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HomeMy WebLinkAbout22915-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24116 Date JANUARY 12, 1996 THIS CERTIFIES that the building NEW DWELLING Location of Property 5960 ALDRICH LANE MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 120 Block 3 Lot 8.7 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 12, 1995 pursuant to which Building Permit No. 22915-Z dated APRIL 30, 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 ONE FAMILY DWELLING WITH ATTACHED GARAGE AS APPLIED FOR. The certificate is issued to DAVID & DANA DEMCHUCK (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-95-0074-JAN. 10, 1996 ELECTRICAL INSPECTION CERT. /9532 - DECEMBER 20, 1995 PLUMBERS CERTIFICATION DATED JANUARY 11, 1996 - JOHN DEACY dz- Building Inspector 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 AUTHORIZED) NP 22915 Z Date... ~ 19 Permission Is hereby granted to, , & V.e.'U- 40 ,..,..V~.. to d"q ` 41 at premises located at.. C,,~~.... x1r County Tax Map No. 1000 Section Block Lot No. ...0.x:..7............ pursuant to application dated 19..~~! and approved by the Building Inspector. eld Fee $.~...r'a~. „ . f...... Building Inspector Rev. 6/30180 i Form No. 6 a 9- 3 asp TOWN OF SOUTHOLD 9~= 36 i(iY BUILDING DEPARTMENT L 11996 JAN g TOWN HALL 765-1802 BLDG. DEPT. ry~ TpWry OF SOI OLD _ 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 Buildina - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15..00, Commercial $15.00 Date 4 / New Construction.... . Old Or Pre-existing Building., ~~J////`~/ Location of Property... ./.WV 4!( l , , ~.~.........1.4 IA • 4~~(/(/ House go\,.~ Street 1/Hamlet Onwer or Owners of Property.. 0• 4. • r•t3...7 • 0 ~ - " • • • County Tax Map Noyy 10000~,ISection .....Block.... Lot.. Subdivision ..r. <jo V. V •••••••••••••.Filed Map...... ..Lot... ltldefq Permit No.. .~.1/•°~•~Date Of Permit ................Applicant... Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: $ fi~ . n A M! - ~•.5o6S~f UU APPLICANT....... C~ e0zd I P 6 Town Hall, 53095 Main Road Fax (516) 765-1823 P. O. Box 1179 't Telephone (516) 765-1802 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 9 ) C~~ DATE : / / I r Buildin -Permit No. Owner: x~AI 41 ~7~Y1~~ U c (please print) Plumber: - C (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers signa ure) Sworn to before me t is day of 19j-~ DEBRA ANNE DEAU NOTARY PUBLIC, State of New YON Notary Public, County No. 4818621, Suffolk Gault Commission Expuas March 36, 9 00000000000000000000000000 0000000000000000000000000 O° 0 p (516) 286.6642 ELECTRICAL INSPECTION SERVICE, INC. 0 375 DUNTON AVENUE 0 EAST PATCHOGUE, NEW YORK 11772 -9532 _ f O Date. 12-20-95 APPLICATION No. ON FILE ° Lot #5 Farm Vue C 0 ADDRESS: Aldrich Lane _ VILLAGE: MattitUCk TOWN: Southold C O C O ISSUED TO: Ray Hartman 0 INTRODUCED BY Deliane~_j_EctriC _._.LIC. No.^. 