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HomeMy WebLinkAbout23514-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24738 Date NOVEMBER 15, 1996 THIS CERTIFIES that the building ADDITION Location of Property 75 OAK PL. & 1200 FACTORY AVE. MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 142 Block 1 Lot 9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated .MAY 29, 1996 pursuant to which Building Permit No. 23514-Z dated JUNE 18, 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 2ND STORY ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to TIMOTHY & DOREEN SEYFRIED (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL INSPECTION CERT. #13260 DATED OCT. 7, 1996 PLUMBERS CERTIFICATION DATED N/A s // ue!;.r4 Inspector Rev. 1/81 I } FORM NO. $ 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) t Lv 23514 Z Date ......... ..........�................. ... 19.. i Permission is hereby granted to: n � ........ ..X6. .............. ..... ...Xa. ..a, ...... ............................. r �. ...... � lT..`.....: ..��. 0 .............. ���...�p��� at premises located at . . . ... .... .. ................... .. ... /.���. ..." w�.. s � ..........................................................� Q..., Il, -or..... ........................................ �1� 1 ..............................qq...................... County Tax Map No. 1000 Section ...... ..... Block ..........1........ Lot No. ...f.................... pursuant to application dated ................. M. ....l........ 19.. a and approved by the ... ....... .... Building Inspector. Fee 5.. •(�......... C .(..o.fa.. . .... .. .. ............. . . Building Inspector Rev. 6/30/80 s _ i� Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT 0�' r 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. 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. 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 - .25i� 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, 1$15.00, Commercial $15.00 Date '. . . . /. . . 7/?, . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing Building.e. . . . . -!�. . . . . . . y Y Location of Property. . . . .�r.��. . . . . . . . . . . . . .®�}{_. . .el-SIL41-0. . . . . . . . . . . . . . . �. . House No. \" ' Street Hamlet Onwer or Owners of Property. �{✓�aJ{y. . . 4 ' fl. . . . . .� 1 . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . 9. . . . .Block. . . . . , . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . Subdivisionnn. . . . . . . . .t.J. . . . . . . . . . . . . . . . . . . . / �Filed Map. . . . . .:". . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. .43.� I.I. —Date Of Permit. . �@ Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . .N3. 2-�q©. . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Cer.ticate. .T. . . . . . . . Fee Submitted: $. 32 5�f�4'?. . . . . . . . . . . . . . . . . S �qq . . . . . . . APP1.ICA co i ELECTRICAL INSPEC'TI©NSERVICE INC. . 375 DUNTONATIENUE EAST PA TCHOGUE,NEW YORK 11772 (516)286-6642 33260 . . . . . . . . -- - DATE: 7017196 APPLICATIONNO.ONFILE - - V/LLAGE: MATTITUCK TDK`m SOUTHOLD ADDRESS; 75 OA PLACE IssUER TO: TIMOTHY SEYFRIED INTRODUCEDI3y: HOMEOWNER LICNa: was eras ad on 1017196 andfbund to be in compliance with the NahonatElectxfcalCode - LOCATION: Base" 2nd r - 3rd Attic - Det Gawge Slot Tub Pool - - - - SWITCHES RECEPTACLES FIXTURES I HEATERS FANS G.F.I. AIR.GOND. 12 16 11 1 3 4-20 AMP, DISHWASHER DRYER CLOTHES WASH, GAR.DISP. RANGE OVEN SMOKEDETECTOR 4 FURNACE OIL OAS CM, MOTORS BELL TRAM.. SERVIC&DISCONNECT Drax AUPS Phase OTHER EQUIPMENT . 