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HomeMy WebLinkAbout27052-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27732 Date: 06/06/01 THIS CERTIFIES that the building ADDITION Location of Property: 1560 BAY HAVEN LA SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 88 Block 4 Lot 15 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 29, 2000 pursuant to which Building Permit No. 27052-Z dated FEBRUARY 8, 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 ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT H & RUTH MILLER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N 556176 04/18/01 PLUMBERS CERTIFICATION DATED N/A Authorized Sagnat e 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. 27052 Z Date FEBRUARY 8, 2001 Permission is hereby granted to: JASON C. LEONARD, INC. (MILLER) P.O. BOX 1528 SOUTHOLD,NY 11971 for CONSTRUCT AN ADDITION TO GARAGE OF EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at 1560 BAY HAVEN LA SOUTHOLD County Tax Map No. 473889 Section 088 Block 0004 Lot No. 015 pursuant to application dated NOVEMBER 29, 2000 and approved by the Building Inspector. Fee $ 75 . 00 Authorized Si ature ORIGINAL Rev. 2/19/98 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR,CERTIFICATE OF OCCUPANCY A� A. This application must be filled in by typewriter OR ink and submitted­tW�iie'�bxi6g 1 11 - Wn inspector with the following: for new building or new 1g 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 o� 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 completed application and a consent to inspect sin4 rO 1"h ' If a Certificate of Occqpancy is denied, the Building Inspector ,shall- -S,taie--,the reasons therefor in writing to the applicant. JUN 4200 C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dweiiin-g',"4�_60....... Alterations to dwelling $25.00, Swimming pool $25.00, Access�rhudld Additions to accessory building $25.QO. Businesses $50.00. - 2. Certificate of Occupancy on Pre-existing Buildine - $100.00 3. Copy of Certificate of Occupancy - Min 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15 00 Commercial $15.00 '� Date . . .4 bt/0 A . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. /... . . . . Old Or Pre-existing Buiding. rr. . . . . .. .. .. .. . . . . . . . . d Location of Property. .. . ./'5_6.A . . . . .. LAe'j C5 . V"o L-0 House No. Street Hamlet Onwer or, Owners of Property.. . . . . . . . . . . . . . . . .. . . . . . . . . .. .. . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section—©.4P0 . . . . . . .Bfock. .0.Q0.Zj . . . . . . .Lot. . . f�. . . . . . . . . . . . Subdivision. . .. . . ..A A . . . . . . . . . . . . . . . . . . . . . . . Fi ed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . L 7 . .0A . .Applicant. .-T . . . . Permit No. .0, q 0 P7. . . . .Date Of Permit. . .i g Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . .. . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . V, Fee Submit ted: $. .. . . . .. . . . . . . . . . . . . . . . . . . . . . t5 I S')'�) . . . . . . . . . . . . . . . . . . . . . C� (" APPLI it THE NEW YO(2K •BOARD OF FI UN:O RW.R,CTEI�S r1000121 - :-', BUREAU Ol= EiLECTRICITV' 40-FULTON SYREET, NEW YORK, NY:TD038 Date APRIL 18,2001 Application Noon ale : '12151$01/0 ; N ,55676. "' THIS CERTIFIES THAT only the electrical equipment as described beiowiand inh'edace[t by the,applicant named on,ihe e applicatio abovie number is,ih,the premzses'of,i ROBERT MILLER, HAY HAVEN LANE; :SOUTHOT:i7, NX . in the following location; ❑ Basement 0 list FI 0'2nd Fl GAR/OUT Sechoh- Block- Lot APRIL 10 2 1:.. , l -was,examined on t � •' and"found to:b-e:an opmpliaaee weth;the.Nphonal ET-eetisaal Gdde FIXTURE RECEPTAClE3 SWITCHES FIXTURES RANGES COOKING DECK) " OVENS - DISHWASHERS, EXHAUST•PANS OUTLETS INCANDESCFNi RUORESCENi OTNER AMT' K W .AMT K W. I AMfi K W:,. AMT. :-K.W '•AjMIT.. H.P: it DRYERS FURNACE MOTORS FUTURE APPLIANCE F#DERSi SPECIAL OC PI Tim G601CKS BE��, UNIT HEATERS, MULTI.OUTLET VD(NtMER$,::. SYSTEMS AMT. K.W. OIC H.P. GAS X.P. "AM7.71[ NO. . A.W 'G AMT.' ;AMP. 1AMT...'AMPS. :IRAN$ AMT; .'H.P•.'. NO.OF FEET ;'AMI. WATTS;' - SERVICE DISCONNECT" No.OF METER NO.OF CC CON, .; A W G•' - ;-�A W.O A.W a: .. AMT. AMP. TVPE EQUIP. 1 D RW I 0 JW J R,JW J D 4W pER e "OF CC.COND.,�: NO AfHI-LEG OF HI-LE6 NO.OF NEUTRALS :�' ,OF NEUTRAL 1 200 CB 1 X '.1• 2/O »: , �., 1 . 2L0 OTHER APPARATUS: '.'.. . ;, .. 