4354E 0 was examined on 12-20-95 and found to be in compliance with the National Electrical Code. C 0 LOCATION XX BASE. XX 1st. -2nd -3rd -Attic Pool Q OUTSIDE,RES. DET. GARAGE HOT TUB O 0 FIXTURE RECEPTACLES SWITCHES G. F. C. I. DIMMERS FANS AIR. COND. C o Exhaus ° 0 34 40 29 3 1 c 0 DISHWASHER DRYER CLOTHES WASH. GAR. DISP. RANGE OVEN SMK. DET. O - O 0 30Amp. 20 Amp. 0 FURNACE OIL GAS CIR. BELL TRAN. SERVICE DISCONNECT C O ers m s. ase ° 12-F MOTORS 1 1 200 OH C Oo 1-1. HP Motor for Well o ° 0 O President o O 0 This certificate must not be altered in any manner. e 0 Inspectors may be Identified by their credentials. O 000000000000000000000000000 00000000000000000000000000 J r . %,4001,tco c~ Gym C40 a Town Hall, 53095 Main Road ap ® Fax (516) 765-1823 P. O. Box 1179 Telephone (516) 765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD December 16, 1995 Mr. Ray Hartman North Ray Corporation 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 An application for Certificate of Occupancy is not on file. (Enclosed) xx No Underwriters Certificate on file. xx The check is not on file. $25.00 xx 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 # 22915-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1N ATION [ ] FRAMING FINAL [ } FIREPLACE & CHIMNEY REMARKS: DATE 6 INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] F ING [ ] FINAL [ FIREPLACE & CHIMNEY REMARKS: ?~9 DATE INSPECTOR 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] RO H PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ' ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS:-u-c.yyi _ DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ~RAMING [ ] FINAL [ FIREPLACE & CHIMNEY REMARKS: DATE t INSPECTOR ~ 765-1802 BUILDING DEPT. INSPECTION [ ] "UNDATION 1ST [ ] ROUGH PLBG. [ /]FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: C DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ) INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: W© ~V,-r 6,c DATE.QVOP INSPECTO y FIELD PECTION REPORT_ DATE _ _ COMMENTS 0 _ A/c7 ry H FOUNDATION (IST) jj FOUNDATION (2ND) _ _ II II a i, p II 11 4 "'&y. ~ z lfill O ROUGH FRAME & r o PLUMBING it it I INSULATION PER N. Y. do ,,Lt y STATE ENERGY e n CODE / /i? ir~a/~ c9~ 4 -7 it ii lilt 01 I II jj II I i II II FINAL ADDITIONAL COMMENTS: 1 n ro ~ o n H O m ` BOARD OF HEALTH FORM NO.1 3 SETS OF PLANS TOWN OF SOUTHOLD SURVEY Y` • • • • , `i'• I,'~!2 BUILDING DEPARTMENT c If ec> 1. TOWN HALL SEPTIC roam _ SOUTHOLD, N.Y. 11971 TEL.: 765-1802 NDTIFY; CALL j~~/ Examined .~.30 19Y MAIL TO:~ - . . . 3lr-~ ~14? q / Approved 19 Permit No.. ?f15~/J~`_a . Disapproved a/c (Builspector) APPLICATION FOR BUILDING PERMIT nSi 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 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 i ctions. - (Sig ture of applicant, or name, if a corporation) 1A (Mailing address of pplicant State whether applicant i owner lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . (as on roll or latest deed) If applicant is a poration, signature of duly authorized officer. (Nam nd t~rporate 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 won will be done. _ ,5-696, 1-louse Number Street Hamlet County Tax Map No. 1000 Section . 0... Block ...y) Lot . ~ . Subdivision ..!!l!`"~'~'~- Filed Map No. WNI Lot (Name) 1 State existing use and occupancy of premises an~d^inter ed use and occupancy of proposed construction: a. Existing use and occupancy . . b. Intended use and occupancy 3 Repair of work (check which a 1 . oval able): New Building . .Dem. o Addition Alteration . Re ition .............Other '.y (Description) 4. Estimated Cost © d{. !1a a ..1........ Fee . (to be paid on filing this application) 5. If dwelling, number of dwelling units 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 Iel ensions of existing structures, if any: Front Rear, Depth Height Number of Stories . . . Dimensions of same structure with alterations or additions: Front Rear • . Depth . . . . . . . . . . . . . . . 