HomeMy WebLinkAbout23739-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27839 Date: 07/25/01
THIS CERTIFIES that the building ADDITION
Location of Property: 23865 MAIN RD EAST MARION
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 18 Block 2 Lot 26
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated pursuant to which
Building Permit No. 23739-Z dated
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 ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to ARTHUR RUROEDE & WF
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N 457842 07/02/98
PLUMBERS CERTIFICATION DATED 06/29/01 KING PLUMBINGG
a Ck e6'nk-
Authorized Sign re
Rev. 1/81
FORM N0. 2
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° 23739 Z Date .... �..J'x7....................... 19��
Permission is hereby granted to: 164
.............. .. .. .. .. . ...... ... ®3
. .. .�.. g.y............/ ��.
-... .. .... -................ ........... .. ......... ............ ..........
�/ 2 G/ CQ...®..
at Premises located at ......................................1�`.. l.d.So�..j /�L F4dr: .
.......................................................................................i, .............................................
.................................................................................................................................................................
County Tax Map No. 1000 Section ........1. .. Block ......�.......�Lotot No. ........................
..XJ.q
pursuant to application doted ................. ...... 19and approved by the
Building Inspector.
Fee $• •••
... . ................... ....... ......
Building Inspector
Rev. 6/30/80
✓ Form No. 6
TOWN OF SOUTHOLD r----.
BUILDING DEPARTMENT
TOWN HALL
765-1802y� �
NOV - 8 1999
APPLICATION FOR CERTIFICATE OF OCCUPANCYLeo-tim
A. This application must be filled in by typewriter OR ink and submibuilding
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.
jB. 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 Buildin¢ - $100.00
3. Copy of Certificate of Occupancy -
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.000,, Commercial $15.00
Date . .l I .-. Ji. . l 9. . . . /4 A4'. . . . . . . . . . . . . . .
New Construction. . . . . . . . ..z.cc. Old Or Pre-existing Building. . . . . . . .
,i.1
Location of Property. . d.4 .�J� . . . . . . . . . . �t.�l Qc;,A. . . . . . . . . . . . . . . .0 I uhf. . . . . . . . . . . .
House No.
Street Hamlet
Onwer or Owners of Property. . A.r. 1-}A . . . �.� eJe. . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . .
County Tax Map No 1000, Section. . . . . . t. 2. . . .Block. . . . . .�L. . . . . . . .Lot. . . . . . ( , . . . . . . . . . . .
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
Permit No. r .�. J. .3,T h.Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . /
Request for: Tempgrary Certificate. . . . . . . . . . . Final Certicate. . .
Fee Submitted: $. . . .g
P 1 L�39 . l 1. ... . . . . . . . . . . . . . . . .
APPLICANT
42
Cz
Town Hall, 53095 Main Road CA Fax(516)765-1823
P. 0. Box 1179 Telephone(516)765-1802
Southold, New York 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C E R T I F I C A T 1 0 N
DATE: L�'kP–V-0
Building Permit No. 3'7
owner: /`�
(please print)
to-) �1�6,�j
Plumber: �),
(plehse print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
(Plumbers SignaA--ure)
Sworn to before me this
day of G"' KL6 0
V
Notary Public, County
HELENE D.HORNE
Notary Public,State of NewYotk
No.49611364
Qualified In Suffolk Count'&
Commission Expires May 22,
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1000773 BUREAU OF ELECTRICITY
F 40 FULTON STREET, NEW YORK, NY 10038
Date JULY 02,1998 Application No. on file 13638497/97 N 457842
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of
ARTHUR RUROEDE, 23865 MAIN ROAD, SECTION 1000-018-2-26, ORIENT, NY
in the following location, ❑ Basement 9 Ist FL ❑ 2nd Fl. OUT Section Block Lot
was examined on JUNE 18,1998 and found to be in compliance with the National Electrical Code.
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W AMT. KW. AMT. K.W. AMT. K.W. AMT. H.P
9 11 14 9
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS I MULTI-OUTLET DIMMERS
AMT. K.W. OIL H.F. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. SYSTEMS
NO.OF FEET AMT WATTS
1 20
SERVICE DISCONNECT NO.OF S E - R V I C E
METER NO.OF CC GOND. A.W.G. A. q,W G,
AMT. AMP. TYPE EQUIP. 1 0 2W 1 0 3W 3 0 3W 3 0 4W pFR 0 OF CC G.
NO.OF HI-LEG AW.G.OF HI-LEG NO.OF NEUTRALS OF NEUTRAL
OTHER APPARATUS:
PADDLE FAN-1
G.F.C.I:-3
SMOKE DETECTOR:-1
ARTHUR A. RUROEDE LIC.#2334- L L
23865 MAIN ROA
ORIENT, NY, 11957 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.
