HomeMy WebLinkAbout22698-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24802 Date
DECEMBER 13, 1996
THIS CERTIFIES that the buildin~
Location of Propert~ 655 HOBSON DRIVE
House No.
County Tax Map No. 1000 Section 122
Subdivision
RENOVATION
Block 6
Filed Map No.
MATTITUCK, N.Y.
Street Hamlet
Lot 23
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 18, 1995 pursuant to which
Building Permit No. 22698-Z dated APRIL 25, 1995
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
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
MARK & DEBORAH FARINA
N/&
H-049219 - MARCH 22, 1996
N/A
Rev. 1/81
/ /~di~ Inspector
FORM NO.3
TOWN OF BOUTHOLD
BUILDING DEPARTMENT
TOWN ~
$OUTHOLD, N.Y.
22698 Z
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
/
CountyTax Map No. ~000 Seotion...Z~.,.~., ............ Block.......~...~... ............ Lot No. ..~..~.. ................
pursuant to application dated ......~ ......................................................... and approved by the
Building Inspector,
Fee $.,..~....~,..'...~ ....
// / Building Inspector
Rev, 6/30/80
TOWN Of SOUTHOLD
BUiLD:NC DEPARTMENT
TOW~ Y~LL
765-[802
~DPL£CATiON FOR CERTI:=iCATE OF OCCUPANCY
IIoyo
Thcs appiicatzon must be filled in b? typewrlaer OR ink and submzzzed :o :he building
inspector wizh zhe fo!low,n§: for new buildang or new use:
Final survey of property with accurate location of all buildings, property iznes~
streets, and unusual nacurai or topographic features.
2. Final Approval from Healzh Dept. of water supply and sewara§e-disposai($-~ form).
3. Approval of electrical znstai!amion from Board of Fire Unde~ri~ers.
Sworn statement from plumber certifying that the solder used in system connains
less ~han £/10 of [% lead.
5. Commercial ouiidiqg~ industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from arehltecz or engineer
responsible fDr the >~ilding.
6. Submit Planning Board~Approval of completed site plan requlremen~s.
For ex{stin~ buildings (prior to April 9, i957) non-conforming uses, or buildings and
"pre-existing" !and uses:
1. Accurate survey of property showin~ ail property lines~ streets~ building and
unusual natural or nopo§raphic features.
2. A properly comp!eisa application and a consen~ to inspec~ signed Dy ~he applicant.
if a Certificate of Occupancy is denied, the Building inspector shall state the
reasons therefor in ~riting to the applicant.
... Fees
~;. Ce ......... of 'Occuoancy. - New ~'we~'___n== $~.00. Additions to awe_,~_zng $25.00,
Alterations :o dwe!lln~ ~_~.00, Swiping pool ~25.00, Accessory building $25.00,
Additions :o accessory building ~25.00. Buslnesses $50.00.
~. Ca ...... at_ of Occupancy on
3. Copy of Cerzifica~a of Occupancy - .25c
a. Updated Certificate of Occupancy - iF0.00
5. Temporary~=~-~=~c~_~-~ of Occuoancy. - Residen~ia!
... ...................
iew Construct!on ........... Old Or Pre-existing Building...~ ...........
House No. S~reec Ea~et
m,,~r or Owners of ?:oper=y.../~.~gf. ~.~?~'¢~d~... ~<~.<~ .............................
,ubdi';ision .................................... Filed Map ............ Lo t ......................
~ealcn
....................... Under-~riters Approval .... .~ ................
A~p royal
FIELD INSPECTION REPORT 115DATE
II . II
FOUNDATION
....... ADDITIONAL CO~S: ~ '
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION ZST [ ] ROUGH PLBG.
FOUNDATION ZND [ ] INSULATION
FRAMING [~~F~L-
..,.,,.KS= ~./X~X~ ~
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ] INS/ULATION
[ ] FRAMING [~*]"'FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] FIREPLACE & CHIMNEY
[ ] ROUGH PLBG.
[ ] INSULATION
[ ] FINAL
DATE NSPECTO
THE NEW YORK BOARD OF 'FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NEW YORK 10038
THIS CE~IFIES THAT
o~y ~he el~trical equlpmen~ ~ ~scri~ be~w and i~t~uc~ by t~ ap~icant ~d on ~ a~ application number in the p~m~es of
I~31RK A. & DEBORAH FARINA, 655
in the followlng lacation; [] Basement
K~sexamlnedon ~ARCH 19,1996
MOBSON ROAD, SEC.9122.~, MATTITUCK,
[] iht FI. [] 2~d FL Section BI~A~6, OOrot
and found to be in compliance with the Na~onal Electrical Code.
