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HomeMy WebLinkAbout22888-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24162 Date FEBRUARY 9, 1996 THIS CERTIFIES that the building NEW DWELLING Location of Property 405 HARVEST LANE MATTITUCK NY House No. Street Hamlet County Tax Map No. 1000 Section 120 Block 3 Lot 8.30 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 29, 1995 pursuant to which Building Permit No. 22888-Z dated JULY 13, 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 TWO STORY SINGLE FAMILY DWELLING WITH ATTACHED GARAGE AND WRAP AROUND COVERED PORCH AS APPLIED FOR. The certificate is issued to RALPH & JILL PASSARO (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL RIO-95-0075 2/8/96 ELECTRICAL INSPECTION SERV. 9534 DECEMBER 20, 1995 PLUMBERS CERTIFICATION DATED FEBRUARY 6, 1996 JOHN DEACY Bdilding spector Rev. 1/81 d 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 AUTHORIZED) Q . .1~.......................... 19... l~ Date 71.1-1 PVC 228$8 Z ~ Permisslon Is hereby granted to: 00. .....x........ . /7/...Iq ~ ray to /y~ .......c rr ~..........Tw '......A . W~...... ? 9Z t...,, ...,IfQ.rf at premises located at............ 7`. J......... ~ i .........~~f'~.. . ..................................................................J County Tax Map No. 1000 Section ...~l..rcc~..g....... Block I!V ....QQ... Lot No. 'P.3f......... pursuant to application dated .............iA 19...:l. and apptoved bythe Building Inspector. Fee . Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT 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 17 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 - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $~~17)5.O , //mm(Jercial $15.00 Date ......rJ~/,F•~T~ New Construction Old Or Prey-~ isti ~ldi Location of Property... 9-'a' House NoStreet Hamlet Onwer or Owners of Property... V.\ V.. o U` .Block.. Lot..•••••••••• County Tax Map No1~0~00~, Section...... . Subdivision.... J~ Filed Map. RT0.....Lot.. / JI -6 Permit No.... I Date Of Permit Applicant.......•• . Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: $ APPLICANT Lj I Ca Town Hall, 53095 Main Road Fax (516) 765-1823 r.' Telephone 516) 765-1802 P. O. Box 1179 s ( Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE: Building P mitt NO. G^~6cr~ Owner: (please print) Plumber: -30 ~ W 1~>~ C (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Plumbers Signature Sworn to before me this Q day ofaCVC-y 19 / 6D Notary Public, U'7'7"~ County JLANANNE DAWSON Notary Public, State of New Yotk No. 4861446 - Suffolk County Commission Expires Jniy'14, 19 9 CP T e0oooooeoeooooo000000000oooooeoooooooooeooooo0000oooo~O 0 (516) 286.6642 ELECTRICAL INSPECTION SERVICE, INC. 0 0 375 OUNTON AVENUE 0 ° EAST PATCHOGUE, NEW YORK 11772 ° - 534 0 Date _12-20-95 A PPLICATION ri ONFILE O 0 e o Lot #41 Farm Vue O ADDRESS: Harvest Lane-VILLAGE, Mattituck TOWN, Southold 0 o O O ISSUED TO: Ray HartMUl p O 0 INTRODUCED BY DeLane],getri0 _ LIC.No._ 4354E______ o 0 O O was examined on_ 12-20-95 and found to ho ht compliance with the National Electrical Code. O . ---......m....... . .«~==z______--, 0 LOCATION XX BASE. XXlst. XX 2nd -3rd -Attic Pool p O RES. GET. GARAGE HOT TUB Op O O O O O FIXTURE RECEPTACLES SWITCHES G. F. C. I. DIMMERS FANS AIR. COND. O ° 0 27 48 38 3 - o O O DISHWASHER DRYER CLOTHES WASH. GAR. DISP. RANGE OVEN SM K. GET. O ° O 30Amp. 20 Amp. 3#8 1 0 O FURNACE OIL GAS CIR. MOTORS BELL TRAN. SERVICE DISCONNECT O O e m ae 0 1 1 1200 UG O 0 0 p e O 0 p 0 0 p President 0 0 0 O Tnb certificate must not W elbrae In any manner. O O Insmeamrs may M Id.mufbd try that, creeenesu. O O ° 00000000000000000000000COCO0000COCO~00000 o000000Past 0fear 0asset Gyp C4 Z Town Hall, 53095 Main