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HomeMy WebLinkAbout22754-z y FORM NO. 4 I TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE, OF CUPANCY No Z-24152 Date rBRUARY 5, 1996 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 30697 COUNTY ROAD #48 PECONIC NY House No. Street Hamlet County Tax Map No. 1000 Section 73 Block 4 Lot 4.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 20, 1995 pursuant to which Building Permit No. 22754-Z dated MAY 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 A DECK ADDITION, RAISED PATIO ADDITION AND ALTERATION TO A ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT GOBER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N365771 OCTOBER 6, 1995 PLUMBERS CERTIFICATION DATED JANUARY 25, 1996 MICHAEL DAWSON vilding Inspector Rev. 1/81 FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWNHALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) pp~ Date 19.. lvf . N? 22754 Z Permission Is hereby granteyd to: at premises located at..~.~?.. Y°...! County Tax Map No. 1000 Section .......7 Block Lot No. pursuant to application dated 19. and approved by the Building Inspector. t Fee.-.... 14 Bui ing I spector 1 Rev. 6/30/80 a = TOWN OF SOUTHOLD e~tllc BUILDING DEPARTMENT TOWN HALL -y y 765-18028?dS APPLICATION FORCERTIFICATE OF, OCCUPANCY , A., This application must 'bd,filledAn,.bytypewriter 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 toUographic 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 - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential //JJ//$1500, Commercial $15.00 Date l/`.S Q .S New Construction..... Old Or Pre-existing Building Location of Property.$ Q~.R~.....cizu'. Lot..:. AR House No.L~ / Street Hamlet Onwer or Owners of Property.. 1 u v b¢ County Tax Map No 1000, Section.....? Block tj Lot...:l..I Subdivision ....................................Filed Map............ Lot............... Permit No... v~ ..Date Of Permit. s~Z).~gJ~.......AppIicantso)1.tt~?rn C.' X02 6 u)*-t.,, Health Dept. Approval .1r°.' ................Underwriters Approval.'................ Planning Board Approval... VAP- Request for: Temporary Certificate........... F• al C ica e. ../1..... Fee Submitted: . p J©rN / SJFrt - ;'rhl,a.riw~Y L.~ ~j r THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1000121 BUREAU OF ELECTRICITY F 85 JOHN STREET. NEW YORK, NEW YORK 10038 ` Date OCTOBER 06,1995 Application No. on file 88362495/95 N 365771 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 ROBERT GOBER, 30697 ROUTE 48, PECONIC, N.Y. in the following locationt• ? Basement I Ist FL ? 2nd Fl. GAR/OUT Section Block Lot tvas examined on SEPTEMBER 29 , 1995 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K W. AMT K W AMT. K.W. AMT. K.W AMT. H P. 4 11 10 4 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K. W. OIL H. P. OAS H. P. AMT NO. A. W. G. AMT MP AMT AMPS. TRANS. AMT, H P SYSTEMS NO. OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP. TYPE METER EQUIP. 1 OF CC. COND. -0 ]W 1 JW 9W 3.0 AW NO. OF CC. COND A W G. rF HIIEG OFAHI{E ~'G NO Of NEVTRAIS A' M' G PER B OF NEUTRAL 1 200 CB 1 X 1 2/0 1 2/0 07HER APPARATUS: G.F.C.It-1 SMOKE DETECTORt-1 PAUL R. BURNS LIC.#3897-E P.O.BOX 1061 SOUTHOLD, NY, 11971-0932 GENERA ' 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 their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. TEL. 765.1802 UFFOI,F 05 Cp TOWN OF SbIITHOLD OFFICE OF BUILDING INSPECTOR P.O: BOX'128 ` in TOWN HALL` SOUTHOLD, N.Y. 11971 11 ~~jyyyyy g1'~~GSq i P~ per' t1J S5 S) r~ C.. rn C E R T I F I C A T I O N 'M co ~j bits ..2 5 Building Permit No. ;2 ;7-7511-2--1 owner 20SF r (a !