HomeMy WebLinkAbout24775-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26521 Date: 06/24/99
THIS CERTIFIES that the building ALTERATIONS
Location of Property: 300 COTTAGE PL SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 62 Block 3 Lot 15
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 10, 1998 pursuant to which
Building Permit No. 24775-Z dated MARCH 17, 1998
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 ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to KATHRYN M PULVER
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 24584 04/14/99
PLUMBERS CERTIFICATION DATED 06/24/99 VAN ETTEN PLUMBING & HEAT
Yv,
Building In ector
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. 24775 Z Date MARCH 17, 1998
Permission is hereby granted to:
KATHRYN M PULVER
448 EAST 88TH ST APT 4B
NEW YORK,NY 10128
for .
CONSTRUCT AN ALTERATION AND REAR DECK ADDITION TO AN EXISTING
SINGLE FAMILY DWELLING AS APPLIED FOR.
at premises located at 300 COTTAGE PL SOUTHOLD
County Tax Map No. 473889 Section 062 Block 0003 Lot No. 015
pursuant to application dated MARCH 10 1998 and approved by the
Building Inspector. "
Fee $ 86 . 60
Building Insp for
ORIGINAL
Rev. 2/19/98
Q Form No. 6 SG� 60'af_e t4
TOWNOFOF SOUTHOLD_.-- �-
JUN 1611
BUILDING DEPARTMENT
TOWN HALL
765-1802
WG
N FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR ink and submitted to the buildin,
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 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 a
'.'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 applican
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 Building - $100.00
3. Copy of Certificate of Occupancy - t .25c-
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . . . . .!t::q.114 . . . . . . . . . . . . . . . . . . .. . . . .
New Construction. . . . . . . . . . . Old Or Pre-existing Building. . .X . . . . . . . . .
Location of Property. . . *jQ.. . .C�Q10.?1GIC?.. . . . . ... . . . . .. . . . . . . . . . . . .�{�o( .. . . . . . . . .
House No.
�-44�h� Street Hamlet
Onwer or Owners of Property.. . \4Yl . fil: . .. (,Vp2 . . . .. . . . . . . . . ... . . . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. .6.;.�. .. .. .. ..Block. . . .3.. . . . . . . . .Lot. . . .(.S/ . . . . . . . . . .
Subdivision. . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . .
Permit No. .a�.y�1.��. . . . .Date Of Permit. _$.117.is'. . .Applicant. lC�kl rjvl. lel '.Cu( Ui?:�-. . .
Health Dept. Approval. . . . � 1�. . . . . . . . .. . . . .. ..Underwriters Approval. . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . . .. . . . . . . . . . . ..
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . .
Fee Submitted: $. . � � LIL¢ ,
APPLICANT
{ae, C� l� lG/z��/
��o��SpFFOCK�oGy
Town Hall,53095 Main Road CD x Fax (516)765-1823
P. O. Box 1179 • yc Telephone(516)765-1802
Southold, New York 11971
'flp� 411 �0
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C E R T I F I C A T I O N q
DATE:
t
Building Permit No�✓.s�
Owner: �fr� IUIyI��
(pleas print)
Plumber: eoha(- ��� � 3,908-P
(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 1951�1
Notary Public, County
ZP- <141� c.Q
Notary Public,Sta eofN w Yorko. \
Q64
ualified In Suffolk County
Commission Expires May 22, l�p o/
Elizabeth Thompson, Architect
270 Lafayette Street, Suite 1303 T/F 212-274-8336
New York, New York 10012
FL
January S, 1999
Building Inspector "N 2 ' iooq
Building Dept.
Southold Town Hall
Southold, N.Y. 11971 '�'���- " ��"_"'"..
Re: Pulver Residence
Southold,N.Y.
1000-62-03-15
Dear Sir,
This is to confirm that I have completed a framing inspection of the above referenced residence,
and all the framing is complete and of sound construction. All the new construction meets the
NYS building code. Please call my office if you need further assistance.
Sincerely,
Elizabeth Thompson
�Z.2x� Pos•{S�TI'P,�
I II
� EX+�TIu� Palz�k To P�6 fzEFf�.+'1�17
PbsTt) A, SWww Ut/
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ED Apo
OFN FEHzabe�-Lh Thompson Architect
yette St. Suite 1303
^.yes e it, N, Y. 212- 274-8336
ELECTRICAL INSPECTION.SERVICE INC:
375 DUNTONAVENUE.
EAST PATCFIOGUENEW YORK 11772
(516)286-6642
24584
APPLICATION No.ON 11HE
DATE: 4/14/99
VILLAGE. Southold TOWN., Southold
ADDRESS: 400 CoCotb plate—
ISSUEDTO: K Pulver
Etrdc�iutmn'Electnc--``'"
was examined on 4114199 and found to beim compliance with the National Electrical Code
LOCATION: Base.. ,x lit, XX 2nd NX 3rd" Attic
f Det.Garage Hat Tub Pool
'k.
