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HomeMy WebLinkAbout22331-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23625 Date MAY 11, 1995 THIS CERTIFIES that the building ADDITION Location of Property 65 LAKE _DR. & 3405 KENHYS RD. SOUTHOLD H.Y. House No. Street Hamlet County Tax Map No. 1000 Section 59 Block 5 Lot 24 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 25, 1994 pursuant to which Building Permit No. 22331-Z dated SEPTEMBER 15, 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 SECOND STORY ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MARIO DiSANTO (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. M-344973 - MARCH 8, 1995 PLUMBERS CERTIFICATION DATED APRIL 13, 1995-FRANK GIANCONTIERI Building a ctor 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 AUTH RIZED) N 22331 Z Date . 19?K. Permission Is hereby granted to; ...:.-..ac... s/ ~ t ......ft ` .../.....93........ to .~fY'....r4.~.'...3`0 .........,017`i a..... b..,.,. ?¢s .............,.f?./~~..A../.............................................................................. ,y ............:./..,.Q.~.. d Tl . at premises located at........ 4a...../...1..f.X .(V/ ~.Q.(%........N. ~~1 County Tax Map No. 1000 Section Block .........QQ....,. Lot No. Zy pursuant to application dated ...............~/ur. 19..1.,. and approved by the Building Inspector. r9o Fee $..,7 Building Inspec r Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENTR S X995 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 electricatt installation from Board of Fire Underwriters. 4. Sworn statement from1plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial buildin 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 - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 a^t Date .(.,I~- `JS New ConstructionV ..st Old Or Pre-existing Building.. . Location of Property.... 6 5 y G . House No. 1 ' Street Hamlet Onwer or Owners of Property..Mr..`.mrS I1 \Ar)'D 0 ~5^ r\ p County Tax Map No 1000, Section Block Lott . 2, `I .....L Subdivision............ .Filed Map..........y...Lot Permit Z...Date Of Permit..9.. ! ....,....Applicant. IIC~c..l ~ c~ 4....... Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval / Request for: Temporary Certificate........... Final Certicate...' Fee Submitted; $ z5. . r. _c'~o.~6as Ann. rn Town Hall, 53095 Main Road .i Y Fax (516) 765-1823 Telephone (516) 765-1802 P. O. Box 1179'? ' Southold, NewYork 11971 OFFICE OF THE BUILDING INSPECTOR MAY " $ 1995 TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE: ~ Building Permit No. Owner: J(9$Lpk>ne Di'-UC }'D (please print) Plumber: FIAOII"~ C 0A?1 . /#i(,l (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers Signature) Sworn to before me this day of 1~ Notary Public, County t `~~Fe;:ary+!'uhlio, State of New York NO. 30-5412890 Qualified in Suffolk County ~'nOMMIS3lon Expires Mar. 30, 1996 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1000954 BUREAU OF ELECTRICITY F 83 JOHN STREET, NEW YORK, NEW YORK 10038 Date MARCH 08,1995 Application No. on file 86400894/94 N 344793 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 MARIO DpSANTO, 65 LAKE DRIVE, SOUTHOLD, N.Y. in thefollowing location; ? Basement ? Ist FL ® End Fl. OUT Section Bloc-h1000 Lot 59-F24 was examined an MARCH 06,1995 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS ECEPTACLE S SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K W AMT K. W. AMT. K.W. AMT. K. W. AMT. H.P. 9 15 9 9 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI OUTLET DIMMERS SYSTEMS AMi. N. W. OIL N. P. GAS H. P. AMT: NO. A. W. G. AMT. AMP. AMT. AMPS. TRANS. AMT. H. P. NO. OF FEET AMi. ,WAJTS SERVICE DISCONNECT NO' OF S E R V I C E AMT "P. I WK METER Imo, iW 1 8W 3,e' ]W 3,e AW NO. OF CC COND. A. W G NO. Of HI-LEG A W G. NO. OF NEUTRALS A. W. C' EQUIP. PER 9 OF CC. COND. Of HIIEG OF NEUTRAL OTHER APPARATUS: ELEC. ROOM HEATERS13-2,0 K.W.,1-1.0 K.W.,1-.75 K.W. G.F.C.I:-2 SMOKE DETECTOR:-1 BEACON ELECTRIC CO. LTC.