HomeMy WebLinkAbout22422-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OC~3PANCY
No Z-24351 Date MAY 13, 1996
THIS CERTIFIES that the building
Location of Property EQUESTRIAN AVE.
House No.
County Tax Map No. 1000 Section 9 Block 4
Subdivision Filed Map No.
ADDITION & ALTERATION
FIBERS IBI~%ND, N.Y.
Street Hamlet
Lot 14.2
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 13, 1994 pursuant to which
Building Permit No. 22422-Z dated O~OHER 31, 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 ADDITIONS & ALTERATION TO EXISTING ONE FAMILY DWELLING
AS A~PLIED FOR.
The certificate is issued to
of the aforesaid building.
ET.T.mN HARVEY
(owner)
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-368326 -OCTOBER 30, 1995
PLUMBERS CERTIFICATION DATED SEPT. 7, 1995-F~%RIO ZANGMETTI, JR.
Rev. 1/81
I:O~M NO.3
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y.
N~ 22422
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNtiL FULL
COMPLETION OF THE WORK AUTHORIZED)
Permission Is hereby granted to:__ , , / ~, ~
......
~~ ....... ~~ ............ ~ ........... ~~~.~. ...........
CouniyTax Map No. 1000 Section ............ ~ ....... Block ....... ~ ........... LotNo ......~..,.~.,~,.~ .......
Building Inspector,
and approved by the
Rev. 8/30/80
BUILDING DEPARTMENT
~65-1802 ~---~BtD ~ :
G DEPI.
.jOWN OF
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 r~quirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
'!pre-existing" land uses:
I.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 theappl~cant.'
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
· ~ z7 z95
C ti Old P i ti ildi g ~ '
onstrsc on.... ....... Or re-ex s ng Bu n .............. ..
ltion of Property~ .................. Equestrian ~v~ Fishers Island~N.Y.
House No. Street Hamlet
~ Ellen Harvey
!r or Owners of Property ..................................................................
livision File~' Map Lot
~it No...~Z~.~. .Date Of Permit..~g~31/94 ..Applicant. Z&S Contractin~ Inc. '
~th Dept. Approval ......................... · Underwriters Approval .........................
sing Board Approval
est for: Temporary Certificate ........... Final Certicate..X
Submitted:' $...$.25. O0
.. ....
Co g 9'3J/' ' ............................ "
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR' '
P.O. BOX 728 '
TOWN HALL
SOUTHOLD, N.Y. 119';1
'CE,~T
I F 'I C A'T I'O N
TEL. 765-1802'
'Date
9/7/95
Building Permit No. 22422 Z
Owner Ellen Harvey
° (please print)'
Plumber Marlo Zanghetti Jr.
{please print)
I certify that the solder.used in the
· con~ains'l~ss than 2/10 of ~% lead.
w~ter
supply system
, Sworn to before me this,
', [~, ,day of _ ~ ,'i
"' ' ' ' 19h, ,~- ' -- . , , ~' - : Notary ~ublic
. ,~ ounty:' '..~
, -- EILEEN O. ~AAL~,
NOTA~RY-PUBflC, NEW YC~K STATE
- NO. 0~1WA9509~85
QUALIFIED IN SUFFO~L~.K ~COUNTY q
TERM EXPIRES OC"r~ ~ '.';- ?'~ ~.9 ~
FOUNDATION ( 1 st)
FOUNDATION (2nd)
ROUGH FRAME &
'.PLUMBING
INSULATION PER N. Y. ..
STATECODE ENERGY
FI~;AL
~BDITION~B
. .
pLUMB
ON LEAD
CEflTIFIC~
SOLD£~ USED IN WATER
SUPPL¥1S¥STEM CANNOT
EXCEED2/IO OF !% LEAD.
'R CERTIFICA rlON.
iTE OF OCCUPANCY
'~ PLUMBING
AU. PLUMBING WASTE
& ~TER LINES NEED
TESTING BEFORE COVERING
,,. 5o
REQUIR~.O ~ ~
//
~y, .73'~!
,-It
THE NEW YORK BOARD OF FIRE UNDERWRITERS 1
1~3~656
BUREAU OF ELECTRICITY
~- STREET, NEW YORK, NEW YORK 10038
85
JOHN
Date OC~O[~R ~ t ~995 ~pplication ~o.o./,~ ~7444795/95 N 368326
THI~ CERTIFIES THAT
o~y t~ el~trlcal ~aipment ~ ~serib~ be~w a~ int~uc~ by t~ appl~ant ~med on the a~ve ap~icatio~ nu tuber iR t~ prem~es of
in the follow~ng locatlon; ~ Basement ~ Ist FL ~ 2nd FL OUT Section Bilk Lot
~s examined on OC~OB~ 24, ~995 and found to be in compliance with the Na~onal Elect~cal Code.
FIXTURE FIXTURES RANGES C~KINGDECKS OVENS DISH WASHERS EXHAUST FANS
DRYERS ~RNACE MOTORS ~TURE A~UANCE ~E~RS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUT~T DIMMERS
~RVI~' DI~ONNECT ~. OF S E R V I C E
METER
M~ORS ~ 1-F H. P,
P.O. BOX 202
FIS~RS IS~, NY, 06390 ~N~AL ~AGER
This ceH;ficate 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 COPY0 ~'E" A
~ ---..,.-..~: .... F CERTIFICATE MUST~NOT~ BE~ AL ED N NY MANNER ·
TOWN IIALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Disapproved a/c ' '
APPLICATION FOR BUILDING PERMIT
BOARD OF I|E^LTII ...... , . .
3 SETS OF PL,,'~{S ..........
SURVEY ...................
CIIECK ....................
SEPTIC F 0 R,'l ..............
I;OT I FY I
CALl ....................
