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HomeMy WebLinkAbout25548-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26937 Date: 02/17/00 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property: 430 WEST SHORE DR SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 80 Block 5 Lot 2.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 22, 1998 pursuant to which Building Permit No. 25548-Z dated FEBRUARY 18, 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 ADDITION & ALTERATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to FERESHTEH GHAVIMI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N-493299 07/02/99 PLUMBERS CERTIFICATION DATED 02/17/00 PECONIC PLUMBING&HEATING Authorized Signat re 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. 25548 Z Date FEBRUARY 18 99 Permission is hereby granted to: FERESHTEH GHAVIMI 430 WEST SHORE DR SOUTHOLD,NY 11971 for CONSTRUCTION OF AN ADDITION & ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at 430 WEST SHORE DR SOUTHOLD County Tax Map No. 473889 Section 080 Block 0005 Lot No. 002 .001 pursuant to application dated JANUARY 22 98 and approved by the Building Inspector. Fee $ 75 . 00 1 Autho ized Signature ORIGINAL Rev. 2/19/98 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 FEB 1 7 Mr'a APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the buildir inspector with the following: for new building or new use: 1. Final survey of .property with accurate location of all buildings, property line: 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 buildi 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 '-'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 applicar 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 Buildin¢ - $100.00 3. Copy of Certificate of Occupancy - 25�. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . c3t1/�J �l�ca . . . . . . . . . . . . . . .. . . . . New Construction. .. .. .. .. .. Old Or Pre-existing Building. . .X. . . . . . . . . . . . Location of Property.. ..) . .. . . . . . . . .. .. V 5,... � d:C?Fr, �.`&.Av%r. . . . .S.?. House No. Street Hamlet Onwer or Owners of Property...F!C'1; IfTZ1'f. ..tse/?Ulsa.l. . . _. County Tax Map No 1000, Section— PP. . . . . . .Block. .. . . . . . . . . . . . . .Lot. .2: �. . . . . . . . . . . . Subdivision. . . . . S ° 5 . . . . . . . . . //.Filed Map. (. . . . . .Lot.�fJ- 21 �R .- Permit No. .�k3�sY.$.Z. . .Date Of Permit. z�l°t .�9. . . . . .Applicant.eg?� '���Cl Health Dept. Approval. . . .. .. .. . . . . . . . . . . . . .Underwriters Approval. A/. . rr 3 t l`• . .. • • • • Planning Board Approval. . .4V/. . . . . . . .. . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . X. . . . . Fee Submitted: $. . .91:s. . . . . . . . . .. . . .. . . .. . . . APPLICANT Qu . �o�ogpFFOtkCar% o Fax(516)765-1823 P.O. Box 1179179 Town Hall,53095 Road y Telephone(516)765.1802 �� Southold, New York 11971 o � dao OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C R R T I F I C A T I O N DATE: Building Permit No. Owner: FffC9511 r4ht (please print) Plumber: '(pleple gal>lr des f✓/� 9k/7NI ���/ - ase print) i certify that the solder used in the water supply system contains less than 2/10 of 1% lead. a 1P1 rs S nature) Sworn to before me this _ /Z _ day of ; .0 W-60 Notary Public, (�S(/ rF0 LAI— County r> 4 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1195099 BUREAU OF ELECTRICITY 40 FULTON STREET, NEW YORK, NY 10038 ;7 Date JULY 02,1999 Application No. on file 18241999199 N 493299 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 FERESHTEH GHAUI111, 430 W. SHORE DR. , SOUTHOLD, NY in the following location, ❑ Basement ❑ Ist Fl. ® 2nd Fl. OUT Section Block Lot was examined on JUNE 25,1999 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT I OTHER I AMT. K,W. AMT. I K.W. AMT. I K.W. I AMT. I K.W. AMT. H.P. 5 2 1 1 1 5 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS JSPECLALRECTT, TIME CLOCKS J BELL I UNIT HEATERS M SYS EMS ET DIMMERS AMT. K.W. OIL N,P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF S El R V 1 C E METER NO.OF PER COND. A.W G. A.W.G A.W.G. AMT. AMP. TYPE EQUIP. 