#865 c9~ 637 SEAFORD AVENUE MASSAPEQUA, NY, 11758 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 MUST NOT BE ALTERED IN ANY MANNER. 't FoLlre, C2 Town Hall, 53095 Main Road a* Fax (516) 765-1823 P. 0. Box 1179 Telephone (516) 765-1802 Southold, NewYork 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD April 5, 1995 Michael Dedona P.O. Box 512 Easthampton, N.Y. 11937 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasonst 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. XX No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 22331-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. IPAT II i ONMENTS • H JNDATION _ ~(tst) JtJDATTOU (2nd) IL co y JCH FRAME ",'•PLUIIHING • yI~ ~ /jam^~y]~. •.M~. • 1 • Aim • ^4M ? wws~..~a.... to m e m 10 :ULATION PER N. Y. y STATE ENERGY CODE FINAL AD TTIQNAL COMMENTS: FY/ M o M ' X • H a 0 i 13 -.f 2 • M ' r ' v• M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ( } ROUGH PLB . [ ] FOUNDATION 2ND [ ] INS TION [ ] FRAMING INAL REMARKS: DATE INSPECT M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: 7 n J DATE o~ 9 INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 LATION [ ] FRAMING FINAL REMARKS: DATE INSPECTO M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBQ. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL /~/Z/~ ~~20 REMARKS: /Xfll% _ ~©l1/D71-' DATE Z2 / INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ) FOUNDATION 1ST [ ) ROU LBG. [ ] FOUNDATION 2ND NSULATION [ ] FRAMING FINAL REMARKS: DATE KiNSPECTO r 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL, REMARKS: DATE l~ ~~INSPECTOR M-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ' ROUGH PLBG. [l F NDATION 2ND [ ) INSULATION FRAMING [ ) FINAL REMARKS: emu; z~~~2 (;Vk Lf,/9 -(0. :r - ale DATE //A~44 INSPECTOR t TITLE No e Y z y, - 50. ss• . RN !L p" 3S~ 14 `b 1q I~ / 7- Pn E r" a'= f C D e~ CrA, R` < 'YC v s0 +o G x EA T Pn/r o - -mot CJ72 't \ r JC Zl- <c I \ 4 Y a+.J V ,T I I _ - L-D Qc OB"N /98•/ pp- d. roe / ~:r Pr ? 7-n.r rte/.?" MAP OF PROPERTY AT OF NEW 0A4 ~o / PS6 YO / GUARANTEELfTO SS JAS E. Mll</y 9•r 7MC ;0/C .~J?r?+. j`EE Corn/~?o~• FOR 'cf .~lhsc No. 0~ y SfG LANO Sum C 11)ZE1 `~jL±LL:LIl=~ NEW YORK STATE LICENSED \ .lE iror PROFESSIONAL LAND SURVEYOR 169 SCARS ROAD V.-EST ISLIF L. I N Y 11795 BOX 291 NO •,9 ai c- 569.g952 - .neoe V<GC Nni tD gcc<De or TITLE No / Z ! Oo 5,.. A° ~at01 APR 11995 R ` ` L c lya33 5', 9s \ ~ `i 3A do;0 _ P~ l 5 ~ 4y~ " ,102 10 d f Vii j~>, fler° C O e 0 y° cD .-a J ? 39' W° o 0 o s G 1. /Z.a ' ~ ~ ~ ~ tt ~ v 9 Y . \ \ a i B• V I /A9 oT ,ec1 or'" r h" Pr' D r, MAP OF PROPERTY AT 7o,r ma'r' d.r."' of NEW v ? f~~'o GC Co ?H f//- 4./. v 1,0k14 v.i d •..~a/ ?J.°. /S J. GUARANTEE/ ES TO 1 21- /94Y * ?hc %i¢/e Jrv yee Co:"/1 yY tws + FOR 10 0 f ftt 14O.W% SJ/ G~.,A~anw/nfo J/ ~1 sfO LAND SV~ ~JCLII2E~ t'`1CLLCC2i1 ~I NEW YORK STATE LICENSED 110 M~rt~I _/s /~J/ PROFESSIONAL LAND SURVEYOR 189 SCARS ROAD WEST ISLIP L. I.. N Y. 11795 BOX 291 ' No. ~7 • ' TE•L 669M1962 - 1'.1fA°C1-ITFF tJ(lT T°I,Nf CFR nF1F BOARD OF HEALTH 1 r~ FORM NO. 1 ~~gQ J SETS OF PLANS , I Z 5 TOWN OF SOUTHOLD SURVEY . . i BUILDING DEPARTMENT C11CCK . BLDGDFPT. TOWN HALL SEPTIC FORM TOWBOFSO\fr? - SOUTHOLD, N.Y. 11071 'f,a( r~ n TEL.: 765-1802 t:ofl L F L l . Examined C A 9 19 1ll../ y~ 2 2 NAIL TO: Approved . 19//. Permit No r!: J_ 3l~ _ . Disapproved a/c { _ . (Building Inspector) P (CATION FOR BUILDING PERMIT Date 19... 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- 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 code, and regulations, and to admit authorized inspectors on premises and in building for necessanf.inspect; ens.- (Signature of applicant, or name, if a corporation) PU • .rsox. , sip ~~z !~:M~ ~/Y,. , , ~ly.