HomeMy WebLinkAbout22346-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24875 Date
JANUARY 30, 1997
THIS CERTIFIES that the buildin~ REPAIR
Location of Propert~ 2125 WESTPHALIA ROAD MATTITUCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 141 Block 1 Lot 1.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 26, 1994 pursuant to which
Building Permit No. 22346-Z dated SEPTEMBER 26, 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 REPAIR, REPLACE WINDOWS & INSTALL NEW HEATING SYSTEM IN
EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to THERESA pADULA
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
H-053298 - DECEMBER 23, 1996
N/A
~ B~ildin~ Inspector
Rev. 1/81
FODM NO.3
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALt,
SOUTHOLD, N.Y.
N~ 22346
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AU/T~RIZED)
z ' .......................
Coun~,,Tax~op~o. ~000 Seo,on ...... /..~/. ....... B,oc~ ........... /. ............ Lot,~o..../..,...Z'. ..............
pursuant to application dated....~~-7......,~....~. .................. 19...?....~...., and approved by the
Building Inspecto~o
Fee ~.....7.~.~.~.~....
Rev. 6/30/80
Building Inspector
Teresa Padula
2125 Westphalia Road
Mattituck, NY ]1952
· (516) 298-1932
· (516) 924-5533 (work)
(516) 548-9164 (pager)
Remove existing sheetrock and windows
Insulate ceiling with R19 %nsulation and walls
with R13 ~nsulat/i~on
Add headers and jack studs to all window openings (see diagram attached
Replace existing windows
Model numbers: 2442
2432
20~]0
with Anderson Double Hung
( amount- 9 ) ~,~ ~/<
(amount-2) ~¢/~ ~m~-~
( amount- 2 ) /gtO ~,/w~-~
windows
Replace 1/2" sheetrock
Remove existing heating system (forced hot air) with baseboard and oil
fired boiler (see diagram attached)
Change bathroom fixtures
Replace wiring and electrical boxes (inspection from N.Y.8. Fire
Underwriter scheduled for September 22, ]994)
FE_."~ 7~- ~
NOllF~ IBUILDING DE~
7~5-1802 9 AM ~ 4 ~ FOR ~E
FOLLOWING INSPECTIONS:
1, ~OUNDA1]ON - 'rwo REQUIRED
FOR POUI~ED CONCRETE
2. ROUGH .. FRAMING ~ PLUMBING
3 INSDL AT,ON
4 FINAL CONSTRUCTION MUST
8~ COMPI,ETE FOR C,O.
AL.L CONST~IUC'r~O~ SHALL MEET
THE REQUIREMENTS OF THE
STATE CONSTRUCTION & ENERGY
CODES, NOT RESPONSIBLE FOR
OESiIG!~ OR CONS'ERUCTtON ERRORS
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT
OF OCCUPANCY
PLUMBER CERT;?ICAT~OfF
ON LEAD CONTENT ~5;~EFORE
CERT;?ICATE OF OCCUPaNCy
SOLDER USED/N WATER
SUPPLY SYSTEM C~AWOT
EXCEED 2/~0 of I% LE;4D,
If copper tubing is use3
for water distributing
System; piping shall be
of types K or Lpnl_z
PLUMBING
.ALL PLUMBING WASTE
& WATER LINES NEED
TESTING BEFORE COVERING
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [~NsULATION
[ ] FRAMING [ ] FINAL
~REMARKS: ' .~ ·
DATE ?//~y INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING
[ ]FIREPLACE & CHIMNEY
REMARKS:
[ ] ROUGH PLBG.
[ ] INSULATION
[ ~FINAL
DATE
INSPECTOR
TO%~ OF SOUTHOLD
BUILDING DEPARTM~NT
TOWN HALL
763-i802
APPLICATION FOR CERTIFICATE OF OCCUP~NCY
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:
!. Final sur~ey of .property with accurate location of all buildings: property lines~
streets, and unusual natural or topographic features.
2. Final Approval from Kealth Dept. of water supply amd sewerage-disposal(S-9 for~).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in syste~ contains
less than 2/10 of i% lead.