11
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
,
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ELIZABETH THOMPSON • ARCHITECT
270 Lafayette St. Suite 1303
NEW YORK, NEW YORK 10012
(212) 274-8336
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Q�osoFFULt
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Town Hall,53095 Main Road Oyijo ���� Fax(516)765-1823
P.O.Box 1179 41 Telephone(516)765-1802
Southold,New York 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
August 25, 1999
Elizabeth Thompson
270 Lafayette St. , #1303
New York, New York 10012
RE: Ruroede, 23865 Main Rd. , Orient. 1000-18-2-26 .
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons :
kc'4 v XX An application for Certificate of Occupancy is
11-�rrg not on file. (Enclosed)
No Underwriters Certificate on file.
Rce-f4 XX The check is (not on file. ) $25.00
No Health Department Approval on file.
No final inspection has been made.
XX No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984 ) .
BUILDING PERMIT # 23739-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
PII;I,D IN WEG I'ION 128POR'I' DAI tS (;OPIr11iN1'^"> _ 7�
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Town Hall,53095 Main Road W Fax(631)765-1823
P.O.Box 1179 O Telephone(631)765-1802
Southold,New York 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
June 29, 2001
Arthur Ruraede
23865 Main Road
Orient, NY 11957
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)
No Underwriters Certificate on file.
xx The check is (not on file. )$25.00
No Health Department Approval on file•
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984) .
BUILDING PERMIT # 23739-Z
Please contact our office on this matter• Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
: � o��S�FFOIk�oG
y�
0
h Z
Town Hall,53095 Main Road OyijJ 0��� Fax(516)765-1823
P.O.Box 1179 �� l [ �` Telephone(516)765-1802
Southold,New York 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
August 25, 1999
Elizabeth Thompson
270 Lafayette St. , #1303
New York, New York 10012
RE: Ruroede, 23865 Main Rd. , Orient. 1000-18-2-26 .
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons :
XX An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
CA XX The check is (not on file. ) $25.00 % ��1-4 or 3/►3/60
No Health Department Approval on file.
\ No final inspection has been made.
�! XX No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984 ) .
BUILDING PERMIT # 23739-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
c;?3 7:3
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] 1 SULATION
[ ] FRAMING FINAL
[ ]
FIREP1.461549HIMNEY
REMARKS:-54�0
lei
!. Y j74
DATE INSPECTO
7'65-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH LBG.
[ ] FOUNDATION 2ND [ ] IN LATION
[ ] FRAMING [ INAL
[ ] FIREPLACE CHIMNEY
REMARKS:
y�--
DATE INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ LJ/ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY �✓
REM RKS: Z)16
l
DATE J7 �9 �✓ INSPECTOR �c�
M-1802
BUILDING DEPT.
INSPECTION
[ ] F NDATION IST [ ] ROUGH PLBG.
[ FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE INSPECTO
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] BOUGH PLBG.
[ J FOUNDATION 2ND [ ]/INSULATION
[ ] FRAMING [ ] FINAL
[ } FIREPLACES CHIMNEY
REMARKS:
— ,2/ c
DATE 7 11 -� INSPECTOR
BOARD OF HEALTH . . . . .
FORM NO. 1 3 SETS OF- PP
_ L. NS . . . . . .
TOWN OF SOUTHOLD SURVEY . . . .
BUILDING DEPARTMENT CHECK . . . . . . . . .
TOWN HALL SEPTIC roan . . . . . . . . . . . . . .
SOUTHOLD, N.Y. 11971
TEL.: 765-1502 NOTIFY ;
A yyy///������/' it C ALL
Examined . (, , , , , - ., 19a MAIL T 0 :
�. . . . . . .. 19�PermNo 7 ?
Approve
. . . . . . . . . . . . . . . . . . .
Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Building Inspector) SEP 2 5 19%
Q - -ICATI01l1 FJ BUE6D!Nfs PERMIT
Date '.'... . . . .. . . . : . . :.:.'19
INSTRUCTIONS
a. This 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. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stieets
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 been 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, ousing code, nd regulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
. . . . . . . . . . . . . .
-- (Signature oapplicant, or name, if a orporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Nt4C. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Name of owner of premises . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Name and title of corporate officer) r �
LS � _til �,
�.
Builder's License No. .1,16.. . . . . . . . . . . . . . . . . . i
« � F_ .
Plumber's License No. . . . . . .'. . . . . . . . . . . . . . . . . . `' , SEP 2 51996
Electrician's License No. 9i-DG.DEssf:
TOWN OF SOUTHOLD
Other Trade's License No. ..... . . . . . . . . . . . . . . . . . .
1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . (VA . . . . . .. . . . . . . . . . . . . <2CurNT. . . . . . ... . . . . . . . . . . . . . ..
House Number Street Hamlet
County Tax Map No. 1000 Section . .O-'16 . . . . . . . . . . . Block :. . . . 2. . . . . . . .. . . . Lot . . . . . . . . . . . . . .
Subdivision . . . . . . . ... . . . . . . . . . . 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 . . .r?�rCu , . u �4 ?5, . . , ... , , , , , , , . . . ..
. . . . . . . . . . . . . . . . . . . . . . .
b. Intended use and occupancy . . 5i"�G '. T?� E!�?N.i . .