~f 2 (please print Plumber 1W&11,f15L 0 (please print) I certify that the solder used in the water supply system contains less than 2/10 of l%,lead. . (plumber's signature) Sworn to before me this ,g~]~flay of 19 Notary Public Notary Public, ~1 a <fn~ << CountY kIraoa K: nrawsoN Rory Publio StMe of New York No.4684688 Qualified in Suffolk Coun Term`&>,,;os Selarctr30, 19 4 FIFLD INSPECTION REPORT DATE COMMENTS v H FOUNDATION ( 1ST) II II II u p ~ I~--ll FOUNDATION (2ND)____ _I ROUGH FRAME 5 PLUMBING iii - h,L f V o u u ii i INSULATION PER N. Y. STATE ENERGY I H Jk CODE n n i y Ij FINAL ! ~ n a ADDITIONAL COMMENTS: H~ H x t~ ro H M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: _C c„ a DATE jy r INSPECTOR mr"Yli l ' Environment East, Inc. 3075 Indian Neck Lane ® Box 190 Peconic, New York 11958-0190 [=1 516-734-7474 6'©,oli7~ - Irv, ~ l> R2 L a,-a 7 S CF Z R® p U Town Hall, 53095 Main Load A Fax (516) 765-1823 P. O. Box 1179 ~S Telephone (516) 765-1802 Southold, New York 11971 4Q.( q Y`'h?rlrcU~11'" OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD September 14, 1995 rr- r es ) C=d Environment East Inc. ar~c~f"' I P.O. Box 190 Peconic, NY 11958 7u Re: Robert Gober - SCTM#1000-73-4-4.1-~ ca? q~n Prem: 30697 County Road #48, Peconic tr._- To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) xx No Underwriters Certificate on file. The check is (outdated/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 # 22754-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. FF01.t c~ Gym y Z Town Hall, 53095 Main Road p • Fax (516) 765-1823 y~Ol ~ao~ Telephone (516) 765-1802 P. 0. Box New York 9 11971 Southold, N OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD September 14, 1995 Environment East Inc. P.O. Box 190 Peconic, NY 11958 Re: Robert Gober - SCTM#1000-73-4-4.1 Prem: 30697 County Road #48, Peconic To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) xx No Underwriters Certificate on file. The check is (outdated/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 # 22754-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] SULATION [ ]FRAMING [v"'] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR 7s A Y M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FO NDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: l ~L1~ SG p~ M DATE ~~INSPECTOR }t..Y ' y Timm ~'L~ Tl. d wee Environment East, Inc. 3075 Indian Neck Lane x Box 190 Peconic, New York 11958-0190 516-734-7474 AWti ce Comic c ~r<' c ~ r- .a. JUN 2 81995 BOARD OF HEALTH FORM NO. 1 3 SETS OF PLANS TOWN OFSOUTHOLD SURVEY APR 2 1 M BUILDING DEPARTMENT CHECK . TOWN HALL SEPTIC FORN SOUTHOLD, N.Y. 11971 8 DG,U'EPC TEL.: 765-1802 tioTIFY CC'' CALL Examined~p., , , , , 19 .J ~y /y NA I L T0: Approved 19,c/3. Permit No...c~ 2 11 1 Disapproved a/c 73 c' 2~ . uil g Inspector) APPLICATION FOR BUILDING PERMIT Date Q°p+ y. 19.' INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with3 sots 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 must be drawn on the diagram which is part of this appli- 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 issued 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 until a Certificate of Occupancy 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 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 necessary inspections- ,(Si~n~a ur~e9off applicant, or name, if a corporation) . (Mailing address of applicant) State ~whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. l~ e!>~t? v~~..