HomeMy WebLinkAbout20459-z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22082 Date JANUARY 6, 1992
THIS CERTIFIES that the building ACCESSORY
Location of Property 5220 STILLWATER AVENUE CUTCHOGUE N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 137 Block 2 Lot 14
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 3, 1992 pursuant to which
Building Permit No. 20459-Z dated FEBRUARY 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 ACCESSORY 6' x 6' STORAGE SHED
The certificate is issued to THOMAS P. GRALTON
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
uild ng Inspector
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22080 Date JANUARY 5, 1993
THIS CERTIFIES that the building ADDITION & ALTERATION
Location of Property 5220 STILLWATER AVENUE CUTCHOGUE N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 137 Block 2 Lot 14
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 28, 1992 pursuant to which
Building Permit No. 20459-Z dated MARCH 3, 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 ADDITION & ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING
AS APPLIED FOR.
The certificate is issued to THOMAS P. GRALTON
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. H-032690 - DEC. 30, 1992
PLUMBERS CERTIFICATION DATED JANUARY 4 1992 - T.P. GRALTON
~L
Building Inspector
Rev. 1/81
Foam NO, f
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 20459 Z
Date 19.Ze
Permission is hereby grontedtqe~
...1' .
~
fib
to .4
of premises located at A
. .444
~
.
County Tax Map No. 1000 Section .......1.0.7... Block Lot No... l~T
pursuant to application dated ........2/12--d 191/. and approved by the
Building Inspector.
Fee 5..`~•X,7V
B din
g I for
Rev. 6/30/80
Form No. 6
M,
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
i~ 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).
y 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.
of 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
j ~
Date L
New Construction........... Old Or Pre-existing Building................ `
Location of Property. U... . f :.LL 1/?!?l ...~~?........C 4:!
House No. Street Hamlet
Onwer or Owners of Property T P.~. P /7 ,,,,,,,(,..I ,
County Tax Map No 1000, Section...... .?...Block... ........Lot....I..!,,,,,,,,,,,,,,
Subdivision ........LL ............................Filed Map............. Lot......................
Permit No..... 7.' s!~L Date Of Permit ................Applicant.............................
Health Dept. Approval ..Underwriters Approval.........................
Planning Board Approval
Zequest for: Temporary Certificate..........: Final Certicate...........
lee Submitted: $
NSA di
APPLICANT
Form No. 6
_.w»
' TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
JAN 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 19 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 - Residentialp $15.000, Commercial $15.00
Date - V,1
New Construction........... Old Or Pre-existing Building
Location of Property. ?'...E 4?.........(_ 6-vim
House No.J Street Hamlet
Onwer or Owners of Property.... J.Jj : !.~~':~.6. ~ ~
County Tax Map No 1000, Section..... `......Block..... .......Lot...
y z l.`'~
subdivision............. ........................Filed Map............ Lot......................
'ermit No..... ~.O . !..Date Of Permit ................Applicant.............................
lealth Dept. Approval ..........................Underwriters Approval.........................
)lanning Board Approval
request for: Temporary Certificate............ Final Certicate...........
'ee Submitted: $
.535 =
en aaoA APPLICANT
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS: 16 re"-)
5
DATE INSPECTOR
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INS LATION
[ ] FRAMING FINAL
REMARKS: DATE INSPECTOR
z
765-1802
BUILDING DEPT.
INSPECTION
]FOUNDATION 1ST [ ] ROU PLBG.
[ ) FOUNDATION 2ND [ INSULATION
[ ] FRAMING FINAL
REMARKS: ~ 3z-~ o _
DATE ill? kt,-' INSPECTOR
c y
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
? p
REMARKS: =9
At-
DATE 2- INSPECTOR/-
t
THE NEW YORK BOARD OF FIRE UNDERWRITERS qtr 1
803~L1N2 BUREAU OF ELECTRICITY
F- 85 JOHN STREET, NEW YORK, NEW YORK 10038
Date DSCE1Rm 30,1992 Ap;plicationNo.on ile 78561192192 1I 03"690
THIS CERTIFIES THAT PIRMIT NO, 2 459
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
THOMAS F. GRALTOU, 92,O RTSLLWATER ATIENIIE, CU'TCHOGUE, N,Y.
