Loading...
HomeMy WebLinkAbout24065-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25070 Date JUNE 3, 1997 THIS CERTIFIES that the building ALTERATION Location of Property 1540 GLENN ROAD SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 78 Block 2 Lot 33 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 7, 1997 pursuant to which Building Permit No. 24065-Z dated APRIL 22, 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 ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED " AS BUILT" The certificate is issued to LARS TORKELSEN & ORS. (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-421233 - MAY 29, 1997 PLUMBERS CERTIFICATION DATED MAY 30, 1997-MIKE JACOBI PLUMBING Buil ing inspec Rev. 1/81 FORM 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° 24065 Z Date ..... .. ........ ...... �............., 19ff.. Permission is hereby granted to . � .... v . . . . . . . ... .'wfi, : �... ........:�....... . .... .." ................................................................................................................................................................ ............................................................................... .. .. ........ . . ..... ........ ....... ...... ...... at premises located at ............... 1.�.... ../.. •.:....... .. ....................................... County Tax Map No. 1000 Section ........�A.......... Block ...... ........ Lot No. ..M-0 ............ pursuant to application dated ............ '-7- ............... 19.�2.' and approved by the Building``Inspector. Fee $..../...�' ........ ..*.' . ........ .... .. Building Inspector Rey. 6/30/80 Form No. 6 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. X 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 Building - $100.00 3. Copy of Certificate of Occupancy - .25¢, 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date New Construction. . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . . Location of Property. . . . b 7� . . . . . . . .. . . ! 14 !�l. . . P./JA. . . . . . . . . . . . ur.. . iGov. . House No. Street Hamlet Onwer or Owners of Property L�?S • .. 7-0... . � �S GJ/�. . . . . . . . „ . . . . . . • . County Tax Map No 1000, Section. R.?F�. . . . . . .Block. . !�% . . . . . . . . . . .Lot.. . ?. . . . . . . . . . . . . . . . Subdivision. Filed Map. . . . .Lot. . 7. . . . . . . . . . . . . . . . . a �O l�3J � .e?�. . . .`�7. . .Applicant All?S. �QRK�LS. . . . Permit No. . .Date Of Permit. / Health Dept. Approval. . . . . . . .. . . . . . . . . . . . . . . . ..Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . .. . . . . . . . . . . . . . Request for: Temporary� Certificate. .. . . . . . . . . Final Certicate'.'____-�. . . Fee Submitted: $. .a1.. . . . . . . . . . . . . . . . . . . . . Y. . . .GG2!% r/4 �'9 7 )V APPLICANT TEL. 765-1802 �p���fa�CpO TOWN OF SOUTHOLD yL OFFICE OF BUILDING INSPECTOR z P.O. BOX 728 v' TOWN HALL SOUTHOLD, N.Y. 11971 C E R T I F I C A T I O N Date 30, Building Permit No. , go 6,s- Owner rn( T—s 2 WSa ) (please print) Plumber T� (please print) I certify that the solder used in the water supply system contains less than 2/10 of to lead. -• 1 (plu ' s signature) Sworn to before me thisi!cliay of 199-7 . Notary Public Notary Public, County HELENE D. HORNE Notary Public,State of New York No.4951364 Qualified in Suffolk Count yy Commission Expires May 22, i 9 25 THE NEW YORK BOARD OF FIRE UNDERWRITERS 1TAGE :I 1.000484 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NY 10038 Date mAy 2�>,1.9t)7 Application No.on file 13462597/97 ISI 42123 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant homed on the above application number in the premises of TORKELSON BUILDERS, 1540 GLENN ROAD, SOUTHOLD, N.Y. in thefollowinqlocation; N Basement N Ist Fl. ® 2nd Fl. OUT Sertion Block Lot was examined on I4AY 29,1997 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES I RANGES ICOOKING DECKS I OVENS DISHWASHERS EXHAUST FANS OUTLETS ECEPTACLE$ $WITCHES INCANDES:ENTI FLUORESCENT I OTHER I OMT. I K.W. AMT. K W. PMT K.W WT K W, AMT. H P. 35 36 31, 35 1 1 1 1 8.1 1 1.2 2 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS ISPECIAL REC'PT TIME CLOCKS BELL I UNIT HEATERS MULTI.OUTLET DIMMERS SYSTEMS AMi. K.W. OIL H.P. GAS N.P. AMT, NO. A.W.G. AMi. AMP. AMi, AMPS TRANS. WT H P. NO.OF FEET WT7 WATTS 2 F 2 - 1 SERVICE DISCONNECT NO.OF S E R V 1 C E METER NO.OF CC COND. A.W.O. A W G. A W G. AMT' AMP' TIPS EQUIP. 1 X RW 1$3W 3 6 3P/ 3 A'AW PER, OF CC,COND. NO.OF HI OF W 0, NO Of NFUTRAl3 OF NEUTRAL 1 200 CB 1 X OTHER APPARATUS: VIELL PUMP-1. MO'T'ORS-I-F H.P. G.F.C.1:'-6 SMOKE DETECTOR a 5 RICHARD KLEINF'ELDT LIC.#665-E aw r 114 CARLTON AVE ISLIP TERR. , NY, 11752-2904 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. o�OggFFO(,�-�O �+ x Town Hall, 53095 Main Road p Fax (516)765-1823 9y'jlpl � Telephone (516)765-1802 Southold, New York11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD May 29, 1997 Lars Torkelsen 1130 Glenn Rd. Southold, N.Y. 11971 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. / Plumber Solder Certificate on file./ (All permits involving _plimking being issued after Ap~ri—l--T 1984) BUILDING PERMIT # 24065-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSWLJCTION [ ] FRAMING [ [ ] FIREPLACE & CHIMNEY REMARKS: & -- --�.----- DATE �O �VINSPECT &WwAen jquwt�� tY(~. BOX 1475 • 790 CLIPPER DR•SOUTHOLD, NEW YORK 11971 Tor 516.765.4008 • Lars 516.765.3174 FAX 516.7656008 Addenda to Building Permit Work performed at 1540 Glenn Rd. • Front Portico added TX 5' • 12032 window next to front door • 2 2035 casement windows in corner in kitchen • 2 mullion windows in family room instead of a triple window • New sliding glass door instead of pair of doors • New R13 insulation in walls and R19 in crawl space. • New sheetrock entire house. New doors entire house. • Poured concrete foundation instead of block piers in rear of house. • New Kitchen cab. and appliances. • New fixtures in bathroom. • Added three skylights on second floor. • All new electrical including service. • New siding and roofing. We originally planned to do minor upgrades to the house to bring to code, but it required more than we anticipated to bring up to code. Respectfully submitted Tor and Lars Torkelsen o MAdMa- 262.4 WN""mA� 4 . Aem Yo& . A4fohalimn6 . o�.�,laliatconb fII:I,II I Il;il'lil,.;I'11111 IU:1'Utt'1' IM 1'4: .-.. ., ._, �U O N(IIIIIIIA'1'f(11f +;UU I'MATtUhI (2UU} nnnr •�,�.n..n-_..,..n.m.n„—n..-nmm�n..,.,-T.n,,.... l'� 1111111711 FRAIW d --.n 1'1111111 I tlU -------------- +rnnnnmnrtnn�nn..mnnn_mmn. ,- nnnm ---- ------ - IIL'illl.n'I'I(111 IVCIt 11. Y . �•�•+-++ — f:01 M -nn�nnm..nr_nnnnnnn �nnnn n ,n r ,��mnm nnn ---nrnrr mm n mmmn m n n_nr m mn Ijl ISI IIAI. \' nnnnnmm�mnnnnmmn-------- -------- nmm_nnmrnnnnn, -----------mnn__m------ nn------_----- .n..nn_mnnnnmm�mnnn nm/1'rlunnl• Ct711nI;1r1'7i : n �+ nJ `. .mm� n nnmm�m.,nnnnnm� nmm�---------------------------- { \S� 1 nrrnrnnrrmm-nnrn _ \ 1 • NI ,.r 1 u &4/1�w� X"We" #WV, BOX 1475 • 790 CLIPPER DR •SOUTHOLD, NEW YORK 11971 Tor 516765.4008 • Lars 516.765.3174 FAX 516.765.6006 Addenda to Building Permit Work performed at 1540 Glenn Rd. • Front Portico added TX 5' • 1 2032 window next to front door • 2 2035 casement windows in corner