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HomeMy WebLinkAbout13861-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z14011 Date Novembe= .19 198..5 THIS CERTIFIES that tbe building .... .o.n.e.% .f.a.m.~.l. ¥..d?.e..3-.3-.~.n.~: .................... Location of Property ....3.2. 0. ............. .~.n..1. e. ~..V.~..e.w..~.a..s~ ............ ~a.~. ,~5.~.u.c.~.. House No. Street Nam/et County Tax Map No. 1000 Section 100 .Block .3 Lot 10.3.2 Subdivision...~.n.l.e.~...E.a.s.~...E.s.~.a..~g.s ........ Filed Map No....6.2.4..9.Lot No.. 3.2 conforms substantially to the Application for Building Permit heretofore Fried in this office dated · April ll 8..5 13861Z ................... , 19. pursuant to which Building Permit No ...................... dated ....A.l?.r.~.1. .1..2 ............... 19.8..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 ......... Private one-family d.~.e.ll.i..n~: The certificate is issued to PAUL F. ZIPPEL (owner, of the aforesaid building. 14-SO-244 Suffolk County Department of Health Approval .. ........................................ N73,6~ ~5 UNDERWRITERS CERTIFICATE NO ............................................... Building Inspector Rev. 1/81 FO]F,~ NO, ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NB 13861 Z Date Permission is hereby granted to: ..... ~. ~ ~ ,.. ,. ...... (...2~ .................. ............... County Tax Map No. I000 Section ...... L..O..?. ........ Block ..... ..~...~. ........ Lot No .....)..~...:.)....~.. ..... pursuant to application dated ........~.....]) Building Inspector. and approved by the 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 mm,,.--~ 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 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 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: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.0 0 3. Copy of certificate of occupancy $1.00 .~.~.~..~..~.~. 4.Vacant Land C.O. $5.00 Date . .-- .......... New Building ........ j ..... Old or ~ro-oxistjn~ Bui~din~ ............ Vacant kand .... t ........ Location of Property ~; ............. ~-~..~.. ~,~ .Z ....... ~&~'. ...... Owner or Owners of Property . .~ ' . . ' ................................. County Tax Map No. 1000 Section ................ Block ... ;- ......... Lot ................ Subdivision ................................. Filed Map No ........... Lot No. L.%~.~ ...... Permit No~?¢/~,~. Da~e of Permit ~$:-. ~AppHcant ~[~ ~.. ~¢Y:~-. ...... Health Dept, Approval .~ ...................... Labor Dept. Approval ........................ Unde~riters Approval . ~ ...................... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate . .~ .................... Fee Submitted $...~ .................... Construction on above described building and pe[~it meets aJI applicable co~es and regulations. _.. ...... .... ...................... TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL..765-1802 CERTIFICATION Date Building Permit No. (please prfnt) Plumber ~4~ (pleas~ print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this 19 ~ Notary Public gNN~. T£D£8O0 ' Notary Public, %c~\[~_ County Notmy Public, State 0* Now gO~ ~m~issJon ixpircs ~ ~C~ FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & FLUMBING INSULATION FER N. Y. STATE ENERGY ?DE FINAL ADDITIONAL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS 00069:~ BUREAU OF ELECTRICITY .? 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the electrical equipment ~ described below and introduced by tl~ appl~ant named on the able application number in the premises of Tele Mark Cor~.