(check
which applicable):
plicable): New Building . . . . . . . . . . Addition . . . . . . . Alteration
Repair . . . . : .
3. Nature of work check oval Demolition . . . . : . . . . . . . . . Other Work . . . . . . . . . . . . . . .
g (Description)
4. Estimated Cost . . . . 1.?iMlp. . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
,
(to be paid on filing this application)
S. If dwelling,number of dwellingunits . ... .I. . . . . . . . . . .. Number of dwelling units on each floor . .
If garage, number of cars . n^. :. , " " " " " "
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . -- . . . . . . . . .
7. Dimensions of existing structures, if any: Front . .42:-.8:.. . . . . . . Rear ,`1L. .8.' . . . . . . Depth . . . .'. . . . , , , , ,
Height . Jl! . ! . . . . . . . . . . Number of Stories . . I . . . .
{ . . . . . . . . . . . . . . . . . . . . . .
Dimensions of same structure with alterations or additions: Front „`l.Z, S. . , . , , • , , , , Rear . 2.Z .. .'. . . . . . . . . . .
DepDe th . . . . . ...' . . .
Sq1 . . . . . . . . . . . Height . . J�.'. . . . . :. . . • . . . . : . . Number of Stories . . . . . . . . . . . .
Height lvr. . . . . . . . . . . Number
Front . . L.�'. . . . . . , . . : Rear . .ZZ.'. . . . . . . . . . Depth . 3q. .
8. Dimensions of entire new const '
g ber of Stories . . . l ... . . .
9. Size of lot: Front . .dZto'. . Rear . . . . . . . . . . . . . . . . I . .
]0. Date of Purchase .197P>. . .IAS. . . . ' . . . ' . . . . . . Depth .174.'... . . . . . . . . . . . . . . . .
• • . . . Name of Former Owner
11. Zone or use district in which premises are situated . . . . . . . .
12. Does proposed construction violate any zoning law, ordinance or regulation: . . (Ub,
13. Will lot be regraded . .Nr7 , . ; , , • , , . . . . , . Will excess fill be removed from premises: Yes 0
14. Name of Owner of premises Xg kh9 . F-Vt , . , , Address . MP11P Rcrip,ol` VVV.T, . Phone No. S1.6Name of
Name of Contractor .pw {t, Address??o.4RF"1etty,�c"i , Phone No.21z All;A33(„•
Address Ny' ' N)M - 1O 17-
15. Isth sArcteu7fi in 3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Phone No. . . . . . . . . . . . . . . .
property :00 feet of a tidal wetland? *Yes, , , , , , , , No.X . .
*If yes, Southold Town Trustees Permit may be required.
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.
STATE OF NE ORK,'
COUNTY OF�. . . . . .p. ��/ .( �
.zpJ. . . . . . . . . . .
P being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
l�aisthe . . . . . . . . . . . . . . . . 4 1 . :. . . . .
(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 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.f.�rn.'. ..e. . . . . ., 1
9
Votary Public, . County
NZ49ETliANN N
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Al 152-8125850t,,Suffo k CuYork
yr�ty
4(iigne oEVLLE
f applicant)
Tem Expires Octdber 31,15..L.k �
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PLUMBER CERTIFICATION APP OV D AS NOTED
ON LEAD CONTENT BEFORE D,
CERTIFICATE OF OCCUPANCY
FEE:—�J� B P# 7 M. �= 2161996 -
NOTIFY LIING
pEp NT 'JIJ�''pli� GO, 'rAX �� I�.�C L y
SOLDER USED IN WATER 765-1802 S AM TO q E o00 - p g , Z _ 2� B�''-D�°E'T
SUPPLY SYSTEM CANNOT FOLLOWING INSPECTIONS: TOWW oil 10y¢ r
PLUMBING EXCEED 2/10 Of 1% LEAD. 1. FOUNDATION - TWO REQUIRED
ALL PLUMBING WASTE FOR POURED CONCRETE - NIN
&WATER LINES NEED
2. ROUGH - FRAMING & PLUMBING OCCUPANCY OR
INSULATION
TESTING BEFORE COVERING 3. j,
4, FINAL - CONSTRUCTIONFORC0MUST USE IS UIlII.AV�IFUL
ALL BE COMPLETEFOROR C 0
NfOr cOPper tubingIs used THE REQUIREMENTS OON F THE
N.Y.LL
ta"U PIPIng $haling WITHOUT CERTIFICATE
STATE CONSTRUCTION & ENERGY
$yeten, piping shell be CODES. NOT RESPONSIBLE FOR
Of tYpee OF OCCUPANCY
K or— L °My iF N e ,j
DESIGN OR CONSTRUCTION ERRORS �j/
i
Job Date ' rl'k Olt,,
Elizabeth Thompson Architect RufLo��GP,�sfPE! fes,` Z ="" �` lie Tti
270 Lafayette St. Suite 1303 Title St,{eyle
New York, N. Y. 212-274-8336 -2-iz rap ¢ GE$A1LS - dF,-
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