HomeMy WebLinkAbout20589-z e
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23047 Date JUNE 17, 1994
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 1350 GLENN ROAD SOUTHOLD NY
House No. Street Hamlet
County Tax Map No. 1000 Section 78 Block 2 Lot 31
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 28, 1992 pursuant to which
Building Permit No. 20589-Z dated APRIL 28, 1992
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 TO CONSTRUCT A ONE FAMILY DWELLING WITH ATTACHED GARAGE AS
APPLIED FOR.
The certificate is issued to SAMUEL & ANNE DE LUCA
(owner's)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 91S033 MAY 5, 1994
UNDERWRITERS CERTIFICATE NO. N316770 JUNE 9, 1994
PLUMBERS CERTIFICATION DATED NEW SUFFOLK PLUMBING & BEATING
~r
Z
Building In ector
Rev. 1/81
FORM NO. s
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)
WN° 205692 Date ........Q 1"'fi''......a.$ 19.9.E
i
Permission is hereby granted to:
i
..a4..?. ttF:.......d..~A...
.
~..ta~ ~.....'(i....C.
to . Y4. ...S~ .....A'3&~ a ..l.~.L s7-r>~.a ..l ~a t .CX~ ...fal Y.t0.C R d(.........
. 4 ~.....41r.4 PAN4
at premises located at ...I . G. ....N :Y.t........34--c f 4
County Tax Map No. 1000 Sectio PL I* OBlock Q. Lot No...Z.L
pursuant to application doted / °S.2 191.E and approved by the
Building Inspector.
Fee S.#R J...........
` Building Inspector
Rev. 6/30/80
~ Form No. 6
TOWN OF SOUTHOLD
JUN 6 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 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.
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
II Date f..
New Construction. (4) Old Or Pre-existing Building......... n
Location of Property..P.Y.A. D.. C,,,,,,....6....... 4.ek
House No. Street Hamlet
C~
Onwer or Owners of Property .15nmR~~~,//4~Q,,, ,,,I~l).Q (_Cx C¢i..,, .
County Tax Map No 1000, Section.... <.i; Block Lot........
Subdivision Filed Map............ Lot..
Permit No.~ ,5.p.gZ..Date Of Permit. ~Ild f fsR,,,,Applicant,&N. u"l ~44G 6Y1....
Health Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval
Request for: Temporary Certificate........... Final Certicate...........
Fee Submitted: $
22c-"- 4$00
ln70' -Z a3D q 1 APPLICANT
:.ak
S~FF 0L/S'~ TEL. 765-1802
0~0l,~. Ol? TOWN OF SOUTHOLD
l•r . 7 OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
` gr im ' TOWN HALL
Oj. SOUTHOLD, N.Y. 11971
C E R T I F I C A T I O N
Date ~j14 /L"/
Building Permit No. ~)O TId? z
Owner 5~9,,,, LLB .sr
(please print)
Plumber
(please- rint)
I certify that the solder used in the water supply system
contains less than 2/10 of to lead.
eplumber's signature)
Sworn to before me this
l day of ,
19.
Otary Public
t1otary Public County
t~O/s,•rl v 7 d/ 9 ~ ~
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1000665
BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK. NEW YORK 10038
Date TRINE 09, 2994 Application No. on file 82551493/93 N 316770
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant namedon the above application number in the premises of
SAM DELUCA, GLENN ROAD, SOUTHOLD, N.Y.
in thefollowing location• 1g cement 1~ Ise Ft. n 2nd Fl. GAR/ATTIC/OUT Section Block Lot
was examined on JUNE 08, 94 and found to be in compliance with the National Electrical Code.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K, W. AMT. K W AMT K.W. AMT K W. AMT H P
54 41. 55 48 6 1 6.8 2 8,6 3. 1,4 4 IF
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALRECTT TIMECLOCK$ BELL UNITHEATERS MULTI-OUTLET DIMMERS
AMT. K. W. OIL H. P. GAS H. P AMT. NO A. W. G. AMT. yyAMP. AMT AMPS TRANS. AMT. H. P. SYSTEMS NO. OF FEET AMT. WATTS
2 F 1. 30 1
SERVICE DISCONNECT NO. OF S E R V I C E
MAT. AMP, TPPE METER I YW 13W T 6 3W 3 q dW NO. OF CC COND. A W. G NO. Of HI LEG A W G NO. OF NEUTRALS A. W. G.
EOUIP. PER 9 OF CG COND OF HIAEG OF NEUTRAL
1 200 CB 1. X 1 410 1 2/0
07HER APPARATUS:
MOTORStl-5 H.P.,1.--P" N.P.,7--F H.P.
