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HomeMy WebLinkAbout22162-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23360 Date NOVEMBER 18, 1994 THIS CERTIFIES that the building NEW DWELLING Location of Property 1150 SOUTH HARBOR LANE SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 75 Block 3 Lot 15 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 20, 1994 pursuant to which Building Permit No. 22162-Z dated JULY 1, 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 ONE FAMILY DWELLING WITH ATTACHED GARAGE AS APPLIED FOR. The certificate is issued to MICHAEL PISACANO & ANDREW HARBIN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R-10-94-0040-NOV. 18, 1994 ELECTRICAL INSPECTION CERT. #5515 DATED NOVEMBER 17, 1994 PLUMBERS CERTIFICATION DATED NOV. 15, 1994 - LARRY LISO PLUMB. & HEATING Building Inspect 0;1~ Rev. 1/81 FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL - SOUTHmD. N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) C!~~ Date NQ 22162 Z 19... Permission Is hereby granted to: ~~i s Jr% . ............../9/...... to r~ ............................................5.........."'00, c r I ..............................mss...... ~~,~~~?......~ocx .~%J:.p....................................... at premises located at ..............//,~.V ............77:: z 1. ! ~i3 County Tax Map No. 1000 Section Block .......!V Lot No. pursuant to application dated ..................T 19, 'and approved by the Building Inspector. Fee $..,SZ.~. Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD 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. „yB. 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 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 ....e//<.° AS. :1./ New Construction......... Old Or Pre-existing Building..~.J................. Location of Property sgpyrx ..r.S+:......... S?RT." ~:g. . House No.. J~~/ Street Hamlet ;Onwer or owners of Property...~/.!~//J'G.4.TlCi9e/p?r!~/, L~ ~/UUer//fQ~/~ County Tax Map No 1000, Section...... 75......Block $ .........Lot.. 1~ Subdivision ....................................Filed Map............ Lot................. Permit No ................Date Of Permit Applicant Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate..:........ Fee Submitted: $.,.e2~PO O•g,+C~3~0~ APPLICANT trt~.kxwah ..aW^xarautap'~~-\ . zik9F`?fE7a. CC'JA"' P7 T NYC H £'RVICk'e SINGLE FAMI~ Y DW _LLSNC - APPFO l of CaMfnJcWd Woft Rate NOV 18 1994 nn 't3a~ ersr ~ d +ii fsraf Md T'ste~r M1 B ciSSC3~ /l~~~l~ JC D~© E r";?s S i m?Se:s~ Saav assns Sss w.", Y se'tor cal zS9Eau4 t: p Stall,.: gay, aA+avet sas taS7 ear i >laa cesf f sisr,:J to W', d rtcry. 7 -7-7 o~ "~i G4AGQS61 ,~~A\ fr~i~i4r P.L., 44fv f at ~lslv'.i„"~., tN 1+N.rp~4~1t'.Y.S~,rJ`~~WUYr£°°w[IlT1 aK. 