~rt., Inletv~e~ E~w/~ 200' South of ~arbor View Ave~ ~ Ma'ttit~ck in ~he following location; ~ Basement ~ 1st Ft. ~ 2nd ~. Section Block Lot was examined on ~0~ ~ ~ ~ ~ ~J ~ and found ~o be in compliance wi~h ~he r~quirements of this Board. FIXTURE OUTLETS 56 IECEPTACLES SWITCHES 56 59 DRYERS FURNACE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS FLUORESCENT VA~OR FUTURE APPLIANCE FEEDERS TiME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: Elec. P. oo~ HeaLers~ 2-~1.5 Motorm- 1~-3/4 C~F~C.I,~-~ )~ Smoke Detector-. 1 Track Lighting'--36' ~0"- 8.~l,ites S E R V I C E OF CC COND. NO O~ HI4EG A,W,G A.W,G. OF HI-LEG · 4/0 1 2/0 Piekut Elec. Inc. 23 ~ii1 Road St. Jame~ N.Y.~ 11780 This certificate must not be altered in any manner;, return to the office of the Board if incorrect. Inspector~ may be by their credentials. JNER. Examined . · .~.'. · · · ! .~. ....19 .~ .~.~' ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BLDG. DEPT. TOWN OF SOUTHOLD Received ........... ,19... // 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 agxees to comply with all applicable laws, ordinances, building code, housing code, a/nd regulations, and to admit authorized inspectors on premises and in building for necessary inspectio,n~'¢ ) .......r ....... ........... (Sigimture of apphcant, or ~die, if a ~c~rporation) (Mailing address 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. ~ r~ Ir, Plumber's License No..'~ .f.~..¢~.. ............. Electrician's License No. ~ ~ [~ 1~ Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. House Number Street Hamlet ooo ..... mook ..... ........ s ....... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... ~Bg.¢~.'r ..................................................... b. Intended use and occupancy . ~D ~ m G ~ , ~-~ · 7~.7_ & wx ~ ~ ~ ~r~ ~ ~ ~ ~ c~ 3. Nature of work (check which a~plicable): New Building ..~,..'i .... Addition .......... Alteration ....... ~. Repair .............. Removal .............. Demolition .............. Other Work ............... ', 1t '4 ~ (Description) 4. Lstimated Cost . '1. !. .~.~ ....................... Fee ...................................... ~' (to be paid on filing this application) 5. If dwelling, number of dwelling anits..C.;.U .~.~. ....... Number of dwelling units on each floor..~.~..~ ........ If garage, number of cars .. ?T. '..~. ~ .............................................................. 6. If business, commercial or mixe occupancy, specify nature and extent of each type of use ~ ................ 7. l)imensions of existing structures, if any: Front.. 7;-. .......... Rear . :; ........... Depth..~¥ ........... Height . .x ............ Number of Stories..-.; .................................................... Dimensions of same structure ~ith alterations or additions: Front x~. ............... Rear . F. ............... Depth ................... i ' ' Height ...................... Number of Stories ........ , ........... · ~. Dimensions of entire new constrUction: Front .~..~.?.T .~. ~.~ :... Rear ?..~.F. ]~. .~. ! .d .... Depth ..U...~. ?.T...Q.'.4 Height ! ?.'~. ! ['i ........ Number of Stories . .C~..d.~.~- ............................................... 9. Size of lot: Front . .I.~.o.. ~.~.i ........... Rear ...I.~.~.. ?..~. .......... Depth .~.4 ~..~.~ ........... 10. Date of Purchase /~ O ~ :2 ~ .~.~ 2-. , . Name of Former Owner g} $ Ll-.t/~ ~ J~. ~ ~ ~ ~ 11. Zone or use district in which ' ' are situated '~. t'~-.~ I ~ ~kt pr~m~ses ................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: N].~. .......................... 13. Will lot be regraded . .M. 9.... i ................... Will excess fill be removed from premises: Yes 14. Name of Owner of premises .D.