HomeMy WebLinkAbout23854-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24805 Date DECEMBER 17, 1996
THIS CERTIFIES that the building ADDITION
Location of Property 600 NORTH OAKWOOD ROAD LAUREL, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 127 Block 8 Lot 6
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 26, 1996 pursuant to which
Building Permit No. 23854-Z dated DECEMBER 10, 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING "AS BUILT"
AS APPLIED FOR.
The certificate is issued to ALAN J. & SUSAN G. LANGENUS
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
71idini Inspector
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)
N423854 Z Date ...... .. ... .XIS., ....../�...................
Permission is hereby granted to:
' .... . .. . .. ...............
...... /,21q '.
*. .- ... ..-.. .............
of premises located at .....................5� . .......... ?...I.l .1� . ...........
............................................................
.......................................................................J........ ...... .........................................................................
��ff
County Tax Map No. 1000 Section .....,1.,` .1........ Block ........f......../Lot No. .....1 c ..............
/..!�i.
pursuant to application doted .................. :l�.,1?11.................. 19 6, and approved by the
Building Inspector.
Fee $....J.. ` ..
..... ........... .. —!.C. .... .
.... .. ..... ... ..... ..........
Building Inspector
Rev. 6/30/80
Form No. 6 ®d (35rf ']'L
TOWN OF SOUTHOLD 1� 9N9/
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.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 1% lead.
t5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
A 6. Submit Planning Board Approvalofcompleted site plan requirements.
3. 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.
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 - .25t�
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, yComme cial $15.00
Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Jew Construction. . . . . . . . . . . Old ,O�r/ Pre-exist'nn'gy�B�uildinng.. 41 . . . . . . . . . / _ ,g� � p p��' ry
,ocation of Property. . . . .Na,-M. . . . ✓:z/(W 4? .R �• , . . . . . . .4 q.4 P,,/, X C./•: ✓/
House No. ((�� �/ Street j / Hamlet
�nwer or Owners of Property. . . .^J.� Xa4 � . J4. ./.,�",<l� .. . .'✓.�. . .4 alv
v.e .u. I. . . . . . . . . . . .
ounty Tax Map':- 0No� 1000, Section. .lz?. .�?c? . .Block.(,?J. .-.P/Q . . . .
Lot.
subdivision. . . .a. . . .P(zrtl . . . . . . . .Filed Map. ./. 6�. .g�Loot. f. . . . . . . . . . . . . . . . . .
'ermit No. . . . . . . . . . . . . . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. /./h/1. . �!. - 444_ e4e lS
�Iealth Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
lanning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .
request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . .
�ee Submitted : $. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c� .sa3 ��- . . . . . .
co-:M �Fsd 5 . ;,;CANT
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5 BY THIS CERTIFICATE OF COMPLIANCE THE 5
5 NEW YORK BOARD OF FIRE UNDERWRITERS 5
BUREAU OF ELECTRICITY 5
5 �p 325 40 FULTON STREET — NEW YORK, NY 10038
5CERTIFIES THAT 5
5 9- 00� 5
5 Upon the application of upon premises owned by
5 R.J. CORAZZINI ELECTRIC ALLEN LANGENUS320 5
C5 RICHMOND E
600 PECONIC, NY 11 58, LAUREL,TH 1
NY 199948 DR
eLocated at 600 NORTH OAKWOOD DR LAUREL, NY 11948 rj
c5 Application Number: 2060241 Certificate Number: 2060241
Section: Block: Lot: Building Permit: BDC: ns11 S
C5 Described as a Residential occupancy, wherein the premises electrical system consisting of e�
electrical devices and wiring, described below, located in/on the premises at:
5 Basement,Outside, 5
A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5
5 herein, was conducted in accordance with the requirements of the applicable code and/or standard
rj promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5
5 authority having jurisdiction, and found to be in compliance therewith on the 30th Day of June,2005. 5
5 Name QTY Rate Rating Circuit Type C5,
5 Service
5 1 Phase 3 W Service Rating 200 Amperes 5
5 Service Disconnect: 1 200 cb 5
5 Meters: I 5
5 5
5 5
5 5
S 5
5 Sea/ 5
5 1 of 1 5
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
5 5
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M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN OLATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: _
1416
DATE A INSPECTOR -7'
Mln�P OF PROPER
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+ BOARD OF BEALI'll . . . . . . . . . . . . . . .
i'vltM N0. 1 3 SETS OF PLANS . . . . . . . . . . . . . . .
