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HomeMy WebLinkAbout21288-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARI~ENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22318 Date MAY 12~ 1993 THIS CERTIFIES that the building. Location of Property 695 YOUNGS ROAD House No. County Tax Map No. 1000 Section 18 Subdivision ADDITION ORIENT~ N.Y. Street Hamlet Block 1 Lot 5 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 19, 1993 pursuant to which Building Permit No. 21288-Z dated MARCH 25, 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 CHIMNEY ADDITION & HEATING SYSTEM INSTALLED IN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to of the aforesaid building. TOBA LAJA ORRO (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-268527 - MARCH 5~ 1993 PLUMBERS CERTIFICATION DATED N/A i Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEPu~AIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N-eNo. 21288Z Permission is hereby g,r~nted ..................... ~..~/~..~./~......~.~.~. ......... ~..=.....~~~ .............. at premises I~ated at ..~ ......................... ~ ................................................................... ................................................ .................................................................................. County Tax Map No. 1000 Section ....... .?., .~... ........ Block .......... ./.. ........ Lot No ......~....."~... ....... pursuant to application dated ....... .~/./~../..~.. ................................... , 19../...'~.., / Building Inspector. Fee $..~ approved by the Rev. 6/30/80 Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN I~LL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by ~ypewriter 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). 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 Approvai of completed site plan requirements. For existiog huildings (prior to April 9, 1957) nou-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 applicatiou and a conseat 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, Con~nercial $15.00 Date ....... ~ ............................... New Construction ........... Old Or Pre-existing Building ................. Location of Prone~tv ~f fO~]~ ~)~p tlouse No. Street Hamlet ~nwer or Owners of Property '. ....................................................... ~ ~ax Map N 1000 S cti /.~. / ~ounty o , e on ........... · Block ................ Lot. ;ubdivision .................................... Filed Map ............ Lot ...................... 'ermit oN ............... Z tZ ~ · Date Of Permit. .?./..~./?.~. Applicanto .~..C.O0.~/~' lealth Dept. Approval ......................... · Underwriters Approval...~.. ..... ~lanning Board Approval ........................ lequest for: Temporary Certificate ....... · .. · Final Cert[cate: .......... . 'ee Submitted: $ ........... f .... . .............. ~O ~ 1~ ^PPLICANT OUNOA~ION OUNDATION (1st) (2nd~ 0UGH FRAME & .PLUMBING :NSULATION PER N. STATE ENERGY CODE FI:IAL ADDITIONA'L COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS [~)0012[ BUREAU OF ELECTRICITY V 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date H/'iRC {] ~lJ~ , 'J ~) 9 ~ Application No. onfile 04i~5593/~3 }~ ~' THIS CERTIFIES THAT o~]y the electrical equipment ~ ~scribed be~w and introduced by t~ ~ppJicant ~med o~ the a~ve appBcat~on number in the prem~es of Fl. [] 2nd Fl. Section Block and found to be in contpllance with the requirements qf this Board. Lot FIXTURE FIXTURES RANGES OUTLETS SWITCHES FtUORESCENT OTHER OVENS DISH WASHERS EXHAUST FANS DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI.OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT $ E R V I C )THER APPARATUS: NO. O E COND. OF CC, COND NO OF NEUTRALS OF NEUTRAL P~IlI', R. BURl, IS 275 'l'O~l',l lt~RBOR LM'll~ SOU'I'HOf, D, NY~ 11971 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by the C I DN DE R E .THS OPY F ERTIFICATE MUST NOT BE ALTERED /~ 765-~,802 ~ INSPEI~IION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [;/j/~INAL REMARKS: !'-1lAP OF pPOPERTY SUI2'VEYEP ANNE F !,.xE.ATI NO AT ORIENT 'ro,~N oF ~OUTNOLP - LJC, L./'JqP .