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HomeMy WebLinkAbout21282-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22613 Date SEPTEMBER 23, 1993 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 425 PINE TREE ROAD CUTCHOGUE N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 104 Block -1 Lot 8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 16, 1993 ____pursuant to which Building Permit No. 21282-Z dated MARCH 24, 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 & ALTERATIONS TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN P. GRIMES (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-284127 - JULY 27, 1993 PLUMBERS CERTIFICATION DATED AUG. 9 1993 - MATTITUCK PLUMB. & HEAT. Bui ding Inspector Rev. 1/81 FORM NO. $ 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° 212622 Date 19.f Permission is hereby granted to: .c`.... r.r..~~ e B v o to .Ter..~'el..... ....~~~~.L& f at premises located of / . ord f'r... . ew . County Tax Map No. 1000 Section .......~~d Block Lot No....af pursuant to application doted A 19', and approved by the Building Inspector. 0 ~ Fee $....%c...../.G...!. . uildin to Rev. 6/30/80 ? Form No. 6 r, TOWN OF SOUTHOLD JUL 16 1593 BUILDING DEPARTMENT TOWN.HALL 765-1802 BLDG. DEr'~Y. TOWN OF SOUTWOLLY Yom. 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. 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 $15.00 1 Date ...a',~~ Z_ Lf.'f New Construction....... Old Or re-exi ing Building.... 1 Location of Property...~J.......7.------- /Kr4.4:.°`. Bul!m ................~Ge CAA Af~.~... House No. Street Hamlet ,JJ' Onwer or Owners of Property. S/~!d County Tax Map No 1000, Section..~./ .....Block..../............Lot... 63 Subdivision ...FFilleed Map........ Lot. Permit No~Cr~,47A 7 ....Date Of Permit.i/~!`/ Z..Applicant 4 4.... Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate...., Fee Submitted: $ ........1...... AP.L T ENERGY CODE CALCULATIONS (For Non-Electric Heat) Design Criteria 6,000 Degree'Days / L / O.A. /10°F I.A. 70°F FOR: 41'evrT 1, PER: o -e P,n4 r<~ 41~a DATED: S f1,< 3 e3 f J SUBSYSTEM AREA DESIGN THERMEL RATING REMARKS Exterior Walls (Opaque) 1023 D S M /07 E(; oo- ~'M Glazing 0, % /J a le, At Doors Ceiling/Roof (Opaque) 57 & o S p Skylights L•f $ 40 ,.3 S S ov 2 / Floor Foundation Walls Slab Insulation TOTAL 7 ~..,r., Notes: I Building Envelope Systems to meet requirements of 7815.2 MAR 1 199,1 ! HVAC Equipement to meet requirements of 7815.11 h HVAC Systems to meet requirements of 7815.12 Duct Systems to meet requirements of 7815.13 Ventilations Systems to meet requirements of 7815.14 Insulation of Piping Systems to meet requirements of 7815.15 Service Water Heating Systems & Equipment to meet requirements of 7815.21 Electrical & Lighting Systems & Equipment to meet requirements of 7815.31 To the best of my knowledge, O'Zlpy belief, & professional " oe judgement, these plans are in a V compliance with the code. ( pT Y'. 4: C322o4-1 ~V 9~F'ESS10~aP~' .3 i3 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 r1185077 BUREAU OF ELECTRICITY 83 JOHN STREET. NEW YORK, NEW YORK 10038 Date July 21,1993 Application No. on file fOf2$193i93 N 2fl9;12'7 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 JOHRl GRIRIF6, 425 PT.NF TROD ROAD, CUTCHOGUE, N,Y, inthefollowinglocation; ® Basement © Ist FL 91 2nd Fl. GAR Section Block Lot was examined on j I1 T' Y 2 1 , 19 9 3 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K. W. AMT. K.W. MIT. K.W AMT K. W. T. H P 9 14 1.3 2 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K. W. OIL H. P. GAS H P AMT NO. A. W G AMT. AMP. AMT. AMPS TRANS. qM}, H p SYSTEMS AMT I WATTS NO. OF FEET SERVICE DISCONNECT NO.OF S E R V I C E MIT AMP TYPE METER I .0 ]W L S 3W 3,e' iW 3q dW NO. OF CC COND A. W G. NO OF H-- A W G. NO. OF NEUTRALS A. W G EQUIP, PER9 OF CC. COND OF HI-LEG OF NEUTRAL OTHER APPARATUS: G . F ,'1" ` ~ 2„., BROKE' DFTBCy'TQR'r -1 i ft ROS[AK E1,8f;7'RTC LLC.03671•E P.O,pCtg 164 CUTCHOGDE, HY, 11935 GENERAL MANAGER 1l Per 