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HomeMy WebLinkAbout22809-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 2-24425 Date JUNE 12, 1996 THIS CERTIFIES that the building ADDITION Location of Property 260 ORCHARD STREET ORIENT NY House No. Street Hamlet County Tax Map No. 1000 Section 25 Block 3 Lot 4.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NAY 23, 1995 pursuant to which Building Permit No. 22809-Z dated JUNE 7, 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 AN ADDITION WITH COVERED PORCH AND DECK TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JERILYN & JOHN WOODHOUSE (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. 9306 NOVEMBER 6, 1995 PLUMBERS CERTIFICATION DATED JUNE 7, 1996 KING PLUMBING & HEATING INC Bui ding Inspect 04r Rev. 1/81 FORM NO.3 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 ALIT IZED) Date 19 f N2 22809 Z Permission Is hereby granted to: 01 ..0F..... y/....... 6....................... ..2....<..eeu. s-a to .....~.,.....z r ~r 4 ' .<..a~. l . at premises located at 'vA. 42 q .................................................~...,~iL. ok/ ........A....•`•. yY...........C../....../.............. County Tax Map No. 1000 Section Block Lot No. T~.(................. pursuant to application dated ..................t s......, 19.. ~.1..., and approved by the Building Inspector. / 0 ...'far.......... Fee $ 6...... Building. Insp..ecto Rev. 6/30/80 CD i, I N. Z e° r a N 0 u? .A., V VIC` Ar. Pi 4 u s'y, p all I1 o in -I C)a ryl ~ . 11 1~ ~W. )T~ • ~ ~ ~ _ ~ A>~; ~'p(i f14A H^J ~~~45 Y J A L Y 1 r_ I ~ ~ ',°t Fns <`f t ~ EJ~ yI ~o^ Vie. TOW-N Or SOUTHOLD 3TUILDING DEPP-RT ANT OWE HALL 765-1-802 a°PLICA__0\ FOR Can IFICAT_E OF OC-Up4NCf 1-s applicatiD- muse De or = vewrirer OR ink and sabmitcec to ::,e Duac ng :,nspector with the following: for Pew Duild g or new use: 1. Final survey of properry with accurate location of all buildings, prope_'zy 'ads, streets, and unusual natural or tonograpnic _eatures. 2. lnal 3DDroval 5rom Healf. Dept. o-- waver suDD_v and sewerage-daszosal(S-S form) 3. ADDroval of elac_-_cal insta_la:ion --rom Board of --_e underwriters. Sworn Statement '_rOID plumber cer,i-ying ,Pat the solder used in svs:em contains less than. 2/10 CS lead. COIDIDerdial DL'L-Gina, inallStrlal Dullaing, moltiDle residences and similar buildings and installations, a certificate of Code Compliance from arc: tec: or eneileer reSpORSiDie for zne ouildiag. 6. Suomi: Planning Board Approval or completed site plan requirements. 9. -or exlsting oL`=ldings (prior :O Apr'. D 1-057) non-conformf.n- uses, or ouild_nas and Dre-exisz_ns° ianC uses: 1. Accurate sur"Jev Of Drooerry snow--na ail property lines, streets, OL'1_Cfma and unusual natural or zonoarap P-ic =eaturas. 