Road p Fax (516) 765-1823 P. 0. Box 91971 y~Ol ~aO~ Telephone (516) 765-1802 Southold, New York 1 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD January 24, 1996 North Ray Corp. P.O. Box 655 Shirley, NY 11967 To Whom This May Concern: We are unable to complete your Certificate of occupancy because of. the following reasons: xx.,' Application's for Certificate of Occupancies are not on file. (Enclosed) xx jjNo Underwriters Certificate's on file. f xx k )N'o e check's are not on file. $25.00 each. xx Health Department Approval's on file. No final inspection has been made. xx / No Plumber Solder Certificate's on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 21930-Z & 22888-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. FIELD INSPECTION REPORT DATE _COMMENTS - of II FOUNDATION ( I ST) ~I FOUNDATION (2ND) - - - - Ga ROUGH FRAME & PLUMBING ------ii - - Z INSULATION PER N. Y. STATE ENERGY -Jo CODE II-----Ii- _ II FINAI. IIII---------ii - / ADDITIONAL-COMMENTS--------- ~-I- W - - - - O kz~ M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ INAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN ULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS jw~ DATE ~~INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: y , 6 DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] R UGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE 9 INSPECTOR ~s'" J FPP7 M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION iST [ V] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ A--'FRAMING ( ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: GDATE J INSPECTOR ROARO OF HEALTH p FORM NO.1 3 SETS OF PLANS TOWN OFSOUTHOLD SURVEY BUILDING DEPARTMENT CHECK TOWN HALL SEPTIC r•ORN SOUTHOLD, N.Y. 11971 2 TEL.: 765-1802 ttOTiFY~ q, 32 Examined .1-3 19 CALL HAIL T0: Approved jlJ..., 19/. Permit No. ~2v? d'Z`T. , . Disapproved a/c (Buil rig ).Spec tor) APPLICATION FOR BUILDING PERMIT Date 19 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 19cation of lot and of buildings on premises, relationship to adjoining premises or public stieets 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 Ithall 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 in c ohs (Signs Veofy applicant, r name, if a corpora ion) (Mailing address of applicant) State whether applicant i owner essee,'agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ./1!. ~ a ~ . . . . . (as on the tax roll or latest deed) If applica s a corporation, signature of duly authorized officer. . rte` (Na e 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. . , . House Number Street Hamlet County Tax Ma No. 1000 Section ~Q....... Block ....3........:p.. Lot.. Subdivision C..................... Filed Map No. . ~.~~.Q • , , Lot . (Name) 2: State existing use and occupancy of premises and inten/d/gd use and occupancy of proposed construction: a. Existing use and occupancy ...............";;::..:,c . b. Intended use and occupancy . rK!! y~!, ? , 0 •3. Nature of work (check which applicable): New Building Addition Alteration . Repair Removal . . . . Demolition , . , , Other Work . (Description) 4. Estimated Cost ~~•U', ° • ~ Fee . (to be paid on filing this application) S. If If dwelling, number number of of cars dwelling' ' units ..~y / Number of dwelling units on each floor . . . . . garage, 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . 7. Dimensions of existing structures, if any: Front ' Rear, . Depth Height Number ofStories Dimensions of same structure With alterations or additions: Front Rear . Depth Height Number o tones . 8. Dimensions of entire new construction: Front . ..y.~ , , , • Rear ....`y • Depth , 3.7 q;., Height , ; . Number of Stories . . 9, Size of lot: Front Rear ./v-- . Depth 10. Date of Purchase Name of Former Owner eZ 1!