~p. ~.x. '?..~) ?. g.~..Lc.... Address ~. P. ~.~..~...~. ! .~.~..~.. Phone No. ~...~?....~.~B.. Name of Architect ~.~¥?: .~.. ~D. 2~..~.L~ .......... Address ~o..~.t~.~.O~ Phone No 7~.~' .~.~).~.. Nam of Co o o D~L~E-- 5 ,3~'~:~ .......... ~]~ 7 e ntractor~ .~..q... ~ ............ ~, .... Address .. Y'. ................ Phone No. }~..~.~ ...... Locate clearly and distinctly al property lines. Give street and block interior or corner lot. PLOT DIAGRAM buildings, whether existing or proposed, andAndicate all set-back dimensions from number or description according to deed, and show street names and indicate whether STATE OF NEW,Oldie, ~ n S S COUNTY OF..~~ .... ,. ' ......... · .. :~ ................ being duly sworn, deposes and says that he is the applicant (Name of individual sigfling contract) above named. He is the ....... D(xZ.~e.~. .... I ................................................................... i (Contractor, agent, corporate officer, etc.) of said owner or owners, and is du!y authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manta :r set forth in the application filed therewith. Sworn to before me this .............. [] ........ day or...~ Notal~ Public, (y.. ,., FLOOD ........ County Notary Public State o~ ~qew Yqrk , ,L_~,. ~ C0mrr!issi0n Expires ,~darch 30, 19~',~ TAX M/~P 1000 -.3 -10 -1~ LOT AREA = 42,119 sq, ft. z / l O0/+ / '1 n SUFFOLK COUNTY {DEPT., OF THE WATER SUPPLY & SEWAGE HEALTH SER~IC,ES FOR DISPOSAL FOR THIS RESIDENCE DATE_~ ARDS OF THE SUFFOLK cOuNTY ~DDRESS ,.o...,o, ,,o~ '~':.',,',"; . ,,, ,.,o, I~TRUCTU~ES TO T~E P~OPERTY FOR WHQM TH~ SUR~[Y I$ ~R~, SURVEYED FOR GUARANTEED oN'Ly 'To · ~Ns JR N Y LIC NO 048992: TEL£PHONEC'~ 'FILE TOWN OF SCALE 1" = /.,,=,o~, DA~E FILED ~AP NO. ~ DATE BoOK NO. ~.~. PAGE ,HAROLD ~ TRANCe'ON ~A~D SURVEYOR SUCESSOR TO WILLIAM G. MEIER NORTH COUNTRY ROAD - WADING RIVER NEW~ YORK 41792 SEPTIC TAN,K;.C.E$.SPOOL ~ WELL LOCATIONS BY OTHERS ~UFFOI~X OOU~ITY H~TH D~PART~2 O 7 U TAX M AP 1OOO- 3 -IO -12 > O J LOT AREA: 42~119 ~:1 ft The existence of right of ways and O~ easements of record, if any, not shown are n~t guaranteed. [ \ f~ O APRIL 30,1985,,,.UNDER 2dONS, T. rLOCATI©,N ,,, tjx:-~'''' SUFFOLK COUNTY DEPT, OF HEALTH SERVICES FOR APPROVAL OF CONST, ONLY DATE H.S. REF. NO. APPROVED BY THE WATER ~suPPLY & SEWAGE DISPOSA£ FOR THIS RESIDENCE WILL CONFORM TO THE STAND- ARDS OF THE SUFFOLK COUNTY DEPT. OF HEALTH SERVICES· GUARANTEED ONLY TO /'/~,, 0_~ - / ~.. ~ ~--~/,- - N.~. LIC. NO. 048992 ADDRESS ~JOB NO. ,~Z~ '~,~ SURVEYED FOR TELE_PHONE FIk. E NO. I~L~_'~ SITUATED AT TOWN OF SCALE 1" FILED MAP NO. BOOK NO. L..L PAGE HAROLD F. TRANCHON JR. P.C. LAND SURyEYOR SUCESSOR TO WILLIAM G. MEIER NORTH COUNTRY ROAD - WADING RIVER NEW YORK 11792 .~ (~.16) 92~9-4695 :~ ~ il ;il.. :..~, ·~ i, NAME ~OLDER USED IN WA'T~ I ~.-_.~ -. SUPPLY SYSTEM CANNOT~_ ~ EXCEED 2/10 of 1%LEAD. ~ ~~ If copper tubing Js used for water distributing system; piping shall be of types~K or L_o_nly NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: T, FOUNDATION - TWO REQUIRED FOR PrhURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3, INSULATION 4. FINAL - CON'STRUCTION MUST BE Cq~API FTE FOR C, O. ALL CONSTRUCTION SHALL MEET THE REOUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS --d~-~ , "~ CERTIFICATE OF OCCUPANCY OCCU?ANCY OR ~ i~ [tlLAW[UL ~lfli~f CERTiFiCATE OF OCCUPANCY -p r'.~-- F~gsr,rt~.lr:-r;* K*1' T 14"! P O,pc iU'~pL,'-Tm4 ./ '--;T 464 'L~ r , 7]~ nDNALD A1 DENIS Ali. A,! I:llCl ARCHITECT J I i '\ DONALrt A. OIENI=: A.I.A., P.C. ARCHITECT 4 1'2- I ~.AT' I I ,I 9 9 r! +- ,j DONAI. O A. OENIS A.I.A.i ARCHITECT