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HomeMy WebLinkAbout23471-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25992 Date: 09/28/98 THIS CERTIFIES that the building ADDITION Location of Property: 725 GOOSE CREEK LA SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 79 Block 2 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 8, 1996 pursuant to which Building Permit No. 23471-Z dated MAY 30, 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 ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT W PRITCHARD (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. H 060801 07/29/98 PLUMBERS CERTIFICATION DATED 05/12/98 ROBERT W. PRITCHARD got/ Building Inspec or Rev. 1/81 FORM NO. I 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° 23471 Z Date .....��................................... 19.?v Permission is hereby granted to: s �` � .1......7 .lelf... ......................... ................................... si7G ..... . ..R...../.l.1r..�.1............ f0 ..tirGlo.:..✓//...'.'. :7........... /.�V....... f�N.I. e.vY........ .., 0..... ✓:.::..... /.��N.l i�/ V/�yy�C .... ....... .. . 1�:�....... .......�.�..dC,.... ofpremis located at ........ ....C-Oe4� ....... ......` 1.:..................................... . r�7 4. '�!........................................................................ ..................................................................f............................................................................................. County Tax Map No. 1000 Section .... ........... Block ..��:.......... Qi�Lot No. .. l............... pursuant to application doted ........,/.."14141 �... ....................... 19.../..#Pond approved by the Building Inspector. ma Fee ................ .. . ............................. Idi Inspector Rev. 6/30/80 ffat/(4, , 1,91e" Town Hall,53095 Main Road 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: Building Permit No. 2 3 Uwner: (please print) Plumber: k6 /t/ pi- k4o (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers Signature) Sworn to before me this day of 11�2cl-(V 19yo- Notary Public, CZ, '(v County /V 4a cj�L J/7 BARBARA STEPNOWSKI Notary Public.State of Now York W01ST4844752 Oualiftodin�0'1- "County Commission Eplrcz - 130,110 Form No. 6 TOWN OF SOUTHOLD 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 buildin; 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 buildin 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 an "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 Buildine - $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 . .. . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. .. . . .. ... Jp1d Or Pre-existin Bu lding.. . . . . .. Location of Property.7S'.t?.C3(Jo �, , /4 . . i✓ . ... ... ... . . . . . . . . . . . . . House ;Noo.� , }} Street Hamlet Onwer or Owners of Property.l4V/3r14!. . . .. . . . jql�_7. . . . . . . . . . . . . County Tax Map No 1000, Section. .. . .. . . . . .. ..Block. .. . . . . . .. . . .. . .Lot. . . . . . . . . . .'