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HomeMy WebLinkAbout21176-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22420 Date JUNE 25, 1993 THIS CERTIFIES that the building ADDITIONS & ALTERATIONS Location of Property 1905 MARLENE DRIVE MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 144 Block 3 Lot 10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 4, 1993 pursuant to which Building Permit No. 21176-Z dated JANUARY 5, 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 ADDITIONS & ALTERATIONS TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MARK & ANN GAYNOR (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-277917 - JUNE 3, 1993 PLUMBERS CERTIFICATION DATED JUNE 8, 1993 - MATTITUCK PLUMB.&HEATING wild ng Inspector Rev. 1/81 701M NO. A 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 °_N9 2117 6 Z Date ....f, " 19 9 Permission is hereby granted to: ?Q,..:.. ....~a > to y. kaa ..f.'"° .....n at premises located at lC.... . County Tax Map No. 1000 Section /1.g,w......... Block .--'A........... Lot No...... .f!5~ pursuant to application dated 12... and approved by the Building Inspector. Fee ding Inspector Rev. 6/30/80 c~ C~, i t ~ a Form No. 6 • ' TOWN OF SOUTHOLD JUN 2 q 19M ~ BUILDING DEPARTMENT } TOWN.HALL 765-1802 . , rv.':S. 431:F•,~. TOWN OF 80UifiJ SN_D 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 lJ New Construction........ Old Or Pre/-~ex•stin I ildin Location of Property....~1~5 (2Lg:..g ...............Wlj~.e House No. Street Hamlet Cower or Owners of Property ...ftm -~~n~~~L t...6viC)(... • • • • I • , • , • • County Tax Map No 1000, Section..1~ ! ! !.!.........Block.. .o. Lot...0.rS ..0 0...... Subdivision ................................CC ..Filed Map............ Lot...................... Permit No..1~~.~.~..... Date Of Permit. l~ .....Applicant Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval . Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: C~,•r~ c L(6301 APPL T c0-2aayao %c~V ULA-c, TEL.765-1802 TOWN OF SQYJTIiOLD p t .Y < OFFICE OF BUILDING INSPECTOR `e • ~ rn P.O. BOX 728 c!? i C TOWN HALL SOUTHOLD, N.Y. 11971 j94 2 41993 TOWN Ut C E R T I F I C A T I O N . Date 6 1-~-- Building Permit No. Owner- Mar-k G2..- A2 ' (pleas print) Plumber, k P`uMlO) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (to before me this /~da y of 19 Notar1 Public, C2/~~j~/~ C unty Nota?FJAMCKSONN NftFu~ Stdo 7o Nvvj Yaac Ojdbd In Suffolk County Tom Evk" Feb. 16, lBW INSPECTORS Victor Lessard ODSUFFOj/C Principal Building Inspector p Curtis Horton Gym SCOTT L. HARRIS, Supervisor Senior Building Inspector H z Southold Town Hall Thomas Fisher P.O. Box 1179, 53095 Main Road Building Inspector Southold, New York 11971 Gar Building Fish tar 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 June 8, 1993 S&Z Builders P.O. Box 722 Cutchogue, N.Y. 11935 Re: Mark Gaynor To Whom This May Concern: We are unable to complete your certificate of occupancy because of the following reasons: /z XX An application for Certificate of Occupancy is not on file. (Enclosed) rK XX No Underwriters Certificate on file. c1,/ XX The check is not on file. $25.00 No Health Department Approval on file. No final inspection has been made. K, XX