HomeMy WebLinkAbout25190-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-27029 Date: 04/11/00
THIS CERTIFIES that the building REPAIR
Location of Property: 440 SOUTH LA EAST MARION
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473689 Section 38 Block 6 Lot 12
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 3, 1998 pursuant to which
Building Permit No. 25190-Z dated SEPTEMBER 22, 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 ROOF REPAIR TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to LILLIAN H & LEOPOLD STERN, TRUSTEES
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Aut o ized 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. 25190 Z Date SEPTEMBER 22 , 1998
Permission is hereby granted to:
LILLIAN H & LEOPOLD STERN
1101 RIVER REACH DR #404
FT LAUDERDALE FL, 33315
for
ROOF REPAIR TO A SINGLE FAMILY DWELLING AS APPLIED FOR.
at premises located at 440 SOUTH LA EAST MARION
County Tax Map No. 473889 Section 038 Block 0006 Lot No. 012
pursuant to application dated AUGUST 3 1998 and approved by the
Building Inspector.
Fee $ 75 . 00
Building Insp for
ORIGINAL
Rev. 2/19/98
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN 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 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 buildir
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 an
"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 Buildine - $100.00
3. Copy of Certificate of Occupancy - .25C.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential/ $15.00, Commercial $15.00
Date . . .�(. J/ . . . . . . . . . . . . . . . . . . . . . . . .
New Construction. . . . . . . . . . . Old Or Pre-exist
Pre-existing Building. . &Pf
.�? � P , . . . . . . . . . .
Location of Property. . . ; . 04we. . .
�/�rni ?1W. . . . . . . . . . . . . . . . . . . . .
House No. ��/ Street Hamlet
Onwer or Owners of Property.. . G� ... . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. . ..? . . . . . . .Block. . . k. . . . . . . . . . .Lot. . d.lL. . . . . . . . . . . . . .
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . .
/�
Permit No.�`. . / tqq.�!. . . . . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . .
Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . .
Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . �
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`j�1 7th S APPLICANT
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INSULATION PER N . Y. (�
STATE ENERGY �)
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FINAL
ADDITIONAL COMMENTS: x
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TCNOL 0 G1 E'S,
DESIGN, 'PL' N,G & CONSTRUCTION, SERVICES- -
FIELDINSPECTION.
DATE; 12/17/98 "
DATE OF CONTACT: T2/15/98
PROJECT: Roof'rep'air at the Stern Residence', 44Q South Lane, E. Marion, N.Y.
Building Permit#25190 (issued 9-22-98) '
ATT: Town of SoutholdBuildtng"Department '
Minutes, of a Field Inspection. The following was noted-
1. Anew roof structure was,ad'd'ed to an existing flat roofed addition to give an,
increased;pitch to prevent further water intrusion.
2. The new woof consist of T')( 10"ceiling joists, 5/8 cdxply'. Sheathing,and new
roofing membrane. Due,to the low pitch, a properly,supported twin 2 x 12"
continuous,gii-der was added in thecenterof the span.
3. .Two gable end vents were installed as weil,as r-30;batt insulation..Existing ceiling-
panels (with solid insulation) were,left'in placeInereasing the insulation value. .
4. Iii"conclusion, the work was executed in a professional manner and is"structurally
sound-. . .
5. If your department has any additional questions,please don't hesitate to call. -
Yours Truly
Frank Notaro Architect -
�a��4tnamaanreata®jdf
Kato l,4° �v��
-
- c10
100 MAIDEN LANE N.Y.,N.Y. 10038 212-747-9112 `ti.. T P/111.
BOARD OF HEALTH . . . . . . . . . . . . . . .
FORK N0. 1 3 SETS OF PLANS . . . . . ... . . .. .. ..
TOWN OF SOUTHOLD SURVEY . .... . . . . . . . . . . . . . .. . . . .
BUILDING OEt'ARTTIENT CHECK ... . .... . . . . . . . . . . . . . . . . .
TOWN HALL SEPTIC FORM .. . . . . . . . . . . . . . . . . .
SO117HOLD, N.Y. 11971
TEl.: 765-I802 NOTIFY:
CALL
Lxanined. 19.... q /� MAIL TO: . . . . . . . . . . . .......... .. .
19.... Permit No. �:3....I...�' .....................
A1><>rovcKl.. jP .
Disappnwe<1 a/c ....
�5 u (wilding Inspector)
11� 3 PPLICATION FOR BUILOING PERMIT
IAV •nate. .�u;�Y. ,?!�. . . . . 19 c�3
T
LOG.DEPt-
DO.OEPI{ INSTRUCTIONS
a. is application must be completely filled in by typewriter or in ink and submitted to the Ikdlding Inspector wi
3 rets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan allowing location of lot and of buildings on premises, relationship to adjoining premises or pml>lic
streets or areas, and giving a detailed description of layout of property Mist be drawn on the diagram which is part of
this application.
c. The work covered by this application mey'not he conmeoced befora issuance of Building Permit.
d. Upon approval of this application, the Building Inspector wilt issue a Building Permit to the applicant. &'oim
permit shall be,kept on the premises available for inspection throughout the work.
e. No building droll be occupied or used in wiiole or in part for any purpose whatever until a Certificate of
Occupancy alhall have been granted by the lknilding Inspector.
APPI.IMICN IS ME= MARC to the building Department for tine issuance of a Building Permit pursuant to tine
Building Zone Ordinance of the Tbun of Saittold, Suffolk County, New York, and other applicable laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, code,as herein
described. The applicant agrees to comply with all applicable laws, ordinances, building cods, housing
regulations,iad to admit authorized inspectors on premises and in building for necessary inspections.