TOWN OF SOUTHOLD ""SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
BUILDING DEPARTMENT -CHECK . . . . . . . . . . . . . . . . . . . . . . . . .
TOWN NOV�26 ial),) SOUTHOLD,i1Nl.Y. 11971 SEPTIC FORM . . . . . . .. . . . . . . . . . . .
h 'ji ._ _ ,_ TET.: 765-1802 NOTIFY:
CALL �
� 9
� . . . . . . . . !. . . .
I'.�curnirreol... ............. 19.. /y1 (� MAIL. TO: . . . . . . . . . . . . . . . . . . . .
ve
Approd.,. .J i!.., 14, Permit No g.?jj- .�'� ....................................
Disapproved a/c .................................. ....................................
iding Tnspector)
AP
POR BUILDING PERMIT // 96
INSTRUCTIONS
a,. 'phis application most Due cougletely filled in by typcmrriter or in ink anal sulAnitted to the Building Inspector will
'3 sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan o:lxxving location of lot and of;Jbuildings on premises, relationship to adjoining premises or Public
sl.reets or areas, and giving a detailed description of layout of property oust be drama on the diagram which is part of
this application.
c. 7be work covered by this application orry not be commenced before issuance of Building Permit.
d. 11" approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such
permit shall be kept on Ura premises available for inspection throughout the work.
e. No building shall be occupied or used in Axle or in part for any purpose whatever until a Certificate of:
Occupancy rdnall have been granted by the Building Inspector.
APPLICATION IS BEREBY MAM to the Building Department for the issuance of a Building Permit pursuant to the
Building Tore 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 demlition, as herein
described. 'Ile applicant sprees to comply with all applicable laws, ordinances, building code, housing coxle, and
regulations, and to aduk autborized inspectors on premises and in Wilding for necessary ins*)ns.(Signature 0f . ]i a oa corporatirni)
r or
lee
(Mmiling rens o Sapp tea nC)
State whether applicant is owner, lessee,
Iagent, architect, engineer, general contractor, electrician, pludx:r or Wilder.
.................................. ........................................................................
Naof owner of premises .......:e�✓1-..SJ.:...` .�J. .� ...tl <... 11 .?{. 1!
Name. ................
(as on the tax roll or latest (teed)
If applicant is a corporation, signature of ohrly autlnrized officer.
.........................................................
(Mare aril title of corporate officer)
Builders License No. .........................
Pluofiers License No. ..........................
Electricians License No. .....................
Other Trade's License No. ....................
1. Location of lard on which proposed work will be done..............................................................
....Ze.vp.. 61,IX......�akwuv/.,Ac/ ...................
House Mjduer Street yg,ry Ham et
�y
Qxjnty Tax Map Nn. /10(X1 Section ...� 1.°r.-�J5�.0.. Block .(�>�'S-F��.^^IIIO... lot ..®.4✓.k�!./4+�1 00
SulAivision ....... I.Y4......PU.p.(.1.... Filed Map No. Q1J.:�....... Tot ...'I.: ......
(Name)
2. Slate existing use and occupancy of premises awl intended use arxi occupancy of proposed construction:
a. Existing use and occupancy, ,g✓ � r ......................................
b. Tnlexled use and occupancy ..0��...!/1�,Y�,Y..../l/......................................................
'l, !:moire of %wilt (check %Arida app!. cuble); Net) Ikrildirnlf ... .. ..... Acklilionnr Y�.... Altercation . ..... .. ..
m!pair ........ .... Ilenoval ........ Ikrmlit-lon ..... ....... Other !York .... ....................... .......
9 �//y Ukscription)
4. Ent invited Cost: .......1..®Y,.... ....... fee ................... ...........................
(to Ixe field on filing this application)
5. If (houlling, nxnber of dmilinll !tufts ....... ..... lAnber of (k+elling unit's on each floor ............... .
Ifgaraj e, oiler of cars .......... ..... .... .. .............. .. .
