HomeMy WebLinkAbout23463-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 2-24969 Date APRIL 10, 1997
THIS CERTIFIES that the building RENOVATION
Location of Property 2600 OREGON ROAD MATTITUCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 100 Block 4 Lot 5.1
Subdivision Filed 'Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 6, 1996 pursuant to which
Building Permit No. 23463-Z dated MAY 22, 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 RENOVATE EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to CHARLES SMITHEN
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-414966 - MARCH 25, 1997
PLUMBERS CERTIFICATION DATED MARCH 27, 1997-MATTITUCK PLUMBING & HEAT.
Bui ing In ctor
Rev. 1/81
k
FORM NO. 9
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)
Date ..Z
1Vb 23463 Z ........... . ..�.......................,........., 19.�.�
Permission is hereby granted to:
:. .x..:....rf .......................................
to ..�. .✓..!...�..`........... .....��'G�`........ ,.�.t.�.tr .�.....�-X1.1.. . .....1 !�'
.......4o ...... ............................................................................. .........................
at premises located at ......e�.4 ........ ! 7r. .....A ....................................................
.......................................................... ?71 ..................................................................
.................................................................................................................................................. .............
County Tax Map No. 1000 Section /0t�.7.............. Block ..6; ....... Lot No. s `!...........
pursuant to application dated .............. - ��.....................
......, 19,, .,., and approved by the
Building Inspector.
Fee $....`. ....`............
,J ............................
�n Inspector
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD MAR 2 8 1997 i
BUILDING DEPARTMENT �"
TOWN HALL amL "v
765-1802 BG®.D_P7r_. 11,
j
y "OWN OF L,-FiOL.. a
J
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 sewer age-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.
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.
Cn Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
F 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 - .25C.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . . . .3/ . . . . . . . . . . . . . . . . . . . . . . . . . . .
New Construction. . . . . .. . . . . Old Or Pre-existing Building. . . .
Location of Property.. %"('.Ge7.. . . . . . 0/1�L700 r2b. . . � . .. . . . . /n"?9 ? :et�� . . . . . .. . . . . . . .
House No. Street Hamlet
Onwer or Owners of Property.. . .ah Ar/t L� . . .�rl! l F . . . . . . . . . . . . . . . . . . . . . . . I. . . . . . . . . . . .
County Tax Map No 1000, Section. .I.��. .. . . . .Block. . . . .0.*4. . . .. . .Lot. . . . . s . 4. 1 . . . . . . . . . . .
Subdivision. . . ...jj. . . . .. .. ... .... . . . . .. . . . . . . . ...Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
Permit No. .2!3ZG?' . . . .Date Of Permit. . .. . . . . . . . . . . . .Applicant
Health Dept. Approval. . . . . . . Nb .� . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . ..
Planning Board Approval. . . . . e�114. . . . . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . .
Fee Submitted: $. . . . . .. . . . . . . . . . . . . . .
a4r, ,�p� �pa APPLICANT
Coi
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1001071 • BUREAU OF ELECTRICITY
F 85 JOHN STREET, NEW YORK, NY 10038
Date HARCH 2 5,1997 Application No.on file 13510t97/97 N 414966
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises'of
CHAS. SMITTEN, 2600 OREGON ROAD, CUTCHOGUE, N.Y.
in thefollowing location; ❑ Basement ® Ise Ft. ❑ 2nd Fl. .Section Block Lot
was examined on MARCH 18,1997 and found to be in compliance with the National Electrical Code.
FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS INCANDESCFNiI AMT K,W. AMT. K.W. AMT. I K.W. AMT, K.W. AMT, H.P.
