HomeMy WebLinkAboutZ-27067FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
UPDAT~u
PRE EXISTING
CERTIFICATE OF OCcuPANCY
No E--27067 Date MAY 8, 2000
THIS CERTIFIES that the building ONE FAMILY DW~Z.IN~
Location of Property. 9955 SO~DVIEW AVE. SOuT~OLD
House No. Street Hamlet
County Tax Map No. 1000 Section 59 Block 2 Lot 5
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a One Family Dwelling built
Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER B-27067 dated MAY 8, 2000
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 ONE FAMILY DW~.?-IN~ *
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
RICHARD & MIRIAM~LEIN
*NOTE: THIS UPDATES PRECO Z-24104 DATED 12/31/95.
BP ~22398Z-COZ-24103 ISSu~J FOR ADDITION & ALTERATION ON 12/29/95.
BP ~26472-Z-COZ-27063 ISSUED FOR HEATING SYSTEM TO CONVERT TO
- /~uil~ing Inspector
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
pEE EXIBTIN~
~KTIFICATE OF OCCUPANCY
No Z-24104
Date DECEMBER 31~ 1995
THIS CERTIFIES that the building. O~E FAMILY D~.nIN~
Location of Property 9955 ~O~FNDVIEWA~. ~OuT~OLDw N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 59 Block 2 Lot 5
Subdivision Filed Hap No. Lot No.
conforms substantially to the Requirements for a One Family Dwelling built
Prior to: APRIL 9~ 1987 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z-24104 dated DEC~3~R 31~ 1995
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupanoy for which this certificate is
issued is O~E F~MILY SEASONAL DW~-INg *
The certificate is issued to C. AIL B~(3KLEY
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTA~v INSPECTION EEPORT.
H/&
Rev. 1/81
Snilaing~ Ins~ctof
LOCATION:
SUBDIVISION
NAI~ OF OI,/I~R (s)
BUILDING DEPARTHENT
TOWN OF SOUTHOLD
IIOUSING CODE INSPECTION REPORT
9955 SOIF~DVIEWAVE. SOoTHOLD,
(number & street) (municipality)
HAP NO. LOT(s)
GAIL NUCIU..EY
OCCUPANCY SEASONAL SINGLE FAHILY
(type)
ADHITTED BY: ~kIL BUCKLEY
KEY AVAILABLE
SOURCE OF REQUEST: GAIL BDCgl.gY
OWNER
(owner-tenant)
ACCOMPANIED BY: SAI~
SUFF.CO. TAX MAP NO. 1000-59-2-5
DATE: SEPT. 8, 1994
DWELLING:
TYPE OF CONSTRUCTION
FOUNDATION
TOTAL ROOMS: IST FLR.
BATHROOH (s) NONE
PORCH TYPE
BREEZEWAY
DOMESTIC HOTWATER
T~PE HEAT NONE
OTHER:
WOOD FRAI~
CgI~IiT PIERS
REAR ENCLOSKU
CELLAR
5 2ND FLR.
TOILET ROOM (s) ONE
bECK, TYPE
FIREPLACE
Y~S TYPE HEATER LILCO CAS
WA}~! AIR
FRAI~LYN WOOD STOVE OUTSIDE SH{Y~IER
{ STORIES I { EXITS 2
HONE CRAWL SPACE NONE
3RD FLR.
UTILITY ROO~ OUTSIDE PI]~P HOUSE
FROI~ STOOP PATIO NONE
GARAGE
AIRCONDITIONING
DOTWATER
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.
SWIHHING POOL
OTHER:
STORAGE, T~PE CONST.
· GUEST, TYPE CONST.
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORH FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
REHARKS: BP ~22398-Z - CO Z-24 {03 ALT & ADD
JOHN M.- BOuI~IS ~/
DATE OF INSPECTION SEPT. 19, 1994
TIME START 9:50 END {0:20
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
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 i% 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.
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 completed application and a 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.
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 9ccupancy on Pre-existing Buildin~ - $100.00
3. Copy of Certificate of Occupancy - ~ .25~
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date .............
