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HomeMy WebLinkAbout13879-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy NO Z15506 Date December 15, ' 198.6. ilding One family dwelling with attached garage THIS CERTIFIES that the bu ........ & deck Lo fP tM .1.5:1.5. 'Anchor Lane Southold, New York cation o toper .. ................................................... tYouse. ~vo. Street ...... Hamlet County Tax Map No. 1000 Section............079 Block ..4 .......... . . Lot..5. ......... . . . .. Subdivision .M./.9. H. arbor Lights .Filed Map No. 43.6.2 .Lot No. 14 conforms substantially to the Application for Building Permit heretofore Fried in this office dated 8..5 pursuant to which Building Permit No 13879 Z' Ma. rch 1.1 z 19 dated .... /~1~ .r 52-. · ~. 7, ..............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 ......... ..... 9B.e..f.~tn.i.l.y..d.w.e. 1..1.i.n.g with attached garage .&..de. ck. HOWARD SHAPIRO The certificate is issued to ........................................................... (owner,~e~ m'~te~a~ x of the aforesaid building. Suffolk County Department of Health Approval 14- S 0-2 z~ 8 N751735 UNDERWRITERS CERTIFICATE NO .................................................. Plumbers certification dated 11/6/1986 y/ Uulmmglnspector Rev. 1/85 FOBM NO. II 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 13879 Z Date Permission is hereby granted to:_ ~ ~ A ,e ....~.....~~...~..: ....... ~...~f...~ ~.~.~ ~ ...... .~...: .... ~ ~~....~.:.~..:....,.~..~..~.... , · '~y~'y"i'~'::z ..... ~' ....... ~ ........ ~ .............. ~ ........ :::'~ ........ ~ ............. at prem ses located at . ..~....!....~. ..... ~~ .~l..~ County Tax Map No. 1000 Section .... .Q...-'i..~. ....... Block ....... ..Lt. ........... Lot No ..... .~'~. .............. pursuant to application dated .... ..~.(~)~.....~...il ...................... , 19.~..., 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 A. This application must be filled in typewriter OR ink, and submitted ~ ~ 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-(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 p~"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 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 r 5. Updated C.O.~/// $15.00 D ate ~. 0. ,.. 63 ~. //~.q~%.~ NewCons %ruc t, ion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .... Z~. ,/~.. ....... , nchac.. ............... . House No. Street Ham/et Owner or Owners of Property //0(~(~£~c~-~ - .o.,??: ,./.. County Tax Map No. 1000 Section... ....... Block ........ .... Lot..~v ............ Subd,v,,,on . / . ............. F,,ed Map .o. .......... Lot No.' Permit No. ~,,~]. ~,,.. Date~/Of Permit.(~,//.~,...Applicant~,.].~b.O ............./~' ~C~') ' ./~,, '~J ,~'~' ...... ,?.~.~.M' Health Dept. Approval '" App ........................ Labor Dept. roval ...... ~,, ............. Underwriters Approval Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ..... ~.,...~ ,q~? .................. Construction on above described building an.cl_,~!t~ mee~s.~.all applicable~(G.~/,~...c°des and regulations. Applicant. C~ L~L ¢/~L~j ~.. ~ .~.. ............. 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 Date~/~F Building Permit No. (please print) Plumber /q/6;/;~ p~ ~ (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 Publ~c,~cc~ Notary Public County UNDA K. DAV,~UON . . gotery Public, State of New Y(R'K No. 4694688 Qualified in Suffolk Term Expires March 30, 19 _ FiE~D~ I~SI~ECTION FOUNDATION (1st) C OMM EN TS " FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. t 1971 TEL. 765-1802 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. /~//NoL Underwriters Certificate on file. /_~/T~e check is(~/not on file.)