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HomeMy WebLinkAbout26819-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27343 Date: 10/10/00 THIS CERTIFIES that the building ALTERATION Location of Property: 580 SOUNDVIEW AVE WEST PECONIC (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 74 Block 2 Lot 6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 28, 2000 pursuant to which Building Permit No. 26819-Z dated OCTOBER 4, 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 2ND FLOOR BATHROOM ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR "AS BUILT" . The certificate is issued to LONNIE B SOURY of the aforesaid building. (OWNER) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. H-068756 08 02 00 PLUMBERS CERTIFICATION DATED 07/21/00 K&K PLUMBING & HEATING 4 /Au/orized 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. 26819 Z Date OCTOBER 4, 2000 Permission is hereby granted to: LONNIE B SOURY 301 WEST 108TH ST NEW YORK,NY 10025 for CONSTRUCTION OF 2ND FLOOR BATHROOM ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR "AS BUILT" at premises located at 580 SOUNDVIEW AVE WEST PECONIC County Tax Map No. 473889 Section 074 Block 0002 Lot No. 006 pursuant to application dated AUGUST 28, 2000 and approved by the Building Inspector. Fee ; 75 . 00 Autlforf&ed Signature ORIGINAL Rev. 2/19/98 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 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-existing Buildinc - $100.00 3. Copy of Certificate of Occupancy - .25vp 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . .j�. . . . . .2 . 0 .�.. . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . 1:�' : . cc��p Location of Property. . . . .. VnAV5 e.tq' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property.. . .d��. . . .� o�/IVI, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . WT. . . . . . .Block. . n P A 'Z . . . . .Lot. . Q 0 .b. . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No-Q.68.0-t . . . . .Date Of Permit.1A1.060 . . . . . . .Applicant. . . .hUhkLe,. .Soy:�j. . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. H 7.016Y. ZAP. . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $. . .o��.��A:Q. . . . . . . . . . . . . . . . . . . Q • S S 7 7 . . . . . . . . . . . . . . . . . . . . . . . . c o mm a?3 V 3 .APPLICANT . THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 80130►760 BUREAU OF ELECTRICITY i� 40 FULTON STREET, NEW YORK, NY 9003E Dam AUGUST 02 ,2000 Appficadon No. an,ltle 10579700/00 Ji 066 ' THIS CERTIFIES T14AT only the electrical equipment as described below and introduce, h., r applicant named on the above application number is in the pres,ii . u� SCJUF�YDAWN, 580 SOUNDVZEVJ AVENUE WEST T(', NY in the following location; ❑ Basement ❑ Est Fl. ® 2nd F1. OUT sectwr, Block Lor was examined on JULY 27,20W, and found to be in compliance with the National,Eleeerkal coa:= FIXTURE FIXTURES— � RANtiEs COOKINo DECKS VINS ISN VrA" 'rvt� EXHAtUSf FAN! iU1LiTs RECEIIACIES SWlTCNES -01 ►lLOK1eC(NT oTMrli AMT. K:W� AMP, K.W. AMP. I K.w. AMT. j K.m AMt -r N r DRYERS FURNACE MQTORlF-- FUTURE APPLIANCE FEEDERS SPECIAL REVIOT.i TIME CEM LOCKS UNIT HEATERS M II.OUsysn�TLET DIMMERS __r�_�_� BEIt AMT. K W. OIL N.►. OAr M,►` AMT. NO. A.W,O. AMT AMP, AMT -. '=sF TRANS. AMS. M.►. NO.OF FEET &M-y. WATTI SERVICE DISCONNECT ao. —' --- S E R AMT. AMI TYM � 1 0 2W I 1 e Jw 5!SW J•4W NiY. CC kC. —'A.w. _ A.W.. -{ _ _ - rlr 2,-2 0NG. N0.Of XI•LIO Nt, NO.of NILMkA j OTMiR APPARATUS: _--- ------L— • SCREEN PORCH-1 - Z 2.S SECOND FLOOR BATH--1 ANO VISUAL I)EF'ECTS, "An survey has b--n .pari,-, electrical eq�lipment. ;� t.},1- premises Bred �:3'terj ",,, cyb�r crus misat.isfact:�ry ,�c. .j.: ;: was tor_In i. I I Y� Nw L JENNYFER P. ' �� P. 0. BOX 177 GENERAL MANE GREENPORT, Ny, 11944 Thk OdlIcats Myst not bo ai tered In any Mannar,return to the ott+co Of rho Board It Incorrect. 1 - n=peefets moy be Sa�itlfted by their arocs�:rra�a. 765-1802 BUILDING DEPT. INSPECTION [ j FOUNDATION IST [ j ROUGH 'BG. [ ] FOUNDATION 2ND [ ] 1 CATION I 1 FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: _Z7 DATE 0 INSPECTOR AIIA - ZZ UNDAT ION ( I ST) 11 II if----- II .1 II UNDATION (2ND) __________________ ________I ====___________________________________________________ UGH FRAME & u u PLUMBING t�— u H SULATION PER N. Y. H Nt STATE ENERGY i H CODE u " u © n crD t� u i FINAL --u n ADDITIONAL COMMENTS: ti O y H z ra --- b C= Town Hail, 53Cq5 mam riozvj fA r O. 179 76518':-r 8':-' saulhoo, Ne., 0* 4,- OFFICE OF THE BUILDING 114SPECI-OR TOWN OF SOUTHOLD c T I F I C A T 1 0 N DATE Build.inq Permit No - Owner: (pleas rint) F-1 Plumber. �j�1� � � 1 �y�f (Please pri I certify- that the so."'der used in the ',4a"r supply system, contains less than 2/10 of 1% lead., /7 —(Ph�mbers Signature) sworn to betore rr'o "L41'Is day o Mor-axy 0 n t.Y JOYCI M."LKjN8 CiY N NWW Sh"Of hie*York 40. 