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HomeMy WebLinkAbout24405-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25333 Date OCTOBER 23, 1997 THIS CERTIFIES that the building ADDITION Location of Property 1170 PARK AVENUE SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 56 Block 1 Lot 2.8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 5, 1997 pursuant to which Building Permit No. 24405-Z dated OCTOBER 9, 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DERRICK & DEBORAH DOUBRAVA (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Bitildinj Inspector Rev. 1/81 TOED[ 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) � ...................... 1 NO 24405 Z D. ate ........ ., 92 Permission is hereby granted to: .....!� :. ....... .................................... to . . . .............. . .. . .�.. � �^ ..... ......... .. . l...moi . ......:� . . �. ... . . ... . .........(... ' . ....... -.-............................................................................................................... ............................................................................ . ................................................................................ at premises located at......./. ZQ............ ...........4� .!.................................. County Tax Map No. 1000 Section ............-._t ...... Block ........Z.......... Lot No. ..��..a........... pursuant to application dated .......... .. ....... ................. 19 7 and approved by the Building Inspector. Fee5.....7.............. ...... ............ .' ..? ...,... .... . .. .... ............. Building Inspecto Rev. 6/30/80 --' JV -?7eLv---e: 0R __:1k _,iC suomi_ ac LJ L_^.e 0C�_. = - _hSDeC ___. e =0Owi^z or e°.i Ju_ic=T'z or :SET..- use: _ -aa- su=7ev or :)rODe=_;% viz-h ccc- raze -ocat_on of all OL'=_C1_g , JrODe_ _J __ne5 o:_ee�sr and unL`s::a._ natural or toDogravHJc fa=cures. _ . al nnrOva1, from He—al t-^. Dene 0= water suDDly and sewerage-disposal(S-9 =ori) , iDDrova1 o. E1 EC__:Ca1 :nstal1at10n from 302rC or _ -_e lP_Cer-w:iLers S'wOrra statement ==om plumber cer"74.g that the solder used i_'1 system contains =ass 2/10 0= iw i_aQ. J . Colmnerc=ai bu=ld_ng, _nd st==al bu-iic=ng, mule-Die residences and Similar buildings amid 4-isL_11aL_ons, a Cern_ficaLe of Code Compliance =ram architect or engineer responsible for the binding. o. Submit ?lancing 3oard approval of completed site plan requirements. 3. For existing buildL-igs (prior to kDrii 9, 1957) non-conforming uses, or buildings and "pre-_Mist—g" land uses: Accurate sur-Jey Of property shoLv-ng all properr7 ?3nes, sL=_ets, bu;1 ding and unusual natural or topograpn=c =eazures. _. a ?roper v compfated aDDljcation and a consent LO J"SpecL signed by the applicant. _= a Car_-=_tate Of OccUPancy is denied, the 3uild--g aSZeCLor Sall state Lile reasons therefor :n wrt.L_ng to the applicant. C. ees _ Carr==_tate o: Occupancy - New dwelling 525.00, fee Lions to awell_ng S%5.00 , _LLeracions Lo dwelling S15 00, pool $25.00, accessory ou4 Cin' 525.00, additions to accessory building 525.00. Businesses 550.00. Ca=t_:icat= os Occupant? on Pre-exist=.