HomeMy WebLinkAbout23005-zFORM NO. 4
TOWN OF SOUTHOLD
EUILDING DEPARTMENT
office of the Euilding Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OC~umANCY
No Z-24074 Date
DECEMBER 11, 1995
THIS CERTIFIES that the building
Location of Property 900 GIN LANE
House NO.
County Tax Map No. 1000 Section 88
Subdivision
ALTERATION
SOUTHOLDF N.Y.
Street Hamlet
Block 3 Lot
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated ~UGUST 30~ 1995 pursuant to which
Euilding Permit No. 23005-Z dated SEPT~4BER 11~ 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 ALTERATION TO CONVERT GARAGE OF EXISTING ONE FAMILY DW~LLIN~
INTO BATHROO~ LAUNDRY ROOM & STORAGE APdA AS APPLIED FOR "AS BUILT".
The certificate is issued to MARY F. FREER
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF ~EALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
pLUMBERS CERTIFICATION DATED
Rev. 1/81
N/A
H-047207 - OCT. 3, 1995
N/A
F~ui/~lding~
FORM NO.$
TOWN OF $OUTHOLD
BUilDiNG DEPARTMENT
TOWN HAU.
$OUTHOLD, N.Y.
N?
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNllL FULL
COMPLEtiON OF THE WORK AUTHORIZED~_
// .
Date ................. ~; ....................
23005
Z
Permission Is hereby granted to:
/~- ~.~ ....... ~..~ .............
..... ~..'".,"~i ...... ~~ .........................
...... ~.~..~:....7;...: ............................
CountyTax Map No. 1000 Section .......... ~ ..... Block ........ ..~T... ............. Lot No. .../../.. .....................
pursuant to application dated ....................... ~,,,~ ........ 19....~,,~, and approved bythe
Building Inspector.
~e S......7.~....~ ....
Rev. 6/30/80
~orm MP. 6
TOWN OF SOUTIIOLD
BUILDING DEP ARTHENT
TOWN ~IALL
765-!802
A?PLICATION FOR CERTIFICATE OF OCCUPANCY
This applicstion must be filled in by typewriter OR ink and ~ubmittad to the building
inspector with the following: for new building or new use:
I. Final survey of property with accurate location of a2~ buildings, property lines,
streets, smd unusual natural or topographic features.
2. Pinai Approval from Nealth Dept. of water supply and sewerage-disposal(S-? form).
3. App~o~.al of electrical installation from Board of Fire Underwriters.
&. Sworn statement from plumber certifying that the spider used in system contains
less than 2/10 of 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and instalia'tions, s certificate.of Code Compliance from architect or engineer.
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-existing" land uses:
[. Accurate sur~ey of property showing ail property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and s consent to inspect signed by the applicant.
Ifa Certificate of Occupancy is denied, the Building inspector shall state tile
raasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions ~o dwelling S25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00.
Additions to accessory building 525.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existinR Buildine - $IO0.00
3. Copy of Certificate of Occupancy - $20.00
d. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.~O-, Commercial $15.00
Dste ...~.7.~.~.a'~'.. ........................
New Construction ........... Old Or Pre-existing Building./. ..............
~ocation of ~roper~y..~...~.~.~.~.~. ......... ~.~/~¥.,.'' .~..~....~.~72~ .......
~ou:se No. S~reet Hamlet
Onwer or Owners of property.~J~A~y..K,.~5..r~. ...........................................
OOO, it . ot ..............
~ubdivision .................................... F/iud H:H) ............ Lot .....................
?ermit No ................ Dote Of Permit ................ Applic:mt ............................
UealLh Dept. Approval .......................... Underwriters Approvol..~'.~S&~.~/. .............
'lanning Bonrd Approv~l ........................
~equest for: Tempornry Certificate ........... Finnl Cer~icate ...........
Fee Submitted: $. ~
~ ~o 3~ ..... . ......
THE NEW YORK BOARD OF F RE UNDERWRITERS
~5657~ BUREAU OF ELECTRICITY
BS JOHN STREET. NEW YORK. NEW YORK 10038
Date OCTOBER O~i
THIS CE~IFIES THAT
}~Y FR~, ~% GIN ~
. SEFTEt~ER 27,1995 a.dfou.dtobelncompliance~iththeNa6o.alElect~calCode.
