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HomeMy WebLinkAbout26588-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27407 Date: 11/15/00 THIS CERTIFIES that the building ADDITION Location of Property: 1425 STANLEY RD MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 106 Block 8 Lot 9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 5, 2000 pursuant to which Building Permit No. 26588-Z dated JUNE 16, 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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DANIEL & KAREN LISS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. H-069806 11/03/00 PLUMBERS CERTIFICATION DATED 09/07/00 DANIEL LISS s y hor' ed 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. 26588 Z Date JUNE 16, 2000 Permission is hereby granted to: DANIEL SALVATORE & KAREN LISS 1425 STANLEY RD MATTITUCK,NY 11952 for CONSTRUCT ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. at premises located at 1425 STANLEY RD 14ATTITUCK County Tax Map No. 473889 Section 106 Block 0008 Lot No. 009 pursuant to application dated JUNE 5, 2000 and approved by the Building Inspector. Fee $ 75 . 00 Authori e5 Signature ORIGINAL Rev. 2/19/98 ' Form No. 6 119-4 _ - TOWN OF SOUTHOLD BUILDING DEPARTMENT r y 9TOWN 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 ofFire 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 0xx_ pancv - 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - .2%A 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . ./..O/��UO. . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . . . . . . . . �/ S o1� Se c 2 Location of Property. . .!``? 5. . . . . . . . . ST?3�/L .�.0 . . . . . . . . . . [ �. . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property. .Qan;e l S , + �o,t?. , A , L *,s S qq, County Tax Map No 1000, Section. . (?. . . . . . . .Block. . Q! . . . . . . . . . .Lot. fl�y. . . . . . . . . . . . . . . . Subdivision. Se . .�nt?��5. . 5�� . .�// . . .Filed Map. . . Sy�l .(.�Lot. . . .a�s. . . . . . . . . . . . . . Permit No.P6�� . .� . . .Date Of Permit. .' //G/?000 „Applicant. . .VgnQ-1. . . 5. .�:SS . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . yyr Planning Board Approval. .l.. . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. ... . . . Final Certicate. . .C.�S. . . Fee Submitted: $. . C. .... . . . . . . . . . . . . . . . . . . . 6ZpG• . 7 S "."' ' .�oa n . . . . . . . . . . . . . . . . . . . . . . . . . . . . S co-27,0 q0 9 APPLICANT o�oSUFFoc,�c ~� OGt Town Hall,53095 Main Road p !� Fax(516)765-1823 P.O.Box 1179 y x Telephone(516) 765-1802 Southold,New York 11971-0959 O BUILDING DEPARTMENT TOWN OF SOUTHOLD November 3 , 2000 Mr. & Mrs . Daniel & Karen Liss . 1425 Stanley Rd. Mattituck, NY 11952 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons : XX An application for Certificate of Occupancy is not on file . (Enclosed) No Underwriters Certificate on file . XX The check is (not on file. ) $25.00 No Health Department Approval on file . No final inspection has been made . No Plumber Solder Certificate on file . (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 26588-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. -- a Town hall, 53095 Main Roa6 N Y Fax (516) 7G5.1823 P. O. Box 1179 � � � 7olophono (516) 7G5,1807 Soulho(d, Now York 11971 �- OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE: !�17,7rwo Building Permit No . 