in kitchen • 2 mullion windows in family room instead of a triple window • New sliding glass door instead of pair of doors • New R13 insulation in walls and R19 in crawl space. • New sheetrock entire house. • New doors entire house. • Poured concrete foundation instead of block piers in rear of house. • New Kitchen cab. and appliances. • New fixtures in bathroom. • Added three skylights on second floor. • All new electrical including service. • New siding and roofing. We originally planned to do minor upgrades to the house to bring to code, but it required more than we anticipated to bring up to code. Respectfully submitted Tor and Lars Torkelsen *twF'WBawv°frd'A't° "»" " nOARD OF HEALTH . . . . . . . . . iry;T Cil xi:i'4.'.irf"".vEd� FORM N0. 1 3 SETS Or PLANS . . . . . . . . . LFA`?`'' "� tfa^a ^z TOWN Or SURVEY . . . . . . . . . . . . . . . . . . ���W_ w i1ti3;,. ,;>' 1' tt;' J,191 BUILDING DEPARTMENT CIIECt . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC TORN . . . . . . . . . . . . . APR ` 7 199/ SOUTHOLD, N.Y. 11971 TEL.: 765-1802 }:OTIPY ; ._.Lt." _...,. ...... s �� CALL . . r . . . _ .�.t . . . � . . . . . . IIA IL TO : �©� . . . . . . . . . . . . . . . . . . . . ExanriT�'dUP!. is , 1 Approved IYI. . Permit No.lTf C. . . . . . . . . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Building Inspector) A P ICATION FOR BUILDING PERMIT Date . . . . . . . . . . . . . . . . . .. 19 . . INSTRUCTIONS a. 'Phis 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. Pee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises 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 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 becn 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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Mailing address of applicant) Slate whether applicant is owner, lessee, agent, architect, engineer, general contractor, elect rician,.•plumber or builder. . .�U/ 9V GS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . I . . . . . . . . . . . . . . . Name of owner of premises � � 5 . . .� VLSGSt ./ar!�? p� �QY 2SLJ >L . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authoriied officer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . . ['lumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1, Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �°6`�D . . . . . . . . . . . .�G? ti �! .�. . . ... . . . . . . . . . . . . . . , House Number Street Hamlet ? County Tax Map No. 1000 Section . . . 01<f . . . . . . . . Block .ate. . . . . . . ..'/. . . : . . . Lot .�J.��. . . . . . . . . . . . . . . . Subdivision W�.r. C/� ��. .L� S�/�T�'$ Piled Map No. 3� ?.� . . . . . . . Lot . .� . . . . . . . . . . (Name) 2, State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . .. C� b. Intended use and occupancy . `. . ! �4V. I . .� �.S �G�/(�CGr . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . J. Nature of work (check Which applicable): New Building . . . . . . . Repair . . . . . . . Alteration K Removal . . . . . . . . . . . . . . . . . . . , . . . , Demolition Addition • • • • • Other Work . . . . . . . . . . . . . . . 4. Estimated Cost . . . . . . . . . . . . . . . (Description) Fee . . . . . • . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on Cling this application) If garage, number of cars . . . . . S. If dwelling, number of dwelling units . . . , : , , , , , , , , , Numn ber of dwelling units oeach floor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G. If business, commercial or mixed occupancy, specif nature and extent of•each t , 7. Dimensions of existing structures, if any: Front . , �/', , �te of use . . . . , . . . Height . . . ? Y . . . . . . ; Depth . ..�. . . . . h . . ., . . . . say Y. , • . . . . . . . . . Nmnber of Stories . . . ,/. . Dimensions of sante structure with alterations or additions: Front �Md 5,/}/,yprGear . . . . . . . . . , • • , , Depth . . . . . ... . . . . . . . . . . . . . . . 1leight . . . . . . . . . , . . . . . . . . . : . : Num her of Stories . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . . , . • , , , , • , ; Rear . . . . . . . . . . . . . • , 9. Size of lot: Front Depth . height . . . . . . . . NumberofStories !vq .!9,pQN'f„S�paSy' Rear . . , . . . . . . . • , , : . . . . . . . . :Deptlt. . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase l0�� ,`fib, , , , , , • • • , , , • , , , Narne of Former Owner �'y,t�� C 6% 11. Zone or use district in which premises are situated ,AAt q(F '174l �' 'exp , ' 12. Does proposed construction violate an zoning1 w ordinance or regulation: N. . ,i,. . . . . . . . . . . . . ­ ­Yes* . . . . . . . . . . . . . 13. Will lot be regraded S NteF, •, 2 g 0, tiG'. . . . . Will excess Cl be removed from premises: Yes No)( 14. Name of Owner of premises,44' . !LYt[TCS�'iri Address!/3 O �1P)t,/r. R'd Phone No. Name of Architect , . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . . Narne of Contractor 44PE ,� ,7Q/G,To./(y(jL. . ..1?! , , Address 11,30, alA4'tt. AP • ' ' • ' ' ' ' •” ' • ' property yPLOT DIAGRAM Yes. . 1 . Phone No. . . . . . . . . . . . . . . . *If es, Southold Town Trustees Permit may be required. y©°" " " " ' 5. is thiswithin 300 feet of a tidal wetland? � 7< Locate clearly and distinctly all buildings, whether existing or proposed, and,ind:icate 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. ycPGr UNDERWRITERS CERTIfICAIE Hyl//Lstw I REQUIRED e % y a � r j.)• q `;,� ,li':.i49�e• 4,✓' ay4. itiji'a,s 1�[,OCoY f1n '181 1"i'V ds- I i Cok: f'fr,h"etti_Ika_•dtS�d.l��'-r[_ ;'l'u. rl:x@ro 4�d�8?^-l�,e£s�b�-; re;: &'`¢.Ro;•�1�°§'',t°: TATE OF NEW Y 'OUNTY OF . . . S.S (Name of individual signing contract) • • • • being duly sworn, depose$ and says that he is the applicant rove named. e is the . . . . . . . . . . . . . . . . . . . . . . . . .fir. W?-IcAr (Contractor, agent, corporate officer, etc.) ' said owner or owners, and is duly authorized to perform or have performed the said! work and to rake and file this gnlication; that all statements contained ut this application are true to the best of his knowledge and belief; and that the ark will be performed in the manner set forth in tine application filed therewith. vorn to beforeeme this 4 .t-. . . . , . d of . N. 19�.� Mary Public, . . . . So (� • • • • • • • . County IIOBERT 1.SCOTT R. � Notary Public,Stat o ew Ybrk . . . . j Qualifiedl';Suff County (Signature of applicant) No.01SC47 089 ' %m Expires Me . _ 36,�413 o62?/-- 4 _.. Y 09 30 012 t . 49 fLDoL Za ti .. L.S• � k Via tA Sr-alte . 30 ,- ' • i ( $ , yyyiii �B�t�� sa'.,ei'F' �tt�r!w+ s+");Z2,0C}2 ;r�''f is k f frame F ltQus,Qoop Zoe /F4-4mF/,2M ® = "14 I pipe I � � �J �Gcao �C�'°f' r�vrx�ber's,5heayvr'r 1�"d•°"�'Y'� fGoo,0 Zo�v, Q ¢ c,< ofce " no tib.3848 . ' couft-io max ' tomo" 1 9 %,D LAp0 !33 � a I { m ysk surrey k a oiniation of �• G Wood4�x tion 72oE>nt me tJew vnAc 19P �G L E WWI '9(, s ud±+cation Law- V �A _ cx p; sas o±this j!"map no bearfnq �O 0 _ kftd seat of 9 t YC> (G arwssedsn.4wnidrlre++ Q �r :�atraanauuaoov� „1 c,�y to the person forwhom the$--I 1 II epared and on his behalfto rho • cmpany governmental ages:GV 14w_ Y , , ,n tl utlon li5?nd heroco and Ehe lend e« sna •h e3 DNEW 1! : � f �+(. ♦ � � 5ur"'� :�tc�r: lei, !moi gQ r t. PT VAN �' fir-- �9 ,"�.---- l:lr,.�sxt ► �+or�rcd o