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HomeMy WebLinkAbout21333-z F FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22505 Date AUGUST 6, 1993 THIS CERTIFIES that the building ADDITION Location of Property 33000 MAIN ROAD ORIENT NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 19 Block 1 Lot 14.5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 6, 1993 pursuant to which Building Permit No. 21333-Z dated APRIL 12, 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 SHED DORMER ADDITION & FINISH SECOND FLOOR OF EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to CHARLES E, & LAURA H. BAKER (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-284658 - JULY 30 1993 PLUMBERS CERTIFICATION DATED JULY 15, 1993- PECONIC PLUMB & HEAT.INC Building Inspector Rev. 1/81 I` FORM NO. f 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) NW? 2133S Z Date IZA I9.~.~.. Permission is hereby gra ed to; - o~. -5 0- '1.. :s"....:... at premises located at . ~J / County Tax Map No. 1000 Section ....:../Y........ Block .........1......... Lot No....1.7>.J~.. pursuant to application doted ° 19e-~, and approved by the Building Inspector. Fee $Z.. lip 41& Rev. 6/30/80 - Form No. 6 TOWN OF SOUTHOLD § BUILDING DEPARTMENT TOWN HALL 519% 765-1802 BLDG DEPT. , TOWN 0 F~SOU9'C?0IKKCI 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. e ' B.j 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 - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date Y. New Construction............ Old Or Pre-existing 'Building l~fS. Location of Property... .1.Y.d.Q......!.I[6.~7..'4..f~:ogj.~ ~.;l N..J..... House No. Street l' Hamle~ti Onwer or Owners of Property...ahq:dfs...( .-L- Lfiu.t19 , O; Kl County Tax Map No 1000, Section,.... 0 .....Block..... J,[.......... Lot.... / Subdivision........... .7.F/iled Map............ Lot/...................... Permit No,? lI :53....Date Of Permit. ,.Applicant...) VL~ `t 3., ~ Health Dept. Approval ..........................///Underwriters Approval......................,.. Planning Board Approval Request for: Temporary Certificate........... Final Certicate.. X..... Fee Submitted: !,u,(,,,,,,,,,,,,,,,,,,,, APPLICANT' \C0 ~aso$ r INSPECTORS Victor Lessard UFn(6~ Principal Building Inspector ~v' C9 'C' Curtis Horton SCOTT L. HARRIS, Supervisor Senior Building Inspector Southold Town Hall Thomas Fishery p , n ~ n4 P.O. Box 1179, 53095 Main Road Building Inspector 4, g v Gary Fish Southold, New York 11971 Fax (516) 765-1823 Building Inspector Y~~f l 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 JULY 16, 1993 CHARLES E. BARER s WF P. 0. Box 350 ORIENT, NY 11957 To Whom This May Concern: We are unable to complete your Certificate of occupancy because of the following reasons: MCAn application for Certificate of occupancy is not on file. (Enclosed) %x% No Underwriters Certificate on file. Bmc The check is not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. XXX No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 21333-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. o A c E a o x A q w R d H •y N N m P] k i w C=] C n N A ~ j 77 ~ tr] .i m O b O Y ~ ~ A Z N ~ b x C+ T V V ~ ~ ~ Cad i ZZ ~ A N E .C D .C ~.1~ H W C9 t' m 0 $m} = N 7~ i w rn r CCTw > V N ~ ®H ~ ~ V" Q. Z ~ O A u y Z m ~ F. ty ,'E m W ~ •~E. W IC O 3 ~O m z r~i ~ .P p N o ~ f ~ ~ m L ~ 11 R u S C EQ K .?H ~ O rrO~ R m C O = N W m o iM Q_ ' r. a _ .p SS F O. ya k 0.a 'zc i..t ~ Ly . j O N ~ P# /V r r w p , > . ~ x p , a IA, r - • Z i O CJ nn 10 y E C H 2;0 -n t p0 rn T O Oho o n. 2 O H x o ~ 7 w j~ C e r .y,'"ftf m w O fr O m'^ g • 2.