .~..~..~,...; ........ ?'. .~ ........................ , ~' (to be paid on filing this application) If dwelling, number of dwelling units.. ,i ............ Number of dwelling units on each floor ................ If garage, number of cars ............ ~ ............................................................ If business, commercial or mixed occupahcy, specify nature and extent of each type of use ..................... Dimensions of existing structures, if any~ Front ............... Rear .............. Depth ............... Height ............... Number of S{ories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Hei~a~ t ........... i ......... : Number of Stories ...................... Dimensions of entire new construction: tFront ............... Rear ............... Depth ............... Height ............... Number of Stories ......................................................... Size of lot: Front ..... , ........... ,", ....Rear ...................... ,Depth ................ Date of Purchase ........................ Name of Former Owner ~ .......... Zone or use district in which premises ~re situated ..................................... Does proposed construction violate any zoning law, ordinance or regulation: ................................ Will lot be regraded ,~. ...... i'. · · ,. .......... Will excess fill be removed from premises: ~ No Name of Owner of p~mise's~'~.~.~. f./f... ~.'/r~4c/4~,Address .j-./.t/.~'~.,~f~...~.~ .?P. Phone No, ~.~. ~-?~..~ ~,.,:~)~4.. Name of Architect . ~,, .r/.~../z~,....~.,,.~.~ .,~,~-... Address2'~.~./~t..~f,, .~....d.. Phone No. 2~ 3F,-A~.57~.~ .... Name of Contractor .............. .... ~. ...... Address ................ Phone No ................ pLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from 5er or description according to deed, and show street names and indicate whether NOTI -I U-'-/L' N6 D X TM Nf ~6~.J~02 ~ AM TO ~ PM FOR THE ~OLLOWIN~ INSPECT.'ONS: FOUNDATION - TV'O REQUIRED FOR POU~O CONCPET~ ROUGH - FR~M~NG & PLUMBING INSU~TION FINAl.. CON'STRUCT'~DN MUST BE COMPL~T~ FOR C.O. ALL ~ON~T~U~TtON SHALL T~ ~ON~U~(ON & ENERGY ~ODES. NOT ~'~PONSIgLE FOR ~IGN O~ ¢~U~TION ERRORS. STATE OFNEW YORK, COUNTY OF ................. ............................ '. .................... being duly sworn, deposes and says that he is the applicant (Name of individual sigfling 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 file this application; that all statements cofitained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manper set forth in the application filed therewith. Sworn to before me this Notary Public, . & ... County ~ No, 4707878, Su{~o}~ Coonty ~r F- r~ GARRETT A. STRANG architect Main Road P.O. Box 1412 Southold N.Y. 11971 516- 765 - 5455 SOLDER &%'ED IN WATER SUPPLY SYSTEM CANNOT ~.XCEED 2,/10 qf 2% ,L.F_,AD, GARRETT A, ISTRANG architect Main Road RO, 'Box 1412 S0utholdNN. 11971 516- 765 - 5455 ,~ : ~"~ -~ ~5~ =w-~'~~ ~ ~_~1-" k ~m~-~o'' ~- N~~ t8 ~ , ~o[~ ,~-"-~ "" ~ N o~CTiONs,= ~,vi FOR ~;... GARRETT A. 6TRANG /A/~ N Main Road P.O, Box 1412 Southold N.Y. 11971 - ~/ew 516" 765 - 5455 ri' GAiRRETT A, STRANG architect lMa n Road RO. Box 1412 Southold N.Y, 11971 516 ~ 765 - 5455 ti " 't" ~' GARRETT A. STRANG architect Main Road P,O. Box 1412 Southold N.Y. 11971 516' 765 ' 5455 GARRETT A. STRANG architect Main Road P. 0. Rox 1412 $outhold N.Y. 11g71 516- 765 - 5455 l~F(,Pt~c6f---p, A1;:>D~-rlObl ¢ A~.TE.,,t~ATIOk!