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HomeMy WebLinkAbout22517-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23943 Date OCTOBER 10, 1995 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 635 FARMVEU ROAD MATTITUCK NY House No. Street Hamlet County Tax Map No. 1000 Section 121 Block 7 Lot 4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 28, 1994 pursuant to which Building Permit No. 22517-Z dated DECEMBER 6, 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 A ONE FAMILY DWELLING WITH ATTACHED TWO CAR GARAGE AS APPLIED FOR. The certificate is issued to ALLEN & CLAUDIA JONES (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL RIO-94-0106 OCT. 3, 1995 ELECTRICAL INSPECTION SERV. 8049 SEPTEMBER 14, 1995 PLUMBERS CERTIFICATION DATED SEPTEMBER 7, 1995 ALLEN K. JONES k - Zcc/ zild ng Inspector Rev. 1/81 /y. FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT 1OVm HALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ..................•r•.••..................., 19.`.../•.• N® 22517 Z Permission Is hereby gran alto, .......Q,edl w.xeee....... 1.~........ ........M.y..,....~~.. ~../7... to r!rn / .....e......./~l 'Cad? ..1~.. At W4 4 .......r......,.~~.~........1~../l~v' /V4A A ..~z . f' r!~ .AV..P at premises located at . ..........................................................fir. County Tax Map No. 1000 Sectlon ......1....` . Block . /..............q.... Lot No. ~c~ pursuant to application dated o..l~. ~rk.prl............. 19...1. and approved by the Building IIInsp~e+ctor. Fee $../..>~.5 . Building in ctor Rev. 6/30/80 ;-Orin NO. " F f ToWLD of SOUTHOLD BUILDING DEP@PARTARTMGMT COT TOWN HALL 765-!802 BLDG DEPT. MOWN F SOUTHOLD 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: Ear 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-4 form). 3. Approval of electrical installation from Board of Fire Underwriters. 6. 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 4, 1457) 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 ~~$15.00,,' Commercial $15.00 Date 1.. . . New Construction.... . Old Or Pre-existing Building j Location of Property.. . c. 2v....f. wt.7 :.~..ce 'louse No. / Street C Hamlet Onwer or Owners of Property... f-... ) ~ :ounty Tax Map No 1000, section. ( 13hick ...J...,........ Lot....... Subdivision ....................................Filed Hop ............Lot......... ?ermit No. /..,5.. ..,..Date Of rermic...!'~~.4'- . Pp Iicnnr......(~ ay Oeallh Dept. Approval ..........................Underwriters Approval......................... '11nning Board Apnrovnl . ''equest for: Temporary Certificate........... Finns Certicate..~...... -ee Submitted: 5..... p Town Hall, 53095 Main Road .i J Fax(516)765-1823 P. O. Box 1179 _ Telephone (516) 765-1802 Soul hold, New York 11971 •,.,j OFFICE OF THE BUILDING INSPECTOR. TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE: Building Permit No. TT U 2z- Owner: j le', g' Jo~S (please prr/int) Plumber: Allen /c (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. a 199 ( Plumbers ignature ) _ _ Jii BLDG. DEPT. TOW OfGf;,1711110!,D Sworn to before meQ this day of 19QC3 Notary Public, County ~~~wr. tP FLORENCE A. LO PRESTI Notary 1130lie, State of Now York Np.4897347 Qualified in Suffolk Courtly al Commission ExpirssJuns 1,1W-Ld ;r J v::SI^3G:_u:I OMi1GNT° '11DATI0:1 11DATI011 ? (2ndl N :.11 FRAME - ° ~ ••PLUFIHIYG • • I I ' 1LATION PER N. Y. I~ STATE ENERGY CODE II FINAL DITIOMAL CO?