HomeMy WebLinkAbout25231-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26852 Date: 12/23/99
THIS CERTIFIES that the building ADDITION
Location Of Property: 3340 OAKLAWN AVE SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 70 Block 5 Lot 54.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 21, 1998 pursuant to which
Building Permit No. 25231-Z dated OCTOBER 15, 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 ALTERATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to DANIEL V. JENNINGS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. PENDING 12/15/99
PLUMBERS CERTIFICATION DATED 10/15/98 PECONIC PLUMBING&HEATING
Building In etor
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. 25231 Z Date OCTOBER 15, 1998
Permission is hereby granted to:
KATHRYN C MULLEN
PO BOX 94
SOUTHOLD,NY 11971
for
CONSTRUCTION OF AN ALTERATION TO AN EXISTING SINGLE FAMILY
DWELLING AS APPLIED FOR.
at premises located at 3340 OAKLAWN AVE SOUTHOLD
County Tax Map No. 473889 Section 070 Block 0005 Lot No. 054 . 001
pursuant to application dated AUGUST 21 1998 and approved by the
Building Inspector.
Fee $ 75 .00
Building Insp6ctor
ORIGINAL
Rev. 2/19/98
THE NEW YORK BOAR® OF FIRE, UNUERWRITERS PAGE 1
1185077 BUREAU OF ELECTRICITY
F 40 FULTON STREET, NEW YORK; NY 10038
Date DECEMBER 20,1999 Application No. on file 17556699%99 N 510282
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the aboveapplication number is in the premises of
DANIEL JENNINGS, 3340 OAKLAWN AVE. , SOUTHOLD, NY
in the following location; ❑ Basement ® 1st Fl. ® 2nd FG Section Block Lot
was examined on DECEMBER 20,1999 and found to be in compliance with the National Electrical Code.-
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS CENTI FLUORESCENT I OTHER I AMT. I K.W. I AMT. I K.W JAMT. I - KW AMT. I K.W. AMT. H.P.
5 18 16 5 1 12.'1 1 1.2 2 F
DRVERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS ISPECIAL REC'PT.I TIME CLOCKS ,BELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
AMT. K.W. I OIL H.P. GAS H.P. AMT NO. A.W.G. AMT. AMP. ?'AMT.I AMPS: TRANS. AMY. H.P. NO.OF FEET AMT. WATTS
1 30 ; 3 600
SERVICE DISCONNECT NO.OF S E R V P " C E
METER NO.Of CC GOND. A.W.C� AWG A.W.G.
AMT. AMP. TYPE EQUIP. I 0 2W 1 0 JW J 0 3W 3 0 4W PER 0 OF CO.COND,' NO OF H4LFG 'OF N-LIG NO.OF NEUTRALS OF NEULRAL
OTHER APPARATUS:
PADDLE FAN F-1
G.F.C.Ir-3
SMOKE DETECTOR:-5
TRACK LIGHTING:-16
ROSLAK ELECTRIC LIC.#3677- cE.rL
P.O.BOX 164
CUTCHOGUE, NY, 11935-2453 GENERAL MANAGER
11
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 CERTIFICATE ;MUST NOT,BE ,ALTERED IN ANY MANNER.
1 np Form No. 6 /D - 5---&d13
TOWN OF SOUTHOLD
r .. -- BUI DING DEPARTMENT
CI ; TOWN HALL
2 11 765-1802
L - APPLICATION 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
y 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 - .25C.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . . . . SV9j.. . . . . . . . . . . . . . . . . . . . . .
New Construction. .. . . . . Old Or Pre-existing Building. . . . . V . . . .
Location of Property. 'riz/0 0RK!_494✓W • •�`•v • • • !.AIR . . „ .. „ • • , , , • .
House No. Street Hamlet
Onwer or Owners of Property.. Ii.v'IEL . #(:;T • • • • • • • • • . . . .
-70
County Tax Map No 1000, Section. . . . Q.. ... . ..Block. . . . .Lot.0-5 ... `• • •
Subdivision. . . . . . . . . . . . .. . .... . . .. . . . . . . . . . . . .Filed Map.. .Lot. . . . . . . . . . . . . . . . . .
Permit No. .A—f 2'j `. . .Date Of Permit. .���� �1. . .Applicant.��i�
Health Dept. Approval. . .. . . . ... ... . . .. . . . . . .. . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . .. . . .. . . . . . . . . . . . .