~RVI~ 01~ONN~T ~ ~, OF ~ S E R V I C i
OTHER APPARATUS:
$~KE ~ETECTOR: - 1
*NO VISUAL DEFECTS: "An electrical
survey has been made of the exposed
t>rem[ses indicated," "No obvious
~.~nsatisfacto~ conditicn was [~un~.~
H~Y FREER
9~ GIN LANE
SOUTHOLD~ NY, ~..1971
GENERAl. MANAGER
This certificate must not be altered in any manner; return to the office of the Board if incorrect, Inspectors may be identified by their credentials.
COPY FOR gLIILDtNG DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED tN ANY MANNER.
F IF~I.D 11qSP1 R~r, POET DATE COHMENT$
|:OItNI)AT ION (IST)
FOUNDATION (2ND)
ROUC, I! FRAME &
PLUMB [ NC,
INSIILATION PER N. Y,
STATE ENERGY
CODE
ADDITIONAL COMMENTS:
'\
A. R,:'ILLY &.. SONS, INi~.
Gin Lane, Southold, N.Y.
MATTITUCK, LONG I5I,.~ND
129/79
Re- Request for final payment, remodeling at Southold, N.Y,~
Contract price,
Payments received to date,
Balance on contract,
5,496.00
~,000.00
496.0O
Extra cost items not in contract,
Special ceramic wall tile,
Aluminum storm door,
Total extras,
Total balance due,
$ 195.88
96.00
291.88
$ 787.88
o
O
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, NewYork 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
September 14, 1995
Mr. & Mrs. K. Freer
900 Gin Lane
Southold, NY 11971
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 ~ 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
23005-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
,tUMAN LABORATORIES ,oo~.^u~^N~LLs,-2305L^NE B~'~AGE. N.p.O. BO× ~5 ¥. ,~
ANALYSES OF
CER%'IFICAT]~ OF BACTI!~OLOGICA.L ANALYSIS
TO Harry C~3~cll/l~n Source of Sample
261 W. Main Street 'Wm. Welts
Itiverhead, New'¥o~k ~ Lot 6 (Bayhaven) Gin Lane. Southol,
DAT~: gouectea. .............................. ~ ........ m~v~ ........................................... ~e~n~ ...................... : .....................
S , . Cold Wate~ Facet .... HG
ampdng ~l~ .................... ; .................... ~ ...... Uoae~ by ........................................................................
COLIFORM TESTS ~'
LACTOSE FERMENTATION CONFIRMATION
ML
24 hrs. 48 hrs. 24 hrs. 48 hrs.
I0 O/S 0/~
1. o/1 oil
O.l 0/1
"Most Probable Ntunber" (MPN) of Coliform Group per 100 mi ....................
Standard Plate Count per ml, 35 C., 24 hrs ..................
Chlorides as C~ .......... ~!:...0. ........... mg'/1 Nitrates ~s N..._..~ ........ _6.,._I_5.. .......................... ?g/1
Le~s Than 0, 1
Anionic synthetic detergents, as ABS ........................................................ - ......... ,m.~/1
These results indicate the water was of satisfactory sanitary quality
when the sample was collected.
B-I200g
Lab. No .........~
LAUMAN LABORATORIES
Director
· he New ork. i!Ivar vf; re 1 ui erwrffer
I~UR£AU OF~ EI.~TR~TY
'85 'JOHN 'STREET ~ '
NEW Y,OR'K' 'I~I. EW, YoRK 10038
i~his ~ertifles,rhae the Elec/ric Sq~pmd#t ~ ..
by F. W. Brudi ' ~ i~ premises o/
ontbe basement & 1st fl.' ' ffeorotNo,
as per application on file in this o/lice, and consisting o/;
HEATING APPARATUS 2-150inc.
l~l~59inc.
1-5.8 k.w. cooking ~deck _. ~'. ".~
1-~.8 k.w. oven
~ 0~
..N. 4J1 5~,e
06730
Application No.
as.described below and introduc.
W. Wells
W/S Gin Lane opp. Midway
South'old, L.I.
MOTORS
1-1/2HP & 2-!/8bp
oil furnace & controls
was examined on date o/ ' April
N43159.6' . . .
Service 1 phase 2#'3 & 1#5, 1-100 amp. main' CB.
14,1965; -. :'~ a~df6~wdto$eSncoTn'p'IianceuSththerequirementso/thisBoarda$ofthisdat
F. W. Brudi -
Box 85
" _ STATE SUPERINTENDENT
Holtsville, b.I. r . - 'i .....