HAIL TO:
D~lte ........... ,
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to tire Building Inspector, with 3
.ets o( plansv ac~ur~tte plot plan to Scale. Fee according to schedule.
b. Plot I~lan showing location of lot and of buildings on prmmses, relat'o ~sh'p to adjoining premises or public streets
~r areas, and {giving a det~led description of layout of property must be drawn on the diagram which is part of this appH-
:ation.
c; Tl~e wo~k covered by tiffs application may not be c$mmenced before issuance of Bulhling Permit.
d. Upon approval of th's apphcation, the Buihli,g Inspector will issued'a Building Permit to the applicant. Such permit
.ball be kept on the premises available for inspection throughout the work.
.e. No bnilding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occup~cy
hall have been granted b~ the Building Inspector.
;'. APPLICATION IS IIEREBY MADE to tile Iluihling Departmeut for the issuance of n Building P0~it pursuant to the
lutldlng Zone Ordinance of the To~n of Sontbokl, Suffolk County, New York, and other applicable ~ws, Ord~ces or
(egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
Elm applicant agrees to comply with a~ applicable laws, ordinances, budding code, housing code, and regulaQon., and to
~dmit authorized inspectors on premises and in bnilding for necessa~ inspections.
..... ....... .... '...
' · (Signatnre of applicat~or name, if a corporation)
. , (Mailing address of applicant)
Slate whether applicant is owner, lessee, agent, a~cbitect, engineer, general contractor, electrician, plumber or builder.
............ . . ...................... .; ......................
[[ ' (as dn the t:~ roll or latest deed)
If applicant is a corporation, signature of dnly authorized officer.
{ r~ (Na~and title of corporate officer)
,,,i,a~r'~ u~,,,~ .o./~f4.. ~ .........
Plumber's License NO ................
[~ Electuc~an s L~cense No ................. , · · ·
Otber'Trade's Lken{e No. ~ ~/~
Localion dF land o~ wblch proposed work will be done, ,' ...... ~ ............ ' .........................
I Ionse Nlllllber Street I lamlet
"' '[o,
C tY T' M No.'1000 '
onn dx ap Sechon ............... Block ................ · .....' ''
· ' · ' Filed Map No .... ~ 5.. Lot
~t{bd~vls~on ........ , .................................... "'-'" · ' ..............
(Name) '~ -
State existing t~se hud ocenpancy of premises and intended nse and occupancy of proposed construction:
a. Existing nsc and occupancy ......... .~ ...................................................
b, Intended use and occupancy ........................................................
3. Nal.reo£w'ork,(cileekwhlch.p,ll~n~e) N w I lng , . AddHIon
' ' ' ',· ......... Demolihon .............. Oilier Work ...............
Estimated Cost ~,~ ~ ~ (Description)
' (roi t idon~liJ&fthls pplicat' n)
ffdwelling tuber I
, nu o~ dwelling uni(s ...... Number or d ~11'~ g umts on each floor
l[garage~ numb r QfC ......... w
Dim nsion~ 01 e~lstmg stmctu r-.,--,~, spechy nature m,d exlent or each type o~ usa ....
e ' ' ' re~,ffjany: Front ................. ' .........
.... Rear ........ Depth ...............
~ight ..... Nora bar 1o~ Stories
um~enstOns ot same structure with ~llarntions or nddilions: FrOnt ................ Rear ................
.......................................... Nmnbar of ~lories ..............
Dimensions o~ entire new constrtlctlbn: Front .......
]leight ~'.. Number ~f Stories ............... Rear ............... Depth .............
Size o~ lot: ............ ' ...............
Front ~ .......................................
Date o[ Purchase .............. i ........ Rear ...................... Depth .. ...................
Zone or u~e district iu which preluJS~s nra s~tualed ...........................
Does proposed construction violale ny ,orang law, ordinance or re~ulntlo.: ..... ~ ............ , ..............
Will lot bb regraded ............ I .........
~ Ow ~ P [ ....... Will excess ~11 be removed ~rom premises Yes No
Name o net o remJses ........... o.
........ Address ................... Phone N ...............
Name of Architect
.......................... Address ................... Phone No ................
Name of Contractor ............ j ............. Address .................. Pho~N,o., ........ '... .....
1a th~s ~r~per:y wt~htn 300 rgee~ of ~ ~cn~ well,nd? *Yea ........
~.lf yes, Soutbold Town~ Trustees Permit may be required.
,,' ~ P LOT DI AG RAM ::
Locate clearly and distinctly,MI bt ild ngs, whether existing or proposed, and. indicate all set-back dimensions from
'oper/y ,tines. Give street and block hum ~er or desertptio~ according to deed, a~ld show streat n~nes and indicate whether
terior or corner lot.
. '
FO~.LOWJNG INSPECTIONS:
't, FOUNDATION '~O REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. H~SULATION
4, FINAL CONSTRUCTION MUST
BE COMPLETE FOR ~O,
ALL CONSTRUCTION SHA~
TME REQUIREMENTS OF THE
STATE CONSTRUCTION & ENERGY
CODES, N~ RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
ATE OF NEW YOP, K, S.S
UNTY OF . . . ..............
..... .
. . .......... ~ ............... being duly sworn, deposes and says that h~ I$ th~ applicant
(Nam~ of Ind~Hdual slgnin~ cohtracO
~ve named.'
is the .......... ~ ....................................................................
: i (Contractor, agent, corporate officer, etc.)
sa~d owner or owners, and is duly aut ~or zed to perform or have performed the said work and to make and file this
~lication: that aH statements contained In this nppliention are true to the best of his knowledge and belief; and that the
rk will be perfonped in tho m~ner s~th In the application filed therewith. '
,om Io bcfor~his
..,