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HomeMy WebLinkAbout22037-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23614 Date MAY 1, 1995 THIS CERTIFIES that the building ALTERATION Location of Property 350 BROOK LANE SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 79 Block 5 Lot 16.6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 15, 1994 _ pursuant to which Building Permit No. 22037-Z dated MAY 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 ALTERATION TO 2ND FLOOR OF EXISTING ONE FAMILY DWELLING FOR HABITABLE AREA AS APPLIED FOR. (BEDROOMS & BATHROOM) The certificate is issued to LAUREN PRESSLER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-340716 - JANUARY 26, 1995 PLUMBERS CERTIFICATION DATED MAR.2, 1994-PEC. PLUMBING & HEATING. g Build ng 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) C~ c~n~} Date 19...(. N® 22037 Z Permission Is hereby granted to; ~Gli~E~ ~~ssC .../°aK:..... er4/?,....../? to.. / G/ 4 C/~!! x~sl --y sue...... s.....,~~,,....... ~ at premises located at.......J~......~4!.....Tr TAOa......................................... County Tax Map No. 1000 Section 7,19........... Block dS........ Lot No. pursuant to application dated i 19.../...~.... and approved by the Building Inspector. ....7~`'.,... Fee $ p Q/Ya~ 4 r d~J~ CFTC ~7 LQ C' ,awpv~~-~r"~~~~ ~ Building Inspector Rev. 6/30/80 - XOS Form No. 6 TOWN OF SOUTtIOLD {PR 2 1995 BUILDING DEPARTMENT TOWN HALL 765-1802 fi'Clv.3 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 $15.00 Date New Construction..... ~7~ Old Or Pre-existing Building. Location of Property.. '5 o W~ l l(u?~ D. I, House No. ' I~ n/~~~//nn ,S/treet Hamlet Onwer or Owners of Property... L6 U' rr;//y„ iL°Aer County Tax Map No 1000, Section..~.l.. ,,,,,Block..... ........Lot... / Subdivision.. .........................Filed Map............ Lot...................... .91;b ~TZ Permit No. . ,,,Date Of Permit.... . ..........Applicant... lIealth Dept. Approval ..........................Underwriters Approval....................., Planning Board Approval......... Request for: Temporary Certificate........... Final Certicate.. V/1, Fee Submitted: _ . _Lo,.a30 I y , nUn• n.,,,m Town Hall, 53095 Main Road r^ a Fax (516) 765-1823 P. 0. 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: .t , Building Permit No. Owner: UI 1 f ASS ~f'~ (please print) Pluirher://7~I/lG y- ( please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plu er, Signatyure) Sworn to before me this ~~ai ® J84ARBARA WWSKI day of 19 / S Notary Public, Stala of New York No, 0*74844762 Notary Public, County OualificxlhSuffolk County Commission Cxp{ro3 Sept. 30. 1011 ~F THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1195099 BUREAU OF ELECTRICITY Ir 83 JOHN STREET. NEW YORK. NEW YORK 10038 Date JANUARY 26,1995 Application No. on file 06851795/95 N 340716 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 LAUREN PRESSLER, REYDON DRIVE, SOUTHOLD, N.Y. in thefollowing location; ? Basement FX 1st Fl. 0 2nd Fl. Section Block Lot nos examined on JANUARY 23,1995 and found to he in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K W. AMT K. w. AMT K.W. AMT K W AMT. HP 9 34 7.3 9 1 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS RELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMi K. W. OIL H. P GAS H. P. AMT NO. A. WO AMT. AMP. MIT AMPS. TRANS. AMT H. P. NO. OF FEET AMT. WATTS SERVICE DISCONNECT NO. OF S E R V 1 C E AMT. AMP. TYPE METER l qYW l q JW 3,e 3W 30 AW NO OF CC COND. A. W. G. NO. Of NI.LEG F w G NO OF NEUTRALS A. W. G. I EQUIP. PER % OF CC COND. OF HIAEG OF NEUTRAL OTHER APPARATUS: MOTORS0.