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HomeMy WebLinkAbout22170-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24089 Date DECEMBER 21, 1995 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 10007 NORTH BAYVIEW ROAD SOUTHOLD NY House No. Street Hamlet County Tax Map No. 1000 Section 79 Block 5 Lot 21 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 22, 1994 pursuant to which Building Permit No. 22170-Z dated JULY 7, 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 GARAGE AS APPLIED FOR. The certificate is issued to GEORGE J. BERRY JR. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-94-0044 12/14/95 UNDERWRITERS CERTIFICATE NO. N371988 DECEMBER 4, 1995 PLUMBERS CERTIFICATION DATED DECEMBER 20, 1995 PECONIC PLUMBING & HEAT uilding Inspe or 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 E COMPLETION OF THE WORK AUTHORIZED) 19.. Date N_° 22170 Z 4 f Permission Is hereby granted to: ~~r......... . .........-e..........r.~?r......... to .~~i. c ..........:..!..r~'~ ~ ............/s........~~v........~• I................. ~ ;I ~ ............../~!.....~<S/frFi~. I at premises located at......../••ag I`vL County Tax Map No. 1000 Section.... Block Lot No. .5 L pursuant to application dated L.................,,., 19....1..I., and approved bythe Building Inspector. I Fee$ I G Building Inspector i Rev. 6/30/80 l Form No. 6 'ZCsS-4f t-o3 TOWN OF SOUTHOLD JJJJ ` 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. 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 4pre-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 Buildine - $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 New Construction........... Old Or Pre-existing Building . . Location of Property... 1Q.oo.3.....:.... IrJ.1s~~r ..P"........`~Q House No. Street Hamlet Onwer or Owners of Property..la~.~e_•v:...'a ~j County Tax Map No 1000, Section... Block d.4......... Lot.... Subdivision Fil~e{d Map............ Lot...................... Permit No l-) Date Of Permit...?/.7/./7./.....Applicant Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval / Request for: Temporary Certificate........... Final Certicate....,,!`...... r 'UO Fee Submitted: $..~J....• PLICANT Town Hall, 53095 Main Road ; mz 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: t•~ ~ Building Permit No. KC200% Owner: TOWN F.SpEr3r (pleas print) ~ P7ucrher: Peropli(° i lu-Vt1 r-', (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. ( um s ignatur Sworn to before me this n~ day of 19 BARBARA STEPNowS t Notary Public, Biala of New York Notary Public, No.o1Suffolk ~Tp County ClualiGedinSullolk Co uMy ~ Commission Expires Seq. 30,19) N !n ry i O Q i N F COC M ~ = w W ; tl ) 00 N C W W 00 $ s + a M _ ~WZ W g u w z m f~ S O_ a ~ 3 WY ~ E W 2 im O _ $ d~ n a - - z "I - 9 M Y N 3 {°u~ y ius ~FF g t JC t"'I a Z 6 > 0 Y O ccc,041 5' S~ Q W o i 0 3 zzq Cod~ a do U. a W r~ aC c g`s et au W o 11 0~ W O rb S I S N 00 rS J m a, < o O W O # V o O N W O C Y ~O y; d N m m C 4 E [Y. < o o .0, Lo - x N r 3 m o w m qp g q x c p.^ 'V N W R'i y Wet r-4 Y W ?C t3 ~ ~ I r4 ~4 to C4 ° a Z U W I W CstNO X00 c W < I I U' W f!] LL PIl nc o 8 M Z ~i Ca N W E .5 M ~{p m asp p 0 Y a N asa M ;F ~m~p O V i Ch ~ n W ~ _ ~ Ll r-7 ~ W ~ d 04 L w c ¢a o IL DEC 2 01995 ' BLDG. DEPT. TnVVN OF SOlI°• 1 " ~gpFFOJ/( =0v OG~~ y 2 Town Hall, 53095 Main Road p • Fax (516) 765-1823 y~ol Telephone (516) 765-1802 P. 0. ew York 9 11971 Southold, OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD December 6, 1995 Mr. George Berry Jr. P.O. Box 845 Southold, NY 11971 Re: Building Permit under Carol Ann Weil To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xx An application for Certificate of Occupancy is not on file. (Enclosed) xx No Underwriters Certificate on file. xx The check is not on file. $25.00 xx No Health Department Approval on file. No final inspection has been made. xx No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 22170-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. 