1 B 2W 1 0 3W S 0 3W S 0 4W pER a Of CC COND NO.OF HI-lEG OF HI-LEG NO.OF NEUTRALS Of NEUTRAL OTHER APPARATUS: 2 1/2 TON ATR CONDITIONERS-2 WITH GOA DISCONNECTS-2 J114 SAGE ELEC. INC. tom, L L PO BOB 38 GREENPORT, NY, 11944-0038 GENERAL MANAGER. 11 r. Per 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. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE' MUST NOT BE ALTERED IN ANY MANNER. o��gUFFO(/(C O o� Gyp Town Hall,53095 Main Road C Fax(516)765-1823 P.O.Box 1179 Oy • Telephone(516)765-1502 Southold,New York 11971 BUILDING DEPARTMENT TOWN OF SOUTHOLD May 17 , 1999 Bob Kehls Home Improvements P.O. Box 779 Greenport, NY 11944 RE: Fereshteh Ghavimi, 430 West Shore Drive, Southold. 1000-80-5-2 . 1. 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) ?i`1gS XX 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. XX No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 25548-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. o�OgpFFO(,(-�O oGym Town Hall,53095 Main Road COD ( ) Fax 516 765-1823 P.O. Box 1179 �� O�� Telephone(516)765-1802 Southold,New York 11971 BUILDING DEPARTMENT TOWN OF SOUTHOLD May 17, 1999 Bob Kehls Home Improvements P.O. Box 779 Greenport, NY 11944 RE: Fereshteh Ghavimi, 430 West Shore Drive, Southold. 1000-80-5-2 . 1 . 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) XX 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. XX No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 25548-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. '-PC-CONIC BAY PI t�1t(a. titc,*t wAr .. MIA2� PLp r 0 202 � I 1 ao .- tsd 765-1802 BUILDING DEPT. 1NSPECTION [ ] FOUNDATION IST [ ROUGH PLBG. [ 7FRAIMING NDATION 2ND [ INSULATION [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE 3A/Y7 INSPECTOR���� r 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 LATION [ ] FRAMING FINAL [ ] FIREPLACE & CHIMNEY REMARKS /Ck /22 - U&-O ' Ap DATEd�� _INSPECTO FIELD INSPECTION REPORT DATE COMMENTS ti FOUNDATION OST) a�FOUNDATION (2ND) n ROUGH FRAME 5 PLUMBING I� N cn II massa=ces=aassses=sass=es _ - __#.eeseasssaaxsesasssasesysesas=seas=seseevesesxssysss=e_ 'I INSULATION PER N. Y. STATE ENERGY ` u----il � CODE -------------------- - u =a-saaaaeassamsasaaasssaa x-- - - y-asaaasaa-aaaas�esaaasaaacasssmsaxaaaasassssaaaa=aa H —II FINAL N— —11 7I�I�n II ry ¢sasaasasmssaa=axaaaasasxllsaaaasac�sssasysassamaaseessssaaaasescseaxcaaevaasyssasaaassaasa � ADDITIONAL COMMENTS: aaamaasamassasasssaaasasssssaaesasxs_aasas=assaaasaaaaaaasa=asssasasasasssasa=asxsmsasasa r� 1, H Q H z 2. ro H I- BOARD OF HEALTH . .. . . . . . . . . . . . . FORM NO. 1 3 SETS OF PIANS . . . . . . .. . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . .. . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . .. . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . .. . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: CALL . . . . . . . . . . . . . . .. . . Examined..... ......... 19.,n MAIL TO: . . . . . . . . . . . . . . .. . . . . Approved.........:�D., 19.R;l Permit No. ............. .................................... Disapproveda/c ............................. .. .................................... _ .. ....... ...... Q 1y �� f1 (Buildicg Inspector) ���� 2 2 �9� LICATION FOR BUILDING PERMIT Date. . . J�22 . . . . . . . 19.77. BLDG, DEPT. INSTRUCTIONS TOWN OF SOUTHOLn a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector wit 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 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 thro ghwt 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. APPLICUICN IS HEREBY MATE to the Building Department for the issuance of a Building Permit pursuant to the Building Zane Ordinance of the Tam of Southold, Suffolk Canty, 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. ......