*IFi1T3:A,- e4l4 r- tL".7. m r ~ b GGLe~¢•ti T r Q+ J Town Hall, 53095 Main Road Fax (516) 765-1823 Telephone 765-1802 P.0, Box 117o _ _ (516) 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 Permit No. Owner: (please print) Plumber: (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 day of 19 Notary Public, County I 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 ULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR 4,~ y { a~17, a 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ I INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY ~GZ z REMARKS: 7 2t Z., ~ ~ a~ tl ~ `E se DATE J~ J INSPECTO lov AL 70-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING [ kj'FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE ` INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ROUGH PLBG. [ ] FOUNDATION 2ND [ NSULATION [ ] FRAMING [ ] FINAL [ FIREPLACE & CHIMNEY REMARKS: DATE (O ~ INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ v]/FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMAR ~d 5 DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ OUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL REMARKS: c?, 1 DATE INSPECTOR 765.1802 BUILDING DEPT. INSPECTION [ ] FOUN TION 1ST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL REMARKS:` r~ DATE INSPECTOR .r i _~...u3 ,y 6 ~s i 9 'n 'n n h n n n n ri 'n r~ n r 5 ri n 0 0 0 0 0 • 0 0 0 .00 c (516),Z86-6642 ELECTRICAL INSPECTION, SERVICE INC. 375 DUNTbbI AVENUE c EAST'PATCHOGUE, NEW FORK 11772 8649 c - APPLICATION N6.6N FILE DATE: 9-14-95- 4DDRESS, »t #30 Farm Vu6%Mive. VILLAGE: MattiNS>aClc TOWN: SoutllDld ISSUED TO . ° .Allan JOneI3 INTRODUCED BY: HoIt18' 6Wi743S' LIC.,NOt < a ire < a AREAS LISTED WERE INSPECTED ON:. 9.44-95 AND WERE FOUND `FO BEIN COMPLI'ANCE WITH THE NATIONAL ELECTRICAL CObE ..t,.x..C s,.. - , - i -"_t -F r'n ~ a c, xt* . a„ri>i r+A-: rt^*'+aY • a~kr~~ LOCATION EASE ~:1ST~2ND"3RDI~ATTISPOOL c 4 SMOKE DI?TECTOR _DETACHED GARAGE 50 SWT, ; - c . 73 REpX 1-1tANGE 9:9 BELL j,e c 57 FI 1-DIMMER 3 : E7tH}1USTS 1.- 1-DTSHWASl 1, 2 ' c f'-.FANNY 1-LQAMP' SPEC. 6 (Arl 3F' OII, , "Star/, -30Ve WYER . SERVICE DISCONNECT' -r.. - , - MPxERS MPS. ' , 'PHASE o c 'y 'THIS CERTIFIG kTE~MIJST NbT EE S1I TERED Rd ANY MANNER, GO S SURDI INSPEC,TORS~b1AYBE IDENTIFIED BY THEIR CREDENTIALS n` 'PRESIDE NT- !k, ~u All v Mll v v v y v v y v v v f v v v y v v )'~;F [ t h 3 ra ,f . d P r r 1 - r r`:k ; a~ n t..r 2 ? 3 y, q" sr A at t 'r3 t g .t 4nnYaa cu- a ?B0.AFD OF HEALTH Stt;rnf ~N I2E1j f - - FORM NO.1 ?3 SETS OF PL \asep;1~1~1•+"lI TOWN OF SOUTHOLD ?SURVEY . ..S, BUILDING DEPARTMENT ?cI rcr M Fo. fiwm ~hak TOWN HALL ?SEPTIC F0R:I (-*t:'h?Qrvt.towQ' f3t.DC, ;X 1. SOUTHOLD, N.Y. 11971 auoutcV f'Ovs iV OF,SOtP1,01 may/ TEL.: 765-1802 NOTIFY: ~ Q /~F°..., 19 ( J Examined . . . CNAAILLL TO. 2 98 ;0;/< Approved f..