-..;',cV EY-, I?. -, __ ~ ~ c H I ,~'--£ C 'T'"'~L~L~ 610 ¥o15. Memorlll Hilihw~ Hauppaull, New York 11768 (51~) 5 4 3 * 1 3 0 0 OF J A a C U I T t C T IH I 14J 610 Vols. Memorial Highway Hauppauge, New York 117,88 (,5Il) 54 3 · 1 3 0 0 61p Vets. Memorial Highway . Hauppauge, New York 11788 (~11) 5 4 3 1 3 0 0 OF~ .~/× SUMMARY OF TOTAL THERMAL RATING. If the Total Thermal RaCing is zero (0) or greater, the proposed design for the building envelope complies with the Energy Code. THERMAL TABLE AREA , U-VALUE RATING USED A, ROOF/CEILING ~.. ,o67_ _ B. NET WALLS I I~... .07~ ~ 7~ ~-~ C. o~,, ~ ,7 Skylights H/~ N/&... D~. BASEMENT/CELLAR WALLS Wall Perimeter Feet Exposure Above Grade Feet W~ll U-Value Depth of Wall U-Value Below G,ade ... lnches D3. SLAB INSULATION Slab Perimeter Feet Insulation R-Value .... N/A _ H/A E, INFILTRATION CONIROL Conditioned Floor Are~ Sq. FE. F. SOUTH FA~ING GLAZING South Glass/Total Glass Percent Gl. Area/Gross Wall Area Percen: Conditioned Floor Area Sq. Ft. TOTAL THERMAL RATING .Phi. lip C. iPaTndOill ~ SHEF. T #! 'l ii 0 H E C T ',~ 610 Vets, Memorial Hi!lhwiy Hauppaug;, New y~rk 11.788 ~ '(ill) ,8 4 3 ' 1 3 0 0 A # C '1t I T E C 610 Vets. Memorial Hiihwlly Hauppauje, New York llTII (Ill) § i ~ · I ] 0 0 SHEET N~, OF '~t¥. N.Y.S. ENERGY CONSERVATION CONSTRUCTION CODE REQUIREMENT~ E 1- All work shall conform to N.Y.S. Energy Conservation Construction Code effective March 1, 1991 and shall meet but not be limited to the following minimum requirements. E 2- Design values: 6000 degree days 10 degrees F to 72 degrees F design dry bulb temperature 87 degrees F to 78 degrees F design dry bulb temperature E 3- Windows and Door manufacturers shall certify that their products meet mihimum U values indicated and air infiltration rates as per code. E 4- Fireplace shall be equipped with the following: a. Damper with air leakage of 20 cfm max. b. Dampered combustion air vents ducted from the outdoors with total capacity of sufficient quantity to support combustion located in hearth or at sides of firebox Damper shall be capable of being fully closed. c. Non-combustible glass fireplace doors. E 5- Hot water heater shall comply with requirements of Section 7813.31 thru 7813.34 of the code. E 6- HVAC equipment shall meet the following requirements: a. Minimum combustion efficiency shall conform to Section 7813.21 of the code. b. HVAC equipment performance shall be certified by the manufacturer for conformance with Section 7813.21 of N.Y.S Energy Conservation Construction Code. c. Each thermostat shall have a minimum range of temperature settings from 45 degrees F to 85 degrees F and shall be capable of 6perating the system heating and cooling in sequence. All thermostats shall be capable of providing a deadband of 5 degrees F between full heating and cooling. d. All heating piping'shall be insulated in conformance with Section 7813.18 of the code. E 7- All electrical equipment and lighting shall conform to Section 7813.52 thru 7813.54 of the code. E 8- These drawings andispecifications have been prepared by or under the direction of the u~dersigned and to the best of the undersigned's knowledge, information and belief meet the requirements of the N.Y.S. Energy Conservation Construction Code. Phil!PA r C ,C'" Pa"d°lfll ' t [ c t $1o Vets. Memorial Highway Hauppauge,, Naw York ,(t 16) 6 4 3 · 1 3.0 0 $1t£ET OF ,'~IX 55 Northern Boulevard Great Neck, NY 11021 Telephone (516) 482-5237 FAX (516) 482-5291 RICHARD M. ADLER PRESIDENT RONALD D. GOODMAN EXECUTIVE V~CE PRESIDEN~T BARBARA S. KA~.ISH SECRETARY Members: American Institute of Architects REGISTERED IN: NEW JERSEY CONNECTICUT MASSACHUSETTS PENNSYLVANIA VIRGINIA LOUISIANA TEXAS FLORIDA CERTIFIED: .NATIONAL COUNCIL OF ARCHITECTURAL REGISTRATION BOARDS FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TE£.: 765-1802 Disapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... SEPTIC FORH .............. CALL ................... HAIL TO: 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 br areas, and gi~ing 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 fbr 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 ~he Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of. ~e.. Town of Scuthold, Suffolk County,' New York, and other applicable Laws, Ordinances or Regulations, for the constl~lch~n 6f buildings, additions or alterations, or for removal or demolition, as herein described. ~F{I'e--a-ppli~.an~ a~e~a ~:,~ly wi~h all appl/oablc lawa, uxdhtancuS~, b-uildillg coa--~7~gi~'~ode;~afid rdguiations; and to admit authorized insp.