� ../1��F/:f.go .f!�Fn{C-• .Z!°r0.foU�/3iF.vTS�NC'. ....................... (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State wnnhether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 1,��!ye C L..�oHT.Q�1A 7... ................................................ .................................... Now of owner of premises ......F12/f S/H rEN .�!�lO/ !................................................... (as on the tax roll or latest deed) If applis a corpora ' , signature of duly authorized officer. �.� �.......C4�so��� ( and title of;---_ f co rate officer) ,/ / Builders License No. ..l Plumbers License No. ......................... Electricians License No. ..................... Other Trade's License No. .................... 1. Location of land on which proposed work will be done.............................................................. ......l.J.d...................**./L..... t= 4o Z/Xc ...Soto %f/oc� ............................... ]louse Number Street Hamlet Canty Tax Map No. 1000 Section .....4).F4...... Block ......:� ........ Int P.�......... Subdivision ..✓J•���a ✓ s/jLo 2 E S........... Filed Map No. —6.0...... lnt (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: • WifLC/ ✓ a. Frosting use and occupancy .......Q ..,�......................;......,...:.:..................... b. Intended use and occupancy ..... ✓�Lc/tib( ............. .......................................................... �. riuue or WrK ccnecx which applicable): New Building .......... Addition ..X....... Alteration .........: Repair ............ Removal .........!.... DemlitiOn ............ Other Work .................................. (Description) 4. Estimated Costs, c °Y cls 9.4.......... . fee . ...... ........ .... .... . . . .. . .. .. . ............ (to be paid on filing this application) 5. If okaelling, nuuber of dwelling umitsli..../....... Maher of dwelling emits on each floor ................ Ifgarage, number of cars ........... .......................... 6. If business, uxmrercial or mixed occu fancy, specify nature and extent of each type of use...................... 7. Dimensions of existi structures iflI 2 6 / . � awry• 1?ront.... j t ............ Rear ..�6......... Depth ... f.�.......... height ......°�S ............... Nawar of Stories ..............I...... Dimensions of sane structure with alterations or additions: Front ....6 .... ... Rear ...e2.......... Depth ...4a e ............. Height ....as............. Nnher of Stories ..�.�......... I r 8. Dimensions of enure new oxxustructioxn,: Front ...X 3......... Rear ..X3.......... Depth ... Height ......................... Numhgr of Stories ..................... 9. Size of lot: Front .•%D o: 0 3 . hear (aO. 0.3 Depth A0 2 , b r .... .. ... ,.., ... 10. Date of Rnrcluase Name of Former Owner ............................ '. " II. Zone or use district in which prenise SrG+E v T.q L !t . .......... s aresituated ...4c;....... ............................. :}i.......... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...l.lq.................. 13. Will lot be regraded ....A. 0 .......,,... Will excess fill be removed from promises: 14. Nacres of Owner of premises :e K Hr�N (l1AU!rn! Address 9Yf.!=r.534'r S;'"If°T, aM No d 3960 Nam of Architect ..... ..�................ Address .............................. Phan No. .............. Name of Contractor9��(1..... Address o, )Sox 777. .ti?F¢��>rtT vY. .... cY....Plione No. ............ 15. Is this property within 300 feet of a tidal wetland? 1.