$~0~3 /~ No Health Dept. Approval on file. /Z/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit # ~ ~ _~_~ _~ Z Build, Dept.· ***/// No Plumber solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) 7GS.t802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH ~PLBG. ~ FOUNDATION 2ND [ ] INSULATION DATE , INSPECTOR 765-~,802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH pLBG. FOUNDATION 2ND [ ] I~ULATION FRAMING [~ FINAL REMARKS: DATE INSPECTOR J. oo~uT~t THE NEW YORK BOARD OF FIRE UNDERWRITERS e~ BUREAU OF ELECTRICITY -- ~y ,~.~ ~.~6 85 JOHN STREET, NEW YORK, NEW3Y~38 o,,t,.~ .~,.,,llc,,.o. No.o.,S.e N 751'735 THIS CERTIFIES THAT only the electrical equipr~en~as described belo~v an~introducedbv the a,mlicnnt name on t e b ' ' ' in tfle followlng loca~ion~ Basement [] 1st Fl. [] 2nd FI. Sectio~ Block Lot was exa~nined on ~/ '~ ~,~ and found to be in co-zpliance wi~h the requiretnents of thls Board. FIXTURE FIXTURES RANGES COOKING DECKS[ OVENS DISH WASHERS EXHAUST FANS SERVICE DISCONNECT NO, OF S E R V I C E £-iOoOkWo ~ I~ i. 13. This cerfificote must not be altered in any manner; return to the office of the Board if inco?ect. Inspecto!s may be identified by their credentials. DEPARTMENT. T~I$ COPY OF CERTIF CATE UST NOT B" ALTER? N ANY MANNER FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined....(~.../.~.., 19~.~.'7. Approved .C~.'...i.?.., t9 ?.&~. Permit No. }...~....~. Disapproved a/c ..................................... ................................ ..... (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No .................. Date . [.q~.r.q~.~. ~l.1.,.. 1..9.8.5., 19... 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 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 lxerein 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. (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. .......... e? .............................................................................. Name of owner of premises . ~.r.,. & t~rs. IJg.~.~r.d.. ~.t~n..zr.o ............................................. (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. 2 S Plumber's License No..~?..b.c...1 ./.e.e.n. ~.e? ........ Electrician's License No .... t! .................. Other Trade s License No ...................... 1. Locatio¢of land on which proposed work will be done...qu.f.f 0 l l(..C o,. :b.~x. mt~.n., l..~ p .0. . 0. .7 .9 . .4. . . .5 .......... i House Number Street Hamlet County Tax Map No. 1000 Section .0.7.~ .............. Block ....... .g2~. ........ Lot ~ ~ Subdivision .I~.'q. r.b.°.r...L.igJ~.g.s.. ~.s.~?..~.e? ............ Filed Map No. 4 .'°".~2. .......... Lot ...1.,1. .......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~.~ .i ;l?,;i.~ g. ?,1:o,~ ................................................. b. Intended use and occupancy Resx ~en ct~ 3. Nature of work (check which applicable): New Building ...X. ...... Addition .......... Alteration .......... Repair .............. Rem6val .............. Demolition .............. Other Work ............... (Description) 4 Ft'mat dC st 4200 Or©; Fee : (to be paid on filing this application) 5. If dwelling, number of dwellinglunits oon o Number of dwelling units on each floor ........... If garage number of cars : 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions .of ?xisting ~tmqt~ur~$, if any: Front ....... ".../'.'