5, Commercial building, industrial building, multiple residences and s~m~lar 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
qpre-~xisting" 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. Cert~i~ Occ~Jp~cy - ~dwetling $25.00, Additions to dwelling S25.00,
~i-~ations to dwelling ~25~ Sw~ing oooi $~5.00,
Additions ~o accesso~ building $25.00. Businesses
2. Cernificaca of Occupancy on Pre-~xisn~ Bu~d~ - $i00.00
3. Copy of Certificate of Occupancy - ~ .25~.
4 .. .Updated Ca~%~_~pj~.~cup~cy ~
5. Temporary Cargificate of Occupancy - Residen~iai $15.00, Co~erciai $t5.00
D~g~ .......................................
New Conscruceion ........... 01d Or Pre-~xis~g Bui~d~g. :..~. ....
............... ............ ........ .................
~ouse No. Street
Onwer or O~ers of Proper~y ..................... ~~ ~ ~ ........ ~ ...............................
County T~x Map No i000, Section .............. Block ................ Lot ......................
Subdivision .................................... Filed ~W. ap ............ Lot ......................
Permit No ............... Date Of Permit ................ Applicant.
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Carticata ....... ~...
Fee Submitted: $ .......................
.. ............
~AP PL i CP~
~{DATTOI! '
GH FRAHE &.,
STATE E~ERGY
CODE
;%DD/TIOHA'L COM~EUTS:
THE NEW YORK BOARD OF FIRE UNDERWRITERS ~A~E ~
f~,~Oi141 BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NY 10038
Date Dt~CE~.]~J[~ 2~ , [!')96 /lpplication No. on fil~ 85830394/94 H ~53298
THIS CE~IFIES THAT
o~y the e~ctricai eqaipme~ ~ ~scri~ be~ a~ int~uc~ by t~ ap~lcant ~d on the a~ve ap~ication num~r in the p~m~es of
ANTIMONY PADUhA~ 2~25 Wf:STPH~J~£A, MATTITUCK,
in the following location; [] Basement ~ Ist Ft. ~ 2.d FI. ATTIC Section Bilk
~sexaminedon DECEVff)E~ 17 ~1996 and found W be in compl~nce with the Na~onal Electdcal Code.
FIXTURE ~RCEPTACLE I WIT I FIXTURES I
20 [ 30 29 20
2,",'.,¥. o,, ,,R,.. ,,.ce
RANGES
~PECiAL REC'PT
SERVICE DISCONNECT I ~o. OF I
ICOOKING DECKS I OVENS IDISH WASHERS
V I C E
NO, OF CC. COND
PER ff
OF CC, COND.
A. W.G. NO OF NEUTRALS
OF HbLEG
Lot
EXHAUST FANS
Aa4T. H, p.
DIMMERS
AM/, WATTS
%~IJ., PUIIP-- 1
PADDLE FANS.-7
MOTORS: 1-F H.P. , 7'~ 5 H.P.
G.F.C.I:-6
SHOKE DETECTOR, '- 1
ANTHONY PADU[~
2125 WES'I'PI~ALIA GENERAL ,¥UU~IABER
HAT'~ITUCK~ N%~, 11952 ~_~
Per i1
This ce~ificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credenti~f~
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY HANNER.
