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HomeMy WebLinkAbout20958-z A FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22387 Date JUNE 10, 1993 THIS CERTIFIES that the building ADDITION & .ALTERATION Location of Property 205 PINE AVENUE SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 77 Block 2 Lot 29 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 14 1992 pursuant to which Building Permit No. 20958-Z dated SEPTEMBER 16 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 GARAGE & DECK ADDITIONS & ALTERATIONS TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MARK LOWENHEIM (owner) of the aforesaid building. SUFFOLK'COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITE3C8 CERTIFICATE NO. PENDING - JUNE 10, 1993 PLUMBERS C1 1PIFICATION DATED JUNE 6 1993 - PECONIC PLUMB.&HEATING uilding Inspector Rev. 1/81 i FOFM NO. 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 N9 20958Z Date /zlhol 151... Permission is hereby granted to- of . G .....!lr........... , 4~ 71 to a4ouf 1'e ~ r .......................s...:............................................................................................................... County Tax Map No. 1000 Section Z....... Block Lot No..... pursuant to application dated .1 . 19,?. and approved by the Building Inspector. Fee $...T...1..:.. Bu ~in Inspector Rev. b/30/$0 Form No. 6 y qq- 76 9~ - TOWN OF SOUTHOLD' ~QWP.g22~u..tirrv 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.N 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 j 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 ll0f9 3 New Construction........... Old Or Pre-existing ~Building Location of Property ...........................1.>.M ..A?~........... House No. Street Hamlet Onwer or owners of Property..N...t:Q~r...~®.~?!f (f . County Tax Map No 1000, Section....:K Block..."?!............Lot.•12- 9 Subdivision ...119.OAjr. A~.../ ;5.r A?:~5...... Filed Map..//66.....Lot.... Q.................... Permit No.:aQp4:9:.z...Date Of Permit ................Applicant. Health Dept. Approval...... I,/ ::.............Underwriters Approval...:/ Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: $ w C O APPLICANT C-0 a~3s Lyfflva~i THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1001.093 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date JUNE L5,1 93 Application No. on file '19159492/92 N 219829 ~ THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premise's of I DR. MARK LOWENHECM, PIN!; AVE., €OLE-2, SOUTHOLD, N.X. in thefollorvinglocation • hTTIC/OU4' B se ent /xt Fl. 2nd Fl. Section Bork Lot uns examined on AR 10,119 and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENT FIUORESCENi OTHER AMT. K W. AMT K. W AMT. K W. AMT K W AMT. H P. 66 51 55 66 2 g DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS REII UNIT HEATERS MULTI-OUTLET DIMMERS H P SYSTEMS AMT WAiiE AMT K. W. OIL H. P GAS H. P. AMT. NO. A W. G. AMT. AMP AMT. AMps TRANS. AMT. NO. OF FEET 1 f 1 DLSU ^.11.2 2 1 G 6041 SERVICE DISCONNECT NO.OF S E R V 1 C E . AMT. AMP TYPE METER 1 ]W 1 9 3W 7.e' 3W ~,e dW NO OF CC. COND A W G. NO. OF HI-LEG A W' G. NO. OF NEUTRALS A W G EQUIP. PER OF CG COND. OF HI LEG OF NEUTRAL 1. 200 C. Ti 1 g 9. 2/0 1 2101 OTHER APPARATUS: JA(!Ut0z,I-1 MOTORS0-1 H.P. 6.F,C.It-12 SMOKE DETECTORt-3 DOROSKT ELEC. IN(;, LIC.02941-E 425 MONSE1111 LANE CUTCH(1Crl1E, NY, 11935 I 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. INSPECTORS . ?7y Victor Lessard Principal Building Inspector Curtis Horton SCOTT L. HARRIS, Supervisor Senior Building Inspector .4 " Thomas Fisher Southold Town Hall a; Building Inspector P.O. Box 1179, 53095 Main Road G Southold, New York 11971 Gary Fish Pax (516) 765-1823 Building Inspector Vincent R. Wieczorek r Telephone (516) 765-1800 Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD JUNE 7, 1993 GEORGE KOCH MT. BEULAH AVENUE SOUTHOLD, NY 11971 RE: MARK LOWENFIEIM PLEASE NOTE: AMENDED PLANS REQUIRED BEFORE CO IS ISSUED. 