24 25 12 2.4 1 1.2 1 P
DRYERS FURNACE MOTORS FUIURE APPLIANCE FEEDERS ISPSCIAL RIC-PT TIME CLOCKS I BELL UNIT HEATERS MULTI.OUTLET DIMMERS
i AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP WT. AMPS. TRANS. AMT H P. NO.OF.-MSH. AMT. WATTS
4
I B 600
SERVICE DISCONNECT NO.OF S E R V I C E
METER
NAT. AMO TTPE MUW. 192W 103W 303W 304W NO.OPERr COND. OF CC COND. �'Of Ie1FG OF M LEG NO.Of NEVTRAlS OF NEUTRAL
i
OTHER APPARATUS:
r
1 PADDLE FAM-1
MOTORS:1-F 1LP,
G.PX.Ti-2
I TRACK LIGHTING.-12
G & S CONTRACTOR LIC.#578-E ( L
BOX 215 ANN
SOUTHOLD, NY, 11971 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 1 eir credentials.
I COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST'NOT BE ALTERED IN ANY MANNER. -
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [V FINAL
[ ] FIREPLACE A CHIMNEY
REMARKS: 02 0
DATE 3 9 INSPECTOR vow
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROU H PLBG.
( ] FOUNDATION 2ND [ NSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE A CHIMNEY
REMARKS:
DATE INSPECTOR
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Town Hall, 53095 Main Road p g Faz(59E)'7t39�hi3i9- -
9y�O! � Telephone (516)765-1802
Southold, New York 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
March 25, 1997
Scaramucci Construction
P.O. Box 1403
Mattituck, N.Y. 11952
Re: CHAS. SMITHEN
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) y� / J
XX No Underwriters Certificate on file.--� f
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 # 23463-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
c� Gym
N x
Town Hall,53095 Main Road p • ,� Fax (516)765-1823
New 9y�Q! �.��� Telephone (516)765-1802
Southold, Nw York 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
March 25, 1997
Scaramucci Construction
P.O. Box 1403
Mattituck, N.Y. 11952
Re: CHAS . SMITHEN
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)
XX 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.
XX No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984) .
BUILDING PERMIT # 23463-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
i
+ , q Fax (546) 765-1823
Town Nall,53095 Main Raad ;� :�
P. 0. Box 1179 mrd Telbphone(516)765.1602
Southold,New Yolk 14974 • fry, + '. '�''t ,
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C C R T I F I C h T 1 0 N
DATE i 9/27/9 7
Sui.lding Permit No. �3t/f> z
Owner: � Q„ �
(please .print)
Plumber: l�v< v �cpTr
(please print)
i
I certify that the solder used in the Water supply system
contains less than 2/10 of 1% lead,
umbers ign /
li
Sworn to before me this
a7. clay of � , 1917
Notary Public, _ County
IIMIMry297wNak
fQualified in Suffolk County
Term F.
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rye BLDG.DEPT.
TOWN OF SOUTHOLD _"
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BOARD OF HEALTH . . . . . . . . .. . . . . .
FORM NO. 1 �/3 SETS OF PLANS . . . . . . . . . . . . . . .
TOWN OF SOUTnOLD /SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
BUILDING DEPARTMENT �/CHECR . . . . . . . . . . . . . . . . . . . . . . . . .
TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . .
SOUTHOLD, N.Y. 11971
TEL- 7615-1802 NOTIFY: �1
CALL . . . . . . . . . . . . . .
Examined...... �'....., 19.� MAIL TO: . . . . . . . . . . . . . . . . . . . .
Approved.........l/2 ... 19/..J(! Permit No. 3c loll L�.. ....................................
Disapproveda/c .................................. ....................................
...................................................... ®r;(Buii In. ct
APPLICATION FOR BUILDING PERMIT
Date. . .
INSTRUCTIONS
a. This application mist 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
streets or areas, and giving a detailed description of layout of property most be drawn on the diagram which is part of
this application.
c. The work covered by this application may not be cmvenced before issuance of Building Permit.
i ( . 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 throughout the work.
e. No building sball be occupied or used in wlole or in part for any purpose whatever until a Certificate of
Occupancy shall have been granted by the Building Inspector.
