HomeMy WebLinkAbout27977-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29210 Date: 07/09/03
THIS CERTIFIES that the building ALTERATIONS
Location of Property: 660 KING ST ORIENT
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No_ 473889 Section 26 Block 2 Lot 36
Subdivision Filed Map No. Lot No_
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 21, 2001 pursuant to which
Building Permit No. 27977-Z dated DECEMBER 21, 2001
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 INTERIOR ALTERATIONS WITH NON-HABITABLE ATTIC TO AN EXISTING ONE FAMILY
DWELLING AS APPLIED FOR.
The certificate is issued to HOWARD SCHAFFER
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 1127014 06/12/03
PLUMBERS CERTIFICATION DATED N/A
Authorized Signatu
Rev. 1/81
FORM NO. 3
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)
PERMIT NO. 27977 Z Date DECEMBER 21, 2001
Permission is hereby granted to:
HOWARD SCHAFFER
PO BOX 541
ORIENT,NY 11957
for
CONSTRUCTION OF INTERIOR ALTERATIONS FOR AN EXISTING ONE FAMILY
DWELLING AS APPLIED FOR. THIS PERMIT REPLACES BP# 25913 .
at premises located at 660 KING ST ORIENT
County Tax Map No. 473889 Section 026 Block 0002 Lot No. 036
pursuant to application dated DECEMBER 21, 2001 and approved by the
Building Inspector.
Fee $ 150 . 00
AuthorizedLZignaturev
COPY
Rev. 2/19/98
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT �{
Town Hall
Southold, N.Y.
/W�
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 25913 Z Date AUGUST 3, 1999
Permission is hereby granted to:
HOWARD SCHAFFER
49 PRINCE STREET
NEW YORK,NY 10012
for
CONSTRUCTION OF INTERIOR ALTERATIONS FOR AN EXISTING SINGLE FAMILY
DWELLING AS APPLIED FOR.
at premises located at 660 KING ST ORIENT
County Tax Map No. 473889 Section 026 Block 0002 Lot No. 036
pursuant to application dated JUNE 21 99 and approved by the
Building Inspector.
Fee $ 75 . 00
Authorized Signature
COPY
Rev. 2/19/98
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802 ^^''
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. For new building or new use:
I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or
topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate
of Code Compliance from architect or engineer responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings (prior to April 9, 1957) lion-conforming uses, or buildings and "pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic
features.
2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is
denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy-New dwelling$25.00,Additions to dwelling$25.00, Alterations to dwelling $25.00,
Swimming pool$25.00, Accessory building$25.00, Additions to accessory building$25.00,Businesses$50.00.
2. Certificate of Occupancy on Pre-existing Building- $100.00
3. Copy of Certificate of Occupancy-$25.00
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential$15.00,Commercial $15.00
Date.
Q//e ref it Y.' /
New Construction: ,t 6P Old or Pre-existing Building: ✓ (check one)
Location of Property: 0
House No. / treet Hamlet
Owner or Owners of Property: //O�^/cx ri/ �C�+u I .—_
Suffolk County Tax Map No 1000, Section A(f Block Lot
Subdivision Filed Map. ,/ Lot:
Permit No.0 �`"y Date of Permit. Applicant: {/ 1wet r-( X 4 eIV✓
Health Dept. Approval: 1p/4 Underwriters Approval: A
Planning Board Approvah 1�k�
Request for: Temporary Certificate Final Certificate: ✓ (che one)
Fee Submitted: $ I
ICA C �0 3a b C� Appcs&it Signature
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5 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5
NEW YORK BOARD OF FIRE UNDERWRITERS 5
5 BUREAU OF ELECTRICITY e5
C5 40 FULTON STREET — NEW YORK, NY 10038 e5
CERTIFIES THAT
Upon the application of upon premises owned by
PAUL R. BURNS HOWARD SCHAFFER 5
5 5 P.O. BOX 1061 660 KING STREET 5
SOUTHOLD, NY 11971-0932, ORIENT, NY 11957 5
e5
Located at 660 KING STREET ORIENT, NY 11957
Application Number: 1127014 Certificate Number: 1127014 C�
,lc Section: Block: Lot: Building Permit: BDC: NS11
5 Described as a Residential occupancy, wherein the premises electrical system consisting of
5 electrical devices and wiring, described below, located in/on the premises at: �5
5 Second Floor, 5
5 5
5 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was L5�
5 found to be in compliance therewith on the 12th Day of June,2003. [5
5 Name OTY Rate Rating Circuit Type 5
Miscellaneous
f5'D FINAL 04-04-03 MR RICHERT
5 ROUGH 11-05-02 5
5 Alarm and Emergency Equipment 5
5 Sensor 1 Smoke 5
5 Appliances and Accessories 5
5 Electric Heater Baseboard 2 0 5
5 Wiring and Devices S
5 Outlet 3 Fixture 5
5 Receptacle 6 General Purpose 5
Switch 4 General Purpose 5
5 Fixture 2 Incandescent 5
5 Fixture 1 Fluorescent 5
5 seal 5
5 5
5 I of I 5
5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. r5�
5 5
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"bo
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLA & CHIMNEY
REMARKS: l ��
DATE INSPECTO 4.42z�
as9 �3
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] RO PLBG.
