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HomeMy WebLinkAbout22072-zFORM NO. 4 TOWN OF SOUTNOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF O~CUPANCY No Z-23280 Date OCTOBER 12, 1994 THIS CERTIFIES that the buildin~ Location of Property. 225 JENNINGS ROAD House No. County Tax Map No. 1000 Section 54 Subdivision ADDITION SOUTHOLD, N.Y. Street Hamlet Block 7 Lot 16 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 21, 1986 .pursuant to which Building Permit No. 22072-Z dated MAY 20, 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 SHED DORMER ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to Rev. 1/81 ROBERT & FLORENCE CORWIN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL INSPECTION CERT. 4867 - JULY 18, 1994 PLUMBERS CERTIFICATION DATED OCT. 12, 1994-PECONIC PLUMBING & NEATING Building I~pector FOI~M NO.$ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO 22072 Z Date ........................................................... 1 c) .......... Permission Is hereby granted to: ...a.~..~....~ ~..,.'~..v~.....~..~ ................. ............. o ....... ~._.....&., .......................................... ,o..,.~.~.~...+..~....~....~...~~~..~......~ ...... ~~.~,~ee.~....~ ........ ~.~.:..'.-..~..~...= ............................ ...................................... Counly Tax Map No. 1000 Section ..~.'.'.'.'..'."~ ~'k".i'.ii.i'.~ '.'.'.'.'.'.','.'.'. "i~;';'~i'"~.'.'.~.'. ................ pursuont to ~pDlio~tlon ~Qted .......... ~...~.~V ....... ~.f ................ ] ~..~ ...... ond ~pprov~d byth~ Fee $...,,L.~.~ ..... ~~ ~, ~¢~r~ ~ .... ~ ............. ~uildlng Ins Rev. 5/30/80 ~'~! ~, APPLICATION FOR CERTIFICATE OF OCCUPANCY T~is 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 nnusual 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. 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 · "' - ,, ,', Additions to dwelling $25.00, Alterations to dwelling $25,00, Swimming po,~/, ~i, 25.00, Accessory building $25.00, Additions to accessory building $25.00, Bwroinesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildin~ - $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 ...Q~¢ /~ . ~f ......... './/. f: ..................... New Construction ........... Old Or Pre-existing Building ..... ' ........ Location of Property .... ~...~..~. .......................... ;. ...... ' ......... House No. ~, -- Street /~ Hamlet Onwer or Owners of Property . ~.~ .~...~.?.-~ · ~"'~(.~..~...~.~.. County Tax Map No 1000, Section .............. Block ................ Lot .......... .. .......... Subdivision ................................... Filed Map ............ Lot ...... Permit No ......... Date Of Permit .... Applicant ... Health Dept. Approval.' ............ '--- ......... . Underwriters Approval ...................... . .. Planning Board Approval ........... ~ . Temporary Certificate ........... Final Certicate,..~ ....... Request for: 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) 14575 Z County Tox Mop No. 1000 Section .... .~..,~..~...~. ........ Block ..... ..0....~. ......... Lot No ..... /...~ ............. Building Inspector. Fee $.~.....~......-~... ..... Building Inspector Rev. 6/30/80 Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD CERTIFICATION Building Permit No. ~ 2_~) 7~ ~ Owner: ~,~'f/~'L~ CJ~t/'~.'6~-.--~,~ ~A~/~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. / ' ( Plurr~er,~Y~"f~na/ure ) Sworn to before me t)~ /2 day of ~/ Notary Public, County BARBARA STEPNOWSKI Nolay Public, $1ale o! Now No. O1 ST48447~ Ouslitied in Suf[o,~ Count)' CommJss]or~ E;~.pkc~ C.~pt 30, 19_.~'~' Town Hall, 53095 Main Road P. O. Box 1179 Southold, NewYork 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD August 22, 1994 Mr. & Mrs. Robert Corwin 225 Jennings 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 # 22072-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. Town Hall, 53095 Main Road P. O. Box 1179 Southold, NewYork 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD August 22, 1994 Mr. & Mrs. Robert Corwin 225 Jennings Road $outhold, 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 # 22072-Z Please contact our office on this matter. Thank you for cooperation. $OUTHOLD TOWN BUILDING DEPT. ISFECTION F 0 U__N D A_~T I O__N -- (1st) COMMENTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ~':' CODE FINAL ADDITIONAL COMMENTS: (516) 286-6642 Dale ELECTRICAL INSPECTION SERVICE, INC. 375 DUNTON AVENUE EAST PATCHOGUE, NEW YORK 11772 ~57 7--18--~ APPLICATION No. ON FILE ADDRESS: ISSUED TO: INTRODUCED BY Gene F~eacock TOWN: was examined on 7-16-94 and found to be in compliance with the Nalional Electrical Code. LOCATION BASE, 1st, ~ 2nd 3rd Attic Pool DET. GARAGE HOT TUB FIXTURE RECEPTACLES SWITCHES G. F, C, I: I DIMMERS FANS AIR.'COND. 5 6 6 1 DISHWASHER DRYER CLOTHES WASH. GAR. DISP. RANGE ! OVEN I SMK. DET. 1 FURNACE OIL GAS CIR. MOTORS BELL TRAN. SERVICE DISCONNECT Meters I Amps. Phase ff~(~)President This certificate must not be altered in aBy manner. Inspectors may be ~dentifled by their credentials. OCCUP~NC'~ OR l UsE ~S U~U~WmL ~ ,ccU?ANCY FEE ~,~G DEpA~T~EN~ 765480~ 9 ~ TO 4 P~ ~R ~'WO REQUtR~D ~LL C~.,, ~.