-F H.P. ~ G.F.C.It-2 SMOKE DETECTOR:-1 JIM SAGE ELEC. INC. LIC.#3635E 350 MARINE PLACE GENERAL MANAGER GREENPORT, NY, 11944 11 y 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. 1~ gpPfO(t~OGy Town Hall, 53095 Main Road °y Z Fax (516) 765-1823 R O. Box 1179 - • Telephone (516) 765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD December 7, 1994 Lauren Pressler P.O. Box 1411 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) xx No Underwriters Certificate on file.C.l-~' 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 # 22037-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. 3 M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU N [ ] FRAMING INAL REMARKS- x ken Le-, 1 DATE INSPECTOR 03 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL R ARKS: Kllill DATE 1 9 INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUG G. [ ) FOUNDATION 2ND SULATION [ ] FRAMING FINAL REMA INSPECTO DATE d / . COMMENTS ' m. a FOUNDATION " (1st) - y FOUNDATION (2nd) c N 2. - _ m °.OUGH FRAME & o~ r PLUMBING 3. y W 7] m INSULATION PER N. Y. I m STATE ENERGY II CODE y Jm FINAL ADDITIOJJAL COM:-TENTS: m m ' x H 3f H y C7 5 ' H m .9 - H BOARD OF HEALTH FORM NO.1 3 SETS OF PLANS !lllllj TOWN OFSOUTHOLD SURVEY . qJILAW 15M g BUILDING DEPARTMENT CHECK . TOWN HALL SEPTIC FORM l' SOUTHOLD, N.Y. 11971 TO BN DE LD TEL.: 765-1802 NaT i FY s CALL Examined 19 /.T MAIL TO: . . Approved ~ , 19J~6ermit No.w1F, J . _ . Disapproved a/c . . (B mg Inspector) APPLICATION FOR BUILDING PERMIT Date jam.........., 19 f 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 oir 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, h USE code, and regulations, and to admit authorized inspectors on premises and in building for necessyin ctions. . . ture 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. ~~~y..-..g..'.e........................................................................... . Name of owner of premises ..rC F~/??v!"y t . /a&re!,.. /~e-zXe/ (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 done . &~g Lowe 10 4~ House Number Street Hamlet / County Tax Map No. 1000 Section T:/......... Block tF Lot Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and intended use and occupnanc of proposed construction: p~ a. Existing use and occupancy b. Intended use and occupancy ; , , , , , n:~...... . itic~ta g Addition air Re applicable): New Building Re t 3. RNature epair of work check which val . . . . . . . . Demolition Other Work 1 oscription) 4. Estimated Cost .cY f~4r.4? Q . . . Fee ` . s , . (to be paid on'tiE ~cp ation) S. If dwelling, number of dwelling units rtt'i Number of dwelling units on each t7ttdr , , , , , , , , , If garage, number of cars . . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . g structures, if any: Front Rear Depth of of same existing Dimensions Dimensions Height Number of Stories . . , , . , • , , , , , , • • , • • • structure with alterations or additions: Front Rear . . Depth . Height Number of Stories . 8. Dimensions of entire new construction: Front . Rear Depth Height . Number of Stories , . . 