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HomeMy WebLinkAbout22401-z x k FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23593 Date APRIL 10, 1995 THIS CERTIFIES that the building NEW DWELLING Location of Property 250 KENNY'S ROAD `SOUTHOLD NY House No. Street Hamlet, County Tax Map No. 1000 Section 59 Block 3 Lot 18 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building.Permit heretofore filed in this office dated OCTOBER 4, 1994 pursuant to which Building Permit No. 22401-Z dated OCTOBER 21, 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 A ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to THOMAS & NOREEN HAMLIN (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL-RIO-94-0080 APRIL 4, 1995 UNDERWRITERS CERTIFICATE NO. N345564 MARCH 16, 1995 PLUMBERS CERTIFICATION DATED NOVEMBER 15, 1994 BERTSAND PLUMB & HEAT t Building Inspector Rev. 1/81 I 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 ....C~[../ 19`..'.. N® 22401 Z g Permission Is hereby granted to: t ? . ,I i Ole, to......... ~G..C:~.•. •.••.....,.r.Kr...~~a..+.... r at premises located at..........1C2,6.C) 1 <t~~S/.......ER X. k . M. County Tax Map No. 1000 Section ~r........ Block .....a Lot No. pursuant to application dated 19.... and approved by the F Building Inspector f Fee $..Tt~.. . •....ii5............. i Building Inspe r Rev. 6/30/80 7r Date November 15, 1994 Building Department Town of Southold Town Hall Southold, New York 11971 Re: Building Permit No Owner: YAXt)- C SAS ; t,e,nµ,~os .4 D S P.t,Qo p..ctIC5) Gentlemen: I hereby certify that the solder used in the water supply system for the captioned job contains less than 2/10 of 1% lead. Very truly yours, BERTSAND PLUMBING AND HEATING By sworn to before me this 15th day of NOV.mb n 1994. o ary u is APR - 5 1995 EILEEN M. ROACHE Notary Publi 4 tats of New York Qualified in Suffolk county Commission Expires January 31,15 r ~6 2-3 FORM NO. 6 TOWN OF SOUTHOLD A - Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted = 0. 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: 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 5.Updated C-0. $ 50.00 Date Marcb.29,..1Si95...... NewConstruction.A Old or Pre-existing Building Vacant Land Location of Property 250 Kennys Road Southold House No. Street Namlet Owner or Owners of Property Mr.-. Mrs... ThproaS. Nparp-pp. liwlia... formerly Theophilos & Spyropoulos) County Tax Map No. 1000 Section 59........... Block Lot ......l$ Subdivision QWQ4 k0 .R4gPEtrt:Y...... Filed Map No. ..........Lot No . Permit No. 22 O1Z Date of Permit 10/21/94 .Applicant East Isle Custom Builders, Inc. . Health Dept. Approval ..R1Q-~4-QQ$Q ...........Labor Dept. Approval Underwriters Approval ......N3145,5A4 , , , , , , , , , . ,Planning Board Approval Request for Temporary Certificate .....................Final Certificate X......... Fee Submitted $ ...25 . . ble odes and re ulations. Construction on above described building and Pichard eels 1 p lica ~ Applicant . Oppedi a President n.v. 10.10.78 EAST ISLE CUSTO ILDERS, INC. R&VP 49303 i Co~~a3593 46161AIIIAMI 110 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1035018 BUREAU OF ELECTRICITY F 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date MARCH 16,1995 Application No. on file 86444594/94 N 345564 THIS CERTIFIES THAT only the electrical equipment as described belon, and introduced by the applicant named on the above application number in the premises of HAMLIN, E/S KENNYS ROAD, 170'N/0 MIDDLE RD. JOB#178, SOUTHOLD, N.Y. in thefollowinR location; MI Basement Q Ise Fl. ? 