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HomeMy WebLinkAbout22499-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 2-25195 Date AUGUST 11, 1997 THIS CERTIFIES that the building ALTERATION Location of Property 1905 PRIVATE ROAD #11 SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 86 Block 3 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 15, 1994 pursuant to which Building Permit No. 22499-2 dated DECEMBER 1, 1994 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 ALTERATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to BRADLEY ANDERSON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. M-341767 - FEBRUARY 6, 1997 PLUMBERS CERTIFICATION DATED AUGUST 4, 1997-MATTITUCK PLUMBING & HEAT. J Building Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25196 Date AUGUST 11, 1997 THIS CERTIFIES that the building ACCESSORY Location of Property 3820 SO. HARBOR ROAD SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 86 Block 3 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 15, 1994 pursuant to which Building Permit No. 22499-Z dated DECEMBER 1, 1994 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 ACCESSORY INGROUND SWIMMING POOL WITH FENCE & POOL ARBOR AS APPLIED FOR. The certificate is issued to BRADLEY ANDERSON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-388987 - JUNE 17, 1996 PLUMBERS CERTIFICATION DATED N/A Buildin Inspecto 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)) w/ 1... M 22499 Z Date .../'~~1................................. . 19... Permission Is hereby granted to; 1' ..C ~~>X....... 1~0 . may..,.. 9 - ~ to / .........,mss...... e.4K. Vn.....~s . at premises located at ! ~ . County Tax Map No. 1000 Section Block ~ Lot No. .....O 'LL pursuant to application dated 1,4zl7 ~...,1j . . 19.... and approved by the Building Inspector. Fee y~ ol9 6 To zc~~ Bu ding Inspector Rev. 6/30/80 i Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 5 4 765=1802 , e 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 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, AlteraEions 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 $15).00, Commercial $15.00 Date ..1. .1.` New Construction...... Old Or Pre-existing uilding. Location of Property....P.C~?............'..1:.........,i.... House No.' Street Hamlet bnwer or Owners of Property... . V ,:C.mKS............... C.(.t) ......{S.. County Tax Map No 1000, Section... ....Block.,. ......Lot... Subdivision .tt.~~ ..................................Filleed Map............ ~Llot............ Permit No a.`...... . Date Of Permit../. I~..... Applicant~l~~lOr1h "l .4. ~ Q u1,N$l. Health Dept. Approval.... \ ...............Underwriters Approval................... "JPJ Planning Board Approval Request for: Temporarry~ Certificate..........., 1 1 Certicate. Fee Submitted: $....C J . 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. Z. 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 $15.00, Commercial $15.00 Date ~i . New Construction....... Old Or Pre-existing Building.. Location of Property. ..~.1. VALivm-IJ- J~......... House No.. Street Hamlet . Onwer or 'Owners of Property... !A/.~. r ~ ~ County Tax Map No 1.000, Section.. Block..~..........Lot.... 0 Subdivisionn..,................................. Fi/led Map............ Lot....................... Permit No.2 ...Date Of Permit.. ...Applicants. ~yl h!b,'~ F IS! PProval...... 1j 1.. Tam , Health Dept. A / .........Underwriters Approval. Planning Board Approval:.):, 1/a' / Request for: -Temporary Certif.icate......:.... Final Certicate...../..... 