[ ] FO DATION 2ND [ INSULATION
[ FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
RE RKS: � -
DATE O INSPECTOR
�7 7..
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN LATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE&� CHHI�IMNEY
REMARKS:
DATE#e5� 3 INSPECT
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] 1 ULATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS�YYDA-giz Z4��Z�
61
DATE ( INSPECTO
COMMENTS
;..�` VECTION REPORT DATE e_—------------
-----------
N _ H
NDATION ( IST)
NDATION---_(2ND)______N __ 'N
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IGH FRAME S
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BOARD OF HEALTH . . . :. . . .
_._.
FORM Nb. 1 3 SETS OF PLANS . . . . . . . . . . . . . . .
TOWN OF SOUTNOLD SURVEY
� BUILDING ING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . .� 1999 U TOWN HALL SEPTIC FORM
1 SOUTHOLD, N.Y. 11971
TOWN tOFS UT OL TEL: 765-1802 NOTIFYa)a q 0_d�
W CALL
Exomined............`...... 19...... l -7� �' MAIL TO:fti'l.
Approved........I.......1 19:11. Permit ND . n/ ,�...,..5/�:./ a
Disapproved a/c .................................. ....../': ./!!.{.�r/.o1�!'...
......................................... ............
(Building Inspector) .
LIGATION FOR BUILDING PERMIT 2
Date. . . ./. .!� . . . . . ..
19�.�.
INSTRUCTIONS
a. 'Huis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector wi
3 sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan slowing 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 mast be drawn on the diagrem which is part of
this application.
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 issue 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 airy purpose whatever until a Certificate of
Occupancy shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MATE 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 YorkNof
and other applicable Lass, ordinancesor
Regulations, for the construction of buildings, additions or alteratioor demolition, as herein
described. The applicant agrees to comply with all applicable laws, ocode, housing code, and
regulations, and to admit authorized inspectors on premises and in buiinspections.
.... ..............................
(Sit, or name, if a corporation)
...................................................
(Mailing address of applicant)
State wbether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde-
......¢.t!.2Y?............................................................................................................
Nameof 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)
Builders License No. .. 3.�.y: ..lt 5.......
Plumbers License No. .........................
Electricians License No. .....................
Otber Trade's License No. ....................
1. Location of land on which proposed work will be done..............................................................
k -f.:cIcl ................................Cir .r rA.......................
House Number Street 22t
Canty Tax Map No. 1000 Section ......!:. ...... Block .....�....... Int ..M7......
Subdivision ...................................... Filed Map No. ............... Intim.:.......
(Nave)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ....S. ::'.9. :?:. a:^^:.l7.... s.A `0-
b. Intended use and occupancy ...... :............?,.........d<C n Sg............:,t..............
_ ,T
fd-hhnre of wgrk (check which applicable): New Building .......... Addition .......... Alteration ..........
1/ ............. Demolition .......,.. Other.Work .................
Repair .. ......... Removal
9wi' IA5vo&w-+Aert�OCk30mt !&luto,WLIC� IC�grCli?`-II �((�aJcriMtty�p)
Estimated Cost .u'KV..50.6.6
� ........................C�.�.......... rc
.. .. . ......... fee .. .... ..