2. A prODerly completed aDD licatlon and a consent to inspect signed or tae aDD_'_cant. i Ce______ to of Occupancy aen?ed, !:'--,a Building -nsDector shall s:atc the r=easons ,herecor in writing :o the applicant. Fees Certificate of Occupancy - New dwelling 525.00, Additions fo dwel_ing 525.00, ?iterations to dwe'l'ling S25.00, Swimming pool 525.00, Accessory build= g 525.00, Additions to accessory building 525.00. 3usinesses 550.00. 2. Certi=ica:e o_ Occupancy on Pre-exiszing 3ulid4_,1e - 3100.00 Copy of Cert-ficate of Occupancy - .25c. Updated Certificate of Occupancy - 550.00 5. Temporary Certificate of Occupancy - Residential SL5.00, Commercial S15.00 Date yew Construction....... Old Or Pre-existing Buliding , _ .Dcation of ?rope ertv..4!~?.... 01QICNI.............. House No. Street Hamlet if. . . . . . . . GeJO©,~ /favSc inwer or Owners o f Property . . a :ounty Tax Map No 1000, Section. . a.....Bl000. ~........LOt. C7O ( UGI ;uodivis4_0m.................................... C 1. ed 'Hap -.-.....-...Lot...................... Fermi: NO."` d~~a L..... Date Of pa LLi: ................ApD licant.............................. i-th Debt. nDDroval Under-wrl ters Apnrova.......................... __+S.Cng Board 3DDroval .edues: f.,_. Temporary Ce-___-cite........... Final Certlcata........... 1 &.-2tr 5 CO-I C64 -Z; aquas AIPPLICAN - 4~~SUFFDLX~o~~ ;2- T own Hall, 53095 Main Road °y 2 Fax (516) 765-1823 P. O. Box 1179 • ? Telephone (516) 765-1802 Southold, New York 11971 .j. col ~ ~a . OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N( DATE: ~P fop Building Permit No. Z, Owner: A ^S (please print) Plumber: L ,J &,L, '(please pri t I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers Si ,ghature) Swo n to before me this day of r 1{ 19 np Notary Public County ~F~ CLAIRE L. GLEW Notary Public, State of New York No.4879505 Qualified in Suffolk County Commission Expires December 8,18 0 0 0 0 0 0 0 0 0 0 0 0 o e o rrr W totem V. IS 1.:2 m C7 m N< o(~'] in Z C m r N f 9 r [ay CmA d b7 6i 6~ v m' ~ d N H ~ ~ O O ~ < o b7 y 00 U) O U7 ° ) tri O n ~ xxro ~ m ~ iz Q Rm m m c cr m m ( ~ z O N ID w ) m x m cr xfr m ~z (D > ~v -3 ) 7~~ .m~, z r ct r)u'n 9 qy n m 'o H ~z a z z mz o m N w (D m z 'I Wl rn U tv r p u ~ G) f7 y n Iz3 n 9 .r._s~., m z m rn o o ) ( z C o o O M ) - r ~ m o> FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION ~3f) " .°mm9~ n ~ FOUNDATION ( ) Q u'~,-- N ROUGH FRAME. 6 , _ PLUMBING Ell II ..•,i'JJJ INSULATION PER N. Y. .14 P , - on H STATE ENERGY i=~ isn aP CODE ~ ------_i pI~ p w-/ II II- I I ~ H {f N------- FINAL ------I' ADDITIONAL COMMENTS: `m O Vim!) z r~ t - - IM, ro~ H 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING re-FINAL FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR X-P6(?