'Fee Submitted: $ ~ , s/ . . s' e~ l~ APPLICANT c..S cd -Eas?q ii . Town Hall, 53095 Main noud Fax (515) 795.1829 P. O. Box 1179 ) rJ Telbphone (516) 705-18o2 Southold, New York 11971 d OFFICE OF THE $UILbING INSPECTOR TOWN OF $OUTHOLD C E R T I F I C h T 1 0 N DATES 1yt19:2- Building Permit No. Owner: $?~_Pln, a r'j C 1 c ~~ez ) (please)I print) Plumber: (~t p~ riC'f -1 lease I certify that the solder used in the Water supply system contains less than 2/10 of 1% lead. i (P Lumbe) - 'i S worn to before me this day of 19 AI11; - 719 97 D Notary Public, County BLDG DEPT. Q Q i~ TOWN OF SOUTHOLD ~dn^ NO' M 7orm Expires June I P1 f Ae.OPll"g Tait ` Environment East, Inc. a 3075 Indian Neck Lane P.O. Box 190 Peconic, New York 11958-0190 - - 516-734-7474 October 10, 1995 Southold Town Building Dept. Main Road Southold, NY 11971 RE: Permit # 224992, dater 12/1/94, 1905 Private Rd #11,Southold Dear Sirs, At the owners request we would like to amend the above mentioned permit to include a new swimming pool and fencing as per code. Enclosed are three sets of site plans and a check for $150.00 to cover the ad_d't'onaI costs. If any.'addi' a nformation is needed, please let me know. r~ o Sincer ly, Peter .wt.Purgh Presifdeniz° Environm~ t-K t, Inc. Enc. s OCT 10 W BLDG. DEPT. ll~~ MWN OF SOUTHOLD j on III E II OMMENTZ . IIDA i;•i TIOtf t2nd) I y z o_~! I Gli FRAME G» l ULATION PER N. Y n . - y ' STATE ENERGY T~ ' ~ gc cS~~ CODE ~I B .m FINAL , v ADDITIONAL COMM' TS: rn f - - 4-4 x \ e .J 1-112 PJ m o• , m :.M•'W.._+!is2L•...:.:r.. •~..dla'•..».'~~.:..~,. - .s; _ N ti .,M Cr~. xsr.. is U3LD INSPECTION REPORT DATE COMMENTS it II _ [Y 1 + II II FOIINDAVON (IBT) II it ii-T 11 II 19 ROIICII FRAME 6 PU MBINC 11 II II II II INS111.A'PTON PER N. Y. M STATE ENERGY CODE II , II II II R I II IF IF NAT. II- I I il O ADDITIONAL COMMENTS: --T - M b o~'rgUFFO~,~CO Town Hall, 53095 Main Road y x Fax (516) 765-1823 P. O. Box 1179 - • Telephone (516) 765-1802 Southold, New York 11971 ~jo~ ~ Sao OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD July 29, 1997 Environment East Inc. P.O. Box 190 Peconic, N.Y. 11958 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because f the following reasons: XX An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. / XX The check is not on file $25.00 * ? No Health Department Approval on file. No final inspection has been made. X No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 22499-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. *TWO CO'S REQWIR~D - 1 FOR ALTERATION & 1 FOR POOL & DECK. ~'~C ) -1Z 40 hvt tt r4~ ~atad~~a~r~e ~utu~e ,9-,, Q ~ tCL 'All Environment East, Inc. 3075 Indian Neck Lane a P.O. Box 190 Peconic, New York 11959-0190 516-734-7474 1 p ~ e ~ At Ir" k' °uTtioto a 4 Padt s, ~ ~`Wr~U•.LUe S. Fzw a Environment East, Inc. ,z 3075 lodian Neck Lane PA Box 190 _ Peconic, New York 11958-0190 516-734-7474 YQ3 a J. NOV 91995 Mlvi VZI `-~/~lr~r, ~C V~cc J yye4 -u,' ' "~y. / /cP.OPII(/f/12~ 7~I~ TQdt nom. _ I i VJ, L Environment East, Inc. 3075 Indian Neck Lane P.O. Box 190 _ Peconic, New York 11958-0190 516-734-7474 ~ h~ R~sro ENc~ ~Ys~o~ F.4~2r„f ~ . ~-1t{ Rya ~ t~ SouTff oc.c~ ~~KtT 2249- z 6 467 SEP291995 MIMI 011 -irr ~Y,yAA'~4111n 1 ~yII, WI ~(.l. C. 5. Environment East, Inc. L 3075 Indian Neck Lane P.O. Box 190 Peconic, New York 11958-0190 r . 516-734-7474 A/0 L') . 