... Rear .............. Depth... ............ Height .'.' .. ,. I ( i .... '~... ,~ber of Stories ............................................... I)nnenslons of same structure' With alterations or ad&tlons: Front ................. Rear .................. I)epth ... I.;.~ ~. ~. ~. ii'. 4" Height ...................... Number of Stories ........... , ........... 8. I)in~ensions of entire new cof~stmction Front . .~*. r . ........ Rear g9 t Denth 44 Height 2{; ~ lqnmber ne gt^-~ ~wo ................ ~ ............... 10. Date of Purchase ...1.O.~fi.... ;. ................. Name of Former Owner ............................. 11. Zone or use district in which pr~mises are situated .... .R.o.s..i .~1 ?.n.~..i ,.a,.1 .................................... 12. Does proposed construction vio!ate any zoning law, ordinance or regulation: .............................. 13. Will lot be regraded . Y.~ .... i ........ : .......... Will excess fill be removed from premises: Yes ~ No 14. Name of Owner of premises }I..~h~..~.i.r.q ......... Address ,B.q~y..~.~fl.~..¥'.,..Y.,... Phone No. 212 428 0244, Name of Architect .k. ~i.~.r. 9p.o.u. 1. ? ? ............ Address ~ouSh ~m. ng on..I~..,..YPhone No. ~ Name of Contractor .C..~..~??.~1.1. .............. Address i{~ .~.h.~.°.'~ .~i .~i-..T r. Phone No. ~. ~.~i PLOT DIAGRAM Locate clearly and distinctly alli buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block inumbar or description according to deed, and show street names and indicate whether interior or corner lot. SEE' ]~AGE ONE OF 2UBMTTTEI~ BT,TT~RT~T~ STATE OF NEWrY~R.K., ~/~ S S COUNTY OF .~m/'~ ..... i ' .......... ~i .~.. [)~ ................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named, i 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 contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manne[ set forth in the application filed therewith. Sworn to before me this ............ /./.. L~.'... 2'.day of: .... Notary Public .................. NOTARY PUBLIC, No. $2-81258~, Term Expires Marel 19~ · :WLL£ (Signature of applicant) ~f ~ Ik County. ,1 m '~Oh 'Z.! ~ Y FI.., ~1.o' ,,9 suFFOLK COUNTY SINGLE FAMtL'~ H.D. REF. NO., DATE 'THE SEWAGE'DISPOSAL LOCATION HAVE BEEN FOUND TO BE ~ C~ief EALTH DEPAR'[~ENT . f~ L_e NLV :p z BY THIS DE,,P~,~S. RTMENT ANI APPLISANT; HOWA~.D ~1~0 ~U~oL~. ~-~t~f'l~ I:~A~-T~mNT op ~,~-TH H',~'., la~-~, NO', APF't~V~O ; MAP dt:: H-OW,&~D ~HAP/~ "AT ~AYVleW/" I ,,-j~,OI fo GENERAL NOTES 1, The design for this residence is the proper~y of the architect and intendeff for construction by Mr. Howard Shapiro on this plot only. The drawings may not be used for any other purpose without written authorization of the architect. 2. All work is to be in accordance with the New York State Uniform Fire Prevention and Building Code 1984 edition and in accordance with zoning regulations of the Town of Southold. Insulation shall be provided in accordance with the NoY. State Energy Code; R-11 in walls, R-16 floors above cellar, R-30 below the roof. All doors and windows shall have insulating . double glass and be weatherstripped. 4. Upon completion of ths foundation, its location on the lot is to be verified by a licensed surveyor and certified to the owner by drawing. 5. Soil is assumed adequate for 2 tons/sq.ft, bearing. Notify the architect of any variations from test hole data. 6. Make no structural modification without written authorizationt of the architect. 7. Any'concrete foundations or slab poured during winter months must be protected from damage by frost. 