=
in thefollowinq location: M Basement I-1 Tst FLM 2nd El. OUT Section Bork Lot
was examined on DECEMBER 211,1992 andfound to be in compliance with the requirements of this Board.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS ECEPTACLE$ SWITCHES INCANDESCENT FLUORESCENT OTHER AMT K. W. AMT K.W T. K.W. AMT. K W AMi. H P
21 57 29 21.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECTT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
AMPS. TRANS. AMT. H. P SYSTEMS AMT WATTS
AMT. K. W. OIL H. P. GAS H. P. AMi NO. A W. G. AMT AMP. AMi. NO. OF FEET
it F 1 2 12 1 20 1
SERVICE DISCONNECT NO.OF S E R V 1 C E
y AMi. AMP. TYPE EQU p. 10 2W 1 ,e 3W 3 d' 3W e dW NO OF . COND Of CC. COND NO OF H( UG OF M LEG NO OF NEUTRAL3 OF EUf AL
1 2,00 f:8 1 H 1 210 1 710
F OTHER APPARATUS:
NOTORSt2. kF H.I'.
G. F. C.It-4
SMOKE SETEC'TORt 3
B ell
THOMAS P. GRALTOH
5220 STII LWATER AVENUE °
CUTCHOGUE, NY, 1.1935 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.
I-Ey D
Q•
FOUNDATION (1st) 10
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FOUNDATION (2nd)
2 . 1 A y{
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ROUGH FRAME & Y1
-PLUMBING Z Q
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3. ~
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INSULATION PER N. Y.
STATE ENERGY
CODE
4. y
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FINAL
ADDITIONAL OMMENTS: ?J
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~Oc~F F ~(f(`Oi TEL. 765-1802
TOWN OF SOUTHOLD
o
OFFICE OF BUILDING INSPECTOR
cz-
F=si.-31'• %-r. P.O. BOX 1179
y0 e?? i TOWN HALL
SOUTHOLD, N.Y. 11971
C E R T I F
I C A T I O N
JAN - 4 199:'
Date
Building Permit No.
Owner_:-Z;
(please print)
Plumber
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1, lead.
e .
(plumber's signature)
Sw rn to before `menn this
day of J K /1 .
L
19 2-)
Notary Public
Notary Public, z County
Notary Public, State of New York
No.4878506
Commies onBEaxdpir s Deccember 18*
ETAL"FAB GIVE YOU A CHOICE
TEMP/GUARD
211300 CHIMNEYS T FIT THE JOBO
Choose all stainless or a combination
stainless/ galvanized. C/,
i3oth offer the highest quality, easiest
installation on the market
• Spece Age Insulation - Solid-fill insulation material designed for the NASA
space program. This new technology provides even distribution of flue gas
temperatures throughout the chimney system, while retaining our original 1 /2"
wall thickness. q
• No Hot Spots -Uniform wrap of insulation prevents sags, settling and voids
in pipe.
• Patented Locking System - Positive twist lock provides easy installation
and a tight fit without tools or drawbands. Pipe can be easily disassembled without
tools or damage.
• Lightweight - A section 8" x 36" weighs only 12 lbs., less than half the
weight of some fully-insulated chimneys, Easier handling and installation.
• TGS All Stainless - Inner liner and outer jacket are type 430 stainless for
better resistance to heat and corrosion.
• TGG Galvanized - Inner liner is type 430 stainless; outer jacket is galvanized
for lower cost installations.
• No Insulation Residue - Installations are cleaner and neater without messy
residue.
• Reduces Chimney Fire Hazard - 21000 rating reduces potential hazards
of a home fire caused by a chimney fire.
• Attractive Appearance - Clean, good-looking appearance where pipe
is exposed
• Variety of Sizes - Available in 611, 7" and 8" diameters.
