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Home My WebLink About22105-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. um~TIFI~AT~ OF (Z~U~A~CY No Z-23056 Date J~NE 21~ 1994 THIS CERTIFIES that the buildin~ WOOD STOVE Location of Property 525 NORTH OAKWOOD DRIVE LA~I~L, NY House No. Street Hamlet County Tax Map No. 1000 Section 127 Block 7 Lot 16 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 17~ 1994 pursuant to which Building Permit No. 22105-Z dated ~ 6, 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 AW O OD BURNIN~ BTO%~AS APPLIED FOR. The certificate is issued to ~OB~T Io LEVINE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A //uild~ng Inspector Rev. 1/81 FOgM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENt TOWN HALL SOUTHOLD, N.Y. N~ 22105 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNtiL FULL COMPLEtiON OF THE WORK AUTHORIZED) Permission Is hereby granted to: ./.,.. ......................... ........................... to .....~~_......'~.. ......... . .~...~.... ~r~...~......~.,~¢~..... ,d~.........~'..~j~..~..._ County Tax Map No. 1000 Section ....... ,,~.~..,,~ ..... Block ........... ~ ........... LotNo ....... ,-~.,(?/ ............... pursuant to applloation dated .....~,., ,,~,..~. ...................................... 19...~-..,~C..i.., and approved by the Building Inspector. Fee $...~.. ...... ..~.~.. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 Ai~PLICATION FOR CERTIFICATE OF OCCUPANCY 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 ali 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. 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, Swirmuing pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existinR Buildinm - $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...~....~... ........ .~.: .~.~ .~.~...~.~..~.. ............... House No.~ ~treet Hamlet Onwer or Owners of Property...~.~..~..~..~,~.,~..,,~...~..._..~..~.'.,~..../~.~, ............ County Tax Map No i000, Section. ' ~'~ ~.-...Block.''.~.'. .... Lot. Z Permit No... ............. Date Of Permit.. . pplicant ........... Health Dept. Approval .......................... Underwriters Approval ..................... . .. . Planning Board Approval ........................ ~ Request for: Temporary Certificate ........... Final Certicate .......... ..~.... Fee Submitted: BUILDING DEPT. INSPECTION FOUNDATION xST [ ] ROUGH PLBG. FOUNDATION ~ZND [ ] INSULATION FRAMING [,~NAL DATE INSPECTOR 765-1~0,2 BUILDING DF. PT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~AL REMARKS: ~ ~ - 7&S-IS02 BUILDING DEPT. INSPECTION FOUNDATION 15T []ROUGH PLBG. FOUNDATION 2ND []INSULATION FRAMING [ ] FINAL REMA~S: ~ FOUNDATION (lst) FOUNDATION 2. (2nd) ROUGH FRAME & .FLUMBING INSULATION FER N. STATE ENERGY CODE Ye FINAL ADDI COMMENTS: NFPA Minimum Clearances For Safe Installation 2' 3' I'zctor~.bugl ch~n~'. r~:~l' supl:x~rt supperl bracket stove pip~ .) ,~on.combustible well protector pipe. crimped cl:d down non-combustible floor protection From! Combustibles %Vith 3Vz" masonry wall or 24 gauge ~t~- mc, al with l" airspace A. Listed Wood Healer Front 35" Side, .Back 3§" Top 36" 13. Single Wall Connectrr Pipe 18" (24 gauge or hcav,cr{ C. Chimney Ifeight 3 feet higher than roof; 2 feet higher than any part of roof within I0 feet {mea.~ured horizontaHy}. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved . .~...~. ........ 19,~../~/i~ermit No.~.,~/.~..'-~...~. Disapproved a/c ..................................... h~ r ................. . ........... APPLICATION FOR BUILDING PERMIT , SURVEY .......... ~,> CIIECK .............. SEPTIC FORH ........ Date ...... ; ........... IN STRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspectm 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 publi or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of th 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. Sucl 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 Oc, shall have been granted by the Building Inspector· APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuaT Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordin Regulations, for the.construction of buildings, additions or alterations, oK.for_removal o~'~emolition, as herein The applicant agrees to comply with ail applicable laws, 6rdinances, bu[ldil~ode~houtj~g code, and regulations admit authorized inspectors on premises and in building for necessary -- (Signature of applicant, or name, if a corporati 1 Cambridge Street .... Roalyn .~eigh~a, .,'."~. 11577 ....... .~ .... (Mai:l_ '_rog address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or Owner/ Engineer Name of owner of premises Robert & Gerrie Levine (as on the tax roll or 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 ...................... Location of land on which proposed work will be done ........................................... 525 'Jorth Oakwood ................................................. ~.a.u r.~l ....................... House Number Street ',~,' Hamlet Connty Tax Map No. 1000 Section 127 Block 7 t).'~'; ..:.. 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 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ... Demolition .. Other Work..~... · 4. Estimated Cost·..~.~',.. ~ .'., .' .... ' .................. Fee ................................ (to be paid on filing this applicatio 5. If dwelling, number of dwelling units........O I,t,~. .... ... Number of dwelling units on each floor. '. ........ · If garage, number of cars ........................... ' .................................... .. - 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............ ~ .... 7. Dimensions o[e~isting structures, if any: Front. ,.~[.~: ........ Rear . ~-,I1~'. ........ Depth ..~0 ..... Height . .I.~,...~ ........ Number of Stories .. 1[ ......... ~. ...... i~~ ...................... ,-.... ~. Dimensions of sa~e structure with alterations or a.~d~tions: Front . .~, .............. Rear . ~,O ........ Depth ..... d[.~ ............. Height .... ~..~. ............. Number of Stories ................ 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ......... 9. Size of lot: Front ...ga~ ................ Rear...v-t.,-e ..... , ....................... 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 ...... O,-'g.~.' 'l'ac.'t¥i':- ......... Will excess fill be2:er09ved fffom premises.k_. ,. 14. Name of Owner of premises .~..~2.. ,¥~..It....'.'.'.'.'.'.'.'.'~. ...... Address $.~.~....~...~..~,Ig;...~p~lg... Phone No..~. . .k??~...'~.. Name of Architect ......... s' ' · Address ................... Phone No ........... Name of Contractor ..... ~4~ .~.'(~.' .~i i i i i Address $&~" .. Phone No. 15. Is this property within 300 feet of a ~idal wetland? *Yes ........ No...~..:.. · If yes, ~outhold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether'.existing or proposed, and. indicate all set-back din~ension~' property lines. Give street and block number or description according to deed, and show street names and indicate interior or comer lot. APPA(~V, Lrb AS NOTED _ / hlOTJF¥ BUILD~'NG DEPAI:~t..II,~E"I~ AT 765-IB02 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. COUNDATION 'IYVO REQUIRED FOR POURED CONCRETE 2 ROUGH - FRAMING & PLUMBING 3. INSU~TION 4. F~NAL CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRU~ION SHALL THE REQUIREMENTS OF THE N.Y. STATE CONS~UC~ON & ENERGY CODES. N~ RESPONSIB~ FOR D/SIGN OR CONS~UC~ON ERRORS being d~ly sworn, deposes ~d say~ that he i5 th~ appl (Name---hr individual signing contract) above named. (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly authorized to perfo~ or have perfo~ed the said work and to m~e ~d fih application: that all statements contained ~ this a~plication are true to the best of his ~owledge and belief; and work will be performed in the manner set forth in the application filed therewith. Sworn to before me'this_ 19 ' ~nE L G~ ...... (Signature of appli