7
DRYERS
RANGES OVENS DISH WASHERS EXHAUST FANS
SYSTEMS
NO, OF F~ET
E
OTHER APPARATUS:
MOTORS: 3-~F H.P.
G.F.C.I:-5
SMOKE DETECTOR: -2
E R V I C
NO, OF CC, COND. A,W.G.
PER ~ OF CC. CON~.D
NO. OF HI.LEG
AWG
OF HI-LEG
NO. OF NEUTRALS
MARKA FARINA
108 COVERT AVENUE
NEW HYDE PARK, NY, 11040
GENERAL MANAGER
This certificate must not be altered in any manner; return to the office of the Board if incorrect. ~nspectors may be identified by ih~r credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MuST NOT BE ALTERED IN ANY MANNER.
1995
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
~ '. , ',,,, TOWN HALL
.... ' :' " ....... 8OUTHOLD, N.Y. 11971
TEL.: 765-1802
Exa,nined... ~t]--...,197..57'-' '
Disapproved a/c .....................................
USE IS UNLAWFUL APPLICATION FO. BUILDING'PFRMIT
WITHOUT CERTIFICATE
OF OCCUPANCY INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink an'd submitted to the Building Inspector, with
sets o£ plans, accurate Dior plan to scale. Fee according to schedule.
b. Plot plan show/ng location of lot and of buildings on premises, relationship to adjoining premises or punic sti'eet
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appl/
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 i~sued a Building Permit to the applicant. Such permi
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 Occupan%
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 Southbld, .Suffolk County, New York, and other applicable Laws,Ordinances
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describhd.
The applicant agrees to comply with ail applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspections. . ,,--~= '2 ,
(8ignatur? of applicant, or name, if a corporation)"
[Mailing address of applicant) /cA
State whether appIicant is owner, lessee, 'agent, architect, engineer, generai contractor, electficiam plumber or builder
"'. ........................ ~, ........ ;',' ~ ......... ," '5' .... ~ ........... "'APPROVED'AS ~: .......
(as on the. tax roll. or lateen:eerier;: ~, ~ . ~
If applicant is a corporation, signature of duly authorized officer. NOTIFY BUILDING DEPARTMENT AT
................................... ' ....... If copper tubing is used
(Name and title of corporate officer)
for water distributing'
Bu'lder s License No ...................... .S..y~.tem; piping shall be
of types K or L only
Plumber's License No ..................... UNDERWRITERS CERTIFICATE
r' ' ' ' REQUIRED
Elect ~c]an s Dcense No .......................
Other Trade's License No ......................
765-1802 9 AM TO 4 PM FOR .THE
FOLLOWING INSPECTIONS:
~1. FOUNDATION- TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3, INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
· ALL CONSTRUCTION.SHALL MEET
THE REQUIREMENTS .OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
I. Location ofland on which proposed work will be done.
...... 6. . ....... //.o. .s. e < . . .2 : .... . . . = , ,--, ......................
Itouse NumberStreet Hamlet
County Tax Map No. 1000 Section ../:.~..~-..,..tO...~.. .... Block '...~..~..* ' Lot...r?..~..~.~, .........
Subdivision ........ . ........................... '. Filed Map No ............... Lot ...............
(Name)
2; State existing use and occupancy of premises and iht,ended use and occupancy of proposed construction:
a. Existing use and occupancy ...... .~. 5.2. .~..~.&/..4..~.
b. Intended use and occupancy ..... 5/g tW T/~.L
· 3. Nature of work (check which applicable): New Building . 2 ........ Addition ........ Alteration .-;...;.. ~.
Repair ..,~.5 ..... Removal ............ '.. Demolition ..... :... ' ... Other Work ....... ~". ......
4. Estimated Cost. '<)' '~'e ...... ' .......... ' ...... Fee .......
Z (to be paid on filing this application)
5. If dwelling, number of dwelling ¢nits ..... Number of dwelling units on each floor. .
. If garage, 0umber of cars ..... [ ............ . .
