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HomeMy WebLinkAbout22011-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23420 Date DECEMBER 21, 1994 THIS CERTIFIES that the building NEW DWELLING Location of Property 625 UHL LANE ORIENT, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 15 Block 5 Lot 24.9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 7, 1994 pursuant to which Building Permit No. 22011-Z dated APRIL 13, 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 TWO CAR GARAGE & DECK The certificate is issued to MICHAEL & KATHLEEN BOCCIO (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL-93-SO-76-DEC. 19, 1994 UNDERWRITERS CERTIFICATE NO.-N-328220 - SEPTEMBER 26, 1994 PLUMBERS CERTIFICATION DATED SEPT. 22, 1994 - PECONIC PLUMB. & HEATING a~~41 Building Inspect 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) c'y/ Date . 19. 22011 Z Permission Is hereby granted to; 'a.r..~.... ! S% G?! if........ll r7 rr !v........ _r 4Occi a at premises located at Jam... ~/w...... County Tax Map No. 1000 Section ` Block a 7.... Lot No. pursuant to application dated .................7/ 19...1.17.., and approved by the Building Inspector. Fee $....`~.l..:...rcrt? Building Inspector Rev. 6/30/80 E ~Q. tip 3R o26, M Form No. 6 U D TOWN OF SOUTHOLD ~~C 2 Q BUILDING DEPARTMENT I~ TOWN HALL 765-1802 BLDG. bEPT. TOWN f SOUTHOLD 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-a 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 - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date New Construction....' Old Or Pre-existing Building Location of Property..k°d.J .V.~~ .:N House No. Street Hamlet CRAEL V.....tLEEnJ 3..... Onwer or Owners of Property ...M.. County Tax Map No 1000, Section ...~5 ........Block..... 0J........Lot.. , Subdivision ....................................Filed Map............ Lot...................... Permit No.......Date Of Permit.. Y/ Applicant. .-a-~ 6...0 Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate.,.?........ Fee Submitted: $,.5 (5~Kk 36 ~3 q fLICANT --D 1~; S1'~;,:IU17 11DA,E COMMLN7~ N FOUIJDATION ( st) f ^ - y~ (2 rOUNDATION 2nd) tiny 2.' • \ D Z ROUGH FRAME -PLUMBING wed 3, of H x mTM INSULATION PER N. Y. STATE ENERGY CODE 4. rl m FINAL ADDITIONAL COMMENTS: m • x m ' x x H • N _O S ~ i b H THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE i 1195099 BUREAU OF ELECTRICITY F 83 JOHN STREET, NEW YORK, NEW YORK 10038 Bate SEPTEMBER 26,1994 Application No. on file 85301594/94 N 328220 THIS CERTIFIES THAT _ only the electrical equipment as described below and introduced by the applicant na medon the above application number in the premises of MIKE & KATHY" BOCCIO, UHL LANE, ORIENT, N.Y. 15' 5 -'2q, I in thefollowing location; 91 Basement ® Ist Fl. KI 2nd Fl. GAR/ATTIC/OUT Section Block Lot was examined on 'SEPTEMBER 22,1994 and found to he in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER "I K W. AMT. K. W. T. K.W AMT K. W AMT. H. P. 34 42 39 32 2 1 3.7 3 IF DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K. W. OIL H. P. GAS H. P. AMT. NO. A. W. G AMT AMP AMT. AMPS. TRANS. AMT H. P. SYSTEMS ffTS NO. OF FEET 1 F 1 2 DIS 2 1 SERVICE DISCONNECT NO. OF S E R V 1 C E AMT. AMP. TYPE METER 1 a,tW T BW J% ] a, dW 11. OF CC. COND. A W G NO. OF H) A. Is G. NO. OF NEUTRALS A W G. LEG EQUIP. PER.6' OF CC.COND. W W. OF NEURAL 1 200 CB 1 X 1 2/0 1 1/0 OTHER APPARATUS: MOTORSt7-F H.P. PANELBOARDSt1-1 CIR. 60 G.F.C,Ir-9 SMOKE DETECTOR3-3 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. TI4IB COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. Town Hall, 53095 Main Road 4 r, Fax (516) 765-1823 P. O. Box 1179 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: f ,a-9,` Building Permit No.?,9011 "7 Owner: WchA-e') YIGLt~1~a X17 C~ lt? (please print) PlutP.her: 2eez©YI/C ~~G/JI%~4J!