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HomeMy WebLinkAbout23696-z I , FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24783 Date DECEMBER 5, 1996 THIS CERTIFIES that the building ADDITION Location of Property 1750 PLATT ROAD ORIENT, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 27 Block 1 Lot 10.5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 3, 1996 pursuant to which Building Permit No. 23696-Z dated SEPTEMBER 24, 1996 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 INSTALLATION OF COAL BURNING STOVE FOR EXISTING ONE FAMILY DWELLING . The certificate is issued to MARY B. ULICNY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Ins ector Rev. 1/S1 YORK 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) M23696 Z Date .......... ....... ........a...................., 19. . Permission is hereby granted to: �, ......./JG. ...........1�/.C.�1.1.. �....................... ............. .... / ............... ............. . = ... ................................. to . . . ... ... ., ...... ............. . .. . ...... .. ....... . .. ......... ' .. ....... ...:rx ... .. ..c� �, atpremises located at ......................�., .5. ...... ...................................... ...................................................................... 101 ................................................................. ..................................................................................... ......................................................... ... County Tax Map No. 1000 Section ........ ..7.... Block ........1........... Lot No. ............... pursuant to application dated .......... ... . ...... ................... 19..,,7,.,%pand approved by the Building Inspector. FeeS.. ........... .........................../................ .................... .. Building Inspect Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL � 7 Y 15 -S d / y! 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. ,t 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 - .254�. 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. . . . . . 7�U. . . . . . . . . . . . PLS. . 2s7 . . . . . . . . . . . . .D.?.telv/ . . . . . . . House No. Street Hamlet . • . Onwer or Owners of Property. . . !Y. . . . 1.0 iY/... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . . j°? .7. . . .Block. . UO X . . . . . . . .Lot. . dre.,!r . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . ./0 11. . . . .Lot. . . . . . . . . . . . . . . . . . . . Permit No. . . . . . . . . . . . . . . .Date Of Permit.c. . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $. .©. . . . . . . . . . . . . . . . . . . . . 33® . . . . . . . . . . . . . . . .CANT.-. . . ... . . . . . . . . . . PLI C0 -7_-,�q -� 3 X65-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] LATION [ ] FRAMING [ FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS: ��i Gtx /V? DATE INSPECT P l 81.11 i PI+i.1't la'I t)tl ItE l'Ult C bA•i l: _(;UtIMGNTS ,� FMINI)A'1'10 N ( Is 11) I`UIINIM'l'lON UNI)) N- ItO111:11 1.I(AMN. !, O I FI,`;III.n I'I OU 1'ICIt N. Y . I Inl'f? ICNI�.ItftY CODE Fl IIAT. ( _ s A1)1)1'1'1 UNAI_ COMMI MTS.- n� ' t; 09/'296 FRI 17.:07 FAX KAY & i"GREY Q001 E IVY & FURY f, Emanuel Kay James F.Furey ATT MEYS AT LAW Kathleen Queally Toher 333 FARIZ OVINOTON BOULEVARD � Joseph Varvaro UNIONDALE, NEW YORK 11553-3644 27 John W. Quinn Edward J. Crawford FAX TRANSIV=AL COVER PAGE To: �/ 6I)w bis •l,� _ Fax No.: Firm: Number of Pages (including i.ovcr page): From: )-l- Phone nPhone #: �nvN2t MESSAGE: ., •� � -�,�co '� :cam If there is a problem with this transmissioi. , pV'.,e, c,dl this. sendar• directly. CONT iDEM r:ALITY NOTWE The documents accompanying this facsimile trausmission contain confidential or legally privileged information which is intended only for the use of the individual or entity named in this transmittal sheet. "If yon ace not the intended recipient, you are hereby notified that any disclosure, copying. distribution or reliance upon the contents of this facsimile is strictly prohibited. If you have received this facsimile transmission in error, please notify us immediately by telephone so that we cavi arrange the return of the transmitted materials to ups at no cost to you. 09/2/96 FRI 12:07 FAX Kt.