Teresa Padula
2125 Westphalia Road
Mattituck, NY ]1952
(5]6) 298-1932
(516) 924-5533 (work)
(516) 548-9164 (pager)
Remove existing sheetrock and windows
Insulate ceiling with R19 insulation and walls with ~'13 insulation
Add headers and jack studs to all window openings (see diagram attached)
Replace existing windows with Anderson Double Hung windows
Model numbers: 2442 (amount-9) ~'~'~
2432 (amount-2) /~'O~C~
20~10 (amount-2) /VD~-4-~-
Replace 1/2" sheetrock
Remove existing heating system (forced hot air) with baseboard and oil
fired boiler (see diagram attached)
Change bathroom fixtures
Replace wiring and electrical boxes (inspection from N.Y.S. Fire
Underwriter scheduled for September 22, 1994)
FOR POURED CONCRETE
2~ ROUGH ~ FRAMING & PLUMBING
3. INSULATION
4. FINAl. CONSTRUCTION'MUST
P3E COMPLETE FOR C,O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES, NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS ,
~PPROVED AS NOTED ~ REQUIRED
NOT~FY BUILDING DEPOT Al'
FOLLOWING INSPECTIONS: ,-,.~ OF SO'OLD
USE IS UN W L
WITHOUT CERTIFICATE PLUMBING
OF OCCUPANCY ., WATE..N S "EEO
PLUM~ER CER?/FICA770N
O/V LEAD CON? ENT"~EFOR£:
CERT'J/:/CAZ'E OF OCCUP, q/VCY
SOLDER USED/N ~TER
SUPPLy SYSTEM CAAfNOT
EXCeeD 2/~0 o~ ~% LF~D.
If copper tubing is used
for water distributing
system; piping shall be
of types ~
: :7 :" :.': -i-' T'YP. ....
P
TITLE NO. 630S9808-04
.... WESTPI IAL..IA ROAD
Brd~G. DEPT.
TOWN OF SOUTHO!
S70'33'20"E 167. 45'
103.5'
FRAME~
74.7' SHED~
33,506 S.F.
O. 7692 Ac.
/V59'~6 , . ,,
w
L4A/D N/f- OUDEK
CERTIFIED TO:
ALL STATE ABSTRACT CORP.
FIRST AMERICAN TITLE INSURANCE
COMPANY OF NEW YORK.
TERESA PADULA
FLATBUSH FEDERAL SAVINGS AND
,
27.2,
OOWN ~
LQAN
SURVEY OF
PROPERTY
SITUATE AT
MATT/TUCK
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
EASEMENTS AND/UR SUBSURFACE Sl~UCTURES
RECORDED OR UNRECORDED ARE NOT
GUARANTEED UNLESS PHYSICALLY EVIDENT
ON THE PREMISES AT THE TIME OF SURVEY.
GUARANTEES INOICATEO HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY IS
PREPARED. AND ON HIS BEHALF TO THE TITLE
COMPANY, OOVERNMENTAL AOENCY AND
LENDING INSTITUTIONS LISTED HEREON, AND TO
THE ASSIGNEES OF THE LENDING INSTITUTION.
GUARANTEES ARE NOT TRANSFERABLE TO
ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS
THE OFFSETS(OR DIMENSIONS) SHOWN HEREON
FROM THE STRUCTURES [0 THE PROPERI? LINES
ARE FOR A SPECIFIC PURPOSE AND USE AND
THEREFORE ARE NOT INTENDED TO GUIDE THE
ERECTION OF FENCES, RETAINING WALLS~ POOLS
PATIOS, PLANTING AREAS, ADDITIONS TO
BUILDINGS AND ANY OTHER CONSTRUCTION,
S,C.?,M, DIST. IO00 SEC,
BLK, 01
SCALE 1" = 40' AUGUST 8, 1994
AMERICAN ENGINEERING SERVICES
~46 Mople Avenue Union Avenue
Westbury, N. ~ I N. E 11779
(516) 876-8908 981-5063
LOT 1.1
F2487 12\0894M
UUJ SEp 181994 jlj_ BUILDING DEPARTMENT
., ~L.._.~._.~J - TOWN HALL
· BI.D~D"~ SOUTHOLD N.Y. 11971
' I'OW~F s~r~.iOLD TEL.: 765-1803
Examined..Y. e ........
Disapproved a/c .....................................
//. (~ilaing Inspector)'
BOARD OF HEALTH .........
SETS OF PLANS . .
...,C tIE C K .............
CALL .........
(mod - 'T'h Of'S .
INSTRUCTIONS
a. Tins application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
se~ts 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 necessary ins ections.
-- (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.
o ne/' .......................
Name of owner of premises ...~...~.'.~....~..~. ~f....~../~..~ '*L?/-.':'-4 ..........................................
(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 ......................
Location of land on which proposed work will be done ..................................................