9. Size of lot: Front Rear........... Depth....................... 10. Date of Purchase , , , , Name of Former Owner . 1 12. Does 1. Zone or use district in which premises are situated . . . . Owner of remises to any zoning law, ordinance or regulation: . . . . . . proposed p • • . • • • • . • • • . Will excess fill be removed from premises: ses: Yes N No 14. Name of construction viol' • Address . ...............Phone No............... . NamName 13. Will e lot be of Archit ct Address , Phone No.............. • . Name of Contractor , Address . . Phone No. . 15. Is this property within 300 feet of a tidal wetland? *Yes.. No,. If yes, Southold Town Trustees Permit may be required. ' PLOT DIAGRAM Locate clearly and distinctly all (,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. STATE OF NEW R~b~(~ S.S COUNTY/ OF u. !J~~~~... , l-~~('e!~ • • • • • • • • • • • • • • , being duly sworn, deposes and says that he is the applicant (Name of individuasigning contract) above named. / He is the ~&Un .C. ?.........II.... . (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 j 4L day of 19 g,T Notary Public,Y , , , , , , County CLAIRE L. QLEW N*Iary Publlc6 State of Qualified i 8795 k6CauNYork f ` , . hty (Signature of applicant) Commisslon Expires pecembe f 8,10 M Z- zi,rov, ~I W ii LL. w U. wz cc Q i g W J z j F W y a '~J JW ,W C t Z I cc=> Ewa O =u dfyo h u ? cjo= - aaw0w"d odwozzo I (Y" Z P- va az ~o oci a ~ r/ ,~'~QQ «~io Zz °o y~~c or E i w ~7 iv QV , + ® z~az~a zwt~iw~owcZ G. o i (.aWM-• I I° ~qa>°-wLLZV~WwF-~i CC 0 I c` 0 CD g a l- - z o co c Zoo I s-coo?: LL~®oocZz oawaiz a w W d Q LL LL lLi~ Q 1- V C 1C'_ i 'ai7,O ~1 'l~ ~IX~G ~.>j; I LL~ P LL N rS v m N'i 1 -Ix N a 71- 1- - 1 1~ _ <M7 r n , APR 1 5 1994 DEPT. 41 3 {oWNAFSOUTHOLD 1 ca Q I 1-2 / I ~ 3a5/o 3u 31o ~aTH ~ 1 I F~i~~e 0 FT. -0- I i- ' •LIF ~ I ll~ cr_. URDERWRITERSCERTIFICATE - ---I L_ REQUIRED O ~ F x I N ~7- ~rs~oohi o' a N N~ 711 ~nnlZOlI I`1 u' I i ~ ' 1.~8f:Ary f .1 ~I I OCCUPANCY OR 21-blt l P'L USE IS UNLAWFUL IZ• I I i WITHOUT CERTIFICATE j OPrrvuA -T 6p-WOCCUPANCY V I i ~ FFN(-IEI ~ i 31U F'TLFi hAR AP AS NOTED I DAT~ `S B.P.# FEE: BY: I I NOTIFY BUILDING DEPART I 785-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS. 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE { 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. j STATE CONSTRUCTION & ENERGY 7 CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS v' i 1 ~ECOr^~~ FLr~of~,~' -,4 UNI-IEq Tc.L `-T ~.~~'.w~r+c ~ ~ Phone 477-0400 Main Road ' ' a GREENPORT, N.Y. 11944 ` NurC: VEs21i=r A~. D(mET46~4NS ft~' ",V ISIS W.i. r>~i0 Al vjm t- tz iM1 1 - bWG tan+Me+r,>TnSrt &~W"aE 1 Y i i a Ono WV TV\ i ~~I, III - -pw,9 I -Aw nc I PROVIDE OPENINGS FDR EMERGENCY ESCAPE AS PROVIDE OPENINGS FOR REQUIRED BY PART 714 DI[ EMERGENCY ESCAPE AS N.Y. STATE BUILDING CODE;' REQUIRED BY PART. 714 OF ' N.Y. STATE BUILDING CODE. Z) 77- . .i _ I' T t _ rvu~urf * i, i z, Kamm I ~ . FRO' K OFENMU FOR MERGENCr MAK AA fEQU~ W,x N PAK 7N~Fo;.. u am WIIDIR_ ACI ML {f r i ~ n1°Ti n1Vk Y- t ,oar- . ' FRk1tC laid ! 'fIIPG FE ~ i . 1 I t ~ - ' «e~u~yei F4.:~ri ~ 1H~R7r.f7 ~ ~TUC~i.~,x Pal z~ ' Pbone 477-6400 ~''paet. iF~~Mn Ftaad 97,; Y G3 15 P©R t, N X. f J 44 i ,.pJLt]'$f. V6YG to Ai07-t4~roY4::. t y Y i ~ ( " y "0' w x.'. a "i R-.,.,~,. r-v.. t."4' --.x