This Certificate must not be altered in at~y manne~ return to the ~ffice o-f thp B~a~'~'if incorrect, Ipspectors may be identified by their credentials,
/~U~ 3 O 19~
NO, 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
THIS CERTIFIES ;{hat the building located at ....~/~.....~,P,..~F,~. ..................................... Street
Ba~ Haven @ ~;outho]_d
Map No ....................... Block No...;Z,.:.X ............... Lot No....6 .......... ~.a~.iho~.d.,...~,.~. .....................
conforms substantially to the Application for Building Permit heretofore filed in this office doted
.................................... ~.~,~.~,~,~ ....... 2~ 19,,~.. pursuant to which Building Permit No....2..~...2..2.....ff,.
dated ....................... ..~..~.~.~]~.~.~......~.~...., 19...~..~.., was issued, and conforms to all of the requirements
of the applicable provisions of the Iow. The occupancy for which this certificate is issued is ........
.... .p~i~t e...oZ~e..£ ~i~1~....dw. elli ~4~ ............................................................................................
The certificate is issued to ..... ~J2'lJ.~r~...~.~t]_'l ~ ...................... O.'Eze~.-..]~].lJ.'l~Z'. ..........................
(owner, lessee or tenant)
of the aforesaid building.
"2
SPECIFICATION FOR DWELLING FOR ~R. FBE~ FREES TO BE ERECTED ON
LOT 83 BAY HAVEN AT SOUTHOLD
Buildlmg So be a one s~ory ranch of frame constr~ctio~ on concreSe
block formulation.
Gro~.ud floor area So be divided lnSo living room, kitchen. 1 bathroo,
3 bedrooms, and gauge.
FOU~ATION:
Footings '- 8 x 16" po~ed concreSe wish 8 x 16" comorete blocks
5 co.se, with 8~x 8~sub cellar for f~ce a~ p~p wiZh
Oell~ sash -
CH~
Facing ,- brick wish &'x
~TE~0R W~S:
Wood fr~g - ~1 construction l~ber co~on
Gear shl~le~ - wi~h Celotex
~UB ~00R:
~ x 8 x }" pl~ood
FINIS~D FLOOR:
O~ear red oak In living room, ~lls ~d be~ooms
Kitchen- vl~l ~ile
Bath - ~er~ic ~e
BATH ~
Wall ~ floors ee~mi~ ~ile A~ high - o~er~s choice of color
Americ~ StaDm~ f~es - or eq~l - o~er~s choice of color
Formi~ ~l~y and mirror ~
Shower i~ gauge - terrazzo ~se and s~eel w~la
CEDING ~ING~
ROOF
RO0~
ROOF
FBAMING:
2 x $" on 1~" centers ~1 oommo~
Ridge - 2 x 8"
FRAMING:
2 x 4u on 16" canters ~1 common
1st floor joists - 2 x~ on 16" canters
All framing m~terlal will be ~1 DouElas fir.
SHEATHING:
Plysoore OD -
BHINGLEB$
E~8 Asphal~ Seal-O-matics with 18 lb. felt
GUTTERS:
4 x $" wood or aluminum ~ A~ ~
LEADERS:
E x ~ ~lumlnum
INTERIOR WALLB AND FINI~HEB:
Walls and ceilings in living room, halls, kitchen, bedrooms
will ~e ~ sheetrock, taped, ~ coats spackling and sanded.
Exceptlon~ Front wall in livimg room will have ~/8" sheetrock
under ~ mahogany panelling.
Walls and ceilings will be pain,ed with Sherwln-~illiams pain~,
or equal, own.frs oholoe of oolor.
INTERIOR DOOP~
~hogan~ flush panel with ~tu~al f~n~sh.
WINDOW~=
Bouble h~E - 100% weatherstripDe~ two over two
Oomplcte screen and storm combinations will be provi~sd for
win~ows ar~ exterior doors on house.
EXTERIOR DOORS ~ FRAME~=
Front - 1 'with 8/4 frames.
Wea~hers~ripped'w~$h aluminum saddles.