~4((~~~?y qr?t! Name of owner of premises V~ «~4 ~iPn r . (As on the tax roll or latest deed) If pplica is r iorr, ignature of duly authorized officer. (Name and e o corp^orat@ officer) Builder's License No. p... R-) Plumber's License No. Electrician's License No. Other Trade's License No . 1. Location of land on which proposed work will be done . . . y...9Q1.~f.g............ r ca.IV....... House Number Street Hamlet County Tax Map No. 1000 Section /13.......... Block Dqe Lot. Subdivision Filed Map No. Lot (Name)s. 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .Q :eA rte . ~`1-.?~ 4 ( . b. Intended use and occupancy , 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work q _ (Description) 4. Estimated Cost S O III7 Fee . ~ (to be paid on filing this application) 5. If dwelling, number of dwelling unit's .....k Number of dwelling units on each floor . If garage, number of cars . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . 7. Dimensions of existing structures, if any: Front . y...... • Rear Depth ....L Z. . Height ...e7-.-k Nuntberjof Stories ....I. ~Z.................................................. Dimensions of same structure with alterations or additions: Front Rear ...7.......... Depth Height Number of Stories 8. Dimensions of entire new construct{on: Front Rear Depth Height Number of Stories .....L . 9. Size of lot: Front Rear 7Q..P Depth ......7A dl/• . 10. Date of Purchase ! Name of Former Owner 11. Zone or use district in which premises are situated ~xas % .'J. e w}~ . 12. Does proposed construction violate any zoning law, ordinance or regulation: WC) . 13. Will lot be regraded )Q Will excess fill be removed from premises: Yes No 14. Name of Owner of premises~ob+0; '6'Q' i~r....... AddressCD",, e.WN(L. Phone No. 7 Y.-k w . Name of Architect Address . Phone No. ' Name of ContractoreNh VU- )T!W'N 4 C ...~i-; } . . Addrege 1.46' ' ' '4 Phony No 3./: y Y . l5. Is this property within 300,feet of a tidal wetland? *Yes........ No......... 1r *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. • d~PPR ED AS NOTED~ 7?'~ B. Y~FDE IyIC31IFY ESU L.i ,Nt'a DEPA ORTTWE 76F5-1802 S AM TO 4 PM f f O'LLOWING INSPECTIONS: 1. FOi.ligDATION - TWO REQUIRED FOR p(,)URE[) CONCRETE ROUGH - FRAMING & PLUMBING 3. 1119:3ULPMON . "c71k3 4L n CONSTRUCTION MOST i3E COMPLETE FOR C.O. I r , ALL CONSTRUC-f10R1 SHALL MEET 'SHE' REOUIREMENT5 OF THE N.Y. aaiATE CONSTRUCTION ENERGY €'dii8:s. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS STATE OF NEW YORK, 'IS C TY OF~ n (Name oo ndiv~dual siKVnm being duly sworn, deposes and says that he is the applicant contract) above. named. Iieisthe...... :v 'r. L (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dulyauthorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner Set forth in the application filed therewith. Sworn to before me this ~r - d/a~yof.IL~ ,19Q~ Notary Public, ,.ttL.,t;.~c~L. s~j.~unty~ \ y HELENE D. HORNS Notary Public, State of New York (Signature of applicant) No. 4951!364 Qualified in SuHnik County Commission Expires My 22, 1 MA i ,-4t ljxi gyp; ry ~i ~ s Y ~ 4! rap ~E3 i z i Y. - S k I ~ ~ t d~ 7 4 ~ ry ~+5 Ir, f IN t &e'pi rt r t7 O I z i Sti It I c' p' ~q i - 0.ti y 0 ^1G~l. n t a 0 c a p 1 C r" k ib t "ar4 - ' ~ 1 +t" r , It ~ ' n. ~ s ~ • ti C v~tSV~'l L+~ ~ ti 86.J~ 1 ~I L 4 r .i } ~i om 1 _-Iy CO yt'Zvl x'41 i>4>tti y ~ i~~ r 4, 1*$le I Da 1 ,S r1 ~1 ~ w~tig r `d" - I ° 1 - y Jr "Sl q t o I 1~ _ 1 k ,r t 't, YO F ~ t a / 3O~?0,toq O ki S tih ~ '~J 14 ~,rv C~ r >4 , ~d5 Z,T j} q i (.l• t~.F V y gl k ~Y y Y s t , Y l~Q (iii s 4 r. , s,' i~iw ~~eeexos sr'' ~?fi=1'4 , spy, _ at i f z , _ z I i i I. 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