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 MUST NOT BE ALTERED IN ANY MANNER. M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL REMARKS: DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ( ) R GH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ FRAMING [ ] FINAL REMARKS: DATE INSPECTOR 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [FRAMING [ ] FINAL REMARKS: C _ L DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FO NDATION 1ST [ } ROUGH PLBG. FOUNDATION 2ND [ } INSULATION L [ ] FRAMING [ ] FINAL REMARKS:C, DATE 19-4 INSPECTOR YL'_ M-1802 BUILDING DEPT. INSPECTION [ FOUNDATION 1ST [ ) ROUGH PLBG. [ ] FOUNDATION 2ND [ ) INSULATION [ ] FRAMING [ ) FINAL REMARKS: A DATE d INSPECTOR 1 TEL. 765-1802 TOWN Or SOUTHOLD + ° @ OMCE Or 13UILDII•IG 1NSrecroR P.O. BOX 728 d~ t?? TOWN HALL SOUTHOLD, N.Y. 11971 C E R T I F I C A T I O N • Date~g ~q ~ Building, erm't PI Z Owner (pi ase print) / l Plumber oe-.k 6 cai%~ (please print) r~ I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (p1umbe s nature) Sworn to before me this day of 41s 19~ Nota •f ublic Notary Public, County F. 04M aftAft"k Z of NM York T M Pob it t~yW INSPECTORS Victor O~pSVFFO(~-COG Principal Building Inspector Curtis Horton SCOTT L. HARRIS, Supervisor Senior Building Inspector o Thomas Fisher cc Z Southold Town Hall Building Inspector O P.O. Box 1179, 53095 Main Road y Southold, New York 11971 Gary Fish 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 August 18, 1993 John Grimes 425 Pinetree Road Cutchogue, N.Y. 11935 To Whom This May Concern: We are unable to complete your certificate of occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. The check is (outdated/not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. XX No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 21282-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ } ROUGH PLBG. } FOUNDATION 2ND [ } INSULATION [ } FRAMING FINAL REMARKS: DATE INSPECTOR lELJ i~D; 7E i~ LNI a OUI7DATION (1st) . °~N OUNDATION (2nd) - OUCH FRAME & .PLUMBING a c,e„ a y 1. I r :1ISULATION PER N. Y. I y STATE ENERGY ~•GL? CODE ' I ti- a m FINAL I s ADDITIONAL COMMENTS: : M k \ ' H Fi O y m ^v H a . a, fn I I ~ I CIIRbPJ .Ht.hC mV x,. . } I SZ6*,~; 70 F___ . • 236 C . ~ ar. ~ ~r a ~ k!(•F1y -3 q}3 it i _-p StJ Q ~ n ~ „i=_ g62€~q~ t~@&S tg~g ~ 6~.ir Eac. - -^F r Cs4 Ft I(-f . r BOARD OF HEALTH 3 SETS OF PLANS FORM NO.1 SURVEY MAR TOWN OFSOUTHOLD CHECK 1993 BUILDING DEPARTMENT SEPTIC FORM TOWN HALL I-_ , SOUTHOLD, N.Y. 11971 NOTIFY: TEL.: 765-1802 CAL Examined 19t _FIXTt T0: Approved ....3V ISV Permit No2'1521 Disapproved a/c ( uil(i InspectgrX APPLICATION FOR BUILDING PERI411T Date .A14.<4A? INSTRUCTIONS a. This application must be completely filled in b ti y typewriter or in ink and submitted to the Building Inspector, with 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 tWs 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, housin code, and regulations, and to admit authorized inspectors on premises and in building for necessary in ctio s. Wit ,nature of a^ licant, or name, if a corporation) (Mailing address of applicant) State wheth'e'r /applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . 1~1.~!~l!?. , •`D}, ~q , , , ,C~f~j:/ f~~ as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. .........(N..ame and ..titl..e.. ofc...o rpo...ra..te ...of ..er..) f~ic 2 Builder's License No. yy ..•.l.Z........ • t?R~ ccp_e.t! 10W/4P-6<a Plumber's License No. fA*1 XTvctt._ pp'VIPWC A ('(vIft 1Ut4 Electrician's License No . P051.-A'bt._ -gLf ~l?h-G Other Tradc's License No . L Location of land on wwW proposed work w'll be done, Ilouse Number Street Cl.~.. Inlet County Tax Map No. 1000 Section . f7/ Block ....f Lot subdivision . . . . . . . . . Filed Map No. Lot . 2 (None St2te existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing V .,c use and occupancy . Intended use and occupancy .~/LJ. !t!G. Qom,......, R,/razYinnrr.a~r,~.,,.