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HomeMy WebLinkAbout22235-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23552 Date MARCH 16, 1995 THIS CERTIFIES that the building NEW DWELLING Location of Property 230 RHODA ROAD MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 106 Block 5 Lot 19 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 19, 1994 pursuant to which Building Permit No. 22235-Z dated AUGUST 4, 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 GARAGE UNDER & FRONT DECK AS APPLIED FOR. The certificate is issued to INLAND HOMES, INC. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL-R10-94-0033-FEB. 17, 1995 UNDERWRITERS CERTIFICATE NO. PENDING - FEBRUARY 27, 1995 PLUMBERS CERTIFICATION DATED FEB. 28, 1995 GALE KASKE PLUMBING INC. Building Inspector 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 COMPLETION OF THE WORK AUTHORIZED) Date ..'50 19.9.V. Np 22235 Z Permisslon Is hereby granted to: ..1. ~ia~.L '01 d...04i~. ......11.17 v. . . d.......®... 5tece °2 .....10!?, .r..Ids...... : a ......................................................................1............................®.................................................... at premises located at............ lac) ~..~.../0~.... ~4-'.l..o i..f /..1.YA......................................... County Tax Map No. 1000 Section ../.4?4.P Block........: Lot No. .11 pursuant to application dated .................J .(..........1../......, 19...f..c4.... and approved by the Building Inspector. Y,/ q...-..... Fee $......i3i Building InspectS~l~~ Rev. 6/30/80 i 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. 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 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 3/3/95 Date New Construction..... Old Or Pre-existing Building... . 230 Rhoda Rd. Mattituck Location of Property........... House No. Street Hamlet Inland Homes Inc. Onwer or Owners of Property . County Tax Map No 1000, Section ..l.0.... 5 19 ......Block ................Lot...................... Subdivision.,0aptain Kidd ...............Filed Map........ Lot.................... ....Inc. Permit No....?~35.......Date Of Permit. 8/4/94....... Applicant .Inland Homes . 6730 /94 . Realth Dept. Approval 814, 94 ,0033 ...Underwriters Approval .8.. Planning Board Approval XX Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: $25.00 Inland Homes Inc. C~,. `fq~4o CQ 2 01 3 Y 1 APPLICANT ' . TEL. 765-1802 FuC TOWN OF SOUTHOLD ( .c OFFICE OF BUILDING INSPECTOR ,trP.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 C E R T I F I C A T I O N Date p cS Building Permit No. 22235 Z Owner Inland Homes Inc. (please print) Plumber 0c~ e V4AS ~4e-_ - (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber's signature) Sworn to before me this a8~~day of 19 Notary Public Notary Public, SyFF~fK _County MARGARETC. RUTKOWSKI Notary Public, State of Now York No. 4982628 Qualified in Suffolk County ~ Commission Expires June 3,19 _ U COMMENT m a :UNDATION ~ (tst) ~ y ~1 ALE UIJDATIOtf (2nd) sl n 2 0~~ ~L lFv- o. UGH FRAME & . /y ' m SULATION PER N. Y. II 3 STATE ENERGY I~ CODE ti FINAL y_ ADDITIONAL COMMENTS: x 1;7Z, e r r~ x ^o H~ H W ~C+.