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HomeMy WebLinkAbout22567-z Y FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23656 Date MAY 17, 1995 THIS CERTIFIES that the building NEW DWELLING Location of Property 510 BREAKWATER ROAD MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 106 Block 9 Lot 7.9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 10, 1995 pursuant to which Building Permit No. 22567-Z dated JANUARY 18, 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 ONE CAR GARAGE AS APPLIED FOR The certificate is issued to ROBERT & STACEY NELSON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-94-0124- MAY 1, 1995 UNDERWRITERS CERTIFICATE NO. PENDING - MAY 9, 1995 PLUMBERS CERTIFICATION DATED FEBRUARY 21, 1995 - ROBERT BERTORELLO 216-ilding 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) Date 19.p... NG 22567 Z Permission Is hereby granted to: C 4 ~J e s P....r..'..... a ` 1~~r.J..../~...././...d. / to...4 .....~c~~ ./.E?....../91!`l ......•Cl.C!l./!yvY .c./~.~d ........v .......C~ .......,,,-s' .............................................................................................................L....................... at premises located at....... ©....~ff ...................................................'04 '&i../ ao ...l.~.....C~.......... County Tax Map No. 1000 Section 1. .6... Block .1 Lot No....,/.10../............... pursuant to application dated 19... l..-C and approved by the Building Inspector. 4Fee ...Z.~....,.~ Buildi,...ng . for Insp Rev. 6/30/80 a. FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPAI Instructions A. This application must be filled in typewriter OR ink, and submitted a a ~ to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: f 1. Certificate of occupancy $25.00 BUSINESS $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $ 10.00 4.Vacant Land C.O. $ 20.00 a 5.Updated C.O. $ 50.00 Date NewCons true tion, , , , , - Old or Pre-existing Building Vacant Land Location of Property . 510, Breakwater. Road,- Mattituck, NY . House No. Street Hamlet Owner or Owners of Property Robert. Stacey.NelsOo . . . County Tax Map No. 1000 Section . -106.. Block ..09 Lot . 7 :9 Subdivision AeP,crlr ,13Aq property - . , , , , , ,Filed Map No. ..........Lot No . . . Permit No. a7 ~ d Date of Permit 1~~..Applicant ....Riverside ,Humes,, ,Iq4........... Health Dept. Approval - 110-94-0124 , , , , - -Labor Dept. Approval Underwriters Approval ........................Planning Board Approval Request for Temporary Certificate .....................Final Certificate Fee Submitted $ .25 . Construction on above described building and pe it m 11 pli ' Is codes and regulations. Applicant ~Q S. Gor n, President Rev. 10-10-78 R VERS DE HOMES, INC. 9 CrJ -i.a3(~S~ Date February 21, 1995 Building Department Town of Southold Town Hall Southold, New York 11971 Re: Building Permit No.: 22567z Owner: NELSON Gentlemen: I hereby certify that the solder used in the water supply system for the captioned job contains less than 2110 of 1% lead. Very truly yours, BERTSAND PLUMBING AND HEATING By Sworn to before me this 21st day of Februarv1995. otary Public MAY I O 19,95 EILEEN M. ROACHE Notary Public, State of Newyork No. 4826942 - Qualified in Suffolk County, Commission Expires January Si, 99.` & I FIELD INSPECTION REPORT --IODATE-I- _ COMMENTS_ - - / II 311 0 f K~ - T I II II(/ H j~;' FOUNDATION (IST) 4 II II C~ C FOUNDATION (2ND) 1==~( e II nn ROUGH FRAME 6 ii I Q II e > ~ PLUMBING li II ~lI II II ~ ~ INSULATION PER N. Y. STATE ENERGY CODE it R 1-53 II 1 II FINAL jj YA, \ o AUDI ONA C:- lo/ H O z r C 1 y Nr Riverside Homes, Inc. zdku P. O. BOX 274 1159 West Main Street Riverhead, N. Y. 11901 Phone: 516 - 727-3395 March 20, 1995 Town of Southold Building Department Town Hall Southold, NY 11971 RE: Permit # 225672 Gentlemen: Enclosed please find two original under construction surveys. If you require any other paperwork regarding this project, please let us know. Thank you for your cooperation. Yours very truly, Donna Boble DB:db Encs. i 190,5 06, ygOC1A.?