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HomeMy WebLinkAbout21792-z L v FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23042 Date JUNE 15, 1994 THIS CERTIFIES that the building ACCESSORY GARAGE Location of Property 445 WOOD LANE PECONIC, NY House No. Street Hamlet County Tax Map No. 1000 Section 86 Block 6 Lot 5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 19, 1993 pursuant to which Building Permit No. 21792-Z dated NOVEMBER 19, 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 TO CONSTRUCT AN ACCESSORY GARAGE AS APPLIED FOR. The certificate is issued to EDWARD NORDSTROM (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N305810 FEBRUARY 28, 1994 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° 21792 Z Date .................?.19............................, 19..j.. Permission Is hereby granted to; f Cisd e~co~srs!c~z-....... ~ iffy / r /s~~PL Fd / n/~ ( f l I at premises located at .................f.. /rJOI.......r. ........................................................../".-CQ~?iL.........,/.:.............................................................. s County Tax Map No. 1000 Section .....rP Block 0.(o............ Lot No. OS............. pursuant to application dated ~ . 19.... ?3....., and approved by the f Building Inspector. Fee 5...~7:..,.aa....., I ) Building Inspector Rev. 6/30/80 ( t Form No. 6 (bay 515 fay- 7~san~~, ~ y 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 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 Building - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $115.00, Commercial $15.00 ~°ntOli}urn c / Date ~.6.Rt ..I.-, 1.0_f New Construction..V.goxjq: Old Or Pre-existing Building Location of Property .....r~..!.~t~YL~ ....................C.~r.~jC House No. Q Street Hamlet Onwer or Owners of Property dIIJRYf~..,;1\L'1 ,~DU County Tax Map No 1000, Section..... d.b...... Block.... p 6.........Lot.... ~ ~ Subdivision........, N. (I ................../....Filed Map............ Lot...............n....... Permit No..~.AZ~. ...Date Of Permit.."/ 5 16 ApplicantRo.bat..!:~. .~..1..!') Health Dept. Approval...I- ..................Underwriters Approval......................... Planning Board Approval.. NA Request for: Temporary Certificate........... Final Certicate.. ? Fee Submitted: ~J' 0d C44- q -1 q .....APPLICA a N z p x~ `gym I~ 70 0 C m i F o c m$ w 9 ~ F'•~ Y c ~ t~ 0. S Ox e~i sn M pa 9+ H~a is, Z ® 9 ? c~ n B O H SA 9 N ^ OM m A m = .n c9e b 2 w r o n 4 t?l a r n Z m _ H $m0 P. a ^yr 9A~ N m G CJ ~ Ltl H t--• ~ N M p~ DTI (T! p l9 = Z +1q Q ~ O? ~ ~ Y K f+ l"i1 Y~ d ~ N ;i7 3 +o < aa7 ~a W ^1 p cn m ~ Z ~y^ C N ra N H t2 eP l0 Pti 'n to O c c 3 p~ S 0 ~ 25 A m ~ -xi ~ j5 2 S N y H ? d ' mm -j m TI ^ 'ti an O w G O• O m c ern m. ~o m' G, o m v eP z n O p Or 0 ~m ~ mA T i~ 3 c~it * n Z 2 O O N n ~ ~ N $ F x ~ `D O Zi e o c ~ z' ~ ~ m O p b =_f L £ by a 'A 3 m z s ~ ~ m 30 o 0-r i xxjo n N g to N y f M 7 9 112 ~ = z' f m 9 ~ N M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ J ROUGH PLBG. [ J FOUNDATION 2ND [ J INS LATION [ ] FRAMING [ INAI. REMARKS: 17 4 DATE (all S IN8PECT0 p r M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ I INSULATION [ ] FRAMING [ FINAL J ~r~ REMARKS: 4 E E i DATE ~S INSPECTO Al M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATIO ST [ ) ROUGH PLBG. FO ATION 2ND [ ) INSULATION [ FRAMING [ ] FINAL r REMARKS: oil DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ FOUNDATION 1ST [ I ROUGH PLBG. FOUNDATION 2ND [ I INSULATION [ ] FRAMING / [ ] FINAL REMARKS: c liar" DATE , a INSPECTOR JOB aDmar mermpsT12om IZIrSIA C~ ROBERT T. BAYLEY A.I.A. 4,q5 W&OP L PE_ Pp~cm-jlc- Architect~_ 21 92. 