HomeMy WebLinkAbout22371-z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24573 Date August 15, 1996
THIS CERTIFIES that the building alteration
Location of Property 1480 Factory Avenue Mattituck
House No. Street Hamlet
County Tax Map No. 1000 Section 142 Block 1 Lot -4
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated September 21, 1994 pursuant to which
Building Permit No. 22371-Z dated October 12, 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 2nd story alteration and roof addition to existing one family
dwelling as applied for.
The certificate is issued to Robert H. Krudop
(owner, lessee or tenant)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. H 051022 dated July 19, 1996
PLUMBERS CERTIFICATION DATED August 14, 1996
Bu' ding inspector
Rev. 1/81
FORM NOA
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN MU
SOUTHOLD, MY
BUILDING PERMIT
(THIS PERMIT MUST B-CE p 4p( E,R _~Ivi1l' FULL
COMPLETION OF THE 1VW&"T6THORiZEDY
. _ Date 19. 9V
N2 22371 Z
I
Permission Is hereby granted?
o
fi.........~..~...........
to ...per.. .4-....Q s° ~-44.
,~f~.o ~ fiA/~..... e.........
.
at premises located at .............../..~C
County Tax Map No. 1000 Section Block Lot No. .
pursuant to application dated . A.C 19.. ?.K and approved by the
Building Inspector,
Fee $....Aa).,..4
Building spector
Rev. 6!30/80
~IzrL
! Form No. 6
rye 2C1 S - 65~
TOWN OF
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 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.
f 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 - .25i~,
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
L
Da
New Construction............ old 0 re-existing Bui£ldin
Location of Property ...1ufJ.G v c~.........4 ~P ifv
House No~ Stree Hamlet
Onwer or Owners of Property ...:?c..l`!l/!
County Tax Map No 1000, Section ...J4'_'.......Block...... I ..........Lot.... . 1~
Subdivision .Q~.(J ..................................Filed Map............ //Loo/jJ_
Permit No..:~W;3.? ......Date 1~O +f Permit Applicant...l,l .
Health Dept. Approval..........! ( .............Underwriters
Planning Board Approval...... N.JP,+............
Request for: Temporary Certificate........... Final Certicate...........
Fee Submitted: 7:~U
lec.
~ A PN L
3 T
t~~ • -Zy57 T N
Town Hall, 53095 Main Road ,°n 4 Fax (516) 765-1823
P. O. Box 1179 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
DATE :
Buildin Permit No.~ i
Owner: ObQ,A N J~
(please print) 1_^
Plumber: ~CLA k- rvd
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
Plumbers S' nature)
Sworn to before me this
day of v 19~
Notary Public, County
CLAIRE L. GLEW
Notary Public. State of New York
i No.4879505
1 Qualified in Suffcik County
ComrMesion Expires ecem e ,
APPROAS NOTED
DATE: ~ B.P # .~7/
FEE: /b. t:5 By:
NOTIFY BUILDING DEPA E
766-1802 9 AM TO A FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE "
2. ROUGH - FRAMING & PLUMBING
3 INSULATION
4 FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION 8o ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS /r
' G.7oek ~c-~ ~I~~,
leek C-01
i
,
I
r
I' 1t
OCCUPANCY OR
USE IS UNLAWFUL UNIIER~NR CERTIFICATE
CERTIFICATE REQUIRED
OF OCCUPANCY
`l MEIN
LUl!> RFR CERTIF'ICATI ALL PLUMBING WASTE
& WATER LINES NEED
ON LEAD CONTENT RE FOR I--- ~ TES f~G BEFORE COVERING
CERTIFICATE OF OCCUPANCY
If copper tubing is used f ~
E S®L®FR USED IN 4~ATET? for water distributing 1(4160 taca`y ,
SUPPLY SYSMAl CIA,AfN0T system: piping snail be
LA of types K or-- - - °Y
EXCEED 2110 of 1 % LEA
1
f
a--
i
i
I
f
i
i
i
M
f
t S
1 ~
E
7-4
J
i
Ir
_ - t Ce
°'^a~
C '~J
i
t
k
e
a
alt ~~c~: ~ ~~~a
Ll
M
j
i
V
i
I
r
I
E ove,
may..
f \
i
E
9
f y
o~~ 1
Inge ~
Y ? t 3
6 8 F ~ , Y
s
E
kz~
1 v RX'10 of) c -
E }T- fp~~~f ~
S~
f a room /Y
J,
x
4
F
r
'I
k
F
.1~ , ,
v car toils Weky
i
2x~
-7X ~P'u`tCa (~7
1
Ik ~~x~ ' 1 1 1 ( 1 1 1 1 ~ i ~ Y r Y Y Y ~ i ~ Y ~
f ~itr('sl~~e.
s
k
two bowlayk.
Se-ecr~c) (cc r-- arrcv~
• ~ ^•E ~I .CONMLNTS "~r
II b
111DATION y
_ (1st)
114DATI0t7 _ y \
(2nd) m
Q
GH FRAME &
-PLUMBjN
H
UL:,TIO;I PER N. Y. V2
II y
STATE EFIERGY Ii t
CODE 3 C
m
• c H
FINAL
ADDITIONAL C01.1-MENTS: m
' x
H
' H
H
m
;:•A"+}-r:-••y;.. _.r•'sa.+.ae~.w:. w+'a-.,ter r'v si: •..;_a.:, H ..Y...1m,,a..
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ RO H PLBG.
FOUNDATION 2ND [ INSULATION
[ ] FRAMING [ ] FINAL
RE RKS:
C
1442
v
DATE L L ,~_INSPECTOR G7~ .
tO2
BUILDING DEPT.
