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HomeMy WebLinkAbout22092-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23461 Date JANUARY 19, 1995 THIS CERTIFIES that the building ALTERATION Location of Property 3895 WELLS AVENUE SOUTHOLD NY House No. Street Hamlet County Tax Map No. 1000 Section 70 Block 4 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 9, 1994 pursuant to which Building Permit No. 22092-Z dated MAY 27, 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 -ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT G. BANNON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. M319184 JUNE 30, 1994 PLUMBERS CERTIFICATION DATED / N/A Building Inspector Rev. 1/B1 FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.V. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) y1 Date 19../.., No 22092 Z / Permission Is hereby granted to: °ZS°23 S /?7/ 4Gt/r~.r mot/...../.93J.~.... 15~j 114i1 . . '4- -0.r.?........................................................................... at premises located at........... / i 7f O .a . County Tax Map No. 1000 Section ~ Block //T............. Lot No. ~Z............... pursuant to application dated ........1 19..f...91 ~4 and approved by the Building Inspector. w Fee S.... /7...: Building Inspector Rev. 6/30/80 i < n tI Form No. 6 RR n 2 ~ ~ ~ LK ~ ~J L5 ~33j m~~u~~ i? n TOWN OF SOUTHOLD 1u ~1(~'~LL fl 11 1 BUILDING DIEPPARTMENT 5 +995 TOWN P` - (s U5 765-1802 61_^u. CEPT. TOWN' OF S6UTHOI r' APPLICATION FOR CERTIFICATE OF OCCUPANCY""""-...-.--___.._e 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% read. 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 "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 7,5 New Construction........... Old Or Pre-existing Building... .......~p,F1~~ Location of Property...`~9-_)G .eJ............ r-L.G:~ A9AD...........Y.~!:-1.T/T House No. n Street Hamlet Onwer or Owners of Property /rD..QT.....r..~!~~©~ County Tax Map No 1000, Section Block ......Lot Subdivision ........................Filed Map............ Lot...................... Permit No. ?:?9. 2 Z Date Of Permit. .Z .....APP T licant...x. /4.1 , SS J Y~ . i Health Dept. Approval !~,4 ..............Underwriters Approval. Planning Board Approval.... NA Request for: Temporary Certificate........... Final Certicate..... Fee Submitted: $...z .fl nP&C q9 C 2 t , W ' -27 a 3tIlI~ APPLICANT %ELLI;:SYc IIDn+E 11 (ONMGNiS 1 . II - a 7OU11DATION _ (1st) cya FOUNDATI01d r (2nd) m y , I 2.' • z 0 ROUGH FRAME -PLUMBING C.0 3. -3 I ~ INSULATION PER N. Y. I m Q STATE ENERGY CODE a 4. C~G/~ lJ,~.e~'~ r m a454FM FINAL ADDITIONAL COlgi-1E11TS: s H H \ • m y \ r - H p . m -v H M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ NAL REMARKS: DATE 7 ~O Q INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ) FOUNDATION 2ND [ ] 1 SULATION [ ]FRAMING [ FINAL