~ M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ )R H PLBG. [ ] FOUNDATION;2ND [ INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLAC CHIMNEY REMARKS: z A Z~ ~ DATE INSPECTOR F ~C M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ji]/OUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ Z44RAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: -4-1/v DATE INSPECTOR M-1802 BUILDING DEPT. NSPECTION [ UNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE 1~ 1,24104~ INSPECTO J f° f cy} r.. WNN 0- LY o rt. Di g+r(ci (1 N.e 2o?3a~ D 0 8 981 ~p Q 14. ~ l gas°..25 ' Ar- of? n o~A a z ~ 1, r a ' ~'r'~iF of S R a* o x o l BOARD OF HEALTH G FORM NO.1 tea SETS OF PLANS TOWN OFSOUTHOLD ti SURVEY MAY 231995 BUILDING DEPARTMENT CHECK TOWN HALL SEPTIC FORM SOUTHOLD, N.Y. 11971 TEL.: 765-1802 r:aCALL CALL Examined . 19 MAIL TO: . Approved . .7 19/. f Permit No. . . . Disapproved /c (Building Inspector) A. P CATION FOR BUILDING PERMIT DateA..1 y.'.z.3........., 19?s INSTRUCTIONS a. This 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 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, buildin code, housing co d regulations, and to admit authorized inspectors on premises and in building for necessary rnsp s. f? . / (Signature of applicant, or name, if a corporation) olflccl- y......... (Mailing address of applican State whether applicant i owner lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ° i L /w...lO!! dJ//00-~ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No . Plumber's License No . Electrician's License No . Other Trade's License No . 1. Location of land on which proposed work will be done . . Gc~ ......................o ~~!FWT House Number Street Hamlet County Tax Map No. 1000 Section .~.2s..C.)a......... Block .03-.00 Lot QTY: orl~ Subdivision Filed Map No. -Ldf . (Name) 2: State existing use and occupancy of premises and intended use and o/ccupy of proposed construction: a. Existing use and occupancy C-MCC SII .TFf X!,,t ~Cf 1#1{?fI ° ° ° Y,bt 10 0W?? ,OIJ81)9 VfaATOW b. Intended use and occupancy ° Atifeu.k.btzfPa • ....~.t.~ ~$M~ YFt}X rnia Nature of work (check which applicable): New Building . Addition . Alteration . Repair 3. Npa oval Demolition Other Work 4. Estimated Cost.. OOG (Description) Fee.................................... (to be paid on filing this application) 5. If ; dwelling, number cars units dWi. , , , Number of dwelling units on each floor AJY$" . If g, garage, number of 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dimensions of existing structures, if any: Front .'.43.:-© , . , Rear o.'...:... Depth . -0 , , , , , , Height tuber of Stories ..Q!S(F . . . . . . . , , Dimensions of same structure With alterations or additions: Front / s~S .4sa , Rear Depth ...l7 (208. Dimensions ensions of entire new const ' Height ~ , . Number of Stories , ruction: Front . Xe Rear , , , , Depth th Height . rpber of Stories . 9. Size of lot: Front 04j.•. 2S........... Rear . /.QJ' :63 ~.d...........ry, . 10. Date of Purchase • • • • • • • • • • Depth , 1 1. Zone or use district in which , • ' ' • • " • • • • Name of Former Owner premises are situated . ! 12. Does proposed construction violate any zoning law, ordinance or regulation: e119 . 13. Will lot be regraded ff.. ! Will excess fill be removed from premises: Yes Q 14. Name of Ow er ofremises. . . . Addressa6u pQc/%%PDST Qrj//w?