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HomeMy WebLinkAbout26511-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27646 Date: 04/27/01 THIS CERTIFIES that the building REPAIR Location of Property: 1755 YENNECOTT DR SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No_ 473889 Section 55 Block 4 Lot 21 Subdivision Filed Map No_ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 19, 2000 pursuant to which Building Permit No. 26511-Z dated MAY 19, 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 FIRE DAMAGE REPAIR TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate :is issued to THOMAS & LORI RUTHINOSKI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 100865 04/20/01 PLUMBERS CERTIFICATION DATED 04/13/01 RICHARD R. KIMER aa'— k'L� Authorized S' nature 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. 26511 Z Date MAY 19, 2000 Permission is hereby granted to: THOMAS RUTHINOSKI 1755 YENNECOTT DR SOUTHOLD,NY 11971 for FIRE DAMAGE REPAIR AS APPLIED FOR. at premises located at 1755 YENNECOTT DR SOUTHOLD County Tax Map No. 473889 Section 055 Block 0004 Lot No. 021 pursuant to application dated MAY 19 , 2000 and approved by the Building Inspector. Fee $ 75 . 00 Author ed Sign ture ORIGINAL Rev. 2/19/98 Form No. 6CaP ?j1 970,6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL I, 765-1802 } APPtICATION 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 17 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 Buildina - $100.00 3. Copy of Certificate of Occupancy - .25r9 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . .. . . . .f. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . GG �O�ld Or Pre-existing Beuilding. . . . . . .i. . . . . . Location of Property. . !9F . J�Ii� GE � rr'b,1pg . . .JU1� SOL .I. 1�. .,59��1 . . . . . . . . . . . . . . . . . . . . . . House No. p� Street Hamlet Onwer or Owners of Property.� S. tk 1�C7� '�yJ . County Tax Map No 1000, Section. . . . . . . . . . . . . .Block. . . . . . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. . . �I'R. . . .Date Of Permit. . ��I1D� . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . .. . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . I . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Fi Certicat . . . . . . . . . � Fee Submitted: $. . . . . . . . . � n (9' .58363 . . . . . v''`ia . . . . . . . . . . . . . . . . . . . . l?r > Co � d7)64r APPLICANT APR-13-2001 15:15 L R STRUCTAL 16314712505 P.02 S11fFOt,��, Town Hell,53085 Main Road Fax(516)765.1823 P.d.Box 1172 Telephone(516)765.1802 Southold,New York 11871 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O Nn DAT$• V 1 <)� Building Permit No.(� Owner: !Gy 4L1J10�41 7Nan1 M (please p�t'ibit) - Plumber. U�P� �u /G 1lanC� (please print) I certify that the solder used in the water supply system contains less than 2110 of It lead. (Plumbers Signature) Sworn to before me this � �3 day of i""",C`� }/� Notary Public, � 1 -fo 14 County DIANE A.SAELI-FOX PIC 1.1% PUCLIC.State of New York No. 5003213 QuatifJ in SuffokoC County O Z Commission Expires TOTAL P.02 STATE OF NEW YORK ) ) ss: COUNTY OF SUFFOLK ) �0 A _ being duly sworn, deposes and says: I.�,� T at deponent is over the age of 18 years and resides at That on thy: -C¢- day of t-OVWPV*-, , 2000 deponent architectiengineer, licensed by the State of New York, hereby states that s/he accepts full responsibility for the accompanying plans compliance with the New York State Fire Prevention and Building Code (9 NYCRR); said plans pertain to property located at SCTM# 1000- -0� - a b street address j X55 L 1 �Up�tj i ly I I� frchil ect/Engineer S orn to before me this of�, 2000. 