,V .�...........................
(Signature of applicant, or name, if a corporation)
...... ....4... �� .....`'•...j....�°'..
(Mailing address of applicant)
State whether applicant ie owner, lessee, agent, architect, engineer, general coutractor, electrician, plumber or builde
....... ..............................................................................................
Narc of awrner of promises ........ .................................
..................................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly auttorized officer.
....................................................
(Name and title of corporate officer)
iksilders License No. .........................
Plumbers License NO. .......................
Electricians h.icense No.
Other Trade's License No. ....................
I. lication of land on whidn proposed work will be cone................... ........... ��-Y 'qRC Ff1 a)..,. .•..
... .`T�. 'ovT�„ /•.nuc...............................��yr..?...................................:....
House Number Street Hamlet
County Tax lisp No. 1000 Section .... ........ Block ........... Lot .1...%.........
SubdhvisioA().P!'t414 %Q- NQ'=!� �?'rG(r WT.. Filed Map No. ........:...... Lot ...............
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Pxisting use and occupancy ....
op 49 � P F /ftJ�` ...........................
d
b. Intended use aril occupancy . ........ ..........................................................
1. Mature (if ✓ (dtedt Mildi applltiable)a New Wilding .......... Addition
llepair ............ Removal ..... Demolition .......... Alteration ..........
Other tdctrk ..., .. ...............
.. .... ... .....
......., (Description)
4. Ratitntted Cost .. �,�/ fee ..............................................
(to be Raid on fll hug this application)
5. If A4011 Ing, rxniter of dwelling tatlts ..... �..., tbwher of, dwelling tints oxo each floor
Ifgarage, txniter of care ......................................
A. If Ixtal eas, oonnercial or mixed ocngtancy, specify nature and extent of eodt type of use....... ...............
7, Diaxsnsions of existing structures, If anyt Frxnt....M./. -'..
.... [tear ............... Depth .. .rh,./�.....
IktlglnC .........VP/..I............. tLnber of Stories ......r.....
Dinenalats of sero structure with alterations or 'aklitionst FronP elt ...I��G....., hear ......... ......
Depth ........11G�®r:,.. tieigtul ...&...... ......... Nottber of Stories .. 1...........
S. Muenalons of entire new construction: Front ................ hear ............... Depth .......... .... .
lieli0nt Mnber of Stories ..................... S?¢yYl
9. Size of low Front .................... Rear .................... Depth ..
10. Dore of Rtrdtase, Idrrte of Bonner ( mer
11. Zane or use district in uhidt premises are situated
..
12, Doesproposed utruction viola „
ole any Willtexcess fill be removedfromemisestl YRS
13. Will lot be reeled ............
14. [lames of Owner of premises .�.i4ttPte(Jr9noll...... Ackireaa . ` fOf,rr?r-ef�yH,/4N��`....... Nacre No.�G ?7!/61Q
Name of Architect ..f tdJ��IY{./10 !9/{4............ Address
I'Itotte No.
Mite of Contractor ..................... MIreas 4..�`a�?s°4rh'w�........1710ne No.�G!L1 !!lam
15. is thinrt within 300 feet.of a tidal wetland? * YpS .......... t1O •...•.....
R� r
*IF Yes, S mnx n MM 11'llMmes ralurr M&Y Ott I1. VIMM.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, uttether existing or proposed, and Indicate all set-back dimensions
from property lines. Give street ancf''block nmber or description according to deed, and sinow street mires arxi imlicate
tAtether Interior or corner lot.
r
SI'Allt (xr Mid Y(AM,
SS
(IxMIY (x-1 ...I.....................
a.
(Nene n.
4.e �yiutn igt�g c r h ................being duly sworn, (Iepx)seS 81x1 says that he is the appllckit%
alxwe tuned,
Ile is the ........ ..�. /y. .'''............
(Oon;;actor, agent,-coofficer., etc.)
of said owner or owix-re, nix[ is duly 'zlithorlaed to perforin or have perforned the Pair[ work mid to nrnke and file this
alqulIcattoll, dial: all statelents contained in tilts applicaticxn are true to the hest of his kt"ledge 81x1 Itilief, mei
that the work will Ile performer) in die manner set forth in the appticatloo filed therewith.
;herrn to� before e this
. ....R4 j�...- .`ciia/y ofl� ,y�r)�F.�t1-9.7... c�
Notary l�tnblic 1. 4-::"�rf?S�:,F,�t..,:. ..........
HELENE D. HORNO (Sil;rutt:ure of Appl leant)
Notary Public, State of New York
No.4951364
Qualified in Suffolk Oounj 95j ;
Commission Expiros May 22, --.,F
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NOTIFY BUILDING DE
765-18029AMTO4PM �
FOLLOWING INSPECTIONS=
1 FOUNDATION - TWO !
FOR POURED CONN
2. ROUGH - FRAMING • FLUMWO
3. INSULATION
4. FINAL - CONSTRUCTION MUST
iQUIREBE COMPLETE
FOR C.O.
✓wTlvtJetS�j JF� .�' Ltd- i� - " /�tJA7T" �r ALL CONSTRUCTION SHALL MEET
` THE REMENTS OF TME N.Y. ,
U��` STATE CONSTRUCTION & ENERGY
i ,�" CODES. NOT RESPONSIBLE FOR
�'€. �!`f/7�� i DESIGN OR CONSTRUCTION ERRORS
VA
h t - URDERWRITERS CERTIFICATE
REQUIRED OCCUPANCY OR
USE IS UNLAWFUL
,. WITHOUT CERTIFICATE
a yc -� j �►.� -- - - - -� 5 ,;�r, * v s OF OCCUPANCY I
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