Request for: Temporary Certificate. .. . . . .. . . . Final Certicate. . ,-_ .
Fee Submitted: $ '.5 . .. . . . . . . . . . .. .. . . .
��. s7262
C v aGStS2 APPLICANT
o�os�FFo[,��oG
Town Hall, 53095 Main Road C2 Fax (516)765-1823
P. O. Box 1179Telephone (516) 765-1802
Southold, New York 11971
1 �c �►
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C E R T I F I C A T I O N
DATE: 10 s `
Building Permit No. 257 3
Owner: IA N I C L V . _T0k)N f NGS
(please print)
Plumber: 0.,e-o! e- :S ,P rv-v
(plea)aLz print)
Pe-con -c-
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
IJ
(P 1-6mbe ignature
Sworn to before me this
day of f 19
Notary Public, County
ARA S7EPN0N0W1
NotaryPublic State of�,York
No.01ST414752
QJa!i'dad in Suffolk County
Cc.;rssion UPIros Sept.30,19 C,
o �
Town Hall,53095 Main Road W Fax(516)765-1823
P.O. Box 1179 Oy Telephone(516)765-1802
Southold,New York 11971
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
July 19 , 1999
Mark Schwartz
275 Clearview Ave.
Southold, NY 11971-0959
RE: Daniel Jennings, 3340 Oaklawn Ave. Southold.
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
An application for Certificate of Occupancy is
not on file. (Enclosed)
XX No Underwriters Certificate on file.
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 # 25231-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
'1::LD i7:SPEC+.0%+ ��Ub.£ � CONMGNTS •v �
m
a
•r
W
'OUNDATION ( 1st)
En
m _+
m
FOUNDATION ( 2nd )
ROUGH FRAME & `c
G
PLUMBING
v, C.
H
m
3.
INSULATION PER N . Y.
STATE ENERGY
CODE a
z
4 .
r
FINAL
. 0 7
C3
. z
ADDITIONAL COMMENTS:-----------------
x N
. - J
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROU PLBG.
[ ] FOUNDATION 2ND [ ] 1 ULATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: V
44
DATE INSPECT
r
M-1802
BUILDING DEPT.
I NSPECTIO
[ ] FOU ATION IST [ GH PLBG.
[ ] F UNDATION 2ND [ ] INSULATION
FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
� � L
DATE INSPECTOR
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ vT/FRAMING [ l FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: -ed
1 e.L� '
" r
DATE INSPECTORAT?
UEt'L
p IIUARU OF ' Tfl ...
. . : .... .
\\U •FORIt RU. 1 3 SETS OF ,FY.'VLAANS'..... .... ...
....
TowN of SOUTUOLD' SU ..
RVZY .... . . . . •,...r..• • ... . . .
UUILDINO DP.BARl'MLrNT
CN6CK
O PUG Z` i 'foWN HALL STPTIC FORK ... . . . . . . . . .. . . . . . .
GOES SO111'UOLD, N•Y• 11971 /7
eLo�• OV{Y Tel.: 765-I802 NOTIM
CALL _ 7(,�...�•a 5, �g
BVks.
19....
MAIL TO: . ... . . . . . .
lxuoined... �.�
..�`.� . ` � 19. Permit No: ........... ... ..... ..........................
Ajwproved ... , ... .... ...........
Disapproved O/c ...................................
• A
Aou WILDING P61WIT . '
, •AaCe.. (� 19. . . .
INSTRUCTIONS
s. 'this application must l>e cIWvleteiy filled in by typewriter or in ink =4 VuUmitted to tla nuildiag Inspector wi
3 Seta of.,plans;, accurate plot plan to scale. tree according to adnechde. Dining premises or public
b, Plot plan Showing location of lot and of buildings on premises, relatibe dr tont wlIlaw is part or
Streets or areas, arnl Siv11% a detailed descripti'ar of tayarC of property must' be dracxn on the diagraa
this application. of noildi FerwIt•
C, '11,e work covered try dots application may not txt crnmsnced bePors; issuance ng
d. Upon approval of this application, the Wilding Inspector wilt 190-)e a Auild'PS perwiC to qa applicant. Suds
permit shall be.kept on Che premises available for inspection throughout t1w wont• wtatever until a Certificate of
e. No building shall be occupied or used in chole or in part for any purpose
occupancy alnall lave been granted by the nuilding Inspector. dIng Vomit pursuant to the
APPI.ICJCMN IS ILEn311Y MADE, to the Uullding Department' for t1 eI YsUm ce orkv "A o rlsppliCabla Laws, Ordinances or
Uuilding Zone ordinance of the 'ibwo of Southold. Suffolk County,
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition,
described. 11na applicant alsr Tecode win
Wass to comply with a licable laws ordinances, building coder housing
- - em ' i
regulaCiona,�and to admit' authorized inspectors on premises ani in WI
for tons,
y • if a corporaCian)
11 J�G f 06C �O /i?prrl7i-CrGt N/ (Signature of applicant, or crane,
(Mailing oddreaa of applicant)
State Abedwer applicant is 041er, leasee, agent, 01
engineer,'general contractor, electrician, plrnher or1)uillk
.. .. .. ................................................................
