Loading...
HomeMy WebLinkAbout21171-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22555 Date AUGUST 27, 1993 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 4235 BAYVIEW ROAD SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 78 Block 2 Lot 17 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 23, 1992 pursuant to which Building Permit No. 21171-Z dated JANUARY 4, 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 & ALTERATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to PETER & LUZVIMINDA DOOLEY (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-279332 - JUNE 10, 1993 PLUMBERS CERTIFICATION DATED AUGUST 25, 1993 - THOMAS BALL Building 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) NN! 21171 Z Date 192-p Permission is hereby granted to: o...... ~ . /.1~1... to . 4....... , at premises located at Al ....mil- 2 County Tax Map No. 1000 Section .......7Z Block 2-:........ Lot No. pursuant to application dated 19..9=? and approved by the Building Inspector. f Fee S..•. wilding Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 17 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. 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 ~ ~...~.1.: New Construction.. L Old Or Pre-existing Building/.. Location of Property..7.~3 . cx.........~4*)IVbh`~°b°C. House No. ~n Street Hamlet Onwer or Owners of Property.N,tl~ County Tax Map No 1000, Section.... .......Block ...............Lot.... 1.7,..... Subdivision ............................../......Filed Map............{ Lot............ 3......... Permit No..,-20j,7f.4.... Date 0 {Permit.Ap,licant.~ P,&a. Health Dept. Approval ......~llj/.. J9 ..............Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate.. Fee Submitted: $,,,,p~ 5.~.- ~J APPLICANT NPI, INSPECTORS ~u FII~ ea Aq'I ,T"'' SCOTT L. HARRIS, Supervisor Thomas Fisher Southold Town Hall P.O. Box 1179, 53095 Main Road Building Inspector egg ¢ U old, New Gary Fish 9/ `r-lt N South Fax (516) 765-18231971 Building Inspector Telephone (516) 765-1800 Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE : Building Permit No. d' 17 z Owner: joa-te - (please print) Plumber: % A/0 /naT 60-// (please print) I certify that the solder used in the water supply system contains less than 2/10 of 11 lead. _-7106 /4d (Plumber Signature) Sworn to before me this )-J- fti day of Usr , 19 7n Notary Public, Sd ~Fd1/[ County Notary Public l0~,"f:Afdf3~ ,"1. L~i<`2.•";L'I(1 %bry Puble, : foie of N%pw york No. 49,31031 u, Qualified in Suffolk Criunly 40 6®mmission Expires Jan, 8 ,19y V INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton V 4S SCOTT L. HARRIS, Supervisor Senior Building Inspector rya t ra Southold Town Hall Thomas Fisher v ) ";4:` ,v P.O. Box 1179, 53095 Main Road Building Inspector a R. V Southold, New York 11971 Gary Fish ~Ol~J Fax 516 Building Inspector 5 Vincent R. Wieczorek Telephone (516) 765? 