-; 3uildi.e - S100.00 Copy of Car__-ic=Le of Occupancy - jt daLeC CErt1=iC Le O: Occupancy - $50.00 5 . _emporary Cer_i`=tate of Occupa=7 - Residenti $:5.00, Commerc_a_ 5I5.OQ Dale �o. . . . . . . . . . . . // 9. . VeT . . . !�. . . . . . Old Or ?r=-eYistin; 3iilding. . . . . . . . . . . . . . . . . Location of ?roperty. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . House 4-o. S greet Hamlet Onwer or Owners of Jr . . . . . . . . . . . . . . . .. . . . . . Caintry TAY ?'{2D STC 1000, Se cLi on. . . . . . . . . .31oc_{. J . . . . . . . . . . .T a. 3ubd_v_sior_. . . .Ld'��-�i �� �< � . .. :i_ad Hap . . . . . . . . . . . .�.,oL. . . . . .7 ?e�__ No. . . . . . . . . . . . . . . .DaLe Of ?et"mi... . . . . . . . . . . . . . . . ^va N � . . . . . . . . . . . .under��_ -e-s =LD1'Jva_. . . . .��.. . . . . . . . . . . . . . . . -------- Dep`. D D_., �_ . . . I . . -- - --. . 3oarL --ODroval. . . . .Nl �-. . . . . . . . . . . . . . . . . . . . . . . . . . _ _.'.a_ Cer-_ . ee . I Co X5333 VIC suiLDiNa DE". INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 CATION [ ] FRAMING [ FINAL ( ] FIREPLACE & CHIMNEY REMARKS: DATE�v � INSPECTOR �,� 7c 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU ION [ ] FRAMING FINAL [ ] FIREPLACE & CFIIMNEY REMARKS://000 X DATE INSPECTOR /4�M �r��rt t:t l un nr rn»r uIV» --------------------- `II 1 UUNI)AT 1014 -- . ----------- --- 111.111111 1 _1.1.1111111 tit, Q »----_-w--------------w -- w---,-ww••------------------ww_ ww--w-w--w---ww--- -www-, t!illl./�'f i tw CEA ti. Y taitlti - �n -----------------.�__-w -wwG ---------- ° 1 V 1 Nnl. ----------------------- ---ww- ------------------------- - ntitl t'r 1 trent. +;a1I ttn:►t'rdl: - - ----- --_ --w-w---.�-----ww-----..---------------------------w------w ....w ------------ NI _1_�._ J` t.� h G � SS � + ff i U4 c,4A- R t 4104 oa ;� k'z.� —2x8'!' 6-i���rt � � �'�► �' f i uk J ° ' r ar BOARD Olr MrAl.i'II . . . . . . i 11olm NO. I 7 Sli'1'S OF PLANS . . . . . . . . . . . . . . . TOWN OF SOII'1'110LI1 SURVEY . . . . . . . . . . . . . . . . . . . . . . . . � �� itl1I.LOINC 1)IiPAR'1' IRM' CINiCK . . . . . . . . . . . . . . . . . . 5 TOWN HALL S1,11,1111;•COR" . . . . . . . . . . . . . . . . . . . SOII'1'1101.1), N.Y. 11971 TIi1.: 765-11102 NOTI IiY: I:x:mirxr<I. , 1997 tiAll. 1'0: . . . . . . . . . Approved. ...., 197 Permit 1k). C7`f ............................. .... . Uioapptuved a/c ....................... ..................... ..... .......... ... /.r•• . .. .. (Ik)ildinl; lnsl)ector) P L1CA'i'1ON FOR III1f.l.011141, PRIMIA' II QQ i)ale . . . . . . . . . 19.1. 1NS,l'ItUC'TIOHS a. 