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HomeMy WebLinkAbout21672-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23183 Date AUGUST 25, 1994 THIS CERTIFIES that the building ADDITION Location of Property 1055 NORTHVIEW DRIVE ORIENT, NY House No. Street Hamlet County Tax Map No. 1000 Section 13 Block 3 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 10, 1993 pursuant to which Building Permit No. 21672-Z dated SEPTEMBER 22, 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 STANLEY & EVA RUBIN (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO, x323285 AUGUST 10, 1994 PLUMBERS CERTIFICATION DATED N/A Building Inspect Rev. 1/81 FORM 140.3 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 Date 2...'Zl 19..30. 21672 Z Permission Is hereby ggr me to: s~~'~....... 71 9> " to.z Lc"~....a-'Fv...... / .•e~d j......., . at premises located at...~b.4S.{~ . ....44 /Ch..r.....~!!!.!,,..." . County Tax Map No. 1000 Section Block r Lot No./ pursuant to application dated 1993......, and approved by the Building Inspector. 0-d Fee ..1.... Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD ~SK wry. BUILDING DEPARTMENT PI I~ 1214 TOWN HALL 765-1802 PLICATION 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 19 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. r 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, Commercila1l~ $15.00 Date AJ40..aZe2,)..I~~7'.T New Construction Old Or Pre-existing Building. UY ...........~.~p9. v Location of Property..,/~3 ...:/~a 11Jrev-kk-lka...... ov.IGw7: J~f.l House No. Street Hamlet Onwer or Owners of Property.... el q 1/11,.. ? L44~J? J County Tax Map No 1000, Section /J Block ..3.......... Lot.../ Subdivision .Filed Map.............-LLlot...................... Permit No...Date Of Permit. ..Z-~ZX95.... Applicant. .S t wlC~C...To% b.v.~.. Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate..V.__'~..... Fee Submitted: ~v~?v RQCq83q I G~. APPT.7 CANT 31 B3 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 r1000378 BUREAU OF ELECTRICITY 88 JOHN STREET. NEW YORK, NEW YORK 10038 Date AUGUST 10,1994 Application No. on file 06242494/94 N 323285 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 STANLEY RUBIN, 1055 NORTHVIEW DRIVE, ORIENT, N.Y. in thefollowinq location; ® Basement ® 1st Ft. ? 2nd Fl. Section Block Lot was examined or, AUGUST 08 , 1994 and found to he in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT K W. AMT. K. W. AMT. K.W. AMT. K. W. AMT. H P. 4 14 3 4 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIMECLOCKS BELL UNITHEATERS MULTI-OUTLET DIMMERS AMT. K. W. OIL H. P. GAS H. P. AMT. NO A. W. G. AMT. AMP PMT. AMPS TRANS. AMT. H. P NO. SYSTEMS AMT. WATTS OF FEET SERVICE DISCONNECT NO OF S E R V I C E METER NO, OF CC COND A. W. G. A W G. A. W,G. M1i. AMP. TYPE EQUIP 10 3W 1 a 3W 3.9 3W 3,e dW PER a OF CC. COND. NO. OF HI LEG OF HI LEG NO OF NEUTgAlS OP NEVTRAI 07HER APPARATUS: HOTORS:1-F H.P. moo'( STEVE'S ELECIS.ALHERTSON LIC.