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Home My WebLink About21472-z + ice: FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22431 Date NNE 30, 1993 THIS CERTIFIES that the building ALTERATION Location of Property, 380 EDS ROAD SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 78 Block 9 Lot 67 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NNE 1, 1993 pursuant to which Building Permit No. 21472-Z dated NNE 8, 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 ALTERATIONS TO SECOND FLOOR OF EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to CATHOLIC CHARITIES of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PENDING - JUNE 30, 1993 PLUMBERS CERTIFICATION DATED NNE 30, 1993-PECONIC PLUMB. & HEATING B di g 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) 41- 1 7 9.7.. Date N® 21472 Z f Permission Is hereby granted to: f~ r....e....././.&' . I t0 'J.t/..L.Aa~~.-.~'.~.`~"...;f.f6k,•.... ~,!....1..i~C,. f / at premises located at :~!&Q................. County Tax Map No. 1000 Sectlon......... :~.Gp.... Block Lot No. -(a,2 pursuant to application dated ~a . 19...`..-r....... and approved by the f Building Inspector. Fee $ ..,X115.., 1d . G. Building 4pctor Rev. 6/30)80 a/ IS Form No. 6 -~6s- r TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 19 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 - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.000 Date ....................~Y..a.../..~........ New Construction........ Old Or Pre-existin Building.. 30 Location of Property.... S.. 4 Q~ ~S C .0 House No. Street Hamlet Onwer or Owners of Property.... ,!Q 06/C r(C lli j 5 County Tax Map No 1000, Section ..,,,,,1~...... Block q....... Lot......... Subdivision........ .F/iledd Map.......... .Lot.. . Permit No..... . . ~[.~113 6h / G/7n/~OS1fYKCfj`~ Date Of Permit....... Applicant. „ q Health Dept. Approval ..........................Underwriters Approval........................./ Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: $ Q~ y~3 y ~ APPLICANT' 0 0 -9-L 1) ay31 _ INSPECTORS Victor Lessard OOgpfFO~,~c Principal Building Inspector p Curtis Horton SCOTT L. HARRIS, Supervisor Senior Building Inspector 00 Z Southold Town Hall Thomas Fisher P.O. Box 1179, 53095 Main Road Building Inspector • Gar Fish Southold, New York 11971 Building Inspector Fax (516) 765-1823 Telephone (516) 765-1800 Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD July 29, 1993 Catholic Charities of the Diocese of Rockville Center 380 Ed's Road Southold, New York 11971 Re: Framing Inspection & Certificate of occupancy for 380 Ed's Road, Southold, N.Y. Suff. Co. Tax Map #1000-78-9-68 To Whom It May Concern: After conducting a framing inspection at the above premises on June 16, 1993 I found the ceiling height to be less than the required 716" (reference N.Y.C.R.R. Part 711.1 (a) (2). I brought this fact to the attention of the contractor, Mr. Robert Bohn. He assured me at that time he would correct the problem. I went back to the premises on June 22, 1993 and found the height problem was in fact corrected and issued him an OK on the framing. A Certificate of Occupancy was issued on June 30, 1993 and should assure all concerned that this renovation/alteration meets the requirements of the N.Y. State Building Code. If I can be of any further assistance, feel free to call me at the Building Department, 516-765-1802. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Gary J. Fish, Building Inspector GJF:gar o5 FF0l~'c0~ TOWN OF SOUTHOLD TEL. 765-1802 a OFFICE OF BUILDING INSPECTOR 0 t. ~",f r P.O. BOX 728 ~F 3i~n} TOWN HALL SOUTHOLD, N.Y. 11971 Ol r~a ~ C E R T I F I C A T I O N Date_ Building Permit No.. Z11 Ll Owner a i"YW ~ I C ~VlC( t~1 Y1 E~ (please print) Plumber (please print) I certify that the solder used in the water supply system contains less than 2/10 of to lead. z'A V, 1 ex's i nature) Sworn to before e this ZO day of , 19 Notary Public 110tary Public, 6 ~f-- County BARBARA STEFNMKI Notary Public, State of New Yak No.4844752 Qualified in Sullolk County ~^.T.7=i n expires Sept. 30,19 F I w " r O 1~OZ3 ~0 q i t s 1 SN ~ I ' P a i n ~ os v i 4a cj~ /~1Q l/IVh ~ o i I 7i Y:: r,~ C~ I i C i I I l I I I x t l i I I~ i I ~ ~ I I 1ELD 1nS:'ECT10N ~~UhTE COaYMENT° FOUNDATION ( 1 s t ) FOUNDATION) (2nd) m 2. oW ROUGH FRAME $ PLUMBING co Nt 3. a,.. m INSULATION PER N. Y. 55STATE ENERGY CODE x a 4. 93 J CPIS m H FINAL e. Z4, L2 r ADDITIONAL COMMENTS:, ra ro n~ H \ H O z • x m ' x v m ro H e4 JUN 31993 i)'S8 o ~ 4 • ~ C V t G'q,g o r-~ le q ;7,2,0 G ~ kit n . Y~ NBW ~M c x . r.?.L~C Cv v.rr" is n 4 a O y (D ~ 1 4 . r _ M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] RQUGH PLBG. [ ] FOUNDATION 2ND [ /INSULATION [ ] FRAMING ) FINAL A~ REMARKS: DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ j FOUNDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL REMARKS:_ DATE INSPECTO M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [t.,YVRAMING [ ] FINAL REMARKS: DATE INSPECTOR k BOARD OF HEALTH i " FORM NO.1 3 SETS OF 'PLANS TOWN OFSOUTHOLD SURVEY JUN e 3 BUILDING DEPARTMENT CHECK , , , , , TOWNHALL SEPTIC FORM SOUTHOLD, N.Y. 11971 / TEL.: 7651802 t:a<1LL " CALL . Examined . y 19 .9,~ HAIL TO Approved (a/. 19fPermit Disapproved a/c (Buiding pector) 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 ets 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 )r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- :a{ion. 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 hall 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 hall 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 3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or tegulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. 'he applicant agrees to comply with all applicable laws, ordinances, code, housing nd regulations, and to dmit authorized inspectors on premises and in building for necessary nspections I). p - (Signat re of a~rplicant, me., if a corporation) 11 (Mailing address of a/can;fl~ hate whether applicant is owner essee, agent, architect, ern,~in~e-eUUUrr,, -general contractor, electrician, plumber or builder. .........................!`i! - ;Jameofownerofpremises L~1 ..-s'1-',L,~Q~2/~~ (as on the tat roll or latest deed) f a capnt is a,c oration, signature of duly authorized officer. (Name and title of corporate officer) F Builder's License No. 7~ ~i . , , , , . Plumber's License No . Electrician's License No. S Q 7! e- Other Trade's License No . Location of land on which proposed work will be d/one. . . . 3.RQ...........~~~.-5..... L~........ .