~ (Mailing address of applicant) State whether applicant is owner, lessee agent architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises v ,t,o . , , a; . . Z D ~C~•h,1,~ c \ S~ v (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. C_?. ` A) Plumber's License No. . t • , fL , .o( Qfl C cnf Electrician's License No . Other Trade's License No. I. Location 65 of land on which proposed work will be done . . . ~e-.. 0 r l . [louse Number Street Hamlet County Tax Map No. 1000 Section , . 5.1........... Block 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 , h/,/// n S 2,t ` J.. b. Intended use and occupancy ~(/i n,} , • ,f c , , , , , , , , , , i 3. Nature of work check which !applicable): New Building , n L S~ r Repair oration ( Removal :Addition • Other Work Demolition 4. Estimated Cost. I . , . U (Description) 1. Fee..... 5. If dwellin ! (to be paid on tiling this application) g, number of dwelling units , , . , , , , , 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 . 7. Dimensio~ of existing structu use . ' ' }es, if any: Front ( ..y e~+ Height .....r~~.~.. • • Rear .~/~.'..~4cif' . Depth . 2. %oo}... Number of Stories ...91\e Dimensions of same structure With alterations or additions: Front .1 fD, a • • . • ' ' ' ' ' ' ' . ' Depth .`J...T`.5t....... ...Height ..a~.1 ~ ........Rct .~C~•.J~`~i...... • Number of Stories .T`_! o . 8. Dimensions of entire new construction: Front ,2.1. Height . q. FA,0 Num • Rear ...........Depth . bar of Stories . 4nc , , 9. Size of lot: Front . Rear Depth 10. Date of Purchase .Jq1~...S, . . i!7, V V7 Z; , , , , , • Name of Former Owner . GAS, , , os 11. Zone or use district in which premises are situated . . . . . f ' ' ' ' ' ' ' 12, Does proposed construction violate any zoning law, ordinance or regulation: .d.V 0 , • . • . . . . . 13. will tot be regraded • , , • , , will excess fill be removed fr m premises: Yes 14. Name of Owner of premises M-Yrs QV:-V) 'ru , , Address 6S ':1(` D~ S"14, phone No. 76 S lD~~ Name of Architect . , , , , Address . • ' • Name of Contractor WcNZ `;.n Z Cjns 1 Phone No. Address woo? VcYes phone ati ? r/ 2' 15.' Is this property within !300 feet of a tidal wetland? t< *If yes, Southold No......... • `f own Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly ad 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. I i i I • I STATE OF NE OR COUNTY OF . ..6( (Name of individual signing d 0.y: ~1.... ' ' ' ' being duly sworn, deposes and says that he is the applicant contract) ibove named. feis the ....,'II (Contract ,agent, rporate officer, etc.) ,f said owner or owners, and is duly 4utitorized 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 this G' . 5 . `...day of. otary Public ~p~ County CLAIRE L OLEW Notary Pubito, State of NowY¢rk No.4879606 (Signature of applicant) Qualified in Suffolk C0 /py Commission Expires Decent Mali ExI bT I K4 6 EKtST G LOS. ~ EY--l J-rlu(n LVI -Kn. Misr 13r r1M_. ~1 I S T - L - - - EkiS'r LLOS, - T P T E REMOVC.'Cj U~ NEiW 5t-V) PLUMBER CERTIFICATION TgHZS N ON LEAD CONTENT 43EFORE CERTIFICATE OF OCCUPANCY SOLDER USED IN WATER 7D SUPPLYSYSTEM CANNOT 5-TT r s r: c 7 M. EXCEED 2110 of I% LEAD. ~bATH c r ~ ~I OT //J - ~ C LOS. _ F I R5T F Low - L,&, f-! SGAL>= - - + CF~IS-rItJ.U) PLUMBING I't -cicl5-rl uCs _ _ 2 I'_ Co~ N E~ ALL PLUMBING WASTE & WATER LINES NEED TESTING BEFORE COVERING N copper tubing is used Z for water distributing system; piping shall be I - of types K or L only S z+oTZ- 2 V V6 C Jun nr.. NH v, moan n 57K ~ mfr Ca A~7 1~ l 71 O ~ URQJRWRITERS CERTIFICATE ~I - REQUIRED NDTED '`I-V K.NI 'ROOF cis ,~1~1 ('t DATE: B.P. N / FEE. BY. L ~ OCCUPANCY OR N OTIFY BUILDING DEPA ENT AT LAOS LLJ S. + 785.1802 9 AM TO b P FOR THE ~~~iL~os. uu. LLOS -o`wiu I 30' FIiIJ USE IS UNLAWFUL FOLLOWING INSPECTIONS: FOR POURED CONC CERTIFICATE 1. FOUNDATION - TWO REQUIRED OUGH - FRAMINGR&TPLUMBING WITHOUT 2. R 4. FINAL - CONSTRUCTION MUST ~ ®~~U~~_7~pv~ ,lt~ 3. BE COMPLETE BE COMPLETE FOR C O ALL CONSTRUCTION SHALL MEET bT. .0 N v l THE RFOUIREMENT9 OF THE N.Y. 7h ? ~ Doi u i r, STATE CONSTRUCTION & ENERGY U,00ES. 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