'r ?fRfx .10 y1. LEIS G'S'A * s1ou~~ Q Lwr t Oph wro0t e I f 417. e, Al X91 /V77°Z6'~"E Z~ 2 ' o. Unauthorized atteration or addition \ to file survey 1+ a dofalton of I- ; SBOUon 7208 of fie New Vmk Slab 1n Ed"tionl.aw IlsvP /J,Qja>6Yygy `a, CdMaa of Ha oraurM moo not bevin5 e land $so] a inked Beal Of be oonaWerad embossed to sell C WY. J\ to be a Wild true eePY• o ahel Nn VI/~ Ouaranteea only b Me Ind Person keb for d hares Whom " ft survey N n t`j;, v 10 a CoMPO , and on He behalf to db \ (ACV(; kk.. stod abd hw tje yy0 YPi tlwtl9oon Nve hereon apertcy and and Q VVV"' to Ana aeakneaa of dN Mn6np kM?+dat. B~,~J. 4 0 Guems bee are not trenstu" ~ N C 'VIA to addWWW Institutions 0, wb"*Wd 0: o*nofe. N - leo.+iriarfo• Zd~~ 8 /hwP 5 76` 37' 34 9 1D 1~Acav%-> NOV 16 C'6l7iLbG LOC• i?YOIYN! SUPI~6YFOR• GC?Y/E~'G /3~~'LG E/9N ANn~oNYWL~it/4Naa~vsc-/' _ ur~a q OF 1-4N49 .50WWWW _ .5rwr.UOCa N Y ,000Oriov Ser~rst~i~ .sdyzs~ve.~~.vr,~ Y. ~7Tr~cR ICES ca•! r,ICI,,? ~ 7%71.f'.i:^; !%M,OG dv,8?BY4ero.~le7e 7~•/ f! f-crwlzprnau,t ~rtw//~~ d Oo7E ?uNE3o,/1^~3 NorE: GvTls 75 owu~n,Ti~i6Cas~n~we~ ono s~voinl6 5COGE /~=~lp~ AV077',WXZ. J,4F,14 t4vcY rb7 Jf OC~~y y.t~fEi<a y, An'o A¢e°Nav-T,eoMlF.d',tse~e~. SUFFpe,eG'O. AXMAANV•/ODb-0703-/ss' uztrz 0 S~ErutA. TOWN OF S0UTH0Lb TEL. 765-I802 _e_ OFFICE OF BUILDING INSPECTOR 9 ~ P.O. BOX 728 o',~ ` !W TOWN HALL SOUTHOLD, N.Y. 11971 4 C E R T I F I C A T I O N Date L building Permit No. ~o~pL Owner. / fL /d~r4£'fJy/d Ip ease- print) Plumber ~%F'~SO i ?P 7/1/G tp ease pr nt o?ln~~~ I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. I i i (plumijser's s g ture) i Sworn to before me this 1 j d a y of //o J2 O~ . 19 Y,54 . Notary Public I Notiry Public,„Sa i County D04 RES L, LISO Notary Public, State of New York Sudolk County • No. 4041022 Commission Expires Oct. 31,,4j- F, T. 1a .P El1 _ Sh:_ F'.C3 p ` f opcGOOOOOt:~o®oG+o,~araoG?f"Ga nc~a~ocrapacio~ccaeooc~ec'~ocooocaa~~~ fin p s,s 266-6E42 ELEC`1-RiCAL 1N PECTtON 3,!:-RVICE, INC. 0 ilb BUNTON AVENUE Q . 1 EAST W'CHOGUE, NEW YORK 11772 p O Dal) _ 11-17-99 4N No. ON FILE p vJ "u Soutih_ Naxbor _Rd. "o- _ al-,F vSoutbold_ i Q M3~eY Pasacano _ _ 4 f.~.-tric rJ'Jxje LIC NO lff-S ` o O N»' a ~)aiionaf VocIr"t Code ' O - XX _s+.. Ind s it Attic ~ Pool 0 1 6 L0" P %)r1 _x-X BASE, i0 y JET. G4PAGE Oi a 9 _ c ~ ~ _ Lis"L"ERS F~ { L3 , 37 _ 30 7 zL 177 F d.5., IR. 1 Ml.)T'Jr 5. E'ct T ..P: SER?itlf: C` ._...._._t 0 i't'A7LlE? ' 1 O' $Jatj p 1-EACH IXHAUSP FAN 0 R 0 _ O pt'CBEdCIIT , 7H, certl 4cate mu+t rot be en ~ a°y cr h,perors may bt:&rbf:ea L, Pe 'c o~ saesaoeoe~saeraesn~oesor~ee;7a~ eatyacsooecsoe9e2~kGee~oe3oc~rrae~sa 7/7 2., -a;- 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. IN LATION [ ] FOUNDATION 2ND [ ;/FNAL FRAMING REMARKS: - . r i Ole I "`1 DATE l Z11SINSPECTOR 1 L7 I:: J:i ~~Jn: ( C:(i4ENI~ C Cdc~ OUNDATION (1st) i~ OUNDATION (2nd) - r OUCH FRAME & I~l y d -PLUMBING I y y m n INSULATION PER N. Y. STATE ENERGY CODE I ' i y i FINAL ADDITIONAL CO Ell t A • y Fi • O y m f3jj 162* 765-1802 BUILDING DEPT. 1 NSPECTI [ ] FOUNDATION 1ST ] ROUGH PLBG. [ ] F UNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL REMARKS: &nk=- 61 i DATE INSPECTOR ~ A/ j v M-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ) RO H PLI [ ] FOUNDATION 2ND INSULATION [ ] FRAMING (J FINAL REMA JZ~ DATE ~/4WINSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOU ION 1ST ( ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: r~ i f DATE v-- INSPECTO i M-1102 BUILDING DEPT. INSPECTION [ FOUNDATION 1ST [ I ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: VU f i DATE INSPECTOR f ENERGY CODE CALCULATIONS (For Non-Electric Heat) Design Criteria 6,000 Degree Days j O.A. 10°F I.A. 70°F FOR. r 1, 1> a~1 cl\ JO PER: t D F-,-3, DATED: Zs SUBSYSTEM AREA DESIGN THERMEL "U" RATING REMARKS Exterior Walls (Opaque) M14 Glazing Z % t716 Doors 6p ,yo -23 Ceiling/Roof (Opaque) Skylights % V Floor Foundation Walls Slab Insulation i TOTAL JS Notes: Building Envelope Systems to meet requirements of 7815.2 HVAC Equipement to meet requirements of 1815.11 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 Pleating Systems & Equipment to meet requirements of 7815.21 Electrical & Lighting Systems & Equipment to meet requirements of 7815.31 To the best of my knowledge, belief, & professional judgementp these plans are in complig ce with a code. D t+ BOARD OF HEALTH FORMN0.1 ,,,g SETS OCA'LINS t... .JUN 2 0 M TOWN OF SOUTHOLD _•SURVEY _ BUILDING DEPARTMENT /C11EC1: . TOWN HALL SEPTIC CORM SOUTHOLD, N.Y. 11971 TEL.: 765-1802 NOT -4 FY ; Examined 7//........ 19~~ CALL MAIL TO: Approved 191~./VPermit No. o?d/(p Disapproved a/c _ (Build' d nspector) APPLICATION FOR BUILDING PERMIT i j Date dl L 191.4 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- Ation. 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 inspecti_ cins. _ !`1^'nSl . . i (Signature of applicant, or name, if a corporation) ~...ohk.S~,..c-~l~~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 1V e}} .........,.I...............((......... Name of owner of premises 1.11c~V eWc1.r,y G vLd ! tl t,t uhy t $ ( . (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. -0,24 Electrician's License No . Other Trade's License No . 1. Location of land on which proposed work will be done . . 11S0 - ....i q~ oven House Number Street Hamlet 7P r County Tax Map No. 1000 Section Block 3 Lot , Subdivision Filed Map No. Lot............... (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 ...U. 7, , , , C,oY15 ~y+!e~,l~ • . 3. Nature of work check which ~n . applicable): New Building , AI[cration7 , Addition Repair Removal , , , , , , , Demolition i k 4. Estimated Cost 7!!,,:!oo cl (Description) Fee ' JSation) S. If dwelling (to , number of dwelling units . If garage, number of cars Number of dwelling units on each floor . . ..A ..........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 • • ' ' Height Depth Number of Stories Dimensions of same structure with alterations or add~ittiiions: Front . • • . • • . ' ' ' ' • Depth Height Number of Stories . Het-lit traction: Front ...S.. , , , , , , , Rear , , , Dc th Number of Stories , P "~"3" ~.N , 1........ . 8. Dimnsons . DatecoftPurco ~tirenet~ Nur•••• Rear De th 9. Size of lot: Front F`" ' • • • • • • Depth • • • 10 base P ..