HomeMy WebLinkAbout24404-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25664 Date: 04/21/98
THIS CERTIFIES that the building ADDITION & ALTERATION
Location of Property: 1290 ROCKY POINT RD EAST MARION
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 31 Block 2 Lot 15
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 26, 1997 pursuant to which
Building Permit No. 24404-Z dated OCTOBER 7, 1997
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 AN ADDITION AND ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to DAVID G PURINTON
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N449518 03/31/98
PLUMBERS CERTIFICATION DATED 04/14/98 MATTITUCK PLUMBING
r
Buil ng Inspect,6r
Rev. 1/81
FORK NO. f
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)
N° 24404 Z Date ............ ..:... ..1.................... 19j-�7
Permission is hereby gra ed to:
.... .... ...................... .....
.... ......... .. ......... ....W-. tlz.- sem.......
r ........ ......... .......dA?:t. ... ... ....... ....... ....... ....... .. . .. .. -..........
................................................................................................................................................................
at premises located at<...... ........................ ..........
...............� ........................ ......
....
County Tax Mop No. 1000 Section ..... ........... Block ....... ....... -Lot No. .1 .........
1
pursuant to application dated ....... .................... 19 ...,1 and approved by the
Building Inspector.
Fee $.-eML zK-..
i
.............
........ .. .... ..... ... .....
Building Inspector
Rev. 6/30/80
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 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 ig denied, the Building Inspectot, 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 - $5.00 over 5 years - $10.00
4. Updated'Certificate of Occupancy -• $50.00
5. Temporary Certificate of Occupancy - Residential $1 .000 QCommercial $15.00
Date . . �,/ ;. .� .
4ew Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . , ..� . . . . . . . . . .p
-ocation of Property. . . . �.��5-:. . . . . .(,J. . . . . .C•J• •�•�.`� . .t!`:Y' . . . . .�.:V.�. . .. .•.. �
. . : . . . . . . .. . .
House No. Street Hamlet
Inwer or Owners of Property.. . . . Y.. . . . . . . . . . . . . . . . . . . . . . . . . ... ... . .. . . ..
'ounty Tax Map No 1000, Section. . . �. . . . . ...Block. .:x. . . . . . . . . . . .Lot. . . l . .. ... .'„`. , ,,
ubdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . .
. . . ... ... . .• .. . .
Permit
m
ermit No. - A� . .Date Of Permit. . . Q.: .� .� . .Applicant }�Vjed.. !`! 4 Ail.
ealth Dept. Approval :� � �. . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . .. . . .... .., .
lanning Board Approval.. .l�`�. . . . . . . . . . . . . . .
equest for: Temporary Certificate. . . . . . . . . . . Fi Ce cate.:: . . . . . . . .
'
ee Submitted: $ Q . . . . . . . . . . . . . . . . . . .
(fZ�S D�-A4RLICANT
i l F LIC, `-45 lr 1 i ulJl l 1_11 _,!_I_11 N_LL P.`.
Town Hail,53095 Main Road „J > '� Fax(516)765-1823
P.o. Box 1179 •a :.,;;� ra Telephone(516)765-1802
Southold,New York 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C E R T I F" I C A T I O N
DATE;
Building Permit No. %
Owner: . A
{please .print)
Pl
lumber. ffic",�-4cck-
t
(please print) i��
t, J,
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
1
(Plum era' S g e)
Sworn to before me this--L4--
day of &At 19
Notary Public, i county
3
jy
Term E�pii
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1000121 BUREAU OF ELECTRICITY
F 40 FULTON STREET, NEW YORK, NY 10038
Date MARCH 31,1998 Application,No. on file 15073497/97 N 449518
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
DAVID PURINTON, 1290 ROCKY POINT ROAD, EAST MARION, NY
in the following location; ® Basement L R 1st Fl. ® 2nd Fl. ATTIC/OUT Section Block 1350 Lot
was examined on MARCH 26,1998 and found to be in compliance with the National Electrical Code.
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENTI FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. I K.W. AMT. K.W. AMT. H.P.
17 26 21 17 1 F
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALREC-PT.1 TIME CLOCKS SELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
AMT. K.W. OIL N.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. I AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS
2 F 1 2
SERVICE DISCONNECT NO.OF S E R V I C E
METER NO.OF CC COND. A.W.G. A.W.G. A.W.G.