If business commercial or mixe~ occunancv snecif,, n-~ .... ~-'" -~ ~' ' '~ '~ .... ~ ........................
Dimensions of existing structures, if any: Front ............ Rear .
Dimensions of shme structure wi~h alterations or additions: Front Rear
Depth ' HeiSt } ....................................
8 ................... ' ............ ' ........ ,.. Number of Stories .......... :..~ .......
. Dimensions of entire new construction: Front , .
Height Number of Stohes Depth
............... Rear ................................
9. Size of lot Front . ~ ' ' . Rea- '
10. ~ate oI~urcnase ........... ~ ........ . ......... Name of Fomer Owner ....... ~ ....... ' .....
12. Does proposed construction violate any zoning law, ordinance or regulation: .... ~}'...,.si .1.~.. ~ .~.q.~..
13. Will 16t be regraded ' ............... Will excess fill be removed from prem~et: :-'. ~" Yes No
14 N~e of Owner of premises
Nme of Mchitect ..................... ;. · ·
.......................... Address .................. Phone No ................
N~e of Contractor .......... : ................ Address ................... Phone No ............ '.
15.' I~ this property within 300 feet of a tidal wetland? *Yes ........ No ......... ' ''
. *If yes, Southold Tqwn Trustees Permit may be required. '
.... [ PLOT DIAG~
Locate clearly ~d distinctly ~1 ~uildNgs, Whether existing or Proposed, ~d. indicate ~1 set-back d~ensions from
prope~y ~nes. Give street ~d block ngmber or description aecordNg to deed, and show street nines and indicate whether
~te~or or corner lot. i
....................... ,~' ....... being duly sworn deposes ~d says that he is the applicant
(Name of i~dividual ' ~ ....... ' ......... '
, signing ,~ontract)
~ove named.
(Contractor agent ............................... ' ..............
~ 'porMe officer etc )
' said owner or owners, ~d is duly'authorized to perfom or have perforated the said work and to'm~e and fil~ this
plication; that all statements contend N this'application are true to the best of his knowledge and bel' ·
~rk will be perfo~ed in the manor sc~ [forth in the application filed therewith. . o ~ef, and that thc
T~rm ~r~ ~ 3~ 19~ , ' (Signature of applic~t) .
TO',',~l CF oC T,,OLD, ['I. Y.
HOUSI::G CODE IHSPECTIOfl RE?ORT
Location
6.55 ROBSON DRIVE
LAUREL, N.Y.
Subdivision
M~tp
Cot(=) ....
Name o£ Owner(o)
ROBSON & ANO.
0ccupan~y, I FAMILY
~type)
Admitted by: ARLERE
VACANT
(owner- c enan~ )
Accompanied b · SAME Y.
Key available
Suffolk Co. T~c bio. 122-6-23
Source of request..
T. imothy S. McC~l~y, Atty
Date Aug. 17,
1992
_D:'.rELLI3IG: ..
,Type of construction ,,
Fo ,undation BRICK, BLOCK
Total rooms, 1st. F1
Cellar
4 2nd. F1
~, stories
50 Crawl space
3~ · F1
PA~ 2
5O
Bathroom(s) I
Porch, type 2 CLOSED IN ~Deck, type
Breezewa~ Oarag%
Type Heat OIL 'Warm Air xx
Fireplace(s) No.
Domestic hotwater xx
Other
Toilet room(s)
Patio,
Utility r~om
Hotwater
type~
Airconditiohing_:
Type heater ELECTRIC
ACCESSORY STRUCT'JRES:
O~rage, type const.
Swirning pool
Other
Storage, type const.
Guest, type const.
V~OLAT!oNs:~
~Lncation
.CIIAPTER 45-=N.y. STATE UNIFO[~! FIILE PREVENTION & BUILDING CODE
D .-c. zo,.zon f. Sec.
NON-HABITABLE WITHOUT MAJOR REPAIRS, TO STRUCTURe.,
~IQTE: ENCROACHMENTS OF CmJ.anWA¥,~ CRIMRE¥ ~ OIL
rANK ONTO ADJOINING PROPERI"f - SDRVE¥ FROM HOWARD
YOUNG 7/7/92 ~
Remarks:
InsPeCted
7 Insp .. 8/2 !/.__92
~ i Time start.~0.10 _end ,o:3o
'1
&
;.