~ ; .4~~uo") 3. Nature of work (check which applicab!le): New Building Addition . Alteration . • , Repair Removal , Demolition ..............Swimming pool . Tennis Court ...i. Acce sory Building..........Fence .......Other ',,Wo~k:........... pl~ . Fee 4. Estimated Cost j p (to be paid on filing this application) 5. If dwelling, number of dwelling units e ! Number of dwelling units on each floor If garage, number of cars / ' 6. If business, commercial or mixed occupancy, specify ratuFe and extent of cac type of use •p . 7. Dimension 9f existing structures, if any: Front . S Rear o Depth , . , • Height . /02.......... Number of Stories Dimensions of met structure with alterations or additions: Front J.b , Rear Depth , , Q Height Number of Stories ice........ / . 8. Dimensions of tire new construction: Front Rear . . Depth `d......... , y.. Height 7 (~lum)ber of Stories , . .r . 9. Size of lot: Front J, ~ Rear , Depth . . . 10, Date of Purchase Name, of Former Owner , r' 11. None or use district in which premises are situated . 12, Does proposed constructionyrjplate any zoning law, ordinance or regulation: , V6• • • • • • • 13. Will lot be regraded J" U yy• , . Will e,~~~beacmovc rom premises: Ye Y No . . . Address h ~ .~!~tke'.~ ~ ~ . .Phone No...~~F.~ 14. Name of Owner of re s ,~,7rI.t. J. ~wE........ xce4ss Name of Architect p~t7,4 ~ 0PXRI . , Address Plione No. Name of Contractor~R ~IdeP eeX.4... Address / 4! : a~!• • • Phone No. (~r Is.Is this propert+~locate within 100 feet of a tidal wetland? *YBS.. NO. *If yes, Southold Town T ustees Permit DIAGRAMmay be required. LOT Locate clearly and distinctly all bui dings, whether existing or proposed, and, indicate all set-back dimensions from property Bnes. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot, oil, t 4 - / - i 16 1 Sao ~zA s / /Mft rI~CC ~iD #4a fXWP 44rLr /NfG2l+2 ~sy STATE OF NEW YORK, la~rae -/a COUNT C SS being duly sworn, deposes and says that lie is the applicant (Name of individual signujig contract) above named. He isthe... C>.CU I:& (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 . 19 6..3 Notary Public, . County .vr?cL~ JOYCE M. WILKtNN$ffi k • • • . ~ . Notary Publlc, State of Nwryork (Signature of applicant) No. 4982248, Suffolk puu_r~yr Term Expires June 12,10,9 so I Val i PLUMING ALL PLUMBING WASTE & WATER LINES NEED CA"NC!7CAL GEILINCr \ i W TESTING BEFORE COVERING FJ~1R1 Rca~~ 't~,^Adq r" ONLY IN W, I,',. T-FI AVSS iWRITERS CERTIFICATE , aX15T,,~.. n UNDERWRITERS TIFIC REQUIRED + -4KYLtf1'S 56~iJb PROP95EEf) ADDITION ATNi' If copper tubing is used R+~p I , O 7t j sKYti~r - j _ sKVLi~r CPO iR ED AS NOTED for water distributin 16'd d 2 9 a.R#system; piping shall be Ir V O~q p ® AR ED AS NU' -d'r W. I.G I I i~ CPANCY FE TE3 9 gy BY: of typas K or L only W~' MG DEPA T A1' R14 QPrb~ USE IS UNLAWFUL 765-1802 B AM TO 4 PR y. FOLLOWING INSPECTIONS 9 AM TO 4 PM FOR THE Ir G INSPECTIONS:) UI n ) v 6 i; ~i ~ ~~E1{' ~.P 7. FDUNDPT!ON - TWO MON - TWO REQUIRED " FOR POU6ED CONCRET UHED CONCRETE IO ~4' . - - ~ 2. ROUGH - FRAMING & ~,IG~' OCCUPANCY 3. INSULATION - FRAMING & PLUMBING PION NEW FLOOR- TD 2XP~-I6"o•C,-y : " M N 4. FINAL - CONSTRUCI BE COMPLETE FOR C.O. CONSTRUCTION MUSTNI FI_T FAX 15 Y, FL.' 50 r PLETE FOR C.O.- ,~P.,--•--T • M of riv_s: m ALL CONSTRUCTION SHI TRUCTION SHALL MEET LXX`4'J ~,•Ij Q STHE REQUIREMENTS OF THE N.Y. 2k~• I'4' C-1 02 BOLTG IREMENTS OF u1 o,c TATE CONSTRUCTION a YSTRUCTION & ENERGY e I • GGA 2-NFAF_ F-ACII CODES. NOT RESPONSI ' to _ ' IOT RESPONSIBLE FOR cor-:r,Er. Bpp C,.W.{L+C. '3'-p"Mks I ' CONSTRUCTION ERRORS Q i PL€1MEER CERTIFICATION DESIGN OR CONSTRUCT101 d_ ON LEAD CONTENT BEFORE :1 CERTIFICATE OF OCCUPANCY FR>;07r(',Tii•k Ac7Al1y_;T-WS'ftMrt;'f; n m :I SOLDER USED IN WATER 3 "4 SUPPLY SYSTEM CANNOT , EXCEED 2110 of 1 % LEAD. ~ a I \ m 14'o" I ~ _°i is I I I c t~A1nL,~'. ~'I I I ' 41 ~ i I I r.I,D. .I ~ I • ' N t ~ ~ I I ~ - "12'8^ ' . I n`n >rtiF ~ ~~Pe,~N nh Z^2'{'~i 'I i • , oe w~l y • .I ExIS_; I j LCJ. I -I (D Q5 L._ , i . II ~e I' I E~X15T. F000. 11f ~.?1_ I FULL. 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