AMT. AMP. TYPE EQUIP. 1 0 2W 1 0 3W 3 0 3W 3 0 4W PER 0 OF CC.GOND. NO.OF HI-LEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL
1 100 CB 1 X 1 4 1 4
OTHER APPARATUS:
SPECIAL RECEPT. AMP.30-1
WELL PUMP-1
G.F.C.I:-6
SMOKE DETECTOR:-5
PAUL R. BURNS LIC.#3397- L cn.rL
PO BOX 1061
SOUTHOLD, NY, 11971-0932 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.
2
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND ( ] INSULATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE 8 CHIMNEY
REMARKS: D�./�� � U•
DATE INSPECTOR
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND "Fl
ATION
FRAMING
[ ] FIREPLACE & CHIMNEY
REMARKS:
C -
/V&
DATE 3 9g INSPECTOR
suiwiNc oar.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ r� INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE_ � INSPECTOR
I
BUILDING DEPT.
INSPECTION .
[ ] FOUNDATION IST [Lk4fOUGH PLBG.
[ ] FO ATION 2ND [ ] INSULATION
{ FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: i � � oe-�—
DATE 7INSPECTOR
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D FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
DEP? TEL.: 765.1802
197 Received . . . . . . . . . . . 19 . . .
Approved . . iC./'/. .�. . . ., 4?Permit No":.27.7 7 d
Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .�.,.^. . .
(Building Inspector)
A ICATION FOR BUILDING PERMIT t I n g� G
Date .Y�1 . . .f!4� . . ., 19 .L7.
INSTRUCTIONS
a. This application must be completely 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 showing location pf lot and of buildings on premises, relationship to adjoining premises or pureet�_
or areas, and giving a detailed description of layout of property must be dtawn on the diagram which is part oPthls appli-
cation.
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 issued a Building Permit to the applicant. Such permit
shall be kept on the premises available for inspection throughout 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.
APPLICATION IS HEREBY 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 all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
(Signature of applicant, or name, if a corporation)•
t D—
(BaKE .CCN t c, N ,t l
. . . . . . . . . . .t�9 . . ? . . . . .
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
CX of-
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . :� . . . . . . . . . . .
Name of owner of premises . . Pc,�.� . . �V �► .N - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(as on the tax roll or latest deed)
If a �lican r si na of duly authorized officer. _
(Name and title of corporate officer)
Builder's License No. . . .S�J��. . . . . . . . . .
Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . .
Electrician's License No. . . . . . . . . . . . . . . . . . . . . . .
Other Trade's License No. . . . . . . . . . . . . . . . . . . . . .
1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . .
. �.Q . . . . . . . . . . . . . . . cK.`t . . . '. . ._'R L�.. tEsT iM!`E R . . ... . .. . ..
I-louse Number Street Hamlet
County Tax Map No. 1000 Section . . . . 3. .�. . . . . . . . . . Block . . . . . .. . . . . . . . . . . Lot . . .
Subdivision . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . .
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy . . . . . . ..5t e. . . . . . . . . . . . . . . . . . . ...
b. Intended use and occupancy . . . . . UL . .
t,N
3. Nature of work (clieck which applicable): New Building
. . . . . . . . . . Addition . . . . . �Al*a#°•�.,.:,.:
Repair . . . L/. . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . or . . . . . . . . . . . u.
4. Estimated Cost . .�7,J�•(,L". . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . 8', tl
(to be paid n ing i I I
S. If dwelling,number of dwelling units . . . . . 1. . . . . . . . . Number of dwelling units o
Ifgarage, number of cars . . . . . . . . . /U. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.
� . • .
6. If business, commercial or mixed occupancy,specify nature and extent of each type of use . . . .A A... . . . . . . . . . .
y . . 4, f. . . . . . . -:'� . . . . . Depth . . . ..5.•.?:!. .
7. Dimensions of existing structures, if an Front . �. .�: Rear
Height . . . .Z.O1:'Q. . . . . Number of Stories . . . . .l 1Z,. . . , , , , ♦ , , •
Dimensions of same structure with alterations or additions: Front . ;!aA V.. . . . . . . . Rear . • • •� .'1 .
Depth . . . Skm(5-:t ���.q� eight . . . . S k ryn C. . . . . . . . . Number of Stories . . . . . SSAmfw-. • . .
8. Dimensions of entire new construction: Front s5hg4d-. Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . ... . .
Height . . . . . . . . . . . Nun;ber of Stories . . . to. b2 � � . . . . . . . . . . . . . . . . . . . . . . .
