HomeMy WebLinkAbout21480-z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23966 Date OCTOBER 19, 1995
THIS CERTIFIES that the building ADDITIONS
Location of Property 3225 YOUNGS AVE. SOUTHOLD, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 55 Block 5 Lot 3
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 7, 1993 pursuant to which
Building Permit No. 21480-Z dated JUNE 11, 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 ADDITION & DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to CHERYLE L. AMARA
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. H-047350 - OCTOBER 12, 1995
PLUMBERS CERTIFICATION DATED OCTOBER 18, 1995 - PECONIC PLUMBING & HEAT.
0
Building Inspector
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23969 Date OCTOBER 19, 1995
THIS CERTIFIES that the building ACCESSORY
Location of Property 3225 YOUNGS AVE. SOUTHOLD, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 55 Block 5 Lot 3
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 7, 1993 pursuant to which
Building Permit No. 21480-Z dated JUNE 11, 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 ACCESSORY STORAGE SHED AS APPLIED FOR.
The certificate is issued to CHERYLE L. AMARA
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. PENDING - OCTOBER 17, 1995
PLUMBERS CERTIFICATION DATED N/A
Building 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)
N® 2480 Z Date i;~ zl 19r
~ Gad ~
Permission Is hereby granted to:
to ••:T'~•r••i1iCi.....G~G9l~?h... ..,...?e...... i~
12-a...............................................................................................
i at premises located
f
County Tax Map No. 1000 Section S Block Lot No. .,,'~3
{
pursuant to application dated 1 19. and approved by the
f Building Inspector.
Fee
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I
! iding nspector
t /vv/
Rev. 6/30/80
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Form No. 6
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 17 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 $5 .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 ......-.s
New Construction.... Old Or Pre-existing Building
Location of Property. .o`. yp~,?(6.... A V E...........................
House No. ~J Street Hamlet
Onwer or Owners of Property. G Amd,0
~ounty Tax Map No 1000, Section... 5~ ......L'luck.............Lot....&
Subdivision nn.....QQ ................................FiIcd Map............ Lot...`~............y~.......
Permit No.°~~L~.U~. Z..Date Of Permit ...61o1/,3•..Applicant. ..~}..H~~?.~.. L:. AIWA
~Iea1Lh Dept. Approval ..........................Underwriters Approval.YC 5.....,......,.......
'lanning Board Approval
2e quest for: Temporary Certificate........... Final Certicate. Z.......
?ee Submitted: $...~5, 00 7
-soa~3
eo~396g '
Form No. 6
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 17< 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 .//~jqs .
New Construction........ Old Or Pre-existing Building
Location of Property. °?a~ .................J.D1AfJ ~1)e...............................
House No. C v Street Hamlet
0nwer or Owners of Property ?1/~~96
:;ounty. Tax Map No 1000, Section... 5 Jr Block .............lot
Subdivisi.on...IF......~Q..JJ.... .........................Filled Map........../..Lot..
Permit No.._l.!Y.~ Z..Date Of Permit... pfi/ !.~...AppIicant.SrHEFl
Health Dept, Approval ..........................Underwriters Approval. E~....................
'lanning Board Approval
4e quest for: Temporary Certificate........... Final Certicate...~.....
-ee Submitted: $ )_T: :o
Rt("sDag3
c o ~.3 9 A 9
Town Hall, 53095 Main Road 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 : ?7
Building Permit No. W -z,-y~
Owner: C~EgYL_L? L, 97/~~~Flt
(please print//)
Plumber:, G0/7IG
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% leaadd~-
(Plu rs Si ature)
Sworn to before me this
day of
Notary Public, ~tI FFo uC. County ti(. (J yvl_ P y~y~ .
Notary Public, s::.1o o: New Yak
No. 01ST4N4752
oualilied in Suffolk County
Commission Expires Sept. 30. 19-1
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STATE ENERGY pa.Ccr - rS /1/"OZCI/e.'