~7MN o .MEMBER o 3 Yrixr SLixJd ~G^`hku'< r ~ ~e~u u~Exs ~ A51a ,ms • iMSrnu,E I~ 60ilDE~ f M-1802 y BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: e r DATE 1~2-914-: INSPECTOR r-lJ M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ( ] FOUNDATION 2ND [ ] INS ION [ ] FRAMING [ FINAL REMARKS: L P ~r DATE f~ INSPECTOR 77, 74 M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ) ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS TION FRAMING [ FINAL REMARKS: II es~~iv~J Lbz- i` 1 DATE INSPECTOR i M-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ]FINAL REMARKS: C4PLt_ I i k l DAT INSPECTOR i 765-1802 BUILDING DEPT. IN ECTION [ ] FO DATION 1ST [ } ROUGH PLBG. ( FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: fa~,,V~ r r Ir DATE -INSPECTOR (Zill 765-1802 BUILDING DEPT. SPECTION [ FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL MARKS: Ma,n ~ v cwr ti DATE INSPECTO F THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1035018 BUREAU OF ELECTRICITY F 83 JOHN STREET, NEW YORK, NEW YORK 10038 Date MAY 15 ,1995 Application No. on file 87517595/95 N 351800 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 NLESON, 510 BREAKWATER ROAD, MATTITUCK, N.Y. in thefollowing location; ® Basement ® lst Fl. ? 2nd Fl. GAR/OUT Section Block Lot was examined on MAY 09 , 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 10 28 17 10 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS gEll UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K. W. OIL H. P. GAS H. P MIT. NO A. W. G AMT. AMP AMT. AMPS. TRANS. AMT H P SYSTEMS pMT WATTS NO. OF OF FEET 1 F 3 1 SERVICE DISCONNECT NO.OF S E R -V_ - I C E AMT. AMP. TYPE METER EQUIP. PFR 9 1.e 2W 10 3W 3 e 3W 3,e AW NO. OF CC COND A W G . W G. NO OF HILEG OF A HI-,E6 . NO OF NEUTRALS G. OF C W OND A G OF NEUTRAL 1 100 CB 1 X 1 4 1 4 OTHER APPARATUS: L MOTORStl-F H.P.,1-1 H.P. G.F.C.I:-4 SMOKE DETECTOR:-1 PETER CHARBONNEAU LIC.#2697-E 35 SHEPPARD LANE SMITHTOWN, NY, 11787 GENERAL 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 crtrdt±ntidli.µ COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT RE ALTERED IN ANY MANNER. BOARD OF HEALTH yam,, FORM NO.1 3 SETS OF PLANS TOWN OFSOUTHOLD SURVEY BUILDING DEPARTMENT CIIECK • TOWN HALL SEPTIC .0Rtt SOUTHOLD, N.Y. 11971 nJ c3 / TEL.: 765-1802 ttOriFY: Examined .~a 19! f CALL ttnlL TO: Approved ? /.0 199.. Permit No. o~J~lo / Disapproved a/c . z (Building Inspector P (CATION FOR BUILDING PERMIT Date , . December 20 19 95 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 stieet<, 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. Riverside Homes, Inc. (Signature of applicant, or name, if a corporation) PO Box 274, Riverhead, New York 11901 (Mailing address of applicant) State whether applicant is owner, lessee, 'agent, architect, engineer, general contractor, electrician, plumber or builder. builder Name of owner of premises JQhnt ,Nicholas T. and Irene H. Parck s .......Y (as on the tax roll or latest deed) If applicant is a corporation, signature of duly au'horiied officer. S.. GPrclopi . PPgrident . +......r.. l (Name and title of corporate officer) E YYYY7 Builder's License No. JAN 101• Plumber's License No. ...1487E . BLf3G. Electrician's License No. .2637); . , , , , • , • • , , • , TowN OF SOU i t!4 ~f Other Trade's License No. 1, Location of which proposed work will be done. 6,10 Fl p FS.-FaxthLro `f~S~77;R]6 1 ~l Road - • , , • Mattituck liouse Number Street Hamlet County Tax Map No. 1000 Section '...:.146 Block .....9 Lot , :T.•q• • • • • Subdivision ResP. Property Filed Map No. Lot (Name) Statc existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy , • • Vacant land b. Intended use and occupancy • • • construction of. single family dwelling 3. Nature of work (check which applicable): New Building x Repair Removal . Addition Alteration . Demolition . Other Work , 4, Estimated Cost S7 O°v oo (Description) FCC 5. If dwellin (to be paid on filing this application) If garage, g, number of dwe]ling units ......3 • , • , , , , , Number of dwelling units on each floor . . 6. If business, number of cars ....'71 commercial mixed occupancy, specify nature and extent of each type of use . . . . . . . . 