HomeMy WebLinkAbout20427-z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22130 Date JANUARY 29, 1993
THIS CERTIFIES that the building ACCESSORY
Location of Property 1995 RYDER FARM LANE ORIENT, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 15 Block 3 Lot 1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 13, 1992 pursuant to which
Building Permit No. 20427-Z dated FEBRUARY 14, 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 ACCESSORY SHED & ALTERATION TO EXISTING GARAGE AS APPLIED FOR
The certificate is issued to JANET T. SWANSON
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. PENDING - JAN. 26, 1993
PLUMBERS CERTIFICATION DATED JAN. 28, 1993 - KING PLUMBING & HEAT. INC.
' Building' 1-nspector
Rev. 1/81
roses xo. 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)
No 20427 Z Date ...I 19.~.~
Permission is hereby granted to:
F'.....13.......7s..
to - ........~-r .fem...
"aoz 47
of premises located at
...r
County Tax Map No. 1000 Section ~f Block Lot No.........~..............
pursuant to application doted 19.1.alpnd approved by the
Building Inspector.
Fee 5....
Building Inspector
Rev. 6/30/80
r
Form No. 6
1~ , 1 i°c~ t`r
u' TOWN OF SOUTHOLD
!1 BUILDING DEPARTMENT
JAN 2 (1993 TOWN HALL
765-1502
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 ...~•A. 7:c,3
New Construction.............. Old Or Pre-existing Building.. < 6
Location of Property.. tJ~... ~`~YDE2..,~jtRM..~A~tC ORICN'r„N. .,1lg1 F.7„`6Rtr=A/T /DIY
House No. Street Hamlet ~;'j
5-7
Onwer or Owners of Property. AA J~ I-, ."5!^~AY-1500 3Z 3 7 ~
Oounty Tax Map No 1000, Section..!.........Block.. 3............Lot
subdivision ...................Filed Map.. - .....``.A.Lot......~...............
permit No..... Z,Date of Permit.. 2:lq:.0~ -.....Applicant.J ) ScJ
iealth Dept. Approval ..........................Underwriters Approval.
>lanning Board Approval
request for: Temporary Certificate............ Final Certicate.. L~.....
'ee Submitted: $,Lf: i
: y~ ys1 ~
APPLICANT
C~FOC~'C TEL. 765-1802
TOWN OF SOUTH
OLD
litixr' OFFICE OF BUILDING INSPECTOR
P.O. BOX 1179
TOWN HALL
SOUTHOLD, N.Y. 11971
1 rat
C E R T :r F I C A T I O N
Date f o ! 9-3
Building Permit No. oCFJ ya
Owner'
/3WC 1 ~Ge~~_n)c, 1
(pleas/~e print)
Plumber 116
(p ease prlnt)7~
I certify that the solder used in the water supply system
contains less than 2/10 of to lead.
(plumber's signs ure)
S.Wgr to beforg _mc this
&_12.tday of ~ Q f ~y
19
` Notary Public
Notary Public, Cl I~ County CLAIRE CLEW
Notary Public. State of New York
No. 4879505
Qualified in Suffolk County
Commission Expires December 8, 19
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:IISULATI0;7 PER N. Y. y
STATE ENERGY
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FINAL
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ADDITIONAL COMMENTS: m
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THE NEWYORK BOARD OF FIRE UNDERWRITERS -
WE ARE IN THE PROCESS OF ISSUING A
CERTIFICATE OF COMPLIANCE FOR THE ' - m
ELECTRICAL INSTALLATION AS COVERED X x
IN AN APPLICATION NOTED BELOW. H \
APPLICATION NO. 7-2/ Z R'
I-i
S H \
LOCATION
INSPECTOR % DATE ? \
8D (REV glgkT-
C7
1
CT)
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wX e .
0
SITE
26.00• K
.00'
A
KEY MAP p°
- CJEA pR SCALE -600
NORTH
q
s R"
Nol
n a
SOUNO p!0. .
ISLAND
LONG 613-29 50.E % 7
SCALE- 1"- 200'
59'41 " E. _ 113.08' a \
av N9° 0
N. 78
1 oJ~ ~ !n y
C4
2 z
N a PARCEL 1 0
0 o N oo JANET T. z
- F y? tiz=.a . SWANSON a ae
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y y
ZONING.DISTRICT R 40 & R 80 o a
OWNER
Q e
MARIOND. FITZSIMMONS
68 WESTGATEBOULEVARD y u y S. 86'26'0
ziy 78,731sq.ft. mw 100.00,
PLANDOME,N.Y.. 72, 131 sq. ft. 8 oa
ZONING DISTRICT R 40 ~p
~ w°~~~+++ 200.00'
v s 8826.00• W. ' m
r
4600 sqA 200.00• w
S. 88.26'00" W. 188.00 i red to
J
1,440,301 sq.ft. )10 a a
Po•W. 1,435,701sq.ft. 0Z old; oa LOT 53 0
STEPHENA.
