HomeMy WebLinkAbout21940-z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23110 Date JULY 20, 1994
THIS CERTIFIES that the building ADDITION
Location of Property 105 FISHBRMANS BEACH RD. CUTCHOGUE, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 111 Block 01 Lot 42
subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 8, 1994 pursuant to which
Building Permit No. 21940-Z dated NARCH 11, 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 2ND STORY ADDITION ABOVE EXISTING GARAGE AS APPLIED FOR
The certificate is issued to JOYCE FRIEDLAND
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. PENDING - JULY 15, 1994
PLUMBERS CERTIFICATION DATED JULY 15, 1994-MATTITUCK PLUMBING & HEATING
i' ` .C2~
uilding 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)
r
Date 199
N® 21940 Z
Permission Is hereby granted to:
I.e
r.7o.rrs../.....~~~. ~id/s~~/~
/"'v2Tf!S/.....( ;c`?sT
4j...........
s'
to....... :s? .1.~ ~........J`?
T/
JV irr/1~?G..... 9y1 r r
.
I.........~... NHS.... Q..
at premises located at..... ~ i.Sit i P'~~f!O~s....... ' .......10 '
.TG/f0.1~~r4
County Tax Map No. 1000 Section Block .........Q... Lot No..... L
pursuant to application dated ................11..4. 19....1..., and approved by the
Building Inspector.
` Fee $...,,75°0.,....
iuilding Inspector
Rev. 6/30/80
Q Form No. 6
y u V TOWN OF SOUTHOLD do
.ul 5 jCW . BUILDING DEPARTMENT
TOWN HALL
765-1802
' rows ,
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 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 x15.00
Date ?J? L.'s. jel.. .
New Construction...< Old Or Pre-existing Building..
Location of Property............
54~,......WT
House No. ,,,Street Hamlet
Onwer or Owners of Property. JQ-~(; ~ E?OL,tDn?
County Tax Map No 1000, Section ...1. 0 Block Lot.... .z
Subdivision.rn OPe 141C,~,~p~P•,?NGpiled Map...! Lot....i..
Permit No.. L P, L Date of Permit.. ,,,Applicant. Rict „
Health Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval
Request for: Temporary Certificate........... Fin Certicate.
Fee Submitted: $
Co ~~3 1) 0 APPLICANT
INSPECTORS
e,1;f~01.4•
SCOTT L. HARRIS, Supervisor
Southold Town Hall
Thomas Fisher
Building Inspector P.0, Bost 1179, 53095 Main Road
Glary Fish d,~lj/ dab`''` Southold, New York 11971
Building inspector Fax (516) 765.1823
Telephone (516) 765-1800
Robert Fisher
Assistant Fire Inspector OMCB OF BUILDING INSPECTOR
Telephone (516) 765-1802 TOWN OF SOUTHOLD
C E R T I F I C A T 1 0 N
(4 4) I
DATE.
Building Pe t No.
p~
Owner; VoyCtZ~
(please print
Plumber: 0 c yr~7 a-~ ~lA
please print
i certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
(Plumbers S/ Sworn to before me this
day of _ O~4/ 19-2
Notary Public, ~-Y re G County
MM V JV1"M ANoZt-Zry l i
NftPAk Mad
ft Nsw York
tam MOM Feb. is
THE NEW YORK BOARD OF FIRE UNDERWRITERS PACs 1
1001071 BUREAU OF ELECTRICITY
F 83 JOHN STREET, NEW YORK, NEW YORK 10038
Date JULY 201,1948 Application No. on file 84766694/94 N 320968
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
RICHARD FREIDI,AND, 9.05 HAYWATGRFS ROAD, CUTCHOGUE, N.Y.
in thefollowing location; ? Basement ? 1st Fl. ® 2nd Ff. Section Block Lot
was examined on JULY 15 , 19'_x4 and found to be in compliance with the Nadonal Electrical Code.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS RECEPTACLES SWITCHES 'NC111ESCEN4 FLUORESCENT OTHER AMT. K W. AMT. K W AMT. K W. AMT K. W AMT H P
8 7
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
AMT K. W. OIL H P GAS N. P AMT. NO. A. W. G. AMT. AMP. AMT, AMPS TRANS. AMT H P SYSTEMS WT. WATTS
NO.Of FEET
600
SERVICE DISCONNECT NO. Of S E R V 1 C E
W1. AMP TYPE METER 10 2W11 9 3W13 9 3W 3,e OW NO OF CC COND A. W. G. NO OF HIAEG A W G NO. OF NEUTRALS A. W. G.
