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HomeMy WebLinkAbout29135-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29721 Date: 09/22/03 THIS CERTIFIES that the building ALTERATION Location of Property: 47025 CR 48 SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 55 Block 2 Lot 23 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 15, 2003 pursuant to which Building Permit No. 29135-Z dated JANUARY 30, 2003 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 BATHROOM ALTERATION IN AN EXISTING COMMERCIAL BUILDING AS APPLIED FOR. The certificate is issued to MADELEINE SCHLAEFER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF BEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 114257 05/06/03 PLUMBERS CERTIFICATION DATED 06/25/03 JAMES TWOMEY Autihorize Signature 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. 29135 Z Date JANUARY 30 , 2003 Permission is hereby granted to : MADELEINE SCHLAEFER ROUTE 48 SOUTHOLD,NY 11971 for ALTERATION (CONVERSION FOR HANDICAP ACCESSIBILTY) TO BATHROOM UNDER CONSTRUCTION AS PER BUILDING PERMIT #28767Z (ADDITIONS & ALTERATIONS) at premises located at 47025 CR 48 SOUTHOLD County Tax Map No. 473889 Section 055 Block 0002 Lot No. 023 pursuant to application dated JANUARY 15 , 2003 and approved by the Building Inspector to expire on JULY 30, 2004 . Fee $ 200 . 00 4___,-Ku thor ' ed Signature COPY Rev. 5/8/02 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building 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 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) non-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 complted application and a consent to inspect signed by the applicant. If a Certificate°,of Occupancy is denied, the Building Inspector shall state the Feasons... therefor'.in writing to the applicant. 1 C. 1 > pes.13EP ( '2 1`. Certificate of0 cupancy - New dwelling $25.00, Additions to dwelling $25.00, 1 ; _.Alteraeraas t8 d lling $25.00, Swimming pool $25.00, Accessory building $25.00, ,Additions -tcnacce sory building $25.00. Businesses $50.00. x -27- Certificate of Occupancy on Pre-existing Buildine - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . Old Or Pre-existing �-B Building. . . . . . . . . . . . . . . . . Location of Property. �7G Z . . . .GX. . . . . . . . . . . C ..l�oLc%. . . . . . . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property. . . .�p.:L . .?. ,�, ; . . .j Gl� LO /_ i County Tax Map No 1000, Section. . . . 5. . . . . .Block. . . . . . Lot. . . . .�j. . . . . . . . . . . . . Subdivision. . . . . . . . .�I�. . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . . .LLot. . . . .r.... . . . . . . . . . . . . . . 2 9 /35 . ,Date Of Permit. .��-30 Zf'tl3„Applicant. . .�J.�`L. t'�`•`!• . Permit No. . . . . . . . . . . . health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Corticate. . .(.. . . . . . . . 