. . . . . . . . . Subdivision. . . . . . . . . .. . . . . . . . . .. .. . . . . . . . . . . . . .Filed Hap. . . . . . . . . . . .Lot. . . . . . . . . . . ... . . . . . . . Permit No. 3 . . . . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . .. . . .. . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . .. . . . . . . . . . .. . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $. . . . . . . . . .. . . . . . . .. . . . . . . . . . . �.5) 1gcj� . . . APPLICANT . . . . . . . . . . i a3 � i THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 8066872 BUREAU OF ELECTRICITY F 40 FULTON STREET, NEW YORK, NY 10038 Date JULY 29,1998 Application No. on file 14260297/97 H 060801 THIS CERTIFIES THAT PERMIT NO. 23471 only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of ROBERT & AGNES PRITCHARD, 725 GOOSECREEK LANE, SOUTHOLD, NY in the following location; ❑ Basement ® 1st Fl. ❑ 2nd FL GAR/OUT Section Block Lot was examined on JULY 22,1998 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS (DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FtWRE5CEN7 OTHER AMT. K.W. AMT. K.W. AMT, K.W. AMT K.W. F 5 8 S 5 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET SYSTEMAMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OFFEET SERVICE DISCONNECT NO.OF S E R V 1 C E METER NO.of CC GOND. A.w.G. A w.G A.W.G. `AMi. AMP. TYPE EaUIP. 1 0 2W 1 0 3W J 0 JW 3 0 4W pER 0 OF CC. G. NO.OF 81d OF H17UG NO.OF NEUTRALS OF NEUTRAL OTHER APPARATUS; PADDLE FAN-1 ROBERT PRITCHARD L L, 725 GOOSECREEK LANE SOUTHOLD, NY, 11971 GENERAL MANAGER 1.1 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. COPY FOR BUILDING DEPARTMENT, THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. /-7/ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS TION [ ] FRAMING [ INAL [ ] FIREPLACE & CHIMNEY REMARKS: r DATE INSPECTO M-1802 BUILDING DEPT. I NSPECTIO [ ] FOUNDATION IST [ ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY / n REMARKS: AftZ DATE 4C-171 INSPECTO I' 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROU PLBG. [ ] FOUNDATION 2ND INSULATION [ l FRAMING [ ] FINAL [ ] FIREPLACES CHIMNEY REMARKS: f i DATE INSPECTO ,�2 3 �1 M-1802 BUILDING DEPT. INSPECTION [� IST [ ] ROUGH PLBG. [ Z71DATION DATION 2ND [ ] INSULATION [ l FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY RE RKS:/' -2�z, ,tee DATE INSPECTOR 765-1802 BUILDING DEPT. 1 NSPECTI N ( ] FOUNDATION 1ST [ ROUGH PLBG. [ ] F DATION 2ND [ ] INSULATION FRAMING [ ] FINAL REMARKS: DATE__i% INSPECTOR wze-14-1 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & IMNEY REMARKS: I II:1,11.• IIISI,Iil; hull III;PllllI •, UAII; i.U��lllarl�l �� �'- off'® .: ... ..em ..•.. .. .. 11 � GeC S I'IllllIDA l lull ( I„I') +rou+Il>nr ru+t z.,...,., rn ------------- - - Ii111IC11 fll Af ll? I'1.111III IIiu � ' --� lnsul.n'lulll rr.n it . v . --- '- ---- :.� : !i 1'A l Ii IiII1i 110Y ---. nl. d...,,..vm�,.....�.,-•........... AUUI'I IOVAI. C(111l 11?rllfi: ------ I�, Q'IOHin S d NM 1. 1d30 'JOl9 ;. 9661 _ pub t y T 3 6Rt � c v t GIONIn S d NTM 8661u lYJNq�y I t} M'_ liltqjr t=z' r.. . &Z WAS _ y \,....., Wrt-CeW re.,u,{a�Tc'm�. 