SWITCHES RECEPTACLES . FIXTURES HEATERS FANS G.F.L AIR.COND.
i
35 46 28 2 Exhausf 5
DISHWASHER DRYER CLOTHES WASH. GAR.DISP. RANGE . OVEN SMOKEDETECTOR' -
1.2KW 30A 20A
FURNACE OIL GAS CIR. MOTORS BELL 1RAN. SERVICEDISCONNECT
2-f - tmrmt - antes PHASE, -
Z xx
2000H
OTHER -
EQUIPMENT
-air handler, 2-paddle, _
HUGO S. SURDI
PRESIDENT
BUILDING PERMITNo. _ nis.Nfioawm'u nobegtemd inmymmn - '
b pe msmq beidentifiedby tfiea cadaihals
BLUEORIGINAL YELLOW COPY PINK COPY OFFICE
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M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN LATION
[ ] FRAMING j FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE INSPECTO
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-1°LD iI:SPE07l0N JJDATE q COMMENTS A,
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FOUNDATION ( 1st )
FOUNDATION ( 2nd ) — m�
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Odle
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INSULATION PER N . Y. y r
STATE ENERGY
CODE �4
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FINAL
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ADDITIONAL COMMENTS : x A
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765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST OUCH PLBG.
( ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACES CHIMNEY
REMARKS: Ai-- 4:0� fxec';,
DATE I INSPECTOR
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] RO LOG.
[ ] FOUNDATION 2ND [ INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLAC � HIMNEY
REMARKS
i
DATE INSPECTOR _
--. --- ----------
PIC
— --- _ - ---
�x+��t� uG PO�i}I To Pte' G R�FfZd�l�p
x
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PARA 11�t FI L Fl�ro4? P1>r1-1 G PO U*
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,�aA ��.r G�JI�NEu1� PEP.NiI�Dive
f'pix/�ia�5 N T NnM ��
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FElizabeth Thompson Architec•LLOF N�`� 70 i_Fvayette St. suite 1303
it, N. Y. 212-27478336
4
BOARD OF BEAT:III
her. M I FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . .
L TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . .•. . . . . . . . .
(BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . .
u' . . . . . . . . . . . . . . . . . . .
1. TOWN HALL SEPTIC FORM
yT'r,)'dJ!\Or,51OU�I OLt> V_J SOUTHOLD, N.Y. 11971
TEL- 765-1802 NOTIFY:
CALL . . . . . . . . . . . . . . . . . .
, 19.... `MAIL, TO: . . . . . . . . . . . . . . . . . . . .
�G
Appruml..... 19.... Permit No. �.....
Disapproved a/c .. ....................................
..... ............ .... .
ilding Inspector)
AP CATION FOR BUILDING PERMIT �1
Date. .. . . . . , 19.16
INSTRUCTIONS
a. This application mist be campletely filled in by typewriter or in ink and submitted to the Building Inspector with
3 sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan slwwing location of lot and of buildings on premises, relationship to adjoining premises or public
streef9 or areas, and giving'a detailed dcscripticm:of layout of property must•be drawn an the diagram,which is part of:
this application. • • ' ' ' . . .:
c. The work covered by this app]ication i* riot be ccnnenceol before issuance of Building Permit.
d. Upon approval of this -application,. the-Building Inspector will issue oBuilding Permit to the applicant. Such
permit shall be kept on the premises available for inspection thr(xq#mut the work.
e. No building shall be occcrpied*or used in wlole or in part for any purpose whatever until a Certificate of
Occupntrcy shall. have Ixten granted by the Building Inspector.
APPLICATION IS 109BY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone 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 nil applicable laws, ordinances, building code, housing code, and
regulations, and to admit autborized inspectors on premises and in luildi for necesmi inspections.
(Signature of applicant, o name, if a corporation)
sr. �. o�..t�y.►�'t.
(Mailing address of. applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
r1eGl�jTKeT.......................................................•............................................
Nwe of owner of premises XA TH-CRAtya...� -.k4F.&................................................................
(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. ..3: : :...............
Plumbers License No. ...
Electricians T.icense Nn. .. .................
Other Trade's License Na. ....................
1. potation of land on which proposed work will be done...............................................6..............
..4114 ...............GdT.TI.k".T414.4 ....... ................................................
(louse Number Street Hamlet
County Tax Map No. 1000 Section .....102 ...... Block ..0.'3........ Lot ..052..........
Subdivision ...4.Q.4R&AIU...................... Filed Map No. ............... Lot ...............
(Name)
2. State existing use aril occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ...eP.L64% ke..F'AKA ..04%((D81444't........................................
b. Intended use and occuparwy ...t?.!wilt'(%..Tl4t"l:..leS'fr em(,6 .....................................
t
X
I. N•nlure of. wink (tlreck wlninln ul,frlicuble): New Ikril(ling .......... Aklllion ...,.,."'.Alterecion'.....,,...•.-•'
Repair ,X........ Itenloval ......... Dennlitlan 0iberWork
(Description)
4. rutialatel Cast ,.'4 611mv :~ :........ fee ..............................................