PANELBOARDSI2-1 CSR. 60,1-29 CIE. 200
G.F.C.IL--17
SMOKE DETECTORt-2
RUDOLPH EtJOKA LSC. #4044 -E
670 ROUTE ROtTTE 25
SAINT ,TAMES, NY, 11780 GENERAL MANAGER
11
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.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
gpFFO(,~C
~~~~0 CGy
o ~
Town Hall, 53095 Main Road °y ¢ Fax (516) 765-1823
P. O. Box 1179 Telephone (516) 765-1802
Southold, New York 11971 .j.
col ~ ~a
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
May 11, 1994
Mr. Samuel De Luca
1614 Falmouth Ave.
New Hyde Park, NY 11040
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) 4--
xx No Underwriters Certificate on file. 10%
xx The check is not on file. $25.00 dl
xx No Health Department Approval on file. No final inspection has been made.
xx No Plumber Solder Certificate on file. D~-
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 205892
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
).LL 37 L..~.C L....i.l 11Dn.u ~I
~:rrtENr
_ td
H
70UIJDATIO"1 (1st) I ~
I _
'OUNDATION L
(2nd) ti
- m
;OUCH FRAME & W
d
-PLUMBING
I m Q
~NSULATIO.1 PER N. Y.
rn
H
STATE ENERGY j~
CODE I to
' C
a
y Q.
FINAL
o ~
ADDITION CO ENTS: cn
b
C/J
~s
1-7
~ Rr
x
H 6
A
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el/, m~e~ e
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fit: 2 5 !
i
ENERGY CODE REVIEW F
(non-electric)
7814 (Part 5) 61000 degree.,days
For 4 c.< Per Dwgs d e'a7p,j IVZ 6 `
Dated
Envelope Component R-Value
Exterior Wall R-18
Roof/Ceiling R-19
Floor R-19
Foundation Wall R-10
Slab Edge Insulation R-10
Glazing R-1,7
Entrance Doors R-2.5
All 11VAC Equipment to meet requirements of 7814.11
All HVAC„Controk Systems to meet requirements of 7814,12
All Duct Systems'to meet requirements of 7814.13
All Ventilating Systems to'meet"requirements of 7814.14
All Piping Insulation to meet requirements o£. 7814.15
All SerVice,Water Heating Systems and Equipment- to meet
requirements of 7814.21
All Electric Systems to meet requirements of 7814.31
a To the best of my knowledge,
belief] and professional
judgement, these plans are OF hEW
in compliance with the code t' - Y
7 1
r~ enr
h
+6~ 037254-7
9oFESS I OR 1
S
I~ t 1 7
' } ifs
g APR 2 81992
M-1802
BUILDING DEPT.
INSPECTION
[ FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ) INSULATION
[ ] FRAMING FINAL
REMARKS: G <
f
DATE INSPECTOR
I~
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND INSULATION
[ ] FRAMING t NAL
REMARKS:
a
vk a
DATE S-y INSPECTOR
S~
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUG LBG.
[ ]FOUNDATION 2ND [ ] IN LATtON
I
[ ]FRAMING L
-4 24
REMAR /
L;L 9, ~ po-0 X-
6 c,'
DATE INSPECT
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST ( ] ROUGH PLBG.
FOUNDATION 2ND [ INSULATION
[ ] FRAMING [ ] FINAL
REMARKS: cr~c ~a~
DATE ` Z 3 INSPECTOW:~-'
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [Vl~ ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS: 6~---~"-~"'C~f /G
DATE INSPECTOR 74,
Deow
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ FRAMING [ ] FINAL
REMARKS:
r
c
i
DATE INSPECTOR
t
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST ( ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS:
DATE INSPECTOR A57~
765.1802
BUILDING DEPT.
I NSP CTION
41W,61&&1;wPL
OUNDATION 1ST RBG.
I F
FOUNDATION 2ND ( ) INSULATION
L 7 FRAMING FINAL
REMARKS: .
DATE 6 ' INSPECTO
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING FINAL
REMARKS:
r
DATE Z INSPECTOR "l
BOARD OF HEALTH
FORM NO.1 3 SETS OF PLANS
t 4~?~ TOWN OF SOUTHOLD SURVEY • " ' - . ' " " • " • "
BUILDING DEPARTMENT CIiCCh . .
TOWN HALL SEPTIC FORD!
SOUTHOLD, N.Y. 11971
ter? ` TEL.: 765-1802 ttOCALLl~a :715- l (p
Examinedm. , ..~8 l9QL MAIL TO:
Approved ......F~ 2 aOS-~p
19 Permit No.
Disapproved a/c
C
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date 19`7.
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 ins ctions.
(Signature of applicant, or name, if a corporation)
lle. ~f. L .Un ? ce /41.
