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HomeMy WebLinkAbout20474-z t ~ FORM NO.' 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20805 Date JUNE 18, 1992 THIS CERTIFIES that the building ALTERATION Location of Property 8145 ALVAHS LANE CUTCHOGUE N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 95 Block 3 Lot 10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated. MARCH 10, 1992 pursuant to which Building Permit No. 20474-Z dated MARCH 12, 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 INTERIOR ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING" AS APPLIED FOR. The certificate is issued to ROBERT & DARICE CLARK (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-237229 - JUNE 2 1992 PLUMBERS CERTIFICATION DATED MAY 5 1992 - MICHAEL DAWSON Building Inspector Rev. 1/81 FORM X0.9 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 ON? Z Date 0 20474 Permission is hereby grant d 11f -3 to , at premises located at ...dz . ~z E'..................................................... r? County Tax Map No. 1000 Section Block Lot No....1.°................. pursuant to application doted ...3y( 19...~.~ and approved by the Building Inspector. o-o Fee $.......~J t f p ".r .O~ • ilding Inspector Rev. 6/30/80 - Form No. 6 yE` TOWN OF SOUTHOLD BUILDING DEPARTMENT JUN 1 ~ 1992 TOWN HALL k,''' 765-1802 i,;.l Leh: 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-O 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 $/1,5.0 , Commercial $15.00 Date k! . New Construction........... Old Or Pre-existing Buildin ,tt~~//~~ / Location of Property.. V IU7 N..:.........1 JC` f/!?~"U -ar House No. Street Hamlet Onwer or owners of Property. ~PI,~. , County Tax Map No 1000, Section.... Block................ Lot.... 1. . Subdivision riled Map............ Lot...................... Permit -..Date Of Permit.v~°.Z/,7 ;,,App7.icant~ y.~L Ilealth,Dept. Approval ..........................Underwriters Approval... Planning Board Approval Request for: Temporary Certificate........... Final~Certicate........... 07~~ Fce Submitted: -Ial(z V_ CD-2~a6$DS APPLICANT YORK BOARD OF FIRE UNDERWRITERS eA, 1 THE NEW r9,001.@71. BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date JUNE 02,1992 Application No. on file ,76924592192 11 2337229 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant ndmed'on the above application number in the premises of ROBERT CT.,ARK, ALVAHS LANE WtS N(OT RT',48, CUTCHOGUE, N,Y, ' in the following location; ? Basement 0 Ist Fl. ? 2nd Fl. OUT Section Block Lot was examined on HAY 21 t 19 9 2 and found to be in compliance with the requirements of this Board. FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K. W. AMT K.W AMT KW. AMT K W AMT. H P 4 b 7 i. P" DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K. W. OIL H. P. GAS HP. AMT. NO. A. W. G AMT. AMP. AMT AMPS. TRANS. AMT H P SYSTEMS AMT. WATTS NO. OF FEET z - SERVICE DISCONNECT NO. OF 5 E R V I C E TYPE L I %]W 3 %~W 3%4W NO OF CC. COND A. W. G. NO. OF HbLEG A. W. G NO. OF NEUTRALS A W. G. AMT, AMP. METER EQUIP. PER % OF CC. COND OF HI-LEG OF NEUTRAL OTHER APPARATUS: ELEC, ROOK HKATERSt2-1.5 K,W.,1,-.75 K.W. HOTORSo1-P H.P, G, F.C.J:o-1 0 & S CONTRACTOR GTC.