'Ibis upplicaLioo oust be UxilActely filled io by typewriter or in iak,itjd sulxntr ted to the Nil liliol; lospecl.or will 3 sell) of plans, acarraLe plot' plan to scale. Fee according to scirechile. b. Plot plan r.lxxaii% location of lot nrxl of Itiiildingn cxr premises, relr►tloosliili"lo rxijoininl; prernisen or public st reels or areas, moil giving n detailed descripLirm of lnyouL of prc,lrerLy rruat be drmni on Lite diagram cAric_I► is lr:u t of this application. ..yr c. 'lire work covered by thiH'aliTAicatioo r-rry rx)t be caarrerrc:ed before inscunwe of )krilding Permit. d. llixtir apprtwal of Lhis'-upplicaL'im, file Iktilding Itrspector will issue a lkiildinp, Petinit to Lire nppl icant. Such lxtrnrit 01,111 lie kept,'oti Lire lirernises available for insix:eL'ion throut)- v tit the t.roric. e. Nei ltirilding sluill he occupied or used in whole or in part for airy lxrriose wlrnLever rml-il it Certificate of Occultani:y shall have been granted by the ikiildiM Tnspector. i AI111MMION IS 1011il1Y ME to the lktilding Department for lite iRmtruice of it lktilding Permit lxirsonnh �b the Rrrildiog 7ooe Ordinance of the turn of Soothold, Suffolk Ccxurty, Nara York, nrxl other applicable laws, Ordifian.es, or Rel;ulaLioos, for Lire coontruction of Wildit%n, rickliLicios or aheraLiovis, or for reaxwal or deroolitioo,,na herein descrilx!d. lite applirnrt ngrees to comply with all. applicable laws, ordi►rrrncen, Wild' i code, housing code, nail regulaLiorrs, nrxl to txlnil rtiiLhorized inspectors rxr pmnines ntxl in till ling for t nnr i pecticnrs. (Sigoat-ure of allA icatiL, or ita:nc, if n corix►rnt ion) 1 ice?<..�.� ?C....►. .I.E?.. 0H, (Mailing ncklress of nlgAlennl) !;(:it(! whether ;%pplicnot 1 cxaner, lesser., al;eot, nrchil.ect, engineer, gerrernl cootrnctor, elecaric•ino, phrdx'r or Ixrildc•r .. . . .. .....!.........................................................`................................ .... ..... ... . . .. . .. tl:xw of (xnx>r of:•proni nes ..�LiL{!`_``', .. .. ....!✓�1.` c.:` .1......................... .. ... (ns all lite tax roll or lnlenL deed) 11' il,pl icnnC in a corix)ration, nigriat-ure of: duly rxr0x)ri7.ed officer. a . .. . .. ............................................:.. .... (N:nx! nrxl Lille of (-orlx)rnte officer) lloildern LiceIlse No. ......................... 11lurlrern I.icenne No. ......................... iSlecCric:lann l.ic:en:re Tin. ..................... ' Other '1'rrxle's I,icenre No. .................... 1. i<xnuiexr of lnrxl err which prolx)red we)rk will Ix! dorx!.. ...... ............. ....................... ..... . .... .. . . ... . .- M-70 ......... ......tt'10f.............. � ............................. . ..... . Iloose 1401l►er Street:// Unittlet CcxroLy '1'nx ftr1p,Ho. RXx) SecLicxr ....J�4�........ lll(x..k .... /.......... ir►t xIiviaicrr .4�-?�`.� �.. SY�� �.... i,iICd MIT) No. ............... int ...-??4 ....... (N:tne) 7. !dale exinliol, use aril ocoolow-y ofcprcnnises roil i �erxI I use and cx•cup:n)cy, of proliosed ecnisLnar.Lion: n. Exisliog Ilse aril occopmxy ....s?i... �. �... .......... ............. ,n �- b. Int erxkt<) rrre rnxl cx:c:rrli:nx:y .... .......... .... .h1,�.Y_` ..._........................................... � d LAS �s,�:�:..i►�., • . 