9. Size of lot: Front . . . .�.� .�?. . . . . . . . . . . . Rear . . . C.Q.-.q l. .`. . . . . . . . . Depth
0. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Nance of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1. Zone or use district in which premises are situated . . . .'.9 . . . . . . . . . . . . . . . . . . . .
2. Does proposed construction viokate any zoning law, ordinance or regulation: . . . . . . .0. . . . . . . . . . . . . . . . . . . : . .
3. Will lot be regraded ".0 . . . . . . . . . . . . . . Will excess fill be removed from premises: . Yes No ' +
4. Name of Owner of premises��.E pY�'NTO.. , , Address I'-ao.l2ocicY, .P.T•.RP'Phone No. . . . . . . . . . . . . ♦ .
•-Architect . Address . . . Phone No. .
!.'aaie of Contractor elan. : . . . . . . . . Address�-Q:P4?.'c-LRQ.QI .U(�iC'P40he
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from
roperty lines. Give street and block number or description according to deed, and show street names and inlieate whether
iterior or corner lot.
i
i
r '
FATE OF NEW-WK.OUNTY OF . . .C . . S.S
being duly sworn, deposes and says that he is the applicant
(( (Name of individual signi g contract) .,
Jove named.
_ isthe . . . . . . . .. ..... . . . ... . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • . . . . . • • ♦ .�• ♦ . . ♦ . . , . .
(Contractor gent;corporate officer,etc.)
said owner or owners, and is duly aut i to perform or have performed the said work and to make and file'this
plication; that all statements contained in this application are true to the best of his knowledge and belief;and that the i
irk will be performed in the manner set forth in the application filed therewith. " 't
.orn to before me t is G�
. . .day of. .. . . ., 19 `
itary Public, . . . . . . . County
7
• (Signa of applicant)
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PROPERTY 36. k
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TOWN OF SO.UTHOLD
SUFFOLK COUNTY N. Y.
1000 - 31- 2- 15.0 S ?4�5s
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Scale: l,= 30 x Nip/F
June 15, 1997
July Ir 1997 (Mons. Set! .
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Town Hall,53095 Main Road y Fax (516)765-1823
P. 0. Box 1179 % . Telephone(516)765-1802
Southold, New York 11971 �A • �`F
dol � Sao
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
April 13, 1998
Environment East, Inc.
P.O. Box 190
Peconic, N.Y. 11958
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)
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.
XX No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984) .
BUILDING PERMIT # 24404-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
CGF 4, .
RRDERWRITERSCERTIFIGTE 5
u �;
I REQUIREDly4' ✓1��2u I RC1. ( -'s'__._.___ _-_ '
Or", WTI AS NOTED � ��. '/� � � � � \ 2 ' 2✓m HEhaeR v�ut �
./27B.r: aa OCCUPANCY OR
GvT n��
PROVIDE Fnr1P LENC-T rl I -d - la o t hsc ,hs 4 veN,r r }
_E. �../ Bv, JJSE IS UNLAYUFIJL �EIECIIIN p oeff yc:"'„ m G
PIC;Tlr�: riu lwI DE a ENT' 1 P' M��- E KA6E yIN"1 L. 'd c frau;
OF OCCUPANCY T _ zoc
� ➢Ivl TO 1 THE WITHOUT CERTIFICATE Et Isg y { �.
hf11 ! !U¢Vf IPI�Sv ECTIONa AS To l i ry ray �i C Ft of"1 �-� a
1
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F �/ ex+'T 2 fps 24" �I�� 1I�
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- r OL¢xrR f'ONCRETE h1 t•.• M2 M
't '6t FRAMING K PLUMBING -!', ✓���fl+ E- i^e • --._ _ �J�I-E'.b P G e > SNA :rr c ,
r t` it c AVUi ¢I nEzvG ......p 9� ?c�.'�r ,,. . ,S LO .E 2" NIAk'. 4
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!- C47h,,TRUCTRON MUST x
RF C:OMP'LETE FOR C.O. \, P i '( Fl��` G-2><p �' Eq gA•Y
;,td. CONSTRUCTION SHALL MaET �, ' ,. 2 2 v _ 12' o G
'6'H,_ REOUIREMENTS OF THE N.Y. �`x 4 i : , y. • I r;J aw- ___ __
VATE
CONSTRUCTION & ENERGY ia P.O n 'I it .--r .. _ t w:; .•-
,�_
CODES. NOT RESPONSIBLE FOR �-
DESIGN OR CONSTRUCTION ERRORS
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