~.,(~.. , 19~ Permit No. . Disapproved a/c _ . (Building Inspector) P LICATION 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 location 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 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 inspect sj ./~h?b (Signature of applic nt, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises y CG/ft o/, . crp! 1 (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. ~,~^•C~~1~. , , • . . . . . Plumber's License No . Electrician's License No . Other Trade's License No . 1. Location of land on which proposed work will be done. 1Prhv]! CV . ~3~ (v JV . mW.ra..Kv?/.~......... g. ~?ac~ House Number Street Hamlet County Tax Map No. 1000 Section Block Lot............ Subdivision Filed Map No. Lot ~o (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . b. Intended use and occupancy ?svAn • Z M 1• :f tf ` e . 3. NNaa~~I of work (check which applicable): New Building Addition Alteration moval , , , , . • Demolition Other Work . (Description) 4. Estimated Cost ~5~©mlJ Fee 5. If dwelling number of dwelli (to be paid on filing this application) um If garage, number of cars h° e~~s Number of dwelling units on each floor . 7. Dimensions of 6. If business, commercial or misted occupancy, specify nature and extent of each type of use existing structures, if any: Front Rear Height Number of Stories . Depth . . .of . s.... ,with alterations or additions: Front Depth Dimensions .Height. Rear..... 8. Dimensions of entire new construction: Front RearNum... of Stories . Depth • . Height . .Number of Stories , , 6 9. Size of lot: Front ...L`14... ' Rear . (yp........................ . 10. Date of Purchase Pt}i 33.`f . Name of Former Owner . A r 1 { M<L . 12. 1. Zone or use district in which premises are situated , • , Does proposed construction violate any zoning law, ordinance or regulation; , , 13. Will lot be regraded .......:II... • , , , , , , , , , , , , , , , ,}gill excess fill be removed from premises: Yes No . I4. Name of Owner of premises . Address . Name of Architect . J/Rrft+4 • ar&Son . • • . • • • • • . Phone No. Name of Contractor . o Pr eMaw~ ' • • Address . . ,fa{c411"V. . Phone No.. I5. Is this property with n 1,300 feet of a tidal wetland?' . ....F PO% . Phone No..a:r~6; V *If yes, Southold Town Trustees Permit may be required. No......•., PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and blockinumber or description according to deed, and show street interior or corner lot names and indicate whether . i I I , ~I STATE OF NEW YORK yUNTY o• onpS S, S Name of individual signing being duly sworn, deposes and says that he is the applicant above named, contract) le is the % .....Pe.~ , .fhne.R. . (Contractor, agent, corporate officer, etc.) f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this nplication; that all statements contain;cd in this application are true to the best of his knowledge and belief; and that the ork will be performed in the manner set forth in the application filed therewith. worn to before me this dayof..l.