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HomeMy WebLinkAbout20477-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No: Z-29149 Date: 12/27/02 THIS CERTIFIES that the building ADDITION Location of Property: 150 HOBART ROAD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 62 Block 3 Lot 4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 6, 1992 pursuant to which Building Permit No. 20477-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 TWO STORY ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. THIS CERTIFICATE OF OCCUPANCY REPLACES C/0# Z-22762 ISSUED 12/2/93. The certificate is issued to THOMAS K TALBOT & ELLEN E KRUDOP (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. H 037268 03/30/93 PLUMBERS CERTIFICATION DATED 11/30/93 THOMAS TALBOT 7/iz'd Si `ature Rev. 1/81 FORK 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) N1119 ~Z Date Rte 19.9a- 20477 Permission Is hereby granted to: 'T3oa 119 c sal, !:!~......~.!9..'. to . s.4 a ..~s's2.... ,1... D 1^ Cam.. ~o- JP 44. at premises located at ....kY ......................1.`:............... County Tax Map No. 1000 Section ~.fBlock Q...~...... Lot No.....11 pursuant to application dated .kY!rS l....l 19%. and approved by the Building Inspector. Fee Building Inspector Rev. 6130180 i i FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22762 Date DECEMBER 2, 1993 THIS CERTIFIES that the building ADDITION Location of Property 150 HOBART ROAD SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 62 Block 3 Lot 4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 4, 1992 pursuant to which Building Permit No. 20477-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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to THOMAS & ELLEN TALBOT (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. H-037268 - SEPT. 30, 1993 PLUMBERS CERTIFICATION DATED NOV. 30 1993 - THOMAS TALBOT d, B .lding Inspector Rev. 1/81 Form No. 6 , r TOWN OF SOUTHOLD BUILDING DEPARTMENT s 9 - , 3; 3 TOWN HALL ~a' 2 3 d~ DEG 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANC TOWNorSOUT}£(XD g 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, Co ercial $15.00 Date ::ew Construction........... Old Or Pr/e/-e/xisti g Buildin Location of Property.... House No. Street Hamlet Onwer or owners of Property... r County Tax Map No 1000, Section... . ....Block Lot 5.............. ':ubdivision .Filed Map............ Lot...... i'ermi[ No.~u.? 7...... Date Of Permit.. e./,~ 1.~ ,Applicant ilcalth Dept. Approval ..........................Underwriters Approval......................... ''lanning Board Approval ::equcst for: Temporary Certificate........... Final Certicate........... 'ee Submitted: c~~. N la~~ Cam p' APPLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 8038652 BUREAU OF ELECTRICITY BS JOHN STREET. NEW YORK. NEW YORK 10038 Date 8CP71F7MER 34,'1993 ApUcotionNo.an/ile 80062093/()3 11 03'72.CA THIS CERTIFIES THAT f E:ttRIT NQ, 24$77 only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of THORNS TALRt)T, 150 11011AR1' ROAD, SOUTHOLD, N.Y. II--~ in the following location; L'J Basement 2 LJ 1st FL M.J 2nd F'1. 