HomeMy WebLinkAbout26186-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27474
Date: 12/18/0q
T~IIS CERTIFIES that the building FOUNDATION
Location of Property: 1930 BRAY AVE LAUREL
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 126 Block 7 Lot 21
Su]~division Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 29, 1999 pursuant to which
Building Permit No. 26186-Z dated NOVEMBER 29, 1999
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 FOUNDATION UNDER AN EXISTING ONE FAMILY DWELLING & REPLACE PORTION OF
A ROOF AS APPLIED FOR.
The certificate is issued to EDWARD A EANUS, JR.
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPANTMENT OF ~ALT}{ APPROVAL N/A
ELECTRICAL CERTIFICATE NO. PENDING 12/11/00
PLUMBERS CERTIFICATION DATED 12/12/00
EDWARD A. HAAVJS, JR.
Rev. 1/81
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
(THIS
BUILDING PERMIT
PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO.
26186 Z Date NOVEMBER 29~ 1999
Permission is
hereby granted to:
EDWARD A JR HANUS
1930 BRAY AVENUE
LAUREL~NY 11948
for :
CONSTRUCT A FOUNDATION UNDER AN EXISTING SINGLE FAMILY DWELLING &
TO REPLACE PORTION OF ROOF AS APPLIED FOR. THIS PERMIT REPLACES BP#23314-Z.
at premises located at 1930 BRAY AVE LAUREL
County Tax Map No. 473889 Section 126 Block 0007 Lot No. 021
pursuant to application dated NOVEMBER 29 1999 and approved by the
Building Inspector.
Fee $ 150.00
Jo r i~d Signature
Rev. 2/19/98
ORIGINAL
Form No. 6
TOWN OF SOUTHOLD
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. F%nal 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.
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.
2.
3.
4.
5.
Fees
Certificate of Occupancy - Hew 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.
Certificate. of Occupancy on Pre-existing Buildin~ - $100.00
Copy of Certificate of Occupancy - = .ZS~
Updated Certificate of Occupancy - $50.00
Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
oate .......
lqew Construction ........... Old Or Pre-existing Building .....
Location of Property .............................................................
House Ho. Street Hamlet
~ ~a~,~ ~-..~>.::?.~...?.>.: . . . ................. .. .
Onwer or Owners of ~roperty .................... · ...........
'~ ~-~ j.~. .0?.(3.7 ,.,,~ ~/ .......
County Tax Map No 1000, Section .......... Block .............................
Filed Map Lot· ..-- .....
Subdivision - ·
-D~/~Z.... Date Of Permit..~7:~.7.Z ...... App&ican~ .......................
Permit ~o ............
a','V.°.° ....
lth pt App ...... '
Hea De . roval ................ Underwriters royal ...........
Planning Board Approval~..~ ......................
l~equest for: Temporary Certificate ........... Final Certicate ...........
Fee Submitted: ' .... ~ ,'~' .~..-0 .................. ./1
~Y.,~.c, :',~ '~ ~2, ~ -,..:...,.~.:...:.~?..., . .....................
b
Town Hall, 53095 Main Road
P, O. Box I179
Southold, New York 11971
Fax (516) 765-1823
Telephone (5 $ 6) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
CERTIFICATION
(please print)
Plumber:
(please print)
I certify that the solder used ~n the water supply system
contains less than 2/10 of 1% lead. '
( P~umb%r$ S i gn~ tut o )
Sworn to before me this
LYNDA M. BOHN
Qualified in Suffolk Coun~.
Term Expires March 8, 20 ~..%/
,
THE NEW YORK BOARD OF FIRE UNDERWRITERS Pa ;
119~204 BUREAU OF ELECTRICITY
~'-- 40 FULTON STREET, NEW YORK, NY 10038
Date DECE}~SER 18,2000 A~lic~#on N~. on y~& '~2997296/96 N 545~76
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above applicaHon number is in the premises of
~D F,%NUS JR., 1930 BRAy AVE., MATTI~UCK, NY
in the following location; [] Basement [] 1st Fl. [] 2nd FL OUT Section Block Lot
was examined on DECEHBER 11 t 2(~)t~ and found to be in compliance with the National Electrical Code..