~1A. =..~%C.:_T.3fiyc'..:v.iw.. r:. ce....r. :'Slu'•. %..t r W M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN TION [ ] FRAMING' FINAL REMARKS: DATE /~S INSPECT M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ I ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS ION [ 7 FRAMING FINAL REMARKS: DATE ~o~ ~J INSPECTOR MINN 765-1802 BUILDING DEPT. INSPECTION [ FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL ~t REMARKS: ti DATE INSPECTOR aa35OR:~- 765.1802 BUILDING DEPT. INSPECTION [ ] FO DATION 1ST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: 4 i DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ) ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING [ FINAL . REMARKS: DATE 3 INSPECTOR c~ M-iso2 - BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS TION [ ] FRAMING [ FINAL REMARKS: 6z c5v4& 2~y -A W44-1 DATE1 [3 1 bf INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL REMARKS: c DATE I INSPECTOR y y 3 f-45" M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ vf"ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [vj-FRAMING [ ] FINAL REMARKS: DATE %L ~_INSPECTOR °V"J THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1. ( ~1195099 BUREAU OF ELECTRICITY I 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date MARCH 02,1995 Application No. onfile 86 7 3009 4 /94 N 3442113 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 INLAND HOMES, RHONDA ROAD, MATTITUCK, N.Y. in thefollowing location; ® Basement - Ixt Fl. 2nd Fl. GAR/ATTIC/OUT Section Block Lot was examined on FEBRUARY 27,1995 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT K W. AMT. K.W. AMT. KW, T. X. W. AMT. H.P 21 39 25 20 1 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS ;ELI UNIT HEATERS MULTI-OUTLET DIMMERS AMT. N. W OIL H. P GAS H. P AMT NO. A. W. G "T AMP WT. AMPS. TRANS. WT H P SYSTEMS AMT WATTS NO. OF FEET 1 F 2 - - 3 1. 1 600 SERVICE DISCONNECT NO. OF S E R V 1 C E AMT. AMP, TYPE METER I C TW I % 3W S % 3W I3 p' AW NO. OF CC. COND. A. W G. NO. OF HI-LEG A. W. G. NO OF NEUTRALS A' W. G' EQUIP. PER % OF CC.COND. OF HI-LEG OF NEUTRAL 1 100 CB 1 X 1 4 4 OTHER APPARATUS: MOTORS:1-F H.P. G.F.C.IL-6 SMOKE DETECTOR:-1 TRACK LIGHTING:-B JIM SAGE ELEC. INC. LIC.#3635--E 350 MARINE PLACE GENERAL MANAGER GREENPORT, NY, 11944 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 MUST NOT BE ALTERED IN ANY MANNER. _ ~R ~ p p~1~ ACS OCT I I M t Bt.DG. DEPT. G" c a 3 w o 7JG?;' \w '11 C70 14-f 71 0.06 - •M, 6E..^_t -N l~Clb ~ U a 4 N w 4~~ a ' a . w t} a t s- . - \~TItG j i~ I ~z to m A" z o° v i Ia f 4 ~'c tb H i 3 S Q h R o 0 0) !QA E< C m ;n.4 t q i { x a jh °,fi ~ W a, to ~ry m E v? 0 m C C O< x m m yz p°_c A0>1Z O r uI3 s mr cmx x 3v'm O n m -00 QIAu o U~, D J. Q t2 \w 4.1-0 a u O Y o~j 2-~ a -e N w U n a 6 w z o Q p'' 1 LL. IL z w rn z l", U. w z iL Eno w F- 0 3: F=- (AU(n 1'n(npUOxQ O O f, O M Ot 4 ? a Q 9 ' j ~f' .n n2 ~ n2 P Al, Ilk. hJ • h I a . ; i J t Z ~y L 1 V - - Q N9on. _ - - hr !2 `34' p+l. O ' l le~ i N \ ifL D BOARD OF HEALTH '3 SETS OF' PLANS • •FORM NO. 1 SURVEY t TOWN OF SOUTHOLD QH1ECK,*• f Q0L-: • . ~iR g BUILDING DEPARTMENT SEPTIC FOkM TOWN HALL - Q/ SOUTHOLD, N.Y. 11971 NOTIFY •R TEL.: 765-1802 CALL MAIL TO:, Approved , . 