7- I f J Notary Public Nov - 6 2000 RUDOLPH H.BRUER NOTARY PUBLIC;STATE OF NEW YORK N!1.52-0465530,SUFFOLK COUNTY COM AISSION EXPIRES Mf,RCH 30,ZC61 cc: Applicant 765-1802 BUILDING DEPT. -, NSPECTION [l� ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ' z22294#1111 DATE /� INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ IGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLA CHIMNEY REMARKS: (ov�� DATE INSPECTO X66// 7W-1802 BUILDING DEPT. 1 NSPECT10 [ ] FOUND ION IST [ ROUGH PLBG. ( ] F NVIATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS s ,DATE O -INSPECT O 765-1802 BUILDING DEPT. INSPECTION [ FOUNDATION IST [ ] ROUGH PLBG. [�] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE S CHIMNEY REMARKS: t C ` ;DATE j INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING A [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ` y DATE d/ INSPECTO 765-1802 - BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I ATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS% DATE �/D INSPECTOR LONG ISLAND ELECTRICAL INSPECTION SERVICE, INC. 670 Middle Country Road • Saint James, NY 11780 Tel: . 631) 265-3075 Date 04/20/01 Application No.an File 100865 Building Permit No. THIS CERTIFIES THAT our local dUnbict impeew conductadan inspection of the visible portion of electrical installation described below and intradaced by the applicant named on the above applimlim in the premises of TOM RUTHINOSKI 1755 YENNECOTT DRIVE SOUTHOLD in thefollowing locations; ❑ Basement ❑ let Fl. ❑ 2Zd Fl. ❑ Outside Section Black LEA wasesambEadon 04(13/,01 found to be in camp mance wuh the current edition of the National Electrical Code. ❑ this certificate may be accepted"a"letter of Approval"that all circuits are in goad working co dUum,not overloaded,and ad wiring,fwares and other electrical equipment are in stoadord condition. FIXTURES RANGES COOANGDECNS OVENS DRYERS FNP as SNITCHES RECEPTACLES GR gMYEM1 INCANDESCENT FLUORESCENT I HID, An. SZE I ANT. WE AMT, SIZE AER. I SZE EXHAUST I PADDLE 40 1 60 10 45 1 DMI LAUNDRY HEATNGEOUIP.NDTmi EIUT EMEN. SUB FEED TIMER TRANSFORMERS 'AIG EQUIP MOTORS`" GENERATORS -' ANT. SZE AAT. WE AYE. N.P. SCANS LIGHT AMT. SZE AMT SZE WT--r-AIF--r TYPE AtR. N.P. AVT. SZE 1 1 3 r"r1Y POOLS MICA) VIATERNEATERgypE TPACX ELECT SERVICE INFO ABV ❑ NOT DEFECT LTG TEAT SNIGIF EALTI. CONDUCTOR NO,OF TUB ❑ ANT. SZE AMT. SZE ORS BFT. TYPE AMPACRY PHASE REAP VOLTS 517ESTYPE METERS ON x gun ❑ roo ❑ 1 H 1 w 150 1 a H OTIERA"PAAR'S'2-40A 240V A/C Condensers TIME DeRbcata IS not ki Wended as an approval or 9unrontee of 6w"1 -20A 24 Q V Air Handler eBlden w4wvws rieelecmcW emwWinstaktionasofdttw. w «di wa�PIR w d Upon to ttlrodction of addioonl equipnlam a ahenntbnc,appliatim Shall be wwt0y made kx inpwwn. ELECTRON OCPING '; 9 SHAMROCK RAD ROCKY POINT, NY 11778 LIC#4435-E R a V MTF-ORIGINAL COPY YELLOW-MUNCIPAL COPY• PW-AGENT COPY• GOLD-OFFICE COPY LOT P/O LOT 3f w 55• °"' ,r airs w�• . g.I LOT s1 p. p�j LOT 31 NN 1^w S " T 32 C LOT 1" M1 M1 y Q r V vl V r y 1 pl Fn• o " 1 ro rzs.oD' 86 B p6 _ i S. 65"42'°0' W. ORI VE YENNECO T T SURVEY OF P/O LOT 31 "YENNECOTT PARK" FXW OCT..9.1968 ME NO.507 AT SOUTHOLD TOWN OF SOUTHOLD CERTIFIED TO, SUFFOLK COUNTY N. Y. THOMAS RUTHINOSK! , LORI A. RUTRINOSXI 1000-55- 04-21 VERNON GL XD GUILD Scale: 1Y+- 40' FWEU LNATIONAL TITLE INSURANCE COMPANY OF NEWYORK Sept. 26, 1995 Oct. 14, 1995 S•�Q'`NOI.ME toYOjJf AREA =29,105 sq.ft. µKG7Y09AE'M YSTf TEb LiW ( '�7" Ian} I, �,�+is rte secrxw nos-snv z.�c�xrrx.A'rnws � P,/��k.i, .L+� S. LIC. NO. 49618 �tYl'gViuPM ia�wcsrw6AL St.1Pwf'aP WTIR? R P.C. (31LY TO CCYwLY WIrH SA1D LAW T/,E TERN S4TERE0 BY' P. OT e¢LusFn aY.wY uo N.L u.wvEY Urxuwc F torr 123ET OF ANOThlSr suevEYpws u..r. rorus s As•nsrEcrEo•AAC SOUTHOLD, N.Y. 11971 slWLWT-rO AFV ARE Nor N LCIFLlANLE wail TW CAW, 95 - 246 i i 1► 1 1 1 W'�•�� _� _i - -� moi_-�4 / _ � �_ ,��,� ����_"_�i/ _ �. J/:".3✓1�I /. BOARD OF HEALTH . . . . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . MAY 1 9 V BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . ! SOUTHOLD, N.Y. 11971 j PLD3.GePT. TEL: 765-1802 NOTIFY: TOWN OF SOUTHOLD � CALL . . . .tf^. �. Ermined. .�/9... 10 M.A.I.L. TO: . . . . . . . . . . . . . . . . Approved.. .... 4 / VPermit No. . � " " ' ZZ Disapproved arc .................................. ...... .......... ............. ...................................................... Zu!�in- or) APPLICATION FOR BUILDING PERMIT n INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Ntilding htspec 3 sets of plans, accurate 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 Pohl streets or areas, and giving a detailed description of layout of property mist be drawn on the diagram which is pat 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. 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 Co-rtificate of Occupancy shall have been granted by the Building Inspector. APPLICATICN IS HEREBY WUR to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Tam of Southold, Suffolk Canty, New York, and other applicable laws, Ordirkmces o, 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 build' for (n ssaJ i/nsptr.t'ionns. e BINO S,fLUMNSWAft Signature of applicant, or nm , if a corporat uNDERWRITERSCERTIFlCATEWATER LINES NEED /+y 55.. 'RENUEDIESTprG SUM COVERING (Mailing address of applicant) State whether applicant irl w r lessee, agent, architect, engineer, general contractor, electr�icciiaan,7lIiILnher or .....1...................................`...... ..... % a a�wttru . Nme of owner of premises ....'�ILLO...�61�.I.......... ..f•� ;G:1: , . .. . (as on the tax roll or latest deed) FEE_ BY` NOTIFY BUILDING DEPARTMENT AT If a�camns a rorporation, signature of duly authorized officer. 785-1502 9 AM TO 4 PM FOR THE FOLLOV NG INSPECTION'.•••• ••-•-•••••••••• 1. FOUNDATION • TWO REQUIRED (Name and title of corporate officer) ��+� /�•CI QI� FORPOUREDCONCRETE �UA�S'��(�{� CERTIFICATE E• IS UNLAWFUL S NSULATION�MINQ A PLUMBING Builders License No. ...........•YFI�+ 4 FI COMPLETE TRUCT ON MUST Plumbers License No. ............ -•••-•••••OF O0XUPMCy ALL CONSTRUCTION SHALL MEET Electricians License No. ..................... �/ THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION A ENERGY Other Trade's License No. .................... t� ( CODES. NOTTe, ESPON�$I�SL�I FIR 1. Location of land on which proposed work will be done....(.,1. �. �C iB � '1^ '�. ."!.... .......................................................................................... ... ... ... ... .. . ... ... .. . House timber Street n Hanlet County . Coty Tax Map No. 1000 Section �e:')�. ion ... . ....... Block .....(.......... Int ..2�.. ... ..... Subdivision 4e.K.O.�t1:ati� J 1.................. Filed Map No. .... ........... Let ... ... .. . .. . . .. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed roost ruct inn: a_ Existing use and occupancy ..'!kmc.......'r�.—Y-� �tS c b. Intended use and occupancy ... .........-_J,�E(r�as....................... ...... .. .. .. . ......... fi 1Jr 3. Nllure of wck (dbecdr which applicable): New Ikiildi n ..... Addition .......... A [enation ........ 1` +e pair . .. .. .. .... Removal ............. Demolition .......... Other Work .................. ...... ... 7 (DescriptionT- 4.4. Est hTUtal Cost . .. ....................... fee ...... ............... ........ (to be paid on filing this application) 5. If ckoelIing, ixuber of dwelling uniyts ............ Number of dwelling units on each floor ................ Ifgarage, umber of cars ........lam.......................... 6. If Ixrsirx:ss, rYnnrrcial or mixed occupancy, specify nature and extent of each type of use...................... 7. Diinensionu of existing structures, if any: Front................ Rear ............... Depth ................. lkrigirt . .. . . . .. . . ..... .......... Nniber of Stories ...................... Dimensicxbs of sane stricture with alterations or additions: Front ............... Rear ............... Ik pUr . .. . ... . . . . . ... ... .. Height .. .................. Number of Stories ............... 8. Dinrnsions of entire new construction: Front ................ Rear ............... Depth ... ... ........ Ikr4ri . ... . ..... ... ...%........ Number of Stories ..................... 9. Size of lot: Front —.4a ...... .... Rear .................... .De th .................... 10. Dote of hirchasc ..'til: .:? ........ Name of Former O�wlner ... .�1.L .S........................... 11. Zone or use district in which premises are situated ..!7 P����l,��. ......................................... 12. Skies proposal eobstroction violate any zoning law, ordinance or regulation: .:v©................. A:13. Will lot be regraded ...A:.../............ Will excess fill be removed from premises: y' YM y 14. Hanes of 0.mer of premi ses{�ThpYnf l•4`!"��!�4i':)I. Address ./`7 Sax C<'/!%4��` l... '•Z: Pt e�iE...S/�.` Nzale of Architect ......IvA--FethrO................. Address .............. Phone No. ...... ......... ................ ..... Name of Contractor .. ................................. Address ...............................Phone No. ........... 15. Is this property within 300 feet of a tidal wetland? * YES .......... NO ...:�.... *IF Yl,-,S, "11101D TOIdI TRUSIM-3 MMIT MAY BE MgnRED. PLOT DIAGRAM Icbcate clearly and distinctly .all buildings, whether existingOr ; proposed, and indicate all se[-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or comer lot. Y 1rle GPC6CA 01)�.d CuLtVI 431A2?AJA37AW i &F�1;r23t;��At3938 r7NIT8�1° � CiflHiA3A 3i;% NOT Uq 16 OT 1AA @ 3T3R�•r+OJ' +Jfi � �� f��wl� ti �` ;a?1NLt.IQ i$iIiFAAt11 Ft 1 S �° ,'';' A. 'ZU 0"I ` SPAII (A' NW WWI( t.��.;31 AIU330 ._'»,�Irt 114 �.( IT.. . ............—Le in% duly sworn, deposes and says that he is the applicant alxrwe'`na�ed�)119$ �+.D913�R TUot .�s.:- :a Ile is Clio .. JrG rn:Q �L.l)✓l�q (C<mtractor, agent, corporate officer, etc.) of. said Owner or o+nx:rs, aml is duly authorized to perform or have performed Ube said work anal to make and file this application; that all statemnts contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the banner set forth in 011e application filed therewith. 'kcorn to/ t(beefore lips r this. .... . . . . . .. n of ... . .... .. . .. 29.&J Notary Public ... . .. ...f...................... Ly� JOYCE M.VALKINS �(Signra of ican Notary Public,State of New York •-- • %' No.4952246,Suffolkmy Term Expires Junel2�OO/ //✓>� L'(Q/�/lit