11DATE I~ LNT^ H m OUNDATIONI (1 t / c OUNDATION ( nd) r• ;oy r-~.~fd 32~ma C.. ~fd~C.L? O P COUCH FRAME & /,~k L r;r ~r V .PLUMBING II/ Av 5, 1. 11SULATION PER N. Y. y STATE ENERGY r^"' .CODE cz4 dyc y FIi1AL~ 061, avv o, A ITIONAL COMMENTS: x a A H ~B r ( H ~I I 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ) IN ATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: k DATE r INSPECTO I 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS TION [ ] FRAMING [ INAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE ~l INSPECTOR a.a ) 70 1- 765-1802 6 UILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ - INSULATION [ ] FRAMING [ ] FINAL REMARKS: c -fz c- DATE ® INSPECTOR' _ M-1802 BUILDING DEPT. 1 NSPECTI N [ ] FOUNDATION 1ST [ ROUGN PLBG. [ ] UNDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL ~j RE RKS: L DATE117hS INSPECTO M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [M"'~ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL db,24 REMARKS: ~%il6S ~a rib C, N, I-A 4AI ',0W All DATE S INSPECTOR a~ 7D- 65FD BUILDI EPT. s mss'""~ INSPECTION [ ] FOUNDATION 1ST (RO1UGH PLBG. [ ] UNDATION 2ND [ ]INSULATION FRAMING [ ] FINAL REMARKS: 3a 4®~. ~41 C9/hG ~~-/oar J~. ~r A10 f0 aloe DATE / INSPECTOR 4 E / 7a 765-1802 BUILDING DEPT. INSPECTION ( FO ATION 1ST [ ]ROUGH PLBG. [ OUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL REMARKS: r f ~Alge 4 I 4 ~ t c DATE INSPECTO f f ENERGY CODE CALCULATIONS (For Non-Electric Heat) Design Criteria 6,000 Degree'Days O.A. 10°F I.A. 70°F FOR: ~eal rf SevYy Jv PER: Lo ke, k-ell / DATED: Ian YIP ~ L SUBSYSTEM DESIGN TJ1PRMEL REMARKS AREA uGn RATING ~ Exterior Walls (Opaque) l Z ~ 1077 1- 6 1 evSea Glazing /T~ r~/p Lf~ ~F e t~Uff/ Doors Ceiling/Roof (Opaque) /'5-U2 L) t) Skylights % Floorp . U'S Foundation Walls A~ IPA Slab Insulation TOTAL 1 Notes: Building Envelope Systems to meet requirements of 7815.2 IIVAC Equipement to meet requirements of 7815.11 IIVAC Systems to meet requirements of 7815.12 Duct Systems to meet requirements of 7815.13 Ventilations Systems to meet requirements of 7815.14 Insulation of Piping Systems to meet requirements of 7815.15 Service Water Heating Systems & Equipment to meet requirements of 7815.21 Electrical & Lighting Systems & Equipment to meet requirements of 7815.31 To the best of my knowledge, FE11fP, belief, & professional r,~~e c` • rvT~~' judgement, these plans are in compliance with the code. rr y; a w i R.:s ' i'~2^ct1~4 ~ BOARD OF HEALTH M ' FORM NO.1 3 SETS OF PLANS D a v '1 TOWN OFSOUTHOLD SURVEY u BUILDING DEPARTMENT CHECK JUN Z Z 1994 TOWN HALL SEPTIC FORM SOUTHOLD, N.Y. 11971 6 jl~ SLOG. c (jam ? rt/ D l; TEL.: 765-1802 NOTIFY; y n CALL J(r?I Exami 1D........ 199K MAIL TO: rG .G ron5f-. 3 .6 any Approved ......7`7......, 19" Permit No.-V Oe.. . cry q X. Disapproved a/c 5p a rLhp/c/ N.% itf7/ (Bui Inspector) APPLICATION FOR BUILDING PERMIT Date Q,..., 194"/.7 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 of 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, bu' ding code, housing code, a regulations, and to admit authorized inspectors on premises and in building for necessary i ections. (Sign ure Z applicant, r me, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 0Pr n':C Name of owner of premises aof. 3.E'-.... e~... f' y . xv?ti (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. .................