1. I'alode o1.'. W1111( (t-beck %Adds nlq►licttl►le). lk:W Ik►Ildinll ..... .... . Ackillion ...` .'`�.�, AlleroLlon . . . . .. . . .. IG:IuIl . ............ Itc:tncNnl Dulls)I(1:1(111 ... ......... Other Usti( ......�...... .. .... . . . . . . . . ... . . 5D-C) --� (Delicrlptlot t) 4. 1:.11 Inut1 ed 1.:c►:►t: ....VV V.:..... . . . .... fed ......41 .�.� ........ .......... ...... . . . . . . ((o Ix: pit Ill oil filllilt IItitt nplil lcot I oo) -i. If 11111, ►Minter of A4eIIililt till iln . . ... ... .. .. ll,nl►er• of c1x,Ilin11 oolln cx► elicit floor ... . . . .. ... .. . .. f1%111 1111U, txrdlxlr of ct►1'n ....... . ..... . ... .. ...... .... . . .. . . .. . (1. II` Ix►olimum. cimmerciol lir ndxted mcrdixux:y, ulx:clfly /'t,,►,,nlVit mill axluul of r://�uc,h Ilype of tine...... . .....(..... ... . . 1. I►inKl110611t► of exist f ll nl'r►rc I.ko•eo, if silly: Irrdx1l..41f ......... . Ite11r .. CeA........ Ik:pl11 .�©. .. ..... .. Ik:f1,111: ._....2. ....... ... lAydlxer of NIorion .. . ..-2 ....... ....... Ililwililicxds of.undde atom:ttlre With allerntloon or ►xklil:loon: Front' 14nr . .. ..... . .... . IklPllt .................... Ileil,lll ikndxer of 18Lorieln . ............. / 0( 11. Uilwotlino.,(Si' enure 111-1 coolltrtx:11(x1: Ft-oilL . ...�p....... 14ai ... ... . DCPli► . .. . .. .... .... Ik:iI)IC ......................... lk.dix,r of f6coriet► ..................... 9. Size of Iola. IrtfxH: .Itear . .... . .............. I'm 1) 1 .... ............... . 10. kik(! of 11►r4:11111ce Iltntr, of Forn>Lr 0.41 er ............... .................. ..... .. . Ii. 7cxx.: lir tine (lislricl in tAt(cat:prcyniactt nue situated .... ........... .................................... .. . . . . .. . ... 12. Ikxln puolxtaed coostilwticxl vIblaLe any renting low, ordilwtx:e or re1lulat:ion: ........................ 11. Will IoL be regrlxk:d .................... Will excer►s fill. be rourwed from prr,niueut /1. M:►tK:a of; tknser of pt"tilues .................. ......... Ackireon lltcxxt No. .... .. . .. .. IL't►K- of Architect ............... ..................... Ackirenn I'llooe No. ... .... . . .. . . MditK: of Cootraclor ................................... Acklresa ... , ........... .............11lone tk). ..... .. .. .... Vi. In this prop(iLy within 300 feel' of.tr► Lidnl 1x 11111x17 x YK.5 .......... 1.111 .......... All. Y13$, -;(XIIIXX1) 7(XM -11111SI1SS 11L14•ti'1' 11AY Hl: Illypl1tK1). ' 14,01' DIAGRAM Icx:oUn clearly mill dlaLloUly all Ixtilcli11ga, "+Reciter existing or prolxmed, ntxl ImIlc:ate all net- :k disixanalons frudu prolx:rly Bien. Give street arxl block rxniter or cktscripLlem ncrorcling to ek=ed, 111x1 sitar street ot.nen acxl (rxiiciao 1dtc:ther 11111:1 for c1r'c:ortx:r lot. ' f �ep h D AS DOTED DATE. IMP.