41'IT Ser[ionly t Blcek3 Lot 4 uns examined un S L P 9. h R I3 E R / F 19 9 3 and found to be in compliance with the National Electrical Code. OINCANDESCENT FIUORESCENi OTHER AMt. K W AMl K.W AMi NW M1i. K W AMi H P F7DRYERSFURNACE I7CHE5 FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS 2MOTORS FUTURE APPLIANCE FEEDERS SPECIALREC'PT TIMECLOCKS BELL UNITHEATERMULTI.OUTLET DIMMERS AGAS H. P. AMT. NO. A. W. G. AMT. AMP. AMT. AMPS TRANS. AMT H. P SYSTEMS MAi. WAt15 NO. OF FEET 1 2112 DYS11 SERVICE DISCONNECT NO. OF S E R V I C E AMT. AMP. "PE METER EQUIP. 10 ]W 10 3W 3 R 3w 3,e Iw NO.OF CC. COND A. W G NO A W G. A. W G. PRO OF CC. COND NO, OF HI-LEG OF HIAEG NO. Of NEUTRAl3 OF NEViRAI OTHER APPARATUS: G. P,C.II-11. 'SHOEF DEIT11CTOR~-2 THQPIAS TALBOT 154 EIOAAR7' ROAD SQIITHOLI.1, t1 i'f 11971 GENERAL MANAGER 2 7, Per This certificate must not be altered in any manner; return to the office of the Hoard if incorrect. Inspectors may be identified by their Credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. o~ol.v ~l2 TOWN OF SOUTHOLD TEL. 765-1802 C' OFFICE OF BUILDING INSPECTOR P.O. BOX 728 •Y ens t R TOWN HALL SOUTHOLD, N.Y. 11971 C E R T I F I C A T I O N Date 1111-3f /f 3 Building Permit No._7 Owner (please print) Plumber (please print) I certify that the solder used in the water supply system contains less than 2110 of to lead. (plumber's signature) Sworn to before me this q6 day of 19 93 . Notary Pu 110tary Public, County ow"Mm Exxpkgs Xs 'ns T 994 M-1802 BUILDING DEPT. 1 SPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL p, REMARKS. I I DATE ~i INSPECTO c)c,q77 765-1802 ag"~ BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ l FRAMING [ ] FINAL REMARKS:. I ~ i DATE o~ INSPECTOR LD I c . _U;J UA: ^ ~ ~~'MhiENT~ w =0 FOUNDATION (1st) - i~ FOUNDATION (2nd) L Cx.ru ~f= p m!t 2, z T ROUGH FRAME PLUMBING 3. a ~ INSULATION PER N. Y. m m STATE ENERGY CODE 4. m H FINAL E ADDITIONAL COMMENTS: m ~1 x~ • m x •r0 ^o H / H O V' • H y S C7 y M-1102 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL REMARKS: DATE INSPECTOR ~ M-1802 BUILDING DEPT. INSPECTION ] FOUNDATION 1ST [-V ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: 0 DATE ~ ?9~._~~°, I fiOAFD OF HEALTH ' ~•.'.m.,.. - FORM NO.1 ?3/SETS OF•PLANS li 4 Mp~ 6 992 TOWN OF SOUTHOLD RVEY BUILDING DEPARTMENT iI!I TOWN HALL SEPTIC FORM 81.i OF F tte3 la{UP1 70W tS1'F~IOtD ~ SOUTHOLD, N.Y. 11971 . ,nr ..uJ TEL.: 765.1802 CAL • • - Examined NAIL TO: Approved 199~ .Permit Disapproved a/c . . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ......3. . y 19 .y. - 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- catibn. 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 inspections. (Signature of applicant, or name, if a corporation) .......0?D:.~ox ......./.v~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises howtwS, , / be At~~°?° (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. " N4 Electrician's License No. D w N 4!Z Other Trade's License No . 1. Location of land on which proposed work will be done. House Number Street Hamlet County Tax Map No. 1000 Section Block ....3 Lot 9. Subdivision Filed Map No. Lot............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ©/11 YA'><C ?IC Fq~,+/a Gy W£~~~N a. Existing use and occupancy 4............~.../.... , . . b. Intended use and occupancy ~``.?°9ft.. 7 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost 6.0 Fee . (to be paid on filing this application) 5. If dwellins, number of dwelling units Number of dwelling units on each floor ' If garage, number of cars I.. l . . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . 7 Dimensions of existing structures, Number if any: Front A . , . , • • • • Rear ...:4 Depth 9' Height bof Stories ` ...................................l Dimensions Depth , ...ensions o ` sa with alterations or additions: Front , Rear. 19. P Height 9: Number of Stories . 8. Dimensions of entire re new structure wiconstruction: Front 4, , Rear fg.'...... Depth ..,N Height Number of Stories . , y ~ , , . . .S . . , . . 9. Size o 10. Date of of lot: Purchase Front 7.. } • u Rear 9i Depth err . , ~,'.R l Name of Former Owner rw q~p~.. Co l 11. Zone or use district in which premises are situated Al;+ A/ • •0y;'iwfaS 12. Does proposed construction violate any zoning law, ordinance or regulation: . 41/5 13. Will lot be regraded !VA . Will excess fill be re[noved from premises:' Yes Q 14. Name of Owner of premises , ip/a4 f , , Address Phone No. 2' 9.-. ? `13Y... . Name of Architect . , aw n s?~ , , • , , • • • , • • , , • Address . .......Phone No Name of Contractor ..0:YX? : Address Phone No............... . 15. Is this property within 300 feet of a tidal wetland? *Yes........~• „ *If yes, Southold Town 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. w ~ ° ",h d fro?~tl .U/i.?B P a daroela ~ 0 .I O r~ ' ch c c~ Awe n c H 'A v~ S, 76'05' ZQ" W, - 75.4 E OF NEW ,O t, S .S SOU - NTYO~-Fy.. ~c....... • • . , • • • •I• " • • • . . • • • • I Q•4 Cam , , being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He i the , • • • • • • (Contractor, agent, corporate officer, etc.) of 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 work will be performed in the manner set forth in the application filed therewith. Sworn to before me this y of. ...0.^:,e. C!`.... 19 aZ ~o l k Notary Public, ~ ..i. County ~ ~ ~G'Ul~• . • . ROBERT I. •bf KY. . ~G r . NOTARY pUBLI (Signature of applicant) No. 4725089, I~ Cqug~1 Term Expires Y 3n Y~2• I pm IfR T tfi ' \ W f y ? U COO ~ ~ d elA ti) ~JiRF+ ve6.1~"? +Ab "I ol : ~ sale- ~ ~ fi f MAR " 61992 rcav~na~i t~',~~ Tr ~F'O-~YWC~p.4 z 4Q All C ` to f x1 " n, orf'" ~ara~t ~1l .,.4 r4 k) ~~t ryy t ~ +F t tr i 'h? t Irk ~a' t ~ " ///ttt l i 4 M•'3 y p TZP r V~ ,rte.-f. Jn~ furxirw! sltsration or adiRyp 11!^' m ih s aumPp ce a violation of - cation Cfl of t<te NPw Ygrk $tafR "atWn Law. Copl Ica 0! this vary y in betifi(tQ r not G ..•e".„.-_..e_._,.....r--..n.~' --i•. ~-•-.--~~---^-.-^.'.r. • emboss ba a7yahdtf n ¢A egyl(~ryN~ ;r tP bo- a vabq uue tropy,, " I A P L1~' Y" ,Z O 4- oZ7 Y Guarantees lndiantQd hereon th®p rytt! 4 only, io file parson for Wry, e .mil U V, Y = j4Q F= ~.r.~ - is ,repaeed, and on his beh if mthe to thte r=i Mut romaany, governments) agenoyatM rr yam! ~^?f' , Icndiny In81~~rt~ R~ NMd har60n cued / 7j• .!"Y'7 f f~'" ' to ehe -era e a Inndinq lnAti •7~•-^: ,i----•-_ •-•-----*---+-•--r*-,~.---~ tu;ion. GUb,an:easare not tronsferahb ~.3 .AT- - to aautiobal institutions or 9u 'ry pU'rHQLP ,H~t~S.. p.eawa 1~ "c u raL /t' G04ll.lT-Y, y ()f NE 4. Y d/¢",,,XLrtt~i9 q Afk•IX.,IRx':,.