• Variety of Applications - Designed for wood, oil, gas and coal applications.
Ideal for airtight stoves, domestic-type incinerators, steam and hot water boilers,
and central furnaces.
Temp/Guard Chimney is listed by Underwriters Laboratories and meets stan&rd
103HT requirements.
U "STED
To order, determine diameter needed and place in front of catalog number (67GST,
7TGST, etc.). On chimney pipe sections also add the desired length behind part
number. Example: An all stainless section of chimney pipe with 6"diameter and 24"
long is a 6TGS24. Refer to price list for full listing of catalog numbers.
A "
2
i
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOU ATION 2ND [ ] INSULATION
[ FRAMING [ ] FINAL
REMARKS. e H--~ ` w.::~~~-~t~''~ ~ -%:s YYY Yt fie.. ~t,.'7 ~r„
/nwsz
--444
F
DATE r~ INSPECTOR -
t
765.1802
BUILDING DEPT.
v
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[4fFRAMING [ ] FINAL
REMARKS:
2_ *X-1 7Z2
1117
DATE INSPECTOR
i
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS:.
4
DATE 2 INSPECTOR
M-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS:
DATE 's Y~~~~~INSPECTO
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U. {I
BOARD OF HEALTH
FORM NO.1 3 SETS OF PLANS
TOWN OF SOUTHOLD SURVEY
BUILDING DEPARTMENT CIIECK .
TOWN HALL SEPTIC FO R:1
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
NOT It F't; ? U
CALL
Examined , , 19% 2, MAIL TO:
4pProved ~/.--~3 19 ? ermi[ No. ~ . .
Disapproved a/c
uildin nspector)
-+cv Z~ -(-h APPLICATION FOR BUILDING PERMIT
C~A / Ce Date ..~y.~~........ 19
INSTRUCTIONS
I a. so~plication must be c mpletely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
As 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
.iaH 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 in building for necessary_inspec~--
G /
:.?Yl/,' ' ~ .
(Signature of applicant, or name, if a corporation)
52,3,0. . .SF11Lw.9rt)e /9t/ t u~c( ~oc,ti~r,sss"
(Mailing address of applicant)
state whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
..................................p............................:........................
lame of owner of premises. .
(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. 0w.
Plumber's License No .
Electrician's License No .
Other Trade's License No . . . .
Location of land on which proposed work will be done. LL~J~17 E }~(t L+ IZ -(~G of
n ~ ...............T±).-L.WRTL. !.v..........cP 6.- L) .C-.......
[louse Number Street Hamlet
1 y
County Tax Map No. 1000 Section ...1, . { Block Lot ....1..
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 r~rn~
b. Intended use and occupancy ..(:80h ~leJ7~ TJ~~r..62t/v~J7~1.
c/
3, Nature of work (check which applicable): New Building , , Addition Alteration
Repair Removal Demolition Other Work , .
i
(Description)
4. Estimated Cost U , , , , , , , , Fee r
If number of cars ,(to be paid filing this application)
5. If dwelling, garage,
g+ number of dwelling ujilts , , , , , Number of dwelling units on each floor
6. If business commercial or mixed ' • ' . ' ' • • • ' " " " " "
+ occupancy, specify na ure and extent of each type of use .
Dtmgenstons of existing stru Numb if any: Front ,~a; , , , , , ,Rear , , , , , , , , Depth , .
Dimensions of same structure with of Stories . . .
)t alterations or additions: Front . , H,............. Rear . y
Depth -5vZ........ Height
• • • Numb r of Stories'. , . .
$ Height of entire new construction: Front Depth
Rear ~ .
Number of Stories o~ .
9. Size of lot: Front • • •
~ Rear De th
10. Date of Purchase p ' ' ' ' • • • • • • • • •
....Name of Former owner ..w.~•b.!-~•~L~ ,
11. Zone or use distr~ct in 12. Does iare situated .
13. Will lot proposed construction violate any zoning law, ordinance or regulation: i . . .
-raded
Will excess fill be removed from premises: No
14. Name of Owner of premises ,1:1 P?'!' N . (r~Wl7k~ ddress . 5,?~U 5T1. cL,4tr AI Phone No. 7.3 y~~
Name of Architect C ~ I't 066 be`' '
...............Address ...................Phone No................