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) XXK 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. XXX No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984)., BUILDING PERMIT # 20958-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. CC: MARK LOWENHEIM VQL COIF TEL. 7GS-1802 TOWN OF SOYJTHO~, OFFICE OF BUILDING INSPEC% 01 o F ~!J rn P.O.,BOX 728 T TOWN HALL SOUTHOLD, N.Y. 11971 C E R T I F.1 C A T I O N Date ~Q Building Permit No..20V3--~ Owner y !7 iq uk L -,Jfq ZH lease pr t) Plumber (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plum er's signature) Sworn to before me this day of 192_'~ Notary Pub11 llotary Public, P~ County BARBARA STEPNOWSKI Notary Pulft State of New York No 4844752 000111W krSuffolkCounty Canmis on Eq*w Sept. 3o, 199 M-1802 BUILDING DEPT. INSPECTION [ ef/FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL REMARKS: fiOal DATE ~G^JxY/ 3 INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FO DATION 1ST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: i I DATE I~ INSPECTOR I M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ROUGH PLBG. [ ] FOUNDATION 2ND INSULATION [ ] FRAMING [ ] FINAL REMARKS: 7 t DATE ~1 3 INSPECTOR 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [SULATION [ ] FRAMING [ ] FINAL REMARKS: =~~CJ7C DATE ~1-17h INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [FRAMING [ ] FINAL REMARKS: do DATE T L INSPECTOR A-4~ m M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ I ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [INAL REMARKS: i G DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ J FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ J INSULATION [ ] FRAMING [ J FINAL REMARKS: DATE INSPECTO '1ELD i;:S:EC:i~;:~ ~(U„;., j~ :;iii-(i•tLNiC m { / L- 7OUNDATION (1st) Sk' x4o 'OUNDATION (2nd) 0 TOUGH FRAME & C~ .PLUMBING I 1 /NI Qf y 3. m m INSULATION PER N. Y. STATE ENERGY CODE a H FINAL O CZ2 ADD IOPIAL CO ENTS: • x ro • H\ a • H m } o • m H BOARD OF HEALTH FORM NO.1 3 SETS OF PLA, TOWN OFSOUT14OLD SURVEY BUILDING DEPARTMENT CHECK . . srp 141" TOWN HALL SEPTIC FORM SOUTHOLD, N.Y. 11971. q TEL.: 765-1802 C L _ AL rarrl~rrctl ? `R 191,~ MA IL T0: %Pproved % 1 . Permit No. . Nsapproved a/c (B di sp ctor) APPLICATION FOR BUILDING PERMIT Date 9/$ 19 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 is 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 areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ition. 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 .all 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 all 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 rilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or =gulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ie applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to mit authorized inspectors on premises and in building for necessary ipections. p Jli=t, . (Signature of ap or name, if a corporation) f./^~.~?/y...:o~~c?TFCv~A. 1. 11971 (Mailing address of applicant) ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ®t/?i ` ame of owner of premises Pit`s-... ~H 2 1.. Lnc/ ?H `~.H . (as on the tax roll or latest deed) applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No....!17.. /d Plumber's License No . Electrician's License No . Other Trade's License No . Location of land on which proposed work will be done . . 1 ................?....'.........SQ.~rttto«.. / . . . . . . . House Numbaer Street Hanilet County Tax Map No. 1000 Section .......7.7......... Block Lot 9 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 , , ~9N.!~, , , (~l$!!~/T, ads 4j:s; `M'r7t e•dy 5,?@pro .Yr5£?3X'~ ~FF"~.~."e~.^( . b. Intended use and occupancy t"=ft s" ....dslk;sa'u'~tt•+1i1lt#f$.. ilt • yJft s r6, k:1 n®ta ise r-- 3. Nature of work check which aPPlicable): New Building Addition Alteration . Repair Re oval Demolition O V.! rVwo . / Op ti 4. Estimated Cost ii a ~a ©d!U Fee . ? ~A q AF~fl~............ . 5. If dwelling, number of dwelling (to be paid on filing this application) units , , , , , Number of dwelling units on each floor. . a~ If garage, number of cars a . 