`- I J11REY 0002 Godln Small Round fwdin Small Otal Godin Large Oval Galin octagon y�.ciRon„ Model 3730 Model,732 Mode13734 Model 3733 Recommended Ftwl "Nut"size anthracite "Nut-'.,vr.:uuhr,itc "Nut"aizr anthracite "Nuc".ize anthr;wilc Sok mall Soft call Soft Loall 'AA coal! :17(,alcady heat out- _ 380X)btu/hr lull,antlloote coal+ 17,000 btu/hr. 25;+ox)htui W 17,(xxll vhr. Max spaced heated, � anthracite cent+ fi000 cv.k. 9,1x10 c t.ft. 13.500 w.ft 6.0(x)cu.ft. Full loud, rp Ili --1 anthracite coal 20 RX, 4011x 56 IN. :7 Recommended draft' 04-.1)(1 in.water .04-.4x+in.water .06-.6,5 in,stater o4-.06 in.water Diameter of .mcrkcpifK 4" 5" 5" i" Width x depth x z4"x 25"x 37" Ib"x 19"x 35" height(overall) 16"x 21"x 32" 24"x 25"x 30" HLIght to top ofu x r tlun) 30'k"(tlppcK plrlitiun) Ouc oudc't 261A"(tipper(x)siti(M) 26% 13"( 1>E ' pt 'i is-(lower position) 14"(IOWA position) 221/c"(l)wer position) Wcight 140 lbs. 1H6 Ib-. 225 Ibs. 225 lbs. General Nam �only low•tttlatdcatahcad ehouWheWdineGatlin%toye. liR1+•soLstilrylttL(*Inuy:wnKoslia.xitluvtttttat+7lwran 9-11i{+r. '"lTtrhratuutrut.apatnceatc4anduwkdbuntimewithcwlan hard,)t gixxl yuahty",nor".sits andw&Li4e.ratcd at 13.500 fiTuAls..with 10-T. h contetu.Tbe yudity ul'oW)cma hunt.antl dictdare thL perftxrrnntx y,w obtain.may he k- '(i)(lin 5tovt»holaw be sentttl to a lined inasti ty t'hint uy that meets Ilxal ivdc.%tr it)a III,listed fau,uy Wilt chitcnav Hew existing titimne% ar:e suaahle for(:�xlin num.nut exert ntety large tim-piaw Rus dray not attain III.- reommtnded draft.or niay Lk)vaki )only slowly.making it difiicvlt In e%tahlish a go I fire.uch Wye Run atxxtkl he fitted with a rnotal chimney lines Mir-intim rJear"l•ACCs All examples laelow are tidew•allihx-kwall lastalhtions with rear wall liewIrari'M Orarances It)combustible walls(atandaru,ItaraWLh%I and atwall pnxctiton(reductd clearance)and mrasurrmcnn,I'or ikx)r pnxt-t:ttns are given in indu:�.Fur tither Bated irntalbtiots,ser the oV/NERS MANUAL To Sldewall From Neared To Backwall Floor Protector. Model Side of Chimney connector From the Back of the Unit Au Models Standard Reduced standard Reduced 37314).3733 33 15 32 10 To front edge of floor f roacutr from fire door of unit:16 3732 33 15 32 err 3734 34 t IS 37 !0 To.dc edge of flax protector firm either+ids of unit:H CONSULT LOCAL BUILDING OR FIRE OFFICIAIS A.10crr RFSMCAONS-7)7 INSTALLVION REQU[REMENTS FOR YOUR A :I A Ul l'exlin nxxkls ha r Isar ta4nl ui 1.It.9arxlud f�k2.M,xkk 17 Ya.A73L 1743 NW 3',.34 hese twcn rc{-xl nod It9ex Ox v p'i,v•Y>.xxt tL my initt u xx..L tad Nar:Itt:r..2 ions i�das f r�!..an•are.t.'yr�:1 GODIN IMPORTS `;�, Enamel Colors: sky Blue 53 Kennebec`:vt er \ µ �' I � Ivory Portiend,ivi&w .)41uy 207-773-31KA EA,*lisped I&A) Caviar Grey --+f a. "' ,...Axl.�.�:�.vz:,�..;,;ts�.,...a.:;• .�.-._. .. .._. - .....-. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 ULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS• lfl,41A �4,67e-� DATE INSPECTOR BOARD OF IIEAI:fII DORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . i BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 NOTLFY: CATJ. l.-Aani ned.. 01 ... 19.7 MA 11. TO: .. 19 6 Permit No .. .` �°��.�!�Jt?evie w Ax Approved ... .., .... 3 .. ......... ........_. Disapproved a/c .................................. ... �� ✓C�iQ/l/e� _y:/I,ZS .. .. ... ... ....... ....! Building Inspector? AP .ICATION FOR BUILDING PERMIT Date. . . . . . . . . �/.-2. . , 19 INSTRUCTIONS a. 71iis application mist be completely filled in by typewriter or in ink and submitted to the Building Inspector wiN 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 premises or public sl reefs or areas, and giving a detailed description of layout of properly must be drawn ori the cliagran which is part of this application. ' c. The work covered by this applicationrvuy not be ccmnericed 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 th rotolo ut tlhe 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. APPIA(icH IS IlEREBY 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) State/whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Q ✓YG.! ...................................................................................................... Nave of owner of premises ......... ..��.. .L C.!V�.......f.....2��G! 5........ L/L A/Y............ (as on t/e tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ......................................................... (None and title of corporate officer) Builders License No. ......................... Plumbers License No. ......................... Electricians License No. ..................... Other Trade's License No. .................... I. Location of land on which proposed work will be done.............................................................. /.7............. .........o...........................fP/fit e ................... Ilo use Nrnhber Street lianlet County Tax Map No. 1000 Section ... Q,d:.7.... Block .....Q ox..... Lot ..... ..