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Home My WebLink About21214-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 2-23599 Date APRIL 17, 1995 THIS CERTIFIES that the building ADDITION Location of Property 1340 BUNGALOW LANE MATTITUCK NY House No. Street Hamlet County Tax Map No. 1000 Section 123 Block 2 Lot 17.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 3, 1993 pursuant to which Building Permit No. 21214-Z dated FEBRUARY 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 AN ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to FRANKLIN A. SCHOLL JR. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. B043784 DECEMBER 20, 1994 PLUMBERS CERTIFICATION DATED MARCH 12, 1995 MATTITUCK PLUMB & HEAT lding Inspector Rev. 1/81 WORM NO. I 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°-N° 21214Z Date ..P/9 192:3 Permission is hereby gronte to, i ..:~'~r .e la.-......... 01 f at premises located at .....~i. TS~.....su?? ....4C. ........................................................~,latff County Tax Map No. 1000 Section ......../..P..%3 Block Lot No..~7' a pursuant to application dated 19.7 and approved by the Building Inspector. Fee , B ng nspector Rev. 6/30/80 - " 'w'- sir i; Form No. 6 TOWN OF SOUTHOLD V ~M ( BUILDING DEPARTMENT MR TOWN HALL B_,_. 765-1802 AA, 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. M1 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 $15.00•, Commercial $15.00 Date New Construction......... ( Old,`OOrrP,rre-existing Building.. . Location of Property.. 1.0~To.. 3c e L-C; House No. ~ Street Hamlet Onwer or Owners of Property... .1 , y.10\.11.v~\ ,,,•1 : ~5 f County Tax Map No 1000, Section. .t Block ...Q -r- c_: ....Lot... C)~. r A e?....... Subdivision Filed Map............ Lot...................... Permit No.Z177 V. Date Of Permit ................Applicant. vii . 1 Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: $ rr} I APPLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 $051586 BUREAU OF ELECTRICITY 88 JOHN STREET. NEW YORK, NEW YORK 10038 DECEMBER 20,1994 Application No. on file 81027893/93 H 043784 Date THIS CERTIFIES THAT PERMIT NO. 21214 Z only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of FRANKLIN A. SCHOLL ~~JIRI., 1340 I~BIUINGALOW LANE, SECTION#123.00,POLE#12, MATTITUCK, N.Y. in thefollo'icing location; LJU Basement [2 Ist Fl. ? '2nd Fl. OUT Section BlwA02.00Lot 017.0 was examined on DECEMBER 15,1994 and found to be in compliance with the National Electrical Code.; FIXTURE - FIXTURES- `RANGES , COOKINGDECKS OVENS DISHWASHERS EXHAUST FANS I• OUTLETS ECEPTACLES SWITCHES "CANDESCENT FLUORESCENT OTHER AMT K W AMT K. W; AMT. KW AMT K W. AMT. H P ' 15 12 8 14 1 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT "EATERS MULTI-OUTLET DIMMERS AMT. K. W. OIL H. P. GAS H. P. AMT NO. A. W. G AMT. AMP AMT AMPS. TRANS. AMT H. P, SYSTEMS NO. OF FEET AMT. WATTS 1 F 3 600 -SERVICE-DISCONNECT- - NO OR R i C E w _ _ _ METER' NO. OF Cc COND. W. G . A W. G A w. G. - AMT. AMP. TYPE EQUIP l A' 1W 1 ,R 8W 3,e 3W 3,R' 4W NOPER 0 Of ACC. WCOND NO OF HI LEG OF HI LEG NO OF NEUTRALS OF NEUTRAL. 1 200 CB 1 X 1 2/0 1 2/0 OTHER APPARATUS: 30 AMP.GEN/TRAN TRANSFER SWITCH'-1 MOTORS:3-F H.P. ELEC. WATER HEATERS: t1-4.,$ K.W. G,F.C.I:-3 APR 13 1995 AMOUNT PLEASE REMIT BY CHECK OR MONEY P ORDER TO THE ORDER OF THE NEW q I L a uT IrI FEE PAID " 'YORK TOV,I SRARD OF FIRE UNDERWRITERS KII C, AS CASH SENT BY MAX WILL BE AT FRANKLIN A.SCHOLL JR. - RISK OF SENDER. 