2nd Ft. ATTIC/OUT Section Block Lot uws examined on MARCH 13 , 1995 and found to be in compliance with the National Electrical Code. FIXTURE SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLET ECEPTACLES S INCANDESCENT FLUORESCENT OTHER AMT. K. W. AMT. K. W. AMT. K.W. AMT K. W T. N. P. 10 28 16 10 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALREC'PT 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 NO. OF FEEL AMT. WAITS 1 F 2 _ SERVICE DISCONNECT NO. OF S E R V _I C E METER NO.OF CC COND. q. W.O. AMT, AMP. TYPE EQUIP. =03W S X AW POF CC. COND. NO. OF HbA' W' G• NO. OF NEUTRAl3 AW G. OF NILEO OF NEUTRAL 1 100 CB 1 1 4 1 4 OTHER APPARATUS: - MOTORS:2-F H.P. G.F.C.I;-2 SMOKE DETECTORt-1 PETER CHARBONNEAU LIC.#2697-E 35 SHEPPARD LANE SMITHTOWN, NY, 11787 GENERAL MANAG R = 11 Per _ _ This certificate must not be altered in any manner; return to the office of the Hoard if incorrect. Inspectors may be identified by their credentials. APR - 51995 p ~ _r Tol, I 1 I~Jhlu II _..L~ -.n :~Y~r~ .n_~ ..._v... i;ONMLNTE 11DATI0N '(1st) - y JDATIOII c (2nd) d) cli FRAME Y ".,a d'`• Vii' / y 'LGTI0J1 PER N. Y. I _ m y._ STATE ENERGY CODE FZIJAL I~L7 - a ADDITIONAL Cm 9~ ~ x H 9 tx. jV 'L.i~~y'...LY111 ~,...~YL'•_.~r~ L•..•I l.~y'_3 Q~•. +l"~ i , i • • - .r ~ N.~ 'I 19 Willetts Avenue Sayville, New York 11782 (516) 567-0542 U'I nbc, ~l'~~S W~6~ tn.str re n 4NJ. -4:r_ \/iw. 4,~,Ue, c~(uPAOV\. t ~ ee, ~C> i,e~+n'Ota~` w1e. ra'C3 ivy ©T4 , r..t: - aL 'M 516 727 3411 P01 F A X T R A N S M I T T A L 73 DATE: _ TO, c FROM C-P SyrZS ~G L'P S~rnt~rJ~- cMIeprn: v n 'U ii- I v S -41•p-4 x ,J Y J Y m i s W Z .i ~ 2 c-~ ~ ~ LL H ^tl ~ ~ rL 90 zzZ rrr~1133 L! ~ It 10 .a Rod AL I y w A V ~ j ~ ~J ~.tl tl pv VhVj jtl f~ ae a@9~ N ~ti o y "1~ la tli'(~B @ M W.2 O tl E • 6 °3 p J M it V; ha~hQh ZOd TTfiC LZ2731s $ M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ( FINAL REMARKS: /-I-)~ r DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ( 1, ROUGH PLBG. [ , ] FOUNDATION 2ND [ INS TION FRAMING [ FINAL REMARKS: ' EJI~I`~/!~X/_Q //Y...fw/~%~.//Care" b~/"7/?P,f~ DATE INSPECTOR 7FF G . 765.1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ) ~ROUGBG. FOUNDATION 2ND t INSULATION [ ] FRAMING t ] FINAL REMARKS: i l f DATE f - J INSPECTOR 765-1882 BUILDING DEPT. INSPECTIO [ ] FOUNDATION 1ST ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: P 1 I ' 4 1 1 II{tF[4 DATE W10A7 INSPECTO M-1802 BUILDING DEPT. INSPECTION CH PLBG. [ ]FOUNDATION 1ST ( /'IJ [ ] FOUNDATION 2ND [ LAT ION [ ] FRAMING [ ] FINAL REMARKS: aAl i l E i f E DATE INSPECTOR 765-lW2 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ OUGH . J FOUNDATION 2ND NSULATION [ ] FRAMING FINAL REMARK : V L" i i i ' r DATE INSPECT _ I M-lW2 BUILDING DEPT. I NSPECTIO [ ] FOUNDATION 1ST ( ROUGH PLBG. 