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HomeMy WebLinkAbout21989-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23494 Date FEBRUARY 15, 1995 THIS CERTIFIES that the building NEW DWELLING Location of Property 1374 LIGHTHOUSE ROAD SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 50 Block 5 Lot 6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 30, 1994 pursuant to which Building Permit No. 21989-Z dated APRIL 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 ATTACHED GARAGE AS APPLIED FOR The certificate is issued to ROBERT D. & BARBARA M. HEISS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-94-0028-OCT. 19, 1994 ELECTRICAL INSPECTION CERT. #4933 - AUGUST 8, 1994 PLUMBERS CERTIFICATION DATED JAN. 28, 1995 - PETER SOULLAS P ZI: Building Ins 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 AUTHORIZED) N Date 19..... 21989 Z Permission Is hereby granted to: ~3....GtJL s:....., !CdG:.. ..,..~i - `~l to.......~rt s! f4.Gl.......... ..........cl/ !Glr~~....... ir?< 1. ..?E., d ............/'~!r crle;e.~~ ........................I...................... i.................,................ 44-....... s/s.......... / at premises located at G?~j!`s..... i` County Tax Map No. 1000 Section ....S:~T Block . Lot No, Q. pursuant to application dated 19....., and approved by the Building Inspector. Fee ~~!P. jctcT.... Building Inspector l Rev. 6/30/80 1 c{ _ Form No. 6 np m "i u f~ TOWN OF SOUTHOLD BUILDING DEPARTMENT /J? 6 ~9 ¢k TOWN HALL 765-1802 si.DG. DF_P'i: J 'VVVI+i U 50UfNQlD 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, p.roperty,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 e 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 ....1:..4! New Construction V Old Or Pre-existing Building. Location of Property..0.74........C~ / l .1;. k5.. , . . . . House No. J~ Street Hamlet Onwer or Owners of Property. „i ; ,~z ~t , . , , ,ee, County Tax Map No 1000, Section... . Block..~.......... Lot.fv Subdivision..`` ..................................Filed Map............ Lot...................... Permit No.' J q.m . Date Of Permit ................Applicant............................. Health Dept. Approval ..........................Underwriters Approval... Planning Board Approval Request for: Temporary Certificate........... Final Certicate............ Fee Submitted: $,gC6QC) C~~-~ y9gtay9 to , f~iCYY~a!.ss~.s.ma,aaxsa':v.4wmtda~.,asa`.raadf«,ukna . i Town Hall, 53095 Main Road Fax (516) 765-1823 P. O. Box 1179 , , i - - ^ N Telephone (516) 765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE: Building Permit No. _ Owner: ii 1~ t SS (please print) Plumber: 4-`'c lease print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (P1 mbe s gnature) Sworn to before me this day of 19 < J Notary Public, CJ?F/~Jr County ~ft"K taq vS* 00"M in swiglk J / J _ r~ o OCT 19 1994. BLDG. DEPT. A.,r000000000000000000000000004a 0G4000000000000000000000006~~ 0 (516) 286-6642 ELECTRICAL INSPECTION SERVICE, INC. Q O 375 BUNTON AVENUE O ° EAST PATCHOGUE, NEW YORK 11772 _ 4933 O Date 8-8-94 APPLICATION NOON FILE_ O 0 ~ O ppp~ O ADDRESS: 1374 LI.Q11t17oUSG Road VILLAGE: Soutbold TOWN: Southold V p 0 O ISSUED TO: Robert 6 Margaret Helss O 0 INTRODUCED BY Eeoo _Electric Corp. LIC. NO._ 2816-E O O O was examined on 8-8-94 and found to be in compliance with me National Electrical Code. n~ O LOCATION XX BASE. Nx 1st. XX 2nd 3rd -Attic Pool ° O DET. GARAGE HOT TUB O O O O FIXTURE RECEPTACLES SWITCHES G. F. C. I. DIMMERS FANS AIR. COND. O 0 28 46 39 L O DISHWASHER DRYER CLOTHES WASH. GAR. DISID. RANGE OVEN SMK. DIET. O - O O 1 1 1 O 0 O FURNACE OIL GAS Cl R. MOTORS BELL TRAN. SERVICE DISCONNECT ° 00 HOT - e ers =Sase 1 AIR 0 p Ul ° p 1 - WATER PEW 0 0 0 ~ 0 President ° Q ~f lSuxo 0 O ° O 0 0 This cerfdicate must not be altered m any manner. O Inspectors may be identified by their credentials. O ° ooooeoeoooeoeoeoeoeoeoeoeoeoooeoeoooooeoeoooeoeoeoooo h~o~oSpFFO(,~~oGy o ~ Town Hall, 53095 Main Road y Z Fax (516) 765-1823 P. O. Box 1179 • .F Telephone (516) 765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD December 20, 1994 Mr. & Mrs. Robert Heiss 1374 Light House Road Southold, NY 11971 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) 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 # 21989-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. Sqf F kt Town Hall, 53095 Main Road Cz CA Fax (516) 765-1823 P. 0. Box 1179 W- Telephone (516) 765-1802 Southold, Now York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD December 20, 1994 Mr. & Mrs. Robert Heiss 1374 Light House Road Southold, NY 11971 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) 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 # 21989-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. p~ I.-.. L'~ 1b J~•~.~. -UI, I~Dhlu 'I y]La'•`^1•R.~~ -•r ~Y~r. ..~'v. v'.yw~r+~' COMMENTS m a'te' ?OUNDATION 3 (,st) my a FOUNDATION (2nd) 2." ell ROUGH FRAME .PLUMBING 3 .Y~ _ y avr-e Q`7. - m INSULATION PER N. Y. m STATE ENERGY CODE 4. 2 i dyt L- - cn FINAL I~ 6 ADDITIONAL OMMEi' S: m h m • x H 77 A H H m ~ O • r C7 R M H ti en 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS TION FRAMING ( FINAL [l REMARKS: DATE l INSPECTOR M-1802 BUILDING DEPT. INSPECTION t [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INS TION [ ] FRAMING INAL REMARKS:GAf~r 4wee 3-~ 6i~ DATE O - INSPECTOR 4 f 1 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ) R GH PLBG. [ ] FOUNDATION 2ND INSULATION [ ] FRAMING [ ] FINAL REMARKS: f k DATE AVINSPECTOR 7 M-1802 BUILDING DEPT. *4SPECT, N [ ] FOUNDATION 1ST [ ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL / REMARKS: J ~r DATE 6 INSPECTO ~p~ M-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ROUGH PLBG. [J [ J FOUNDATION 2ND [ ] INSULATION [ 4-ARAMING j ] FINAL REMARKS: , r o/ Cam- Xe /A L,3 DATE g INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ( ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL REMARKS: Q ~ v DATE INSPECTOR / { M-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ( ] FINAL REMARKS: f k , DATE INSPECTO :f ,BOARD OF HEALTH FORMNO.1 .3 SETS 0~1:7S . TOWN OFSOUTHOLD 'SURVEY .BUILDING DEPARTMENT C•FIECF , . TOWN HALL SEPTIC FORM SOUTHOLD, N.Y. 11971 TEL.: 765-1802 NOTIFY ; ZTOWNL CALL .1.. .i~., Examined T,//. , , 19 9 ..7 c~ q MAIL TO: Approved .....1 l , , , 19 Permit No..