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HomeMy WebLinkAbout25210-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26345 Date: 03/26/99 THIS CERTIFIES that the building ADDITION Location of Property: 3780 ORCHARD ST ORIENT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 27 Block 3 Lot 3.5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 12, 1998 pursuant to which Building Permit No. 25210-Z dated OCTOBER 1, 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 ENCLOSE EXISTING PORCH UNHEATED, NEW CHIMNEY & FIREPLACE & REBUILD EXISTING TWO STORY DECK AS APPLIED FOR. The certificate is issued to MICHAEL F LOPEZ (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N-482101 03/09/99 PLUMBERS CERTIFICATION DATED N/A Building Ins) ctor 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. 25210 Z Date OCTOBER 1, 1998 Permission is hereby granted to: MICHAEL F LOPEZ 3780 ORCHARD STREET ORIENT,NY 11939 for ENCLOSE EXISTING PORCH UNHEATED, NEW CHIMNEY & FIREPLACE & REBUILD EXISTING 2 STORY DECK AS APPLIED FOR. at premises located at 3780 ORCHARD ST ORIENT County Tax Map No. 473889 Section 027 Block 0003 Lot No. 003 . 005 pursuant to application dated AUGUST 12 1998 and approved by the Building Inspector. Fee $ 88 . 00 Building Inspec r i ORIGINAL Rev. 2/19/98 Form No. 6 TOWN OF SOUTHOLD niegg BUILDING DEPARTMENT �i,�TOWN HALL ` I765-1802k 1 APPLICATION FOR CERTIFICATE OF OCCUPANCY BLDG-DEFT' +OWN OF SOUTHOLD s 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 17 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 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 Buildins - $100.00 3. Copy of Certificate of Occupancy - MC, 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . �". . .Y �: . . 1 . . . . . . . . . New Construction. .. . . . . .. . . . Old Or Pre-existing Building. . Location of Property. . .37 `�) . . � F . . . . . House No. Street Hamlet 1 Onwer or Owners of Property.. . . .V . . . . �.`. .. .. .:. ��:. • • • • • • • • . • • • • • . County Tax Map No 1000, Section. . . . . . . . .. . . ..Block. . . . . . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lota . .s . ... . . . . . . . . . . . . . Permit No. . . . . . . . . . . . . . . .Date Of Permit. . .. . . . . . . . . . . . .Applicant. �.1. °( H'�. Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . .. . . . . . . . . . . . . Request for: Temporaryrr��Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $. . . . . '. �.. . . . . . . . . . . . 5 G 0.2 I . . . . . . . . . . . .APPLICANT. . . . . . . . . . . . . . . . Co X63 y5 O�OgUFF04-cO Gy` Town Hall,53095 Main Road H x v, ,� Fax(516)765-1823 P.O. Box 1179 Oy Telephone(516)765-1802 Southold,New York 11971 BUILDING DEPARTMENT TOWN OF SOUTHOLD March 11, 1999 Michael Lopez 280 W. 12th Street New York, New York 10014 To Whom This May Concern: We are unable to complete your Certificate of Occupancy be!�:X e of the following reasons: 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. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 25210-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. 1 • \ L • • • � �/moi i f1/ ♦ P ,.� �Lli u.% t ,,ice � • Ir • � � r II o =I • 1 1 • • t M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS ION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS• DATE /d INSPECTO r M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [>FINAL H PL [ ] FOUNDATION 2ND [ TION [ ] FRAMING [ ( ] FIREPLACE 4k CHIMNEY REMARKS: DATE INSPECTOR I M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] RO H PLBG. [ ] FOUNDATION 2ND [ INSULATION [ l FRAMING [ ] FINAL [ ] FIREPLA777% REMARKS: i DATE INSPECTO M-1802 BUILDING DEPT. INSPECTION [ FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ /,�FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: �fr oda ® — X o of ®t �'t�� ot1 ci• Zk D DATE '—INSPECT THE NEW YORK BOARD OF FIRE UNDERWRITERS PACE 1 1000121 , BUREAU OF ELECTRICITY. : F40 FULTON STREET, NEW YORK, NY-10038 - MARCH 09,1999 17342598198 N 482101 DateTHIS CERTIFIES THAT Aun! i ACa. on1e11g -, only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of MICHAEL LOPEZ, 37801I—� ORCHARD LANE, ORIENT, NY in the following locatftC,_.L.,_ gaS,eptB3Ft A 1st Fl. ❑ 2nd Fl. OUT Section Block Lot was examined on MMXX tTfi 'BOO lNJ��`�JJ and found to be in compliance with theNational Electrical Code.- FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT I OTHER IAMT. I K.W AMT. I K W I AMT. I K.W. I AMT. I K.W. 2. 3 2 1 2 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI—OUTLET DIMMERS AMT. K.W. OIL H.P. GAS N.P. AMT. NO. A.W G. AMT. AMP. AMT. AMPS.' TRANS. AMT. H.P. NO.OF FEET AMT. WATTS -SERVICE DISCONNECT NO:OF___. ._ -_ __ __—_.S _.. E. . ._ R ___ .V_.. __I____. C__ E METER NO OF CC COND. q.W.G. A.W.G q W.G. AMT. AMP. TYPE EQUIP. 1 0 2WJI 0 3W 3 0 3W 3 0 4W pER 0 OF CC COND, NO OF HI-LEG Of HI-LEG NO OF NEUTRALS OF NEUTRAL OTHER APPARATUS: ENCLOSED PORCH-1 ELEC. RQ014 HEATERS:1-.375 K.W, , PAUL R. BURNS LIC.#3897•- L L PO BOX 1061 SOUTHOLD, NY, 11971-0932 GENERAL MANAGER /1 Per , This certificate must not be altered In any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT, THIS COPY OF ERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. BOARD OP UEAL"ll -/. . . . . . FORM N0. 1 3 SETS OP ,IsI.ANS ' . .. . . .. . .. ..... TOWN OF SOUT1101.D SURVEY .✓V!.• . : BUILDING DEl'AWMENT CHECK . TOWN IIALL SEPTIC FORM •. • . . •• SOIITNOLD, N.Y. 11971 TEL: 765��la�Z � /�J_ NOTL' [ •3B(aJ!' y CALL at:. . . .. . . . .. /� MAI;. T0: A{�>rwcd../A0 ,. 19.... Permit No. .... ..... .......I...I....................... Disapproved a/c .................................. (Ik:ilding Ina{xictor) 0 15 APPLICATION FOR BUILDING PEIIHI'T AUG 2 Date..�u�.. .. .. . . . 8. K INSTRUCTIONS ih4 BLDG.DEPT. T WN F UTHOLD s. 'Deis application aunt be completely filled in by typewriter or in ink and submitted to tine Building Inspector w: 3 seta of plans, accurate plot plan to scale. Pee according to schedule. remises or Mic h. Plot plan alhowiag location of lot and of buildings on premises. re Ci Jr awn on ti�ndi�raa ui:ic: is part of streets or areas, and giving a detailed description of layout of property be this application. of c. 'lite work covered by this application may not be ccnmenced before isauancew a beil?erwiC to U:e,applicant. S::ci: d. Upon approval of this application, the Building Inspector wIliClo work.Building permit slmrll be•kept on the premises available for inspection througl whatever until a Certificate of e, No building stall be occupied or used in wiwle or in part for any purpose Occupancy small have been granted by the Building Inspector. APPLIC/nON IS kiEMM MADE to the Building Department,for the New Ysuanceof a jiuildIPS er appliaePermit ble pursuant Dws Ordinances or Building Zone Ordinance of the 70,40 of Southold. Suffolk County, Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, rem described. Ilhe applicant agrees to comply with all applicable laws, Ordinaznces, twitting cote, tianshousirg regulationa,,and to admit authorized inspectors on premises and in building fC�searYy P f ................... ......................... (Signature of applicant, or name, if a corporation) '785- Hai". �a�„4hi@hl ........... • (Mailing address of applicant) State ednether applicant is o6rber, leasee, agent, architect, engineer, general contractor, electrician, plurber or Iuilde ...........,�•:�»Gra.. Go..¢^Q'����........... ............................................................... r .. 1 a � !°....................:......................................... / o ez Name of owner of premises ...:....................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly autluriztxl officer. (Nurse and title of corporate officer) lhnilders License lb. ..................:...... Plu*vrs License No. Clectriclana License No. Outer Trade's License No. .................... I. [ncation of land on winicih proposed work will be done............... , ........................................... ........... a laahle�t ........ .............. Qr�tia ae................................ house Numher Street ......... Mock 3............ Tot ...:A. ....... County Tax Map ler. 1000 Section ..... .. ... Subdivision ...................................... Filed Map No. ........:,..... I4C ............... (Name) 2. St'al'e existing use and occupancy, of premises and intended use and occupancy of proposed construction: lE: /'Q' �! 