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AD T.IONAL COMMENTS: x
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M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST { ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN LATION
[ ] FRAMING Z [ FINAL
REMARKS: ade- Z _ ~;e
A*tlk
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DATE INSPECTOR
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M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ) ROUGH PLBG.
FOUNDATION 2ND [ ] INS TION
[ ] FRAMING FINAL''
EMARKS:
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DATE ' INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
'FLOG.
[ ] FOUNDATION 1ST [ XFINAL
OUNDATION 2ND ATION
F
FRAMING [ ] FIREPLACE & CHIMNEY l
REMARKS: ,0 74` ~v
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DATE INSPECTOR
M-1802
BUILDING DEPT.
If
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
( J FOUNDATION 2ND [v INSULATION
[ ] FRAMING [ ] FINAL
REMARKS: 1 Gi
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DATE INSPECTOR
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M-1802
BUILDING DEPT.
INSPECTION
[ I FOUNDATION 1ST [ ) ROUGH PLBG.
( /F0 NDATION 2ND [ ] INSULATION
MING [ ] FINAL.
REMARKS: DATE INSPECTOR
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS: f
DATE L INSPECTOR C4"U",q 4
THE NEW YORK BOARD 'OF FIRE' UNDERWRITERS FAGE.1
8056751 BUREAU OF ELECTRIOITY .
F ,y as JOHN STREET', NEW YORK,,NEW-YORK 10088 - - - buLe OCTOBw 12 t 199 ' Appilcation No. on file 1037$295J95
10$7550.
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,,
THOMAS zAMARAt3,225 YOU NGS AVE..i SOUTROL1)y N.Y'.,
in thefollowing location,' 0 Hosement Ist Y7.^ ' 2nd hl. O Se~ tion llf6ch' Lot
uws examined on - " O0,:O,R 04, 19,95,
5: ' rind found to be in compliarzce with the No'tional.Llectricaq, 9Be.
y
FIX TURE "FIXTURES °'iAANOES COO NdDECKS OVEN ' DISHWASHERS EXHAUST FANS
OUTLETS ECEPTAClES SWITCHES INCANDESCENT RUORESCENi OTHER AMT. - K W. AML K, W. PMT. K.W. AMT. K.W AMT. H. P,
f DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECtALREC PT TIMEt:LOOKS REII UNIT i1EATERS MULTI-OUTLET DIMI'ERS
i SYSTEMS
AMT. K. W. Olt H. P. GAS K P. AMT. NO A. W. G. AMT. AMP AML + PMPS. TRANS. AMT 8. P. NO. OF FEET AMi.
M'-SEBVIGE'E-0ISC-0NNE6f•-: ,MO.OF. ¢,.....-.,.sF&..,>R>,.._,_-.,IL..,:.-N,.»;,.1~.a,.........L..,:....w,.._E.-»-.:...~..~.«..:,..e.:~..._.....,
METER mw m • NO. Of CC CONe ACC G A. W G. A. W. G.
AMT. AMP. TYPE EQUIP, 11,12 W 1 %3W S,P 3W J,e' AW PER a OF CC COND., NOAF HI-DI i.G' - F H4lEG NO. Of NEVTRAlS OF NEUTRAL
4 1
OTHER APPARATUS:^ "
'NO VISUAL,DEFECTSe "Ara electrical
survey has been made of the exposed
electrical equipment ~-n,the......
prAmises.indicated ."as"No 6bvious a.
uhsatisfacto4y. donditioh vras fbund. -
3 ,4 P, rLEksE RurAM 'opp" BY
OIIDER TO^iNE ORDER OF THE N
FEE PAPA YORK BOARB OF FIRE UNDERWRITERS
AS CASH SENT .BY, MAIt U. BE At
THOMAS AMMA RISK oF. SENDER.
T.O`.BOX 145.