4rPermit No. °~~1 S J Disapproved a/c (Building Inspector) AP CATION FOR BUILDING PERMIT, . Date dul$ 18 199W . 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. I . 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 Bui1dL*tg Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit eltall 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. "I'lie 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 inspections. Inland Homes Inc. (Signature of applicant, or name, if a corporation) P.O. Box 117,Mattituck,N.Y.,11952 . (Mailing address of applicant) State whether applicant is__owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..........Geexa~.~oxlt>"a~t4~ Name of owner of premises ...Inlat .9(?mes••Jw.••.. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. Robert E,. Hiltz (Name and title of corporate officer) ALL CONTRACTOR'S MUST HE SUFFOLK COUNTY LICENSED Builder's License No . #2451-P Plumber's License No. Electrician's License No. #3635 -E Other Trade's License No. 230 Rhoda Rd., Mattituck,N.Y., I . Location of land on which proposed work will be done. . . 230 Rliod`a, RD. Mattituck [louse Number Street ; • • • • . • • • • . • . • . • • •Hanlet 11; 1 County Tax Map No. 1000 Section . .106............ Block 05 Lot Subdivision Capt.. ..a...in...Kidd Filed Map No. Lot . (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: y~{ b t trf .nJ IMAM a. Existing use and occupancy b. Intended use and occupancy , Single • Family Dwelling d1`;r` , , , • , • , , • 3. Nature of work (check whilFh applicable): New Building # , . Addition r ton "i; . Repair Removal , Demolition e . k-.Ij....... . r (description) $5 000 .001 4. Estimated Cost , . Fee . 7~.... (to b aid o filing th' plication) 5. If dwelling, number of dwelling units Number of dwelling uni" If garage, number of cars 1. CaSS C7. . If business, r mixed occupancy, specify nature and extent of each type of use Dimensions of commercial structures, or existing ifany: Front Rear Depth Height ...............'Number of Stories . Dimensions of same structure with alteratio pr additions: Front Rea Depth .0 Height Number of Stories . 3. Dimensions of,~egtiire new construction: Front 55~ Rear 5.5 ~ Depth ~.r. Height . Number of Stories . 9. Size of lot: Front 90 . Rear ..90.x., D . Y . 10. Date of Purchase 13/,4/.86; Name of Former Owner ether Soualas 11. Zane or use district in which premises are situated . 12. Does proposed construction violate any zoning law, ordinance or regulation: . NO . 13. Will lot be regraded ..Yeas Will excess fill be removed from premises: iM 1, 14. Name of Owner of premises', ..I.. H'otries:: . Address , Phone No.2298-9.696.... Name of Architect . Address Phone No. . Name of Contractor . tnTarid Homei3 Address . Phone No.,~~j1,1~1~ . 