EQUIP. PER 9 OF CC. COND OF HIAEG OF NEUTRAL
OTHER APPARATUS:
ROTORS T 1-F 11. P,
G,E%C.1s-2
IT: & 5 CONTRACTOR LICa#578-N
BOX 215
SOUTHOLD, NY, 11471. GENERAL MANAGER
9.1
Per
This certificate must not be ohered 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 :~~:.lL~ii. ,Ci ~U:f IIDniE ~I .est.; m_•~~~~ ;q•e^~ v
COMMGNT~
1. I -v
m~
FOUNDATION (1st)
an'
cb
FOUNDATIOf1 (2nd)
m~
2b
OQ
ROUGH FRAME $
PLUPIH2NG Cry
i
3.
INSULATION PER N. Y.
~ y
STATE ENERGY
R
CODE
y
4.
H
FIi7AL
1
ADDITIONAL COMMENTS:
x Cy
o
• x~
N
77
H
O
A
m
.ti
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FO DATION 2ND [ ] INSULATION
FRAMING [ ] FINAL
REMARKS.
144
r
i
DATE INSPECTO
M-1802
BUILDING DEPT.
I NSPECTI
[ ] FOUNDATION 1ST [ ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMAR S:
4 A9
DATE 2-7 h INSPECT
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ I ROUGH PLBG.
[ ] FOUNDATION 2ND INSULATION
[ ] FRAMING ] FINAL
REMARKS:
1 s
DATE ~//7:744 INSPECTOR V(A
I
FORM NO.1
r~:... .,o. u
TOWN OF SOUTHOLD
1 „~8 s ff BUILDING DEPARTMENT
y TOWN HALL
ILi1..1.,, SOUTHOLD, N.Y. 11971
Tls'dR1"isF' qq TEL.: 765.1802
Examined 7 . 19l Received........... 119
Approved 19(.~~Permit No. o f
Disapproved a/c
S o~
(Bu'di,Ins ector)y
APPLICATION 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 necessary inspections.
(Signature of applicant, or name, if a corporation)
r(N .
21b~a Gor?. m l N off....
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
!L/..f~?-
Name of owner of premises `t' ..T17- IEED"--f-jo
(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. I. q I 4T-
Plumber's License No. G
Electrician's License No .
Other Trade's License No .
L Location of land on which proposed work will be done .
.
House Number Street Hamlet
County Tax Map No. 1000 Section Block i........... Lot 4.z.......... .
Subdivision . .OF GOsJI~, Y (7p'j'S /IVC.... Filed Map No. 77.6A........ Lot I...........
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
A I
a. Existing use and occupancy'.. j ~ 1h1G{ DYY)! .
b. Intended use and occu an ? ti SI rv61,6 (=D~') I L`e ~ tolEa c:;
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E FAUST I~ ) ~ NEW tY,, 111 = If2 RY V'JcOQ 7~~nVCdA g9DM NM94T UNDI UNDERWRITERS CERTIFICATE REQUIRED OCCUPANCY OR -
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USE IS UNLAWFUL
~kl~'WbL ~.ICYs1E ail ,P 1 l ~ _II 443 2X12 If cop If copper tubing is used WITHOUT CERTIFICATE
for water distributing OF OCCUPANCY
tvela system; piping shall be
3 -uaklr Cl of types K or L only
Nitc([ol bn1 30 oft
. ~'/.4 xlCo aw ~ APPROVED AS NOTED
3Y2 w 12~ J )?y.1~Tll~yL~ G7
`41 7E~ PLUMBING DATE: 434e.P.s ~21q ~I~ ALL PLUMBING WATTR FEE ~BUILDING BY.-
& NT AT & WATER LINES NEED NOTIFY
h•51 TESTING BEFORE COVERING 765-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
7-NV J C W 15 G W 1 S "s 1. FOUNDATION - TWO REQUIRED i FOR POURED CONCRETE
PLUMB! PLUMBER CERTIFICATION 2 ROUGH • FRAMING d PLUMBING
~ ~wSTlr~~ Izcor---- oyE2 C~DK,DrgG ON LEAD ON LEAD CONTENT BEFORE 3. INSULATION
4 FINAL - CONSTRUCTION MUST
- - CERTIFIC~ CERTIFICATE OF OCCUPANCY BE COMPLETE FOR C.O.
SOLM SOLDER USED IN WATER ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y.
SUPPLY UPPLY SUPPLY SYSTEM CANNOT STATE CONSTRUCTION & ENERGY
t ' 1?I " L 1^IINL"X>7^lS P.~ELP.1"1 b~ EXCEED EXCEED 2190 of 1 % LE/U)- CODES. NOT RESPONSIBLE FOR _ DESIGN OR CONS TTRUCTIISLE RUCTION ERRORS
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