APPLICNrION IS 11EREBY MAD- to the Building Department for the issuance of. a Building Permit pursuant to the
Building 7xone Ordinance of the Tam 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
gu pec prem' ld'ng for necessary inspections.
regulations, and to admit auUxxizel inspectors on promises and in
Signature of applicant, or nam, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
...........l................C......./..................................................................
Now of owner of premises ..`.�('1!l 5.....,J/??l.� "!e.!)......................................I...................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
......................................................... II
Mme and title of corporate officer) MAY - 61996
1
Builders License No. .... 3 ��. ...... TOWN OF SOU HOLD
Plumbers License No. .........................
Electricians License No. .....................
Other Trade's License No. ....................
1. Location of: land on which proposed work will be done..............................................................
2�OO.............!sZ .!l "J... !�......................... ` ' 7��je/�............................
House Number Street llanlet
Canty Tax Map No. 1000 Section .....lb.U..... Block ...... T........ Lot .....5.%J......
Sabxdivisiun ...................................... Filed Kip No. ............... bot ...............
(lune)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
Occupancy
a. Existing use andG ,
.�!k':E..C!`J.�/C/� ......................................
b. Intended use and occupancy �� .. !.�. _. °�a 1� UJ!J�°l° w• 1r
..........
NV
—i.11 ,it Y0-A�21Ega d MIA A
3. Riture of wcxk (dieck ndaich a
Ijlnl(cable): tJL1J loilding ......... . ncklition .......... Alt eraC ion
Ikelwir ............ ltcatrrval .!........... Iknnlit!oil ............ Other eerie '...•'.• .... .....
r . �- C1GD , (I)e to(:r i pt-ion)
INS
i 1'ssl;bnne«I (:oaC .... .�.................. fee ....... ........................... ........... .
(to Ile I)aId on filing (ilia application)
'i. If: tkaellinp, nknber of tkaellLy; units ..... �..... ti.nber of clwelling units on each floor ... . .......... ..
Ifgarage, Ixrdter of cars ...���...... ........................... .
G. If Ixasilaess, ecnnnercial or mix"'I a:tnlxax:y, specify nature sol extent- of each type of use....... ... .......... ..
7. Dillensions of lglres, if any: lrrcxn .. .. -::.... Rear .... .ZZ4: :.. . Depth ....Sz-?.......
I
nt L�
ikeIB ............ I.. Mniaer of Stories .....Z:..... ... .
Disenstos of sce
lslrucui ewith alterations or acklit-ions: Front .. ....A.Z-r... [tear ..`.��. -.......
Iktplh .....5.. .......... leflllat ..... !?..:........ tknixer of Stories ....?.:.......
ll. Dissensions Of: enLie new coosyrx:Pion: Front ....Av/i'.7. .... Itear ............... Will 11 ..............
Ileigllt ....................... Nudler of Stories . ..........
J. Sias of lot: Front, ....A .. Rear ..... Depth �
10. Dene of 1\crrha.,e .............,........ Nam of Fonmr Owner .............. ..... ........ .............
II. Zone or use district in wDaich 'ipremises are situated ....................................................... .... ...
12. Does proponent const.nx;lion vio laLe any zcxning law, ordinance or regulation: _V-0
.....
...........
13. Will lot be regraded ...N./rv..../. .... WIi/ll� excess fill lie reicived frolic pccraises: YV.S
14. Names of Owner of rem]sea S! ('irr r.�.,�Ml.�":?� ... . Acklress/(o3 �•.�� s7'N. .� / / Fl ?f, ..�+�P �• /. ...i... .../...... Phonee.. ......
Wase of Ard i1tecC I�O�A L �,.. Ci Le- fPo 6eE zy'ule Lnl. A,-g.W_
... ................ Arklress .6
Pleone No. L
Nen■ of (oorractor h �e �??!1`"'��.C.C�..... Atkiress ..:!! .! •................ ...Moet No.�� `63
e (.. .6.
15. la this property within 300 fGef of a Lidal wetland? * YES .......... Ix) ,. .