�.. Subdivision .( !¢ /t?!` /QG Filed Map No. ............... Lot ...V.......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......O!VQ ........r ............................. h. Intended use and occupancy ....... . ........................................................... 1. Kiture of work ((:lueck tiA►icl► a14)licahle): New Mildinl. ........ .. Acklition .......... Alteration ........:. 4 14!pair ............ Renvval ............. ikniolition ............ O(her Work .w"."'.�...,S.C�.V Lam.......... (Description) 4. lis t.invited (bsl: .Self_/!✓ TAZ��/7,�Dd U-� fee .3 5�....................................... ((o be paid on filing this application) 5. If ckael I iol;, rxnirer of time)l irrg unil s ............ tk►rix:r of (It-ml I ing coils cx► each floor ................ 1f garage, rxnirer of cars ................... ................... G. if Ix►siness, crrmrrercial or mixed occupancy, specify nature aocl extent of each type of. use...................... 7. Dimensims of existing structures, if any: FronL................ Ite-ar ............... Depth ................. Deigl►t ......................... Roiber of Stories .................. .... Dimensions of sane structure with alterations or ackliLions: Front ............... Rear ............... Depth .................... Ileiglrl .................... Umber of Stories ............... Il. Dhwjisicxrs of entire new ccx►str►Kaim: Front ................ Rear .... ........... i>epth .............. Ileil;f►t ......................... Midwr of Stories ..................... 9. Size of lot: Frrxrt .................... Rear. .................. .. Depth .................... 10. Dale of Purchase ..................... Nan of Forner (turner ..... . .................................. 11. Tune or use district in ml►ich premises are situated ................................................... ........... 12. ikres proposed (xmis(ru:tion violate aoy Toning law, ordirkince or regulation: ........................ H. Will lot he regraded .................... Will excess fill he renoved fro-in premuises: YTS m) r 14. Names of Omer of premises ........................... luklress .............................. Pfxaie M). .............. Mane of: Architect ............................... . ..•. Arkiress .............................. P1xirm No. .......... Marne of Contractor ................................... Acklress ................ ...............Mone No. ....... ..... .. 15. is this pmlx-rty within 3(X) feet of a tidal wilaml? * YL.S ...... .. .. NO .......... *i i. YES, xxrillx I) ImN •i1211511FS lumn. MAY IU. Iasi it W7). PLOT DIAGRAM lcx.ate clearly aux) distinctly all iuildings, whether existing or proposed, auxl irxlicaLe all set-back dimensions h(m) property limes. Give street aril block ummiber or description according to deed, and rJKw street rkanes aril irxlicate c,Aiellier interior or corner lot. A OY D AS NOTED L DATE: B.R# a 3 4��1-4 �/,�✓Lt-BGG!/ `'� [�• � �'".-�' ���`'�.FEE• NOTIFY BUILDING D �1D6� 765-1802 g AM TO 4TPFOR THE FOLLOWING INSPECTIONS: or,, c w 1. FOUNDATION - TWO REQUIRED ��CY FOR POURED CONCRETE P 2. ROUGH - FRAMING & PLUMBING IS "i,"flAWFUR3. INSULATION 4. FINAL - CONSTRUCTION MUST � a BE COMPLETE FOR C.O. ALL LUT sryu ffiIC, � THE REQUIREMECONSTRUCTINTS SHALL MEET �.. ENTS OF THE N.Y. X �nn STATE ON St ENERGY COD S.0 STRUNNOT RESPON BLE FOR DESIGN OR CONSTRUCTION ERRORS SI-mv% (w ww Y(XW, CC �/ 3 L! L/✓y Ix�ing duly rlac)rn, delx�ses arxl says lhatshe is the appl icant ........... ..... ...{. / (Marine of imlivichkal signing ccmtract) alxrve Irrnr(I, Slk! is tl►e ....... . 1............................................................................... (CcmLracLor, agent, corlx>rat.e officer, etc.) of said (mx�r or oar►ers, aril is duly enr(horize(1 to perforin or have lrerfom"I the said work aril to mike an(I file this alg)l icalicm; (hat: all statements contairx�d in this al>f>I icat i(m are true- to the hest of his krx)wledge aril Ix?l.ief; arxl that the murk will be perfotmeol in (he n>Krm►er set forth in the application filed (herewith. .`)Gaon► to 1wrore nn this /?'. .. ...clay of: 19..�`... Notary Plblic ... .a� ... �n !� •.... ...... STH%- ` &0,v pA K (SigoatAip. of Applicam.) 644— l irq-s s� e ou.�✓'� �O✓Ft? ��a0 6��3