150 Lakeview Terracet~c1., • ~ P.O. Box 595 i !!A `~JL E DATE I / EAST MARION, NEW YORK 11939 CHECKED DV (516) 477.5024 ~ Vj/0. ' J>OV T ttc~LrD i'owh? .Sul Ll>t1J, £Vtt~kY~D., .I.FDRDsTCtoM , R~5?.i~t~c~-.. _ , . . (~ouA d. ~1..)tw. • .."~'~ccrn.~?c~ . t~,l ; . . e _ .........:..._L 1 V YJb~k-1 tCJF~~ 11.~~T~iGcTt L1~J ' Sd~•si4U; al-CF1> ..TKO1.N.Tt.rtN...?tZMUI2.C~' TKAT, NeV. Z9 KWTr-->l. T~.2 ..BIZ ~ _~iL.~n~ ATI~- ~QPW I CC<tf~-~!I,~.?T(..v~..OF-.;l-!N._....;..;.. rz 1=TE PcrvrL,,,.~ p V ~R.`(, c. 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In !7 b .t. ove. cox. prcM /D.6' U[ vj, 1 nB Dµ' conc. ~ I piort ~ r I ~ I tl W 3 S X :E tl 12. t 3 ¢ W z S o 5.2 ..1 Z Q~C~ . x o /e z' Q M F 0 ' .y r N U N cf) v 41 f - Cl) (D 0 ry goo z z LL 4 O U O 0 W Q Z Z ii : /82 Q O \ 4 O' \ W W F Q J z ~ o O z m F- e e W W F ¢ U F- U)OW~ Ev J L Lit E MA um m p z o y W O '3 L m 2 3 ' O v° 0 $ m \ `0 m W co z o e O W o x ' c c 7 L krt ~ y ~ ~yY roUHDATI04 - - -tZ (7st) eYY I •c~ 4r~C/fT~ /I,/i 'OUNDATIOt1 f 2nd 1 y - G ?OUCH FRAME -PLUMBING • I M II y i . II a rJ 11SULAT201! PER N. Y. • y~ STATE E1IERGY I~ CODE 9 z CZ m FINAL may` ~ ° - ADDITI 1AL COMMFNTS: S Jl,. H O U1 r y E 14L~W PrULL%Pirtt(,1 "CV 2EIDll+F,~F~iS'F, BUVLnronL~ 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work II ; (Description) 4. Estimated Cost 4 . ' tv Fee . ~1,~ (to be paid on filing this application) S. If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars C Z ..........1- Ps! •lttZAC.~.. io , , ~V,ugc~. c?N~ cp.IZ eyj~~~ . . 6. If business, commercial or mixed occupancy, specify nature and extent of.each type of use )'Ap . . 7. Dimensions of existing structures, if any: Front , Rear Z 4 Height c1 Dept h . ,T2::4~....... . Number of Stories LE • . Dimensions of•sa re structure with alterations or additions: Front 5A!n~ Rear ...5?`?-M~......... Depth ....sftME Height 1 1: G,° Number of Stories ..0NE. ft A-1rIc- 8. Dimensions of entire new construction: Front Rear . Height Depth Hei g • • • • • ..........Number of Stories 9. Size of lot: Front "i>r...5 r12v ~.T..:.. Rear . Depth . 10. Date of Purchase • • JAKE, • 16IA7 • • • • • • .........Name of Former owner yNf:iN9wN 11. Zone or use district in which premises are situated 1:~,.40 , , , , , , , • , , , • , , 12. Does proposed construction violate any zoning law, ordinance or regulation: ~49..... 13. Will lot be regraded t4 Will excess fill be removed from premises: Yes 14. Name of Owner of premises PRAMP.5.'NOIZO.T.17QM Address Phone No. (516,73!(-9_Gt25' Name of Architect V-O1Wr .lZT. FiAk LJEV......... Addresslw4 515. •1 ?4uN... Phone No(510g77-.5)A1 , 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. J ~E !~'C-fgTC~1~D SUIZV~Y STATE OF Y NEB-I YC(`r S.S COUNT 1( f \ d eT fi • •1 • • • • I• e • • • • . (.n..... being duly sworn, deposes and says that he is the applicant (Name of individual signing contr~t) above named. He is the ....rC l T G I . . (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 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. Swom to before me this d yyo 0.11 ....Jot. . County CLAIRE L. GL.EW Notary Public. State of New York . No.4879505 Qualified in Suffolk County (Signature of applicant) Commission Expires December 0, 19 BOARD OF HEALTH yi {~,,`;•F~„s` eke FORM NO.1 3 SETS OF PLANS - TOWN OFSOUTHOLD SURVEY BUILDING DEPARTMENT CIIECK .c*.195V . • • • • • • • NOV I i i 0 1TOWN HALL SEPTIC FORM IiA SOUTHOLD, N.Y. 11971 1 TEL.: 765-1802 NOTIFY CALL Y.72- s©~~~.... Examined =/7t7-...., 19p12. 