#57B-E BOX 215 SOUTHOLD, NY, 11971 GENERAL MANAGER Per11 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 IN ANY MANNER. ALTERED TEL. 765-1 ova OraU~FOLkCG, TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR a z P.O. BOX 728 c°rz TOWN HALL SOUTHOLD, N.Y. 11971 "p7Q1 ~ C E R T I F I C A T I O N Date 5/5/92 Building Permit No. Owner Robert Clark (please print) Plumber Michael Dawson (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber's signature) sworn to before me this 5th day of MaY 1992 Notary Public Notary Public,(( t/ iz County LINDA Y. DAWSON Nine Public, Stote of Now York Mo.4694688 tluil0w i in suifoi,c county Tn r^ ~,nr <s'Mirch'10, 14 _13 INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton SCOTT L. HARRIS, Supervisor Senior Building Inspector co Southold Town Hall Thomas Fisher + t,".? : Building P.O. Box 1179, 53095 Main Road Gary Fish Inspector nc Southold, New York 11971 Building Inspector Fax (516) 765-1823 Vincent R. Wieczorek Telephone (516) 765-1800 Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD MAY 15, 1992 ROBERT a DARICE CLARK 8145 ALVAHS LANE CIITCHOGOE, NY 11935 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: Kxx An application for Certificate of Occupancy is not on file. (Enclosed) M No Underwriters Certificate on file. xxx The check is XmWEEtaftnot on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 20474-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. FOUNDATION (1st) c FOUNDATION (2nd) _ cy* A 2. L z 0 ?OUGH FRAME & U PLUMBING ti H m c7 INSULATION PER N. Y. STATE ENERGY CODE 4. H FINAL 0 ADDITIONAL COMMENTS: m x • cn x ^n H F~ \n 0 O W . S r d H M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INS TION [ ] FRAMING FINAL REMARKS: ' I DATE J V INSPECTOR s! B . . . OAFD OF HEALTH . FORM NO.1 3 SETS OF PLANS MAR 101%2 TOWN OF SOUTHOLD SURVEY . . . . . BUILDING DEPARTMENT CHECK - . - - - • . TOWN HALL SEPTIC FORa I SOUTHOLD, N.Y. 11971 TEL.: 765-1802 I:oTLF1 ; 71 f -j~~r.1 V y ALL`? . . Examined 19 HA TO: kpproved Z......., I^Permit No.. -7V Disapproved a/c G'.. (B ing~Inspector) 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 ,ts 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 :tall 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 'tall 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, 59d regulations, and to dmit authorized inspectors on premises and in building for necessary 1nsp t' ns. (Signature of applicant, or name, if a corporation) Sl`fs RtiuNN'S..4,1W;T.. ~uTCNo(44) ,.k-y. (Mailing address of applicant) r3s- ;late whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. dame of owner of premises (?X?t'tT./.:`?T, ,O.Af~ F ...C4Ne,~ . (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 . Plumber's License No . Electrician's License No . Other Trade's License No . Location of land on which proposed work will be done. 8/5 ....!7b?Of! S (q.~/E 4 v.rC:H.o.~ vim.................. (louse Number Street Hamlet p i County Tax Map No. 1000 Section Block Lot ....l 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 O SSQ£ b. Intended use and occupancy . tC. r,QE,oA~~,E 3. Nature of work check which applicable): New Building Addition Alteration ` Repair Removal . Demolition Other Work . 