Picture window will be thermorpane glass
KITCHEN:
Cabinets - Birch or ash
Formica counter top - edging s~ainle~s - ownerls choice
Stainless s~eel or enamel sink
Exhaust fan - wall oven and counter top range
Built-in breakfas~ mock A x 6
INSULATION~,
Walls - B" Fiberglass semi-~hlok
Ceiling - ~" Fiberglass - full thick
FRONT STOOP - F~ont bri~k
GARAGE:
As specified on plan
Door size - ~ x ? - * panel - ~rd panel glass - Overhead Door
Corporation
Exterior finish same as house
Interior - ceiling and walls covered with 8/8" sheetrock
EXTEBIOR CORNICE AND
Idaho pine fascias with i x 2" flat crown
~ x 8" wood gutters or sluminum
Idaho pine fascias and soffets
All faucets'Amerlca~ Stand?rd or equal '
plp~nE - copper for hot and cbld wa~er
Waste line ~o be ~ $" copper - cass iron trap
WATER BUPPLY AND ~EWAGE DISPOSAL:
To be laid out $o Suffolk Co~uty Board of Health requirements
after building has been placed on
HEAT ING $
Hot wa~er hea~lng system - oil fired wi~h convector radiators.
American Standard or equal cast iron fur~ace~
880 gal. oil tank insSalled u~dergrounde
ELECTRICAL SERVICE.'
Inspec~io~ and hook-up - New York Board of Fire Underwriters
Oer~iflca'~e.
GRADED AND T.~WN SEEDED
STATE OF NEW YORK
County of Sul'folk
I,, .~i '~ 1 lam G, Hol st Clerk o! the Count~ of Suffolk and Clerk of the Supreme Court of
the State of New York in and for said ~gunty (said Court being a Court of Record) DO
HEREBy CERTIFY that have compared'~he'~nr~e~e~ copy of
and that it is a just and true cop'~ ot sdCh"6 -- R
°f the whole thereof. 'rig/ua/ ~d, ~ andDr'D
IN TESTIMONY WHEREOF. I have hereunto set my hand and al'fixed the seal o1' said
County an~d Court this'~ 2 ? day of ' ~-~/'"'~2 I9
Form No. 104 ............................
clerk.
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN~JLATION
[ ] FRAMING [,~ FDNAL
[ ] FIREPLACE & CHIMNEY
:: ' ·'~ ,, ,),~ORM NO, 1
~OWN OF SOUTHOLD
BUILDING DEPARTMENT,.
"AU0 3 0 1995 TOWN HALL
Examined .., 19 '~.. f~ .
Disapproved a/c .... . ................ ~' ~' (Building.~..
- · UCAT ON FOR
BOARD OF HEALTIt ........
3 sETE OF PLANS ........
CIIEcKSURVEY.~]5~']-~- ...... . ]] 2'.
SEPTIC FORH ............
Date .... .~'.j .7 .......... 19 ~'2
INSTRUCTIONS
a. Ttds application must be completely filled in by typewriter or in ink and submitted to the BuildLng Inspector, with
,~ts of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relatiouship to adjoining premises or public sti-eel
Or areas, and giving a detailed description of layout of property muir be drawn on the diagram which is part of this appt
bation.
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 igsued 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 Occupanc
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 tit
Building Zone Ordinance of the ~'own of Southold, Suffolk County, New York, m~d other applicable Laws, Ordinances o
Regulations, for the construction or 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 t,
admit authorized h'zspectors on premises and in building for necessary inspections.
.... (Si,,nature of applicant, or name, it' a corporation)
· ~-o~q.~c.~x~..~. ~. A4 .a4e.~'..~4z..../.,. 7.*.t. .........
/'V/~*'[ p'z.z34 (Mailing addr%ss of applicant)
State whether applicant is ssee, agent, architect, engineer, generai contractor, electrician, plumber or builder
................................................. ': ................... "AP.p~0¥ED AS'80TED ..... ];
N~me of owner of premises . .~.~..s~?.y..~-. ~*ffi*n ......................
(as on the tax roll or late~ed)
N~{~ BUILDING DEPA
If applicant is a corporation, signature oFduly authorized officer· 765 1802 9 AM
, ; ........ ~ ~ ~ ~. ,m FOLLOWING INSPE~IONS:
.............................. .'''':~r''''~' ~','~ ~ :' , 1. FOUNDATION ' ~REQUIRED
(Name and t fie ofco~orate Offi~e~)~' '~ ~ t ~' ~" ' FOR POUREDCONCR~E
Builder's License No .......... . 2"}'}:*~ ~ [' ~:' ~!:'x ~ , ...... , [,~ 2. ROUGH - F~MING & PLUMBING
PIu z~ber's L ~ense No. ' ~_.~ ;.~ )x~== ;.: ....... ~ ....... 4. Fr~L - CONSIRU~ION MUST
' ~ ~ .... ~,~= ~'~ ~ ' A~ CON~U~ON'S~ ME~
[[ectric'an s License ~o ......... ~ .......... ,~
,. ~f THE REQUIR~E~ OF ~E N.~
O[herTrade'sLic~nseNo. ' ..... ~"' ':¥ ; ~' ~:~] STA~ CONS~U~ON & ENERGY
co. s.