# 0 CUP�Nu U FEE: B� EN AT UCS'E 1S URQ NOTIFY BUI ING it VNITUCUT CERT IFICAIE FLLNP70 4 'HEOOWING INSPECTIONS: OF OCCUPANCY 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING S, INSULATION 4. FINIAL - r,13NSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT- RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS sS (AxilllY 1.A' r 00 k . . . . . . . .. ..�. . . a .... .. .... ... . . ... .. . . ... . .Ix!In1, dilly m-mill, (Ic:lx►ell mxI nc►ys lh11L he In the r►pplicnnl. Dhow of itxlividosil nignirdg cool.rncl) siixrve o;KdK d, Ik! in lin! (lkudl:rliclor 111,111 , corlxmlie officer, etc.) of dudid rn11xlr' or odxx:rn, 111x1 In duly ot11horized to lx:rfordn lir hnva Ix:rforlied I.I1e 1111141 Wf►rlc mill it) nrdice mill I Ile ihi11 11ppl icrt1.ioo; 1.1ml: nil nl11tc+11entn coOtalmd in IRin oppi icuLioo lire lttx, to lite 1x1111: of 1►ia'ktxn+letil,e mill Ixil ief; 1,10 111111. Ilse cnrdlc Will Ix, lx,rfontded 311 Iho Inunx:r net forth in the npplicnl:Ion filed lRercwlil.h. :),.vr11 lu�lret(c►de lir, Ihln 1 V.. ... . .. ....d11y Iktlnty 111h1Ic: .!/Y....4!../✓/!!. ..D nn ,,nn wtr.kc�..... (Sil,natille of Appl icunt) MARY W.Dow iVOWr� ��Otk 0, loll EJgMM� -2 OR- , SCDHS. Ref.-# R.'0-9(5-0051 ANY AL TERA TION OR ADDITION TO THIS SURVEY IS A VIOLA TION O OF SECTION 7209 OF ThE NEW YORK STATE EDUCATION LAM,1 EXCEPT AS PER SECTION 7209-SLODIV ION Z ALL MRTF/CATIOIKS HEREON ARE VALD FOR THS MAP AtV COPIES THEREOF Olk Y F SAD AdAP OR COPIES BEAR TW &OWS30 SEAL OF THE SLRVEYOR O WHOSE SIOM JURE APPEARS HEREON, L O ADDITIONALLY TO COMPLY 07TH SAID LAW THE TERM 'ALTERED BY' MUST BE USED BY ANY AND ALL SURVEYORS UT,XMN6 A COPY cry ? OF ANOThER StPVEYCWS /IAP. TEWS SUCH AS WSPE AND Z65•!�. MROU6HT--T0-0ATE` ARE NOT N COAI'L/ANC£ WITH THE LA It R� 2S ro T Op. 3�Oy, y 7,G a,n o m � w � • 8�5Q• E• ^ � N. To 3 0 SUR VEY OF >3# ZLOT 24 "LONG POND ESTATES SECTION ONE" t¢� - � z ',` =" � , � tit DEC ?7,1985 AAP NO. 8037 sT '° j° N AT SOUTHOLD 9 z.j = TOWN OF SOUTHOLD �. _. �� SUFFOLK COUNTY, N. Y. 114- 1000 — 56 — 01 — 2.8 Scale: 1" =40' June 4, 1996 4 2Fj5•►�. .1�ne' 9, t 9 9Co SC DHs DCI. 21 1996 (foundation) e .L r p Jan. 28, 199 7 ( Final ) o•' m y�, �nd S- 1Q 85Q• n F!8uFFQ"LY o O sa.DFSERVICE3 F�.Y � W. /ppravdl O:Cw.stLrgd o o,jell d�2 �o,r/ ' Sul well p- `oma' Csi :�•:�~_.. ::; r . . .. � _. � i5o't The locations �U'L&W � : ; -.✓ �� (e:.:'n?Y� c:;dr:: ., s a ons of wells and cessp ols ;;,;;;f„to b,�N shown hereon are from field obs vafions � D Z and or from data obtained from hers. !�,.;,,•^ ,� / ,7 CERTIFIED TO, 5 phen A DERRICKS DOLMA VA DEBORAH A. DOUBRAVA y AREA = 40,143 3q. ft. ELEVATIONS ARE REFERENCED cf Water a•id FIDELITY NA TIONAL TITLE INSURANCE COMPANY '` TO AN ASSWO DATLU g - NORTH FORK BANK z am fam1w with the STANDARDS FOR APPROVAL • '; v ' � T AND CONSTRUCTION OF SUBSURFACE SEwAti;E a . . DISPOSAL SYSTEMS FOR SINGLE FAMILY R£.IDENCES ' 'y . y� N,:'QS LIG NO. 49616 t and will abide by the conditions set forth )herein and on the c' ` FLe3 �, permit to construct. %PECLt .C. 1516) 8401k Co.De a 1997 Q P. o. Sonze At of 1230 TRAVELER STREET ���yelSe SOUTHOLD, N.Y. 11971 96-181