4. Estimated Cost ~P/...... ,i (Description) OQd ! Fee...................................... 5. If dwelling, (to be paid on filing this application) g, number of dwelling units . , , , , Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed 'occupancy, spp~99ify natu and e tent oWe h t,yp o use eptl rZ 7. Dimensions of existing structures,! if any: FrontA59..(0. Rear f¢ QAer/3 ~E Height +a a ii~ C • • • • • • , Number of Stories J. Dimensions of s me structure With alterations or additions: Front Number o Rear Z Depth . Height of Stories ~ . . . Dimensions of entire new constcu~tion: Front . Rear Depth Height y umber of Stories Depth......... . 9. Size of lot: Front , , Rear ,~7 .aZ~ . 10. Date of Purchase ....owl 7p . , , , , , , Name of Former Owner AcNeS.T. ?4W~`z'Yt ~o use district in wich te a , lotion................... . . H. Zone . Does or 12 proposed construthon violate any zoning law, ordinance or regulation: _ , ! 13. Will lot be regraded v~ * 'AV-0- ; Will excess fill e remov d from premises: Yes [o 14. Name of Owner of premises ??'*~92~ (u*ddress .~y ~upy;s , ,Phone No..~~ Name of Architect . . . , Address Phone No. , N ameof Contractor .o,~~OPf . `~~z: eet 'Address d li~ ,*es.. 1~ ..Pone Na% . ~5. Is thisproperty ywithin . 0 feet of a tidal wetland? * *If c~d 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 / Cn n s, ~ •-0 rJ ~ l~ ~l~ , ° o °cl TATE UNTYF FEW YORK S.S! edwt E O of in..( 44 s, . , . • ' ' ' • • • • being duly sworn, deposes and says that he is the applicant (Name o signing contract) )ove named. ! e is the ~1 A) r,L-,2 (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 )rk will be performed in the manner set!Iforth in the application filed therewith. vCm to before me this , p ....day of ...'i 1 >tary Public, unty HELENS HORNS ? Notary Public, tote of fVAyu York No. 4951364 Qualified in Suffolk County :5 (Signature of applicant) Commission Expires May 22J 19 j : n• i;,N•••t ..rti.r_.-, n.:. ~f ~ - !'.J.4•.'.., a,. =.:n.to:w ~ . c • wl_!,Q,,•'.t .+~7iT^% rr'f i1 ~ , r. OWNERS, SUFF. CO. HEALTH DEFY. APPROVAL, H. S. NO.4- O•? j. l''~ ',.n'da ,:.E'~,. ~.n r-zycJ:2 ~•T•:. t`V y-Y• 1 : U[.J'3"Nc7t[i iV. ~y. . "zt w.`.,~;, ' ' •`3''''" _ '+T.'1 ~~i•,i ~.~:e - ~ "'i^•.i^ :r;C Ctr`vS l„ i y 4 rK - ~ ~ yr,. .,;`(TCGT6S-t~?.r4,~•"-.',.... "'i, s~;:'~~~'`~' :r:C: ' .:.L`^i .•o.~'Lh'A.•rT^^:I,'„'t, k,.:," ~s~~:)`-':L< <.'Y.r :V.^a4 `r<t'ir ,~'.\~iy Q AREA-.47.SS S~.f'f; t.~` "-}~;1. .2. -t~~•1 ?N'I•`,..4. Hi. .,s::r:.:f+rY.,.'-:.RS:i ;s•'IS7'~b""Y i:' , ~ ~~^•i ~'Y Vii:... ,v . Q~IY.. '+,C~4 r ~ 3i tss;•i. ~'••G: ; .'j ' 7<'~ < ~ ' : r D:L.7433.F7f-sue F,....-'. eJ~ t SCAM41 F L.,, ^M1`y,~.Yn•- ~1111Y~/O'.tl,0 - N.56.3Z'rGi"E.`'~~': .'::'~~=+'_.-'27561';. _ •','~p`• - :y..; : - p_ ter,: ~`axre • ~~(V/~ 'p.' _ IG~~''r`~^b>a't. Y•~/ 'rte .`b.,' px'~• - % CALK 5.56 32'!C3"W r' -~"1'a`'.t} - _ _ , rSGt-lhf~s1 ©L.: '_tw... _'Z~.i_:.`9,.~>!•F. ~ _ ~~4 _ SURVEY i a~'Dtl10y TD THIS SUBVET I LS A 'AOl WoEAT10N W /,1~~' . 