-' - ~ 41 r , I. n~ Z r 3 n t~'I " m ;3 b _ t t . 0! C x a$ a z s w;c a is C g 9.' ti k.a m. H ° 9'~E 1~ a ,:d~'p'p~kkig$d C„~6K trb t EE 4. n} PF~EarA~c~~ff@e!a~~~_sg ° y D A T. Ru ~ k , I~ t:~F TEL. 765-1802 TOWN OIL SOUT11OLD CCk7. o ~hz OFFICE OF BUILDIIIC IN '2p; SPECTOR P.O. BOX , 1179 Tb%VNHALL ~l ~b0 SOUTHOLD, N.Y. 1 ]971 C E R T I F r C A T I O N. Da to c L~r is 199 Building Permit ~t No. R f~_ I1 u Owner, l Les ~i xl L" ~P wrt ZT1~121~ Il . (phase print) ' Plumber ~171C77/llY (please print) I certify that the solder contain used in the water supply system s less than 2/10 of 10 lead. p tuber's signature $worrnn to before me this --JJ_day of 19_L7_, ~~LJd_ Wel Notary Public Notary Publi County NoSlatePo1N Y ~~49447 ~0mm~°°Fa,Pb~~~ ~19~`~j INSPECTORS Victor Lessard Principal Building Inspector 3 Q Curtis Horton SCOTT L. HARRIS, Supervisor Senior Building Inspector o'~ 1 o Thomas Fisher k e Pyul a ky Southold Town Hall s +t p P.O. Box 1179, 53095 Main Road Building Inspector t 6~« Southold, New York 11971 Gary Fish a, `~?1r yo3 Fax (516) 765-1823 Building Inspector 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 JULY 16, 1993 CHARLES B. BARER & WF P. 0. BOX 350 ORIENT, NY 11957 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: XXX An application for Certificate of Occupancy is not on file. (Enclosed) M No Underwriters Certificate on file. XXX The check is OugUOM&Mnot on file.)$25.00 No Health Department Approval on file. No final inspection has been made. XXX No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1989). BUILDING PERMIT # 21333-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. re. ik. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU TION [ ] FRAMING [ INAL REMARKS: _~~)lt 4L (-Z;-) r DATE 3 INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [v}--ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ~RAMING [ ] FINAL REMA KS: DATE 4/ INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ l _ FOUNDATION 2ND INSULATION FRAMING FINAL REMARKS: G DATE INSPECTOR S. ~~LJ n...l-- C: i.:;i i~U,;: c i~ ;:~_-tt•1~Nr~ a ,OUIIDATION (1st) i -OUNDATION (2nd) _ o CU ~OUGH FRAIME & -PLUMBING I O 5-11V /v? 0~el 3. I - m lSULATIOiI PER N. Y. m iZ 9 STATE ENERGY CODE ! _ m 1 -07 A 0A FINAL V ADDITIONAL COMMENTS: try ' x ' b b ly H • l m • r -3 H 3. Nature of work (check which applicable): New Building Addition Alteration . Repair Removal , Demolition . . . . . . . . . . . . . . Other Work.............. . (Description) 4. Estimated Cost 3$~ 6021 Fee , . (to be paid on filing this application) S. If dwelling, number of dwelling units 0 , Number of dwelling units on each floor ?t a _ . . . . . . . . garage, number of cars .m,.A.., 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . 'n, :g . Dimensions of existing structures, if any: Front r r Rear Depth ag'......... . Height Number of Stories . Dimensions of same structure with alterations or additions: Front Rear ....Y& Depth a Height AD Number of Stories (31,4 Dimensions of entire new construction: Front Ng' Rear 4g'......... Depth ..dg' Height as Number of Stories 13{y . . . • . , 9. Size of lot: Front . (SC) Rear .....dal. Depth -575" (8OJ~1J6 10. Date of Purchase ....7 8 y h( r~q~d p~(t .......................NameofFormerOwner 4..... 11. Zone or use district in which premises are situated ....j °r z 12. Docs proposed construction violate any zoning law, ordinance or regulation: O9 13. Will lot be regraded 09. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ..?L . 6fi_k~i Address ,POP ,35U l~Pr2RY phone No.3 ;a 593 Name of Architect Address Phone No.. . Name of Contractor . 4..o.G KekQ .Address Sa~.r.~uu~f?aLd-. Phone No. ~?3 ; 35x7, , , , • 15. Is this property within 300 feet of a tidal wetland? *Yes No. X...... *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. t •Aez ~culuec~l and ~EQ~. .t e jlA62h~ S•~ ~ ! 3 ~l o ~ i $ S 5~ ' ~ufzz f STATE OF NEW YORK COUNTY k_1 _ S.S • • • • • • • • • • • • • . • being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. 3e is the OCtI/ ell eQ /~/tel~u ®pe' (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 vork will be performed in the manner set forth in the application filed therewith. wom to befoye me this p ................day of fi 19 l.~ fotary Public, County COQ a~c.~ TNYa wF I C/Gtc2~t(,rv t3ctkx~ No rypublic, to of Now York (Signature of applicant) Suffolk County No. 467 721 commission Expires ptaL_be eA ~l~3~1~•~rr r~ f..,,.a !p!p lyl9 BOARD OF HEALTH FORM NO. 1 3 SETS OF PLANS APR - 6 19~2 TOWN OF SOUTHOLD SURVEY _ . BUILDING DEPARTMENT CHECK TOWN HALL SEPTIC FORM SOUTHOLD, N.Y. 11971 TEL.: 765.1808 NOT Y~i i7 CALL Examined 19% Y 1 i IA L TO: Approved , , 19 y/ Permit No.,?/t33 . , Disapproved a/c . 1 - - uil g Inspector) APPLICATION FOR BUILDING PERMIT Date 199A INSTRUCTIONS a. This application must be complitely 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. G 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'i 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 411 applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premise s and in building for necessary inspections. DD (Signature of applicant, or name, if a corporation) Po8..350 N Or6?...f , YY 1 959 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. IJGUI~ Plt Name of owner of premises .....~Q~Lled . odd LQ (eyCt f{.. ~ake/t (as on the tax roll or latest deed) If applicant is a corporation, signature'of duly authorized officer, .1,61..... (Name and title of corporate officer) 1 Builder's License No. 7 ff / ~~O(t Kam) Plumber's License No. . Electrician's License No. Other Trade's License No. . . i 1. Location of land on which proposed work will be done . Road Oree House Number Street Hamlet County Tax Map No. 1000 Section Block / Lot ! T) Subdivision . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . Lot (Dame) 2. State existing use and occupancy ~'f premises and intended use and occupancy of proposed construction: a. Existing use and occupancy m.