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HomeMy WebLinkAbout13805-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. Certificate Of Occupancy No. Z-15312 Date March 2, 1987 THIS CERTIFIES that the building ONE FAMILY DWELLING WITH ATTACHED WOOD DECKS 505 Midway Road Southold,' New York Location of Property ............................................................... House No, Street Ham/et County Tax Map No. 1000 Section 90 .Block 02 .Lot 029 Subdivision M/o Cedar Beach Park .Filed Map No. 90 .LotNo. p/o 144 conforms substantially to the Application for Building Permit heretofore filed in this office dated February 19, 1985 pnrsuant to which Building Permit No. 13805z dated................, ...........Ma r c h 28, I 985 ~ was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy ~r which this certificate is issued is ......... ONE FAMILY DWELLING WITH ATTACHED WOOD DECKS The certificate is issued to WINDSWAY BUILDING CORP. ..................... X .................... of the aforesaid building. Suffolk County Department of Health Approval I 0-S O-48 N746732 UNDERWRITERS CERTIFICATE NO .................................................. February 27, 1987 PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 FO]ll~ NO. ~J TOWN OF SOUTHOLD BUILDING DePARTklENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 ~3805 Z ....~.~~,....~.....~ ......... ~..~z, .......... . .................. ~ .............................................................. .,~~~,...~....ff... ...~...:.~.~....~.~ .................... ~.,..~../.~ ..................... .'.,.... Coun~ Tax Map No. 1000 Section.,.~.... ,~,,,,~,, .......... Block ....,,~..~,- ........ _Lot No. ~,.; ,,~,,, .......... pursuont ,o oppllcotion doted ....'~.~..~......,~...'~.. ......................... , ,9.Z.~:ond opproved 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 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tot wlth 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. 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 peoperty 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 required to prepare a certificate. C. Fees: 1, Certificate of occupancy $5.00 / / 2. Certificate of occupancy on pre-existing dwelling ~r land use $ Is'/$5.00 3. Copy of certificate of occupancy $1.00 / Date ....... New Building .... ,~,, ...... Old or Pre-existing Building(X) ......... .~ ~Vacant Land ............ Location of Property .,.,. ~-.. ~ ....... ~ .............. +(~-, ......... Ham/et Owner or Owners of Property .... ~ ........ - ............... Co..tv 000 g 0 ...... Block . .......... Lot ..... 7 .......... 8~lth De~t. A~proval ........................ kabor Dept. Ap~rova~ ...................... ,.. Underwriters Approval ........................ Planning Board Approval .................. ~ ,., Request for Temporary Certificate Final Certificate - Fee Submitted $ ............................... Construction on above described building and p~ets a~l-/a~' ?ble~code~ and ~ Applicant/~,..., .,, ...... _,~ .~. ....... ~.~.'?', .~.~: .......................... Rev. 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building P~rmit No Owner (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber' s signature) Sworn to before me this ~ day of ~ , 19~__. Notary Public, ~ County Notary Public tto. 4707878, Te~m Exp~es Mamh COMMENTS FIEL]~ INSPECTION ~ , FOUNDATION (~J.. FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION FER N. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: NE~ YO]IK STATE DE~AItTMENT O~ ENVIRDNt~AL CONSERVATION Envtrmmen~al ~-~_lysi8 Unit Sto~y ~rook, NY 11794 Peter A.A. Berl~ William H. Price, Jr., Esq. 828' Front Street Greenport, NY 11944 July 1, 1980 For: Susan C. Ranscht~ owner Ralph E. Salamone, Contract Vendee NO PERMIT NECESSAKY - TIDAL WETLANDS ACT P~: TW 15276-0343 Dear Sir: This is to inform you zhet we have dmtarmine~ that your proposal to construct one-family dwelling on Midway Road, Southold, NY. has been reviewed and that it has been found that no permit is necesear~ under Article 25 (Tidal ~.Yetlands). As~,~in~ you have obtained any other applicable per, kits, you may proceed with 'your project. ll~L/cr THE NEW YORK BOARD OF FIRE UNDERWRITERS 10007 71 BUREAU OF ELECTRICITY STREET, NEW YORK, NEW ,Y, OR.K 10038 5taBate ^prix 2~:1r~6~S ~o.. ~.