7. Dimensions of ex, istinlstructures, if any: Front Height ...........Rear Number of Stories . Depth Dimensions of same structure with alterations or additions: Front • . • . • ~ • . ' • . ' ' ' ' Depth . . , , Height . umbe Stor Rear . . 54' • • • ' ' ' ' ' Number of Stories . D , , h 8. Dimensions of entire new construction: Front . Rear .Height Number of Stories . 54;;,,, Depth ...4~ . one 9. Size of lot: Front . .19,3.,26, , 1 Rear , 200.............. • . . • ' ' ' Depth ' , ' ' ' ' ' '186.13 and' 2b~1:44' 10. Date of Purchase Name of . ' Former Owrer John Parckys. 11. Zone or use district in which promises are situated , ' ' ' ' ' • , • ,12. Does proposed construction violate any zoning law, ordinance or regulation: . 13, Will lot be regraded , ,Y,?a no, • • • premises: , , , , , , 14. Name of Owner of premises , Parckys Wtll excess till be removed from premises: Yes Name of Architect RiC17dCd .W~ridolos•ki Address c/o builder , , , , , , Phone No. . • Address PO Box 971, Riverhea~hone No, . 727-6b.2. Name of Contractor $}yQrside Homes, Inc. Address 1?0 Box 274,' Riverhea 15.' Is this. property within oo feet of a tidal wetland? *Yes ,`ohon.X ,,7~7,-3395 ; • *If yes, Southold Town Trustees Permit may be required. No...X. " 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 SEE ATTACHED SURVEY I I I i 'I i) ff¢ rATE OF NEW YORK RUNTY OF.... S'S. S , • • being duly sworn, deposes mid says that he is the applicant ove named (Name of individual signing ~ontract) . is the Px'sW94 9f.-mlicarlti/builder (Contractor, agent, corporate officer, ctc:) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this Aication; that all statements contained in this application are true to the best of his knowledge and belief; and that the rk will be performed in the manner set Torth in fte application filed therewith. om to before me this .......a0.,..dayof..• ~eCe,Y,rr199f ary Public, County VM4qX V AbVWAU L rARY• PU01.1c, slope of Pd 'I rr,gE~ . sa.ao2a2 o s.mo,a `'ban, 6IS'- S. don ? „ a ;on 't,utr,a Mart er / (Signature of applicant) ~a(~j b Cc: a Ob k Qh QcQ 41Z va-cant' _ ~~V~~ N/D/F HENRY HAS ~W y g S. 0' 29' 00' E. 200.00' ^ 14<13 tl o tip Ili W O II Q ~O~ 3~ Q ~Z~c~ QOo4 O J I tQ I J d0 n D V r 57' N 57 All \ y = 405.77.. ; ® n Nom- - X9326' o I O c RpP w r Pit iD Pic 1y'Y x 9j o52 p1 w C-11 Op W { N r1. 26 S o _ v, S / NE u ~q 0 o N r t~ypF o x 4Nk e, Z ~5~2 I ~I ono aom~ Q - pk~ ®0F ~ Z b Ilan C i#:;, l a P k fly 1-1 A ` - a. 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A 7~QUT CE ~dGsC ~ SUPPLY SYSTEM CANNOT UIIt `I 01,171-DING DEP WITHOUT Cl G DEP EXCEED 2/10 of 1 % LEAD. ? 9 AM TO 4 R THE ypp/~/Z nan;riC INSPECTIONS: C.atil-~iuJoua ~2 IVCgE VtTNT s OF UCCUPAP Kr 9!1'~9Utl AN Y TWO RFOUIRED ,i 0(q;C1,)CONCRETE If copper tubing is used sRaMING & PLUMBING INSULA(ION ~4 s for water distributing 4 NNAL CONSTRUCTION MUST system; piping shell be BF. COMPLETE FOR C.O. of types K or L only ALL CONSTRUCTION SHALL MEET TFIE REQUIREMENTS OF THE N.Y. L F~_• FI_, 7 STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR ri_li ie3ulid Ci DESIGN OR CONSTRUCTION ERRORS t ALL PLUMBING WASTE & WATER LINES NEED - - diwYL... - 1\ TESTING BEFORE COVERING DO NOT PROCEEB WITH Ll FRAMING UNTIL SURVEY 0 l2o OF FOUNDATION LOCATION VIOY'L- slc, c, \vOenD fitAt~E !F ~ 12° w -_4z„ i ' HAS BEEN APPROVED. i~ @ffNl~~ MaI.A,- - {4 AC.m _ ~ dr Gor..+ji,.+Jo+~s (2iozctE JEl..l1^ , 7-4c>* As•PAAL-7- Gan Imo- • sN~-rrE1ss i i w' r - iw5 f; + 34124 -171 ~ 5 0 o p~ `;~L . rid"'nom azEr ~I YIE9'A+-Et~S fo'S n_n _ fGi ~ _ ~i I S ao Y' t f- R E R m y GPf~~ 1 ~-+~f _ 1-_ Jh..1I - I n 1 ? I p.,N ILI r~m ;L i r 7T-- OF Ml0Y1DE Ii MR. IRE ~ 9 I ~1 RATED SENIRA 10 ® Lio N.Y. _ PARE 7173 M Of 40" Pc \vAu-s N.Y. $TAR RDILDI CODE. i( fi 'Y S. / '1" - 'S S.~ VINYL ~ ~ 2'- r 'Y ~ ~ U; ~,~Kk12 NCT 4NE 7LnOP,R, ~ . a f r MINBf F 2LJa} 1 1.4 1-XK4 ?r1+N- .,F UCA 0 ; M 1 N' MNL 714 5- ~ ~ tJ~tsXCM4VA-~~ , I . e N.1C IMNNIM CODI ! - 1 i NI w / Rio Log 34 J Si 1P' 10'-P" t1 L •OV ~ L ~.'_O~. ~ ~I A ~'rf ~(p'.2j1 s 'N ~ ! 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