't ~eP~s : -`s- S€GTION 7309 OF THE NEW YORK 9 ' T fit' (.,,J ~n',T.ib., - IDUCATION UW. ~ ~~a•' nbJ ~'Y - `Y ~ COPIES Of THIS SURVEY NAP NOT 6E/•WQ THE LAND SU..VEYOP.'S II.:3~ S:AI OR t P~"' • ? `~~•••~~~,,~~~'••y~~~Si~~~. Q~,{j-`~- EMBOSSED SIAL S44EL I:~i B: GONSIDEYD TO BE A VALID T:-W COPY. . - i..,:' GUARANTPS INDICAT:SHALL eIBP 1 ONLY TO THL_T'S •TCt O:1 Yii.CM THE BPsVE rrl PH acrd are a x. Ca_ O. P. O~r/d[ ^ ' ._a. - ~'r ~''.l,?' i IS PEEPAR[[i, A. D O:1 v.5 .:::Pti i0 Fm ' < `i'>" . ' • ~ ~ ,TIttE COgFANYw's.:VC'J.+L:rAI AOENp Af4 TITLE LENDP•,;O INSmLI-10:4 MIiD H.K_ ANa '-:TO nH AST==LP ni LLSWG r srE r1 ~7./~,~ '±`ne,,:: 4AJ4~r E _PI7V ./l1K"C4w~B dA ' TOAKT ~ Aa %TitNtli MAP 9t- PK.~ IC-~qc. ( EC TXTL' (.~Fff7Sa C N ~ TO Am rH NAa Benue STAMP 1 - - a • : FtrvrE~,' Ac/x}rni5•k',r~fG>'ttr7fs~.St.ttl-Ark sEAL ; G(1'T°Cf 406U Corigit ~IrtcyaiEd Prv.£ewri 7jRLh %~L •''•s GGtQfbY'PGd:tO'3 GU)r4'fst(i~K't~ 7'owN by vQ(JY'/IOY• DER7CK YAN YTLLYL ?.•C`_ - LIC. LAND SURVEYORS .ORE Pp , N. Y... _ . 1 Oft~" o.7liK7YfKV "~ie~i M4' i4tr:I,~r~f.lQ{ ,t c^9f:14t;81o:14':t, Fltr PC 1. 14.Z.. jHS7 HOLE ~ SUFF. CO. DEPT. OF HEALTH SERVICES"' STATEMENT OF INTENT. - - j p. "'':.~-•,'a=j ~i!y,,. .:.``':.'`~..a' j''%~~~"~i_.;^~ sr•; r•r rTl~' }opG,o/t FOR APPROVAL OF CONSTRUCTION ONLY „r. (DaKI .THE WATER` SUPPLY AND. BEWAOE 93 BATE: DISPOSAL'SYSTEMS• FOR THIS REST, DENCE 'WILL, CONFORM To THE d H. S. REF. NO.E g s o 3 ~ • ~ ~ ~ STANDARDS Or SUFFOLK Co.DEFT. % s .'4„:`s ',»,..f.:_'.'.. .OF..H4wLTH.l3ERV70$81'".~.` APPROVED:. 'Yb -ice ra , -'S,r. 'ice,,' ' Mi. r"~ 'L~. 1.:. i:.J.v+l N.:.,T •.iE, .,S•rL'`r,. 114 t' 1C'rD O I'g TL Mov :r L N`g T PG 7k)[5 2t u F/L 14 CLEkR FOIi '~.~T{'I[fRf~: ~ATIapLRFE - - \ FDOV¢ IµSO~ F_X 15-( ZXb - - m , f AAFr[K F.nof M ' / i ~ ~ ~J `fyum ES ~ - IY~oIn ro f m r,_ t, one cIL ` R19 non M19 / . 1 . G EY19^t C:J t 1 1 _ ~~rI251rr "IaC PERU LIWC -n ~r I -/v* r4T -4' I.tl M.r c~ - ROeF BEXRINCr _NnTOLN. - ~ ~ { - ,Yt"-JZI,FY ~'aP~to:'*-,g4uc•w lxx~ AL bV CED MLA R. -Na ;fj60Y1_ -iED C"Onrt ~'Y , ti 0"m ri91c7 ~/ti~~ 3BLD 4oG F" -KE DOV- 7t, AE A: A'T t`J 2eti. 'PUG(`I Aug A9GEb 7~,,H - l1 A LS() Wt(y$fl -'r DV'Y F~ CIT '.F•!.- vW:rfiT(I 3PTH CLonnnj 4AV1E L nn1J3 c±i,)C ~..r n--rr--~h:= - F Win='/ CIft L?( 6'e, hr' s ALTER NA-rC liZ_'r if coPPer tubing is used HE Moni AV for water distributing ALTEIHAT E r I~ I _ i system; Piping shall be UNDERWRITERS CERTIFICATE \NI N,h>bv.l 51 rS Yl J- of tYPes K or_=nay REQUIRED i PCPpRolfED 0 MOTO PLUMBER CERTIFICATION F 3SY R R I ON LEAD CONTENT BEFORE FEE CERT;FICATE OF OCCUPANCY McAn U BUILDING DEPaRR T AT ,6S-1802 g AM TO 4 PM FOR THE QI jl o I P, i SOLDER USED IN WATER FOLLOWING INSPECTIONS' SUPPLY SYSTEM CANNOT I FOUNDATION - IWO REQUIRED FOR POURED CONCRETE m EXCEED 2110 Of 1% LEAD. 2. ROUGH - FRAMING & PLUMBING ' tail V 3. INSULATION 4 ill 4. FINAL - CONSTRUCTION MUST raj ~ CJI BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION 6 ENERGY ~a 3 2% CODES. NOT RESPONSIBLE FOR P-I,``CUPANCY OR DESIGN OR CONSTRUCTION ERRORS l ~ Y USE IS UNLAWFUL r f a o y," VOTHOUT CERTIFICATE 0),F OCCUPANCY - 'bone -4 77 O) V)t_ ) ~k w, ~'u sBNpwnsm _ ---G12! FN P!R { ti y -I!~~-, •V=UNES NEED COVERING TES'RNOBEFORE - 9 I ~l I tams SECraanf ILq ~ mo d. ~ t3 t~ f~ o ; ! 1