REMARKS: a e tis DATE ~,91,2-Al INSPECTO -ni a-lee 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ( ] FOUNDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL REMARKS: ~C DATE L l INSPECTOR %%%%f fat Town Hall, 53095 Main Road °y Fax (516) 765-1823 P. O. Box 1179 tp • Telephone (516) 765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD July 11, 1994 Samuels & Steelman 25235 Main Road Cutchogue, NY 11935 Re: Robert Bannon 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 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 22092-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. I N f~ N $ W i K ; V~ w i2 N ~ ;Z ~ Y a Q6 3 x i s Y co 0 .4 QN~ ~J v 3 a g N~ W 2 e m 8 N~ " a ~ `o ~ v F > dW Y W 3 cr. 0 ; E W ~O$ Z ~Z W 5 Z m ° Ilk .n m~ a Z 0~ ~ r "y+ s S 5 Y 00 3 V Y Y N g V i w 3r n g uW m g E f g p LL ; CZ e y o W U n 2Y W N ; LL Y. O W> > o o~ u ae W o F N W VM U o Q aZ c $ M zz O rcW NEl tl W' R G p Z : p mN R [ O~ Nz ~ i l ~ Yi Z ~ W s ry i ° O 3 n .O a `2 m i R r- p Oi E v : C E i i 4 N c Z ~ ro ~ ~ N ~ O W? '-J ~ L Y C N U Fi 00 2 a E gzS w - a 00 I - m W 4 OZ a Z W N a o O N ~ ~ ry g ~ F aH aarn E a I W` i F~~ 3 ~ y< O U v rW4 G ri. ' r I Cp W. I t Q F• L BOARD OF HEALTH R Q M FORM SETS ..PLANS........ ts IS U ; TOWN OFF SOUT SOUTHOLD SURVEY . BUILDING DEPARTMENT CIIECK MAY -9 TOWN HALL SEPTIC FORM SOUTHOLD, N.Y. 11971 TEL.: 765-1802 NO,T I FY CALL Examined . , 19* MAIL TO: . ~j Lt;~tC•2- zJ Approved ?.7 19. Permit No. ~~y2 z? . Disapproved a/c ( It GG~( . . . . .Isn . in.g or) APPLICATION FOR BUILDING PERMIT h Date a . 19 . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sms 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- 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 e6tje, and regulations, and to admit authorized inspectors on premises and in building for necessaytons. - (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. 7- Name of owner of premises ~6e~.er C'4~N~t/ l (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. Electrician's License No . . Other Trade's License No . 1. Location of land on which proposed work will be done . . 3AoJ ' A/zcz L s o/ U ~ 1o 6!T/fc Z L~.................. . House Number Street Hamlet County Tax Map No. 1000 Section Block Lot R............ 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 . ii b. Intended use and occupancy ~t......... :ure of work (check which applicable): New Building Addition MI[eton epair Removal , Demolition Other-Wm - Oescription) i Estimated Cost 000 Fee . . (to be paid o is ion) 5. If dwelling, number of dwelling units Number of dwelling units on apCb1 If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . 7. Dimensions of existing structures, if any: Front Re r . . . . . . Depth Height ...on~.s........ Number of Stories . Dimensions of same structure with alterations or additions: Front ....S?' k:...... Rear SQ^' Depth Height S ~ Number of Stories e 8. Dimensions of entire new construction: Front Rear ' Depth . Height - Number of Stories . 9. Size of lot: Front ......./.GC% Rear Depth . 10. Date of Purchase ....17.1'el! - `l.`4 Name of Former Owner COT . 11. Zone or use district in which premises are situated R.- q 4 12. Does proposed construction violate any zoning law, ordinance or regulation:......./F'. U . 13. Will lot be regraded ........../i'S' Will excessfill be re vm JJ~~~nnises: Yes o~ 14. Name of Owner of premises i(oCSr ,13!tithe/?, , , , , ,Address 60 `r ~ i5iioC9 . Name of Architect ; ji~/v[~S S! bz! i!...... Address Yq !7t?6r r!4-.... Phone No. .S Name of Contractor Address Phone No............... . 15. Is this property within 300 feet of a tidal wetland? *yes...k 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 from property lines. Give street and block number or description according to dee4, and fghow street names and indicate whether interior or corner lot. o~eev STATE OF NEW YORK, S.S COUNTY OF 4-. 7. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. L He is the ~ ~Tt.C,/..71 (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 9~-.:..........day of. .`2.` 19 Notary Public, County LINDA J. COOPER (Signature of applicant) Notary Public, State of New~-e-;~17r~ No. 4822563, Suffolk C m Term Expires December 31,18 rli..IU --I K 111 of 1-111W M. 1195311 `rry 1U~11AI 1~~yII U1~ O = ° T O Q T > M -4 0 s c In D @ Y D < 00 > CA ?5 -4 ;j z PR to ic ~t T) o b Z~°>N ti o> o m ~~aaau'RAMp"'~y, Ir ` mD`sA° nnum~"`~ 3 ~1L 1 z It' 111 oZ y GI ; E y 61p~,,a fir Rt '~'7VM o... ~ U w lY o a gA ~ Y p N 0 ~z R m ` n SO D {s Z C ~ ~r J v as A ^ r N \ \ WN m oo.cr/ 00'00/ ~ 00. O~~ ly O fA (1 y a OdO,~7' G-IW T m 3 O m A:~ m - „ n c IN o z ~9 r A i Z ca 0 z ~ N Z W7 00 ~~KISTtNG FOOF TL's KEMAIN~ I DO ~ o ~W rmo,eE NINPOW * R~RTIoN F-EMOVe f-ultTION of S71N6, WALL. Plco?IPB px167INGI WALL. t-W VIPE NFN FI~ADER ENV F!k?e. NEW C.A&EMENT WNPOWs-r-- r Z NEW P=W- L ~ExlsrrN~ Slt .IS^7N 61 SID INCr TU ~ Q~ E rbslN, P/*TCH A~~ ~ REM.sIN, P/*T (tE6tU I R.,E P. cQUIR.~P~ Q Z ~ ~~pn Z O VI 7 12LMOdE ~~ToN Cxs k WI NIO, NC2 ION NI 14DW-7I0rJ W4LL, ND t~P.PI?Tbf2. T ut+LL.PRwIDeC~) weer r! -~P°DF ANDE~p'_3Er 1NPEF~3E1~ - ~GIN235 v1i22xIO Hole. I ,g.F'Wq 12069-~{~ tW vvNe H-W H ibg_sf, vR D WC2~V 6Tel~ 2-2x12- y?tvg,,x l l , sT X3'9"x I" STL, PL4TLz 'LF sT;~v .~JPPORT ~X{~'rl - cN To Grupe -i oN MuLTiF'L(L srLAP PN IZGM OV@ Ex i6'~NG LAFi Ir1ATE L PKo?I ~E NEW v~IK FLO. K 4." L AN15 ~ "THAN DAiSTINCa. KnGhT~R Ta REM.cIN L i y i 17 ~2C'MOVE P•LL ~xlsr. wa ~xlsr. wa•LLp,>~. I' 'L- ~Liv I g I LIPPEI2 G~pIN J i ~I y PAINT FAINT FAINT i== FOK Fce r-Ts i /I~, V~ ~I ~ AND wRINGr >rALL. PaIN r $ y-KEMoYE IARP'ET. NEYJ ~f~NS, INSTiQLL. FIxTI-Ir~E-s ~Y cw~ r= R, , N-L osK FL~Ie-S .1 _ SIG Wa.LL. et-4 P TGH FLGL'71c Wi L LS.L . Wi•LLS ' ~n ~n,• - z y AND cGILING AS IzgQ'!7, As RgQ'r. \ I -LIP i t. eooonoen At Nnren ~l II I~ Q II 1l cL DATE: ^3 1J B.P.N FEE: 7,Sw' BY:^~- ~Wr end, ",e{~+/ W rRr wrJs NEW FA~4 ~9zov1 E NE R-orl E NEN( F.