'j/FOUNDATION 2ND [ ] INSULATION [r a FRAMING [ ] FINAL REMARKS: i l t i r I DATEOZ INSPECTOR 765-1602 BUILDING DEPT. INSPECTION [ ] FOU TION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING- [ ] FINAL REMARKS: f G { I DATE .Z INSPECTO M-1802 BUILDING DEPT. INSPECTION [ FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: f p i kE 1 I i DATE ~ S INSPECTOR S~' - 3 ~ $ z2 l~ ~ 23s~ THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1035018 BUREAU OF ELECTRICITY I 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date MARCH 16,1995 Application No. on file 86444594/94 N 345564 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 HAMLIN, EIS KENNY1I7~S~ ROAD, 170''}N/O MIDDLE RD. JOB#178, SOUTH.OLD, N.Y. in lhefoltowinq hRCation•L'1 Basement ry L'J let Fl. ? 2nd F'1. ATTIC/UUT Section Block Lot wosexaminedon MARCH 13, 1995 andfound 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 qmT K. W. AMT. H P 10 28 16 10 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECiT •7IMECLOCKS BELL UNITHEATERS MULTI-OUTLET DIMMERS AMT. K. W it H. P. GAS H. P. AMT NO. A. W G AMT. AMP. AMT. AMPS TRANS. AMT. H. P SYSTEMS AMT. WATTS NO.OF FEET 1 F 2 - SERVICE DISCONNECT NO.OF 5 E - R - Y - 1 - - C E - - - - I METER 1,92W 1.93W 309 3.94W NO. OF CC COND. A.W G. NO OF HHEG A W.G NO.OF NEUTRAI$ A.W r' AMT. AMP. rypE EQUIP. PER0 OF CC. COND. OF H4LEG OF NEUTRAL 4 1 10V7 CB 1 X 1 4 1 4 07HER APPARATUS: f MOTORS12-F H.P. G.F.C.IE-2 SMOKE DETECTORt-1 i r 4 p PETER CHARBONNEAU LIC.#2697-E 35 SHEPPARD LANE SMITHTOWN, NY, 11787 GENERAL MANAGER 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 13UILDING DEPARTMENT. THIS COPY OF CRP«TlF9CATE,M!,JST NOT BE ALTERE_D.IMANY MANNER, y BOARD OF HEALTH Ihpj j~ FORM NO.1 ] SETS OF PL.171S i 11 V1 TOWN OFSOUTHOLD SURVEY BUILDING DEPARTMENT • ClIccr • • • • • • - • • . OCT - 4 W TOWN HALL SEPTIC FORA _ SOUTHOLD, N.Y. 11971 pp TEL.: 765-1802 1:071 FY i 7 = / Examinedo~ r 19J CALL fS~! (l k621-3 . , , , . . MAIL TO: Approved ~ Ot9rPermit Nod;,Ze%5/n~ Disapproved, a/c ; Quilding Inspector) AP LI ATION FOR BUILDING PERMIT i 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,aecurate 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 inspections. _ r}rjT ~SGE GS ~~z ~~~G?c7LS ` . (Signature of applicant, 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 kp. ~~I~LU~o~e1 oS (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer RL~etA-a~ Of~~f'015,4A)0- ' .J>? 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..... D4 /..C ivy,, V~ . u ti4bG`~ House Number Street Hamlet q County Tax Map No. 1000 Section ~...:5./........:.. Block ..3 Lot.. Subdivisions G`?C: ~?CN-T Piled Map No . Lot . Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy G Q b. Intended use and occupancy 65,>~cL.?Ozc,• d QLLCloGGj;~:/~ j ~y?.G which 3. Nature of work (check which applicable): New Building x ' . , Removal Addition Alteration . , Demolition . Other Work , 41 4. Estimated Cost ~ „ (Dcscriptio Fee S. If dwelling, number of dweil'iing units 3. (to be paid on filing this application) , If garage, number of cars Number of dwelling units on each floor . 6. If business; commercial or mixe .d..occupancy, specify nature and extent of each type of use g existing Nures,ifany: Front Rear Hei ht umber of Stories , , , • • , Depth . Dimensrons of same structurt with alterations or additions: Front ~ • • ~ • • ~ • ~ ' ' Depth . i Height . Rear 8. Dimensions of entire new construction: Front . ; • ' . ' , • • NumberyI Stories . .Height Number of Stories . Rear `r S~ . , , , , , ,Depth . . 