_ ItiNP-0 CTI-ON
t _ [ ] VNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
FRAMING [ ] FINAL
ri
REM RKS:
a
l i
cyle
f 7 p c
DATE ! r S INSPECTOR
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ el"FINAL
[ ] FIREPLACES CHIMNEY
REMARKS:
DATE INSPECTOR
?1-,t-
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING FINAL
REMARKS:
DATE 0'~ INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ) INSU TION
[ ] FRAMING [ FINAL
[ ] FIREPLACES CHIMNEY
REMARKS:
DATE 1 INSPECTOR
2
z2 3
/L/7--1-4
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
r8051827 BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NY 10038
11 ',4)ate, JULY 1.9,1996 Application No. onfile 86918295/95 H 051022
THIS CERTIFIES THAT PERMIT NO, 22371Z
only the electrical equipment a r described below and introduced by the applicant named on the above application number in the premises of
ROBERT & KELLY KNOOP, 1480 FACTORY AVE., HATTITUCK, N.Y.
in thefollowing location; ? Basement L.G. Ist FL ® 2nd Fl. OUT Section Block Lot
was examined on JULY 16 , 1996 and found to be in compliance with the National Electrical Code.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS RECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT K W. AMT. K W AMT. KW. AMT K W AMT. H.P
32 42 30 32 1 8.6 1 1.2 1 F
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'?T TIME CLOCKS EEII UNIT HEATERS MULTI-OUTLET DIMMERS
AML. K. W. Oil H. P. GAS H. P. AMT. NO. A. W. G. AMi AMP. AMT. AMPS. 7RANS. AMT. H. P. SYSTEMS AMT. WATTS
I NO. OF FEET
2
j SERVICE DISCONNECT NO. OF S E R V I C E
AMT. AMP. TYPE METER I ' 2W i 6 3W 3 X 3W 30 4W NO. OF CC. COND A. W G. NO. OF HI-LEG NO Of NEVTRAl1 A. W. G.
EQUIP. PERe Of CC. CONO Of HbLEG OF NEUTRAL
I
OTHER APPARATUS:
PADDLE FAN-1
MOTORSt1-F H.P.
SMOKE DETECTORI-2
TRACK LIGHTINGt-32
I
i,
G -
ROBERT KNOOP
1480 FACTORY AVE. GENERAL MANAGER
P.O.BOX 1042
l MATTITUCK, NY, 11952 z, Per
it t~~7-
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.
D R f7n R Ilp R BOARD OF HEALTH
L5 UU lS V L5 FORM NO.1 - 3 SETS OF PLANS •
TOWN OFSOUTHOLD `SURVEY
j„1 . 1198A _ i BUILDING DEPARTMENT `CHECK
TOWN HALL SEPTIC FORK
BLDG, DEPT. SOUTHOLD, N.Y. 11971
TOWN OFSOUTI10L0 TEL.: 765-1802 1:DT IPY iq
CALL r
Examined l0l,l2 19 q.~J</ MAIL TO: ~)n - (Q (0 0 6 L.,ML
Approved Id/y , 19l~ermit No. 45.2.°~ 37I'
.
Disapproved a/c .
(Building Inspector)
A P [CATION FOR BUILDING PERMIT
Date.... I........ 19C?I
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, o sing de d gulations, and to
admit authorized inspectors on-premises and in building for necessar y inspections.
(Signature of applicant, or ame, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
1.................,...................................
Name of owner of premises ~G1~1. !
V(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 .
Plumber's License No.
Electrician's License No .
Other Trade's License No .
1. Location of land on which proposed work will be done.
! C~c [ fl~~ .
House Number Stree Hamlet
County Tax Map No. 1000 Section Block ...0.1........... Lot... ®u
Subdivision . Filed Map No. Lot
(Name)
2. 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 ,k.~r.". ::`e,:,. • "sa{ .
~ e~'~s.33t4b~i... 5"YU Poe[tts 3dr.3L1!?Iii4fiSe2
3. Nature of work (check which applicable): New Building Addition Alteration Y.... .
Repair Removal , , , Demolition , Other W.'... .
(Description)
c~ y-
4. Estimated Cost UA..... I'C.J..~J. , Fee .
(to be paid on filing this application)
S. If dwelling, number of ca dwelling units Number of dwelling units on each floor , .
If garage, number 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 of Stories .
Dimensions of same structure with alterations or additions: Front Rear
Depth Height a. , , Number pf Stories . . .
8. Dimensions of en ire new construction: Front Rear I i? ; Depth .
Height Number of Stories
.
9. Size of lot: Front Rear Depth
10. Date of Purchase . Name of Former Owner .
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 .y............. . Will excess fill be re oved from premises: Yes No
14. Name of Owner of premises Uia4. !k"),r........ Address F°0r-q /A;4ftone No. ?r7i'-/a~3( .
Name of Architect , Address . Phone No............... .
Name of Contractor . . Address Phone No.
15. Is this property within 300
feet of a tidal wetland? ~cyes,,,,,,,, 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.
E1470
i
d
i
TATE OF NFL I?0
,1 FQ .
s.s I'I
OUNT;OF .
• • • • • ' 1•~ K~V•~ • • • • • . • • being duly sworn, deposes and says that he is the applicant
(Name of individual sin Contract)
above named.
He is the .............~l 4uP Q ? I. .
(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'i forth in the ap lication filed therewith.
Sworn to before me his
...........v\ 5 q
.day of . .
Notary Public . . . , I,... , , ounty
Not rV PublIC8t ~e~of ewN York . . . .
QuaIMW In Suffolk Cou ignature of applicant)
Commleclon Explree December $,19