800 Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD JULY 16, 1,993 EDWARD E. WILLIAMS 150 SEAWOOD DRIVE SOUTHOLD, NY 11971 RE: PETER DOOLEY 6 WF To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: %xR An application for Certificate of Occupancy is not on file. (Enclosed) XXX No Underwriters Certificate on file. XXX The check is not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. B%% No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 21171-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. CC: PETER DOOLEY s WF c1E! 1 E i"N i~JATE iiLUT Jr, ~.it/p -OUNDATION (1st1 n~ =OUNDATIO;J - (2nd) _ 4 0 ')OUCH FRAME & .PLUMBING \ • I m 1 M n '11SULATION PER N. Y. STATE ENERGY CODs FINAL ADDITIONAL COMMENTS: m~ ' H p `1 m ^o H . M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION FRAMING [ INAL REMARKS: f r DATE INSPECTOR ~II~ l M-1802 BUILDING DEPT. INSPECTION [ VJ FOUNDATION 1ST ( ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: C4 DATE I INSPECTOR / M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: G r h7a; INSPECTOR yvtj DATE all THE NEW YORK BOARD OF FIRE UNDERWRITERS tinc 10@)~~ BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date ,PONE JZ, 199 Application No. onfile 80256193193 P3 7.')9:132 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant "motion the above application number in the premises of 28TER DOOLFlir, 4235 B8YV1'H)W ROAD, SOUTHHOLD, N.Y. in thefollouinR location; E3 Basement J /at Fl. ? 2nd Ft. OUT 3ertion Block Lot was examined on J N N Fi 03,1993 and found to be in compliance with the National Electrical Code. FIXTURE EPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K W. AMT K W. MIT. K.W Ami K W. AMT. N P. G f3 .1 1 3 a 1 1+ DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALRECPT TIMECIOCKS FELL UNITHEATERS MULTI-OUTLET DIMMERS I "P AML AMPS. TRANS. "T H. P SYSTEMS pMT WATTS AMT. K. W. OIL H. P. GAS H. P qMT. NO A. W. G M NO. OF FEET I SERVICE DISCONNECT NO. OF S E R V I C E AMT. AMP. TYPE METER I -R. 2W 1 EW 3 M 3W 3 Jt lW NO. OF CC COND. A. W G. NO. Of HI-lEG A. W G. NO OF NEUTRALS A. W. G EQUIP. PER a OF CC. COND. OF HIdEG OF .W.0 NEUTRAL OTHER APPARATUS: ,7AC11%'GT.-1. BMOCCk~ DFiTEC1'OCtr~l THOMAS J. }3ALY, IITC,H7Ei2f3°N P.O,. BOX 1708 SOUTHOLD, NY, 11971 GENERAL MANAGER t1 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. 4 COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. BOARD OF HEALTH FORM NO. 1 3 SETS OF PLANS TOWN OFSOUTHOLD SURVEY BUILDING DEPARTMENT CHECK TOWN HALL SEPTIC roars SOUTHOLD, N.Y. 11971 TEL.: 765-1802 i7UT =FY: 2> C2 a CALL Examined ,[/.7.. 19!(,;J MAIL TOIs~.~ n~ Approved , 1990 Permit No..~`~/. Disapproved a/c U BLDG. S cv (Bu' di sect r) ' TOWN OF SOu APPLICATION FOR BUILDING PERMIT Date . IdKS 191 Z 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 inspecti. (Signature of applicant, or name, if a corporation)/ I.S c7• SWV?~.. Al j.aOfN (Mailing address of applicant) State whether applicant is~owner, ()lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises 1 .F~~ v 2 V C 1M i hb A ) ©r0~ 4 (as on the tact roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ...~.~.1.D.2~. I (f , . Plumber's License No . Electrician's License No . Other Trade's License No . . 1, Location of land on which proposed work will be done . ..q.9.35 ......................g~yvd~. nol.A................ 6,1 House Number Street Hamlet County Tax Map No. 1000 Section Q.7 Block r Lot . Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...I, .FMv,. i 4 . b. Intended use and occupancy Q .9:.. ~.A`tYniLe a? •C3!-JU-1 , • • • • • • • • , • , • . • • . .a+ - „ 3•s~5 , 3. Nature of work (check which appllicable : New Building • Addition ....v Alteration ? , . . Repair Removal Demolition Other Work (Description) 4. Estimated Cost.....) g~. ........................Fee...................................... 5. If dwelling, (to be paid on filing this application) S, number of dwelling units Number of dwelling units on each floor If garage, number of cars .................................g . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . 7. Dimensions of existing structures,',if any: Front rg`7`.......... Rear .4 . 7? Depth . , , . , , , , Height la.......... NumberofStories ...l.................................................... Dimensions of same structure with alterations or additions: Front . , a).(........... Rear .7. . Depth ..5.1f! i t I Zc. . Sh • . • Number of Stories / . . . . 8. Dimensions of entire ne ret : Front , `.tear ...2a,I A , , , , , . Depth ..9. ! . L.....~ Number of Stories,, - ,:1 . . 9. Height Size of lot: Front ...g.............. Rear.::i? Depth 2-42 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated . 12. Does proposed construction violate any zoning law, ordinance or regulation: .../.t{ . 13. Will lot be regraded Will excess fill be remo d from premises: Yes No . .3.4-X 14. Name of Owner of premises ppLky, , , , , ,Address ~iAy..Vik w. IV i Phone No. 7.6 5- 7r „ 15. Name Architect , , , • . , . , • . Address Phone No............... . Name of f Contractor . . NVJi 11.ilYwAS . , , . , . , , . • ,Address !~`P.'~tauv+rfl..9. .Phone No. `l.6 S:.~ ~ Is this i property within 300 feet of a tidal wetland? *Yes -(n) *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, andshow street names and indicate whether interior or corner lot. U 211 STATE OF NEW YO lr~~k S11 S COUNT lr W . • • , being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the.... . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly lauthorized 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 get forth in the application filed therewith. Sworn to before me this ..........27',rcQ ayS „ 19C{Z Notary Public, / L 7 C unty ROB W , ERT 1. ~ NOTARY P O Bll ff ~ofKy. (Signature cf_ applicant) lion TE>~t8s9, 3 MAM 3~. , SJ~ C'J'!fcylV.f~'P~ V r Z Z 45.09 U) i - M Ln i-o I i f2Y F¢.HO~ ~ i ~ ~ 1 Isro u '--T.:1 Yq'~4 f C ' m l7 I , W: rZ F FENCE RLAh1G :_ttiE CYCLC"A E FENCE G- -W ,i L._. _ ~ _ -a= _ ~ ~f ~i ltitr•»tir;-ryt nhara•bn atldkbn • 5.. °''.^i~?vC~~+,v. 22v to tr>rs rurvav is a vio"m of I N Sr~ 720P of the New York $swuo [duwtlan law. r y of We t1 _2Z' IM ~.,dy'W"ey s lrirNar1W, bm ' - I - anlEa.wd ttd droll not be eartklrad C LobavdM Vrra aooV, j w D EVC..rCPMENT Gwrarlktte Mr I I htaoat abll rtat _ a+rr uro wnan for vNrwn tb wry 4Raotrad aM as lrb kdrrtotb + {S} v~ MAP rtlaoatrrarMl,ortrnnrtnrlpwroParrrF v r U!k Yr I + adon. Guwrrttto ara not VarWarakki D - !fir' p "I.+e~aWxfd+rrut an.