9I SSC m ��i.!,l,«.JF'�st '�,'.m�C9 f�e.�� �� �..�'i..st1"'r.�'�,-:'� -,,:�.'�<�-r` c✓ � �'�2��- '' FY � ' -�-- ._..�m.a. v.. -...e..»... ...�..._,m.._.m.. .v_ ..w-v..... ...., 4 3 G,3 -9 _.�.��._-..........�._-�....._,_..�__..........."_...a... ..ti,_.,..—�......_.._.d ,�. __...,...,.,,-Q� .>..._�.-_«>....,,..,.....s,..-.,, ._.,....ems..... . - 1 sf � G e s el / L f/ S � � &. , �A� /V ? rj ,'3a-y' 120OA4 . 1.1@@��....�g�����ew.�warSrlr.� BOARD OF HEALTH D . FORM NO. I 3 SK'I'S OF P Na .tl. . . . • ' . . . . • , ' D 'TOWN of S(lllTHOLD SURVEY . �}��},,,,�� . . . . . . . . . . . . . . . . . . i~8 BUILDING DNI'ARTMRN'f CIIRCR At.�(Y:7. . . . . . . . . . . . . . . . . a 'TOWN WALT. SEPTIC FORM SOII'I'NOLD, N.Y. 11971 •., TRL: 765- 1002 NOTIFY: CALL ATI Y49.50 Rxnullled...... �. 19. MAIL It: . . . . . . . . . . . . . . . /30 19J..�i �Sc7/ .. Appnaved....... .�/..... PerrrtiL NO. .. ... .. .:'.............................. .. . . I Disapproved a/c ............... ...ii,.. ...... ........ .......... ...................... .. .. .. .................................................... APPLICATION FOR BUILDING PERMIT : Date. . . . . . . . . . . . . . . . . 19. . . . INSTRUCTIONS r 11. 'Thin application noxi Ire o1gdalely filled in by Lypnriirr or in ink and nulxollted to the lAtlldintl Inspector with 7 new or pinnn, accurate plot plan to scale. Fee according to nehedule. b. Plot. plan sllnwing location iof lot: aol of boildings on premises, relationship to adjoining pronisen or piddle. nlreeln or areas, and giving a (lelaillled deactipCion of In),owL of property sled: be drawn On lite diagram which in part of !bin application. c. 'tile work covered by Ihinapllp licatiol nary tell: Ile coaleo:ed before Ineualx:e of Owilding Permit. rt.. Upon approval of illi" applli,cal.ion, the Building Innpector will Ingle a Building Penult to the applicant. tdrrh Ixrulit shall be kept of the premises, available for inspeclior lhronghooL Clio wank. e. Ho Imildhlg nball Ire o:cupled or used in dole nr is part for ally purpxrae whatever until a Certificate of: SkcAlpax:y ahall have been granted by the Snildiryl Inspector. Af'I'Ll(:81'IOtI IS 11iID?IW IW1Ii to f,he IAdiding Depnitmeut for the issuance of a Building Pennit pow% nal. to l.he Building 7.one ordinance of [lie 'Alwn of Scothold, %iffolk Comity, New York, and other applicable lawn, Ordinances lir Regulat:ionti, for the cotstroclaoh o�: baildings, ocklitiona or allerationa, or for relxrval or donolitiow, an herein dencrllrevl. The applicant agreeit Lolcanply with all nppilcnble law", ordinances, Indicting code, Ixxlsing (!Ode, 111x1 1, I innpeclors ort preini"es oxi In Ixrilding for necessary IInnspectionsns. rendal.i<ms alxl in rxllmC mtllxtrixe(I ............ . (Signature of appli'gant, or anoe, if a corpxlrnl.ion) 8S:1,.. UK K..11ay.at 460 .mr zeI..... .. . ... (Mailing midrenn of nplAicallO i Slate whether applicant 19 owner, leasee, agent., archilerl , engineer, general contractor, electrician, plodmr or builder. C.rvmc-r r..................... ... ........ ........... ... ... .. ...... .................... I...... .. .. .. .. Nate of caller (if preninen ...t'T.d4�16�'. ..W...¢..1.1`�y�'f!..�, �h.. . ..... .... ............. ........... .. . ... . (an al the ton roll or Intent deed) Ir apptlicanC in n corparaClol, "itpNriure of duly nothorized officer. .............. ... ........ ........... ...... . .......... .... (tone and title of corlxnale officer) Builders License No. ........�.... ........ .... Plhuirer" License No. ........� ................ Electricians License No. ....1...... .......... 011ner 'I'rrxk's License No. .. I. Incal:iol of: land of which pro,xrsecd work will Ile done. .......... .......... ........ ..................... ............ . ................Lslla�7.115... ............ ... o 011!A,...... ........... ........ Donna firdrer Street I-'77 Mantel: (kxully Tax Kill No. Bxx) Se.ctlian .. ... .1.9....... Illocic . .. .... .... . Int ..... ....... Sulxdivinion ........ . ....... .L ... . . ... .. .... ... . .. Filed Map Do. .... ........... Int ... . ......... .. (Nrrre) II 2. State Minting one and oc(upmQy of npprenisea/nad Illleaded Alae and occupancy of proposed connt.rlrct loll: a. Rxistirpl line and o:ccpxlncy, ....fi.r $./,`C i:.k!AyC—........ . .. ..................... ....................... b. Intended are and ereal><nx: I' y . .. .Sid, :4'.'. ..........:kiijoil•ei•a4•'ti•;i:._.:....... ... ................ � .Y.Yi io ou": ,JJ60'i YEA1T0A VInUO3 ftftktc:.tlioe"Ab.o14 w el JE VOilll e;l'fitJAJ 11lltil' I. I.IUue ul' ,nak (cheek IAlldl elgdlruble); Ilea/ Ik,lldinil . .. .. .. .. . Mldllien . . .�. . .. .. Aj�lg,{ 14aX11r ........... . 11rnlgval Ikdrnl 11 ton (11 her Iknk 4. F:ILIuXlled (bnf ...b.�... ....... . . ... .... fee . ... ... . . .... . . . .. . ... . :... . .. ... ... . . .. . . .. .. L. (lo Ix: paid oil fit log title nppl co f4. '1. If linalilyl, Ixllllx:r llf c6mllLy; unlln . . . .. . ... . . Umber of cl,mllluil Iloilo on each Fliiil."::"`. . . 11` Iluruile, Ixuller of enru ........ .. .. • . .. . .. .. .. .. .. .. . . ... . . . . 6. If: Ix011onna, coinalcinl or udxed oc:c.Oluu K:y, slx:clfy nnluRe 11cXl eldeol, of euch tylN of une... . .:�:--- 2. Dino In loon Of ex i a P lot, al nXaur en, If July hrvxd . . ..W.3 9... .. . Itear .. .�.3 -.9.. .. . Ik!ptb . . .J.R. .. . . ... .. / I001L ... .1 IP'. ... ......... ..... Uidx!r of 6lorien . . . . .../�. ... . ... . . . . ... Dblieosicos of InnX; slnuaure whit itheraHont, or ,Nklitioon: Front . . .6.3.-.% .... . Item .. .6.�. : .�.... . Ik:plll . ... .. ..3.d.......... Ik:ilp . . . . ... of lilor hm . . .. �. ....... . u N D. DIIIM'.IIIrIfNI!1 ol` e!olirn new axutl rcXa ico: 111'cN1 ...6.$. Y.. .. .. Ilenr ..63,-g ,. - Ik:pi6 „� 0 .-_ • ,_, . IkalfU. ..... ....9........ ...... hAnlN:r of lilorieu . .. .r. .f. . . . . . .. .. . . . 7. Sive of IoL: plant .....2.50..... . . ... Ilear ... .'6`. ... .. ./. ... .. I0. Rrle of 11,rdume ....�./�8�9a: . ... . Unity! of Fol filer (x,lIII r .