(to be paid on filing this application)
If dwelling, number of dwelling units .... .. timber of dwelling units on each floor ........!
Ifgarage, number of cars ...D(.4................................
If business, eomnercial or mimed occupancy, specify nature and e��x�t,JJent of each type of use..N.�.:......:.':..
Dimensions of existing structures, if any: Front.N n G�4:.... `'"'ReDepth
Height ......................... amber of Stories .....................
Dimensions of same structure with alterations or additions: Front '-........... Fear ...............
Depth .................... Height .................... Number of Stories ...........
Dimensions of entire new construction: Front o' e"he ."—
.. ar ............... llepfth ..............
Height .................:. ..q..//..aumber of Storr .................... / B
Size of lot: Frontn.... ..... Fear ..�l! ./........ Depth .1 !t �
.C! .......
Date of Purchase .!�.�......7...�.�f Name of Former Owner Ir/ ael.:V..�F1. .
..............
Zone or use district in which premises are situated .X 0 Q.....................................................
Does proposed construction violate any zoning law, ordinance or regulation: •N d...................
Will lot be regraded .......KQ......... W11 ss fill be removed muses• Et10
Names of Owner of prises I�YY.cI�.Y.v✓4a 1... Address .:7.�1 .!.` se j':IC-s!'^/.. Pha ! ..........
Name of Architect .....-..�.........,,...�................... Address .....................-......... Phare No. ..............
Nape of Contractor ..-7:,4Q'!YlF!l ......... Address 38,)'d$ Qrn.�aet.�•._..Pthone Ncdl';.. �...-...
Is this property within 300 feet of a tidal wetland? * YFS .......... G........
*IF YES, 9Di1HffiD TDIdi 7id1SHF-S FEla11T MAY DE ISQTIM.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dinensions
-om property lines. Give street and block ember or descriFtion acco 'ng to deed, and show street names rndfcate
nether interior or corner lot. -C N S v X1+1 N O /'I � W q ,Ur Q e l 4 Ir l( ul J
p
N S USI o � "J t� � oVV1 (2
rAlr OP NZJ YOI`dC,
JUNSS
1Y Or
............being duly sworn, deposes and says that he is the applicant
ime of individual signing contract)
hove owed,
isChe .............................v....�./.........................................................
(Contractor, agent, corporate officer, etc.)
r said owner or owners, and is duly autborized to perform or have performed the said work and to make and file this
pplicatioh; that all statements contained in this application are true to the best of his knowledge and belief; and
uat the work will be performed in the manner set forth in the application filed therewith.
wurn to before me this 1 Q, n
....0�I ........day of .V Uh.4.......19...!!�..
Notary PublidJ.1.
.. .......... . . . . ...............
( goalure A is t)
LYNDA M. BOH
NOTARY PUBLIC, Staa of New York
No.01806020932
Qualified In Suffolk County
Term Expires March 8,20 �
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APPROVED AS NOTED 9 7
DATE: 119.11.91 B.P.# F62112 B
FEE: 8 - BY:11 '�L.
NOTIFY BUILDING DEPARTMENT AT
765-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1 FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE C
2 ROUGH - FRAMING & PLUMBING 6VCUPANCY 0
3, INSULATION �
4, FINAL - CONSTRUCTION MUST _SE IS UNLAWFUL
BE COMPLETE FOR C.O. f i HOOT CERTIFICATE
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y. - OCCUPANCY
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
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SQlJTH BAY ABSTRACT, T/TLF N0. S3717
,$URt!EY OF
LAWWRS IrTLE' INSURANCE CORP. PROPERTY
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A��P__P��ROgqVg�ED AS NOTED
DATE: B.P
FEE: 75 BY:
NOTIFY BUILDING DEPARTMENT AT
765-1802 9 AM TO 4 PM FOR THE _
10EIMITERS FOUNING DATION E TWO REQUIRED SND REQUIRED FICAh
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FI CAL - C COMPLETE C TION MUST OCCUPANCY OR
O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y. USE IS UNLAWFU
STATE CONSTRUCTION & ENERGY WITHOUT CERTIFICATE
CODES. NOT RESPONSIBLE FOR OF OCCUPANCY
DESIGN OR CONSTRUCTION ERRORS