1 PAUL R. BURNS _ LIC #3$97 - GL.l)L PO BOX 1061 ,. NAGER SOUTHOLD, NY, '11971 0952 . Thio beHilicate must not be altered Iri grit'manneC'return to flie;gfflce of the.Board If IricoiIoct Insp6Gfors ML y bg IQ9nfl)ied y fhelr cretlentlals M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOJNDATION 2ND [ ] INSULATION [ ✓]/FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ,DATE l�® INSPECTOR 765.1802 BUILDING DEPT. FOUNINSPECTION [ DATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY EMARKS: © ;rt jo it4- ,DATE INSPECTOR i 765-1802 ILDING DEPT. INSPECTION [ ] FOUND ON IST [ ] ROUGH PLOG. [ ] F DATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: ` Lol _ � ? — 4 DAT ' INSPECTOR c aubv a. oau aaV L rvml "A l6 COMMENTS _=�x>x=_x Du I � FOUNDATION ( 1ST) FOUNDATION (2ND) i y _ ttl II II � I � ROUGH FRAME PLUMBING I p N INSULATION PER N. Y. STATE ENERGY y CODE xxaesxsssaxsaexxxs=xxsaxx a a_� =a x=mem--=x=---__ II II � y I N-- ---II FINAL ADDITIONAL COMMENTS: w H x r BOARD OF HEALTH . . . . ... . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . .. . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . .. .. .. . . . . BUILDING DEPARTMENT CHECK . . . . . . . .. .. . . . .I... .. . . . . TOWN HALL SEPTIC FORM . . . . . . . . . .... . . . . . . SOUTHOLD, N.Y. 11971 DEC . .. . . . . . .. . . .. . . . ....... . . . TEL: 765-1802 TRUSTEES . . . . . . . . . . . . ....... . . . NOTIFY: CALL . . . . . . . . . . . . .. . ... Examined... .. ..... .PJ.l ^i MAIL TO: . . . . . . Approved. y� ......pc;)4 .el Permit No. .. ................................... Disapproveda/c .................................. .................................. . ............................................. ....... ilding Inspector) N10\1 2 9 LOGO APP CATION FOR BUILDING PERMIT t „ Date. . . . . . . . . . . . . . . . . 2C. . . . INSTRUCTIONS a. 'Ibis application must be completely filled in by typewriter or in ink and submitted to the IAuilding Inspector w 3 seta of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan sharing 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 application. c. The work covered by this application may not be comuenced 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 any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLIC&TICN IS HLw[M MALI: to the Building Department for the issuance of a Building Penmit pursuant to the Building Zone Ordinanoe of the 71own 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 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 winether�ap/pllicantti(ss owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde .�c- 1 f h.-r---(.Z -r........................................................................................... Now of owner of premises ?0.&E-ee,......./� 1.(L cL-- .... ........ ... .................................................................. (as on the tax roll or latest deed) i If appl' t is a corporation, si of dulythorized officer. .................. n and title of co rafiicer) Builders License No. ...Lt ` �� ....� . Plumbers License No. ......................... Electricians License No. ..................... Other Trade's License No. .................... 1. Location of land on whichhS�proposed work will be done.............................................................. ....�. ... .............�S:.w.:.r:.r�. ......0 ..................,. �fQ� .... .... ............................. House Number Street Ilarul County Tax Map No. 1000 Section .....Q.Q....... Block ....4........ Lot ....A/J......... qq Subdivision .. ...............1A ..I.6.i� L4... Filed Map No. .L �...... Lot ..al ......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy f_proposetl'Ic6nstiaofi-6'R,' )?5 a. Existing use and occupancy .............................................. . dd�,,, b. Intended use and occupancy ... li ::.L .. ....,...,, ,t.hfor�......... hurerduon ........ Repair ............ Removal ... ....... Demolition Other Work (Description) 4. Esi'icmated Cost ...�rLhC7c7U...........}....... fee .............................................. (to be paid on filing this application) 5. If duelling, nuriler of dwelling Units ............ tkaber of dwelling units on each floor Ifgarage, number of cars .......,............................... 6. If business, commercial or hruwed loccupancy, specify nature and extent of each type of use...................... 7. Dimensions of existing structures}, if any: Front................ Rear ............... Depth ................. Ileight ......................... Number of Stories ...................... Dimensions of same structure with alterations or additions: Front ............... Rear ............... Depth .................... Deighq .................... Nuhber of Stories ............... 