UAMAN PARCEL 2 o w MARION LANE"
o S N.88126'00 1E. //z.00'
! ~5 MARION D" FITZSIMMONS 150.00' PROP- W4 wide R. 0. W., 3
1`• 588'26.00"W, 162.00'' I'
REMAIND OF
12' WIDE R/6HT I LOT 54 _ o w i
F WAY TO SCALE: 1 _ 60 ABONDANED e~ Q y oo R
SURVEY OF PROPERTY I z n m
FOR A" o = z
y:_ a LOT LINE CHANGE °z
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAVE 1.
1.0v7k)7'T
+ BUREAU OF ELECTRICITY
85 JOHN STREET. NEW YORK, NEW YORK 10038
{t FI;Etl2t1AR1' 02,1993
} pate Application No. an file 78635292/92 N 265149
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named an the above application number in the premises of
dANNT SWAN$ON, BOUND VIEW RD,, ORIENT, N.Y.
in thefoilowing face rSftFiirnt se ~4 t IRE FL ~ 2nd Fl. OUT Section Block Lot
~v ~P,
was examined on and found to be in compliance with the requirements of this Board.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
pOUTLETS RECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K W AMT,' K.W AMT KW PMi K. W. AMT. H P
$ DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS SELL UNIT HEATERS MULTI-OUTLET DIMMERS
AMT. K. W OIL H. P. GAS H. P AMT. NO. A W. G. AMT. AMP. AMT. AMPS TRANS. AMT. H P SYSTEMS AMT WATTS
NO. OF FEET
~ 2 F 1 600
SERVICE DISCONNECT NO. OF S E R V I C E 'e.
AMT. AMP. TYPE METER. L O 2W 1 A 3W 3.e 3W 3,e dW NO OPEC . COND Of CC. COND NO OF Ht LEG OF HINEG NO OF NEUTRALS OF NEUTRAL 'W
OTHER APPARATUS:
MOTOR3 1.--F 1f, l~.
~ kAtIEL))GARll9t1°11 CTR. 10r<7
G.F.C,It._3
$MOXE DETECTOItt--.t
t
ARTHUR A. RUROEDN I,I:G.tE2334E C~~~~
MAIN ROAD
ORT.RNT, NY, 11957 p 4 MANAGER
11 .°}`lam/~,,,,
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.
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BOARD OF HEALTH
FORM NO.1 3 SETS OF PLANS
TOWN OF SOUTHOLD SURVEY
BUILDING DEPARTMENT C1IECK
TOWN HALL SEPTIC FORM
FEB E 1992 SOUTHOLD, N.Y. 11971
TEL.: 765-1802 YOT-FY ~ JAN Su1A-TIsoN
CALL . 3z3. ?S.?rte........ .
Examined 19 MA I L TO:
kpproved - 19~~ O y~'yZ J NET 1 •~aWANSo rh.. N
ermit No.. . ~OtC .75 ~ . .
Disapproved a/c . .bt2t6T1Ti
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date . 3. l;Z3Rt }Ry.., 19`:~ -
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
at's 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
r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
ation.
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
`.iall 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
.call 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
uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
:egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
'he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
dmit authorized inspectors on premises and iti building for necessary inspec o s.
S-.........
(Signat r of applicant, or name, if a corporation)
(Mailing address of applicant)
t; -7
U1Zr 1 l I S -
state whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
4`~ [A? t~ C R .
lame of owner of premises .>NET. I , WIAAt4LN 1 .
(as on the tax roll or latest deed)
f applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No. .X00. LRAGN.A-.fJ.......
Plumber's License No. . ?RQ. KfXy~
Electrician's License No. Pn , ..ppezwi
Other Trade's License No .
Location of land on which proposed work will be done . .
1~Rh..... yp ~~M...LokN.E.......o2fE T....tqy.....................
House Number Street Hamlet
County Tax Map No. 1000 Section Block Lot !