(to Ile laid on filing this application)
:i. if dwelling, nxnber of Aaellingllunits ....L...... Umber of (kwelIing nalita On ea(ll floor .....1..........
ifgarage, o lber of care '--":................................
G. If Ixminess, armnercial or mixesI oeagancy, alxicify nature snot extent of each Lyq: of use..... .. .. . ......... ...
f 1 . r
Ile Wit 47.1 g.,.......es, If any: Fr(x,t...4�.... .....(tear...hg........ rk:pth .
7' Il Witioos of suDillikinsions of ......... etwll. Mnber of Stories ... ..
with alterations or fxklilions: Front ..�8�....... gear
Depth ...�..�............. IleiglIt ...9.'1 J............ Naber of Stories ..... ...
S. Dimensions of entire new construction: Front . ............... Itear .......... ..... Depth ... ...........
Ileiglnt ............. ...........:. Amber of Stories ...... ... ... ... ......
9. Rize of IoL: , Front. ., / gear 1
1 �t
10. tele of Pnl-chase ,.rn........ ....... Nnnxe of Fonlx:r Owner ........... ............................ .
11. Z(xx: or use district in whidw premises are loft ated ........................... . ........ ............ ..... .. .......
12. Was prolxlsed construction violate any zoning law, ordinance or regulation: ..N.0 .................
13. will
lot
Ig .... .......... Will excess fill Ile reamed from premises: YES
14. tiatiesof (kn,er of preniseN.�CrIfF.'f1'f47�U! ..I�.yyu�•R,.. Adresa '.4'fB..4�..8.�1 $.T,"�E?p ,Gt )Dome I1o212714.6!lop.
,C 1:40 6RFAYt!Tli3 6f.*loss
Name of ArdiILect .hawser} TI'�1lLW 0.......... Address .N.-.Y,.MY..I.tW1.'L... ...... phone No2(Zr:�7:�•.�331
Neale of Crx,Cractor ............. 514^17.....)
I:UGHI�iL.. fe�lyAtOreas 16.r?4V1VP.R0. �! FN('?.I1� ..1'Ixlne llo. ..........7.
15. is this properly within 300 f +t of a tidal wetland? * YIKS .......... ND X .....
*1F YGS, SQfmilD 'iI m -`;JISm s PEFMIT MAY m wputm.
PIAT DTAGItAM
I.(x:ate clearly and distinctly ;all Ixaildings, tAkedwr existing or proposed, and indicate all sec-lack dimensions
fran property lines. Give street and block umber or description according to deed, and allow street nHllea and indicate
ubelher interior or corner lot.
i.
.Sd'Sj D\VG�S. A•31711rd�s'1,
SUM W NW Y( W,
....... ............................',......................Wing duly sworn, deix,ses six[ says that he is the applicant
(Neale of individual signing contract:)
Axwe naxird,
Ik: is file .....! .�JTp'!Y'.`. !rte,{................ ...... ................... .
........................... ...
((:cnnl'ractor, ngenC, corlxa-nte officer, etc.) , . ,
o1' said owner or owners, and is duly authorized to perform or have 1x>rforrred like said work and to wke and file this
application; Lhal: all staterlenta.conta#r"I in this nl>)ilicalion fire true to the hest of Ills knxnwledlki anal Ix:lief; mxI
that the w( rk wiLl be perfornled ituthe nkauler set forth in the allpl.ication filed therewith.
.. ..
Lhd)m Lo Ix. ay ofAA�.fore 11P (Ilia
N(Itary Mille
i. 013 -e of Ap#)licinrt)
w,"y i'Dbllc, State of Plary York
iti 131-5004,7,12 Yor
#i4'ltui In'New York Gorl
POMM7119AR" Fxplrns mvav- If„ 1d
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7 71
UNDERWRITERS CERTIFICATE
REQUIRED
1=4
n V^•1C/k/Imo/V" _
L PROVIDE OPENINGS FAR
EMERGE
NC.Y
E
� Z� � REQUIRED BY
qS
N.Y. ST BY PART. 714ot —
{ l 0, E � 136 0� ATE BUXDING CODE
4v
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ANCA o
J LAUL
PROVIDE s�pKF-p Q �����FICi�
ALAR ETECTINC CCU,p
M DEVICES NCC
AS TO PART. 721.1
N•Y•s BUILDING CODE,
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PWMBING
ALL PLUMBING WASTE
►�k TESTING BEFORE COVER�N�
PLUMBER CER TIFICATIO qv
- -
- ON LE�4D--CONTENT BEFORE-- `D ,.
If+cortubing r• CERTIFICATE OF OCCUPANCY
P
Used All
for water di
git:ibet�irn� ;1 I
PROVIDE ANTI-SCALD ASD/Q 'CJLDER USED 1/l WATER -� c
R system; pip,
ng shelf b
THERMAL SHOCK PREVENTING °�` � ter l ori SUPPLY,S KS TEM CA NOT 'i f
DEVICES AS TO PART. 902.6(K) EXCEED 2110 of f% LEAD. �
-Y. STATE BUILDING CODE.
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