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HomeMy WebLinkAbout21825-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23408 Date DECEMBER 14, 1994 THIS CERTIFIES that the building ADDITION Location of Property 1330 PARADISE SHORES ROAD SOUTHOLD NY House No. Street Hamlet County Tax Map No. 1000 Section 80 Block 1 Lot 23.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 25, 19934 pursuant to which Building Permit No. 21825-Z dated DECEMBER 9, 1993 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 RECONSTRUCT EXISTING GARAGE ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to EDWIN & MARY SELZER (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N313690 MAY 12, 1994 PLUMBERS CERTIFICATION DATED N/A lding Inspector Rev. 1/81 ' FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMW TOWN HALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date... 19".. Nm 21825 Z Permission Is hereby granted to: € ...L ...4G.... j...... l z- 4 lr~ 1 i at premises located at.... 6Me......~~/1.... E Lot No. ! County Tax Map No. 1000 Sectlon Block / pursuant to application dated 19 ~l and approved by the Building Inspector. Fee $...9~... k f j ~ uilding Inspector I Rev. 6/30/80 I Form No. 6 CaAL,),4 f(bA~ in4 d i''`( a4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~in~ 765-1802 32Jb 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 /Ld-! .pp1 . New Construction........... Old Or Pre-existing Building.. Location of Property.... . j. 3~V.... ,~Avc,4DI SF K1.vJ"V_i. a......... S u v 7w ~ d House No. Street Hamlet Onwer or Owners of Property.... p W)..... S C Zt 2 County Tax Map No 1000, Section... 9b........Block...~............Lot...~ 3. ~ Subdivision ....................................Filed Map............ Lot...................... 2S, Permit No .,?.)............Date Of Permit Applicant Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: $ w q<~q l,o 14~_- - GV lJ APPLI+ THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1135185 BUREAU OF ELECTRICITY F 85 JOHN STREET. NEW YORK. NEW YORK 10098 Date 14AY 12,1994 Application No. on file 05869fb94 f 94 N 31359@ THIS CERTIFIES THAT only,the electrical equipment as described below and introduced by the applicant Homed on the above application number in the premises of EDWIN SELZER, 1330 PARADISE SHORES ROAD, POLE#12, SOUTHOLD, N.Y. in thefollowing location; ? Basement ® I.Rt Fl. ? 2nd F1. GAR/OUT Section Block Lot wgxs examined on MAY 09 ,1994 and found to be in compliance with the National Electrical Code. FIXTURE ECEPTACIE$ SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER MT K. W. WT K. W T. KM AMT K.W AMT. HP 4 1 4 4 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECTT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K. W. OIL H. P. GAS H, P. AMT. NO. A. W. G AMT. AMP. MAT. AMPS TRANS. AMT H p NOSYSTEMS pMT WATTS .OF FEET SERVICE DISCONNECT NO.OF S E R V I C E METER NO. OF CC COND. A. W G. A. W. G. A-1 W G. AMI. AMP TYPE METER 1,0 tW I,e'8W 3$8W 3%4W pER ,e" OF CC.COND. NO. OF HIdEG OF HbLEG NO OF NEVTRAlS OF EUTRAL EQUIP. t OTHER APPARATUS: G.£.C.I:-4 t I I l MODERN ELECTRIC EAS'C,INC, I,IC44253-E 10470 ROUTE 25 MATTITUCK, NY, 11952 GENERAL MANAGER 11 Per f 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 MUSTgNOT BE ALTERED IN ANY MANNER. t -1~. K M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INS TION [ ] FRAMING FINAL REMARKS: /Vz Z~s DATE p INSPECTOR 3 M-11102 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ) ROUGH PLBG. [ ] FO NDATION 2ND [ ) INSULATION [ FRAMING [ ]FINAL REMARKS: Gc-sue.-~'-- DATE INSPECTO ILS.'ECTiON IIDATE Corr Burs 1cLD FOUNDATION (1st) FOUNDATION (2nd) _ 2. ' 644~-e_ it ROUGH FRAME & PLUMBING W G y 3. y, INSULATION PER N. Y. STATE ENERGY CODE x 4. FINAL ADDITIONAL COMMENTS: x ` d cn H H H O Z 6J p x m b H BOARD OF HEALTH , FORM N0.1 J SETS O~PLANS TOWN OFSOUTHOLD SURVEY O BUILDING DEPARTMENT cllECF:~lr~t . ~~LI ~5 19 TOWN HALL SEPTIC road _ SOUTHOLD, N.Y. 11971 f.`, TEL.: 765-1802 t:OT I FY ' 3L1;`` f'csr CALL~.d9~r:R5.7 Examined r~ f/.... 19. 14qq~ GG MAIL TO: Approved 19Permit No............... Disapproved a/c '(Bu iin'gg Inspector) 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) (Mailing address of applicant) State whether applicant is owner, lessee, 'agent, architect, engineer, general contractor, electrician, plumber or builder. C9~tC9Y1.. Name of owner of premises ~ ~WAeD..... ICJ] 7 ! * . (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. ©Z Plumber's License No . Electrician's License No . - J Other Trade's License No . 1. Location of land on which proposed wor c will be done . . . 3 3 0 . Q~ . .z.tfSnd-V t ? . House Number Street Harriet County Tax Map No. 1000 Section $:q........... Block ....I..........:. Lot t............. Subdivision Filed Map No. Lot fA (Name) ~ 2: State existing use and occupancy of premises and intended use and occupancy of proposed cofistru~tibn: a. Existing use and occupancy C/7 Q!fC: ...........~:>'fv~,.:'•; b. Intended use and occupancy , , , • , , 3. Nature of work (check which applicable): New Building N Repair . addition Alteration Removal . Demolition ~ y Othe~r~ ~Wk , . cr'ption) 5 4. Estimated Cost pD.c9................. 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 cars 4I. t^ . 6. If business, commercial or mixed occupancy, specif nature and extent of.each type of use . r . Dimensions ofexistin ~ g g structures, if any: Front , , ..Rear . ,a~.Q., Depth... . Height ton of same structure Number of Stories , • . , • • • • • , , , , • • With alterations or additions: Front Rear . Depth i Dimensions o , . entire , new construction: Number Height Number of Stories , . rnction: Front nt g ; Rear Depth AO of Stories , , iSize of lot 1 Font . . 9. Rear ...hP Depth hZV.- )8. . 10. Date of Purchase / , • • • , . • , • • , . , , , • Name of Former owner J4,Q A , CC~tv¢li 1. Zone or use district proposed premises are situated • , , • , . • , • • • • , 12. Does construction inwhich ' vio late any zoning law, ordinance or regulation: J\ .Q . 13. Will lot be regraded N.b. • r • • ......Will excess fill be removed from premises: Yes 14. Name of Owner of premises 'VjA r l ,~A 3i A?r , , , Address Phone No............:.. . Name of Contractor AV. 140N • • • ' ' ' ' • • • Address ....:.....:........Phone No....... . Name of If hiest Southold Address hone No. 15. Is this property within 300 feet of a tidal wetland? *Yes " " " " No......... • yes, Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly a0 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. i f I tit~w V AS NOT0.) Kb'1'PF fi . u' k DIM f)t fly€?YP - RAT '.765-1807 AiVI TO 4 PM F011' THE . F01-.tt nrl4f-,IhJsfECpIONS; 1. FIAUNI1PaTlf)Ci '414111 REQUIRED Pm> POURED CC9li1(.`. wrF, 42• ROUCII; : FSlsk~~dlsyCl t PLUMBING el• INSULATION 4. FINAL _ CONSTRUCTION MUST BF COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION fk ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS STATE OF NEW YORK r COUNTY dp~FI~Q. • I being duly sworn, deposes and says that he is the applicant (Name of in rvidual signing ~ ?t S contract) above named. He is the.., b (Contractor, gent, rporate officer, etc.) of said owner or owners; and is duly lamhorized to perform or have performed the said work and to make and file this application; that all statements contairjed in this application are true to the best of his knowledge and belief; and that the work will be performed-ip the manner s,et forth in the a placation filed therewith. Sworn to before me Imi day of. y 19 Votary Public, . . . . . \ CLAIRE f3LN County No, of ftiewYorkff r Notary PublK State No. State Of . . flualifled in Suffolk Cpumy Commission Expires Decem, or a, 19 (Signature of applicant) • r _R ~ t wU' a~ I i L i N.h3°~43'-F :•.r~--_-.136.1 C ~6_ t 3 0 TO i 'm I AtJD ~ i r i ~ LlCEN6EDt SUK_~r~Y.. . 21~z S9L SILO -Shy -$1L •,f_ • 1J '..1_~0.~ N ~T3~CJ , ~ ~ _ , 49 a ~ d Nth _i 1 i } ri ~ { i t{ ~ NF~IY~ NVS~13N ~ ~ Z i `X~ zo_ : 1 i.1. g ~ B s = R.,_, o Volt) 4 -11 -A l$ 02 1 } O '7. UNDWffl"~ CERTIFICATE I y,.: ytit CC I a i i4o . . scl-m~ i ~ , ? ~ t FT L f -1 A _