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HomeMy WebLinkAbout24436-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25677 Date: 04/24/98 THIS CERTIFIES that the building ADDITION Location of Property: 2345 PLUM ISLAND LA ORIENT (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 15 Block 5 Lot 24.3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 16, 1997 pursuant to which Building Permit No. 24436-Z dated OCTOBER 28, 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 GARAGE ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to PATRICIA LOLLOT (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. H059309 04/01/98 PLUMBERS CERTIFICATION DATED N/A ildin4 Inspector 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) Date.......OCTOBER.......28.......................... 19...97.. 24436 Permission is hereby granted to, PATRICIA LOLLOT ................................................................................ 2345 PLUM ISLAND LANE ............................................................................... .........ORIENTS NY...11957............................................ to......CONSTRUCT A GARAGE ADDITION TO AND EXISTING SINGLE FAMILY ................................................ ...... . ............... DWELLINGA.. APPLIED ED FOR . .. .. „ .............................................................................................. .................................................................................................................................................................. ........ ..... .................................................... ..................................................................................... ................................................................................................................................................................... at premises located at.................2345 PLUM ISLAND LA ORIENT ................................................................. ........... .................................................................................................................................................... County Tax Map No. .....473889 Section ....015........... Block ......0005,,..... Lot No. .9.2.4...00.3 pursuant to application dated .....SEPTEMBER. 16 , 19...., .97. , and approved by the Building Inspector. Fee$.........75.00 0 ... .... ..................... Building In actor Rev. 6/30/80 Form No 6 dL" TOWN OF SOUTHOLD o24' BUILDING DEPARTMENT A: 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 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 - _ .?Sc. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $155.00l. it Commercial $15.00 Date . . . . . .4 i . . . . . . . .. . . . . . . . . . . . . . . New Construction....!!.... Old Or P e-exist Bui ding.... .. ..... ... . `f FLI M . ..* ..Q0! . . ... . . . . . . . Location of Property ... ' House N Street Hamlet AM "00W Onwer or Owners of Property.. . .. .. . ... . .. . . .. . . . . . .. . . . . . . . County Tax Map No 1000, Section. ..`.'. . . . ....Block. .. .`. . . . . . .. .Lot • • • • • • • • • - Subdivision. .fr�/.� . .�. . . ... . . .. .F' ed Map. . . . . . . . . . .Lot. . . . . . . . . . . . . . Permit No. `-4� �� Date Of Permit.��! !� •Applicant. . �k • • • • • • •,,•�• Health Dept. Approval. . . I .. .. . . . . . . . . . .. . .Underwriters Approval. . . . . . . . . . . . . . . .. • • . . . . Planning Board Approval. .P!. • . - •-. . . . .. • • Request for: Temporary Certificate. ... . . .. . Final Certicate. . . . .. . . . Fee Submitted: $. .01 • • • • -• • • •• •• •• • • •• •• • • • � C � s y3 . . . .. . . .. . . .. . . . . . . . . . . . . . � C THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 8070404 BUREAU OF ELECTRICITY 40 FULTON STREET, NEW YORK, NY 10038 Date APRIL 01,1998 Application No. on file 15721798/98 H 059309 THIS CERTIFIES THAT 4, only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of PAT LOLLOT, 2345 PLUM ISLAND LANE, ORIENT, NY in the following location; ❑ Basement ❑ 1st FL ❑ 2nd Fl. GAR Section Block 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. I AMT. I K.W. AMT. K.W. AMT. K.W. AMT. H.P. 18 1 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. K.W. OIL N.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS fA SERVICE DISCONNECT NO.OF _ S E R V I -G- E- - METER NO.OF CC GOND. 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 OTHER APPARATUS: PANELBOARDS:1-5 CIR. 80 G.F.C.I:-4 BRIGHT IDEAS ELECTRIC L 6 ROBERTSON LANE HAMPTON BAY, NY, 11946 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. BUILDING DEPT. INSPECTION [ ] F UNDATION IST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: �-t DATE z z y S7-INSPECTOR yes-ieo2 suanINc oar. SPECTION [ FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS: 4�, DATE �� jj INSPECTOR de suIwiNc DE". INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN ION [ J FRAMING [ FINAL [ ] FIREPLACE & CRIMNEY REMARKS: 119 DATE4// //9f INSPECTOR P7ak 1 1 I�1.11 111'11'1:(,i I1111�I11,'�I'MIT I1 t1 V. 1 I�I IIIIIIIA'I'11)11 ( I!i�l•1N1 I I`UUm1AT IUM (2tiU) �1 r.n..•1►Y,nn.nw.«....n.nn«n..w...-- 1 r+ ..w..e�.�.��..wn-.w......�•....�.... nnu1:11 huAllr, r; n 111.1111111 HCS —_ r ,........w nw.-«w.«nw..n-.,n-ww...-w.- •J-n...�..w.- ..n,n..nrt•«....-n-...�-w•�..,----rt.--------I,r.----------------- ------ I II:SIII.A 1'11)11 I-Kit II. Y . !I'I'A•1'It 11.1II;It1:Y (:1)1)1: Y �C -----------------• - .ten©f� wr+—w.'Y--.•......•tA.-n—l'.—w.w.--w....w--.-------------------- 0100f) A--w—...—.Itwn--._nl...w.w JI Ir I VIAL A1111ITIU11A1, t;(11Rn�lrilis \ ... ----....----- ..........----............w.........w.-----„-.,..-----------^--------..--- --------.,. ———— t I • 1 • 1 • j 6)� h u BOARD OF HEALTH . . . . . . . . . . . . . . . FORM NO. 1 3 SETS OF PLAN . . . . . . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . .. . . . . . . . SSP 6 19 2,7 TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: ov CALL . . .