11. . 8. Dimensions of entile new construction; Height Front nt r t ...:..Numb ~f tgries . ~4..Rear ..7 . . . Depth 2. . . Height G?Z.0........ Num'ber of Stories . . . . . . . . . . , . 9. Size of lot; Front Rear ?A S Depth . 1 .7.. n 10. Date of Purchase Name of Former Owner . 11. Zone or use district in which premises are situated 1 13. Will lt be 2. Does proposed construction viol ale any zoning law, ordinance or regulation: .11rko . g 14. Nameoof Owner of premises . . . • . • • • • • • • • Will excess fill be removed from premises: Yes ................Address ...................Phone No................' Name of Architect • • • Address Phone No.. . Name of Contractor i • • Address ne No...... . 15. Is this property within 300 feet of a tidal wetland? *yes,,,,,,,. N *If es, 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. j i i I~ i i i I i I STATE OF COUNTY OFLW YORK, S • • • • • • • • • • • • • • , being duly sworn, deposes and says that he is the applicant (N e of individual signing contract) above named. He is the... r.',''c!~ Y`, (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 contaiped in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner het forth in the application filed therewith. Sworn to before me this ...'.n.dayof,.........., 19 Notary PublicGJ/ G!~!( County D, HORNE Notary PubllicESta a of Nam York Na. 4I~ Qualified in Suffolk Counttyy (Signature of applicant) Commission Expires May 22,. 1% (wt( tijT) '49 10 SQUOD V kQ ' 3di ` N:2314 r 14 C) rn ~ ~ ~ X~X~~~" Ol4C#R{5 D~ t~ II i r pp 1 ~ { 10 m - y 40 3d T1} G1- r h . f1tt (j" 4:ri jib . r 10 iz C5 % C~ w C~ + fa t_ N ~ m_ v D O m c c 0< x ' d ~n pb"~U)p ~n00 < m On: ~SffE FILED MAR x < m - r r Di . 6 D Q m:1 ;K D A3 m a ~o ~mn v o-1'nW X, n ~ m `3 n Q 7v 2 1 d 0 U 0 O z --4 2 '9 -i xm r f iti 'A`c~i T m s'~a S g3'8 s v x -C S D x z Oro •i ;fl' X m$ m' g m m .N~ H 6 u i lA UI vNS K s6 3 W v m D v x2 > 3: OR 11 a~oq ~A~y~ a w m< llr r v 'm 2 nt to * ~,mnm,_ ou so _3 zo 0,. T r D m y m ~'-roi _ Aa 's ova p 6! O O m fl zD di In r~ om y °m ~A_ v z < x upi m i ,pro U! 4m ~ g m 14 rx 4O us b© {{m z mss. ~r O +r-t MS r A ~1~"., aux m r r ,"Aahin ~ .var._ _ . . ......m .w...,.... +r.-F...r...w....-.-,i.....+.._Y.+~rv- S.~.G-s-K _ J Nt DA lo I ~ - M It! 4, r 1A _Z 14 as -1 O 1. < .4 r4 SEE FILED MAP i per . i. 7c w n n a. p a ? q tA' x E' p q G S 3~n B~ v ?K. R00"9T~, 0 con Z O .o r F'P 7q F, ,b F~~ gm< ~gst "o. p p m R AA sit i rn m ~ Zia e vmgm u , T, ""Ill I I S t' P' ALA' -al ~NT " 4il tA- Irk.; Q T' "L to 0 _ IT, 0 m 7n see P "M Q tic li C erg s•_ I a.~ 0 al ^A 0 W o : UO "17 ; 1 Pk b '?1: 0 ya Ro0 Hag _ w Iz b ilk t ~f SL iv m -A kl t7 Er, ~'aslFarncnded,cf'Fectfye IvfarzNh9,i~)~?1-,` Parf'~-15eGI,'on 7814;191dg.7?esign be_~/tccep)-able i'racfrce. Sou, re.