~ ! 1. • . Disapproved a/c u' ing nsI' pector) APPLICATION FOR BUILDING PERMIT Date RA10.4la..:~1 19 ~T 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. ~ 00 (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. ........................~.1...........T........................................................... Name of owner of premises -*W Al 1~ . 02D .S/1 . / (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 do~g . S..~ri~o~A Ill. . .:...........4)Z, Tl~ vs ~ House Number Street Hamlet County Tax Map No. 1000 Section Block . 4 Lot . 6............... . 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 . l~~.C,4 .~tIT . . . . . . . . . . . . . . . . . 3 . b. Intended use and occupancy 3. Nature of work (check which a pplicable): New Building Addition Repair . . . . . . . . . . . . Remqval Demolition . • ............Other (D 'ption) o s7ao 4. Estimated Cost I 1..... • Fee • . • i • • • • • • • • • • • Yt; (to be paid on i in iori) 5. If dwellin number of dwelling units Number of dwelling l7it g. units on each fl' If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use , • . 7. Di mensions of existing structures, if any: Front Rear Depth Height Number of Stories . , , , of same structure with alterations or additions: Front Rear DimDepth ensions Height Number of Stories 8. Dimensions of entire new construction: Front • • • Rear . Depth Height Nurnber of Stories • • . 9. Size of lot: Front 11 Rear • Depth 10. Date of Purchase • . Name of Former Owner , • . 11. Zone or use district in which premises are situated • • . . 12. Does proposed construction violate any zoning law, ordinance or regulation.4 . 13. Will lot be regraded ~ o . N Will excess fill be remove_d from premises: Yes o/ No 14. Name of Owner of emise 0205 Il l p 1~ ........AddressY7rPJ'muNVq(y,ib, cod,F,!$honeNo. Name of Architect i G~ i ulr)i!C L Address N , ,Phone No.......... . Name of Contractor L` fu^ . Address~Y4)!<GD,kl6T. ~J /~oL/pj ~b~Phone o. yloS ,/o Dori , . 15. Is this property within X00 feet of a .tidal wetland? *yes........ No.. *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whe~tller 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. t ' IBC ~ STATE OF NEW YORK, $.S COUNTY OF • • • • • being duly sworn, deposes and says that he is the applicant (Name individual signing contract) above named. J~ /l He is the..., i~.' q.`"44.T...L /55.....©uJl1I./~z........................................................... (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 Cam- qq ...day of)' 0 19. f. ~ Notary Public. . ounty i JOYCE M. WILKINSu^? J` Notary Public, State of New York No, 4952246, Suffolk Count,- (Signature of applicant) Term Expires June 2.15..