� M .. ..... NO .......... *IF YES, SOf7Ili D MW TROS1mE.S Pam MAY 1E w9cw Zed). PHOT DIAGRAM locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set—back dimensions from property lines. Give street and blocki amber or description according to deed, and show street names and indicate whether interior or comer lot. j SII TA•lE Om Now Y(AZiC, S,4 )"17 OF ....................... �ixl � l�g�ni ) t..............being duly swore, deposes and says that he is the applicant Xase of above naned, le is the ..........�OY (Contractor, agent corporate o .........:.................................................. ' officer, etc.) )f said owner or owners, and is duty authorized to perform or have performed die said work and to make and file this application; that all statements contained i(n this application are true to the best of his knowledge and belief; and hat the work will be perfonmed in the mamx1r set forth in the application filed therewith. worn to before me this 0?02 64 ....day of 19.1..... Notary Public ..i� ,......... ............. (Signature of Applicant) LINDAJ.000PER Notary Public,State of Now,York No.4622668,Suffolk Cou�'ty '� Term Expires December 31, �a BUILDING PERMIT REVIEW CHECK LIST Application Name: A m �efPSN e Architect/Engineer: Date Submitted: SCTM #: District: 1.000 Section: Block: _ Lot: Z, Subdivision Name: 43O 1)�,05r Jhore C,/C' Swe-5 Req. Req Zoning District: [Lot size: Actual: ] [Lot coverage Proposed: ] Req. Req. Req [Front Yard Proposed: ] [Side Yard Proposed: ] [Rear Yard Proposed: ] Project Description: ��►��t AGENCY PERMITS Permit REQUIRED FOR REVIEWN.A. N4 YES Number Suffolk County Health Dept. -71 New York State D. E. C. Town Trustees ✓ Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation ??? Flood Zone: �— X Notes: 1 I (1t� — 11 aw_r`�it -PE,;CQN1C BAY MAS OF PROPERTY SURVEYED Faq WATift IFt1 �. VAI loa ,,53 PST t} iN /� ��yry� F{ �t�/ bihbaarveysavpgp� ' Q NB OF Cf -R'W3J t LV,3 .i;� {. ECucEfion law.Cte NBx Ypk yyM • - �� � _ —, — �pYl�, _ � � _ `, Cm,.es otlns s�rcry mag mf Q i ''�{ lne A:n6 tu;reY✓ls in:.etl se„1Ma 1 [l M Ews dsa y:all not bo onyQa� !t mbEay.:.dtr ecoyy. i Gvman:ees� ,cafeC nerc�n shell nei Berson loe whym yrye yt 3 �' {* � x. iC U19 EE�1&nCes Cf lhB lefltlln9{�. T � . .;�� { fuiron.Guardn,aesare nathanslefayy - i � � - to eEEai0na18151ipgpag piy {- eMTOnt r . 't f r ,tV �3 Al ! 5�0 j �b TITLE Mt eaM--5-f A4, i K -(a . �acvxrv- -rip.) tT S23 E} E AO NCK,�Vq�� A3 YFE-p JIKN, 291199a,5 co . Xl 8AY MAP Q PROPERTY `� �"LP`s iC3GL�5� ZZ- . - 'wag, iV1M8 Se ©Fr waw TOWN QF G""'�o`Me y°*�' . ne '�fM+s ' � � Cap>°s of th>sserveY maA not Eesriyt lV hj3 the tndgW✓eyroYs�r6,�se�i cr �,. © yy _ emb:sue saG x`.a�l not be coisiaered Mbeava�d opy.C ' - - } � - i ; 4rieagbl'1C31'AiCated h2lepl Bha:I NA Ms surveyis - plepnfoa. It.behz:f bto campaa, t �^>m=^t9l agerKY;vAd �' to Mease1yaees ottnekndmgmstl. p _ _ .+ '� tmmn.duattn.�es arenoCtransfeypls . to aodimal msLiwWns o�SyCaeyy911r f� p y wnera, it 40 , ° t �! t s t } r AX IT T ..- , 7,,.0.GA. � ass lh i b t , kIP --------------------------- t '5 5T t vl� I ---------- vI FYI,�r-I,� AIL PROVIDE OPENINGS FOR EMERGENCY ESCAPE AS REQUIRED By PART. 714 OF N.Y. STATE BUILDING CODE. s� UNDERWRITERS CERTIFICATE REQUIRED 17 APPROVED AS N= DATES 10 9Li op.#-?��rll FEE: PROVIDE SMOKE-DETECTr _s xts NOTIFY BUILDING DEPARTMENT AT _#q�?- 765-1802 9 AM TO 4 PM FOR THE ALARM DEVICES P, FOULORING INSPECTION& AS TO PART.721.1 1. FOUNDATION - TWO REQUIRED FOR LOURED CONCRETE FOR S BUILDING CODE 2. NOt= - FRAMING & PLUMINING I INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. OCCUPANCY OR ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. USE IS UNLAWFUL STATE CODES.CONSTNOT RRESPONSIBLE UCTION & ENERGYFOR WITHOUT CERTIFICATE - DESIGN OR CONSTRUCTION ERRORS OF OCCUPANCY ce Ir Fi C, ---------- 01 7T ____ rte___--. --------------- f i i i ! CLoSF OJ- tj Ps I 00 I I _ i _ J P 2,e10- fcb" F Op.r ouAie VfsW — P�PeF'fls�a sro F�oo.� L Fo Q G2Q2 s HT€h yNV>n i I SCd[[ i 3 of-21