/ w' . Phone N Name of ~OR00/v / K-' . Addres~'dX 3!0 •di~i~ivT" • • ' o.~:~,?6~ , . Phone No3-37So Name of Contractor ~o,(~NSoN Ci1RPl~h7e/'..~ ~ • ' ' . , . Address ...................Phone : $So?-.... . 15. Is this property within X300 feet , . feet of a tidal wetland? *yes....... & *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly alit 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. TciJc=~?~~rPrN L= X C $ I~FF'7t'S 7'0 OwL~ YA2~7X STATE W Yo ' ' C~o 17~~is COUNTY OF fzrC _ S1 (Name . in signing . . • • • • • being duly sworn, deposes and says that he is the applicant contract) above named. He is the.... .................I' W.u-. Ar (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized 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 man~t forth in the application filed therewith. Sworn to before in this d f..I. . Il9Q?~ Notary Public, - . . . unty BERT 1, SCOTT, JR. N.Y.:' PUSLIC, state of N. No.47250825089. Suffolk Gou~ty ~ (Signature of applicant) I .xJp Term ExIiires May 31 P 19 ~C 1 OCCUPANCY OR WINDOW 26 USE IS UNLAWFUL OAp~~~ DA DV" ASP NOTED rj5 Z..J - FEE: _ BY: 4 YS 51 •C~L1J?il IC~PATIo WPSSGRI~G~ Ko 5=aX 6'g t NOTIFY BUILDING DEP T ~ ANDS-PSSraR { >(~'-~$516Rl(~'.ATlb ~.~'~StO~'v~l '~65=CI rjr`i 765-1802 8 AM TO 4 PM FOR THE WITHOUT CERTIFICAT ~ -1 FOLLOWING INSPECTIONS: 9`3 3 - OF OCCUPANCY [cJal-uZ7 Ex Ca-EK1~fiKCrN(f~1-SEN~CE~ryJ I . FOUNDATION - TWOREQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING &PLUMBING ~r~~ SQ5MV~(u7 5m~' ~K~ LITF'FiY'a F, c, }C 7i:~ 3. INSULATION CGIE ~OZCV{ - n NWTC4lKIS'i It lc~ J GX~1-INO~ J7~L/DN f(y (,IVI/~G~C$~f~A•~JE ~~'-~0•T~,~E D 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. I ALL CONSTRUCTION SHALL MEET '~f~7`I YL~TIFI II~KIICH E[y• EI~IJ RO YD M THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION III ENERGY I~E~'/-ANlNE WplCx7tN/7'ELLR P,'3 `){>~,N, OMC( CODES. NOT RESPONSIBLE FOR IfRA.ME-CA51t.~~•,SEE ~II SG'TfON ~'~'L~C/t? DESIGN OR CONSTRUCTION ERRORS ''ANEI. MATcN EXIyItp GEU RZ~oo 1IMOEI1MIpREIIS CERRR W i 9 8 pu CI 14 vN - I e C~j o eX l r~ II ; _ S, i PLUMB f~CERTIFICATION - ON LEAD (CONTENT BEFORE a )R - p - I U CERTIf/ TE OF OCCUPANCY, o SOLDER USED IN WATER n NCY'I, c \ FR n' ~EFR_' Ih SUPPLY YSTEM CANNOT 'OT NIS = O I~ = EXCEED 110 of I% LEAD. II 01" r ° 2D. t--- - - - - - - r - --,~F 3' II 4 9 ~ZJ~', - - 1 J iLL+~:3J10" - n DW IFI) ALL PLUM ING WASTE /2 - ( J & WATER SINES NEED ! $ (•'k! / ! TESTING SEF RE COVERINI II ~ ~I ~'IG~' OILI KI7GtI~N _ I~;T'` i~ `a ~(~TiNG171NINa? ~fil I ~ ~ O C) 1 11 copper tubin 1s used n' - - - N for water die Ibutiny system piping 0all be .?AAR,~ of types K on on I I I / i I ~vtP _I ~rN tt- - ~ FRONT ~I llVllvcT f2Q~~ _ i 1 I ~ r-h / -~ED ~k----°I-f - ~~T NCs Tl~~1CTqC~ -11~~ r R ~i I AN F NEW o r 5 Q~~P LALE ,{1 APPROVEDBY DRAWN BY P + _ ATE' S 31p /5 V{1~- ```Fi c~s_~~1 y~'~~2->5E,(ik',ENo~/RTfGi~l ILG?T{tom FE~s:~~*°t/ p~X1Y5TTiynl~ ST~s.tcT"~-lK.