5 O• dU . ee Submitted: $.,. . . . . . . . . . . . . . . . . . . . SOLDER AND ANTI-SCALD CERTIFICATION Date: G/25,17 Building Permit No. �35 Owner: __ (Please Print) Plumber:�r.SS`j17�"�2 �_P�� (Please Print) I certify that the solder used in the water supply system contains less than 2/10 of I% lead as per 905.5 of the NYSFPABC. I also certify that I installed an anti-scald and/or thermal shock preventing device at all bathing and/or shower fixture in conformance with part 902.6(K.) of the N.Y.S.F.P.A.B.C, to mitigate the potential hazard. du to shower va1v that allowed surges of high temperature water to flow from the shower hea . Plumbers or HomeownwAignature »>>>>> »» i»»»»»»»»»»»»»»»»»»»»»»»» Please Check One. ( certify I am the licensed plumber ('License # —3 0 5 Z" P _) that installed all Plumbing on the above referenced premises. ( ) I certify I am the homeowner and I personally installed all the plumbing on my above Referenced premises. Plumbers or Homeowners Signature — Sworn to me this --�h __day,of :, ' 2003. Notary Notary Public,_ w�� _ _County -- --- -- S ;o �c --- --- - -- Notary Public USA A.SCHIAVONI NOTARY PUBLIC,STATE OF NEW YORK NO.4870323,SUFFOLK COUNTY TERM EXPIRES SEPTEMBER 2. *Z=o LONG ISLAND ELECTRICAL INSPECTION SERVICES, INC. 670 MIDDLE COUNTRY ROAD Application No.: 114257 ST. JAMES, NEW YORK 11780 Permit Number: (631)265-3075 Block: Lot: Fax(631)265-6057 section Owner: Glenn F. Heidtmann Agent: Top Gun Electric Address: 47025 Rte. 48 Address: P.O. BOX 1002 Municipality : Southold NY Cutchogue NY 11935-063 License#: 5150E top gun OwnerPhone: Agent: No. ITEM SIZE _NQ, ITEM SIZE No. ITEM SIZE 49 Switches: 0 SubFeeds: 0 PoolsAbvBlo: 68 Receptacles: 1 Timers: 0 PoolslnGround: 3 GFCI Devices: 0 Transformers: 0 Pools Filter: 0 Dimmers: 3 ACEquipmentCentral: 50 0 Pools Lights: 0 MedlumBaseFixturss: 0 ACEqulpmentWlndow 0 CO Detectors: 38 FlurcescentFixtures: 0 MotorsbyHP: 0 Disposal: 6 HID: 0 Generators: 0 Metal Halide Lamps: 0 RangeOvenCookTop: 0 WhirlpoolHotTub: 0 RefrlgUnits: 0 DryerElectric: 0 Microwave: 0 WalkinBox: 2 ExhaustFans: 0 WaterHeaterElectric: 0 ExhaustUnit: 2 CallingFans: 0 SmokeDetectors: 0 SteamShower: 0 DW: 0 TrackLlghtingStrip: 36' 0 BreadWarmars: 0 Laundry: 0 ElectrlcHeat: 0 GarbageDisp: 3 HeatingEqulpMotors: 0 PumpMotor: 0 CentralVac: 8 ExitSlgns: 1 Disconnects: 2DOA 0 ChandellerLlfts: 3 EmargencySlgns: 0 FutureOutlets: 0 ElevatorLltts: LOCATION OF WORK• ©Basement ©FirstFloor ❑ SecondFloor © Outside ❑Addition ❑ Survey [_1 New Const. Comments Renovation 1 -Sign Circuit 3-50 Amp A/C Units Final 5/07/03 !Additions OH ❑ UG © Amp: 4ffi Phase: 1 Volts: ,ZU Wire AL Conductor 4/0x2 #of 1 Temporary ❑ Type: Size: Meters: Member l.A.E.I. Electrical Certificate Certificate No. 114257 LONG ISLAND ELECTRICAL INSPECTION SERVICES, INC. Certificate Issued on: 5/6/03 THIS CERTIFIES THAT LO ]STRICT INSPECTOR CONDUC ED SP CTION OF THE Issued to Glenn F. Heidtmann VISIBLE PORTION O HE ECTR AL INSTALLATION,PES RISE EREI AND IS Address: 47025 Rte. 48 COMPLIANTWtTH E C RENT ATIONAL Southold NY ELECTRI LCOD . Top Gun Electric P.O. Box 1002 — Cutchogue NY 11935-0633 IAEI Certified Inspector BUILDING PERMIT EXAMINER CHECK LIST DATE REVIEWED: __L/.,30 APPLICANT: c 0 {c1 S DATE SUBMITTED: / /03 SCTM# DISTRICT: 1,000, SECTION: 5–"' ,BLOCK: Z , LOT: Z S SUBDIVISION: *4/.6' ADDRESS: y jko 2T' f R VA CITY: 5_0 vJH®c,� ZONING DISTRICT: CONFORMING? ,.._. If IN l `i t'. �'M - MA �t t'.. - .4Cc SS Ar(�lt BUILDING PERMITS OPEN/EXPIRED: .;7 BOW 3-Z/C/0 Z-_alcLr4 , INFO AOD /BP -Z/C/0 Z- , INFO BP -Z/C/0 Z- ,INFO /BP -Z/C/0 Z- , INFO PRE CO: Y OR N BP -Z/C/o Z- , SINGLE & SEPARATE CERTIFICATION-REQUIRED_ /o NOTES: LATS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at any time after 7/1/83; REQ. LOT SIZE: gT. LOT SIZE: R�F���.