Itouse Number Street Hamlet
Cotinty Tax Map No. lOOOSection ...(.~f..! .......... Block .... ..(~..! ......... Lot I ~ [
Subdivision ..................................... Filed Map NO ............... Lot ...............
(Name) '~
2. State existing use and ~ccupancy ~f premi~es and intended use and ~ccupancy ~f pr~p~sed c~nstructi~n:
a. Existing use and occupancy [~.03..~.¢"(~.
b. Intended use and occupancy ...............................................................
Nature of work (check which apphcable): New Building .......... Addition .... -~4Jleration ..........
-- ..... !t
Repair ......... Rem. vel .............. Demolition ............
.~ ~ .~..(~.. "' ~ (Description)
Estimated Cost ............. Fee
(to be paid~o.~'~(lj~B'' 'hi' ~'~ '~?ion)
If dwelling, number of dwellinglunits ..... ] Number of dwelling units on eJdh;:fl6OSZ ......
If garage number of cars I
If business, commercial or mixed occupancy, speedy nat/tre' and extent of each type of use ..; ~.:~... ,'.... ~ .........
Dimensions of existing structures, if any: Front...~.(? :;~ t. ...... Rear .. ~. (2.%.~.~. .... Depih...~. ~.o. ~.. ~ .....
Height ............... Nun~ber of Stories .... f * .~ ................................................
Dimensions~f,~sam~_ge]tructure with alterations or additions: Front ...,~.(~ ! :dL~... Rear .. ~.~ .~..~.'. .......
Depth .'T. ~¢ ~> ~ H~:-,*, ' '"
............. q · · *~r~t[ . · , .......... Number of Stories .... I.,.~. ...............
Dimensions of entire new const~ction Front ' ' R~e pth
i , · . ...,,,,..,., ........ ar ............... De ...............
ight ~' ' ~'. ~
He ............... Number of Sto~ies .,.., ......... . ~.
S~ze of lot' Front ~ .'7.. ~ Rear.. I.q O, R~q
........ . ................ -~.~ ............ Depth . .~ ~[~.o.~.~ ...........
Date of Purchase.. .... q ................ Name of l~'ortr~er Owner . ~..~ l'F.~..~/(2.Q/2q ~ ...........
Zone or use district in which pr :raises are situated...g...~.~..(MY~. .........
Does proposed construction vie .ate any zoning law, ordinance or regulation: .. ~ .~ ..........................
Will lot be regraded .... th{.~. ................... Will excess fill be rewoved from premises: Yes No
Name of Owner of premises .t'.{ 5.12.~.5& ~./~.O/.-t-t~.. Address ~(~. ~.~.¢ .t~Yg[~.../0.a,;P&. Phone No../~.q~ 1 .~.~'~.
Name of Architect .......... i ................. Address ................... Phone No..qqlh .,5".~.~
Name of Contractor .. I
........................ Address ................. Phone No . . .(, ........
Is this property within ~00 feet of a tidal wetland? *Yes ........ No .........
· If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
buildings, whether existing or proposed, and, indicate all set-back dimensions frord
10.
11.
15.
Locate clearly and distinctly alli
property lines. Give street and block
interior or comer lot.
number or description according to deed, and show street names and indicate whether
STATE OF NEW VO, J , .
COUNTY .....
....~.e~i2,~::~ .4k.... ~..~.~..~:...~..... ii .......... .... i .... being duly sworn, deposes and says thatlhe is the applicant
(Name of individual signing contract)
above named.
~He is the Q..kilO..l~..~,. ~'g '
~ (Contractor, agent, corporate officer, etc.)
of satd owner or owners, and ~s dulyi 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
........ ~[ ~ ......... ,_.day of.! .S..e-~....~3~...~., 19 .~.'~.
Notary Public, .~.~~ ,~), ^,..o..,. County ~x~..'~¥---- /h .
Hc~*y Pula~', State o~ N~w ¥ ~ / .....................................
OommbsIgnSuff°lR ~Jqlflm$C°untY'N~embe*~'N~. 40~24S~9. q ~'~ (Signature of ap p licantl.