-title. (Name and of corporate officer) Builder's License No. ...15r-. 11n_F se 11 PlumberIs License No. . -Electrician's License No. ~C_4- Other Trade's License No. . 1. Location of land on which proposed work will be done. . House Number rSStreeet Hamlet I County Tax Map No. 1000 Section Block .-5 Lot . 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 .:..~2Gc~l ~~o ! . /J . . . b. Intended use and occupancy P. . . . . iU` ....I./.Q17 ? I . p applicable): New Building ;~•~-"TM" Addition { .'_Alterafio'YY"^~~:•-~~.~... . Repair o work (check which Removal . . . Demolition `Othet`Work , . , (Description) 6 4. Estimated Cost O C> Fee ~ • • ~ ova . (to be aid • n .E ' application) P g t g . 5. If dwelling, number of dwelhn units Number of dwelling unfits-©n p; _ i s If garage, number of cars ~IL J 6. If business, 4.....C r or mixed occupancy, specify nature and extent of each type of use . . 7. Dimnsions of exstinglstructures, if any: Front Rear Depth . Height Number of Stories . Dimensions of same structure with alterations or additions: Front Rear . Depth Height Number of Stories . 8. Dimensions of entire new construction: Front ...(D J......... , Rear . , . , . Depth ..30 Height (g.......... Number of Stories ........~h 9. Size of lot: Front ...~P..C1.. I........... Rear /..9yr ff~/ Depth . , 69: 6......... . 10. Date of Purchase ~Wt. /,Z.9 , Name of Former Owner (*Al.. „Wj?.i i................. 1112. . Does Zone or r use district proposed in construction which pre raises are situated . , .A -.Cr.. , • • , • • • , • • • . . . . • , P P ate any zoning law, ordinance or regulation: NO . 13. Will lot be regraded • ..IVO'; • . , , . , . , Will excess fill be removed from premises: _Yes 14. Name of Owner of premises Cep:r.~ C . j , rv YAddress Pa SPX .19a H...... Phone No. 7.6.5`.5 2 . Name of Architect ` c~, Address C Phone No.. S er.... . Name of Contractor . . 6'e.f... Address :A-f:n.,C Phone No. ;T~.~. , . . 15. Is this property within 300 feet of a tidal wetland? *Yes No./. *If yes, Southold Town Trustees Permit may be required. j PLOT DIAGRAM y 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. II i I ~I STATE OF NEW YORK ~-.__QQ ~G, S I's COUNTY OF StI ~~1~~` « (Name of individual signing ' • • ' • • being duly sworn, deposes and says that he is the applicant contract) above named. Heisthe .......................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 forth in the application filed therewith. Sworn to before me this ~ R!A ...day of I'. 19~T - 1,7Z4 Notary Public, - 944 • . . h. U~Co~ . unty BAABAM ;w ' 1V51(?I N*q Pub k, wtato of New York . • . . . • • • • 0 AkZ8U1 k0=q' ignature of applicant) oomr?rhtioa cow rw.30.10 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1.001071 BUREAU OF ELECTRICITY F 85 JOHN STREET. NEW YORK. NEW YORK 10038 Date DECEMBER 04,1995 Application No. on file 84282194194 N 371988 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 GEORGE J. BERRY JR., 21 SI-MLL FISHER ROAD, SOUTHOLD, N.Y. in thefallowing location; ® Basement ® 1st Fl. ? 