No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 21176-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. a FOUNDATION (lstj I = ~p I l :OUNDATION (2nd) 3 ?OUCH FRAME $ o o Q .PLUMBING H fi LNSULATION PER N. Y. I y STATE ENERGY CODE H FINAL I - ADDITIONAL COMMENTS: m ~ s I ' x "o o~ m a - - - - - - - - - - - - - m - o . M-1802 BUILDING DEPT. INSPECTION [ J FOUNDATION 1ST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ]]INSULATION j ] FRAMING [vr r:NAL REMARKS: _ DATE ~P INSPECTOR r a X76 ~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ) ROUGH PLBG. [ ] FOUNDATION 2ND INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE :)ci INSPECTOR V l~ . , M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [1/} ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ] FINAL REMARKS: f DATE INSPECTOR i 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ROUGH PLBG. [ ] OUNDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL REMARKS: 1- i DATE -INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ FOUNDATION 1ST [ I ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE 0 INSPECTOR rA/ 997 765-1802 BUILDING DEPT. INSPECTION [ FOUNDATION 1ST [ ] ROUGH PLBG. L FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE INSPECTOR THE NEW YORK BOARD OF FIRE UNDERWRITERS l+{ ri z r1, 1250W) BUREAU OF ELECTRICITY 83 JOHN STREET, NEW YORK, NEW YORK 10038 Date JUNE 0311E193 Application No. on file 80149193!93 11 ?779!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 MR,GAYNOR, 195 RARLENE LAN, IIOLE#13, MATTYTUCK , N.Y, in thefollowing location; ® Basement © Ise Fl. ? 2nd Fl. GAR/ A'TTIC IOUT Section Block Lot was examined on RA`'. 24,t9')3 and found to be in compliance with the National Electrical Code, FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT K. W. AMT K.W PMi KW AM} K.W. AMT, N.P. 41 45 37 AI 1 t . 5 2 11 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALRECIRT TIMECLOCK$ BELL UNI7 HEATERS MULTI-OUTLET DIMMERS AMT K. W. OIL H. P. GAS H. P AMT NO A. W. G. AMT AMP. qMT. ;MPS TRANS. AMT H P NO. OF SYSTEMS FEET AMT. WATTS F 2 2 20 1 1.1 li00 SERVICE DISCONNECT NO, OF S E R V I C E AMT AMP, TYPE METER 1~0']W 1,e'3W 3RJW 3,e'4W NO.OF CC. CONO A.W G. EQUIP . PER % OF CC. COND. NO.Of HILEG OF H lEG NO OF NEUTRALS OF NEUTRAL 1. 150 CD 1 X k i t I 07HER APPARATUS: FEEDERS;].-3 # 10 PA5EMNNT TO BASEMENT PVDDSR5 r 1 - # # 8 BASEMENT TO BASEMENT MOTORS II-3 11,a „ 1.2 N.P.,12-F it .P. PANELBOARDSI:?-1 CCR,. 60,1-6 CIR. 125,1- CIR. 30 SMOKE DETECTORt - I LAKE ELECTRIC [,It;,01.845E 17 FOREST TRAIL RIDGE, NY, 1.19 6 1 GENERAL MANAGER 11 Per '/y i. i 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. h MM z h `2 ; Z C7 Z y4- V 0 J m ~ X02 Cj J I N~F 4,917e- Q q Q v w u~F 48irZ ~S /9'// /O 75 W ~ Q/ W Q CL W N Fin,YF/ /4.2 U ¢ pj C N N En IQ GF4arr~ .s.~+ 4y1 N ~ ^ cj E /RJ \ IVC F.C4M6G4Pi~+GE Z% ~S"a v V rT ~ h~ J V \71 ii 1 ~.z ~Neia uvc Q \ pao.n RY / 45 7-Y \ M • ~ ~ ~u i--h 1 F~.4~1 tE' ~ 3 VVi~ J V //.9 £2.9 LL QV J qV z q lz3 03 ,v 20 °39'/0 "W /oo. oo v " ~a f`V1Vf 4. µ i Q Q 'tnu a p~~ o c~ ui F U. u, cc V H Q Jt N X An 0 -j 2 N to o co Uy~~ BOARD OF HEALTH FORM NO.t 3 SETS OF PLAYS I' 4 1{~t~`} N OF SOUTHOLD SURVEY . . . . y ~!!