2�:�e r a f $ :;? ftYlw4}:;R .... ................... a. Existing use and occu{hency ... .. ShoY said to sista,a,i tM y7bloN 3�vn cjle. �aao,./y T�s�Si/+ l.sidu2 n:br;lsiruQ....................... b. Intended use and occupancy ......... ............. 1 Mrtlure a! work (dleckQildl applicable)t Now iluilding ........ Addition `•!l•`•/•(•T•kAecltreirpatt�gionn)mlV Ilelwir Remoal ............ Outer work y•. ."..y•.. frobP �.. ed 2ss,%I Lstiotated Coat /�y. ......... rtq�r ,) fee . ........... .. .. . . ' (to be paid on filing title application) If If &MIli unherof f "Ill: nxnita .,.......... I&NIber of 64elling units at each floor ./....... ...... ng. y/ garage, 7 R.............................. If Ixtehtesa : amrterclal or mixe<f occupancy, specify nature and extent of eac]i type of use.,. ................ �. I 3r ,ihtenelana of existing strtcturep, If any% Pront.....�.....,...... Rear 3 2 Depth Ilul tc 23 ................I Monter of Stories ..�.........I........ //a. cyyN6EiNJ�T �Riiy� Dimensions i F alterations or rront ............... .. ..... lk! t Rear .. • .......... .................... Mnluer of Stor[ea .............. Illnenslans of same etntcture wit �n 1. Matenaians of entire new construOtiont Prone 4 ' NjAh r a .. ............... Iki(ltr .... !Mnber of Stories ..................qt� ... ... 1, Size of loo Front ..../5!v ...... Rear .....91.,.. ..... NO, ..31.... 1. ..'.I_ 'i .11�.•.-..1__,ft� it 10. Nice of Purdtaae'...I.�q:�.. .... Rams of Ponter Omer ..N,.e,✓d.e................ 1 (1 iT 11. 74116 or use district in tdiidt remises are situated ......... p Rn R Ce arty zaning law. Ordinance or re uletionc v 1 -------- - ! 12. Ibes m aecl construction vlole' 1:l. Will lot be regraded .....fYl?.. ....... will exceea fill 3 raved frau �••, .a ' 'YES CU. r pr lees.t ., 14. Nunes of Owner of premises ie� (e/ ,TGz' Acklreae©rdm,,`.`So6- Or.eµh Z Plane N07 -/3 Nmre of Ardtitect .... .... �............. Address ., • ••.......... 11 tons Ilo. None of Cattractor .....7Ja vr..��a' l Fr eA. . . R.. � yAddreae ... . � l'ane No.3Z3.3B68 IS. Is (life property within 300 feet.of a tical wetland.? * YES .......... No 1'.......,. *ir YES. S{x1D101D TWH TAI=Mfi Mmrr MAY m RG(X11Rt+D. PLOT DIAGRAM Locate clearly sad distinctly all buildings, mustier existing or proposed, end indicate all set-Itack dimensions from property lines. Give street end'biock outlier or description according to deed, and alum street nares sotl irxilcate tdtether Interior or corner lot. r (1xM1Y (xt .... S 1.0 41 ..... �S 19C� a n l ` f :s /I t V ..........Weill duly wwo, delxraes and Paye that be in the applAcvnu: (Rahe of hxlividual alStilog contract)', alxrve limed, 110 is LiteCrCorMW.-.e:, :,,,,a . ......f......... ...... ntplorpornte officer., etc.) of acid cr+ dilly iaudio0zed to perform or have ix;rforaecI Line said work atxl to make orxl file LWH alAtl Icatioll; dint 11.11 staterents contained in title nprlullcattrnt are true to the Itent of his knxuwlcdae nod Ixilief-i eM that Line murk will be performed I Llnenner set forth in Lite appitlentidm filed,titerewlth. 9w;orn to before Pre Utas .......M2: .....day of .: ... Notary Ittbtic ' ................ R0BERTI.„BCORTJR ' (Sigtvtture of Applicant) Notary Public,Slats e1 H Yetk Qualified In SuNdJNt No.013C4728� Term Expires Mey 31, II I SUFFOLK CO HEALTH DEPT. APPROVAL AH S. NO. 14 22-i-29 _ , ! ehGloaG :s ", y YpI'ah / STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL � \ SYSTEMS FOR THIS RESIDENCE WILL 1 CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT OF HEALTH SERVICES _ I . � N.a?'I �,1J E._T % 151 25?,13/ j" APPLICANT iIr t" u) I<E�'l'f -TFLf y' SUFFOLK COUNTY DEPT. OF HEALTH 1 V;i. SERVICES — FOR APPROVAL OFI QI,p I� SfOILY C. tq" CONSTRUCTION ONLY p _� _ !O, �1.. •9'53 SF •�'n nr.( r y _ .. DATE: 1 4.9¢1 </I."' '1•w..a J>,q'YY� ••t �� �, / ��.�!_' t _�F �-, H.S.REF.NO 14*Z•D`-:;JU APPROVED _t'y_�' ,d weic-til �r rcTRIC LI NE to SUFFOLK CO TAX. MAP DESIGNATION X85"9 (i DIST, SECT. BLOCK PCL. I I .J OWNERS ADDRESS zw/dry, 7 1 .I .. . . b n) ,•-� DEED: L. b/;, P • ! ' ! r TEST HOLE STAMP I' � , I m :. :i ii,r rl-1r:• ei-r'. , �L.r_r,.� _ y'rn::r-_ � - -- I _ _ _ _ I _ .__ •-- .-,"I Ir—Y" arae �..�.1 ! PE _ ��/S��✓14' V ` ... sh;n rind ,I_ I 2 \ �.._ ( .V i� �Jr. •" •rj nxnon.T•l,._..�nnp . s�yy/l�U.� T i.l i."(_ ..I-r _:�. 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