7 MA I L TO,: Approved 119.... , 199j . Permit No...................... Disapproved, a/c (B i ng nspector) APPLICATION FOR BUILDING PERMIT Date ...v v:. g 19%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 availabl 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 oval or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, build' g co , housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspectio 's . (Sign re. of applicant, or name, if corporation) N91V-0. 595 F-#67 MAIUoj NY. U!39-. S95 (Mailing address of applicant) State whether applicant is owner, lessee, 'agent, architect, engineer, general contractor, electrician, plumber or builder. r?C6lJT,ECJ. Name of owner of premises . EDW~cfZ P , ib Nb 2~ 1NA No2I>5TIZ0M (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. NR (Name and title of corporate officer) Builder's License No. Plumber's License No. tJAI Electrician's License No. Aj . . i Other Trade's License No. U~c9P~~ ~NOt{El.i N~K ROAD 1, Location of land on which proposed work will be done. . , , . , L PE60~1t-- yys ..............U~l(9t?P• ,1 At~E ~NDIRt l NF~C1< 17AAD P~Gan?,l~° House Number SStctrre~ee//t Hamlet County Tax Map No. 1000 Section ,...:.....O.l 0 Block (-9 Lot . . Subdivision .N.11~ Filed Map No . Lot , , . (N'ame) 2: State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy 5l NILE .GFlyZ,Gl~I?1~ ~Tc. V] ? U o)-, b, Intended use and occupancy . I,. , St N(~LF C'A0Z GIl~Y2E , alb--- _ a ' arty N C7 T"E. COW, . '4'X4 C4 A^ sttu DYE-?- _ tST. 5", cfilYA2 'F.StIA.. lo xi~r.-ca.@.nte. To. 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Y. 7=0" HIi5 F1 f conc GL'- L ' f NORTH F- L, EP\ST EL, WE5T EL, fSPHALT SHIN iLE YCOF - ' - 2%l0 ¢1D5E - ~P RIAGIE. - ~ - . S1,t L~UVER9 ALL ASPHkLT COMP. {iF q' I DES aF GVPOLA ' .LT COMP. {i HIN61LE5 tf :30.#F=LT OVE,Y FELT DYERveGDX PLY 5/(i "rE.xT, IU PLYV~JOD r2%r:5 ZP.FTE¢5 2AFTE25 a) - N 16"O.C, - _______.___-24-4" j 8 COLLPV 71 COLLAfL T\ES a'74`O" 1 -ALL'o~1G"OC. NON-L v- GTGI L\NEOF COV25E M or 13EARIKZt P.4QT./ MA11.1 FL2>NL'( ' 1H URQICp?{E CUSS TYPI OF CoNG BLOCK ~3TA11Z - i A7T(~ t { ~ -21'14 56LKT 'FIR 9TR1 NITER ~ p Gas _ (STOR-kC~E) - - - -21610 SFLELT FIR TREADS W N \ 0 y -EpGlt 57EP OJE2V.f5 ST V ~ f FS ~LI / / ;.BIZ ~ ai4••A/C. PLY m J_ r171c. _ ff' USE PRE9ERVPT\YE AT I < IbOTT0/+1 OF STI.IK ON SLPIS ~ ~ i S 2%10 o~1b"O2. GIAI t4. \0 b O t 1- M l 2xb Alb" o / tl~ r-° I a ~ ,_1A Wv 1 I ~ ~ II 14 ~ a I 1 O 13 F12"TGYT Y' 4 ^r N Q W O1 m IU PLY••. N U V p ~ I = K~ ~ lY I a, I i j I .1 P M ~ , 1 'I I .a a9 kl II.00 U a~ rI ND+=L. (i I ICI i j~ I I ~ r ~I (5T Knf~, x N - 9 '.f- 241E C, tR9ER_ APPROVED AS NOTED 0 R.O. O DATE: ) BPR__aL gyj'2 3 - 2 rrq c112ne.K,' y. 7 A NOTIFY 'BU L MO DEPARTMENT AT UNDERWRITERS CERTIFICATE 66-1802 9 AM TO 4 PM FOR THE REQUIRED 1 7 FOLLOWING INS ,SOUTH 1L~ 1 ,=L 1. FO UNDATIONP - TWO REQUIRED ~J~ GT A D N - FOR POURED CONCRETE - 2. ROUGH -FRAMING & PLUMBING 8. INSULATION 4.. FINAL - CONSTRUCTION MUST KFAEp O BE COMPLETE FOR C.O. USE IS UNLAWFUL °`SgEpT r. q~'~; evf '7,\ ALL CONSTRUCTION SHALL MEET 0 e9,. ~ O 2USTi~.O M C~AR.AG~ ~ THE REQUIREMENTS OF THE N.Y. 'FLAI.l, Sr-~c.TIOyTI ELEVATIOrJS~ D~/.TAIL.IS STATE CONSTRUCTION & ENERGY VVT OUT ~t m CERTIFICATE `•{,DI A-Jhj NEGK , PEr-4="tG , 'N E W Me, CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS OCCUPANCY a OCSEfGT FSAYLEY P.IA, AiZCI-IIt F~CT ~?CA1~'". Y#"j LI`IO~gI~„ - I C~ V o Pr ar NEW aw