9. Size of lot: Front. ; 10. Date of Purchase Rear l ~?9• . , • , . Depth 3. s 3 ' • ' It. Zone or use district is which premises are situated . Name of Former O rAr 12. Does proposed construction violate any zoning law, ordinance or regulation: . 13. Will lot be regraded . yt~. . 0 . Y 14. Name of Owner of emisesTo N ~aS . ' ' ' • • Will exc ss fill be removed from remises: Yes pp{{ P. f AddressG 4 cA r-.-s . Phone No. Z?7-~o?3 Name of Architect's ~t+!IR~ uS~G ~~ptnSKi ` Name of Contractor ~~,i{5% lScE 5 1~JLg' Address 9?,,-iJt12Ni , Phone No..7?7-,G, o~2 " Ad I ess Phone No. 7 ?,7• ; ?3 15.' Is this. property within' 300 feet of a tidal wetland? *yeS•...*'...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 fro property lines. Give street and block number or description according to deed, and show street names and indicate wheth interior or corner lot. ;TATE OF NEW YORK :OU Y OF 6 . S ............K.... +S (Name of individual si 0. ' ' ' • . • • • being duly sworn, deposes and says that h g g contract) he is the applicant hove named. eis the .8 ..4P~b- (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this 'plication; that all statements contain4d 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. vom to before me is v\. 10 day of..t• 19 ,tary Public, ' County CLAIRE L, GLEWS Notary Public, State of Now York No.4$79505 ~ l cl1/I r~P5,4 rill . (Signature of applican icant) mCIon Eli SuD ce Count CO b ` 8, 78.. ti ? 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Q n z ~ A U a 2 N " o r Tm ti `-ate a ~1 Z ~ 3 ya3 '`~vry y'F F ~ ~ m m O g c: z o 0 y~ 0 Z :GU a m nt O h (11 N ~A z O - ro ~ ro Z •j N /m W Z o a c c Odd l~ a s a e^ a / ~~.bo ~/N x~ ~ ~ Q NZ ~ tl ~~gnN 4 rq y^ ~f th 3 a ( N W ~t Q\ n m ~ f~ Z W f3 C, e, AUG 10 1994 V ~ cn ~ ~ d a S.G. DEPT. OF ° ° HEALTH SLRkflr lb Min, f", (7% rl 71 s 11 ~ CSC p p Q D a m A.'~ Q Q,'a as Z a 3 3 m f ._r..r C7 m'N s r L M-0 0 °F co s N 'k olm c°~ d 0 o ~ v0 L 4 s Y ~.0 8 Y n 2%'L9l \ as v F °p : !r t~ N ( N AZI Os ?~C~ ~ o_ GL agd a o p m t M Z ~ C as o U Z r y cl o v'~~ Nd ti < r A' ~ ~c ag N 0 I1~ Z, o ~a 77- i' APP VED AS NOTED / DATE: B•P 2~[~ FEE BY: NOT V BUILDING OE <-c~.1T n1 "o vs (zlayE VEL-~T'---~~ ~ZKO"MW . 765-1802 9 AM TO 4 FOR THE _ FOLLOWING INSPECTIONS: - 1. FOUNDATION - TWO REQUIRED P" „ FOR POURM CONCRETE - z ~'tV!BING Zqo *E As.pF1k~T - l~b jr.r.. 4 0- ~~o•L ena19T _ ~C ~ F~Li. bNALL. MEET Ti -•.'q OF THE NY ENERGY --,?-I SIBL FOR ".7, ERRORS H~ 17-1, VItiYL- a" tii" 4ti" Z7 CCUPANCY OR w UqP B3 U LA ~Ir vt"'yA- SIDIW6 - %JUL ~v wlu+~w q~q `W THOUT CERMFICAT rF ANCY- s-r,4e 24" 12° 34r ~'°i i PLUMBER UMBER CERTIFICATION If copper tubing Is used f 13'7J' ON LEAD CONTENT BEFORE for water distributing system; piping shell be CERTIFICATE OF OCCUPANCY of types K or L only SOLDER USED IN WATER rNjcJS wztntnt veuT SUPPLY SYSTEM CANNOT EXCEED 2110 of 1 % LEAD. r 12 `r4.S I - 24a ASP Hr, T` - PLUMBING UNDERWRITERS CERNRCA ALL PLUMBING WASTE REQUIRED WATER LINES NEED TESTING BEFORE COVERING - 1-- 26P• DO NOT PROCEED Hill - UNTIL 2nd SURVEY OF FOUNDATION LOCATION T ° o sraw~ ~ 36 ~L fi HAS BEEN APPROVED r, 1 _ 1ftl-1Y4 SLVw4 ..j ,loft „ I 4~ Qr, 1 I II I 2R ii MP- w~L1 8 ~I t-r ~ lu( MYER Fo , 3~ 5'Tm~E. v~ -46 pp Lq~ o~ d- 1 x , 2- „ I T_ ! al gyp. c.. OA S G' b , .Q ' w - q i I I c- F:C.o-r?- 9~ I n._. S" x eo" 'p- C- • V4I4LL.6 &~r.i I(,"K A" P-c- - ~ f t 9' f ~ ~ 3s IraT'mea7- Co 2-7 s LA _ , I