Name of Contractor,,,,,,,,, Address . Phone No.
L5. Is this
property within 30'0 feet of a tidal wetland? *yes, No ,
*If yes, Southold Town Trustees Permit may be required. N 0 • Puke, kunD M9y _-$k7weeN'
PLOT DIAGRAM Tk ei°2 er Nn T7 L yOu3t'
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 st)names
nd indicate whether
interior or corner lot.
i
I
~0~ S R N Noo
l -
-
Tz )DES APR'°R'Ji;A,
TO REMOVE EXCESS ALL
=FOR ABOVE PREMISES BY
"r "RAD1NO LO Ti
P 11VrW Y CONSTRUCTION
C1:SvDt,?i OONSTtIUCTION
L~_`,l.A IR CONSTRUCT On ,per
t
TATE OF NEWS ORKQ~ S S
OUNTYOF-.~~:-i:~,F,1?~,/
' ' ' ' ' ' ' ' ' ' f i ~5` " Ct + being duly sworn, deposes and says that he is the
(Name of individual signing yontract) applicant
ove named. - '
e is the i
(Contractor, agent, corporate officer, etc.)
• , • • • • . • • . , .
said owner or owners and is duly an thorized to perform or have performed the said work and to make and file this
placation; that all statements containe~ in this application are true to the best of his knowledge and belief; and that the
nk will be performed in the manner setli forth in the application filed therewith.
vorn to before me this
° .4... ~-day of... /Q..., 19~Z
y l.
xary Pub1~Q~, ,off, County
.
Notary Public. State of New Yak
11 . e of ap .
No.4879806
(Signature
Qualified in Suffolk County re of applicant)
cant
Commission Expires December 8, 19
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~J Ili I H copper tubing is used lbinp is used ~
for water distributing 9 distributing _
" system; piping shall be »ngshall be D fJG Komar.
1 1 I - - i of typos;x orL only C or L, only "
- rY n s._ . - W Ai -I- -
ERTIFICATION
(~I L ON LEAD CONTENT BEF ITENT BEFORE
CERTIFICATE OF OCCUP4 )F OCCUPANCY
1 I ~ SOLDER USED /N WA7 ED IN WATER
TEM CANNOT
r- SUPPLY SYSTEM CAN - I
T-1 PLUMBER CERTIFICATI EXCEED 2110 of 1% LE 0 of I% LEAD. t
APPRPVEDAS NOTED iD AS NOTED
ar. = x ~~5y~69~
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NOTIFY 8UI G DEPARTMEC G DEPARIMM AT ,c=~;~Ut uEdy y"~
765-1802 9 AM TO 4 PM FOR TO 4 PM FOR THE ri.'r _ M1: q ,
FOLLOWING INSPECTIONS: IECTIONS:
1. FOUNDATION - TWO REQU FR QdT E16 c /A_Yi Oil FOR POURED CONCRETE TWO REQUIRED
2. ROUGH - FRAMING & PLUMI 'ONCRETE , 1t R v MING & PLUMBING i-
- CONSTRUCTION N
OCCUPANCY OR 4. FINALINSULATION INSTRUCTION MUST ~f``__+N -~'T:~Asc TS,C$19 ~F~- --~7j-iI.rFG•r0'FE'-
BE COMPLETE FOR C.O. FOR C.O.
USE 1S V UNLAWFUL - "LAWFU THE REQUIREMENTS OFA N fION SHALL MEET
THE :NTS OF-THE N.Y. store. RGVeG rv. ICTION & ENERGY DNA" BY
WITHOUT CERTIFICATE CSTATE, ODES. CONSTRUCTION NOT R RESPONSIBLE E IESPONSIBLE FOR
7RUCTION ERRORS
' OF OCCUI ANVY DESIGN OR CONSTRUCTION ERR
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