2nd Fl. GAR/OUT Section Black Lot was examined ors NOVEI4BER 30 , 19'95 and found to be in compliance with the National Electrical Code. FI%TLIRE ECEPTACIES SWITCHES Ft%TURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT K W. AMT. K. W. AMT. KW AMT K W AMT H P. 40 35 41 40 3 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL - UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K. W. OIL H. P. GAS N. P. AMT NO. A. W. G. AMT. AMP. AMT. AMPS TRANS. AMT H. P, SYSTEMS NO. OF FEET AMT. WATTS 3 F 2 1 SERVICE DISCONNECT NO.OF S E R V 1 C E WT. I AMP TYPE METER I a• PW I BW 3 9 3W 3,9' 4W NO. OF CC COND A. W. G. NO. OF HI -LEG A W' G NO. OF NEUTRALS A. W G. EQUIP. PER .B' OF CC.COND OF Mb LEG OF NEUTRAL 1 200 Cf3 X 1 2/0 1 210 OTHER APPARATUS: PADDLE FANS-2 WELL PUMP-9. MOTORSt2-F N.P.,1-F N.P. SMOKE DETECTORS--1 G & S CONTRACTOR LIC.0578-E BOX 215 SOUTHOLD, NY, 11971 GENERAL MANAGER 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 MUBT NOT BE ALTERED IN ANY MANNER. c ti r u, 4 UJI y t39 ~9 C9 .40a >t, N ~ UL. 6 e-,. ~~4 ~W S KI ~ i V tsz `s.ca i. of O b.. > ~ p€ of 3 W 3 @ 2v Pt.. EY. '0~2 !a J J m W Q 4 ' P.lS ' O (7 I to tPs ) ~ V1 ~ ~ 0 0 okm 0 A Z VA w 41 v0 ~rSZ/a °JZj,,~ V n h v Z _r -''mow a bk a %F cl, `4„~roG~ / ''Fd' `U yr; . z m m I ~Yq~ 9Nr, n OTC N p ~i ' ~ p ~ 2$8 f~~ ,u8 o- `'tp:~~ E~26.p tp ~ 8- o ~ a o ti~ u' m m el 4-0 C 0 a .;cKn ~xl ~ ~ Y3 FY 5Q gd l Y QS~ (O ~'Q ~ Y 3 C Y ,,,r, i r 9 r .E # tl ate z 'S ~ ~ is e; ~t r F i Q ~ ZBg ~~'yB . LA E~7~.a ~yy 4,*o u. 0 ~d Anr ~y NpyL (14 z w y; , ;,y(& p Azl D f ~9 A ` rn ri 'Xi z. ~ u n a~ o• N/~ ~/67l/'/vT 1 c p O tt•? gy¢~ e ~YY Y, _ • ' ~ V.y,Y. ,a ENERGY CODE CALCULATIONS (For Non-Electric Heat) L dign Criteria 6,000 Degree Days O.A. //10°F I.A. 70°F FOR: euk ('77e S_rV) LA_ PER: /S J 6Pr ~ /~Pry'1~ O.,DATED: J0 DESIGN THERMEL SUBSYSTEM AREA .1U" RATING REMARKS Exterior Walls (opaque) p~7 _ Glazing _.L % i'4 try"'T '/0 s„ Z/O Doors ,J ~ 'TO l 6 Ceiling/Roof (Opaque) /S O U S Skylights 8 Floor r 0 Foundation Walls Slab Insulation / TOTAL p Notes: Building Envelope Systems to meet requirements of 7815.2 HVAC Equipement to meet requirements of 7815.11 HVAC Systems to meet requirements of 7815.12 Duct Systems to meet requirements of 7815.13 Ventilations Systems to meet requirements of 7815.14 Insulation of Piping Systems to meet requirements of 7815.15 Service Water Heating Systems & Equipment to meet requirements of 7815.21 Electrical & Lighting Systems & Equipment to meet requirements of 7815.31 r9v P FIyY To the best of my knowledge, belief, & professional judgement, these plans are in compliance with the code. • ~ a~ESSroe1P' T- I i PWMDIN3 ~ AY )LAM~10 NMSR M/ILPA AS NOTED D .,,E~: nom~ . i- ( A ¦NNIIr111ENpN11Md NOTIFY BUILDING DEPARTMENT AwwmbrdiarWulln~ 766-0802 B AM TO 4 PM FOR THE ~ •r piping sposm 'a ~M PLUMBERCERTIFICATIOIV 1DFOu oar INSPECTIONS: REQUIRED ON LEAD CONTENT BEFORE FOR POURED CONCRETE CERTIFICATE OF OCCUPANCY 2. ROUGH FRAMING PLUMBING . p ~ 5 NEQUMED 3. INSULATION s SOLDER USED IN WATER 4, FINAL - CONSTRUCTION MUST SUPPLY SYSTEM CANNOT BE COMPLETE FOR C.O. OR ALL CONSTRUCTION SHALL -MEET, EXCEED 2110 of I% LEAD. THE REQUIREMENTS OF THE N Y- OCCUPANCY OR CODER. - NOT RESPONSIBLE:.•'0OBS USE IS UNLAWFUL I~RfM STATE CONSTRUCTION 3. f LA DESIGN OR CONSTRUCTION EAfl A0 WITHOUT CEKnRCl DERRICATE, OF OCCUPANCY M DO NOT PROCEED UNTIL 2nd SURVEY OF FOUNDATION LOCATION HAS BEEN APPROVED F I t ~ (till 1' - LTIL-i I~ ilI 4~t ;i 11, a - - - - - - - - - - - - - - i - t i f ~ "t NElly ~p ,.tee °~.,~.c 1 t I' ir t r s I tilt I li ; i F-A if -~--J l_V..l i ~ ~ i~ ~ ~ ~ U R r _ _ i f~ ~ _ __rT-= 7 i ~ . t.`_.l ~ E 310 . _ _ i ~8f ~Leue:~+~u lcPf_ ei~rLNr•.w. A~ ~d11L gGC uttr~orJ ~ ~ F ~ ~ '9Cgcf ~ c / l SCdCE ~ ~ SCALE Sc,rcE ~3"-/~ :~j 3 ~ /~ACi~o~k"L7 ~ l~vA$, .1~°a_ _ ~ k ' 1~~8y E ~-,.-TM-... 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