6. If busfoesa, munercial or mixed'.. o:cupxaey, specify nature soil exfenf of each type of. une............ .. ........
1. Dinxnsloxns of exfsling strtxaurep, if: any: lrro l .. ..... ..... .... Itear ......... . ..... Depth .. ..... ..........
Ikighl. ..........................I tA.dx!r of Stories .. ....................
Ilinwusims of serve strrvchire whit alterations or cxklicionsi Front: ..... ...... .... hear ...............
Ileptb .................... ifei(l1n'1. .................... Miler of Stories .. .............
S. D'Iniensions of entire new coust ocl ion: Front ................ 11var ... . .. ... ...... I)epth ...... ........
Ikeillht .................... .....'� Milner of Stories .. .............. .. . ..
9. Size of lot : Prcxd. Itear .................. .. Depth, ....................
I0. Ibnte. of ILrcbase ...... Nam of Ponier (Mier .. ... .. ... . ........ ........ ............ .
H. Zone or use district fn rA%icit premises are situated ............. ..... ............ .... .......................... ...
12. 1Mes propxasal corslrrxaion violal:e any zonlr% lira, ordinaoce or r'eltolatloo: . ............ ...........
I'1. Will lot be regraoled ...........'',......... Will excess frill lie reamed fran pronisen: YES M1
14. Noires of Qalner of premises ........................... (vklreas ................. ............. Mone lki. .. .... .... ....
Mine of Ardn(lecC ..............�;..................... Acklress .... ..... ............ ......... 11lore Mn. ...... . . . .....
f I ......... ..................... ... fvkiresa .. .............. ...............Moon Mr. ......... . ....
1'i. Its (Vols prop rLY within 3(Y) feet!! of it tidal neClaoxl7 * YI?S . .. .... .. NO r�.......1 �
*IF YI?S, 91Y111YlID '11lIdJ 'lllllb""�11J:S 19illklfl' k1AY IY: IL3(i111R1'D. (yyy'�'yJ')/// �I.t� ��';~/„/� ,�yao q, ,n 1lwl
1'LD'1' DTAGItAM /%v'/y— 1°(/ ,`'/� C.%Cl / Vl`/G/
fac:ale clearly six[ distinctly nlil buildings, wltelher existing or proposed, nix] irxlicate all set-back dimensions
from profeoty lines. Give street: six] block nnnber or description according to Gleed,-and sixav street mines six] iixlicate
%Anellser interior or corner lot.
APPROWn AS NOTED
DATE: 13.P.#
FEE: BY: AT
P
NCYPIFY BUILafNG DEP
' 765-1802 S AM TO 4 M FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
nFOR POURED CONCRETE
2. ROUGH - FRAMING At PLUMBING
R. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALI. CONSTRUCTION SHALL MEET
TIME REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
(la Nlv (a jh�... CODES. NOT RESPONSIBLE FOR
"r/a��w/J/ DESIGN ORCONSTRUCI'fONERRORS
. ... . ..•J"r ••f• .p.(..... .. ,. '�.J,�. S..... . ....Imilln duly rwuru, deposes six[ says that' he in life app! icon!'
(Name o ' nxliv(t ucd signing conirac�
alxrve oned,
Ik! is the ....... . .... .. ....... .� !.rl;,)..4�,,..V,,..... ........... . .. ........... ..............................
((hnntractor, agent, cbrpxrrate officer, etc.)
of said uwoer or (""Orr., not is duly fit'Ahorized to f)erfonu Of- hava Ix!rfornred the said mirk mil to melte mil fit(! Ihin
application; that sill stataoents contained fn this application are t.r a to the lest' of his knowledge mil [xilfefi, mil
that. lift tnrrk will, be Inerp'onieol/n le'ii,ma/nixar aet: forth in the application filed [heuetlit.h.
Sworn to
Mr.ary m bl
CLAIRE L.GLEW (Signator f Applicant.)
Notary Public,State of New York
No.4875506
Qualified in Suffolk County
Commission Expires December;,8,19