8. The general contractor shall be responsible for obtaining all permits and pay all fees. 9. The General Conditions contained in AIA document A107-1978 Abbreviated Form of Agreement Between Owner and Contractor shall govern all work under this contract. lC. All plumbing work is to be in strict accordance with all requirements and ordinances of the Town of Southold. 11. The water supply and sewage disposal systems shall conform to the standards and requirements of the Suffolk County Dept. of Health Services. 12. The contractor shall be responsible for arranging inspections~ and approvals of the regulating authorities and obtain the final certificate of occupancy upon completion of the work. 13. The contractor shall provide temporary electric power and a temporary chemical toilet for use during construction. 14. The contractor shall remove construction debris and maintain the construction site in a clean and safe condition at all times. ,f coppe~' tul_*ing ~s use¢~ system; Izq-Hng d,,~ll be OCCI]? C¥ OR lEE IS ih:;b i CBUtflCATF. OCC ? C¥ tbLe USED IN SUPPLY SYSTEM CANNOT EXCEED 2/10 of 1% LEAD. NOTIFY BUILDING ~'=--' 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: ~o k4Ai~l ~T~F:~-T gOb~'~AM?'lb~ Ny 4 M ITI'2..OF:'~LJ LOS A1z¢-4'~ IT~ 30 MAIN STREET SOUTHAMPTON NY .b **%, ~F:::~TIOI,.I F- F I" ~1LO" q ,,0 30 MAIN STRE£T ~-C,~ I -I-~- C~T~ SOUTHAMPTON NY ',, x, 30 MAIN STREET $OUTRAMF~TON ,/ ,I ii WDST DLEVA'TIoN l/~,." ~ /LOrI .( / / He / 'i' L II SECTION jSECTION "D'D" GABLE 1' I I .I SHOWING RAKE !xlO pITcH 4*¢ SECTION "E'E" T~PI~L WALL SECTION ' ~:' ". I' .¢/~". ~,.~, . ~Z : ~ , ~ ' [ N" '" ~VATIoN'- BATH' 2 9 ELEVATION- ~H 2 ~1 ~EmVATION - BATH 1 ~ ~ ~ ~ ELEVATION-- KITCHEN / PLAN,- BATH 2 i :blN~ i, PLAN- BATH I PLAN - MASTER BATH ~¢..". tg~lr I i yc.L IJ~" , SECTION' -TYPCA B1 NET 'el'l" MAIN ST R£~? Tv/ycr. FIRST FLOOR PLAN lA"' 1'-O" '% ,,,+,x / SECOND FLOOR PLAN 1/4"' 1" O" / / '/,0/k. C, It~;UI'I- ~/~ ~w ut;," ~ENERAL NOTE3: ELECTRICAL SYMBOLS Af~NP/NST ~O~o1 W~lfl~p~F pox ~ ~Tb~, w~w~ ~Ng~- I~JF~L.UCDiAI~ Wlr~N~ oE AU_. ~ ~EhgmAbf ~. NO suOs~ituclon oI m~uer~als or equipment speclIied sn¢ti.~ ~er~ltted.' Alu railings, d. Closet liltings (clothes poles and sheSv~s). un,~s. ~. Wallcover,ngs.- - 3. ~xcawCe to grades lno~c~ted on the drawing'~. ~oundatio5 walls until lirst floo~ pla~o~m is buil~. p~acing snail be not lowe~ than 50 ~., no~ nigne~ than 85 ~. The ' i~dmixtu~e, 2~ Gay cylinde~ strength ~o De 2,~00 4~.S.1 mznzmum. SI~UCTURAL Die,L; t. Structural steel shall con/btm to ASTN A-Do.~ z[ , bending of 1450 ~,b.I. in. 2. All sills to Oe pcese~va~lve pressure t~eate~d 3. ~ovide minimum.2-2xo lintels ove~ all openings in .f~aming not o ' . . m~nuzac~ure~s 8uzdel~aes Sot closed valzey II~sning, ste~ tla~ning ~t do~me~ a~d'~i~ slmll~c uo %.uKA ,' 124/ idb s~ries of the Overhead Door Corp , ,*iNDOW~ A,D SLID1NG ~LASS bOOR: , , ]. Aluminu~ wzndo~s and doo~ ,lu~n~sh¢~ wibn spar~ ar;esuor top, outside ~ir kit and glass d~o~s. ' ......... ~,,~,,Uey 9y~em,,, ["INISHES: '1. llbg: Ilies are to vil~eroy and Soch "Oatoha" (f~rst floor) ~'Picco~o', ~$~:n~ '1 '& ~ostllzioQ: U'lasuer dash). ~11 tiles and accesSOries are ~o oe.iurnip~d mortar on a wood sub-l, loo¢ 3. FurniSh color ~mpl6~ of pre'-mixed cb'~merci~ r cu~enu accep~e~ standard p~actice of t~e. Tlle Council bi AmeDlca Io~ lay. in~ Zloor-~pg and O~rcn doors to be sanded smooth and ~ln~shra w~t~'~,~ ~ ~ % : % . ,~e¢. ~..Oa~ plumbing wor~ in full Conformity with requirements ~ ~ne:'N;~ bode'; '~e':~ow~":O~"'~edC~eld '- , '~ ~