FIXTURE
OUTLETS R~CEPTACLES. SWITCHES
FIXTURES OTHEH
INC~t~ANDESCEN! ELUORESCENT
5
DRYERS I FURNACE MOTORS FUTURE APPLIANCE FEEDERS
OTHER APPARATUS:
G.F.C.I,-3
TgACK LIGHTING: -~
RANGES I COOKING DECKS I OVENS I DISH WASHERS
SPECIAL REC'PT ~
TIME CLOCKS BELLUNIT HEATERS MULTI-OUTLEI
SYSTEMS
AMT. AMP. AMT. AMPS. TRANS. NO. OF FEET
R I C
OF CC COND. NO, OF HI-LEG OF HI-LEG
EXHAUST FANS
AMT. H.P.
DIMMERS
AMT. WAITS
NO. OFNEUTRA~ OFNEUTRAL
KMNNMTH F. $CHU~AN}L
PO BOX 1505
RIVERHEAD, NY, 11901 GENERAL MANAGER
COPY FOR SUILDINGDEPARTMENT, THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
~d
F
0
Ah"
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] IN__ION
FRAMING [,~] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS. C~.~'*~ ~ _ ~c~
jDATE
!NSPECTOR *~ ~~
FORM NO.3
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
ToWN HA~L
SOUTHOLD, N.Y.
Ne 23314 Z
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Permission is herebv granted to:
...~. ~;~.~.<........~..y..,......./...,.~..r..~ ................... ,
to ...~:~.~...-.,.,...~...... ~.~...:.~:./..~,....~-~<~'.~.~. m
.... ~.~......./..~.,,.././.,~ ........ ~ ....... m......~.-.~ ...... ~.....~....~..~<
af premises located at...../.?...~....(~.. ........ ~ .i.........~..~...: ..........................................................
CouniyTax Map No, 1000 8ectlon.....Z~..,~.. .......... Block ........ .,~..Z ........ LotNo ..... ...~......"~.. ..............
pursuant to appllcatlo, dated ............. ...~./Z..,~... ............................. ] ~....2 .~...., and approved bythe
Building Inspector,
Fee $.../.~.~.. ...........
// -/ Building Inspeotor
Rev. 6/30/80
FORt4 NO. I
TOI,/N OF SOUTHOLD
BUILDING DEPARTHENT
TOI~I HALL
SODTtlOLH, N.Y. 1197 I
TEL: 765- 1802
Ar' ........ NO.
Disapproved ale .............
....
(~ ld~/~n~tor )
APPLICfiT~O~ FOR BIJILO-~N~ PERHIT .
BOARD OF,~HEALTN ...............
3 SETS OF PLANS ...............
SURVEY ..., ....................
CHECK .........................
SEPTIC FORM ...................
~OTIFY:
CALL ..................
HAIL TO:
· ' ' ' iNs~ffUCTIONS
a. 1his ap~lleation n~mt be cc~pletely [illc~l in % ~itur ~ in ink ~ ~1tt~ to t~ ~ild1~ Ins~tor
3 ~ts of plus, ~rate plot pl~ to ~ale. F~ ~co~i~ to s~le.
- b. Plot plm ~i~ l~ti~ of lot ~ of ~ildi~s ~ ~s, ~latlonshlp to ~joini~ p~i~s or ~lie
sC~ts or areas, ~1 givi~ a ~tail.~ &~ripti~ 9f l~t Of ~ ~t ~ dr~ ~ the dia~ ~i~ is ~rt of
this ~li~ti~.
· c. l~ turk ~ ~ fl~is ~licati~ ~ mt ~ ~m~ ~fore is~me of hildi~ Pemit.
d. U~ a~t~al of ~is ~limtim, t~ ~ildi~ Ins~ctor will is~ a hildi~ ~t to the ~lieat.
~t ~mll ~ kept m fl~ ~s ~ilable for in--tim theft ~e ~rk.
e. ~ ~ildi~ ~all ~ ~i~ or u~ in ~le or in ~rt f~ ~ ~ ~at~r mtil a ~rtlficate of
~ ~l h~ ~ ~t~ ~ ~ ~ildi~ In~tor.