*1F Ylug, SYllt111tm1) '1DIVN '11�11SDos miml.l' itAY lv3 ltG(iIIIRF.D.
li PLOT DIAGRAM
locate clearly aaxl distinctly all txaildings, ubether ex]st]og or proposed, six] folicaLe all set-back dimensions
frau property lines. Give street anil block nuldaer or description according to deed, and allow atreet names aril indicate
w1cether Inlorior or corner lot.
411...�,
... ...,'Y,11- '.�, ;
51'A'Ili DI' NIs1J Y(N2K,
SS
(X my (NSI ...... .
(V•.. G.... ... . ..... ,... ..... . .......... . . .luting duly sworn, delwses aunt] says that. be is the applican(:
t t,7?"—U Ccs.. ...'
(Nance of hxlividual signing contract)
alxwo aallvd,
Ikeit; file ..... ... ....... .. .n,etnt .. .............. .... .i................ ... ............ ............... ....
(Contector t, corlxnraleofficer, etc.)
Of* said Owner or cavo:rs, acxl in duly! aufhorizecl to lxerfoun or have lxerfonised lice said cork aaxl to slake auxl file this
application; that. all statecsents containecl in this application ate true Lo (he Iaesl. of his knowlet1ge aol Ixa ief; aol
Ilial the wknik will Ix, perlbnned in (fie asanxer set forth in like application filed therewith.
tkdcnrn Lo/Ix.foa. nr this
........�......day n' . .... c
).. . ...
IJ ,olary Rablic ..C .. (\_. ...
Signature of Applicant)
ROBERT 1. SCOTT,JR.
NOTARY PUBLIC,State of N .
No.4725089, Suffolk Cou
Term Expires May 31, 196
H copper tubing Is used
for water distributing
PLUMBER CERTIFICATION system; piping shall be
of types K or L only
ON LEAD CONTENT BEFORE UNDERWRITERS CERTIFICATE
CFRTIFIC�iTE Of OCCUPANCY REQUIRED
SOLDER USED IN WATER
SUPPLY .SY,3�'7FM CANNOT
EXCELL) 2110 of 1% LEAD.
PLUMBING
ALL PLUMBING WASTE
&WATER LINES NEED
TESTING BE00RE COVERING
I
� 51/4 x q '/z fwSH Y.n�
ITGN
��rl I (� >= N I �I ISI I NCS
I I 'I u
1,-4OLL5
(70 E�1= rwFrnwEo
31/2 x ai'(Z M16Ro�M 5'/4 x 10/6 M L - 3'Ja x 117/8 ML
toF
-
- 4 xl i pos7 -- JJI �ROt`{T
Pa l�L.O'IZ,
� I
II
OCCUPANCY OR APPROVED AS NOTED
USE IS UNLAWFUL DATE: s. « B.P.N 13s�G3�
WITHOUT CERTIFICATE FEE:NOTV 8� UILDING BY
DEPART
OF OCCUPANCY 765-1802 9 AM TO 4 PM FOR THE
j � 7,0 F, I _— /— 1-4 FOLLOWING INSPECTIONS:
1---C./C.�� I,� [� I �'2 0 1 FOUNDATION TWO REQUIRED
FOR POURED CONCRETE
I/^n rz2 2. ROUGH - FRAMING & PLUMBING
`T 3. INSULATION
UNDERWRITERS CERTIFICATE 4 FINAL - CONSTRUCTION MUST
REQUIRED 6E Co PLETE FOR C.O
ALL COW.TP,UCTION SHALL MEET
Tf'2 ":111;L^r,_NTS OF THE N.Y.
�S' L� ""TF.LECTION & ENERGY
NOT RESPONSIBLE FOR
OR CONSTRUCTION ERRORS
P �D I �IT�Ri OP �,E�I�ATIoNs T� l�"E
P�S61CIYu'k, my 4'995?' m ISIF",
2�PC:0 C�R�aDN �D, NIA I1uGK,� N `� 5�2( 91�.