(9 C}eyt,(w~ 19. g P otary Public, County g . . . LINDA J. COOPER . cant). f appli. NoNo~822663SSuffolk' uo Qy 4"1(t;n,3Iu*re'o* Term Tres December 31, [ _ 8, a A ' Y i U ~Y % r. %1.. ~J fJ r Y" I ZJ / I i 5Yr II V i• ~ ~ ' osl ~ ~ cv j • ,ter t VIA `~F~ p ~ ~ rte.. ^Sr ~r-,..; 1 •S x C~'.6~a 6; 'S tn~ $'?f>~S fJ~~O .'7 ,~.ilt «'t~•~~.. 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NOT RESPONSIBLE FOR' DESIGN OR CONSTRUCTIO_ hEflRORS i• • I PLUMBER CERTIFICATION EF7 ON LEAD, CONTENT BEFORE b "CERTIFICATE'OF'OCCUPANCY-- _ SOLDER USED IN WATER Elm ?rN is sra+w c SUPPLY SYSTEA CAA010T . EXCEED 2196 9 °/a L,EAd 1: PLUMBING, ~ EDwm ALL PLUMBING WASTE. ~w~tr & WATER LINES NEED. ' Iwo " w~.TESTING BEFORE COVERING I.3042 2D32- 7n/2 txe°-°Hafos'R'..G9Z. C Z 3Z4 w3mmAM!11011 e r If copper tubing is used - ~ oll~ I ~ ~ ~ ~rCR~e roc lbr d for water distributing , systanx piping shall be of'fypes K or L only - 1 T_ -II 40 GS FOR CAe' l k' 1 N u j P DE DrEllIN a X N _ ERGENCYESCArEAS n.= . REQ IREP BY PM 714 (p F ro 1 N.Y. SUT AYE WILDING CODE - ~orat stint I y.. .ha'p' oQ'P ID' "-'f LSE hTY1C_ J O .O a ` : td 3'2X -32X12GrR OER - - i - i24 %ZV ~i~ --.V-DR ";SfioRAC„~•, 06F Tv4"O 'I cU - _ _ ax 4' r tn1,C:E~YT'rX nP-. k v x 6 11 O IN I _¢N RAbE ? 8ET w'E.E M"-~ R's r' yr~~ r7a vl I1w Y,'' sue: Fua r9 WAL~5 1b L FgIy PRO IDEOPENINGS EN GENCY ESCAP Ti+ OCCUPANCY OR ' I REQ ED BY PART.7Q rArr7173Ma)oF 4, . USE IS UNLAWFUL „ N.Y. S ATE BUILDING C t~ SWIE Np101~0 000E. z4s~a. zas~u -30'42.-2 4 Z'~c.. ~ - ~ - i SCp= GovEF-El7 poecri X10.\ o~ $ CC SCp- \2m psi \,5 ~ 10~" PRC?- P;LV ni. Yet, H,IOU M.,':.. woo 0 A~PR~vw my; 4A b y j 41.0-040 W"7 -4AE ~ \tl'ti ; ~ sum ~ ~1 n okirwn ad ~ . 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JOI~7S l4. ~d~C fr<~(~~...U~art+a4+uc m± _ Q O . „ + EMERGENCY ESCAPE ASv., RhII. INS{` I A4,, P~-y r' N~ II i REQUIRED BY PART. 14q i I j _ - ~ . - N.r' BATE WIIDING~CODEj GNOF ~ 3A0.w ~L, DFGK 2 Xr,O,( r,JRJ_R /~8. C3P 86ETS'£r ~5.,! _ ~'1'e+c-d.ad RQA = ' .v~~L y+m~7r'c L.. qp,~„ 'YEN/nI~E SNrERp. ~ _ - ac. PIERS µ ls-a To, Z4t5(2' 1 !I - 3 _ - .a~ ra S~~r-,,.mow: fr~rus C' 7~ .O ~ S ,!?r MrY 7` t•`i'; U k5 K_ ~4' Y . DRAWN k 'y 4p. 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NUMBER ,t x.u ..m~4uirM0. ;obui - cod" Lote w to en"r gy : Calcul at i ons shown are to demonstratv compliance and arc. not to b" used for Selection on of heating system. SUMMARY OF TOTAL THERMAL RATING pr greater. the proposed 1s zero (O) En er Code. If the Total lhermal Rat e^9 elope complies with the 9Y design for the building TABLE THERMAL USED AREA U-VALUE RATING j ' C7 ~r-- A, ROOF/CEILING B. NET WALLS C. GLAZING _ Window Window "g, Yli9hts Sk p1, FLOORS 02• BASEMENT/CELLAR WALLS Feet Wall Perimeter Feet Exposure Above Grade Wall U-Value Depth of wall 0-Value Inches -SX Below Grade 03. SLAB INSULATION feet Slab Perimeter lue Insulation R-Value INFILTRATION CONTROL Sq. Ft. Conditioned floor Area F, SOUTH FACING GLAZING Percent South Glass/Total Glass Percent Area Sg, Ft. G1. Areal Gross Wall conditioned floor Area TOTAL THERMAL RATING is knowledge. 5~/r that to the best of tans are in o Engineer certifies these P The and professional judgement, Conservation Code belief, 4x - - C compliance with the New York, State Energy as amended effective 3/l/gll - ` c • To