~1 s M~ .r - ° e J°~GQl+ L7 s~.. FQ~GY, V'j 0 • h o0 0 ~n"`~ "r G.c d,kQt,~,.. ~+AF+~-~°h4~~,~ ~',Q," ~ r s , ,1 ~ Gi w rr>GxIY6'lVb9/~ ? ¢ ~,~",L"~y~-~r q. ~~~ir'rf,•~`'- r - ' ,i, 4roM F+~~ A . p~ ~ fii~ ~'L.~ CS 25y'ryro S~..r} ~(O~4w... ~ 1 - i AcifFh Go. 'rrtt',rcwt~r~ ~`~~arvo~~~ ,arrsx o~La.IV~y'e= i... """+•'^'!'~^"*+"'<rrh^^""•'•' ,«.w+~w.--y. • m ,,...+.+»+-rr~.y,.wwwl~vnn.,p~f-q!^M=w.~•,»wr~.°,r^~y`^";.°H'r. + MAIN ROAD NYS 25 C~ J O WODA j6 OS Z wA~ -75-00 3 4~2 NSF POL O'E eLOCK s N FRPMU rn. .SHE N 'o. .o 4 2 PS N Cn Z NE510NE pRVEWAY PP (J W 6C n LL GA`Gr^ COVERED f£vw ~O EONTRY N "c \ r c 0o 9 0 o. Z~A PIPE Npa FOUND 75-00 N~nSGUNPNP s MP O EQE NORiN OF UNE gEN4 EN NN IN ~ W N~F S X605 GUARANTEES INDICATED HERE ON SHALL RUN ONLY TO ME PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY, LENDING INSnTLOON, IF LISTED HEREON, ANO TO THE ASSIGNEES OF THE LENDING INSATUTTON. GUARANTEES ARE NOT TRANSFERABLE TO ADDITIONAL INSTIMPONS OR SUBSEOUENT OWNERS UNAUTHORIZED ALTERATION OR ADOMON TO THIS SURVEY IS A NOLAPON OF SECTION 7209 OF THE NEW YORK STATE EOUCAPON LAW COPIES OF NIS SURVEY MAP NOT BEARING THE LAND SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE SURVEY OF COPY DESCRIBED PROPERTY SITUATE SOUTHOLD, TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. SURVEYED FOR: WILLIAM RUE MARGARET T. McMAHON TM# 1000-062-03-004 SURVEYED: 25 NOVEMBER 2002 SCALE 1"= 20' AREA = 5,484.11 S.F. OR 0.125 ACRES SURVEYED BY STANLEY J. ISAKSEN, JR. GUARANTEED T0: P.O. BOX 294 WILLIAM RUE NEW SUFFOLK. N.Y. 11956 MARGARET T. MCMAHON' COMMONWEALTH LAND TITLE INS. CO. 631 - 734-5835 CTX MORTGAGE CO. LICENS D, LAND S EYOR NYS Ic. No. 492 3 02R1795 f CONSENT TO INSPECTION THOMAS K. TALBOT the undersigned, Owner(s) Name(s) do(es) hereby state: one of That the undersigned (WA-are) the owner(s) of the premises in the Town of Southold located at 150 Hobart Road, Southold, New York which is shown and designated on the Suffolk County tax map as District 1000, Section 62 Block 3 Lot 4 That the undersigned (has) (have) filed, or caused to be filed, an applica- tion in the Southold Town Building Inspector's Office for the following: Updated Certificate of Occupancy That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws, ordinances, rules and regulations of the Town of Southold., The undersigned, in consenting to such inspections, do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used as evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: December 6, 2002 (signature) Thomas K. Talbot (print name) (signature) (print name) m teC ~ ~ /gyp ,('C c b a 0 APPP,OVED M'~ WTED f:,47E 9 A-b B F td i S'CtTiTY Rf' nr '(-rat I° r,5 t.. F tit (l o') n trlN }~t )i i w N-11. -SHALL "r- T 4d~ T E ZEQUIR MEETS OF THE NY CIS ..5. RESPONSIBLE F-H +f.;IL OR C(7,,,ISTRUCTION t R -)f R / STaQ y oP~~ovE I G Q- y I ! / S720R? N X D4) ~ 7-Y 0// o ~ yai,,f Z~ yY,wdaV/ I i - - - - - 14 /9 1 0 i I 1 - i f I I ILL, t-I ~ 4 I ! I I I f- ~ I i I I, L- - - !t v T _t- It ~ I ll } I- _ 1 1 ~ I ~ I _ T 1 ttt I I 1 ~I I I I _ I /~ontA .11~io ~ I I --r- I---I-I - I ~ I T-- f ~ I I i ~BJrtp ~ Cg:l n ~F,,4y ~ C, t4a WS-101,13 F / ~OJ OI? + Y L VnN e l m a x G ~'i ~ wn» ~a.aa d.Jbly 2k~ .v As4-r 1ng~lnd.e ~ ~ $I"~y ~xG x8' v/Af1 As i J