~.~.,,o.~o.o,~.~ 36~SS2/~S N74673 THIS CERTIFIES THAT only the e~c trical equipmet~t ~ described below and int~dueed by t~ applicant ~atned on the abo~e application number in the premises of Winds Way Building Corp,, n/s ~idway Rd,, (Private Rd.)~ 200' s/o Little Peconlc Bay LaBe, Cotlar ~,,each~ Sollt]~old~ in the following location; ~ Basement Sectiort Block Lot w~ exami~d on A~ X' J ~ 2 ] , 19 ~ 6 and /ou,,d to be in compliance with the requirements of this Board. OUTLETsFIXTURE SWITCHES FIXTURES RANGES :OARING DECKS OVENS DISH WASHER EXHAUST FANS 42 46 31 42 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATER MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: Motors-~ 1-1 1-2~ Ton A,,C, Unit G,FoC,I.-]~ Smoke Detector-~l Track Lightlng-16'-0':~7~!ttes S E R V I C E PER g OF CC. COND. OF HI-LEG OF NEUTRAL 1 z/o ~/o Ru~ and Electric P. O~ Boy: 143 ~att~.tuc~, N.Y,~ 11952 GENEI~AL MANAGER Per,' This certificate must not be altered in any manner;, return to the office of the Board if incorrect, inspectors may be identified by their credentials. lENT. THIS COPY OF, I ANY MANNER. ~ TO~N CF ~-J::LITI4OL.D, N.Y. , I STAT THE WATER SU SYSTEMS FOF CONFORM TO SUFFOLK C/g~ SUFFOLK CO SERVICES CONSTRUCT[O! DATE: H_ S. REF. NO APPROVED: DEED Disapproval Issucd 'Appllc atica Received FORM NO. 10 APPLICATION FOR DEVELOPMENT PERMIT In the Town of Southold Type of Development Proposed: New Structure (tnctld~ng storage ta~ks~ Addition and/or Altoration~ Flood. Proof Below Base Flood Elevatmo~ Other ~~ ~V~' e Elevati..,n Data in relation to above mean sca leve[~ of: (a) Lowest floor elevation, including basement-~'feet~Z~ _'inches (h) In ~ V Zone, bottom of lowest structural member feet" inches FIRM--Fllood Insurance~ Rate~ ~~~MaP~Z°ne d~ignatl$ns Location of Property: ' ~ Co=ty Tax Map N~~ict/ 1000, Section ~ Block.~__ Lot(s)~ Per, aisslon to be gFDDtedi ,L~Ownor as above~New Owner IOUnde~ Con~ract{~Lessee{~Oontrncto~ - .~ ~_? 7. Approval from other(s) before Permit is issued: BUILDING PERMIT~~ PLANN~G BOARD~ 8. I, ~~ , the applicant, ~ the 0wner.~, Co- O~~~~nder. C~n~r~ct[~, gessoe~l, ~gentl---I, Con- tractor~, and agree to comply w~th all applicable sections of the of tho Town of $outhold; Comity, and State and to a~it ao. tho~fzo~ specters to premtsss authorized to perfoz~ or hsve performed the said work ~d to make and file this npplicat[on, thst all statements contain- ed in this application are true to the best of my knowledge and m~d thst the work will bo performed in the mannerset forth in t~ application filed therewith. ~ / SWORN T0 THIS ~ DAY OF~- 19~ N~y~uc, sm~'~ewY~k' ~ota~y ~ublic ~. ~22563, S~k Cour,~, ~erm E~ires March ~, 1~ Applic~t' s mailing add~ess and phone ~ tf not given above: 4/80 FORM NO. ~0 TOWN OF SOUTHOLD BUILDING DEPARTMENT P.O. BOX 728 SOL~?HOLD, NY 11971 (516) 765-1802 TOWN }{ALL MAIN ROAD SOUTNOLD, ~f.T · ' ': ~" APpLICAT±ON FOR DEVELOP~_~4ENT PEI~I.iiT Instructions: The app!leation to the Building Inspector includes (each ~-~up l~-~) 1. Form No. 10 filled out in ink or typew~itten) 2. vey of pPemises with ~levations above me~ sea level, 3. Drawings of pro- posed woPk. The application must give complete info~uation to show that the p~oposed can comply to the Local Law No. 1-1980, Chapte~ ~6 of'the Code of ~he To~n of S~u~hold known as "Flood D~uuage Prevention Law" of the Town of Southold. The applicant must submit approvals that any.othe~ agency -' ~a~e~General--'-S'tandards as requiPed, in Section ~6-]-7 oF the law to,'~inimize flood A. Anchoring of $t~uctures, including tanks ~d mobile hoRles B. Uso of constr]~ction material