8. Dimensions of entire new construq tion: Dont ................ Rear ............... Depth .............. Ileight ......................... .Number of Stories .......... 9. Size of lot: Front ............ I....... Rear .................... Depth .................... 10. Date of Purchase ................,..... Name of Former Owner ........................................ II. Zone or use district in which premises are situated ...........................................I.................. 12. Does proposed construction violatie any zoning law, ordinance or regulation: ........................ 13. Will lot be regraded ............',........ Will excess fill be removed from prises: YES ND 14. Names of Owner of premises ......II..................... Address .............................. Phan No. ............. Name of Ardhitect ...............L..................... Address ...................I.......... Phan No. ............, Name of Contractor ..............11.................... Address ...............................Phone No. ............. 15. Is this property within 300 feet of a tidal wetland? * YRS .......... NO .......... *IF YES, SOLIDI" MM 1RUSI�X9 PERMIT MAY BE REQUIRED. PLOT DIAGRAM Locate clearly and distinctly alll buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or descriptiou ing to deed, and slow street names and indicate whether interior or corner lot. NTN SU>P�Ly d— G✓J' 141) TDMIY Or LIQ...... ss :... L.................being duly sworn, deposes and says that he is to applicant Nam Naof individual signing contract) ­T need, i L is the ....... ........ C.rz� . .1....... (Contracto agent, cor�orate officer, etc.) f said owner or oamrn, and is duly aut�iorized to pe:rlonn or have performed to said work and to make and file this pplicatioh; that all statenents contained in this application are true to the best of his knowledge and belief.; and bat the work will be performed in tin manner set forth in the application filed therewith. worn to be e me this Al �... a� ..... :20.6Q.. �a Notary Public . . •........... .. ...... ... ............. �j (Signature of Appl. .c ) NO Ou LYNA IW No 0180 tate Of New II' Oualffled in Suffolk C u Terns Expires March 8,Co -+�.�, T W a N Q � ? •' WZWIOLO �� Iv � Cnva/'Y' • d O .ti F S LL to O Lir f l D CO2inillais b G �wOg z�v� . Cla X14 0S,mite _ Qx_ olLz0zoWI► .+� 3�a> `3�tpZOVzO © � tla( W y ' v1 v12WU�WWZ CIOO roq�` �?Y.cajus o� 3 qG AIL ri .1 W • KIL,{I{i �x�sTia6 2X t?" Liz . 1611 0 .cl . GA�t46C ' &'( z.oX (Loop SHam 41fj& Cho 2 A�►r1°'� r� T PAPr 1L, WAOCk I r 2x4 WAUa STVAS ►b" 6 .c . PROYIIIE�#NR. FIRE + I 1-s- ThL pmrp- NATED SEPARATION M+ INl PART.7'i7.3(# (#;Of (fit=9 c&vA& sr!1AY.cks r Nx STATE eunmm Ix t W!moi ,►4orKca�yT� S C�4 n t, Oil Ct'14n16. �IEG� 14"d " Kt6" •c• �ooz si�� Er-"ATart �y 1)I111�, '1 O1! { Q�C �c MW e.Xcsl i" C•6 u3 - d TO 8� GaJi' sam� ! 6�A� ook � I�►— Ian �IL4,_ b� �} AL RATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF _ fy ♦ 'h. In,� SECTION 7269 OF THE NEW YORK STATE i EDUCATION LAW. COPIES OF T,'S SL,,y NAP NOT BEARING �f 0 ' Y �1 l .• THE LAND SU.V:yCv'S INK.D SIAL OR (E a EMBOSSED SCAL SPALL N[lf BE CONSEDERED'; }v' _ a �, • A`A TO BE A VALID F;UE _ GUARANTEES INDICAND H'R:ON SHALL RUN `� y±`.<:...':" {1 ✓gid - �`�._ , ° A� }t V ONLY TO TH: JE bG,FOR WHOM THE SURVEY _y_ i7 J IS PREFARED, AID 11 Iai&!I-LF O70 THE VF; TITLE COMPANY, vciKR,IMENi AE AG'LNCY AND _ - qg LENDING INST176TION USTSD H.BCON, AND TO THE ASSIGNEES OF THE RENTING INSTI- s star '- TU71ON. GUARAN7ECS A;E NOT TRANSFERABLE ro PCTO ADDITIONAL INSi1TUT1ON5 OR SU6 EQUENT ;h} fi5(JRVI=YcG' F�JF2 Q R ^ 7 C!t� f tank do L�. /Du.c- .t3G� j hb •ate s A T , • `C� . a. ' l� ' 4;. _ ..E) �-- ©� 0,:V . clu�fsr t B � :SS GS: o"W r2' 03 , �h•�_ -'160' ti CG71C �4`QF 1„ ('• Ak, 71C -bo r!-�. -.r ) e14- 17-,17,5T .HALE �A�/ G?n,�<a f = �V c-trve� eel ;^�9 r !/, / 75 L4i„� 74U F? C, evict ct J�rneS, 1972. :,gip., : Tesf tfore 6re`-(,?por-f, slew }! i- �. ,1 - - +� f2r-rA1LA _ - 4 r % I�INy `Iz° iura�> o In o – - — Wit] `/2 ALDnquWAL 2"X4°WALL c5[utilcq -JoIsT-G. �\Llll,, aj I I 4 }L rrc� _ 2Ka_c1 � 2x� JI ScALE3 T- - /4 - I �o cc �EV12 0 0 3/4 ><II /a LvLNr�� – — 0 LL --— — -- - - - -- _ -"�`-�' I��� � i'��� %'„ i' 7• %Axl'IB LCL NEr�-Xa !� 'h�J•i '�•'N(,n".� �- :--,� ..i•G, � � ��^jJy WJP 41 -k - - - - ------ OMry 0,322.54.1 VW A ,. Ii. r-- 1 r•I/iJ� - A 90FEsslo04) N ` — p \ f w V Q �. a