952246.Sufff*CourdV. I certify that tree zcj-u�A. BOARD OF HEALTH . . . . . . . . . . . . . . . -FORM NO. 1 3 SETS OF PLANS TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . .. . . . . . .. TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 DEC . . . . . . . . . . . . .... ... . . . . TEL: 765-1802 TRUSTEES . . . . . . . . . . . . . .... . . . . . NOTIFY: CALL . . . . . . . . . . . . . . . . . . Examined..�d��.........., itl.... ��}} Q p MAIL TO: . . . . . . . . . . . . . . . . . . . . Approved../o/S .........,2a oc: Permit No. �C 0R 1.1. .... ..... ............................... Disapproveda/c .................................. .................................... .............................................. ...... ........ .(Building Inspector) r fi APPLICATION FOR BUILDING PERMIT Date . . . . . . . , 2G.q!:. INSTRUCTIONS a. 'This application'--asst be completely filled in by typewriter or in ink and submitted to the Building Inspector wit: 3 sets of plans, accurate plot p an to scale. Fee according to schedule. b. Plot plan siring 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 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 any purpose whatever until a Certificate of. Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MALE to the Building Department for the issuance of a Building Permit pursuant to the Building Zane 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 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 7buildi for�neeccessa inspections. x.. •(Signature of licant, or name, if a corporation) . o.... Qun . . s7.- (Mailing address of applicant) •. G State whether applicant is owner, lessee agent, architect engineer, "9�`� app age ng general contractor, electrician, plumber or builder. ...........D Ok �............. ... ......................................................................... Name of owner of premises ....�P , Le, .S w.r ............................................................... (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. ......................... Plumbers License No. .V2 3.�!:j.-..f'+.k.-Plum)a 1�Q Electricians License No. .354,3CC.:E.......$A6 e, r���,`��'t l✓ Other Trade's License No. .................... 1. Incation of land on which proposed work will be done.............................................................. .........$........................... ,;a House Number Street Hamlet County Tax Map No. 1000 Section ...... .�L...... Block ...a .......... Lot . ............. Subdivision ...................................... Filed Map No. ............... Lot ......6....... (Name) 2. State existing use and occupancy of premises and intended use and occupancy ofiproposed.copgruction: a. Existing use and occupancy ........DA. e—.Cl4An d.�............... ........................:...... b. Intended use and occupancy !':AA�eq................................................ .............. .......... ................ 3. Nature of work (check wumieh applicable): New Building .......... Addition �!(IN.... Alteration .......... Repair ............ Removal ............. Demolition ............ Other Work .................................. (Description) 4. Estimated Cost � .5� ..�.. •1....... fee .............................................. `` (to be paid on filing this application) 5. If dhaelling, nxtnber of dwelling units ...../...... dumber of dwelling units on each floor .... .......... Ifgarage, number of cars ...................................... 6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use...................... 7. Dimensions of existing structures, if any: Front................ Rear ............... Depth ................. height ......................... Number of Stories ...................... Dimensions of same structure with alterations or additions: Front ............... Rear ............... Depth .................... Height .................... Number of Stories ............... 8. Dimensions of entire new construction: Front ................ Rear ............... Depth .............. Height ......................... Number of Stories ..................... 