and methods C. Dosi~ and lo~ation of utilities D. Subdivision proposal with drainage, public utilities d~si$~ ~d base flood elevations ~gciftc Standards as'required tn Section 4.6-18: A. Re sinful c~nstructzon B. Non-re stdential construction C. Mobile homes The applic~t must submit plans and spec~fxcntxons as well as any other tnfoz~ation requested~by the Building InspectoP to substantiate the facts that the structure has or will have the lowest floor, including basement/ cellar, elevated abov~ the base flood elevation or; if pe~itted by the Federal Regulation, that: 1. such structure is flood pPoofed in such manner that below the 'base flood level the structure is water ti~t with walls substantially a~d impe.~enblo to the passage of water, 2. that structural components~are capable to resisting hydrostatic and hydrodynamic loads and effects of buoyancy, 3. applic~t must subH~it cePtification by a registered professional engxneer' or a~ch~tect~ ' that the standards set forth in Section 46-18B (1) (2) (3) of the Southold Code are satisfied. Coastal High Hazzard ~rea (V Zone) ~6-19. Applicant shall submit plans, speczl~catlons including tho required certifications and such other foz~ation as the Building Inspector may require in that l~he p~ovisions of 46-19 are complied wi{h. Mobile homes a~e prohibited. The lowest portion of the structural members of the lowest floor cannot be lower th~ the base flood elevation Qith all space ~below open except b~eal~away walls. Send d~es. If sond d~es exist on the p~emtses and the applicant pro- pose~ ~lter s~e, ~lans and specification must be shown ~n detailed nature of any alteration submitted. ~ildin~. A B~ilding Pe~it is also requi~ed for any structure. Peon a Developmen~ end a Butldlng Pe~it must be issued before any work c~m start in a specia~ flood hazzard zone. A, written disapproval or a pe~it must be issued within ton (10) working days. Du~ing construction, ~he inspecto~ ~hall be notified in time so he may m~e the r,quzred inspectxons. Upon completion, the required certxficatzon' ' fo the final elevations and work must be submitted before the approval to use or occupy c~ be approved. I ,.., (Fill cdt thc form on the back of this sheet) 4/80 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 f ~- ' TEL.: 765-1803 ..... ::2 ,,ppro,,ed .................. ermit APPLICATION FOR BUILDING PERMIT Received ........... ,19... INSTRUCTIONS Date ........ 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 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 insp,~c~,ons. ...... ., ....... (Signature of applica~t, or name, if~ corl~ration) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. · t (as on th~ tax roll or rarest aeea ' Builder's Licenst. No .......................... //-~ ~'~t//~ ~.~ Plumber's License No.. .. . .~.~.~t~. Electrician's License No... ~./t~./~...~.~..,~..(~. ! Other Trade's License No ...................... 1. Location ofland on which proposed work will be done. . .~..~ff. .... .~.[~..~.~..~1.~..~ .......... I~I;~e' iq'u;~i; .................... Street Hamlet ' County Tax Map No. 1000 Se~ion .... . .~..0. ......... Block . ..2-. .............. Lot..o~r. .............. Subdivision ....... .~..~..~/.~.. ( .~.. .............. Filed Map No .... ~. 19 ....... Lot..& .~.. ~.~..~.. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: : a. Existing use and occupancy ......................................... . ............................ b. Intended use and occupancy ' ' "~' '" "i~" ~"~a a,,, ,,,. ff~ 7"-'. ....................................... 3. Nature of work (check which applicable): New Building ..... Addition .......... Alteration .......... Repair .............. Removal ............. Demolition ...... Other Work ............ ~[ '1(*)i ~ , ~ ~--***** ~..~,.~_.~,. (Description) 4. Estimated Cost ........... *.'~t.~.~. ..................... Fee ............................. ' ~' (to be paid on filing this application) ' 5. If dwelling, number of dwellinglunits ......... Number of dwelling units on each floor ................ If garage, number of cars .... i .~..~ .................... 6. If business, commercial or mixe~ occupancy, speedy nature and extent of each type of use . ~1 ~ J , t ~ , ~ ........... V ......... 7. D~ansmns of~ st~ctur?s, ffany Front .... ~ Rear . ~. ~ Depth..~ .......... Hexght ... ~ ......... Number of Stones . .~ ................................................. D~ensions of same st~cture with alterations or additions Front ................. Rear .................. Depth ................... ,.. HeiSt ...... ; ............... Number of Stories ...................... 8. Dimensions of entire new const~ction: Front ............... Rear Depth Height ............... Number of Stories .............................................. 9. Size of lot: Front ....ID g.'.~... Rear ............ Depth . J~..~ ........... 10. ~)ate of Purchase .... Ig r.q.; .................. ~ame of Fomer Owner . ~.~ .~.~.0a~ ......... 11. Zone or use district in which pr~mises are situated... ~. ~.(q~ .................................... 12. Does Pro~s~d constructjon violate any zoning law, ordinance or regulation: . ~ o ........................... 13. Will lot be regraded ...~.~3: ~i .... ~ ......... ~... Will excess fill be removed from premises: Yes 14. Nme of Owner of prem~ses .~.4~.~,.~B~Address [9~.~l~q~, .. .PhoneNo~6~l~7.~ .. N~e of Architect ~ ' 4 Address So¢ ~0}O n~ NmeofContractor /~i~3~ ~t/~t~ ~ Address . t*.~ 61~ ~, rh~,~ - PLOT Locate cle~ly ~d distinctly fix bulldogs, whether existing or proposed, ~d, indicate fll set-back d~ensions from prope~y ~nes. Give street ~d block number or description accord~g to deed, ~d show street n~es and indicate whether interior or corner lot. STATE OF NEW YORK, -- n coU Y s.s ........ ...... (Name of individual sig~ing contract) above named, i ......... being duly sworn, deposes and says that he is the applicant : ; (.~(Contract.or,~gent, corporate officer, etc.) of said owner or owners, and is du!y b~4thon-fl'xed-t~erform or have performed the said work and to make and file this application; that all statements cont~ineflXi~ this application are true to the best of his knowledge and belief; and that the work will be performed in the manndr set for'thin the application filed therewith. Sworn to before me this : ......... · .~'~)~.-~ ..... day of .... ~. Notary Public ....... ..~. .... ~,~.,~ .... ..~~County ~/~ .... ' ........................................ ' ~"~~t~ ~p~ ~'~ ~.. ' .... SUFFOLK CO. "E^'T. ~ATE~NT ~TEN T . SYSTEMS ~ THIS ~IDENCE WILL CONFORM TO THE 5T~NDA~S ~ THE SUFFOLK CO. DEPT. O~HEALTH ~PlICANT SUFFOLK COUNTY ~EPT. OF ~EALTH SERVICES -- F~R APPROVAL CONSTRUCTION ONLY DAT~: APPROVE~: :' DIST. ~CT. TEST HOLE : S~AMp FEB 2 ?'"~o~ ~ ' ~,THIE~~:~AL AHD, WA1 ER' ,..' ,P~Y FAOL~ ~R THIS '! ¢II 1AP '~F P~OPEI2TY' SURVEYED FOl~ E. SALAI"lONF 50UTH Ot,._O 'JOy,/. N 0F: ~2UTNOLD, N.Y. Will location subject to Agl~ement, time of approval - filtration 'r~utred prior to occupancy. 1.44 I, !'ii . f~JI2Yb---YED ,Vi~. I0, 1980 ROJ~ESICK VANTUYL P.C, , ~'. V~- LICENSED LAND SURVEYORS GREEN~RT NEW YORK 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 THf SUFFOLK ~VICEE SERV,CES FoR APPROVAL o CONSTRUCT,ON ~"~ L ~-- DATE: ~/~)/(~I · SU~FOkK CO. TaX ~e 10~ 090 2 29 I V~N~IN ~. DEED. L.~S P. 591 T~ST'H~LE ~ STAMP' SEAL ON LEAD CONTENT BEFOR.~ CERTIFICATE OF OCCUPANC7 SQLDER USED IN WATER SUPPLY SYSTEM CANNOT EXCEED 2/10 of ...... , ........ I~'pper tubing is used " for water distributing sys em~ piping shalJ be APPRGYED AS NOTED ~-~_ NOTIFY BUILDIN~ DEPAr~TM~NT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION : TWO REQUIRED FOR POURED CONCRk~E 2. ROUGH - FRAMING & PLUMBING $.~ INSULATION - ' 4. FIjqAL- CON'STRUCTION MUST .BE COMPLETE FOR C. O. 'ALL CONSTRUCT ON-SHALL MEET THE RE©IJIRcMENTS OF, THE N:Y. STATE CONST~U£TIO~¢ ~ ENEFaGV ~dr~ES N'~T -RESPONSIBLE FOR DESIGN 02. CONSTRUCTi0~ ERR6RS. t~