~.I~ IS ~ ~ to tbe ~ildi~ ~r~nt for the isle of a ~ildi~ Pemit ~mant to the
~ildi~ ~ ~i~e of fl~ ~ of ~ld, ~ffolk ~, ~ Yo~k, 'a~ other ~licable I~, ~i~es or
~lati~s, [~ tim ~st~tim of hildi~s, ~itims or alterati~s, ~ f~ ~1 or ~liti~, a berein
~ri~. ~ ~lic~t a~s to ~ly ~th all ~li~bl~ 1~, o~i~es, ~ildi~ ~, Imsi~ c~e,
~lat~ms, a~ to ~it ~rir~ ins~tors ~ ~s ~ ~n ~ld~ for ~ry ln~t~m ·
............ ~ ................. ~..~ ....
State ~tber a~li~t is ~r, les~, ~n~, a~it~t, e~i~r, ~ral e~tyaet~, ~lee~ne~, pl~r or l~flder.
............. 6 ~. n ~ ................................. , ] ........................... ~pp~[~ ~g~ ............
~.../~.~..~,
NoTIFy BUILDING DEPARTMENT AT
If ~lic~t is a ~r~rati~, si~t~ of ~ly ~t~iz~ officer. 765-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1, FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CON.~JTRUCTION SHALL MEET
THE REC~UIREMENTS OF '~HE N.Y.
............... ~ ................... 0C -~. P. ANCY OR
<~ a~ .tie o[ ~o~or~,e o~ieer> USE IS UNLAWFUL
~il~rs ,.ise.~ No ................ ..WIIH.0UT CERTIFICATE
Phr~bers License No ................ OF-O. CCUPANCY
REQUIEED STATE CONSTRUCTION & £'NITRGY
Other 13cade~s License No ..................... CO~ES. NOT RES 'ONe,P:
I. ~ci~ of 1~ ~ ~i~ ~ ~ will ~ ~ ...... !..4 ~ .... ;~... -~. .....................................
..... l!~..' ......................o ~ ~.c~..~.'. .............................. ~~ .................
t~ ~r St~t-- l~et
~ty ~ ~. I~ ati~ ..).~.,~. ..... m~ .~ ...... ~t ..O.~t.'.~.
aivisi~ ...................................... Fil~ ~p ~ ................ l~t . ..............
(~)
2. gtate aisti~ ~ ~ ~ of ~i~s ~ inte~ u~e ~ ~ml~ of ~ c~stmetlm:
,. ~i,ti~ ,~ ~ ~ .....ac~].~...-~;.~" ~ ,~ ......................
..r~.~ ...... .~ ................
~,~1~ .~,'F c.~.~,~ ..... .. '
h. ~L~u~ ~m~ ........... ~ .............................. ~ ...........................
3. H.'ll.re o1: umk (d~eck ~t)id; al,,plJcoble); Nc~ lh}ihli~qt .......... ~klirion .......... Alteration
I f garage. ~l;d~r of car~ ..... h. }
I}in~n~i~a of aam ~rn~mro with alrerari~m or ~itiona; Front ..... ~.t. ...... l~ar .~7 ...........
fl. l)iu~nal~a of enLire ~ ~srnml:~: I~t I~ar ~pth .............
~e o~ Cmtracror ............... i .................... &~lreaa ............................... ll~n~m ~ ...............
~ran prol~tt-y li~s. gi~ ot~r a~] bl'~k axd~r or ~aeripti~ aeconling I:o t~al, a~ ~m street ~ms ami i~licare
~mtlmr interior or con~r lot, ] '
SI'A'IE OF [1~7,,~/~ ,qB ''
Ih ia I.he ..................
.... ....................................................................
(amtraetor,. ~gen[, co~r~rn[e oEEicer, etc.)
of fmld (x~x~r or (~mrfl, tlrKJ i~ duly ;al~lhoriz~l I:o jmrJ'nnll nr have I~rl:ontv~d Ihe flaill ~[k aixJ Jo fl~lJqe illXJ file IhJ.
lhaL the ~)rk wl ti I~ i~rffom~l ia the ~lvJm~r set rortl~ 'ie the al)pi Leal:inn fil~l tlmr~itli.
~)rn tn I~fom 0e this ]
........ o, ....
C~lflE L, GL~ I (Signal:ure of Applicant)
Nota~ Public, State of N~ York
No~ 4879,505 ! ~ _
Qualified in Suffelk
Commission Expires Decemberi
Z
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