9. Size of lot: Front J.QQ............. Rear ..].,3;? ........... Depth cR-7............. 10. Date of Purchase .p21k/l-AM7... Name of Former Owner .V.�?1JI41. .......... II. Zone or use district in whidh premises are situated .............................................................. 12.`- -tkues proposed construction violate any zoning law, ordinance or regulation: ....r1 o............... 13. Will lot be regraded ....... I ......,...5WWiill excess fill be removed from premises: YES NO 14. Names of Owner of premises ...�Y?.Vk Q.. QUY. ... Address "P-?0..�J.0.Qrfm��e/sQr.C1....... Phone No. /. Name of Architect .................................... Address .............................. Phone No. ............. Nameof Contractor .................................... Address ...............................Phone No. ............. 15. is this property within 300 feet of a tidal wetland? * YES .......... NO ...... *IF YES, SOLMM IUM MOMS PERMTT MAY BE WgHRED. PI.OT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. � '-s � ,� STree"C#� 5e0 �wecc) Mtvm lot 3 r c� srnn, a raw W-AT, SS t7pl1N1Y (A' ....... .................. Q �. ... d U r 7 ..............be.ing duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named, Ileis tlhe ............. OW ........................................................... ........... (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 Lhat Lhe work will be performed in the manner set forth in the application filed therewith. Swornt(oo b,Qefore me this C1 a oo-,Lk Q Notary Public .........�... ........... ............ .. .. .. LYNDA M.BONN (Signature o ppli. t) NOTARY No. LIC,S ate of New York Qualified in Suffolk County ' Applicant/ ` Date Owners Name.- i c��(l n� 1(t� -� �� Reviewed: Architect/ QQ Date Engineer: Submitted: o SCTM 1: y District: 1,000 Section Block: Lot. Project \f' Subdivision Location: S!R Single& separate Requlre certification (Yes ! o Rcy. Req. Toning Dutncr Jl,ot size Actual�� �/��sFJ ILot coverage Propuxd q9 9 [t wont Yard Proposed: /t'�L I [S de Yard Proposed ] [Rear Yard Proposed ) Project Description: // ^ A 12"' AGENC)VERMITS Permit REZUIRED FOR REVIEW N.A. NO YES Number Suffolk County Health Dept. New York State D. E. C. Town Trustees Town Zoning Board approval: ✓ Town Planning Board approval: Flood Plane Elevation ??? Flood Zone: Notes: Lof �s !SLrn— Xe C. v Car cF -j - i ti , i I i 1 r rG ' PROVIDE ANTI- CALD AND/ - APP , THERMAL SHOC PREVENTING, DATA ART �90� S• :Y STATE B DING CODE::._ FEE: BY NOTIFY 0 DEPARTMENT 02 ATS Z 1 2 785-188 TO PM FOR THE' z_ .- I __1-_moi---?",-------- FOLLoWIWNS: - - o _ N 011l OPE INGS FOR 1 FOUNDATIN TWO REQUIRED E SCAP FOR POURED CONc��$ _ 2. ROUGH - FAAMtr+t� 3„ 2„ ?�- o � .8i� 7W U DS SSG T. 714 OF 3. INSULATION: N . STATE 6UI DING CODE. 4. FINAL - CONSTRUCTION MUS :301 ? ' BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL THE REEOUI EI�AENTS OF THE E YT a .. f" s Ie i ' �c/ria�sf STATE CONSTIRUCTION & 00 If 1 h' �if�..�i4• fA•✓ CODES. NOT RESPONSIBLE FORv T DESIGN OR CONSTRUCTION ERRORS '" LA UE"'tfT�¢p@�Q Y w k v k 4 '"b+s 9i ERWR>T>� r, 10AS CERTIFICATE U ND , REQ IRED 'ER . 10Y a d I MNLY tEll 1/9 C ON r , OF N E -d PAV 5� If copper gibing is used,, ���'�� �` `A��rl� E'I-U5iC �. ' Y,3 TEM! for water distribu inn , :' .. ALL+`'LUI'v`iSINGASTM w system; piping S11811 e c^ �v &WATER LINES NEED 2 a Z TESTING .F , of types K;or!.or�F / G sE ���E cc�v�� 0 1 v �li"i —, 1 52 � RoyES NPS - : UNDERWRITE CI _TIFICATF REQUIRED To the best of my knowledge, belief and professional judgment, these plans are in / ys�!�os compliance with the New York State Energy Conservation, Uniform Fire Preven- tion and Building Codes. i �p tw'tt T is � •r�k _ _ __ .5d' _.� ` tAtY ' ' M ,• V i i lrl'r X90 � �• .t3 . /e �1 a � r a� ►�.. / �-.•�' � i . � . 1 , , 1 ..r�i ♦..+� _. � ` f ttrr�••!hcrbr•9�N+1rfRfM1 K e4''MtrM1 i "ft SLW"w iE a VICW 0"of ,-, ^;l .... .� • ✓ 7Ar41tftoNetsYwkft" i4ffK,Rffen LAW. ` d'S' M emboarad*@A OMN net bo tiorONO W ; to be t VaNd frno year. :> �, ` �- 1► f3uarenlCCt1 btlf "d lw om 4"fm T - to b*ow"n for VAMI to owvey 'l- 16aQ �_ fJ •�- :..J ; '`�',.;:,.'!,�"�. J( ,. ... i ;��';•`'f::'. .j� �orArad•tlW an tie behsff is ft W4ne.WnOftom Swed horoon ond ii :tie• �+•' •S' `. ... ~ .•r'�1 '( to the atiWWMof*W$"ReinWi- � union.Csaotonteoe aro not irwWareWe cr x v bnel ino*i?uWns er suN-muent 1:7C3. pp NE 6L)i i.'r �..t C_t -rte ,�r:. ` . ►,.. �_i V. JUNE 24 , b LANA`'