#3494-E P.O. BOX 1268 SOUTHOLD, NY, 11971 GENERAL MANAGER 11 Per s This certificate most 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. pS~FFO(~~OGy o ~ Town Hall, 53095 Main Road °y x Fax (516) 765-1823 P. O. Box 1179 W~ • Telephone (516) 765-1802 Southold, New York 11971 ~j~ol ~a0! OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD July 7, 1994 Mr. & Mrs. Stanley Rubin PO Box 254 1055 Northview Dr. Orient, NY 11957 To Whom This May Concern: We are unable to complete your Certificate of occupancy because of the following reasons: xx An application for Certificate of Occupancy is not on file. (Enclosed) xx No Underwriters Certificate on file. xx The check is not on file. 25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 21672-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. MELD 1„S: ECT1U,1 JJDATE commENT° W 3?. 7OU11DATION (1st) ti FOUNDATION (2nd) 2. i~~a^ 2 n z ~ Q ROUGH FRAME &1 PLUMBING 3. m INSULATION PER N. Y. '9 STATE ENERGY CODE x a 4. FINAL o z ~ - ADDITIONAL COMMENTS: \l J H WyJ i d m H M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ] ROUGH PLBG. [ ] FOUNDATION 2ND INSULATION [ ] FRAMING ~L REMARKS: C r l ~ DATE INSPECTO M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ) ROUGH PLBG. [ ] FO NDATION 2ND [ ] INSULATION [ FRAMING FINAL REMARKS: ry~ DATE ! INSPECTORv 765-lWZ BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL REMARKS: /41 f DATE lC INSPECTOR -A 1~72 765-1802 BUILDING DEPT. INSPECTION [FOUNDATION 1ST [ I ROUGH PLBG. [FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL L~ REMAR 5: AA~ G~ DATE ` d, I ~R ! BOARD OF HEALTH . . • . 3 SETS O. FORM N0.1 SURVEY . . . q 5D 1&~ TOWN OF SOUTHOLD CHECK . ! Q..' , Hl> BUILDING DEPARTMENT SEPTIC FORM TOWN HALL BE - tJO ,SOEJTt D J T . LJFlOE..Y~ $OUTHOLD,N.Y.11071 TOWN NOTIFY: TEL.: 765.1802 CALL ~'s'.•/, f'~ Examined 9 19. MAIL TO: Approved .5_:z 19 Pcnnit No..4~~~~7sZ Disapproved a/c (Bu' ing Lector) APPLICATION FOR BUILDING PERMIT Date .,csq/a .._/O_ j9 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 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 inspections. it c applicc if a corporation) 7e ./~ccah 'G y.I.V (Mailing address of applicant) State whether applicant is owner, leI ssee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~j N.Ilglcv Name of owner of premises •~j~j~.2~!`..... ~.114#..Q~...~a6t".''~ (as on the tax roll or latest deed) If applicant is a corporation, signatureiof duly authorized officer. • . (Name and title of corporate officer) Builder's License No. A/ f• Plumber's License No. ........'i Electrician's License No. , Other Trade's License No. l • Location of land on which propose Id work will be done' ~r.~'~d II l pS.s /.Yov^A.. V..~c~.. . .....G, v,,(c,4T . . . House Numbcr Street. Hamlet County Tax Map No. 1000 Section! ....OZZ Block 3 Lot ...I , Subdivision Filed Map No. Lot . . (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: A. Existing use and occupancy.... L$.:Yt~f~.../. Gy ivj /(y '.,(c , , , , , , , , , , , , , , , , , , , , , B. Intended use and occupancy c.'.)'Xur./~+•../. R!:~~.................... 3. Nature of work (check which applicable): New Building Addition . Z • • • • Alteration Repair Removal Demolition ..............Swimming pool.. Tennis Court Accessory Building Fence .......Other Work............ 4. Estimated Cost 1$.00.U f.O) Fee • . (to be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each 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 ....4t Rear Depth . _ZS , , , , • , , • • . Hcigltt .....~.6....... Number of Stories v Dimensions of same structure with alterations or ad~itions: Front ~9.. Rear ,3.......... Depth .....