���6�f•.C:oFS'.q,•r=S If. Zooe ur one dlslrlCL In widdl prainlseB fire situated .. . . . . .. . . . ....... .. . . . . . .. . .. . . .. .. ... .... . .... ... . .. . .. .. . . . 12. Ikxs prolioned cronLrmi Ino v1O1 ale tory z kIIll Lo„Orrl fuel We Or ff%kII nl.lon: .. . ... .1!1�/K.. ...... . .... , 11. Will IOL lie Yeilrncled ........ . /All!�1...... Will�eexce//ss fill he roraved fr�on, prmiine/n: �sYI?), , 14. Dulles of ().Amor of prenilinnu Gh/. a`rly±/�F.lN/Alf�!(Lllese ...JrcfS�.L9PPS4.UA - �A..Javi$04glrzx x: Iki. ILne. of Archltnrl: ............... . .. .. . .. ..... . . ... . .. Nklrenn Mar Ito. . . .... ....... . Dulle of Givil rector .......... ... ....... ....... ... ..... Mkiress .. .'... ...... . ..................Mont a tkr. . . ..... .. . 11. Is Ihin prnlN:rly wllhln .l(X) feet of n I Will se(lmXl7 • YlUS .,........ M) ..4,� .. . . -' AIF YES, SUIIIKXI) '11-M -11(1111,1109 IVIIf11T HAY 14: ItUtIlIlum. PI,DT DIACIIAIt «:Ble cleally Olxl diBLhlctly fill Ixllidlolln, %A,elller addling or [Motioned, OIXI ILrtienl'e all eel-back diuXeoslonu flan prolN:rly thew. Clve ntreel: 111x1 blmli YXrriwr or cMecrlpLi4m acconlioll to deed. Ilrxl shear elreet omlen 111X1 Inklicfile 1Au:1bm Interior Or copier lot. ^ / l JY R8 avesc F.- �,u3 • , r m fi Ca rx rB*P Ian,"a :i I'A'l IS [WIxSH YIxIK, � • Sli /tsao — o79-2—y Ievf��✓ar �o �. . .. . /�!J•��11�. . . . , .... . r`t Q �.�.,�. . . ..beiull duly crvnu o, deloneO mxl unya thatbe in the uppl land ' (IIi YIC: llf i1NIIV 11111:11. liiihliuil conl.rucl) i 1lNNe ni'lliml, Ik! in Ilu: .. . . ... . .. .. ... .... .... .... . . ...- w . . .. . . . .. . . ..... .. . .. .... ... .. . . ... .. . . .... ... .. ........ .. . ((i)IIlruclor, niteni , corlorrde officer, etc.) of 11ofYl Inn K!r or cwnxo'n, IIINI In duly nulhurlzed IO liorfolm Or havO JX!Ifunmd Ibe 11fiid work nIN1 to nrda! Ind lllo Illln npplionl ion; 115111 fill nLatolieoln contaimil In Ihin opplicol loll ,fie tio(I tO the bout. Of hill ko(MI(24111e OIXI IN!lief�) 411X1 thol IhO woc11 will be perfoOned to lilt! nuwli!r net (unit ill the 11pplicfitioo Filed lbcl(twllh. !k,olo to beforrope-.p.erp it in .. ... ... ...U .'.....d,1y filo ... .. . .. . 19.�.L2. Minify 111bIle .. ... .. .. .. . .. . . .... ....... ROBERTI. SC T,JR. (liiiloalure of Applicanl) NOTARY PUBLI State of N.Y. No.4725089 uffolk Co Term Expires May 31. 19 cZ 7i 1 1998 BLDG.DEPT. WN FS U H LD ��EE1L E G00" a Mn2a vj1''t0 ..i } ' FENCE b`NhLt. ,P �i ui a ={o a n 160—.0 .._--�_� �'565°5610 W' S6/ ?TS \ a1 T 58 22090 ' oF 0 N , 6 N W M0, 37 � SPC zw 5O B OF WPY �—� 09•b� � > , / TGN? /go J r A MP . OF PROPEQTY h�.voLF 10¢r bi SURVEYcD F_OR .•. . Pvy6rowc PAno r .� OWE - { CONC6 WALL r ' / \y _ � _L: ¶11fft•• lv'? '�T L ='t' �P� t6Y V i E W i -� mall i n ' cErxE ite. e TOWN. ?,F O✓rlTAOL•Q JJY 1 i „1 Me f•W tl M1I n^f 11 � tl ,N �eA i vJ wtltwom or cuCmaoern ' W \� z Y v ti% fv X I cS25 ew P F�LANDS 4 m nX Or PIPE� � • .r. FEA' 1.157AC, i GUARANTEED TO FIRST_AhdER7CLN'=tl.''NfC;{(sSWJ ANCECJ, AS SURVEYED JAN.:6 X192 -,- Ir i SUFF. CO.TAV MAP DATA 1000-079-2-2 .UC.LAND SURVEYU 25 - GRF�k=,IPO{QTitJ,Y, [[F A 1an �.