(Mailing address of applicant)
c`o is~ / er b `/C)
`~Jcontcractor~
State whether applicant is owner, lessee, agent, architect, engineer /ee
, generall
electrician, plumber or r builder.
4?~.N Gfh.
Name of owner of premises ~ h .q. c~,
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
.................-title.
(Name and of corporate officer)
Builder's License No .
Plumber's License No .
Electrician's License No .
Other Trade's License No .
I. Location of land on which proposed work will be 'done. ,-a . . . . . . . . . . . . . . . . . .
/.a~..4........!~.nh...CdS4~ ......~Lt.n.D~~
I-louse Number ~~yy Street 7 Hamlet ?
County Tax Map No. 1000 Section .....l• .Y Block 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
b. Intended use and occupancy .l ~Lr?~ , 5 f E d~ C ~ . .
3. Nature of work (check which applicable): New Buildin 1/^
Ie • • • Addition , . Alteration
Repair Removal Demolition , , Other Work
4. Estimated Cost ...Y..~ B C)~ (Description)
D v Fee............,.........................
5. If dwelling, (to be paid on filing this application)
g u
e, number of dwelling units Number of dwelling units on each floor . . . .
If garage, number of cars , ,
vZ!.....
6. If business, commercial or mixed' occupancy, specify nature and extent of each type of use .
Dimensions of existing structurif any: Front . Rear Depth
Height Number of Stories .
Dimensions o same structure with alterations or additions: Front Rear , , ,
Depth . Height Number of Stories .
8. Dimensions of entire new construction: Front . J.Z~P,', , , , , , , , Rear ..~r''.~. Depth , , , , , ,
Height . .lot:.. . . .Front. . q Number of Stories ......0.4! F „ . • .
Rear 4+4 Depth
10. Date of Purchase Name of Former Owner
Zone or r use district in which premises are situated ka sib C
'
proposed ate any zoning law, ordinance or regulation: . lot,/~ , , , , , , , , , , . .
13. Will lot be regraded . . . . . . . . . . , , , , Will excess fill be removed from premises: Yes No
14. Name of Owner of premises nL~4~e , , , , , , , , , , Address 1016.. a /,rrjs9f*W1 , , Phone No.~S(~.'.7, 7S; ad/ (p
Name of Architect , , , , , , , , , , , , , , , , , Address Phone No............. .
Name of Contractor . . . . . . .
within T O feet • of a t „ Address Phone
No.... No
' 15. Is thi*If property 3Q O of a tidal wetland? *Yes eyes,,,,,,,. No .
yes, Southold own 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.
!
;TA
TE OF NEW YORK
:OU OAiraz.•c...... S
...,I,..,....
` • • • • • • • being duly sworn, deposes and says that he is the applicant
(Name o of individual signing! contract)
,bove named.
le is the ..:IVV_e .z{r 4 , .
.
(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
pplication; 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 set forth in the application filed therewith.
worn to before me this
..day of. 19' ; .
otary Public, ' • nt
HELENE D. HORNE eb
No.
NQua ffNo,49619 State 513 k 84 CowYork , . • • • of • . • • .
y qty(~ (Signature of applicant)
Commission Expires M 'y 1fD
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APPROVED AS NOTED ti Xo sea
FEE: ~ ""LIP NOTIFY BUILDING OEPARTMENT AT
- III - 765 -1802 9 AM TO 4 PM, FOR THE a as s`~'OO
FOLLOWING fN5PEf71f)Ng,
1 FOUNDATIOf7 rwoi QUIRED - _ - _ _ - -
FOR POURED CONCRETE
- 2 ROUGH - FRAMING K PLUMBING - ~ 3. INSULATION, "-d{
4, FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.0 ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y. 1 -
STATE CONSTRUCTION & ENERGY CODES NOT RESPONSIBLE FOR DESIGN
SIGN OR CONSTRUCTION ERROR
Sib
r,
y
_ r ,-.}u,w
i
`MmPPrlW1MIiYMd PLUMBING iPLUMBING C`.'t d
fo?vmw dlltrl mdno n 0,V-r 'ALL PLUMBING WASTE ALL MUMBINGI WASTE F - _
E: WATER UNMNEED. _ d WATER UNii NEED EY
Ld11V. TEGMNQ BEFORE CQVERING - TEBTiN6 BEFORE twERINQ" oWXP M 3611
FfirAd p~
Phcwe 4770400 Mail) Road
PLUMBER-CERTIFICATION '
ON LEAD CONTENT BEFORE ORFENPORI, N' Y i!944
CERTIFICATE OF OCCUPANCY .t 1"(r Q5~
' SOLDER USED IN WATER
a'+ SUPPLY SYSTEM CANNOT
EKCEED2/f0OF19L4EA0. N,.; o-
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