7, Owner: L.SS (please print) Plumber: 00,n � E�- L � 1SS (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers Signature) Sworn to before me this day of i§-- I'JXNotary Public, County ►AlgIC1Ai91G1ERf NO"Pd* StMe of New Yak Na 90.4741154 "Ifedin n ' Cammfssieston P.lcpirea/ STATE OF NEW YORK ) ss: COUNTY OF SUFFOLK ) .Sot/n-) �oIJ21D , being duly sworn, deposes and says: That deponent is over the age of 18 years and resides at /7GZ5- �i :5f3EEE FO> A!24 'I && That on the _4;�; day of Ji�,tJ6 2000 deponent architect/engineer, 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- '773 $ 9 loo. - 8— ,7/ street address Rd. /)'h ff ,-fuJ.A)Y /i9SZ `h tect/Engineer worn to befgre me this day of J vrvC , 2000. Notary Public cc: Applicant MEiAME Y.IWM Notary Pubk MW of Nrr Volk No./601712 QWMW 1rc«Ar�00 I nmmlpion Epiw f)ot 19, 765.1802 - BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ROUGH PLBG. [ ] F UNDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: " DATE 3C INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE/& CHIMNEY REMARKS: A/r r DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] OUNDATION 1ST [ ] ROUGH PLBG. [FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: DATE 1, a-4( 60 INSPECTOR 70-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ AL [ ] FIREPLACE & CHIMNEY REMARKS;, C�o �— Co DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION ( ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: A4 _ C C� DATE l � INSPECTOR k 1 THE NEW YORK BOARD OF FIRE UNDERWRITERS P=.13E 1 SO8i%C, BUREAU OF ELECTRICITY F 40 FULTON STREET, NEW YORK, NY 10038 Date C' £JASPER 03.2@rd0 Application No. an file 1 'B to X04/F>3 H 069806 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of N?FEN LISS, 1425 STANLEY ROAD. IMATTITUCK. 1St' in the following location; U Basement KI 1st Fl. ❑ 2nd Fl. OUT Section Block Lot OC )BER 30: ± was examined on artd found to be in compliance with the National Electrical Code.- FIXTURERECEPTACIFS FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES INCAPIDESCENTI FLUORESCENT I OTHER AMT. K.W. AMT. K.W. AMT. I N.W. I AMT. I K.W. AW. I H.P. 15i5 ° 1 I F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET DIMMERS SYSTEMS AMT. K.W. OIL X.P. GAS H:P. AMT. NO. A.W.6. AMT. AMP. AMT. AMPS. TRANS. AMi, N.P. NO.OF FEETAMT. WATTS r L r SERVICE DISCONNECT NO.OF1 S E R V I C E L METER HO.OF CC GOND. A.W.G. A W.G. AMT. AMP. TYPE EQUIP. 1 0 3YI 1 0 3W 3 0 3W 3 0 4W PECO OFC..GOND. NO.OF HI-LEG OF HI-U6 NO.OF NEUTRAL$ Of NEUTRAL E L F c OTHER APPARATUS: E E E PADDLE FAN- 1 G G.F.C.Ir-2 S110iX DETECTOR: E E n c E - E FAFEN LISS L LE 1425 STANLEY ROAD E MTTITU'CK, NY, 11952GENERAL MANAGER EPer E This certificate must not be altered in any manner; return to the office of the Board it Incorrect. Inspectors may be identified by their credentials. E COPY FOR OUILONG CEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. FIELD INSPECTION RPPORS' •* DATE COMMENTS R --------------- ___________________________________==`-- c-------- ------------------------- 11 7 z c FOUNDATION ( 1ST) n �� -- -- -- --- -- -- a _j _ II C V _h__ II --Y-- It FOUNDATION (2ND) if -- -------- ---- --- ----------------------------------------------- ------------------------- ---------- ------ -------- II ROUGH FRAME >r n PLUMBING II —II c — II if INSULATION PER N. Y. 1 STATE ENERGY ENERGY CODE n ii ii --- ---------- ---------- II H TT_�11 c II The P New York Board of Fire Underwriters is in the process of issuing a certificate of mss_ compliance for the electrical installation =_===ADDITIONAL—COMMENTS: ----------------------- as covered in an application noted below, The certificate will provide detailpf the items inspected on _ 6 / ?U /GG and certified to be in compliance lth the National Electrical Code as of that date. 4/19 ' du (Application Number) `_7 ) (Location)) -- (Inspector) ro I BD(Rev. 01 196) BOARD OF HEALTH (1 Jlr� 'nnR FORM NO. 1 3 SETS OF PLANS . . . .. . . . . . . . f' TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . .. . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . .. . . . .... . ... . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . .. . . . LD SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: O p CALL 1?J.9 ��!61 Examined...//.�. ... , 20.... 7/ Cp MAIL TO: . . . . . . . . . . . . . . . . . Approved..�J G ......�v D. Permit No. SSC n..J 9. ... .............................. Disapproveda/c ...................... ....... .............................. ................................... ...... ........... (Iiuildi I for APPLICATION FOR BUILDING PERMIT Dace. . . }/Zy. . . . . . . . . 20 INSTRUCTIONS a. 'Ibis application must be completely filled in by typewriter or in ink and submitted to the Building Inspect, 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 publi, streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part 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. S, 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 UEREBY MME to the Building Department for the issuance of a Building Permit pursuant to the Building Zane Ordinance of the Tam of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regalations, 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 rpgulations, and to admit authorized inspectors on premises and in buildi for necfssaryjnspections. y (Signature of applicant, or name, if a corporatio, (Mailing address Of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bu � W/Urk ..................................................................................................................... Name of owner of premises V/4 U Je C V-.xl9f� ........................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ............... . ..C:.......... .................... (Name and title of corporate officer) Builders License No. ......1.��1://.. ,eQ............ Plumbers License No. .....J.:..l.............. i Electriciamq License No. ... Q.......... Other Trades license No. ...l:../.:.......... 1. Location of land on which proposed work will be done........................................................... . . . .............................. House Number Street Hamlet Camty Tart Map No. 1000 Section ......(R6..... Block .... ........ Lot .XGV......... SubdivisionSUnSQf: !C✓UvtLs� .S,�-C',;L Map No. 3yy.&....... Lot ..Cr'iO........ --.......... ...... Filed .. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy - /� PS r ��cC' ............,.t�.......��...//....................................................... b. Intended use andoccupancy ...........9`-:�S_,..�IYI c C............................................... .. Y -I -::WX ?!!CiH '. 3. Nature of work (dnedr whicu applicable): New Building .......... Addition ...L/Alteration .......... Repair ............ Removal ............. Demolition ............ Other Work .................................. /c7 (Description) 4. Estimated Cost (.�..d©........... fee ............................. ............... (to be paid on filing this application) 5. If.draelling, nnniher of dwelling units ......1..... tkmber of dwelling units on each floor ...../. Ifgarage, nuber of cars ..............f...................... 6. If business, comercial or mixed occupancy, specify nature and extent of each type of use.......N.d.......... 7. Dimensions of (existing structures, if any: Front........... Rear ...fS........ Depth ......%......... Height ?....... Nmber of Stories .......!.............. Dimensions of same structure with alterations or additions: Front S:r....... Rear ...:.��.� Depth ....��... .?.......... height .... -F.t ./0:17 ... Nnber of Stories ..//.. . 8. Dimensions of entire new construction: Front .... 6........ Rear ......L.6 Dep `� 9' S Height .......&2.7," ........... Number of Stories ...... ............. 9. Size of lot: Front .....���:.��....... Rear ... /! ........ Depths......�, �........ 10. Date of Purchase .... /.� .