~o . . . . . . House Number Street g Hamlet ~7 County Tax Map No. 1000 Section Block ...1 Lot l............... . Subdivision . . . e) ~~i'°°"u • . Filed Map No. Lot (Nam 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 ...............,.;:•a S.? . AIM, 4 t p (check w Removlicable): New Building , . Addition Alterat' 3. Retu~re. of work check which appljl 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 cars , , , y 6. If business, commercial or mixed occupancy, specify natur and extent of each type of use 7 Dimensions of existing structures, Number any: Front Rear ; . Depth Height r of Stories Z', . . Di t Dimensions sions of f same structure with 'ialterations or additions: Front .S3u--~ • • ~ ~ • • • ....-c.,..... Rear Depth 8. Dimensions of entire new constr.. Height Number of Stories . Lion: Front , , . Rear ,5...,w.._. Depth Height Number r of Stories . i 9. Size of lot: Front .....10 Rear... a Depth r:? P............ 10. . Date of Purchase 1 1. Zone or use district in which pr... . • ' ' ' ' • • Name of Former Owner ,/.'1.W. proposed ses are situated . 12. Does construction vi~teany zoning law, ordinance or regulation: /k. 4 . 13. Will lot be regraded . i. Will excess fill be remoy d from premises: Yes No 14. Name of Owner of premises w 5!~0 ~4 c , • , , Address l .l!! *C! phone No. ?A Name of Architect . .Address . . . Phone No.......... , . Name of Contractor , U. , Address one No..Z,(tc~ P P Y 15. Is this ro ert within 30d If Yes, Southold To feet tea t dal wetland? kyes,,,,,,,, No:........ c~ n 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. r y q v/ v A CJ 2~ ~Ati . v . L/ ow ./j2ZGG~ I~.(iL.~--C~t's2~.c.`2 ~t/~- rwc-•~t.. iTATE OF NEW YO ~OUNTY OF v P\ 5.S ' ' • ' ' ' ' 4' C ' signing ' , ) , • • • • • being duly sworn, deposes and says that he is the applicant (Name of individual contract) bove named. le is the 'P.NS~ v@e ~O yC......... . (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 PPlication; that all statements contained in this application are true to the best of his knowledge and belief; and that the cork will be performed in the manner scr forth in the application filed therewith. wom to before me this . , .WC~... ...day v 19~?? `otary Public, , , u ilk ••••~r• County ROBERT 1. R NqO~T,ARY to of N.Y. (Sig • • •nature of " " " • . • ' 'Tirn4xpl te e ffopt 8 oh ¢ applicant) '1 Y 81, SL i fit N~ PLUMBING ALL PLUMBING WASTE A WATER LINES NEED TESTING BEFORE COVERING : r r carp PLUMBER CERTIFICATION ~~L'^~ EXf~rl^3r~ 7 X! ,_,~1~-~~1~ r_,I~SS ryr~~ 2RF7'~'RS. . T ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY is)a SOLDER USED IN WATER SUPPLY SYSTEM CANNOT IA' EXCEED 2110 of~1% LEAD. APPED AS NOTED xr5`I ~G I~-1 i F~ DATE: go0 e.R a-2 j ~g I ~a wJ h c, S p0 FEE: -S BY: NOTIFY BUILDING DEPART T _ H copper tubing is used 765-1802 9 AM TO 4 PM FOR THE iwwaterdlevibuting FOLLOWING INSPECTIONS. I nREQUIRED system: piping shall be FOR FOR r'R POURED CONCRETE H FR Of types K or L on 2 RQ!16 FF.AILiINCi $i PI_UMRIPJG ' -TION 4. FINAL - CONSTRUCTION MUST r r{~ BE COMPLETE FOR C.Q. (--I ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. ~ _ _ - EXISTS r1CZ~o~ FLa~Y2 :SC7a STATE CONSTRUCTION IN ENERGY CODES. NOT RESPONSIBLE FOR I - - DESIGN OR CONSTRUCTION ERRORS ALLS UNDERWRITERS CERTIFICATE REQUIRED AT 'f$'~ }ILIGIIT 16 O.C I OIt ~I 6N - --fl kZq"71 IS- - 51IHDEr~ r 1 Fb~,T NLLJ 2.9'44 4,JA -LS - - - C-r: CIA h~---' L~ 0~~~~L- Jn15r1~1)EYJ Ar2ca1> . EKt".aTt.JC:> 2.7C*•4 ~"1 aA'(fI12o~w"~5' y iIl I,I qg" Kr E_~au, ,,J4 L)L ILI, EXtSTa~h_,~M1a~Ltr~rv Sa p ~I i r )3C- DR o€ v 4I li KrJ69 wAtM1 CATOooe. Ct-JAf)T: I 6 I III cps ?019 •s,I,U 5 i ou~~~ 1 V