I. Location of land on which ,,reposed ,york will be ~ona. ~0..6.,.~..d.~O ~ ~~~~ ·
Itouse Number Street ............. I'{;~'l;i [/~b~'l~!~/~l £ I/CATE
County Tax Map No. lOOOSection /o,o0.- ~- ~ ~1o ' Lot,..
Subdivision ........ . ................... ' ......... '. Filed Map No ............... Lot ............... (Name) ,
State existing use and occupancy ot' premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .; ./.t/ff..~. , ~' )?. ¢:.¢ .....................
b. Intended use and occupancy .~".&'.~.~,"/443~?.. ~.? .t,f?.~.....~...~..~.~.-~fi.~?..~? .~..,q/../t)9.m..?.~...
3. Nature of work (check which applicable): New Building .......... ,~ddition .......... Alteration .. . ~..
Repair .............. Removal .............. Demolition .... : ......... Other Work ...............
~,~.- .... . (Description)
4. EstimatedCost..~..: ...... ' .................. Fee~ ~ oo
(to be paid on filing this application)
5. I~ dwe[ting, number of dwelling units ............... Number of dwelling units on each floor ................
. If garage, number of cars .................................................................... ....
6. If business, commercial or roi.xed occupancy, specify nature and extent of.each type of use ....... ~, ~ ~.. ~. ~ ....
7. Dimensions of existing structures, if any: Front ............... Rear .............. Ceyth..'~'.i..~..~'~ .:?:(,.)~.
Height ............... Nmnber of Stories ........................................................
Dimensions of shine structure with alterations or additions: Front ................. Rear ..................
De ~ ....................... He ~t ........... ' ........... Number of Stories .., ............ ~.
8. Dimensions of entire new construction: Front .............. : Rear ............... Depth ...............
Height ............... Number of Stories ....................... , ................... ~ ..........
9. Size of lot: Front ......... , ............ Rear ...................... Depth ......................
I0. Date of Purchase .................... . ......... Name of Fomer Owner ..................... : .......
I 1. Zone or use district in which premises are situated ....... . ..............................................
12. Does proposed construction vSolate any zoning law, ordinance or regulation: ................................
13. Will lot be regraded ....... : .................... Will excess fill be removed from premises: Yes No
14. Nmne of Owner of premises ........... ; ........ Address ................... Phone No ................
Nmne of Architect ........................... Address ................... Phone No .................
Name of Contractor .......................... Address ................... PhoneD ................
[5. I.s tb~s property ~ith~n 300 feet o~ a r~dal wetland? eyes ........ No..~ ......
~ yes, Southo[d ~o~n Trustees Permit may be required.
PLOT DtAG~
Locate clearly and distinctly ~1 build~gs, whether existing or proposed, ~d, indicate all set-back d~ensions from
property hnes. Give street and block number or desc~ption accord~g to deed, and show street nines and indicate whether
interior or corner lot.
............. --I{-b~6~p~r .t~.d~in¢ is usmJ for water distributing
CE, RT;F/CA/ ' OF OCCUPAN
SOLDER USED/ j WA TER
SUPPLY SYSTEM CANNOI
EXCEED 2/I0 of 1% LEAD
3TATE OF NEW YORK, S.S System; pieing shatl be
~OUNTY. O? ................. of types
~..~......~..~.."~..~....~.....~... :ff~,'~' .~....~..,x.p~.~... bei,;g duly sworn, deposes and says that be is the applicant
(Na~ne of individual signing cotitract)
~bove named. PLUMBtNG
ALL PLUMBING WASTE
{e is the ,, .~,~'.~'..~. ~,~. ~.//~C-rt ~.~ ........................................ {kW~.TI~B.L. IN. E.g..N~E~
(Contractor, agent, cor'porate officer, etc.) TEST NG BEFORE
,f said owner or owners, and is duly authorized to perform or have performed the said work and to make and tile this
pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the
;ork will be performed in the manner set forth in the application filed therewith.
;worn to before me this
............ ..... ..'x..day ........ .... 19
1otary .Public ........ County
· {l DAWN A, LLOYD ~ ~:..~.~.
Notaq~ Public, State of New Yc~lc .....................
No. 4883005 (Signature of applicant)
Qualified in Nassau County
CommiSsion Expiresdan. I~, 1~.7.~t "