....... ... .... f • • .•��C�.�.�.r�..•..•.V.:.�.�:N•.�.1��•.N....•..•..••...•.•.....•......................
Num of Omer o premises
(as on the tax roll or latest deed)
If applicant is a corporation, Signature of duly autlwori=l officer.
.................
.....................................
(Num and title of corporate officer)
Ihnilders License No- .........................
Plurbers License No. �.
Eleccricians License No.
Other Trade's License No. ............••......
I. locution of land on winidn propose(] work will be done....................................................DLl�
�, .. w.. . ... a
1.X44 ......C?�t .......... '11. ...•.........
........................
louse timber Street'
Crunty To%Yop Nn. low Section......��...... ulock ....� ••••••
.5 ....... IDC ...J.�:.�
Filed lisp No. ........:...... lac ...............
(Name) .
and Occupancy of premises and intended use and occupancy of proPosad caatruetionr
2. Sl'at'e existing use �Pa�Y,• G� .. ..............
a. f�ciatisq use and occupancy •• AiQY.wtir r;ats.�'.ait75d'ySdtliYl••
�Inur�o aKiniVu+''.n=satkitifaax�
b. Interzed use and occupency ....F: t�..... !Y!•• 0000)00Y 4 ni wi.nh3 ... ..........................
,,, , ...,i�9bi'J av khxla,xai
Mature` (it work (diuk winds applieable)I Nax Building ..."..... ALkiltion ........., Alt on .�...
............/P0 `0 ...... Dtmrolition ,............ Other 14btit
Latinv+ted Cost ..... fee ........... i
... .• •• .' �y
r (Lro be paid.txt filng thta a loft
/ r
It thmlling, otrtber of dwelling unite .... ...... !Asher of th4e111ng units oil each oor .. .. .... .
if garage, Imrll)Qr Of nfAfa •.u.u.'........ .................... i%q "b..� js
If. Imalneas, com micial or mix foccl m specify naCura and extent of enc% type of use...... 12 Ye
9 ty. t� 4' ! pp,r q ...
liltnsnnloim of existing atn>cturea,i i f any, rront.�5 7t44:�„y�I.,Rear ..r?7.:9...... ikpeh .3>3•..?f A 15 r
nui tt .... r u, n'.,. llbar of Stories 2. ,,�
DIn,enaloos of�a�+� a nature with alterations or'mklitiones wont ...TY2 1 er . ...
Dapllu ......r7`i/�.�r :... Ik1gl+C I. ..� r �..J.�.tRxiber of Stories ..�147;,&-(
t rl`( ... 1 'd
f. Dimensions of entire new conetrucgiont wont ...AY A........ hear .../Ur 1...... Depth ..fV'.F.. ....
IMIN+t ......
............. 4rher of Stories ... �G J............
). Sirs of togs Prcx,t .. J.$ :.�t�(n.... Rsar .................... rmptiu ..i��l.:.!. .....
Ill. Ilo a of Purdis" ................1..., llama of ironer Owner ...........I......................... .• .
II. 2a+e or use district in u.hich p lose are situated 0.............•.......... • ...
12.
vlolat
zonina
13. N ll lot e proposed �tion A i�¢aRY. willlexcess fill be removedafromtprsnlseat YL*8 NJ
Ih. Nares of Owner of �nnegtae�•r•.Y .lk 1/.i.J�sa.': 'sAciclreea .Q r?"!F�!.�r.�:. rfs� . llla>e� .......•
cKo f t�GnyPd*V �s�uT•�404. t,cM4 rrcyvo crTy, ,vr i�ior- 3�3�
Nano of ArdiitecC ,�Af►l .�S'rr,.',1SI�1'y1�KT......... Address ./t7� s.. sic#jS ��.. those ....7��-�? Q
�.�• �7 ltd' i
Note Of C,onttactor ..............i' Addrass .�.�.�i::l (Pe.K.I..~7.`( *..'S.�lme 1iO.�f�,!....... '
* property of a tidal watland•4 * YRS ., t .... t10 ..........