%lI(r> 9~/TL°y'f//"/g7 (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Jy' (Plum rs ignatu e) Sworn to before me this 0 day o f 19 7 BnRBARA 5STFP\7WSKKj e Notary Public, Stato of New Yak No. C1 S T 4$44752 Notary Public, County OualifletlinSa?fo:kCou* Commission Expf.o; Sept. 30,1961,-A~ M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ J ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL REMARKS: 1<<~z DATE / o?< INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING VJ/FINAL REMARKS: Z tea' O ~ > Lc- DATE A4 INSPECTOR NNW V C 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ "NSUTION [ ] FRAMING ? [ ] FINAL REMARKS: DATE r~ INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / [ ] FINAL REMARKS: A e 4 DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ OUNDATION 1ST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL R A S: e d DATE / INSPECTO U D BOARD OF HEALTH FORM NO. 1 ~3 SETS OF PLANS TOWN OFSOUTHOLD SURVEY AM -7 BUILDING DEPARTMENT r HECK _ _ • . TOWN HALL SEPTIC FORK FM 7 WN~g SOUTHOLD, N.Y. 11971 / TEL.: 765-1802 NOT I FY ; CALL .'3 3. .Examined 19 F1AIL TO I~Jt ,Q- '7 Approved / Y 19 c 1p T: !&J . /Permit No. ~~r?/.. ! Disapproved a/c . . Uilding Inspector) APPLICATION FOR BUILDING PERMIT Date 199 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 stieets 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. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit ,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 jbuildings, 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 tions. " ignature of appli . t, or name, if a corporation) Pyv~OX.:. l~riLyf~../V1....~lS....... (Mailing address of applicant) i State whether applicant is owner, lessee, 'agent, architect, engineer, general contractor, electrician, plumber or builder. . . ..........C~W.W Name of owner of premises . . . . . . . i..f\Qr~w-e?;l, •'f,M1,C~lAeJ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. • (Name and title of corporate ~0 icer) Builder's License No. . /.3 ~~n Z Plumber's License No . , • , , • , Electrician's License No. . Other Trade's License No. . . . location of land on which proposl`gd work will be done . l ~ ! . l h. G.. lwux .....:.............q.Ye.l en(:....... House Number Street Hamlet ~y, County Tax Map No. 1000 Section Block s Lot Subdivision Qkfbf.A?t... A Y. ~ 0 ,5..R Filed Map No. ~ Lot . 07? . (Name) , 2: g a State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy . Y itc-ow.'. Z-0 ( b. Intended use and occupancy °,Q'~ !~e~ ~i n.G~, , , • , , ....anon vYWt~T~"*°'•" 3. Nature of work (check which applicable : New Buildin g Addition'°:......... teration Repair Removal , Demolition iQth ork . (Description) 4. Estimated Cost o~QQ ....i .606 Fee 1:.............: bg{~ g: this application S. If dwelling, number of dwelling units ......f. ff Number of dwellingo u e nits on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of.each type of use 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories . Dimensions of same structure with alterations or additions: Front Rear Depth Height , Number of Stories . S 8. Dimensions of /ntlre new construction: Front Y,S • • , • . • • Rear Depth . b' , , • • , Height ...34.~C Number of Stones ..../..07 . 9. Size of lot: Front ~4.V.,A7 Rear a'~.Y,6 , 3 3 • , , , Depth 110r.V 10. Date of Purchase 3 Name of Former Owner ru%x 4!A.h . ~i9!~igA.. Kp€y 11. Zone or use district in which premises are situated. ,,('hs;QFyriRt, , , • , , . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . 13. Will lot be regraded :.AJ9.. • • •yc• • • • • ....Will excess fill be removed from premises: Yes No 14. Name of Owner of premisesAjr11.1;YULbQa A1A dC~~, , Address D.d3Aj{ZZ.QrLI~nJ:.. Phone No.'x? AONc Name of Architect Address Phone No...... . Name of Contractor KehL,Jgrl n~; IN Addresso$S4.SOIAA !2d 061 4 Phone/No.3a?'~.".3`Sa 7 . . 15. Is this property within 300 feet of a tidal wetland? *Yes No..V *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and dis inctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street d block number or description according o deed, and show street names and indicate whe'6 interior or corner lot. 5Y lSS 1~s 1ST' &S 0 e .2a. IS-6 Y6 -3, 3 p SWIA X,4 (C, i .0 1~ 1) 166 l ~ 19 y_ S xt fmw (,t STATE OF NEW YORK, S.S COUNTY OF . • • • • • • K~h+h 14sfn • m: •i 0* 1Q • • • • • • being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. ~ He is the owxgsec.............................................. (Contractor, agent, corporate officer, etc.) )f 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. iworn to before me this ....day of 19 C `P Jotary Public, Count tiN®AJ: COOPER( . Notary Public, State of Now York (Signature of applicant) No. 4822583, Suffolk Coui~tygj. 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WI) 1.g3` m (p ~ ~ J J z Ile ILI l AP 4 - - - - '-~F,n 'eSFi~ Jl/k,W ,-,oMB F, a' Y II 4kBmN R}..: /Lf I~UMw CER09 CAMN ~Li1lY/ CERYAMW OF OCCUMMCE C F~ J I I 1 _.1 1 J SdLOEIt t/SED Mf W41FR Sfl1 W SYPW CANNOT I EXCEED 2/f0 r11% LEAa I 1 - PLUAANM ~1S ~ ALLuR~aRUN~1lN9 Wq %wm LNGm" _ 7l071N0 ~EfORE COVEJYNO "r i I- r,-t f - - d DO NOT PROCEED UNTIL 2nd SURVEY OF FOUNDATION LOCATION HAS BEEN APPROVED _ - I I 000UPANCY OR I it I ` I ! _ USE IS UNLAWRIL _ I_- WITHOUT CERTFM, OF OCCUPANCY ~~k~ x ~ ~ APPROVED AS NOTED t~ J I 111' ~2 DATE: By' FEE: . it I ( HA OF NOTIFY BUILDING DEPARTMENT AT 9 AM TO 4 PM FOR THE FOLLOWING NG INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED DONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4 FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY F'P CODES. NOT RESPONSIBLE FOR r ftI o, DESIGN OR CONSTRUCTION ERRORS /wnrMwiYrRyMMy _r a v" al"m ppieD. oN be stLmKNLwAy 7, I ~ ONDOW IM EERTNIME It BF NEIY YO 5_ SUF.-NEE Tf. 94 1 r~F a r` V 6 -11 19A•, l : a '90FESSI0NP f i --3 ELE _ - 7 }7~ - - 01, 'TV - I1l51 15 11 `I _1994 nLJ - scntF /S^- _on 'Co_wno- S. pow C) i `v 7 ri-r ` 4 F -Y, MiY _o i u i u i _ goccio I o _ IVL.An/ ~ of i d N ~ ' I 2 _ i 4 j t;il - I~ I I pit t Pit- I i ,~t r II' \ej r.p~ ' n i i r, i ~ hl 7 I1 n, o . Y lj~ I L._ i , I ~ I I ' I ~ 1 i al U r 1 ~ I~~-° c Ii t' I i 1 III 1 } I I ( rl ~ f I ~I II ° ~ ` -L/ 'fit--- - - 1 _ I ~ r . I ~ ~ Y COA 032250-1 ~ti i t ~ f I ~ ~ P~FESSIONP~ ~ I [ / pt~ r:,~l ~ ~ I'I ~ ~ J ?Jl I I ~ ~ _--.L~- 0.o'. o" 'f5=o" ~ i.K. ~6~ F FOUNDATION W SC+14 Ws t Ol %y' x f! o~^ I o" .._._.__.,_.m. f r r a. 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F~oo2 $bQ ~ I 3oau !b It.,X ~~S n j (t 7 I W/,e'FSN M J k y'~e ~ f i i ,,OF NEWY PENCE W 1-x35 ~i ' } a-1 E i- kRm 1 ~ r I I uNE of WR~~ pBuaF _ _ _ ; t p aa22: -j ~`~ti A i 16w1' o~'~,{/1,ERNEAO pooK p i p App" I r pu 6d pu i '~.o'-per ' T yg.or, 1~ V !lye Pl9avo'Tre /Verp //OA,- F.,e /71#?P Alr'S lR1XAE fat"C!{? f~ RoaF p,~A,v z°k'~,~'S Sscrfewr 4 ~ /a SaFS I VA ll ` I 4oFl ~ toPa_ pp ~ R' • flo 1' F{t 6 a~. 5 E j: {t t h, IF 10 ,,lam O j4~d ~ 4F ~~'G eR F~L Y.lut ~ - t.-w f1 X35 ~~r _ T ~n Mi~IM 1F ~-InI F.' +-twig- IL4 1L` 1%le JS f. o ~ he:--. ~T - yP FU Ll~c - -~-----F t-- I Li :-N ' I J _ 1" 2u era 1hs. Emil ~ R SI OF NEW;, ._kzt ---i'-o ylP ¢"ce . tf. ~9,f r w a c p y~ ~ 03?2a9-1 >V 9OEESSIONP i