�'..... Nave of Former Owner ..19.!4 l..Xk'q1-ty.. 11. Zone or use district in which premises are situated ...... �5:l,�Pyt.f.h.Q.l...................................... IZ. Does proposed construction violate anry zoning law, ordinance or regulation: .......!�.............. 13. Will lot be regraded .....89.2.......... Will excess fill be removed from premises: NO 14. Nares of Oaner of promises �4n:�+ f CVC?.� ..._. Address L .5 /�?NCt'y'X'cF' uFh uc N'I rr9S`-a98—/965 No. ............ Nae of Architect .............. ' e................. Address ......411.0....A.✓'�................ Phone No. ./.1/l.4..... Hare of Contractor ,�dlf' .. Address ..... .....................Phone No. .N/.!..... 15. Is this property within 300 feet of a tidal wetland? * YES .......... (*1.......... *IF YES, SOiIHT%D TOM TRUSIMS, PE14rT MAY BE REWIRED. PIAT DIAGRAM locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set—back dimensions from property lines. Give street and block ember or description according to deed, and show street names and indicate whether interior or corner lot. Nr.tr F r�r l4 V iteiv k a � M .p ur.ir SI'n'[E or Nti1UOvo sd4Lf'OIclY OF1 ............ ..................beim duly sworn, deposes and says that he is CEhe applicant (Name of individual signing contract:) above named, lie is the ...... . ............. ... (ConLractor, cent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make anxl file this application; that all statements contained in this application are true to the best of his knowledge and belief; and Lhat the work will be perronted in the manner set forth in the application filed therewith. ~9worn Lo before me Lhis ,L\..........da of GS-.1.. :C�..•.20.A1.�. Notary Public .. .. KARENIGRENA.CA . ............. ................. OTARY �gmNow York IMARYPUBUC,: dWlk (Signature of Applicant) N06 IID./892602- OtrwtNrloa EN»rw OWAM"W RIia Neat o 0 _ - b "D -QJ77B 1r1�{ \ V;iEd —4-/ {a a DO cl 0ZLo q"Z IN in _ cci � r~ I J&- k' aro/,-y � d �` ` o b Y � GNO iM , V3 0 PROVIDE OPENINGS FOR OCCUPANCY OR CY ESCAPE AS REQUIREMERGD BY PART..714 OF S NOTED v USE S UNLAWFUL $ APPROVED A N.Y. STATE BUILDING CODE. 4I y V DATE:(,, B.P #a�.9-7- �+. �'VITFOUT CERTIFICATE , FEE:.11--BY OF (CCUPANCY PROVIDE AIM-SCALD AND/OR co 6<D NOTIFY BUILDING DEP M F TAT THERMAL SHOCK PREVENTING 765-1802 9 AM TO 4 PM FOR THE j FOLLOWING INSPECTIONS: DEVICES AS TO PART.502.6(K) I 1 FOUNDATION - TWO REQUIRED w Q ON M.Y.STATE BUILDING CODE. FOR POURED CONCRETE PLUMBER ERTIFICATI 2. ROUGH - FRAMING & PLUMBING TENT BEFORE, y (4 3. INSULATION ON LEAD C4V Q 4. FINAL - CONSTRUCTION MUST CERTIFICATIOFOCCUPANCY14 co BE COMPLETE FOR C.O. SOLDEREp IN WATER u ALL CONSTRUCTION SHALL MEETdS T _PROVIDE SMOKE-DETECTING THE REQUIREMENTS OF STATE CONSTRUCTION &TENERGY HE N.Y SUPP DY 70� CANNOT LEAD. ALARM DEVICES _ U CODES NOT RESPONSIBLE FOR EXCEEDS AS TO PART.721.1 DESIGN ORCONSTRUCTION ERRORS N.Y.S BUILDING CODE. 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STATE BUILDING CODE. 4I y V DATE:(,, B.P #a�.9-7- �+. �'VITFOUT CERTIFICATE , FEE:.11--BY OF (CCUPANCY PROVIDE AIM-SCALD AND/OR co 6<D NOTIFY BUILDING DEP M F TAT THERMAL SHOCK PREVENTING 765-1802 9 AM TO 4 PM FOR THE j FOLLOWING INSPECTIONS: DEVICES AS TO PART.502.6(K) I 1 FOUNDATION - TWO REQUIRED w Q ON M.Y.STATE BUILDING CODE. FOR POURED CONCRETE PLUMBER ERTIFICATI 2. ROUGH - FRAMING & PLUMBING TENT BEFORE, y (4 3. INSULATION ON LEAD C4V Q 4. FINAL - CONSTRUCTION MUST CERTIFICATIOFOCCUPANCY14 co BE COMPLETE FOR C.O. SOLDEREp IN WATER u ALL CONSTRUCTION SHALL MEETdS T _PROVIDE SMOKE-DETECTING THE REQUIREMENTS OF STATE CONSTRUCTION &TENERGY HE N.Y SUPP DY 70� CANNOT LEAD. ALARM DEVICES _ U CODES NOT RESPONSIBLE FOR EXCEEDS AS TO PART.721.1 DESIGN ORCONSTRUCTION ERRORS N.Y.S BUILDING CODE. 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