I5. is thisxiU►In 300 feet,
1R YLS, SOU11= Tam mIIiiiSSS mmrr MAY m Itf?(XIIIUm.
PLOT DIAGUM .
Locate clearly &4 distinctly alit buildings, utnther existing or proposed, snd indicate all aet-back dltrenalons
Arm property lines. Give street mud block ounher or description according to deed, and show street 'neres and itxlicate
tAmther interior or corner lot. i
r.
sfrcns W MrW Y(Xtc
(XIM17 (V .r.....././......... .........
�vft ....................being duly swnrn, demes and asys Lhat Ile Is the nj+pl!<amt
(Nntta of indIvithnl signing contract)
nlxrve tuned,
Ile Is the ...... ......... ..... ... '..................... .......................... .................
(Ctn+trset r egenC,- iprporate officer., etc.) ,
of sald mier or tmmiers, CM to duly authorized to per,fonn or have i+erfarmed Lhe said work mxl to make and .filo this
n14)I ItnLitm+; lhnt till statetents conta'lned In this rilj)llcatl(xs are true to Ute beag, ofhis ktxmrledge stxl t)dIIef; mxl
that the uurk will be performed In the n,nnner set forth In the nppt.lepticn filed thdre,wAth. `
9xmt to befura me U+le
.'F ......tiny of I .......
Notary Public ...
(Sigtud:ure of Appl.lcont)
ROB EkiT t.SC JR,
Notary Pu 0.State New York
QUSIM u(In Sufi It County
No.QISC472
Arm Expir�a May 91,
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SVRVE' ' OF PROPERTY
A r PINE NECK
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N. Y.
"ERTIFIEU TO, 1000 - 70 - 05 - 54.1
7RST AMERICAN TITLE INSURANCE SCALE 1" = 40'
'OMPANY OF NEW YORK APRIL 16, 1998
rEA = 13120 sores to tie rine
UURR A�1 1yryp0LL Of NElp
fGTq 72� OR Tt YO T STA.rivi Y TION;IAw S >o�N T.Merfia ,tt
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TAS PER SECT�y T2B9= N 2 A2
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N ARE VALA9 FOIL 7}OS MAP AAV COP/ES THEREOF ONLY P * Pn Y.S. UC. NO. 496/8
.(AP OR COPIES 04AR AM'RE•SSW SEAL Off• TME SURVEYOR
$MA TtW APMAS01�4 1;:
ONALLY TO C0kftY WTH SAAR LAW THE TERM ALTERED or O,�V/ R Sr P.C.
BY ANY
S ALL
WMEYOM AS INS CTEV ANO 7 �
RiT-TO-0ATE'ARE NOT!N COMpUANCE W7TH THE LAW. /Q STREET
SCUT , N.Y. 11971
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PROVIDE OPENINGS FOR
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KEHWUErculs7 ulck REQUIRED BY PART 714 OF u � I w �xlsT SwF
CIJIMne�y 'Yv
0,lulm NEn 2x¢sn e N.Y. STATE BUILDING CODE.
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T4Z441` 7-w2¢}L - w y p?xb
PE? MAIN DATE:#�B.P. a.Sr'}3l
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i NOTIFY BUILDING
2 2Y-4 Porn TY •) `- 3- Z.c 6 TAT
1-a s7w/ n 766-1802 9 AM TO 4 PM FOR THE
C c-so¢1Kouwa 4- = f- O FOLLOWING INSPECTIONS:
--- 2-2x-e Nue --- Z-Zs4 I ' FOUNDATIDCONCRETE
4-2xq 1 FOUNDATION - TWO REQUIRED
Tw 3aglo 7w3o410 7w32. ROUGH - FRAMING & PLUMBING
41u ' 7r 4Y0 PROVIDE SMOKE-DETECTING 3. INSULATION
ALARM DEVICES 4 FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
AS TO PART.721.1 ALL CONSTRUCTION SHALL MEET
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