6. If Height business, commercial or mixed occupancy, specify ature and extent of each type of use ..y 7. Dimensions of existing structures, if any: Front Rear , ' Depth • , berofStories ...1 with alterations or additions: Front L y R. Depth ...4./. . Dimensions of imensions of nt..res. ..new....cons. t 'Height . , 3.. , , , , , , , • • , , , . Number of Stories Z , , ; , , , , , , , 8. D kuction: Front - -4,7 . , . , , , , , , Rear . , 7.......... Depth , Heiollt . . . . Number of Stories . " " " " " ....;Z • o . Depth . 9. Size of lot: Front . 4QQ ~ i Rear (P. ../e2S 10. Date of Purchase } . J.). .il . Name of Former Owner .4~ 2 -7t'lw . 1 1. Zone or use district in which pr 12. Does construction Vlo~mises are situated ~ti 5t D a.~!T! 6. r-, , , , , , , , , , proposed ,,late any zoning law, ordinance or regulation: Wfl . 13. Will lot be regraded N.° . Will excess fill be removed fro premises: Yes Name 14. Name of COon er of Premlisse~cn , • • , , , , , , Address ? ?4!4..o~ocVPlflav. hone No. 7,(eX 9'/3 S , • . Name of Architect Address . . . hone No... . , , , , , , , , t G' Address t f-u; 101 .l;?F..~-;.04honeNo.76S.:4~.4." 15. Is this property within X00 feet of a tidal wetland? *y . " ' *If ir•••••••• No......... yes Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all 1, buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block Dumber or description according to deed, and show street names and indicate whether interior or corner lot. ' ago 4 a ter, r Ar&-! Sir-Coc~G iAr' ITaP: /OGb-TT2-~9 STATE OF NEW YORK, SS COUNTY OF L c'+'•~ ('f ' • • ~•(7~P~t3c• ~?•,~°!°cN being duly sworn, deposes and says that he is the a lscant (Name of individual signing contract) PP lbovc named. //vrvr r,4 (~~,/,?E2 Ile is the h?:~/`/Akrni....... ! . . (Contractor, agent, corporate officer, etc.) if 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 York will be performed in the manner set forth in the application filed therewith. ;wom to before me this dayof. f............ 19 Jotary Public, Ffv t '!ICL . County Mo1IVI~ 4kTA No -Vam (Signature of,applicant) - - - - - - - - - - PLUMBING I66~ I O ALL PLUMBING WASTE L_~~1 5, O i E, I2Fi•O TESTING BNE ES NEED Aa Q COVERING r nr.- _ _ _ +1 O O IJc+W ?.-GCrF arjcYtcerff _ . Jab, 1 nI ~'M11' IrJS~GT AI I 0 - - 0 - _ _ S I I EG~IiQH ~'M1TGAL t 40G I ~t I '1'kCN~OE oU"CSKZI~G ioT N O d,1 N I aX,~i `n=+iT w-na,NSCCT I I ~ ~R TLrIS h~Cf~~ r a, ~1G.W ,trr~vEVt4'T' ~ ; I PLUMBER CERTIFICATION i G"~ SACS= 5 ~,na~. 0 I _r - - •a - - - a,~ r.• %.o,,, J.c1.~ ;.Bx:A;%e I - - _ _ _ aw- ON LEAD CONTENT BEFORE 1i T4N 2Gl-E1G 1r~.Tia'M~[.G I I ~'0 • O,d , ~e y CERT/F/GATE OF OCC ~ Fe--y~y••a. b~ ~ I MF I I ,p IIII 2Kb F-•_J• t I .i' 1 ~~L~N•~WOG O~~.i1.1(.r I rt*+e~ Fouuvr.To'-t I I I I e~ I SOLDER USED IN WATER e nxp d nm q Fou v~ ` v `SUPPLY SYSTEM CANNOT 4-2xb ¢fQaee_ I r' 1 I I yo = EXCEED 2110 of 1 % LEAD. F ~.1. I min /,cri-lox~o .u.,.. o-n• ~ I tw tt 14i 1 - 1 ? I W ~ I• - I I I I I +1 ~I I, 0 N copper tubing is used ° I ~vr n ~N - - - W for water dbtributing 4 T r.G, GM Piping L shall be ~ - - - - - - - - - - Of tYM ros Q pax$rg-,.o,sr.~ Yx d 0 C 4"~cN:. GIUaV Ct L' I I - Y%9e RL.J. I kY I ~OOT~~->,4r _ I +I i' I I ~ I 0,- 0 ta0 - O .tiat4~' s~x~oi w T r~~ JIB D!~ N I~ I - Ix~ (MW ' 1 s I I- I Ir V' I I ~ I~~ I I Il I o.- I 6s°" OCCUPANCY OR X I GKXy XL x Graa~X4 SF'1C.GE 1 ? I $ 1 I I USE IS UNLAWFUL v- F.4, WITHOUT CERTIFICATE _ I a OF OCCUPANCY - 1& 19 ka 4~ SEP i 41992 AP RD D AS NDTBD - " L~' x L- - r+t Gt~•OFZY ,~v~t-w~ FEE- NOTIFY U! ILDING OEPA NT AT 766.1902 9 AM TO 4 1, FOR THE FOLLOWING INSPECTIONS. T. FOUNDATION - TWO REQUIRED ~JIT~ A L At~4 c4LFC: I' 30'-o" FOR POURED CONCRETE Spi.-.>RAt~w: w. "7-f --cA.x v,%e P : td:00 - 7r* - 2 -'2/ 2. IN ULA • FRAMING a PLUMBING FOUJ ~'~1D A~ I O F _0„ rsuz.iGa: 'as,oo0 56' 3. o'' 4.FINAL ION FlNAL CONSTRUCTION MUS1f' • L,2T Numpowmmz, tw-vsr32. TO ~ M PP q? !s/t'L'2DE 13[sY CS`r'6'TcS" BE COMPLETE FOR CA. -1=,~ 1 + r~ ALL CONSTRUCTION ¦tIACL.A&W THE REG111REMENTFi,T11,T; s~ v~or-~ rz a ~~x.ven Quw+EY 'Pa.~rb~sc.o io-f STATE CONSTFIUCt ~ fE UNDERWRITERS CERTIFICATE acm..'e~-r n.,Y r-tscc r~sc~.-~sss~ i3 , qea~~ . 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