`;t§0t BSI [1~INGDEPARTMENT CIIECF 11OWN HALL SEPTIC FORK ^t- ^x~1~t0UTIOLD, N.Y. 11971 'TEL.: 765-1802 t: CALL ~ / Examined 19gg MAIL TO: - • . . Approved ! 19 Permit No. . . Disapproved a/c n~ n ector) APPLICATION FOR BUILDING PERMIT Date 19 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, relation"I I ship 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 ipspections. *S c**9-'114/rf.5 (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. I?ON/:...~u/T!/i Name of owner of premises M0 61i t . XPAI.)!~kt6. , C>- Xe?g4 . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No . Plumber's License No . Electrician's License No . . Other Trade's License No . Location of land on which proposed work will be done . . House number Street Hamlet County Tax Map No. 1000 Section Block Lot .Ql~•. Q©~ . 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 A,5it k,5~ <'/z b. Intended use and occupancy . 3 Nat re of work (check which alipplicable): New Building Addition , , , Alteration L?.... , , Repair Rcrrioval Demolition Other Work (Description) 4. Estimated Cost ....l e'_-~U• Fee . (to be paid on filing this application) 5. If dwelling, number of dwellingunits 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 . . Rear , Hei ht Depth . . g • Number of Stories . Dimensions of same structure wFth alterations or additions: Front Rear . Depth Height . Number of Stories . , , . • • . • • • • • • . it 8, Dimensions of entire new construction: Front Rear Depth • • Height Nunjber of Stories . 9. Size of lot: Front Rear ~ . 'Depth /.s.d 1 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: • 13, Will lot be regraded " " " " " ' • • • • • • • • • • • • • Will excess fill be removed from premises: Yes No 14. Name of Owner of premises Address . . Phone No. Wfe. ySs .1 , Name of Architect . Address . . Phone No. Name of Contractor . , , i tt} , , Address . . Phone No. 73y :668/ 15. Is this property within 3,00 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. I, ;TATE OF NEW YORK, :OUNTY OF S.S ' W!. being duly sworn, deposes and says that he is the applicant (Name of indivi ual signing, contract) hove named. e is the C E7k/~*UPG7 C~Z (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this 'Plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the ork will be performed in the manner sets forth in the application filed therewith. vom to before me this • .......7. dayo 19~a atary Public, . , . County ,IpYCE M. WILKIN . . . Ntnerv pubuo, State of NOW York . No. 4952240. 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NOTED ' - - USE IS UN Qr- ~ I "''~L NOTIFY 8 LD G DEPART 11J, ' ~THU~ CERTIFICATE 765-1802 9 AM TO A PM OR THE FOLLOWING INSPECTIONS, j u ~v.+°B~g 1~1 l7NW 1., 1 FOUNDATION CBETiE QUIRED, r rE.,pA'g PqR FpUREO CONCRETE F' " 2. ROUGH- FRAMING 2L PLUMBING 3 INSULATION ` I YJ G FINAL - CONSTRUCTION MUST -II BE COMPLETE FOR C.O. h ti, i! 4 'I^{I III y~~~`' ALL CONSTRUCTION SHALL MEET - III i'Ify1 THE REQUIREMENTS OF THE"N.Y. ll~ iL' BUD DE1 STATE CONSTRUCTION; 4' ENERGY 4 CK't ~r~~ ` ~ r CODES, NOT -RESPONSIBLE FOR TOWN OF SOUTH OLO _ _DESIGN OR CONSTRUCTION ERRORS IF . (EpF\ NEW t - y~'kN`E iVr~4 a , 1-7 e h 1' ` 0 O i V p 14 r7ii { f. a 7 f, 1~ 5 1 r t y J Np>y',Y Y ,RT ~q 3I`6° 3~j~p L4 DQ~ ao 3 ..?S. 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