SOUTHOLI7, NY, 11971" '
r a.1 y
Per
Pp¢t t3 gF
HN STRET„MEW YORK, N,Yi I W38
[ , THIS IS YOU Bll FOR SERVECR.RENDEREDAND IS N - k'~TE6F COMRIANCR. TNIb glµiAYX~.At '11i THE NEW YORK OFFICE,, 83 40
,
c l i cru
THE NEW YORK BOARD OF FIFE UNDERWRITERS. Pict 1
8056976 BUREAU OF ELECTRICITY
`EIS JOHN STREET, NEW' YORK.NEW'YORK-10038
Date OCTOBER ~24 F 1995 ~ _.Applleatiort No. on file 10462095195 ~ H e47486,
THIS CERTIFIES THAT
only the'tllecLriatll'LFgi{ipniient m describ`ed`betoi6 oiui`introi7iaced by the opphaaFPt'nOmod on the above application number in, the pmmiaeb, of
MR.&, MRS.Ai"A,l' $2251',YOUNGS AVE.-F,SOUTHOLOF, N.Y.. '
imtheJoltawingloctlyion}. Bax'ement W IAtFL• 0;2nd'Fi, CxA12/OU`T" - 5ertiort $loc"kL col
awa examined on, OCTOBER 17 T 1995 pnd found io he in compliance with iho National Electrical Code.
i
FIXTURE ECEPTACWS SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS g,
OUTLETS INCANDESCENT FLUORESCENT OTHER AMT K W. AMT, K.W AMT AM AMT. K. W. AMT. H. P. V1,
BEII UNIT~MEATE7I5 MULTI-OUTLET 'DIMMERS i
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS, SPECIAL REC'PT 71ME CLOCKS
AMT. K.W. Olt H, P. GAS H. P AMT. NO A. W. G AMi AMP. AMY, AMP$ TRANS: AMT,,,, H P,: NOSYSTE.OFMFSEET AMT. WATTS
a,
ECT • NO. d'F S E R V 1 C _ E
G
t AMT. AMP, TYPE METER T m T ~N, 3.0' 3W 3,8' }W NO. OF CC COND A. W G. NO. OP H4lEG p.W G NO. OF NEUTRALS A. W
7YV .
OF NEUTRAL F `
EQUIP. PER a OF CC. COND. OF NJ-LEG
OTHER' APPARATUS:
f,„.. ram„...
*NO VISUAL DEFECTSi "An electrical
survey has been made of the exposed
electrical equipment in the 9d „Tr•
ptethises indicated:" "No:pbyious ?
;unsat-Of aotoxyacionditton was found. .
AmOuNT,_
REASEREMIT lYp {CpA~KK Di ANJNEV.' S
~~E 3R PAS . roa~K eo-I of RRE FF TIRE eNE "s
AS N7
THOMAS AMARA , - ~R sR sE DertBY AwL wIU er Ar
P.O'.BOX'145
SOUTHOLDF NYT 11971'
THIS 19 YOUR BILL FOR SERVICE RENDERED AND IS NOTACERYIPICAlEQE,. MT'ALANCE.THIS&LI,pAYABLF,,AT TJIE HEN!.VQRK OFFICE, 85,JONN STREET, NEW-YQRK, N.Y. 100,38
BOARD OF HEALTH
` FORM NO.1 3 SETS OF PLANS
JUN TOWN OF SOUTHOLD SURVEY _ .
BUILDING DEPARTMENT CIIECR .
TOWN HALL SEPTIC FOR,N
SOUTHOLD, N.Y. 11971
r
i TEL.: 765-1802 t: of /TF?~../.°Z
/ //s CALL _ .
Examined ll0 F"~........., 19~%__ rIA I L TO:
Approved ./~q~/ 194/. Permit No.~ .
Disapproved. a/c _ _ .
APPLICATION FOR BUILDING PERMIT
Date . ~.77....... , 19f 3
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.
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 in ections. Q
(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.