~o~ -4-1 , r~~r p Name of Former Owner ."7!!?2eY~,~ wee 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 Will excess fill be removed from premises: Yes 14. Name of Owner of premises 0 Name of Architect • • • • • • Address ,5 f3-lrr;-~• , , , , , , ,phone No. -44 , r. 91" Name of Contractor v ac Address „ Phone No . Address phone No...,r. Is this property within!, uir No. yes, S 300 feet a Permit wetland? *Yes '`If Southold ,Town Trustees Permmit may be reqquired. ~ " • 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. STATE OF NEW YORK, "OUNTY OF H~L S (Na of individ si nin • • . . . . . . . • . ' ' ' ' ' • • being duly sworn, deposes and says that he is the applicant me ual g g contract) ibove named. le is the . qt uw~f...... • • . . (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 pplication; that all statements contained 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 t tis .day of. .~~~t 199 otary Public;. C trl S ounty HELENE 0. HORNE GCS 4 . Notary Public, State of Now York tu . No.4961364 tt, (Signature of applicant) Quali in Suffolk Coun Comm ssiofn Expires May 22, t 9 -2,7- FOR APPROVAL OF CONSTRUCTION OF SINGLE FABUY RESID81CE ONLY I)ATE~U 0 71994 HS REF. NO.R16 A4/01? ADUO APPROVE ~ EXPIRE's n-IREE YEARS FRom DATE OF PPRovArE~ y oar~r~m PLEASE NOTE rev _ _ s It i# th0 applicant's responsibility to t~ r aintaih ade , At. 'sanitary dist& ? An ~S tv~tp-atl w tOr PU ly and sewn r 11404al facili Y S` v Pill ~ q1 MAY 4 *a ~Edd~G -Almv C. DEPT. OF Za9 sl7' H.ALTH SER bES AI77 ePr - 41- 1 a? ~ ,~o. ti ~~SgD LA ryes 6y.('. ;%G'/v4Ji!t*.V _ 11 _ ~y 9 G9L C~zvzaa: a . Q- - \ O NO V. LE oZ ti~ ~A y y~x PG ,vt b O 0 ,Q * z ~ p Q N Q Pvt.. ~1~L5 `r TF 3696 0 ~ , n Q~ Op NEW Y Opp Q 1710kf/EL2- ?A~A.vj 4€9?f'vaG LOC. 8?O~yN .5uevEr,~oa• iYl,~~ srq~G ~~.~E:~~s v<::~ ,nNT•4/ONY /4/•L~w.4~vobs~.sri GaNO SuQVeYO2 L4CAT/ON SOIIjHQGp~fUFFiIG e C'o!/NTY. Al Y. 50arao~o, N tY 04>E• /UNE 30 /~3 NOTE: Gcl 3NlEC 4 Ta D/VNbrt T/jt6Cus~ y w.~~ 4fO~ENO ~/6 5C4LE• I^'=l10' /.venrura-~^s.o.~.arav~rm ~zas~~vouvs~.ce.~er, .Sivo.4ae'Nav-T.¢A•a'J~57ee4~~•F. 5UF L.eG'D. AXMDND• ODIC-O~DJ-/s' i e-r 4 h 1 :A' ~e r, X5'.7 ~ .a ~ ~ v ~ + ~ s ~x~,f'`~, R•''t TC tY"N~+ _ r is 44 i /AS, P f r -.i i ~ ~1rw~iMF Pk*v em be _ V IEIISfflffil E mumwo PUP4MAIIIIIIIIpVAMW . f PLUMBER CEW1,04CA7-100 - zk'E ONLEAD CONTENT BEFORE` CERTIFICATE OF OCCUPANCY axv, t1 ,7 cr ~SOLDER USED INWATW SUPPLY SYSTEM C4NNT s, / V EXCEED2/li of 196E E ~P N I L - - ` APPROVED AS DOTED Lid, y.. i pal DATE i sPe_ •t~ ~~I FEE: ~i NOTIFY BUDEPARTMENT AT NOTIFY 02 9 AM TO 4 PM FOR THE I FOLLOWING INSPECTIONS: w, ~zca. 1. FOUNDATION • TWO REQUIRED FOR POURED CONCRETE 2. ROUGH -FRAMING & 'PLUMBING x 3. INSULATION 1% T H, i 1 4. FINAL -.CONSTRUCTION MUST BE COMPLETE FOR C.O. y' ~ ia/• i'iaca . 1' . ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y 1 rw~ - STATE CONSTRUCTION i ENERGY s~k 1. CODES. NOT RESPONSIBLE FOR - - DESIGN OR CONSTRUCTION. ERROPA 2xb„ OCCUPANCY OR - -t - USE IS UNLAWFUL M.xi'2A ^w { WITHOUT CERTIFICATE y ~i OF OCCUPANCY dC4U I ~ 7je I; M,8 Z.ip. 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