�,O V. ACT.��x/ C REQ. FRONT OP. FRONT w ACTS REQ. REAR PROP. REAR Al— M iREQ. HEIGHT PRO GHT PROJECT DESCRIPTION: F'4- ieoopu Q c 440 ESTIMATED PROJECT COST: ?',l '� D ENGINEER: .S FAST TRACK WATER FRONT? � DESCRIPT ON: PANEL #: COM APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: YES or NO, (BED#): DTE: _/_/_ PERMIT#: TOWN SEPTIC RECEIPT: Y or N NEW YORK STATE DEC: rn-mc 9/1/75 YES or NO SOUTHOLD TOWN TRUSTEES: YES or NO TOWN ZONING BOARD APPROVAL: YES or NO TOWN PLAN. BOARD APPROVAL: YES or NO TOWN HISTORICAL PRE (SPLIA): YES or NO NEW YORK STATE CODE COMPLIANCE (SEE PAGE 2):(YES NO C t.. /"S1 NOTES: FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: SF SECOND FLOOR: SF OTHER: SF IMT OTHER TOTAL TOTAL: SF FEE F 1. ( SF)- ASF)= SFX$ =$ +$ +� $ a o 2. ( SF)- SF)= SFX$ =$ +$ +$ _ 3. ( SF)- _SF)= SFX$ =$ +$ +$ _$ FINAL TOTAL: $ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [i- ROUGH PLBG. [ ) FOUNDATION 2ND [ ] INSULATION [ ]'FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: 77 t r DATE c%3 INSPECTOR M-lW2 BUILDING DEPT. INSPECTION ( ] FOUNDATION IST [ rl4lkOyGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ) FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: 07,J DATE -9/OVA 3 INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS TION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION(1ST) "3 ---------------- G FOUNDATION(2ND) z 2 , ROUGH FRAMING& PLUMBING of C x INSULATION PER N.Y. S `j STATE ENERGY CODE o r P- FINAL ADDTITONAL COMMENTS O m w 0 0 x L � . a TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CH$CKLIST BUILDING DEPARTMENT Do you have or need the following,before applying 7 TOWN HAI L Board of Health SOUTHOLD,NY 11971 �� 3 sets of Building Plans TEL: 765-1802 urvey PERMIT NO.,�t1 15 5- Check Septic Form N.Y.S.D.E.C. Trustees Examined 20 5 Contact: Approved -V 202 Mail to: Disapproved a/c Phone: -- Build' ector r _ _ APPLICATION FOR BUILDING PERMIT jM 15 2003 Date J/A �vuAn / /5', 2003 INSTRUCTIONS a. T4is application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 sets of. as,' ccurate 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 waterways. 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 a permit shall be kept on the premises available for inspection throughout the work. e.No building shall be occupied of used in whole or in part for any purpose what-so-ever until a Certificate of Occupancy is issued 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, Suff&k 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 inspections. ( igiaturs of applicant or name,if a corporation) p ./66ic � ¢! L �byT—c�scd �L9 119 / (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder Name of owner of premises �o t Do,y �,Q 2 l L e/-V&r— :56 (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. f p T Plumbers License No. Electricians License No. Other Trade's License No, 1. Location of land on which proposed work will be done: ¢70a17— G.R , ¢8 Gjourlddcv House Number Street Hamlet County Tax Map No. 1000 Section 5 3 Block o 2 Lot Z Subdivision IZIOZ4 Filed Map No. Lot (Name) 2. State existing use,and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy r4 t L S'�,, ys �` S:o.c a E a /-�'�K �Ta c b. Intended use and occupancy 3. Nature of work(check which applicable): New Building Addition Alteration_ Repair Removal Demolition Other Work 4' _ � (Description) 4. Estimated Cost 5 ,-V Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units ? 