~,?~8.. WGEh UIL.c%.t0~!¢G1. VpslCtUid b. Intended use and occupancy . )'?d ."upSlz2[/tU kX&A, LLu corn Sough 's t- SUFFOLK CO. HEALTH DEPT. APPROVAL N"AP ")P7 PQ0PEQT `lr' H. S. NO. ~U~VE:Y~L% F02 Tq t rr I ' ABOU 37pE} AT STATEMENT OF INTENT ~FQQI} THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL '"Y•f 5 J~•jT j~)L N,Y CONFORM TO THE STANDARDS OF THE o p 11 C) -'~7 SUFFOLK CO. DEPT. OF HEALTH SERVICES. D IuU CO ' (S) r 38 ! APPLICANT { 1 1n ` _ \ SUFFOLK COUNTY DEPT. OF HEALTH 6"e SERVICES -FOR APPROVAL OF CONSTRUCTION ONLY 1 (n DATE t a F L t_ : H.S.REF.NO.: ae-50-IZ6 tq rc APPROVED: \ s \ \ _ SCALD° I e SUFFOLK CO. TAX MAP DESIGNATION: - 55 DIST. SECT. BLOCK PCL. I~ 19 r Pt (4.1 JTU \ ` Q F3U -ic t OWNERS ADDRESS: 1 s. \ sit. ~S2Ir1wT NY . f9 -•1 tt µa } CL) ` ~ ' ~t' t. 323 °.5~3 v, t'" yr ^ DEED: L. 6169 P--742 TEST 14OLE ,y 3EF`7'fG J~ aw. , 5Y°sl eM s AtTV ,rwor's un ei mapro . aV \ 'I eet mro~ aona Lgr ar seal e et t be coP o LOAMY .x ,gelid true oooyy. ,re ' j1LT r srentees mdicat.C hereon sh^ tt, t to t~s Psrson to whom the un ,TY t ,eared. and on his yenel` to ho s u7r governor-jh''e- ~~t tutean h eon rd MgI~PEII 25, Igoe m ig,uee of the the lha td• h7 i .el vi rarsas sre not teen e, p ,S.val dtCjiutioM or w •C ~ h1l!f'AMI~f.K?ED-4CT.~{yi~g ttv rm.:m'a. allRs~iwes.. h COARSE S SEAL Ni63`07 30`W 421°0I 6.6 gC1ER IN BMW. i.l?. E? OF HOEY R G , ~1 G ! 1.' \FAI`i +t f EQ--MH 5EA LEVEL. VAGM(1'i Y/1 TUYL//~ wfk t61, 2~a 3~, 14L. 1 LICENSED LAND SURVEYORS 17, • ~ GRIM44PORT NEW YORK non-_ ~~~..~..~.~r--- •ryl I F Qu('6S~pa A I"~ R tj III pf R~ I i I i i i,. PLUMBING ALLLPLUMBINGwASM OCCUPANCY OR IEED k WATER LINES NEED TESTING BEFORE COVERING WRING USE IS UNLAWFUL ~NITHOUT CERTIFICATE 1 if copper tubing is used 1. used OF OCCupANCY for water distributing ributing _ System; piping shell be. shell bs, of types K or L on L on UNDERWRITERS CERTIFICATE - REQUIRED i a i D AS NOFED OAS; B. P. i - PLUMBERCERTi 1~1 G DEPA TAT 'fBERCERTIFICATION Nan FY a By fa ON LEAD CONTE) 1D CONTENT BEFORE - 785-iBD2 B AM TO 4 PM OR THE ! 1, CERTIFICATE F C FOLLOWING INSPECTIONS: CATE FOCCUPANCY i. FOUNDATION - TWO REQUIRED SOLDER USED) IER USED IN WATER FOR POURED CONCRETE 2. ROUGH - FRAMING h PLUMBING I SUPPLY SYSTEM t. EXCEED 2110 of !Y SYSTEM CANNOT 3. INSULATION ~ OF -D 2110 Of 1% LEAD. 4. FINAL . CONSTRUCTION MUST OF NELy BE COMPLETE FOR C.O. P O ALL CONSTRUCTION SHALL MEET e ,It' rrr 9~ THE REQUIREMENTS OF THE N.Y. ' vTb STATE CONSTRUCTION S ENERGY CODES. NOT flESPONSIBLE FOR 5 DESIGN OR CONSTRUCTION ERRORS c esz a. ti - t ~ 1 ~i r P/-o Pu 5.E IJ /VEW /Jo//ME'R 'Fe k' . I LACE a 00 VIE 7iof ? S//Je EG~N+fY~v.++S ~ ~"°~.T. 4 7 7 q-t r r f - r 4r ~ A b •i, ~ ~A a q S. ~l V- a s ,~,ye~! 1 _ : rs+~ndF . , wfo.w~WS uw-*~.~., L~ndw~ ~rv.'..,n.*^•'r^w'.~wuin«,=, 77 )215o s E t 1 ~ry I i _ 1 .il9 SW E~C 5,pptlr N A0.41~ .YjP 1'C 3,0 ~i F~ AstcruN i r a 44 tl~,'! G qa Zq° kL r ' I ~ ~ SIt0.P~ I 1 i. P a«~ u s AI rl 1 rnns7~~ ~ h ~ 1 ge ©kaom ~ ~`k ~ : { d F lwC ~ r(F i I rj~Y ; Ij ~s'sa JJ~II~~ s j 71111 1 e f 1 errsn- ~ ~ . S ' {II ~ i 4 CE 'C! 24- -I S a r. 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