I.ius1~'~? .
Name of owner of premises ....~%NYL..............................................
(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.
r/
Plumber's License No.
Electrician's License No.
Other Trade's License No.
1. Location of land on which proposed work will be done . .
~3 s~......... Win,
House Number tree t Hamlet
County Tax Map No. 1000 Section 9, , a? . Block Lot
Subdivision Filed Map No. Lot ,
(Name)
1 State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy I .m.l. t .Y49 v='a sag , >xt _yp
24,
b. Intended use and occupancy !'1v
S?"l. / i~ • :
•3. Nature of work (check which app~icable): New Building • • . • • • .
Repair........... Addition Removal . Demolition Other Work
srt (Description)
4. Estimated Cost 1 Q ..Pos... • , , . , .
number of dwelling Fee
5. If dwelling, (to be paid on filing this application)
, If garage, number of cars g units Number of dwelling units on each floor , . , , , . , ,
6, If business, commercial or mixed occupancy, specifyature and "exte t of. . . ' •
7. Dimensions of existing structures, if any: Front , ! n each type of use . . . . . .
Height Number of Stories Rear, S° ! Depth .
. ,c` .
Dimensions of ame structure with alterations or additions: Front r~ ~o .
Depth . Rear ...)L6-
• • • • • • • • • • l Height . . Number of Stories , d
8. Dimensions of entire new construction: Front . • ' `L. ' ' ' ' . ' ' ' • ' • • • •
Height . Rear Depth
Number of Stories .
9: Size of tut: Front........ Rear
10. Date of Purchase ' • Depth .
]I. Zone ,or use district in which premises are situated , ' ' Name of fionner Owner
12, Does proposed construction violate any zoning law, ordinance or regulation: .
13. Will lot be regraded . Will excess fill be removed from premises: _ yeS
14. Name of Owner of premises . Address
Name ofOwne _ ••••••......••••Phone No Architect Name of Contractor , Address ...................Phone No...........
15." Is this property within 3010 feet of 'Ytidal wetland? * " " " '••.Phone No .
*If yes, Southold Town Trustees Permit may be required. No.........
PLOT DIAGRAM
Locate clearly and distinctly all 1%uildings, 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.
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,
I
STATE OF N£e.§y'YOR
OUNTy OF. I . ' ' SI ,
. ' ' • '
' ' " o wa•`' • • ~ • • • • being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
ie is the . J .
etc.)
~ gent
(Contractor,~ 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
fork will be performed in the manner set forth in the application filed therewith.
worn to before me is
y of
'otary Public~: County
CLAiREL GL P N ..44-1.'Ol .
Qua Niel f 8 ffd C 0
y Q~Commission ExpiresDaosmb r9,19L (Signature of applicant)
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2FF2 E.V f vN UNDERWRITERS CERTIFICATE
is Aue 2 =I -c REQUIRED
_ PLUMBING liCCLII MNCY OR
PLUMBING & WATER LIN SNNEEEEDD USE IS UNLAWFUL
TESTING BEFORE COVERING WITHOUT CERTIFICATE
OF OCCUPANCY
N copper tubing Is used APP 0 ED AS NOTED
fOr Water distributing L
speJtaym~;~piping shall be DATE: i B.P. #
Of4WSKorLonly
NOTIFY BUI ING DEPA E T AT
766-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS.
1 FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE PLUMBER CERTIFICATION 2 ROUGH FRAMING R PLUMBING
ON LEAD CONTENT BEFORE 3 INSULATION FINAL -
E COMPLETE FOR C 0 CONSTRUCTION MUST CERTIFICATE OF OCCUPANCY 4 B
SOLDER USED IN WATER ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y. SUPPLY SYSTEM CANNOT STATE CONSTRUCTION a ENERGY
CODES. NOT RESPONSIBLE FOR
EXCEED 2110 Of I% LEAD. D ESIGN OR CONSTRUCTION ERRORS
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