�5� Examined.�. 19.... MAIL TO: . . . . . . . . . . . . . . . . . . . . Approved.. .� .., 19.... Permit Nol:. .................................... Disapproveda/c .................................. .................................... ....................................?PLICATION ........ ..4- uilding�Inspector FOR BUILDING PERMIT Date. . . . . . . . . . . . . . , 19. . . . INSTRUCTIONS a. 'Ibis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector wit 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining promises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. 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 issue 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 MATE to the Building Department for the issuance of a Building Permit pursuant to the Building Zane Ordinance of the Town of Southold, Suffolk Canty, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demlition, as herein described. The applicant agrees to comply with all applicable laws, ordi s, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buia ii for necessary ins tions. G' :r!::: ............................... (Signature of applicant, or name, if a corporation) ................................................... .... • . . ..••..•.'...•-•. (Mailingaddressofapplicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nane•of.owner•of•premise s .`..........LLo� .......................................... (as on the tax roll or latest deed) If applicant is a / a .........tion, signature of duly authorized officer. .Y.!.................................... .............. �l .................. (Name and title of corporate officer) Builders License No. . .... ........... ..... Plumbers License No. ... . ................... Electricians License No. .................... Other Trade's License 4.................... 1. Location of land on ch pr. sed work will be done.c2.3.y .................. ......r................... 9I/r . ........................................................................... House Number Street Hamlet Canty Tax Nhp No. 1000 Section �..... Block s .... Lot `.3:... ..... .. ............ Subdivisions!e: i.. ...1�:4v:.. .... Filed Map No. ............... Lot .............. (Name) 2. State existing use and occupancy of promises and intended use and occupancy of proposed construction: a. Existing use and occupancy .. .. ......... .........../.n....)......................................... b. Intended use and occupancy ............................ do b 01812 Aildu9 YTa1dN p�►o0 Jgtrbu2 ni bar►tlsuU w....A YuM aotigx3� 3. Hlature of work (check wlhidh applicable): New Building .......... Addition i•1.... Alteration .......... Repair ............ Removal ............. Demolition ............ Other Work .................................. •^� (Description) 4. Estimated Cost ....... �f.. ........ fee ..... 'f/• ................................... {r� (to be paid on filing this application) 5. If ckaelling, nuhiher of dwelling units W.o-..... Amber of dwelling units on each floor ....... Ifgarage, nuhber of cars ....oC•.............................. 6. If business, commercial or mixed occupancy, specify naeure and extent of each type of use:::.....Y.... ........ 7. Dimensions of existing structures, if any: Front......... Rear ............... Depth ......... Height ......................... Number of Stories ................... Dimensions of same structure with alterations or, additions: Front ....:.......... Rear ............... Depth .................... Height ..............:.,��. Npmtier of.,Stories ............... 8. Dimensions of entire new construction: Front . p�.l" ......... Rear ....3 2�..... Depth .............. Ileigb .......:1................. Number of St ..../................ 9. Size of lot: Front- ....///�AA-C Rear .................... Depth .. ................. 10. Date of Rudbase ......I 1.k ......... Name of Former Owner .�l 2P 1��.. "..................... 11. Zone or use district in which premises are situated .... :.................................................... 12. Does proposed construction viola te any zoning law, ordinance or regulation: ...A ................ /' 13. Will lot be regraded ...... Y......... Will excess fill be removed from premises: YES �1� 14. Names of Owner of premises T.�:! N. :�' Address .............................. .Phone No.�.�.S 31ya S� Name of Architect .......................... Address ............................... Phone No. .............. Name of Contractor a l ........................... Address .................... ......flhone No. .............. 15. Is this property within feet of a tidal wetland? *,YES .......... NO .. ...... *IF YES, S{3IIl]" 1UWN 11l<MM-3 PERMIT MAY HE WORRM. PLOT DIAGRAM " Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. a suair, of Nu Yaw, SS GaINIY OC ..... 1 ...... 1. ....C.... _ . ............. .� ` U .being duly sworn, deposes and says that the is the applicant (Name of individual signing contract-) above named, Ileis Lite .......................CIWA: ................................................... ........... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed Lhe said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief.; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ...... ......day of ... .. 94 Notary Public ..... ... ... ........ ..... ... 1 WS •Signalure•of Applicant) ..• b St�It01k CVOW No.01>fC~ CCCUPAA'CY OR �'' USS` is LovL4 � �vlTUCUT CERT,FIUL OF QCC UPANCATS' CY . r REQUIREDCATE C� Rf--SPONSIPLE g <� R CONSTRUCTION,ERROI,: PROVIDE% fit. FIRE RATED SEPARATION TO PART. 717.3 OF N.Y. STATE BUILDING�INGCOD E. �U 1, 5z' IK t Fi��N 1:�.� til (►.� 5 �,y 4e 0 i94 CATE P LAW y i i 1 t Pf + t , DI /LT. 1 i t f� - 0� - --- :<'.��,--, -,�,i:.:. � '^Vii.:. �' ►..;'�'�= ��,s`i;:.,� i 1 - � ��,T ,vim � ! •,,�, . i i � t 4 IF 9 i � •ti i r i;.....t �r FE /��,f�•l ,J IIj i < F n I I