~IJ NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE d I '.Ch1v+(B ExIST, p.~.N ELI nIGI. UNDERWRITERS CERTIFICATE FOLLOWING INSPECTIONS: n? pN~ Re Pf*NT. REQUIRED 1. FOUNDATION - TWO REQUIRED I',~.IN'T WALLS ,CEILING. C~ ~ - ' s pn-!Y~, pN~ ~FINL"~I-{ ~LLYJF+~ k; FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING {3. INSULATION . FINAL - CONS BE COMPLETE FORRCO. MUST CCUPANCY OR 4 ALL CONSTRUCTION SH E REQUIREMENTS OFATHE MN.Y. SE IS UNLAWFUL TH WITHOUT CERTIFICAMODES.C NOT RRES RESPONSIBLE ERGYFOR OF OCCUPANCY DESIGN OR CONSTRUCTION ERRORS r~~ ~~~ISThNC~ pmF Tra IZEMAIN~ a ~ o Wo m~ ~ o N'EMcNE WINCJONJp{. pO@'TEOf~J Re.EMOVE PGFTlpNI OF `pUSTNGi WALL, I KCVIpF ~C SfINCn WALL.. FFcO [VE. (`16W HEADER ANP pk27je,--r NEW CAE.BMEN'T WNPOWS-r----- 1 I z EX,' NSW Dave QQQ ' - - - Ell ~E=x IST1NEj SIP ~~T1N6j SiaiHC. To Z R€MAiN, P.AT M<+i ~ , P,A'TC H ,nn=_. I ill ~ REaiu I iz,.E I?. :aiuirz..EC~ A .E' W&LL-,E Poi ~oN bclsT, REMOVER ToN Wj ~.:~T~oN w,s.LL, z ~ / kCAL4, f'(~JIDE C~~/SNDERSe'~ WIN70y! AND C'IAT ~N ° 2xIO NDI't. PROVIDE ANDERSEN NDEIZSEN GbOR $ FvJq Ito 6 a -4 Iwr - - - - vN 06-q WiNEW Hp2 l / "iREA7'E: D WQ7D STEI"3 'z''~IZ Vi?5~B 'I f' STL vs "x I f' STL PLA?~ A (T1ID ,~..iFPOR7 ~X e'1 T° G oE- ' oN MuLnPLC S(uD n -ISM WE Ex r6TNC~ L+dM iNM-E _ ~L, Pk/-r'~cE NEW OnK FLC'ti~ ~~~m/L wNn~iN~ 41' LowErt 'THAN AXI-STiNGy, k.~•~TOk Ta REM.dIN I V~ S'+ i lQI r'Lw- { ITIC-OU - ,r. REMOVE AI -l-1 _ Ex 16T. WA~L 2EMOVE ALL f. :X167. W,O•LLI°,oPER,~ lµ FC. -1ovE eclsr I UPPER C.ApIN eTrz ~'1 III I°O.INT 1 A a,IN'T' = a r4TC~ as _ Q - qI--IN7 -P~FRI S"INSp-AN5 ~rIeEN OVE lsiRPET. zJ G 1`J Iz~M w ALL, PaW7- IhD ¢P-EFINISH FIxTU'S SY oWNFK-.~ - u ,wNEK-.~ LN"iT~Y - ALL a+K ~t~oe S~ i -_44 \ ---REMOVE RlelS7,46 WALL. G waLl.. < ~ ~ eF PATCH FLC--K, lvA?L s /.+•Ly LS.%1 - rn yr i AND «ILI1461 AS IQFQIP, v kk ~r` ~~~~'~jj J APPROVED AS ,NOTED ~G,~ rr l/4 ~1 o I IJED~'Q~~ ~l"~..._..~ Lt~`/ L?r V I~C~ ~r VI~•C~L_l~ _ T~J/4.Df 1.~~~ z a .4! l.V o FEE: ,`5 BY: t UNDERWRITERS CERTIFICATE NOTIFY BUILDING DEPARTMENT AT °w yy~yyd-',o ern G6 New F, 4 't _ ~°FZO~t E w REQUIRED 765-1802 9 AM TO 4 PM FOR THE n5c ~ FOLLOWING INSPECTIONS: 7vibE NEW PAN `"u, "fy 7 i 1. FOUNDATION -TWO REQUIRED B f''AIN'r WALLS,GE LINGf. t \ % 1 IZEMC EXI° 'ICn/$ FTI-~.T. ~,^iY I'rLl FOR POURED CONCRETE G C{-I .•NO ~RM=~AII~-. PANCY OR 2. ROUGH - FRAMING & PLUMBING S. INSULATION ((((~~~~G~~7"---- f2EFINISLf FLc us+ S UNLAWFUL 4 BE OMPLE E FOR C.OTION MUST } I 1 1 WIT OUT CERTIFICATE ALL CONSTRUCTION SHALL M THE REQUIREMENTS OFTHENY. CUPANCY STATE CONSTRUCTION ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS i