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HomeMy WebLinkAbout23974-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25156 Date JULY 24, 1997 THIS CERTIFIES that the building NEW DWELLING Location of Property 400 WELLS ROAD LAUREL, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 126 Block 9 Lot 3 Subdivision Filed Map No. Lot No. conforms Substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 20, 1997 pursuant to which Building Permit No. 23974-Z dated MARCH 11, 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 ONE FAMILY DWELLING WITH ATTACHED ONE CAR GARAGE & REAR DECK AS APPLIED FOR. The certificate is issued to JOSEPH & CAMILLE NOBLE (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-97-0005-JULY 17, 1997 ELECTRICAL CERTIFICATE DATED JUNE 25, 1997 - #15414 PLUMBERS CERTIFICATION DATED APRIL 10, 1997-HERTSAND PLUMBING & HEAT. BuildiiKg Inspector Rev. 1/&1 "am NO. t 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° 23974Z Dote ....... ` P .' ................ 19 , ........ 11 Permission is hereby gran d to: .. ... :....................: Town Hall,53095 Main Road Fax (516) 765-1823 P. O. Box 1179 j ^'—' Telephone (516) 765-1602 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: April 10 , 1997 Building Permit No. 2397/4 / Owner: J9� RL 4C ` Q k�r�l� �dl (please print) Plumber: Bertsand Plumbing & Heating, Inc. - (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. r ? j -11 z� (Plumbe s Signature) Sworn to before me this loth day of April 1997 Notary Public, Suffolk County EILEEN r64.90ACHE Notary Public,State of Newyork No.4826942 Qualified in Suffolk County q Commission Expires January 31,19—LO Form No. 6 TOUid GP SOUT[lOLD BUILDING DEPARTMENT _ TOWN HALL 765-1802 APPLICATION FOR CEP.TIFICAm 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 1lealth Dept. of water supply and sewerage-disposal(S-9 form) . 3. Approval of electricasl installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contairs less than 2/10 of 17 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 - $20.00 - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential/ $15.00, Commercial $15.00 Date . . 7/L.� �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . ?. . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . . Location of Property. . . . . . . . . . . . . . . . . . . . . . . . . . .Wells.Road. . . . . . . . . . . . . . . . . . Laurel . . . . . . . . . . . . . . Rouse No. street Hamlet Onwer or Owners ,,f Property. . . . . , Joseph & Camille Noble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . . . 126. . . . . .Block. . . . . . . . . . .9. . . .Lot. . . . . .. . .. . . . . Subdivision. . described, propertY. . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . n 23974 3/11/97 East Isle. Custom Builders, Inc , ermit No. . . . . . . . . . . . . . . .Datc Of Permit. . . . . . . . . . . . . . . .Applic:ant. . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. R10 97 0005 Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . :Tanning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . lequest for: Temporary Certificate. . . . . . . . . . . Final Certicate. X . . . . . . . . 'ee Submitted; 25 EAST CUSTOM BUILDERS, INC. $. . . . . . . . . . . . . . . . .. . . .. . . . . . . a n A7C, r " 3'[tC _ ::YX i % . . ELECTRICAL INSPECTIQN SERVICE INC . : 375 DUNTONAVENUE ,FAST PA7C4WQ&I Ar4W.YORK 11772 i" (SI,6,1'M46642: ' .Izl 6J?S/97 4 1541 . .; GLGE i. i. _ aI Soulhd! W: urer : I" AL - . ....:.i -' .wgnEss . . :: /�LG''vlrc rlAtrrl .'' :: :,- %`f JssuD Noble(EasllsleBullders) 9 JMODUCBDBY l';;Peter L"harbonrseau I'� :; 4CNa 2697< .. y, i wal examinedart G,2$97 andfourtd lobe rI in cII romptiartc¢with fhe Nahor atEtectricatI FII Code rr r. .LOCATXON: Base.. xx Irt xx 2nd .:9 .,3rd Attic -.:> DeL.Garage ..: Adt Tub ':.Pool is SWITCHES !RECE°TAC7BS .::FLl7YlRES :7fEATL•RS "'.FANS G.F.b '. AJR:CDND. . 17I 37 14 ':: I exhaust 4 . : , AISEIWASIfER. . ;ARPE4 C,GQTHES;tvASN. GAR LISP RANGE 9VEN:. SM1fOKE�DGtCGIOt 24 12 20amp :I gas 5 . rI FURNACE . . -OX. :GASL CIR :MOTORS BELLTRAN. SERVICEDISCONNECT :i 3f arrd ' s r)U= 1 1500lf EQurrtirEOT I Outside,XZ . , i-20airrp water pump i-hood :S SURD? J: PREStDEATT BUILDXVGPEti1TNo. ' �us«anfemuamdadnarw ' I 'P .i l: ]rtsommybcidadfedbyp*c dmfuL... , AE9RGR�L 'YBt.7 �W COPY PGPO4E . .� aCYF . . ,. . VIIi1.0 IMII'LUl' 1011 IUII'U111' 1)AT ': CUtltllitl l':i -._......._�....__._._.. ,n.... -,nom. _.- ,.....- -.. m..n..-.._ -_ -_--_-_ T.I w � 9 h FUUMUA-t'�Gll 2rID)nn It t M1 l 111)111:I1 I•It Arlf! R r / . t Y CUIIIT. r-- fit f UI -------------- ""Af)f111 iMIAl. contilt,IN!, : »a�T• ---------- nn m,.nna------ I --------------v_a..n _ .,--- L s s� r ,L p 0 7 a r.� n{ u 76S-1802 BUILDING DEPT. INSPECTION [ 4.,r FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACES CHIMNEY REMARKS: DATE,�/Z v INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CCyHIMNEEEY �v REMARKS: u�f', -r�L- • 0 DATE a 7 INSPECTOR ')�/ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ J INSULATION l [ ] FRAMING [ FINAL [ ] FIREPLACE A CHIMNEY REMARKS„ DATE 7 !b' INSPECTORi�Gi 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUG BG. [ ] FOUNDATION 2ND [ SULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE_ G INSPECTOR 765_1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMINGFINAL [ ] FIREPLACE A CHIMNEY do REMARKS: C Ie adAt �.-• ,�� d� �� �Qom- �-�._ _ �. DATE 7/// I NSPECTO , 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ROUGH PLBG. [ ] FOU ATION 2ND [ ] INSULATION [ RAM [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: t� .�r. � 4%2 �� DATE '-��� ��INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] F NDATION IST [ ] ROUGH PLBG. 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Approved . . % � /9. ., 19��Permit No. P. 1 . . .� Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ' (Buildingng-In Ins ector) LICATION FOR BUILDING PERMIT January , ' Date . . . . . . 21 . . . . . . ` . ., 19 . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, wit 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 premises or public str or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this ap 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 pen 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 Occupw 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 Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describ The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in building for necessary inspections. . . . .EAST.ISLE.CUSTOM .BUILDERS,. .INC. . . . . . . . . . (Signature of applicant, or name,if a corporation) . . . . . . .278.Jamaica.Avenue .Kedfoxd,. �pC 11.763. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build. Builder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . Name ofowner,ofpremises Doris Harko£f (will be Joseph & Camille Noble) before starting . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If appli is`a orporati i�nature of July authorized officer. . . Af and e r orate�o icer Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . . Plumber's License No. , ,1487P . . . . . . . . . . . . . . . . . Electrician's License No. . ,2597E . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . too 1. Location of land on which proposed work will be done. e/s Wells '. . . . . . . . . . . . . . . . . . . .Road, . 200s/o Albo Drive, . . . . . . . . . . . . . . . . . . . . . . . . . . �. . . . . . . . . . . . . . . . . . . . . . .Well�q Rcwl . . . . . . . . . . . . . . . . . . . Laurel. . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section .126. . . . . . . . . . . . . . Block . . .9 . . . . . . . . . . . . . . Lot . . . 3. . . . . . . . . . . . . Subdivision . described.property. . . . . . . . . . . . . . . . . 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 . . . vacant. land. . . . . . . . . . . . . . . . . . . . . . :: :.: '1:':.:. . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . . . . . 1. . family.dwelling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Nature of work (check which applicable): New Building . .X. .'. . . . . Addition . . . . . . . . . . Alteration . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . , . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . .: . . . . .. (Description: 4. Estimated Cost . .� �.� 00. . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) S. If dwelling,number of dwelling units . . . . 3. . . . . . . . . . Number of dwelling units on each floor. .one .story Ifgarage,number of cars . . . . l. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . . . . . . . . . . . . . . . . . 7. Dimensions of existing structures,if any: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . Depth . . . . . , . . . . . . Height . . . . . . . . . . . . . . . Number ofStories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . 52... . . . . . . . Rear . . 52.. . . . . . . . . . . Depth . .3R'. . . . . . . . Height J6: ... . . . . . . Number of Stories . . . . PAA 9. Sue of lot: Front . 0,0.11 r Rear . . _ ._J. 0 b... . . . . . . . . . Depth 0.'. . 10. Date of Purchase . . . . . . . . . . . . . Name of Former Owner new,owner to be Joseph & . . . . . . . . . . . . . 11. Zone or use district in which premises are situated . .nne .fami.Ly. . . . . . . . . . . . . . . . . . . . . . . . . .Camille. . . . .Noble . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . no. . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded . . . . . . .yes. . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes 14. Name of Owner of premises .Doris .uarkoff . . . . . . Address4.75. Ae.Up. Road,. . . . . Phone No. .r,1Q.1?Vi1Q@z Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. �,P7:-22 ast Isle Custom Buiders, I Name of ContractorE. . . . . . . . . . . . . . . . . . . . . . . . . .rWddress .27.8, JTAWPd. Aye. . . , Phone No. Medford, NY 11763 PLAT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and.indicate all set-back dimensions ft, property lines. Give street and block number or description according to deed, and show street names and indicate wheel interior or comer lot. see attached survey with proposed house Ot STATE OF NEW YORK, S.S COUNTY OF . . . . . . . . Ri CA'V.q oppeoipppo. . . . . . . . . . . . . . . . . . . . . . being duly sworn, deposes and says that he is the applica (Name of individual signing contract) a above namod. He is the . . . ,. ,.. . •Bresiclerit• of. Building. firm. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file if application; that all statements contained in this application are true to the best of his knowledge and belief;and that d work will be performed in the manner set forth in the application filed therewith. Sworn to before me this . . . . . . . . . .21rt. . . . . . . . . .day of. . . . Januyary. . . . . . . . .. 1997. Notary fubhc, /` DONWt��111JVREiN1. . . . . . . . . . Count AiUlo,&�d IJda Yor.. .J CdnnNstanE�LwMaroha0,_ �� � �OPPEDIS O s. rSivnafi,r' n . O a }� !�' 5w ' U ` - Q`J pVU5K1 $qm p L C, Z akw a J IL ^ Lir N as 3 gsT 2Jf - W O . - f 5 � � ;oar S yq Z � YlS4qozS J N ,,,y� 4 ....:.. ♦ "1 .� !fir /� _ _ i0 01 P�3 Pas eaC.itt AryL,'�3!7 i,r,.« �ili��.s .r �.c sa,j,�� ,..c r..►�xlsl.� F u 9 � ` rr} '- � � --- _ >5 WC1 '4�m A4W.p.'S �,.::r; ^"w plLL O N '- l In m U + ` O 1N ' !S1 w , �o -� t, a ±'. b-fe l;Vi^. 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