Subdivision L Filed Map No. Lot
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
- X10
t
a. Existing use and occupancy ' 6ARA6G
2'..15H P . 0&d • 12EXI 5:,M-P . .
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building S~ Addition .G r. Alteration
Repair Remo Val Demolition Other Work
SLED
4. Estimated Cost , , 7rD00 (Description)
frARkak' I I Fee . Q
, .
X000 (to be paid on filing this application)
5. If dwelling, number of dwelling units . Number of dwelling units on each floor
If garage, number of cars I
6. If business, commercial or mixed'ioccupancy, specify nature and extent of each type of use
Dimensions of existing structures!, if any: Front ..ZQ , . , , [tear Depth. . Z • , , . , , , , , ,
Gw-' Height ...2?.... , . , . , , Number of Stories .
. .
G p with alterations or additions: Front , , , , , , , , , . , , , Rear Za , , , , , , , , , , ,
De th
Depth . . JOn.o.f~ same structure ...l Height Number of Stories , , , , , , , , , , , , , , , .
Imenslons o entire new construction: Fronts Ff W.....1. g... Rear Depth... A 2.......... .
Height . H l . . , , . , , . . / Number of Stories ,I
9. Size of lot: Front 200 • • • • • • .
Rear ..'......?r?°........... Depth ...3os~
10. 'Date of Purchase PAC.. £t7,,,,, , , , , , , , , , , , Name of Former Owner ....M f.ILAIS
11. Zone or use district in which premises are situated ...M .
12. Does proposed construction violate any zoning law, ordinance or regulation: , .
13. Will lot be regraded .....M0, , , , , , , , , , , , Will excess fill be removed from premises: Yes No
14. Name of Owner of premises .
J,T IS,WAN SON, Address P4.7,5,7, , o.sw T. • , , , Phone No. 3? 3 2S7s
Name of Architect SU?AN . o . . . , . Address {3lir. .-17 `All. Phone No.212. 7,?.-(/t0
Name of Contractor. °W&Jgc g,
* Y Address .O.~CrK?rT Phone No~.'r?5. ?f''7 .
15. Is this property within 300 feet of a tidal wetland? Yes...;
If es, Southold Town Trustees Permit may be requited':
PLOT DIIA_G
Locate clearly and distinctly all buildings, whether eXtstin" g or proposed, and, indi ate all set-back dimensions from
property lines. Give street and_bleek number or description according to deed, and show treet names and indicate whether
interior or c er lot: ~
Nam
~xtsr~N~ HUUS~
12° t
I S
S' p2oF65ED SH'r ~
d
I o Qosrp (2 7^jb,K'M LA.
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f-
EX15T/N(T
GA RNCrI; 74X22
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PROpost=o Uri u, ZOD
TATE OF NEW YORK,
OUNTY 0 (Na S If bcinn duly sworn, deposes and says that he is the applicant
of individual signing contract)
love named.
e is the L9i0.X K....
(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
Irk will be performed in the manner set forth in the application filed therewith.
nom to before me this
J. ....day of. I. 19,
3tary Public. gFFA.4J............ County
NANO T. FUSCO
T Co TARY PUSLIC, State of New York. ,I
q ~ 4882475
qualified In Suffolk county (Signature of applicant)
nmleelon Expires Jan. 20, 1993 ,
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APPROVED AS N
r s, DATE
FEE:'
_ NOTIFY BUILDING DEPARTMENT AT
705-1802 9 AM TO 4 PM FOR THE - ' 2•g 9Z pp:4W1~.IG"i __EP ~lZ I~~ 5 C.Vii
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED I - FOR POURED CONCRETE x VJ
OCCUPANCY OR a "I J~ ROUGH - FRAMING & PLUMBING - 1
INSULATION
Sf IS-UNLAWFUL FINAL - CONSTRUCTION MUST I BE COMPLETE FOR C,O. JAUC T:Ir1i IFY~11'w ;
t WPTOU7I, CERTIFICATE ALL CONSTRUCTION SHALL MEET NCNI ''f'Ot~l'C
OF THE REQUIREMENTS OF THE N.Y, If copper tubing is used 4 '
OCC UPANCY STATE' CONSTRUCTION & ENERGY for water distributing
s n CODES. NOT RESPONSIBLE FOR - System; piping shell be DESIGN OR CONSTRUCTION ERRORS -
,i, of tYPes,K or C only.
-4 T" N 7 Al i - - UNDERWRITERS CERTIFICATE
REQUIRED
taF ohm ~r h yyE Ni
A RIO 1 Q, 1
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