1340 BUNGALOW LANE MATTITUCK, NY, 11952 Per 11~ PAWS THIS IS YOUR Bill FOR SERVICE RENDERED AND IS NOT A CERTIFICATE OF COMPLIANCE. THIS BILL PAYABLE AT THE NEW YORK OFFICE, 45 JOHN STREET, NEW YORK, N. Y. 10038 f f is M °Ht1il, 83095 Main Road Fax (516) 765.1823 y> P O: t3o% t 179 - N Telephone (516) 765.1802 11Id, N6W York 11971 • r , wok s' r _ •°,>t f s~t ~;`t`• Tux OFFICE OF THE BUILDING INSPECTOR ~zYf+ TOWN OFSOUTHOLD 4 l`y 1 C.._ E R T I F I CATI0N DATE: 2~f V Y5!Y i ~ ' d ~ 1 Lx ~ ~ ~ k ' SuildiT3 :Permit No. y APR 13 1993 '0111,~, `Qrbc~n~r1 please print) ntir••;.. ul9 l „ Siut[tber: &ALk V t' (p ease print) e~ 1n~ .x` Y Yf ..`r," that the solder used in the water supply system n afhs less than 2/10 of 18 lead. , r 2~wv (Plumbers S ~4 " > ~r " t tsrn;to,before me this ~Y x j day of ~~l~rQC 19 e5 ~A t •'~~I ~ry~P.>~~lic, ~dG~ County f EDITH F. JACKSON Nokuy P*k SW* d Now Yak W 4W59 h aft co" Tam E*w ft.18 in „sf tttsy"rfi, . r FZ_Lu~ i::.`',._~.::::i ~~JA:~ i~ :;C:-(i•iLNTC FOUIIDATION (1st) • C FOUNDATION (2nd) SOUGH FRAi•IE & ZZE G -PLUMBING !n H 7 m n =IlSULATI0;1 PER N. Y. • • STATE ENERGY CODE 3 -1 YZZ FINAL ADDITIONAL COMMENTS! , co A • H i~ H 1 • O `m a - - - H M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ I~TION [ ] FRAMING [ INAL REMARKS: _ h- L r lo/ DATE ~ ~ S INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] RO H PLBG. [ ] FOUNDATION-2ND INSULATION [ ] FRAMING [ ] FINAL REMARKS: i 1 DATE 10 /)§q~ INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE © INSPECTOR ~t7 M-1802 BUILDING DEPT. INSPECTION [ FOUNDATION 1ST ( I ROUGH PLBG. ( ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ( ]/FINAL REMARKS: DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL REMARKS: / t DATE INSPECTOR 6. 11 w MAY 3 I X994 T rte, d . /38 x ~ i Ll Q ~w oYaQ_ La.-~ etIl.a t y u c-A-VU, I 0 i i i I I ~ i ' i I i f h i ~ I I I NhL ~b)l5 c@®0~ ? b9- AP-her e4 : BOARD OF HEALTH FORM NO.1 3 SETS OF PLANS TOWN OF SOUTHOLD SURVEY FEB _ 4 1993 BUILDING DEPARTMENT CHECK _ , TOWN HALL SEPTIC FORM SOUTHOLD, N.Y. 11971 TEL.: 765-1802 r:oTIFY i r CALL Examined OX! 1913 MAIL TO: ' • • • • • • • . Approved , 19gPermitNo/F;~1~ . Disapproved a/c (B 'ding ector) APPLICATION FOR BUILDING PERMIT ~~i Date 19.1.E 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 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 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 desc 'bed. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code and regulations nd..to admit authorized inspectors on premises and in building for necessary ins eation . . (Signature of applicant, or name, if rporation) I.'~ R ~.o L-C...... qAJ (Mailddress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises X,~ ...N....J P. ~ a . (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. ....O. ~Y.? Plumber's License No . Electrician's License No . Other Trade's License No . 1. Location of land on which proposed work will be done . House Number I Street Hamlet t County Tax Map No. 1000 Section Block ..O2 !.Q P..... Lot ..V l7 .°.0p 2 - Subdivision C.Filed Map No. Lot (Name) 2. State existing use and occupancy of premises amd intended use-and-occupancy of proposed construction: a. Existing use and occupancy ~.V\ . t 1 I vl-: b. Intended use and occupancy fx 1 1\.\. 3. Nature of work (check which applicable): New Building . ddition . Y Alteration , , Repair Removal Demolition Other Work (Description) 4. Estimated Cost v Fee . a(to be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on eacli floor , . , . , , • , If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dimensions of existing structures, if any: Front Rear Depth , . Height Number ofStories Dimensions of 'same structure with alterations or additions: Front Rear Depth J, Height Number of Stories $ Dimensions of entire new construction: Front Rear Depth Dig .....Nu berofStories 9. Size of Rear Depth 10. Date oflPurchase . ..C4 premises • • , . Name of orme Ow er ( ha.