~ i ,y / t-'KEPEt'QGY YJ I' ~~T ~IRF{"T10~~NGF DRAWING NUMBED Y,o.P~oy_~lo•oRi~~y~,NY, a ~Sq ~.~R~ i OIEIZGEN MASTER FORM MF 139 NI X lj ~ li N ASS ~ C+ 6'ot / x S i L4~ - -r- - _ - _ / - iL - - , ~ Nh m. .f. i ~76i~l W, VIA LA.- ilk ~N3 I mo ~ I ~ III ~ I 1= i 2r d V- a0 m ~ i ~ III it h i - M~NMfL -71= r 7~~ 44 AT-laq V- r r r- n_ i d p v - _ O 1 DETAI~c DEial~v ~ D~rai~ j DETaIt r NOP~TtILVAT6N- STiON AA _wSTFr~v~ i li ,;tea- I - ct4.oeaewrom CONIAAT(ON NOT~~ - IVi ~ ~ i n ,i;?~,a ~N'JK~FiT.~=~LK`ilirgc-h'r~LLNEIU~tt;. NI H TFT''I1 I '1114r lT PFenul~,~T; 11 1l_1 r`II.,I;t.Px'y- -~I / +sa~ ~x~ 5ruro - kl i ~ -,a = ~I ~ 4~L IATE ti/AJrCk IAIp Tlil°J.IhtVs J I I I- -11 TRIT'LP2X6 ~i "TP 1 ~'t, i~ /9Y.6CEpA~ (~FU~_[zx( V Yo MATCH mEW 2XG FRA of 4 ' ZXSYF.~K' 15l" ! I y~ J~ (5T' n . - . i _ ~_-ne)19T~;~~~ ~N JkXB<.1 hR 1cE~ r ~H`;I ,hRc F F ~~oIST I 1C I°_,. yorcHF~ ~Kc ~a~ SKYE ~TF ,o.)c 4M IT ?l PTA °,d \ ?JT_lRF fXi~ c• 8Xf6 C_/ - i _ II tc[Z~~}'UN~~ ~ I:Iloi?~~le~'AT~ FX'STrle~wir:p~ntll"IW;!Frfen4 I PCg~~4-X29- o;~4LIA rnoN14T-) ~ti•,,ES YL'um - I ~ ~'C;8x1dX2~k i ~ ~i cmrur4 - a I I fI II iii one B~~4c~'~T~ SARI A~Np~,7 rzN: o ~ I \ I lBWA1 TIN _ l r~D ~ K ~ f ? TAI~F K)TFnCt~I` - - ZaII _ i ~ scALe, APPROVED SV oRAw, El J ~A11. C • mE uo2Gi plt-,F- WrAt U KITUd N ~cK+1 2Aria~ - TP,I L p 5 t ; DATE J PRbTP,~v C~'(~ l~F'" iIR6CTl0(~, IIyL . oenAwwe NumReP DIETZGEN MASTER FORM MR 139 P.o,~r~x3io~oa~CldTr~1.~(- II s"i. iii I - II III 5y. \ ! 1 li- ~ l TT f 4 - - 0 INS ~ I V- ~~~I ~ P6EP\1y6'#4(NC _ yy -Al To V I fin( rl - - - - - fJ p 3xs ots 16 Lc, I - I ti I, f: ~I Dun Ka*~x~ -F i - I I I 55 'I CyUkiNEy IXcAVATF-G'fiLSTrNCrCUrrp~ o e F P\ -RAU>L A~ ACCE ~ ~j -d -r - i I I z.x~ t%x 2X6 -'i ' I I I I ! ^ ~ I - - TC{IPLE ZX~ ~ p 1 I I I I I; h, I ~ 8 Ark Fo~IN?AT~N V~LAP\I - ~~TP~I~ A~"nn~ZZAtylr 1i/~EyZAriIIN~~FRA~NI~~-(S~EPIAT~%~-- K fTCk(~1 Iti r~°R. III -7-/ K! It~[1 I (L. O~ i ftyOEWEfy Np9 « 91 % A°`FSSacE+j 17 F I i Oi t r ~ ~t I ~ 'I ~ Ir I ~ J! w r FMK SCALE ~S iN'PIcA:(~D APPROVED BY DRAWN RY DATE S A- 1S - 16 p N 7t jtit T{ A.4 oK INE, FIYNdA ELLV - 0 3 5 3. o It lDfFt 01 4 kiANS ~9N 5~~ICCcalDP-v,(2 16 0 INTO DfZKtfiFF N ~I -l ON OIEIZGEN MASTER FORM ME 139 aER ?M ''PAP,FP ( Lt"r1)t%co To (NL, on."O D. I; j I I I f t I I ~I I i I N III jl, !I I I 1! nL-~ Till, I I I } ~I II' "I rF~ tl I I~ tvV+ W fRlniN .Swt,~Lq ~ ;r vAu TED c~iu ~ - -,i l ~'e. = K~FLA~); ?N kTfIGV`Ilt~~ 4uH661N?icp~ i l I,. I I ~ 9~t<~4N SIGN OF rl~N y Yf AT A3 w~~-r 1 ai MEp yp ~ r f f - -i f - r'N YS 3:{rt Y III ' i ~ - r ~ r Irk ~ I I f- -1-- I ~1- 0 ~ 0 9Z ~ Y6 5" 3" 7-p 7~8 - ---5r - II, `4 plTia~lAGT TioN RS~EI~tof. I r~r ~~f~,y-y~~} VM5 i ~ryN~per' \y 1 ~ _ Y 4K A li : ~K T=-_ - I ottN W~ oPAwrv e TI SCALE. 5 [NDTED APPROVED By J- DATE. S 5I ' X ~!UP~ KITCeF-N ANT FM L yATiO~IS 7MA, Y ~~'~j IR(LT1ol~1 ~ RI, - _ DFAWING NUM EP - I" 4 ~.aPJoK31oOr~~T, NY,, 119ST DIE120EN MASTER FORM ME IE9 - - -