-FNcafivt _q ~or fhi5 61dr~ -Non -F-Iccf"C _ ~J~ICG ITIG ? From Tables' S Z of Par{- 5 rot' .5,0oo-(o,ooo Ue ree .Da lYrivelope- , Hon-L )ec, >=lee• IF, ulaTion Cornponen{- Ncakin eakinq ro$ Remarks n a n ,o -Recqll rns ailed - t. Ltr II R-)8 - R- Iq Roof ccdvi R-!q R- I,q oor R-1 19 R J Found ail* R-lo a • o" R- tJA lab E'~Qc~-4 R- la'R-1 R- AM Iazin ~@ R-1.7 ® R-2•6o R- J,7 r. Doors -2.5 _ R•2_ - o lm _ Ross Floor Arco: 5, o0o sP; Th% 6/dg. G F. A.; 6zfQ_r•F_ * Regd• dcp e oW ero e; „17 c_ , Ff. Top oF-~ol,nc 11 11 11 n ~ ; 84- 11 SW-cl)I g)az,ng sha)1 n4evccecl 17f- orc~rosSWnllgrec,. Includes skylights- 5kgll*30s 5ho)I bc,no rna-c than 1% of ~ofol rvoF area. ® ReVq depth:i24inches belovvsrodc,orbclovu fop oF~lab, vshichcvcr is grealer• or Frorn }op OFs)nb fo bo~lo,q of slQo _ _ H-,ert a horizont•at c!'is}-o,~rr: of 24 inches bcncoflt fheslaV. >~l/ Eivss Erna: &/o 5,F; J. ~oo] " LO 6 Ca~/~}ruc/ion of this b/dg. s/loll cogform }a all pert„7cv / sec bons of Por/ 5 as specif eel in t/7c above-i~Jenfi~iaJ Lo 1 NousC for: ~~I7f'TJl r~ y ~t~o~ W!o i~ (i r- i ! I 11 ,a + - 4 13 ! -rl f I _ I J J i I I I ~ ~ I I ~ Y i ~ r~ IL ,I -71 T i t I~ e I i 4 1 i f 4 i t t I"~ o ~ ? I 1 i i I CeLZ.4,1 I! ! . PROVIDE % HR. FIRE I + ! 1 v t E RATED SEPARATION TO r PART. 717.3 (f) (1) OF i f 1 115 t ~ N.Y. STATE BUILDING CODE. r. . -1 ~I ! Fir Ira :I ;EI ! I~ t I i t f~ i{ 1 14{ n ~ If 9 I I 'I~ i PII ~ I I ~(Iz•3 ,8 _~c.i?d 7~{.o.. '~4. `4I ~ Z I 4I+Y ~ 11, ~t III i ~ I { - 1 I IT IIIL I /I y ' _OCCUPANCYOR 7s G DCCUPANC' USE IS UNLA oe NE IS UNLAWFUL c~~~oQ PLUMBER CERTIFICATION WITHOUT CERT CERT fHOUT CERTIFICATE ~QJeopnSNOTEp ^ ~3 ~~s E. ? UIV L.CAU 6U'vIGIYI OF OCCUPA OF OCCUPANCY DATE: J1 B.es ,4/--7/0IT u * p BY: If oWDer tubing is Used CERTIFICATE OF OCCUPANCY for Misr distributin SOLDER USED IN WATER 'IFV BUI D N DE NOi PAR ENT AT DO NOT PROCEED WITH system; PIPing shell be SUPPLY SYSTEM CANNOT ~ Cr G+~ f Tf ,'J f JJ . , ~f 765-7802 a AM To 4 PM FOR THE FRAMING UNTIL SURVEY tYPes K or L on EXCEED 2110 OF 1% LEAD. 7. FOUNDATION aapFrTrolvs - TWO REQUIRED OF FOUNDATION LOCATION FOR POURED CONCRETE HAS BEEN APPROVED. " 2, RaJGH - FRANUN G a PLUMBING FLUme 3. ENSULATION ALLR BINOGiINSTE PROVIDE OPENINGS FOR IINGS FOR ' C-oNSrRUr.TIONMUST & MTE11 UNE9 NEED EMERGENCY ESCAPE AS ICE CMAPLETF FOR C.O. SCAPE AS ILL ,CONSTRUCTK)N SHALL MEET TESTING BEFORE COVERING ART. 714 OF iNll AEd7UIREN11' NTS OF rHE N.v _ _ _ v E REQUIRED BY PART. 714 OF DING CODE. ;.;T.,yJrTION az, ENERGY - - -Y _ N.Y. STATE BUILDING CODE. •LCG {.InT RESPONSIBLE FOR CR E"ONSTRUCTION ERRORS ; UNDERNRNERBCWFICATE k ~"S JG; ,C•f C:, REQUIRED ,~~.c HI i= H q Id, I I DE OPENINGS FOR ~s 1 EMERG NCYESCAPEAs REQUIRE BY PART. 714 OF S{ s s N.Y STATE BUILDING CODE. I I 7~lo`:.. /f- 0 I III 1 - ~ ~ I - ~ ~ I1D I .I f I 1 a ~ ` ~ ~ F ~ ax 1 1 J~ ---/Z-6 I--/a I •--1-- / o - - /o-o /Q ~ n ~ ~ to j i i I PROVIDE'/ HR. FIRE t RATED SEPARATION TO PART. 717.3 (f) (1) OF N.Y. STATE BUILDING CODE. fe, ~ i , I I l ~ L I -III e r ~ ! ~'--ate E l I II k1 i ~ t' 4 'x N4 I I il ~ _ I ' i I ` Cx. a 1 I 1 ~ ' EY7 ~ti J=.cx ems, P' bnc~+t. -i . it i 7 ZS PROVIDE OPENINGS FOR EMERGENCY ESCAPE AS { REQUIRED BY PART. 714 OF N.Y. STATE BUILDING CODE. - r,'D T ° 3,$' X r~bx7 136 uj,7S"X 13AI yo,ZS t 1 7 ~/t l h r j _TJ 51 ~'-1- 2-2 z Z z t 7 f7 7 1 3 { f _ - v i I I 1 ( I i I .Q 7 i i _ koc-ae i 1 n5 E. r. /r ` ~ 4 4 V i ( ~ I ab~ n 7_-E...1_~y" s~z~a - <WJ:' 7"7'9x5_ i i I 7 ~ I 7 s ' -r - iµN I ti ~ I G / 111 1 I I f 1 II r j w i t 1 7 E f . v f J ffN - { y r ~ _A ' Tel?CA' fIU'm. La"'): ~ C ~ Td G ' A_L v; vc. e-a C/RH~nI SCI IeG~ -j`V ~f QF HP[Y/ I i ~ Pte' F~~.w#,o~, c?,r~/% T'rr" : roc, 1 E I I 1 ~ 1 1 i / i t ~0?/(r I~L~/Jf:NG7TYev a ` ~ °°r `v I 1 1 i I { Aft i r - - - u 77 ~ i , 7 9. i t AI x, i r ~ 4'. 1 ~ t r I. x f , , ~ t of ~ a E ti _ -15 T,L r IC f 4 f . 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