1-60AMP. SUB PANEL — ~r--- AN FLECTPTN' ^' NEY HAS 6££N MADE DF ilI r. :; . -D ELECTRICAL EQUIPMENT INIHE PREMISES NO VISUAL [DEFECTS FOUND H GO S sURD7 PRESIDENT BU11.D1i1rG P1Rhf1T No, 771iS arlUScatemurtnot beeUfiedm9RY m6m1� - Inspecfms mapbeiden66rdbyfhae¢edmtials BLUE ORIGINAL YELLOW COPY PINI{COPY OFFICE ry kJ FIELD iNSPL(,CION REPORT DATE COMMENTS W II II FOUNDATION OST) — y 1 FOUNDATION (2ND)_ __— 11-- II Ito { - - og - - ROUGH FRAME 6 11----------l PLUMBING II ii -- ----- ----- --- II I Cl �i /N/4 cq INSULATION PER N. Y. II�--------- ---------- ------- ------- H STATE ENERGY CODE -i ,eg 11 _ 1 II FINAi. H--------II - -- ---- --- -fin -------II - ---- - �1 --ADDITIONAL COMMENTS: Lon ----- ------------------------- --------------- i aareNONE 9Ec�ENO t4l I . .a .: . 4Z as ��" ' • +yli A ' •Z e M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ INAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE�i INSPECTOR , ! 768-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FO NDATION 2ND [ INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEYS REMARKS: LZ DATE INSPECTOR i BOARD OF HEALTH 10 W ' FORM NO. 1 3 SETS OF.PLANS �. . . . . . . . . . . D TOWN OF SOUTHOLD SURVEY . . . . . . . . . uBUILDING DEPARTMENT CHECK O*XA y . . . . . . . . . . . . . . . 17�/F11 2 9 9M TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . .. . . SOUTHOLD, N.Y. 11971 BLDG.DEPT. TEL: 765-1802 NOTIFY, p a TOWN OF SOUTHOLD �/7 CALL ,?.V7 1.8-3. . . . . . Examined............... L! -/�, 19!� MAIL TO: . . . . . . . . . . . . . . . . . . . . r/ 7 / �� .1k, 19. Permit No. .J S' ... Approved Disapproveda/c .................................. .................................... ilding Inspector) AP CATION FOR BUILDING PERMIT Date. . . . . . . . . . . . . . . . . 19. . . . INSTRUCTIONS a. Ibis 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 promises or public streets or areas, and giving a detailed description of layout of property mist be drawn on the diagram which is part of this application. 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 issue 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 untila Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS lEFM MAIC 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 nece spect, s. . .�........ .., .. ....... ......... (Signature of licant, or f a corporation) f.:.1� ..��.O. ... � ........... (Mailing,address of applicant) State whether applicant isonlessee, agent, architect, engineer, general contractor, electrician, plumber j/puim ber or builder. ..................................................................../............/..1......,.p......./.1....................... Now Naof owner of premises ....r l"t 4.� l.. ..�®./.4 G fr.!U.....S..(! /...../,1 ... ...................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ......................................................... (Nam and title of corporate officer) Builders License No. ......................... PlumbersLicense No. ......................... ElectriciansLicense No. ..................... Other Trade's License No. .................... 1. Location of land on which proposed work will be done.............................................................. �...