New Construction ........... Old_Or Pre-existin~ BuildiJ~g.
Location of Property....~.~...5~.. ............ ~ ....
House~N°'~~ ~tre~t ~ Hamlet
Onwer or Owners of Property~.9~ ..........................
County Tax Mmp No 1000, Section .......... Block ............. Lot ......................
Subdivision ..... Filed Map ..... Lot ......................
Permit No ................ Date Of Permit ................ Applicant .............................
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval .........
Request for: Temporary Certificate ........... Fin~rticate ...........
~.5~ // ~PLICANT
BUILDING DEPARTMENT
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 lihes,
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
!ess 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 completed application and a 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-existinR Buildinm - $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
..... ................... ...
New Construction .......... ~O~d O~ Pre-existing Building.
Location of Property ..... . ..... ~ .. ~ .' .......
House No.~ / Street Hamlet
Onwar or O ers of Property ..... ......................................
County Tax Map No 1000, Section .... ~ ....... Block...~. ........... Lot.
Subdivision ...........................
......... Filed Map ............ Lot ....
Permit No ................ Date Of Permit ................ Applicant .......... ...
Health Dept Approval
· ' ........................ Underwriters Approval
Planning Board Approval .......................
Request for: Temporary Certificate ......... Final Certicate
Owner(s) Namc~
do(es) hereby state:
CONSENT
'FO
INSPECTION
· the undersigned,
of Southold located at
That the undersigned (is) (are) tile owner(s) of the premises in the Town
x~hlcn is shown and desifnated on the Suffolk
County tax map as District 1000, Section~_~Block
Lot
That the undersigned (has) (have) filed, or caused to be filed, an applica-
tio. n int/k~ Southold Totem Building Inspector's Office for thg following:
That the undersigned do(es) hereby give consent to the Building Inspectors
of the Town of Southold to enter upon the above described property, including
any and all buildings located thereon, to conduct such inspections as they may
deem necessary with respect to the aforesaid application, including inspections
to determine that said premises comply with all,of the laws, ordinances, rules
and regulations of the Town of Southold.
The undersigned, in consenting to such inspections, do(es) so ~vith the
knowledge and understanding that any information obtained in the conduct of
such inspections may be used as evidence in subsequent prosecutions for vio-
lations of the laws, ordinances, rules or regulations of t, he Town of Southold.
(si ,nature)
'(print rgame)
(signature)
(print name)
NEW YORK STATE ENERGY
CONSERVATION CONSTRUCTION CODE
Building Address:
Design Criteria:
Dated:
Non Electric Heat
6,000 Degree Days
O.A. 10 Degrees F
I.A. 70 Degrees F
One or two family dwelling
SUBSYSTEM AREA DESIGN THERMAL REMARKS
s.f. "U" RATING
ExteriorWalls ~C[7_. ,cl[ 't-5'C~ R- ]] Insulation
Glazing ~ O '7 .33 't ~ 9 Andersen HP or Equal
Doors J-~ ~ .40 4- ~ U 40 Rated Doors
Ceiling(flat) ~ 9'7 , O~'3 '~ ~ R- IQ Insulation
Ceiling (Cathedral) R- Insulation
Skylights .33 Andersen HP or Equal
Floor 897 ,0~"3 -- ~c R- t ? Insulation
Foundation Walls R- Insulation
Slab Insulation R- Insulation
Total: q' ~ ~
NOTES:
Building Envelope System to meet requirements of 7815.2
HVAC Equipment to meet requirements of 7815.11
HVAC Systems to meet requirements of 7815.12
Duct Systems to meet requirements of 7815.13
Ventilation Systems to meet requirements of 7815.14
Insulation on piping systems to meet requirements of 8715.15
Domestic water systems & Equipment to meet requirements of 7
Electrical & Lighting Systems to meet requirements of 7815.31
To the best of my knowledge, and belief
& professional judgement, these plans are in Signed __
compliance with the code. Date