«.rwqu.r + k2; fir/ N DA 2 G'-'A2AN ; ELii I. Ff eS,-- As~iE+z' ::.tv TITLE r- ~ ~ 73 { i IPdSI 12AtiCE tiC. T14 E E 54Vl. r III EANk- I H J1rV"~Lk~_ r ~i A.. 7U VryCD AN 7 i iB6 Af Lltl~ ~C 2 319 2 r r"" -'L 'IAI~I i '.v'Y i•- _iGLTHQl.L 7L WN ;;aF SGUT'HCL D Pli EL6G. OEP°'r: ~ I TOWN OF SOUTHOLD S. 2703 JC.LANC SURVEYQ2~. - GfeE4tvVCfe r l~tY. SUFFaG,TAX MAP DATA; (=-0-78-2-i7. i I b TJ t di v+^ PLUMBING OR ALL PLUMBING WASTE OR &WATER LINES NEED TESTING BEFORE COVERING USE IS U,~Q p @~'I pYy~'r~UL ~ UNDERWRITERS CERTIFICATE P7T~ P" U REQUIRED ~T'MHUDUT CERTIFICA' :R IFICATE A J~ ED AS NOTED 0("C; PANCY PLUMBER CERTIFICATION DATE X f 99? &P.M 2//7/2~ FEE: BY: NOTIFY B G DEPART AT ON LEAD CONTENT BEFORE 765-1802 9 AM TO 4 PM FOR THE CERTIFICATE OF OCCUPANCY FOLLOWING INSPECTIONS: SOLDER USED IN WATER 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE SUPPLY SYSTEM CANNOT 2. ROUGH - FRAMING d PLUMBING 3 INSULATION EXCEED 2110 of 1 % LEAD. If copper tubing is used 4 FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS za„ OF THE N.Y. / STATE CONSTRUCTION d ENERGY m;. CODES. NDT RESPONSIBLE FOR ,I ! for water distributing DESIGN OR CONSTRUCTON ERROR$ system; piping shall be Of types K or L only (312wo S 1-2 ~ISTINCr Zr- ' -~e.~~r~,viJ er e~oc-E F+can.l SPLIT SN6EY 2 mgTUi ea~srirgr PITC~I N vTc GIR 01F ~isT+n((r 2.u.i IZ _ ro B•• ~8 2n 9'I6'o.c. RM1FTE4 .2 Ibo.c. RgFiE45 ~8 \~-2r6-4S ,F. P~]tS ~EY,rST9vG) ~'P'-Ywooe ~-Ywoury 7: 3'/t /L • m+uRlp¢~a-K ~Iy16rjT - _ sP~1I's~l ~L~ PAY R.,.B'lbo.. Fh FTEKS I ~•R wont s I5'~ FFi~T ;6 LI - R-19 2vW ca 12"<accit w/yeNT ~'2 i9 IK6 cAacw INS}-n~e,y 2<4 NCt; .,.nom.. DS. 2k4+ fd. A4E ••-_I`~6 R-AOC iA 12" s~cc,T RNCE ...•a~.. w~VeNT ' Fart oar o" r R-~9 ~'~12"SaFFT '~VBNT ExISTINb 2.•~Iwa+ - EX46 yZ PLY-.p A.. k-T° FE--/ /,2LQ':}~¢S ~ J~Y.~o..n s„gvw~w />]~sTcTZ ~OF.r~urvl .2n4-/6 a. G- 1]-31rvRhiuR H£~[ 7=3 wRhiuR uec..n~ 2+v-i6" o, c. PSFesT 5 ,cw- "s j - ,NTC-2ro2 .,..4.v 2>'6-Ib o.c- /Ln R.r.,fouo I ~P~Ywoun wn....nn n ..n u..r ] 9" 2t4- i I'lEW QK4N6 O.G. SLCCPC¢5, - ~ ~ ~n"r<i5 -'/t p.r.,fouo Sa~B K/.nGft °R l5~" r-e.r ,^Q=ti9 VE 13UILDING CONTRACTOR GFb 'VCM O(A DRIVE Hn4ov o6 - _ YI 1 ip6 sHUE -EM BOUE^TH€_4;. V.Y. 11071 R~iY ?n16r~AV~iYEp rµ,n0 CxIST~N(r LC. ?c~ ` I ~4-~-`x- MoHLLYTML P~f; MiN. $~'O~•' BELG.y GRr?,.:at~ SEG TieoN ® F~N,u- o-Rnm ei~oss ' se ~reorl ~ Phone 477-0400 Main Road GREENPGkT, N.Y. 11444 1 vdziF Y A~ Min ENSi,,e IR _YV rr!] w14c.i Aii.~ - J:.pwY AGUIY, ohl . DWG. y}, + n! N:. _._C~:?SS SEG TI ~hlS - ~ ULAN NU. I,5U SCALE Vy r-O )ar" i i I ~ I II I ti 3 2 4 ~ i I~JTr FIEN ~ ~ ? it f W i ~ I I . v 0 6 v ~ o { - I EKISTiiJ,: 1 E.n g'rWtr S=a6 N~ ~ Fc69 ~ yl I ~ NE. NEw - - Y ~ V ~ ~ ~ Z!H./6 i \i FIR .111 . Al. I 0.I 1 i I ~y a ~ L ~ I Pema..e Eti~5T4-io RE niu~~ E. sr,ao abv2 ,.,w CO... 'ZIP o I ~ a ~ P - F O :o III ~ 9fI~ ° li 0°.4! Nh i c W "n Q s IV O A o III III I~ ~li «K r'I~NO~rNIL no.,n s-n$ kMO F'/G - 2 Cu.L's ~ cGM.'- B~ lp, GuI~iS Gk.ly$ I AI` y . - EDWARD E. WILUAMS BUILDING CONTRACTOR 150 SEAWOOD DRNE .min:n uv 11671 ~----I c_xrs-~No Phone 477-0.400 a Main Road GREEMI sRT, N Y. 11944 NOTEe VF_RIF'Y rj Ime NV. NS 12' ' ED WIL.4IP~^"~~ - ~V O. r_~/ AD DI"(~aN OWG FIRST FGOOA R.AN FoUUOkTIOH Pr1N PI"/1r1 ^dC; 1535 4 ;CALFy=1'Cj 4°c2