�r....i'�.... ..... y... House Number Street Haml��egqt Canty Tax Map No. 1000 Section .../��/ . :G.G.. Block .�./.G b..... Lot ..00. Subdivision ...................................... Filed Map No. ............... Int ............... (Name) 2. State existing use and occupancy of promises and intended rusee1 and occaup/ancy off proposed /construction: a. Existing use and occupancy ........ !.!�JeO �1`......(.A.:. /L!......!.J.(�l..ZF�:./�.tj......... b. Intended use and occupancy �� ,!"l` .(6A f!,G r 3, Milote of wock (dre(Itc��iw In a�n�'licable): New Ikrildirq; .......... AckliCion ....ll.... Ahter�ro`n ,...:...:.a�r- 1 y "� /J .......... Derml iLion ............ Other Work .... � .(t(!.....4?RG N"O. 30 cid / / 3 CJ (Description) - 4. IisCinreLLel Cost .....,,..1. ...... fee ................. li (lo he paid on [fling this applicatib{r) .. 5. If (knelling, caber of dwelling 1 units ...... .... liber of (knelling units on each floor .... rx ' Ifgarage, rber of cars ../Yi ........................ 6. If business commercial or mixed occupancy, at n�urre/aux%extenC of each type of use....,. /1��.�........ 6 dp � 6 Ilaigut.... ...... es, if any: ITr(uC................ Rear .. ............ Dep(lr ...r ........... 7. Dimensions of�e....... s.....u.1. Nr(irer of Stories ....0..'.....,...... Dinenstons��o//f same stnx.ture w th altera ion or addiCions: Front .......31+...17. Rear ....j ........ f1 �fYY....... Ile nth ...... �c 2...... Iter .uC ..... ........... N nicer of Stories ...e... J lief rC zr. ..... construction: 1�Y(xrC ...�.g.� Rear .,�J.R.�4.... Depth .. Z....... 9. Size of loC: rrrxM ,�',�o� Mnirer of pStories .....�........... Dum�spurts of entire new ccxusC Tie'\ / ryhl� � i '\ ) ee rr Mar .............../.+..... wittthh ....�.J.............ee.. /� 1/) 10. mile of Purchase ....`l—ls ?....... Name of roarer Owner .6.94 rf.�la .0Q 41.R�q.J�. C A I A S I-D,z::NT-.M . J.. 11. 7.one or � disLncC to rnlridr remises are aidratect ...... ,,11 ................ � 12. Mies proposed construction violate any zoning law, ordinance or regulation: ......l.Y.�............, •....•,..." 13. Will lot be regraded / ... ....... Will excess fill be removed from premises: YID NO 14. Nams of (kaiser of premises��7P'[�/��QoR�Eu.J�'. pkl sa 7S ,CZ!9k. ! . PII No.a./4 -a� Nave of ArcluiCec:CI�RArsri!l_,.LA1A!0. Address y/JA44e/!i,Solh...:�.b(?C,[< .. IJ' re No./�.45.,'�MQq..i.. Name ofpContractor ,Q. ....��.et..�No. 0'�4-�7 P to Y 15. Ts this m rC within 300 feet Sn o rt/ 1CWki(k N f of a tidal rneClarxl? � YIDS .,........ ND ,....., �it�) Z3y`��7 6116< ]r YI.S, SODnull 1"M 7R[�SN S PtiliMFf MY RL I"PIR 1 23�—{� PLOT DIAGRAM Locate clearly and distinctly 11111 buildings, rnhetluer existing or proposed, and indicate all set-back dimensions from property lines. Give street and block norther or description according to deed, and show street nares and indicate unllether interior or corner lot. Z- MuID G r '3 C°/t %/1",(J ,I(A /3d / gJa tl G 6 CFA jy T A,X'M 1P /vv o G 6 GARASE ,tar.oT c) 090o0 A)6, -44 fl?A) AO �c SI'A'M Ola MW Y(N , ...,....,,..... .�.� ,,,,, 1 r..I,.��,�r.J.4.��"...I>eirq, duly sw(>ru, deposes and says LhaC he is the applicamC (Mvie of individual signing contract), above Stained, Ileis the .............. ..4-✓.?:`n/`+-....................................................................... (Contractor, agent, corporate officer, etc,) of. said (mFer or rxarers, and is duly �'authorized to perform or hwe performed the said work and Lo nuke and file this applications, Lhat, all statements contained in this apprlicat.ion are Lrue Lo the best of his knowledge Find bel ieH and that the work will be performed in tlIe macer set forth in The application filed therewith. Sworn to before. im this ......