~S!~(tti.42 O . 11. Zone or use district in which premises are situated . 12, Does proposed construction ~violate any zoning law, ordinance or regulation: 13. Will lot be regraded 'V Will excess fill be remov fr in premises: Yes 14. Name of Owner of premises Al~?~ Address AN$~X , (Dr?t~~ ~ . Phone No. 4T..? . .?•0~": • , . ' Name of Architect l Address Phone No...... . Name of Contractor . ........Address Phone No............. , . 15. Is this property within 300 feet of a tidal wetland? *Yes........ No.. . *If yes, Southold town Trustees Permit maybe 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. i i' III I e I STATE OF NEW YORK COUNT ,Y S.S . XA. ~m IM P...?:r''. 7v1 / . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the . ./~Jc (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 manner set forth in the application filed therewith. Sworn to before me this day~~of'.. 19.?.I- Notary Public, County / JOYCE rv1~ iMIJONS . V!r ~7'~Z? Notary Public, State of Newyork • No. 495224% Suffolk Coo o .(Signature . of applicant) Term Expires lrna 12,1 ;R uo Gay ~ . ~ 7I~ ~ CTS i 1 r. z r -`fix A ~"T1 _ , I N a { a° :r- C7 t~ m °c'" i-m n. FILkfS ,Y 4 Y'? A X 47S C} '10 ,0 0 0,0 b r ^1 i P S "s s R q . 2 b. -I a m s x tit 10 4 0 61 10 h -j w J z 13 w o I- W III It -j d w o z g > O O F B 8 ,o. o w d a x sod _ ~6 O W' e.., z w ¢ a in m a d w 1 f "s $ u o f„- LL < w It. Ny _ ..j" - w r~1~ T a z I w 4 w z O u a U Z O F O U o J O l O O u) IC to w Y u) tY U 0. W U Z O X Q 31 Q J IL iwo0iA O>k aO ti v) W I- N w w w in ui w _ w a v) W w Z w w z vi a o- z w w d a t~tn (n u~i)n~UO2¢ p H y~ '1 u 0 o >r 32 r~ t~ p 32 UWJ g Ua cl- > lot- Oil ICI OR a , LU r r lcYf 1 { w L + t ]s51 c; rn 1 At1 ~ 4- itt a 19 . IA Z ;a -4 61 tpe FILED o.~oo i o t !t q 0 o ~q({ (!1 U! v.. 9, O g pg w y q. x.05m 46 s .a~ td A: 2 ~ v8 S~e q t a . 71 'l! r; 33 a 1 w~ ~ f N copper bUnD Is used for water chatrKMInD *Menc plPinp shall be Rii of types K or Lonly I f UNDEMITI S CERTIFICATE i i REQUIRED . 4 ' " I I{ ~ ~ 3 PWMBINa I fj `:•ut z ALLPLm i i er ! € , - - - - &VJMEeUUNEBNEED 1 TEMM BEFIM covERING I \ PLUMBER CERTIFICATION i ONLEAD CONTENT BEFORE j I 4 ' O~~j_iGNL~i . CERTIFICATE OF OCCUPANCY } SOLDER USED IN WATER SUPPLYSYSTEMCANNOT EXCEED 2110 of I% LEAD. D I L._L-. ~ L i OCCUPANCY OR -X1, 3 i f ~ I USE IS UNLAWFUL In w~,~ \ { X~I s WITHOUT CERTIFICATE OF OCCUPANCY APPROVED AS NOTED ~ DA FEE: 5-721 NOTIFY BUILDING DEPAR MEN AT F 765-1802 9 AM TO 4 PM FOR THE I~ O'n FOLLOWING INSPECTIONS: - _ w tkl y;, .,._4T{ i-- TT E 1. FOUNDATION - TWO REQUIRED ! FOR POURED CONCRETE i I 2. ROUGH - FRAMING & PLUMBING 1 ®k'~. "/-•C 'f;-i_c Tq,-=' 'lli 3. INSULATION ~ I 4. FINAL - CONSTRUCTION MUST 0 I i BE COMPLETE FOR C.O. 7 ALL CONSTRUCTION SHALL MEETI THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION a ENERGY ? - ' + CODES. NOT RESPONSIBLE FOR I I 1 i DESIGN OR CONSTRUCTION ERRORS kI' - G-ovci2 Pd kcN 1- 12 I WA PG S , r ~ ,1 ~~ifl I ' ~ { o3G" be-Le.v G.1.+aN T7.'~ .Q - - - - - 2 1 Inr'_- E 1 oF NEW f r ~r r r '7 ~et,PS E, T i , a DO NOT PROCEED WITH PROVIDE OPENINGS FOR { ~ S. i FRAMING UNTIL SURVEY EMERGENCY ESCAPE AS , dI n 1 i OF ,~b~ 'OF FOUNDATION LOCATION REQUIRED BY PART. 714 OF u c rys, r HAS BEEN APPROVED. N.Y. STATE BUILDING CODE. . _ ; _ _ y 9 _a y 9 ~-o y PROVIDE % HR. FIRE U p y? l a ''f L ! RATED SEPARATION TO PART. 717.3 (f) (1) OF ~ i ~r p ~g N.C STATE BUILDING CODE _ ._M. 9_._ _.,._r I 1 t7-'o L3~ s`o { i i 6 xee st Aa ~ =s 11= Matt 14 e I ,+fua cq~ca ~ ~ J S 1 ( 7- 2017- My I o ~ 4 1 P ` f V ~ f $ ° kI ~ ~ / F all, N - - ;.i h? J~mF~t^ f7f I M ~ \ Lj ~ ~ V PP ~ 1 M 7E i ~I+ kz Q. I{ ~ ~ M I i -F~ b_ Sri-,?.+F1_gs ~ ~ i fff o . 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