15. Is this property located within 300 feet of a tidal wetland? *Yes No *If yes, Southold Town'iTrustees Permit ma be re uired. . PLOXT DIAGRAM Locate clearly and distinctly' all buildings, whether existing or proposed, and, indicate all set-back dimension:i froi property lines. Give street and block number or description according to deed, and show street names and indicate wheth( interior or corner lot. ISEE ATTACHED SURVEY I' I i I I STATE OF Ng~YYO S.S CO MY OF ~.1. © 11(• l• • 1 • , being duly sworn, 'deposes and says that he is the applicant (Name of individual signing contract) Bove named. I le is the . (Contractor, gent, corporate officer, etc.) of said owner or owners, and is duly authorize r orm' 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 tlti ay ~f 194 Notary Publi,s~/ County " CLAIRE L OLEW Nmq Public State of Now York' • • • • • • • • • • • • • • • • • • . No. "79608 ( ignature of applicant) ouelifled in SU14W C4u~y 9 Ostnndsslon f ites Oeoemper 8,19.4,, ~t Dow, s4 A W µ h I w. i 'V n nYl h v' W t y~ li ~ 4 Wl s i r<t ~tt3r -'%=%44, cs ~.f. fezr r t ~ 'tk ' f J a /n r t~ F G) r ! n o cat ~ C. ~ I 4 V nn rr t M ;u 1)5 lv ; t Fa a DOmG C 0-<S . = r cn 0 m" C0~ X AN-4 Q; a _v Z a N 0 a C h ;a s b vM w (m~ m tiA ) m {x 6cJ S~ 'J 1^f~.~ 1 ri_~ T Z V r ? fir a v. c x r K l 3 tu 10 V /y ~f {iy of M >-Dm2,. 10 a 5 m rD w Z m -Zi W a t L+' a a m rn AL ` "n 2 !A m !r" r c y zi, Aiv Iy `k C1~-ft' - n ZIS m q ml f ~ *a r 4 ~ ~4 s ; e 6 E B m 9,5' 0' J E F '`Y`d ~i a ST N yp~~ 7 N~ q~q4) < C. r~ MYl '~14' I ~MF,.A" §JA+ n u Tyr .pk 9. ` e ~ •fr { EJ ~ n ~ ~ a+ti ~ ~ ~ ~J, ~ N ~ ~ /y~~ 1~ x 9€ +ae 1-4 a. . f i wa Y. s 1 r a+ ~ .r v W rtr 57- y All r l+ Sy C t: 'dh~ "tt 4-1 IN, u ta ~,V. yM F9Y~ Y 4s1 ~ e+a a i3 dR ? a y 777 9 cr~r x Y a7 ;fang. ~ssK"Sy ,>•t: T~'f~'e-~,A~ ~t4" ~ ~ t,~'s r 1 { i . , Pik 'Ut 10 FIR, T, 3k ~s "I'll, 2t ~~y` ~ ~ £'t 'ri.S ' 1~ R7 tlro Ffi ~ V+ 't1 vt -f , r o "n to " c or z 1 + qp t~#~ e p . fn} .O m < m~ r r 3" 4 1" N fi~ 4" m^ C fro 'x y x y m Z-4 -4 a ao ~r s ; ro C7 CI, 0 (n ;D ~ a~ ~Fq x~ ° ~ * th t" A ~ D tero ~5 D Alp ~7 f iz, i DO NOT PROCEED N eopPSr tubing is used PLUMBER CERTIFICATION F/CATION UNTIL 2nd SURVEY OF I ' OCCUPANCY OR for wehr distributing ON LEAD CONTENT BEFORE FOUNDATION LOCATION U USE IS UNLAWFUL ""t""" piPi°g-shall be ~ CERTIFICATE OF OCCUPANCUI Of types K or L on fT BEFO CY HAS BEEN APPROVED CCUFAN APP CV D AS NDTF~D_ SOLDER USED IN WATER V WATER CANNOT DATE: e.a x WITHOUT CERTIFICATE SUPPLY SYSTEM CANNOT FEE: 3 f BY 1 % LEAD. NOTIFY BUILDING D MEN UNDERWRITERS CERTIFICATE 766.1802 9 AM TO M R THE OF OCCUPANCY EXCEED 2110 of 1 % LEAD. PLUMBING REQUIRED FOLLOWING INSPECTIONS: ALLM.UNRRNGVi = J, a" WTER IINFA NEED T, FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2- ROUC!-I Fq=,nrIING & PLUMBING TESTING BEFORE COVVERINO l 4, FIPaP„ RUCTION flill,S RE COMPLEIE FOK C O. ALL CONJ FR ICTION SHALL MEET '~1UI 5,10 THE RFC:..I!REMENTS OF THE N1C. 5. 4 _ STATE ffmCT f°U IN ENE RON' 2 ' - --t ~ CiaDES A7 RESPONSIBLE FORI t:!CW`LQH,GUIUS]3iWr.T,14N4ENai(JBB'~ I I Cor+G ~ J7pnP ?630 36 46 3U 3d 30y~M 30 +oM 2e x A5M Dfi`f I ~u)' MuD RM DINETTE 0 T4-, " 20 I Nl I N G- FZ, M nr T 4 ; ~F bE 1J 017 uu~a/>5 J 10i LiN ~uN o HP HP, I- L_ J 2-2b<v8~, 5a', Ni ~1F:Rf ~~o F~ 4 CoDL 1 w a. 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