26, /q ¢ a,& 38 2 v ~o~ spa j Gee ~u~u~d 6'~ge' 1 G~ V *f r9 ! WARREN A. SAMBACH, SR. CONSULTING ENGINEERS ~ PLANNERS P.O. BOX 1033, 7075 COX LANE CUTCHOGUE, NY 11935 (516) 734-7492 August 28 1995 Peter R. Stoutenburgh President Environment East Inc. 3075 Indian Neck Lane P.O. Box 190 Peconic NY 11958-0190 Re: Andersen Residence Harbor Road Southold NY 11971 Permit: #22499Z Peter: Be advised that 3-2x101s laminated with 3-211 plywood, glued and nailed is more than required to support the roof for the glass doors and frames for the enclosed porch at the above. There is an existing 4x6 header which was not included in the calculations. Sincerely, Warren A. Sambach Sr. P.E. 1 was:s r" I ( ? 1A 01 ,ff i 'S t Al ~°a /'/tPOP/1UU12~G 71 Tact tuWe Fare Environment East, Inc. r 3075 Indian Neck Lane P.O. Box 190 Peconic, New York 11958-0190 516-734-7474 August 30, 1995 Mr. John Bouf.is Southold Town Building Department. Town Ball Main Road Southold, NY 11971 Re: Anderson Res. Permit # 224997 Dear John, As requested, enclosed is a letter from Mr. Warren Sambach confirming that the existing headed is more than adequate for supporting the porch roof. If any add}.t...onal informat on is needed, please let me know. . Sincere- , Peter R. S utenburgh President Environment "Eapl~ C. Encl." ? PRS:jm Twdy"f~'.~"• ,fi£Ijf\Jl TA doomg Id Pat Environment East, Inc. 3075 Indian Neck Lane P.O. Box 190 Peconic, New York 11958-0190 _ 516-734-7474 April 6, 1995 a WA Southold Town Building Dept Tows Hall Main Road Southold, NY 11971 Rc: Permit # 22499Z. Dated 12/1/94 Dear Sirs, Enclosed are three sets of stamped plans showing the addition of a steel header and the changes from Anderson brand doors to Pella's in the porch area being installed under the above permit. If there may" questions or additional fees, please let us know. /T Sincerely, i" Peter R. toute gh PresidentEnvironmen Inc. r PRS: jm f r/- t ' f a~' 4 Viz-' ~ riteOP/ibvc~G~ t6te ~114~ n (~Srawull g /e Frame Environment East, Inc. 3075 Indian Neck Lane P.O. Box 190 _ Peconic, New York 11959-0190 Ir 516-734-7474 --"1=- -/C) //o")"t i f.. ri a- Q r. Environment East, Inc. 3075 Indian Neck Lane P.O. Box 190 - - Peconic, New York 11958-0190 516-734-7474 a~ November 15, 1994 Mr. Thomas Fisher Southold Town Building Department Town Hall Southold, NY 11971 Dear Mr. Fisher, Know you're on Fisher's Island today and hope the weather makes it an easy trip. Enclosed is a permit application for the new Anderson property formally known as the Wortis Estate. We were called in just over a week ago when their contractor for personal reasons was unable to start the work they had scheduled. As we unveil the extent of repairs and restoration, we will get you more details and schedule inspections. As always thanks for the help and information on the existing Schneider permit and the Mulholland project which we will be filing short„ly% ) Sincerel , President, urgh Environment r'.. Inc. PRS:jm '•i nine 1 5 1994 let. ~;v~2 / ICC~(1C/GVV~I~ rvLG ~U4~ Environment East, Inc. ry R. R. No. 3 - 3075 Indian Neck Lane Peconic, New York 11958 516-734-7474 October 15, 1996 Southold Town Building Dept. P. O. Box 1179 Town Hall Southold, NY 11971 re: Permit # 22499z Dear Sirs, The accompanying fencing sample is for use under the above mentioned permit to enclose a swimming pool area alon it ch a` cess ghtes. The fence will run with the 2" openings running horizontally and the 4" running erfically, 4' high 2")ff the ground. If there are a questions please give me a call. Sincerely, Peter R. Stout President ^ Environme~r{ st, I PRS:jm / -pair xWe Environment East, Inc. r 3075 Indian Neck Lane P.O. Box 190 Peconic, New York 11958-0190 L LL-__ 516-734-7474 April 30, 1996 l5 p Southold Town Building Department :MAY 2 1996 Town Hall Main Road TOWDept Southold, NY 11971 SOG7}j LD RE: Permit # 22499Z Dear Sirs, On behalf of the home owners we are requesting a six month extension on the above permit starting at the expiration date. Due to the nature of the renovation and subsequent amendments to the permit the work covered has been glsftd z_V ff4ed. - Thank }lou-foryour consideration in this matter. Sincerely, " i Peter R. Sdq~b h n President, Environmeas1Yf,i;~y PRS:jm~ V L n"Y ' ~ ~ IN~U.f, Environment East, Inc. 3075 Indian Neck Lane l P.O. Box 190 Peconic, New York 11958-0190 -JFL _ 516-734-7474 f~A~f s~®E F~t~t APR« 24, (99,b ANI tPec,Sa(+G EZeSI~~N SDUTK tjAp_j!>C)f2, SDLYT ~ta L. D. T~a-R-M [-r It- 2.2 4 T1 Z. G~rna'rn~l ey-~ -76t 224- q q Z A 7PAPR 2 4 PTQn BLDG DEPT. L„ TOWN Of SOUTHOLD VIL Environment East, Inc. a 3075 Indian Neck Lane P.O. Box 190 7TI i~ Peconic, New York 11958-0190 516-734-7474 71r1lD~SOff fQ~'1DE/UC~ "'~C'• (2~ (1 q.4..,. so u TH tyAKR Sop, {Z~ ~Q2mr7- # 22 4gq-Z p6eCt4:e, `name a s a~t `-au o o~ ~ e v~ ec u wA.t Aao h-u~ Am'p a~a( Gtd rrr's~ c~ o~ ~ ~o kv-ur /W- wa'cz~- C" to Dom. 2 M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ INAL(A~ [ ] FIREPLACES CHIMNEY /117 1 REMARKS: CIO DATE 17- `7 7 INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~4 C r DATE / INSPECTOR T M-1802 BUILDING DEPT. SPECTION [ OUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ]INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY r~ REMARKS: DATE INSPECTO 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION iST [ O PLBG. [ ] FOUNDATION 2ND INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACES CHIMNEY REMA S: DATE Z f S INSPECTO M-1802 BUILDING DEPT. INSPECTION [ ] FOU ATION 1ST [ ] ROUGH PLBG. [ /]F NDATION 2ND INSULATION AMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ }FOUNDATION 1ST [ ] RO LBG. [ ) FOUNDATION 2ND ]INSULATION [ ] FRAMING [ ) FINAL [ ] FIREPLAC & CHIMNEY REMARKS: Ole- DATE INSPECTO le- 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLAj~C??E A CHIMNEY REMARKS: flJL", dz ~ K .ZK « dz~ 3 =1 s e DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ RAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE ~0 INSPECTOR 765-1802 BUILDING DEPT. INSPECTION. [ ] FOUNDATION 1ST ~OUGH PLBG. [ } FOUNDATION 2ND [z+-tASULATION [ ] FRAMING [ ] FINAL REMARKSI r f O b DATE e7ff INSPECT 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. t } OUNDATION 2ND [ } INSULATION ]FRAMING FINAL REMARKS: i DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ R GH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL RE RKS: 6" 6 e' ©,y 6, f DATE. INSPECTO THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 F- BUREAU OF ELECTRICITY I 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date FEBRUARY 06,1995 Application No. on file £357135394194 N 341767 THIS CERTIFIES THAT - only the electrical a ui.pment as described below iimtroduced by the applicant named on the above application number in the premises of 1)0tP5 PILL4a.~4 V f) i^ BRADLEY ANDERSON, SOUTH HARBOR ROAD, SOUTHOLD, N.Y. in thefollowing location; ? Basement ? IRE Fl. ? 2nd Ft. 3FL/ATTIC Section Block Lot was examined on FEBRUARY 02,1995 and found to be in compliance with the National Electrical Code. FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCEM OTHER AMT. K W. AMi. K W. AMT. KW, pmT, K.W. AMi. H P. 14 15 9 14 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALRECTT TIMECLOCKS BELL UNITHEATERS MULTI-OUTLET DIMMERS AMT. K. W. OIL H. P. GAS H. P AMT. NO A. W G AMT. AMP AMT. AMPS. TRANS. AMT. H' P SYSTEMS AMi. WAiiS NO. OF FEET SERVICE DISCONNECT NO. OF S E R V I C E AMT. AMP. ME METER EQUIP. 1.0 3W 1 g 3W 3.e 3W 3A' ON NO. OF CC. COND. A. W. G. NO OF HI LEG A. W O NO OF NEUTRALS A. W G. PER .e OF CC. COND. OF HI-LEG OF NEUTRAL OTHER APPARATUS: PARTIAL FINAL-1 3RD FLOOR FINISH WORK ONLY-1 MOTORSi4-F H.P. SMOKE DETECTOR:-1 *NOTEi This is a partiatl., not a -complete certificate. j~' p PAUL R. BURNS LIC.#3897••E P.O.BOR 1061 GENERAL MANAGER SOUTHOLD, NY, 11971-0932 Per II 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. THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1000225 BUREAU OF ELECTRICITY F 85 JOHN STREET, NEW YORK, NEW YORK 70038 Date DECEMBER 21,1994 Application No. on file 06743594/94 N 337262 THIS CERTIFIES THAT only the electrical equip ent ae described below and introduced by the applicant named on the above application number in the premises of wo" 5 M Chaz,~ FRAN ANDERSON, 3820 SOUTH HARBOR ROAD, POLE 43M, SOUTHOLD, N.Y. in thefollowing location; ? Basement ? Ist Fl. ? 2nd Fl. 3FL Section Block Lot was examined on DECEMBER 12,1994 and found to be in compliance with the National Electrical Code. FIXTURE ECEPTAGLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FWORESCENi OTHER AMT. K W. AMi R.W. MIT. KW. T. I K W AMT H P DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT K. W. OIL H. P. GAS H. P. AMT NO. A. W. G. AMT. AMP. AMT. AMPS TRANS. AMT H. P. SYSTEMS qmi. WATTR NO. OF FEET SERVICE DISCONNECT NO' OF - S E R V I C E AMT. AMP V" METER 1,e' tW 1 ,6' 3W 3.e' 3W 3,e' 4W NO. OF cc No A W.0 . A W G. A. W. G. EQUIP. PER a OF CC. COND. NO OF HI LEG OF HR-LEO OF NEUTRALS Of NEUTRAL OTHER APPARATUS: PARTIAL-1 3RD FLOOR ROUGH-IN ONLY-1 *NOTEt This ie a partial, not a complete Certificate. DICKERSON ELECTRIC CO INC LIC.#36101; 13 TARXETTLE ROAD BOX 1.055 GENERAL MANAGER SHELTER ISLAND, NY, 11,964 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. THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1(300121 BUREAU OF ELECTRICITY F- 88 JOHN STREET, NEW YORK, NY 10038 Date JUNE 17,1996 Application No. onfile 10804995/~9y5 N 388987 THIS CERTIFIES THAT Oi - 3-1 U9') 3,5 only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of BRADEY ANDERSON, SOUTH HARBOR RD., SOUTHOLD, N,Y. in thefollowinglocation; ? Basement ? IRt Ff. ? 2nd FL, OUT Section Block Lot was examined on JUNE 12,1996 and found to be in compliance with the National Electrical Cade. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K. W. AMT K W. AMT. K.W. 11 AMr K W. AMT. H.P. 2 2 2 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT 71ME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. C W. Olt K P. GAS H. P AMT. NO. A. W. G. AMT. AMP. AMT AMPS. TRANS. AMT H. P NO. OF FEET AMT WAirs j 1 201 1 SERVICE DISCONNECT NO.OF S E R V 1 C E AMT. AMP. TYPE METER l s 2W 1 s 3W 3 a 3W13 ,e 6W NO.Of CC. COND. A. W. G. NO OF NbIEG A. W. G. NO Of NEVTRAlS A. W G. j EQUIP. PER 9 OF CC. COND. Of HIAEG OF NEUTRAL !I 1 OTHER APPARATUS: I SWIMMING POOL-1 G.1'. C.I-2 PANELBOARDSLI-3 CIR. 125 *(SWIMMING POOL,) This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have frequent test/and or repairs made by a qualified person. 4L l\ L L VVV~~~ E <<< Continued on Page 2 GENERAL MANAGER Yi 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.. 12 COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ;ALTERED IN ANY MANNER. A; THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 2 000121 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NY 10038 Date JUNE 17,1996 Application No. on file 10804995/95 N 388987 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 BRADEY ANDERSON, SOUTH HARBOR RD., SOUTHOLD, N.Y. in thefolloLCing location; ? Basement ? IAt Fl. ? 2nd Ff. OUT Section Block Lot was examined on JUNE 12,1996 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS ECEPTACIE$ SWITCHES INCANDESCENT FLUORESCENT OTHER AMi. K. W. AMT K. W. AMi. K W, AMT. K. W. AMT, H. P DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALIt 'IT TIMECLOCKS BELL UNITHEATRE MULTI-OUTLET DIMMERS AMT. K. W. OIL H. P. GAS H. P. AMT. NO. A. W. G. AMT. pMP AMT. AMPS. TRANS. AMT H. P. SYSTEMS AMT. WAiiS NO. OF FEET SERVICE DISCONNECT NO. OF S E R V I C E MIT. pMP ryPE MITER 1.02W 1 ,R RW t A' 3W 9,e' IW NO.O7C A.C. CON W. G.D. NO. Of HI-LEG OF HILEG Of N W G. EQUIP. A. W. NO. OF NEUTRALS A.EVTRAI OF C OTHER APPARATUS: PAUL R. BURNS LSC.#3897E L L P.O.BOX 1061 SOUTHOLD, NY, 11971-0932 GENERAL MANAGER 11 " . • S5 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. N BOARD OF HEALTH FORM No.1 3 SETS OF PLANS L5 lJ l5 ll MLr € p}' TOWN OFSOUTHOLD SURVEY NOV 151994 BUILDING DEPARTMENT CHECK TOWN HALL SEPTIC FORtl y SOUTHOLD, N.Y. 11971 BLDG. DEPT TEL.: 765.1802 ttOTIFY ~7(p~(~ y/p TOWN OF SO TF~{~JL.p ^ CALL 7~V.2.(-C.1 . .7F . Examined ' 19~j7. MAIL TO Approved 19/. L'ermit No. a 7 Zz . . Disapproved a/c (Buiki nspector) APPLICATION FOR BUILDING PERMIT Date ...t{1.~. 19... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, ith 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 inspections. n~~yyure ofp ~~pplicant, or name, if a corporation) J C7 C€SOY ~XU c'® ,-A x-. . . .1`0 119 S/......... (Mailing address of applicant) 'State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises(4).f,* "A Jt W9, e. (as on the tax roll r latest deed) If ap 'can ' si nature of duly authorized officer. (Name and title of corporate officer) . Builder's License No. , „ . Plumber's License No...a3~~. Electrician's License No.~. e~ ~Vt L ra1~Q Qther Trade's License No . I. Location of land on which proposed work will be done . . . So. . - . ~.d.......... House Number Strree/et_ Hamlet County Tax Map No. 1000 Section d.d `4...... Block , Lot ........I 1 Subdivision Filed Map No. Lot............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....cam(, , b. Intended use and occupancy, hl:4.t.). I uuu i 3 air which applicable): New Building Addition , • Alteration Re . . . Repair of work ch ck whic a o Removal , Demolition Other Work . (Description) 4. Estimated Cost .i..? . Fee (to be paid on filing this application) S. If dwelling, number of dwelling 'units Number of dwelling units on each floor , . garage, number 6. If business comercialr or mixe'I. , , , • . , . , • • . • • . d occup ecify nature and extent of each type of use , , , , , , , , , , , , , 7. Dimensions of existing structure's, 'f rent . . Rear Depth . Height o tones . . . Dimensions of sam;s~ruct ith alterations or additions: Front Rear . Depth Height . Number of Stories 8. Dimensions of a re new construction: Front . Rear Depth . Height Number of~tories . 9. Size of lot: Front . Q°, /K tT'...... Rear . Depth , . 10. Date of Purchase ...........I . . . Name of Former Owner C~C ~~T... . 1 1 11. . Does Zone or r use district proposed in construction which premises are situated . R:e,Y+. d4~ }?p!(, , ~,tJq~pl,Ct~' ,rsa , , , , , , , , , , , , , , p p 'ate any zoning law, ordinance or regulation: . . 13. Will lot be regraded 'I• Will excess ill be remo,,vNit from premises: Yes No,' 14. Name of Owner of premiseAi nU ,76QC,IA57-. Address,45 ~ Phone No.,57A 765: 3P Name of Architect . I.. ~ud-Lio td' •Ny' ' Address Phone No. . Name of Contractore).)VIAbrl_?, Address Ci-M. gYl% nt(G-, . Phone No. ~71r ,~3,5! 7 ,7 15. Is this property within X00 feet of a tidal wetland? *Yes.... K , No........, *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. tel.fO')eOr) C~2~~Y~P~_ /~3 X~~4~"1rlJC (.t~1~O~u7S (S) AV12~ d- ~tS~ J Q-ftv c 4xrt ~j-PP_ dc_t I . Q 2 ~e ~ (.etc ez l S 1~ e~ele r~, ~,a e W-0- CIN Nt.. `e t Ct nQ r-Ze (,e l tea , I , STATE OF NEW YORK, S, S COUNTY OF g duly sworn deposes and says that he is the applicant te Y-.. . . . . ~a ~ . . . . bein (Name of individual i ni g ) g co ract above+named. Heisthe ntractor ent, corporate officer, etc.) of said owner or owners, and is dulylauthorizc 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. t Sworn to before me this /,,.-Ci.........day of. Ap. n 19 g ~l Notary Public, Count . . LINDAJ. CODPER (Signature of applicant)' Notary Public, State ofNewyor~t No, 4822563, Suffolk County Term Expires December 31, lilt( ; 6 •l~j~r7. )5~w ~Y Mrq 'L.N.ny' 1?»aa'4 ~ 4 \ q' 333 1 r s [ Est ~ +tro-3 / o i e e~,~p5'~~~Y~{ ~~fp~}~".,~a{•{~', • . ii l• I Q 4 r~{{I l'I, .r '.4 ( twl Ilm rA XT, tt fC fti Cif q p Z ~ ° I' t I ~ - Azov c G I d G~ 1 t~ ni .a. 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Coy, 0 MA5on4R 31ac N o-c~i.-o , w-o ~b °c~sr / PtDDE.l~ i'.£J+~DVE,D I ll.Z(o~°.14 gK( ~L PL~ DDc.P oDea ''>IDENCE /~i`~DERS'ON lZE~61DENCE 1.- APPflOVEDBY f=:',l SCALE: O DRAM E" _Jw[ _ :nb S ATE: D ORAWINO NUMBER 1G EN`~1f OH ` - INC T, ~tJG : 84=.239.=1 I a[~~?~~ Argo%`t~.~ - )AI I - ~1 m h~ ~ lol 6 Ifcy) III ~ r _ e z4;;~ ~P~. r, - / RE~ncq-I C cv.~. ar ,.Lose 61~F P To r1Au - I FY I J I Tur - Fk M,Fh K o '01-'.~?.y FC.Fa . T"t ' (I*Arl( I~'~V ~Ij= ~ I - I I Po kst..k:.~ j I I, I Rev. I1~19. °J4- OPT. *1 mil" OPT. *I l A-foV7 APPROVED 1 APPROVED ORAMMPY IVY( DATE ''~O' ;R JU ITS - Tf~ mEnAl~ DRAWING NW GENERAL NOTES i 1. ALL PLUMBING AND ELECTRICAL WORK TO BE UPGRADED ACCORDING TO ALL MUNICIPAL AUTHORITIES, LOCAL BUILDING-CODE AND I UNDERWRITERS ELECTRICAL CODE. 2. ALL INSPECTIONS TO BE CALLED FOR FROM BUILDING CODE AND UNDERWRITERS. 3. ANY STRUCTURAL CHANGES REQUIRED DO BE REVIEWED AND SUBMITTED BY THE CONSULTING ENGINEER TO THE BUILDING DEPARTMENT FOR APPROVAL AND INSPECTION. , r Ir I'. PLUMBERCERTOFICAT/ON OCCUPANCY OR ON LEAD CONTENT BEFORE USE IS UNLAWFUL CERTIFICATE OF OCCUPANCY i SOLDER USED IN WATER WITHOUT CERTIFICATE SUPPLY SYSFEMCANNOT OF OCCUPANCY EXCEED 2110 of I% LEAD. APPROVED AS NOT~E~D[p~ ' I DATE: 1' / 9 B.P.N 21r& .p/ FEE: ~14 If copper tubing is Used NOTIFY BUILDING DEPARTMENT AT for water distributing 755-1802 9 AM TO 4 PM FOR THE I System; piping shall be FOLLOWING INSPECTIONS' of types K or L only 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE I ~ ~ uNDE0. Cl~,~ UNDERWRITERS CERTIFICATE 2. ROUGH - FRAMING & PLUMBING REQUIRED 3. INSULATION 4. FINAL - CONSTRUCTION MUST w i BE COMPLETE FOR C.O. ' ~ We BHR r ALL CONSTRUCTION SHALL MEET r777 THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS ER _ 6 `SE.P.1F y I i P. 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