� ,.Y<.t:�..clay of .. ... — Notary I'nrblic ELIZABETH ANI Z NEVILLE p� (SignaCure of App icanC) NotaoyPublic,St a a of K,:vu York No. 52-8125850, uffolk Cou¢y��((� Term Expires Octo"r 31,1 IV: 7 of UNDERWRITERS CEriTiCATE - r.. WED } REQUIRED f is' --------------------- i Q 5 F SeM m:5 copy. ^_Pdonhiu"hatho 6 GA hl;cah3i: x _ utlo n mpvaoy,,�ov[rnr,©nfst apaP.cy eYxS z ... . [ to[he zsa:oraas of '15n Nng inad- 3 .��„ G�=-'sr,'tzs aro nw,trans:xrett& # - xp?<, ,p[i ttstfi.UiAA3Of 9U$25GU6n2 ; p i 1 i J.j r 5 [ NNDENMAIITERS CENOWATE NEQUIREN OCCUPANCY OR - - - - - _ - USE IS UNLAWFUL _ - APP 0 E AS NOTED - T CERTIFICATE DATE:--L��B.P.# a�.r�S� G�R� N ��&.6 — _ FEE: BV: FY ..- _-. __ _ - 765r 80219LAM TO 4 PM FOR THE OF OCCUPANCY ^ T FOLLOWING INSPECTIONS: FOR POURED CONCRETE °10r «—_ _ - ❑ .. --- - - - --_ - - - ._ 2. ROUGH - FRAMING & PLUMBING MUSY - 3. INSULATION 4. FINAL CONSTRUCTION -7 BE COMPLETE FOR C.O. -7 ALL CONSTRUCTION SHALL MEET Li —._ _.. _ _ .; Ir � STATETHE REQCONSTRUCTION UI STRUCTIO EMENTSNA ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS J I : O 1 V/-ITI O IV _�_� �_;. T ) OI ove %,EQ PF9�Fl�SE _ R _ LSV scla�.e lyar_a' . . - —__ _ _ - - __I• — _ _ ._ - I _ — --- -4 El a, I- E: -�� E�T) N -- , SE YF-R) E L� f�E'`> 1�EwCF— FES F AT HH El MA• -0" Ncvneb ti „ ' E'L-E VA-i-IOIJS AS NCIT'E&. k NOTA ' V�KIFi AL,L, LIMEA !saO&X bub CoraplTToN' ' � + 1 el�� �A��y�•, � b11TC AEENOVEO IV gNI1q INC NUMIEN rT MIPf �-g6 138 - l of 3 uygC'Cnn lvA�Rxc,e97� q6 - - - - `NIpCN1YEq'�I'1TFf(gww'o YbkM�, _ , , - � , - Mnq!IN UA.w. 2442 2442 5 O �I-Su PROVIDE OPENINGS FOR .1 EMERGENCY ESCAPE AS _ REQUIRED DBVIA Q RL 711 OF , iN asTcreptooM N.Y. STATEBUILDING CODE v v a I 1 HObQ SL, � it 46 FROM FN (,6 `! 1 I Y 1 y( .](L" 51N ® r4 _ 7 n PROVIDE OPENINGS FOR �� 3h LLJJ REQUIRED BY PART. 714 OF N.Y. STATE BUILDING CODE ?v M N 1 A� L- `` sPEDAOUM u@ ' 2442_ Z9Y2 ' I I b b I C� I f A C_/ �) �•_ 5rr k I 1 .' iQi1�4 ""AWN 1 � I 'e) L 'D1111}II N4MffN jd � GYi'f#1.�'11V�'�1krlRy MAO*IYUt.#.+' 1' l 1 1 I I Jl J I T J tiy.11¢¢� J)m (2 -b'I 7 II I � ZxD ?,Ib[Ip 7A@ ROOF SNIWC>,LES I vi f 12 i,•�-Gn8 VE �G — fs m Fe�'r 9/iL OWS, Rps sy![ATH"icy , 1 ZR6 C.T Ib"a. ZrG "RAPI Trr�z \ --- Z<Y RAGE PU.t ASOJE sThIRWEu— Oen TOP OF CEILIN(. l �'OlsTv I,V,— I — — _• — , li. - G" FASUA �y RAPP6b IN AIM. I K J II o VIN` L VEAT�p SDFF(P I NEW <ECOK)LFLOOrz I . 2,ry SSA& R-1'S KRAFT Ines I al I II —Vllin LIn�Ny O 15 FELT a T I may' SE TeC� 2iv I�"ocn.,Hlnly z%N Scor ': '� I 2X2't-Ib"O.C. `_SLP IaRIN,�Iu(y, � 2.112 tro+ l3M PLATE wb FlR IL ----- . � _ Exls IN FIRST FLOOR I I, i II I I I I I � j I I I � � I ., ONw Ib + �"M11. I O I 1 E � I � of �,�WI I W I I �N41V - _ 1 I IIK Rj _� j '�j a CLo$Fr zP.c sine rr A icery�. TAY',O.C, €XI'5TIEG 1 I F' I I I I C'M,J,WhIL Y I � i L_ _ _ L I I I I I I I 4"P,G,SLAv� iL - —a.J. __ _ - - - - - -' - - -` — — — � L I J. � =1 I - _7 J�-a; ISTI 14 ,1 NCa NEW 70 1 I 5EYFRIEp F FSIt:�LfUCE CR_.5r$ I�.S F¢.T7D,NNhAT'ION NOTE . VERIFY ALL �IMF_uSr�Ats, Amb C006MOA4 r am" � .;;,�fy oA*r weweovt0 •v CwnWI Dnum.an Jyfi� I a�,��rr �C+G.cnraxwl.cmf Pi�Irda - F y 1'a x 'n T an