-. , .,..~ "~'~:; OF THE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND[/ I~.L~TION FRAMING [ c.]~'INAL REMARKS:/~.'~ // 765-1802 BUILDING DEPT. INSPECTION [/.~RAMING [ ] FINAL REMARKS: ~ 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N.Y. 11971 \ TEL.: 765-1803 Examined' .~.~ .cg~..~..~ .~., 19 Approved 3 aa., 19 Pc=it No. ).q Disapproved a/c ..................................... TOWN OF SOU'PHOLD Rece±ved ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date .................. a. Tins 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 sch~dble. 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. Up6n approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such p?rmit 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 tio . . .... ......... (Signature of applicant, or name, if a corporation) ' ........ ................. '.'.- ..... ~Mail!ng address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or b,uilde.r. Name of owner of premises ... (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... ~ ?..7. ................ Plumber's License No ......................... Electrician's LicenseNo ....................... Other Trade'.s ~icense No ...................... do~ ~ Location of land on which proposed work will be done .... .~...~..~. ~. 1.~'. f .~.. ~O t) ~00]~6~33 I~l.x'/. s 5'0 0T/40 tO House Number Street Hamlet County Tax Map No. 1000 Section ........ . .~...~. .... Block...'7.. ............. Lot .... /.~. ........... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................... b. Intended use and occupancy ....... .~..~..~..~ .... ¢~0.'. -c-~%.. ~~ ........................ 3. Nature of work (check which applicable): New Building .......... Addition . P .0..~./~. ?.-teAlteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... .~) (Description) 4. Estimated Cost ..................................... Fee ...................................... · (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ..... *. .......... If garage, number of cam ........................................................................ 6. If business, commercial or mixed occupancy, spec/fy nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front... ?. ~. ....... Rear .... ?...2~-: ..... Depth ....~.~. ........ Height . .(.?.~q~. ~:'J ......Number of Stories ...! ..................................................... Dimensions of same structure with alterations or_additions: Front . .~.D.....o~.... ..... Rear . .g..~...r~. ......... Depth . .5'.~..,~o. PT ............ Height ... rg...~. ~ .r7~.%.. ........... Number of Stories ..../ .................. 8. Dimensions of entire new construction: Front ... :~,.-~-. .... Rear .. S'~wr_/~ .... .'. Depth .~.~t.~...<.... ...... Height . .5; i~D~, ..... Number of Stories ... [ .................................................... 9. Size of lot: Front ...... /..~.. ............ Rear .... ~...~T~. .............. Depth ..... ./.5..~o. ............ 10. Date of Purchase .../.q.6 .................... Name of Former Owner ...o~.P...o.~..~.g.,.o),.~..//-!.Z.Z.~.. I I. Zone or use district in which premises are situated ..................................................... 1 2. Does proposed construction violate any zoning law, ordinance or regulation: .....~.o. ......................... 13. Will lot be regraded .... ~..O..... ................. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises . .~'.~.tc.-~..~./x.~.e.~..~..'.'.'.~. q~Address ....Y~-. ~.~.,.~.? .g..r?/?.. Phone No...'~/..g~...~.q.~..~.... Name of Architect ........ ~...~o~ ........... Address ................... Phone No ................ Name of Contractor ....... .57r~ t"t'}:,et.~: ........ Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give s~r-'?t 2.'.:~ ~h{,::~: :~:,n~r ~r d~ :_fiption according to deed, and show street names and indicate whether interior or corner lot. rATE OF NEW YORK, 3UNTY OF ................. S.S ............................................... being duly sworn, deposes and says that he is the applicant (Name of indMdual signing contract) ove named. is the ........................................................................................ (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ~lication; that all statements contained in this application are true to the best of his knowledge and belief; and that the · k will be performed in the manner set forth in the application filed therewith. ~rn to before me this ............ ........... ary Public ...... ~. )(~: ./fi.~.g:..~/.~-~. .... County ... ,~ (Signature of applicant)