~~ f PLEASE NOTE ~ ~rzrszu~zce} ~ n0 Sanitary system is nct to be I f seoY;c s.o~ No., w .L N. OF No., 1ZER -M-0) placed under driveway area. 320 M L)GHTHQ10 E f6D.. N.Q£i 54t G E. - - 250 PTO TrSr HOLE ~S WIPG UTUTY I @A°4tmtt-IT - P20P S>: faTic , v a r aaov'v. Nzzvst 1 (U UJ ' L YZ tl N_~1.. ~ ~!1 ~i l~ rJV U UIPlFy~-'' C`hst,,cj•~~;, . ~ t,T 74, - - S' >h w~ L mi ` 4.0 j ^ U'LSEN 96.8 --~r `TnlELL 1- NOTG_: ~ CONTOUfz IDA-rum: MEAN SEA LEVEL. MOST N416M r~ L~ t4~ ~ ~ ~ is _ t IkU x tc a.`l F ~ ~n t x 11 C!E ' All a ~ or) 10, Cl- ~ t4~ J ~ ~ ! J 17 J t75 .O N n n, Vn 4{ - ~k k Q nI,G_ zi 'm'J ip C1 3 c NG Off' .qC RI S°~6 $ o Q u ^5' stU 't 0 O Olt C) + d U) ~ fg'I VA G? _ z ` rill" e i€3>c , . CD N -~I mro 77 i im T3 Ktl , A 7 ,y to 21- 41 1,71 j v ri ' 4 i Aj_o 160 WAI 4 }U1 ~ fj~ C'J% fFi 46 { . f a ~l 41 i ' _ r It jI-) Tj r GWLE FAMILY DWELLNG ONLY EXPIRES THREE YEARS FROM DATE OF APPROVAL x' Q O DxO~ tom mnma -t---- m i v DOmc c 0<2 ti~ c1t t, m O M rr, 0 m i v_ 'a u, .1 z; m m z m to Ut T O y ~jm1't Ohm -J < m0 np~m~ Oz q a r y<y 0. <m cm~ D r-4 ~ m f4 r cn O X O j m n m y i 7C: N rv mCam0 Z I O~c.4 O;. v Yt~iC70 Om2 z~ -t 74 o b X O{ -i m t cm z~ sEEt M-F G) am S' a ae NO ' z m N D !n " n. ~p~pp to > In pmycz ROO~Pi O ff E; > E ~ m ~ ~ f $ ' ~ C 1 A\~ Lo ^QI ~T •m :"3F° g sm i t t t r D b D m(+1 x tz `X; aZ D 3~° y~~. n~ Y G1 OO'~ OmGTZ D E ~`N $ r r a o 3 b Z-6 ni D r D 't m n M -i .o HI. 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O<„ ap O n M O DxtJnu rn cnncnl U~ N { - pky Q v M C m vZi _ 2 1 m ;u 71 OT, f r w u1w ' `~mn <m A <O (O 0 mg I ffj~~w i° O ~y, O, m'1 Cnx r- > a n m E it O t~7 QO -+Nn u O i ;u (A O 0 r, 1 -n -4 n~•_ ~'m~ I O n oocb n fi±7 SH Lo O nZ A m 44;u -4 m . g PJ ~y Z 2 uj O r r Vii, C7 s 4qt r~ m NO D o x A '>0 "~I m 2 m'm - 4 { k 7 d f1 n o m z m g iss C z m H > m *n < v fA o n r n.4*y y o f m r k , r' I i I - ii r A 1 ~ I I 1 I i I I I ' I - 11 777 I_ i_! aooPPKsombiwd DO NwO~T,~ PROCEED watt/ dYtr~4Nh1o UWr L &d SURVEY OF SYMM PIPIrlO BW be FOUNDATION LOCATION offtmKorLenN HAS BEEN APPROVED /1Pd /)-Ply 4EOF NEW yO uuncworeeeenew..M..! r_ ,Fn /r-Ff APPRDVEDASNDTED _ y~pcN°E 'ro 9t ...~IRED Im la w 5Ss sss a DATE: -I11LL-4~-B.P. FEE: (oOF BY: NOTIFY BUILDING DEPARTMENT AT z:+4-i g~ fflmum~ a 765-1802 9 AM TO 4 PM FOR THE 032 +pp FOLLOWING INSPECTIONS: Im"G OCCUPANCY OR 1. FOUNDATION - TWO REQUIRED 9pFp5510NP USE IS UNLAWFUL a s & G J FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING j LPG 1 S. INSULATION WIINOUT CERTIFICATEi 00 4 f 4. FINAL - CONSTRUCTION MUST ONWAD a E OF OCCUPANCY 33. eo 3 eo BE COMPLETE FOR C.O. Q r CERWINTEMO(,~, y ~ j ALL CONSTRUCTION SHALL MEET U THE REQUIREMENTS OF THE N.Y. ~~Op STATE CONSTRUCTION & ENERGY SOLDERUSED/IINigEl1 f ~oP l/L_ SS CODES. NOT RESPONSIBLE FOR Q ? SUPPLYMMMAM t DESIGN OR CONSTRUCTION ERRORS EXCEED 2110 of 1% LEAD. ' I ~/ryEf .cf.t/ae3E yEf ,cf.q/ae3E wns~ ' n~~ ~+d I I IJ.~!iMs NMs sro,~,~~ I ('iY~ J I ~ K /W - V~/~ /~1' ~ /1 ~J i I V~ J _ -~I-. ~6_ ~ ~ _ . _ _ r zL5 ~ T C~AC/+ar ~ OI y o~C o ~3g6Fi"4M6 ~ . _ L I h I1iLL5 N ~ V ~ I i PunTa.G\ I i J tE OF NEW y NCE T~~g+ P ~ 0322G - V . pp~OFESSIOHP`"~r J ~Jl 't, I 15 ^dNp1S53jpba Y ZCG n a ~ 71 3~~~~yS b~'~ R13 P, ip 5 05 o , i j;2 77- i Y^>ZJ p N n A'., e N X I . 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