~..,~i height ....2.C.. . . . . . . . . . . Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories . 9. Size of lot: Front Rear Depth . . 10. Date of Purchase Name of FormerOwner . 11. Zone or use district in which premises are situated ...:Va rde~ 11. 12. Does proposed construction violate any zoning law, ordinance or regulation: 11/6• • • • • • • • . • • • • • • • • • • • 13. Will lot be regraded A6 Will excess fill be removed,from premises: Yes .'1f, No . . 14. Name of Owner of premises .12611rfny . I Address /Vcn ~.Lar,~. Iv.C Phone No..~~ 17J3 . . Name of Architect . Address 'O. ..7.J. • e©ka Phone No..' • • • • • • • • • Name of Contractor . C~~zM~cs.. 1~lnr~rf Pl/1 • • Address vc Phone No..~5 w 7J y7 F . 15.Is this property located 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. STATE OF NEW Y RK S.S COUNTY OF ......v.. ~,/}~ar~d~ .An»y~on . being duly sworn, deposes and says that he is the applicant (Name of individdal signing contract) above named. He is titc J FC (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 perfornacd in the in er set forth in the application filed therewith. Swom to before me this ay of . 19 . 0 Notary Public, County RooERTI.S No. ARY 0 BLI a{e of tLy . . 47 L (Si,nature of applicant) Term -w+r ~ ' E P 2L .-...,....~-..y..e+~w.,..,...,,.'.....L J..~`-a+raY ~,~u rM'^`+te^~'+^^~^~ s ` ~ > < ~ YXfr'r -x~~ , + ~ F.'7' - .Af {m3g1~R~w x s/i ^ { .1 sk Qt=a a^l st d > , e 1 u1 to 3 1 i ( ?.2Q s+<L vw e ty FNI~ 51 S d"¢`KCy' + s.pa r, ro I x?'4~y, 'k : z GAIN, w r`syG' h~$e , 4 MAO rl ?-t ~a, ' ~ ~ > { ty ) s $ Y . a y ~ eY Y3s ~ 4 ~ 10. In. s.- l a 1 t1 rl A r` z.i Lw9 J - - K ro 4 pp a l y'y c v , E - wry i - l3z y~ws a~ y ry limit +3`s rt:.. { b {,g1$ ac ~&'Z 4 - 2 v 5 s t @S ~~'F } - . a _ • ti s„ k'n ~;~•rha. - ~ ~ ~ xx~~~%s~++. mfr ~ ? y TM, 5; y > ~ 3 4 J lag. Ell his f 4t ~ Q ?/f f f • ~ t , C. 1:.. 4 ii CG $ wo.SL V ~ G s Aty r w~. 7s~ / CO- cl v / S.. 1 5~ ~2 ~,o o ION ( / r N Q ` ~ , `kI r 2S Y M+ J ~ 17 G{ wf~,.e~~~ ! a -0 5 y { . f C . 3 f ~F IT, 13 ( }~{6j; l it - `L7+.~~ ~ 4r t xy 'Mfifil AA~e Ft t ~ °yt 'r iS, . ~ . u a _lw.+~`~"i€ .•..~.r~i.?'sa"•".,t~x`x++"3^~~:',p-a Y2'~'t*.n+ N`p, c~ v~Y`Y~'~ ~~4 xsWS.d.€`vx? -L .zs~+...i?a z.~s.tFa Y~ bra, ~ ..ASS M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ( ] ROUGH PLBG. FOUNDATION 2ND ( ] INSULATION [ ] FRAMING gEMARKS i 1 t DATE INSPECTO l y L yy~~~M.~µ REQUIRED T A" y5 ~a T_-_-- ,~aY,% , ~ v~ a~ '•IUt 1yI't YNE~ BIB r 6~~ Ir~G" ~~p' ti L Per - - - - a¢d(_, fl. 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SCALE - rjAncoN B' rjRnwN BY ta p/OM{°S0N ~I- a 7-1 l { I i .3,54, IC141. c Dg - /4,dy e .-vzi,4 W ' ~ '1.7~8iR4rrGN oh ~d~~cTC UA, 10 - - - - - ~ Con Leh l4s~5-so],T1T ?CM-l. - - _ - - - yl's,d vac A.~,Xc~ - q -u iC6PIa-l~C _3 ~ - - \ - ~0 2842 11y11 0h - - x/2 9olnsy 1.4, i L, b c sxf plclt - - - ) - - - - - - - - - .5 plywau - - - -C" T x oW Sold r ~ ~y _ 1°1k c.o -R:%,y.:0', 16uCTG /'ockc~ boou w -o - 7,;,~4c' s4,d4 iccn sal- - ----0- - - --(?S Acon r,efs._~i/ aJe - - I- - - - - - . _'"'~-1-r. ? - - - 5) ii Gor CYC{e'-Y-~U - Y a 7 i DRV'' N ~ f'igDlTloal_ fv Jiu616l, - C44 (A) sr-AnL >_,Y 1 ti ".1 Ab l~Tr' I'T N rPwin OM IbS,O1~ a 9 J , I I yy , - -r _ 7 I I { j