~.~~~ .C~» 0(1 , 11. Zone or use. district in which are situated nnn ~ , ,~A, , qq 12. Does proposed construction violate any zoning law, ordinance or regulation: Yy s"............... 13. Will lot be regraded . . Will excess fill be rem ved from premises: Yes No 14. Name of Owner of premises d~z%'l~,\i_...tKo.~ I, ,Address .C.3P.tiv~aloW. Phone No..`Z..^z .3 . -.G Z" Name of Architect Address Phone No............... . Name of Contractor . Address Phone No............... . 15. Is this property within $00 feet of a tidal wetland? *Yes........ *If yes, Southold 'own 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 Dumber or description according to deed, and show street names and indicate whether interior or corner lot. t ~I s i i i STATE OF NEW Ol S S C,O~U•,NT\Y_QF... L~C~\i f~• • > • • • C,'~ ° • • V being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the.....~V\SL 0 (Contractor, agent, corporate officer, etc.) of 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. Sworn to before me this .....~....day of } .~e Notary Public, Cquntl LINDABtateof . , !j~+^`~4?. . Notary PuMb,BUbdNgw1_j, / GwiHNo,30 (Signatur applicant) comm(NIM ~Mns6MY6 YI /.L', 2 D O I C p I d O A I~v ~ 03 XN 2 a ~tm N ° 03' 00 83.33' W O V V T am A ~2 0 O Z 2Po O a / ~ e2 0 m l 2 m Z : rpp M n 34.5' O w~^o x ym w r \11 m 21.8' c IP.T a < a o y ° m \ \ ~ si ti5` a°2 ot,s ~2 N0 m to a%4 to Cal .%;o 2 D b '9y 1b 3 MO J d r Q,- a m T 14 by moM1O~ v m y $ oacs ~ ~0 :k a4 u o~ o m Alt a 4~ Z °o C m ° Z~~ C, rn Q '02s~Q A~ act ~u NC O~rTl p pW . 9 v c nz, a 3 z x I ~I C I , ~ sT . - anti ~ n y ° n n ~m~Q ° ~ a O O 6 ~a a m -`cY1S- 6R.UN4A•7•IOhJ m PLUMBER v 0 ON LEAD COO i f! EEit r , r! iD CDPd c f !E ] , If copper tubing is used ATE OF OCCUPANCY PLUMBING ALL PLUMBING WASTE for water distributing qa A t- X4,8• CERTIFICATE OF 0 ~ SOLDER USED I OCCUPANCY OR s 3-I~'+9Y cvL ~ IT ER USED IN WATER & WATER LINES NEED system; piping shell be _ ty SUPPLY SYSTEM -Y SYSTEM CANNOT TESTING REFO6E COVERING of types K Or L only USE IS UNLMVFUL 9 EXCEED 2110 of 'D 2/10 of 1% 13~ x t T 1 n l G ' APR ED AS NOTED DATE: 9~ B.PS VATHOUT CERTIFICATE I o p p Y L qm FEE: BY. OCCUPANCY SUL NOTIFY DEPAR N AT OF I A n ' 7fi5-1802 SUIL 9 I 9 AM TO 4 PM FOR THE O -rI LL •F'GO Atc. r^L. ;4 FOLLOWING INSPECTIONS V' cc a~R M 2- 04 1, FOUNDATION - TWO REQUIRED -'k--~- FOR POURED CONCRETE 8'-O 2. ROUGH - FRAMING & PLUMBING INSULATION 1314 ull '/7, LV L'RIfiYB r4 ~p CV1 htTl b7 29: L" I 4. FINAL - CONSTRUCTION MUST .0) 4 rL^T.M.Rl."Mf RE COMPLETE FOR C.O. II0=I~O r N ~to 4 :s1 aV~~ ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF` THE N.V. - ~eQ-T•5 o 0 STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR Q,•3o - f(GPHAL.1k SµIUGLI~.5 ; - DESIGN OR CONSTRUCTION ERRORS R-19 (Y 1tIidI1:0L `1/2 pX _ j J~~YL w UNDERWRITERS CERTIFICATE DI REQUIRED G- _ - R 3e \ ~I lAATr-RING -T3iLM ^LKC.' 2'i e{" 2 1KCe' U' . ? lfEM7 o ro '-.OFFIT L 2"r~"-[Cap 2KG•I"oL - o Val ea l L .tee I -,-~I a d ,Ip/" M - W ,pAY~ tnnn"""111 ~ VINYL -60IN6 6gGa(QKI A-A / cuz~ - ^(I o- IB _VK I 2'KIO" fox - A 4- cmw, --',2 c IR ..A,£~ tkl GKl 2°KG•'-CGA 51 LL q,;rxi"s 41tlsce~ 3v>L#t - l 5 134.4 11716L14 I- 1 TS11G'o6 4 c 06L. - 15! 41 ' e"coNc- a-° z:q - - - s~"Coµc,~ B.flo - - T _ - - _ r ~ - - r 7 I 1 - pil ePPROVEO er: DRAWN BY, I'7LIIppl1<Ilj ATE: -e- REVISED F®- 41ABB U 70WIV OF SOUTHQLD 1I,,t.,.,y I0 RAWiN¢NuM9&R ' Quo-Fr. 7'o T/JILG sR- ALL S?I,MF~1~teaA!'S ~ C}~N-RI ' 1 M-Rt"['1 S7k1'S, To IO X 84 lIIINI~p ON NO. t0o0x OIfI111Fl11Nf •