~ctors ~n pr!raises and in building for necessary in.sp .~n~q/.~ (SiTn: u~re of aplSlicl}nt, or nanle, if a corporation) (Mailing address of applicant) State whether applicant is p. wrm~-, [~;.~, aj~rr, arj;hi{~t, e~-kr~r, g?.ge, ma-l-~ontractor, ele_oh'q~an, pl~u. ml,'~ or baiter. :,. ..4 ......................... ', 7'0 ITA o Name of owner of premises . . . . (as on the tax roll or latest deed) If applicaht is a corporatlbn~ ,signature of duly authorized officer. (Name and title of.corporate officer) Builder's License No .......................... Electriqian's License No. g. Orner lraae s License jwo .................. 1. Location ofland on which proposed work will be~done. ~f41.~ ~6~J ~A~ ~ ~lM ~. House Number Street Hamlet Subdivision .................. . ................... Filed Map No., .... : :..... =... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exhtin~ use and occupancy ................................................................... 3. Nature of work (check whxch applicable): New Building .......... Addition .......... Alteration Repai?..... :.....~.~... ~. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost ....... /. .... . .................. Fee ........... .~.. 7C ............... · ¢ / (to be paid on filing this application) 5. If dwelling, number of dwelling nits ................ Number of dwelling units on each floor..../~'/.~. ........ · If garage, number of cars ..... "' '; ...................... ' ....; .................. .t ................ .. 6. If business, commercial or mixe4 occupancy, specify nature find extent of each type of use . .~/~.. 7. Dimensions of existing structure~ if an,,' Front ~ ~ --dc ~oo, ~/Jr t_ ~r- n,.a. ~/15'-4; ct .... Height .... ~.. ~.~;.t.. Number of Stories ...... l!g .... ' ........ Depth ' Height .... ..... Numberof Stories 8. Dimensions of entire new construction: Front .... N./../~. ...... Rear ............... Depth ............... Height ............... Number of Stories ' 10. Date of Purchase ........ ,..[q~.?. ......... Name of Former Owner ...~?./.~..t'f;..~. ..... 'i'" .'" 1 I. Zone or use district in which premises are situated ..... /'~/~.d ....................... 12. Does proposed construction viol te any zoning law, ordinance or regulation: .../~..O. ......................... 13. ,W, il)lot ?e..regraded ....'' '/~-/~--' '-:' '~'' ':'-'~5.~' '~-:': ..Will excess fill be removed from .2remises: Yes No Nmne of Architect . ~ ./~.b./~.~0 ~ ~.l hI~. ......... Address ~/~. i/.~.rJ. ~..~.,9../(/~./~.~1 Phone No . ~'~ 7. 17 O. 0 .... Nm-ne of COntractor ........ ~ ................... ~ ......... ' .......... Phone No ................ 15. Is th±s property w±th±n 300 feet of a t±dal wetland? ayes ........ No ......... ~If yes, 8outhold T~wn Trustees Perratt may be requ±red. .. I 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 n'umber or description according to deed, and show street names and indicate wh~ther interior or corner lot. ~E' 5 0 gu ~"7' STATE OF NEW YORK, .. C'OUNTY OF ...... Alg II D AS NOT£D ., 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FouNDA?ION ~ TWO REQUIRED FOR POI. J~ED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSUI~TION , 4. FINAL CONSTRUCTION MUST BE cOMPLETE FOR C,O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS ........................................... being duly sworn, deposes and says that he is the applicant ~Name of indiv!dual signin~ contract) above named. He is the .: .............. (Contractor, agent, corporate officer, etc.) *f said owner or owners, and is duly ~uthorized to perform or have performed the said work and to make and file this ~pplication; that all statements containbd in this application are true to the best of his knowledge and belief; and that the a, ork will be performed in the manner s~t forth in the application filed therewith. gworn to before me this .............. .~ ...... aay o~~. ............... ,19.. BA~BI~ 8,R, ~LISH NOTARYFUBLIO, lak of New Y~ I No. 4~o3t I (Signature of applicant)