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 existing structures, if any: Front16) 4- Rear la4- Depth -2- 2- Height 2- Z"Height 76 Number of Stories f y1-- Dimensions of same structure with alterations or additions: Front /6 4 Rear ( off Depth zz Height ZG Number of Store, Z S. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front /S 7 Rear ( 4 Y Depth 10. Date of Purchase 17 reG Name of Former Owner 6,�K vo wy 11. Zone or use district in which premises are situated — 12. Does proposed construction violate any zoning law, ordinance or regulation: 13. Will lot be re-graded Will excess fill be removed from premises: YES NO 14. Names of Owner of premises scgca /K-cF.c Address Dior 10y7 5o�rq4'/-nPhone No. 76 3--Z �v Name of Architect -57-/1-�J^"'i Address 00je f 4 lz '5,vr*e42phone No SGS -5-f Name of Contractor Address Phone No. 15. Is this property within 100 feet of a tidal wetland? *YES NO • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF )�/ 't r c� �f - (f� being duly swom, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)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 manner set forth in the application filed therewith. Sworn to before me this day of 20 Notary Public Signature of Applicant 7. 1 1119 9b APPR ED AS NOTED O FITYIN4fi � 3 � r DATE• `� B.P.# j 17 nwif or # (J r 'n', ro 2G �� BY:�/�I NO IFY UILDING DEPA tRT------ 765-1 2 9 AM TO 4,,� M O T�{CLEAR _ OLL ING IN C710 S I FLOOR PLUMBING F U IR SPACE- 11 NCR I ALL PLUMBING WASTE OU FRA NG UMBI�IG III WATER LINES NEED a INSULA? --- -� TESTING BEFORE COVERING $ 4 FINCOM- C Sir EF TION MUT t8 If co r °€ i:ts1 is used I L CONS tic OR or t' a.� u'selil134ia`o ��Jll I SHALL ME T =48 min J y I 11 min TS OF THE .Y. t220 8?' i 1 i . ltg Spha�i be I LEG CLEARANCE co rit leo17 min CTION & ENERGY F I . cP Orly �`� ESPONSIBLE FOR �r,ft�TERS C�RiIf 1GATE I I s ESIGN OR NETRUC �pppgl�at Lavatoriaa and E "` I Nam Dawhae *==NOW dwaft d(OPI",,,.,w&MR,„a,,,, OCCUPANCY OR USE IS UNLAWFUL / WITHOUT CERTIFICATE OF OCCUPANCY 1B 42 min sett 18 10a5 54 mi V/ 7 '- E-)K 4, mi 12 max _ 4 min 1 min ' 1 n 38 max 7FL I �� 1 N Gr Ta I T 6 ; TOILET PseAPERAI..�T o1sPENR SPACE E Ej 1 Sp • o AR ^ ✓`� c�,---_ 'Hrr '�TIFICIIWON Amin �Et f A. Sr Fc� * pftrc spam permits,"tend ptl 6sr DR aorta 6*- 1625 0,"J D "Orr^^�f�'ENT 'EgFC)�R/E � 11 R,� t✓°.Cf g`("(i..�. 4 ?..�sf ''.��,,:i�it-6�i/vC 9 Water Closet Front View Clear Floor Space at Water Closets ; p ryT i T} S J a s�. Y'4 S.a F-:r��7t`cf€36 'P/ 015744 �� d !r of Iii S EA®. I!� _ N D - 1 TITLE ��OT ' � A� / .li,�-ok 1 �Vd MISTINGYMORiC G A R R E T T A . S T R A N G TO BE REMOVED - -—— -� LOCATION .9 tt-• jie�.-�^��4.r.-.A ,�.. architect l -1-1�=00 � a- �_. . r SCALE t0 J,. REVISED - DRAWING N? TO REMAIN 1230 Traveler Street Southold N.Y. 11971 Y T DATE � \Lo — I � rN1!( NNW � 631'- 765 - 5455 DRAWN BY y K INSTALLED A