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HomeMy WebLinkAbout20506-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20621 Date APRIL 1, 1992 THIS CERTIFIES that the building ADDITION Location of Property 705 FIRST ST.& 17245 NEW SUFFOLK AVE. NEW SUFFOLK House No. Street Hamlet County Tax Map No. 1000 Section 117 Block 8 Lot 14.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 26, 1992 pursuant to which Building Permit No. 20506-Z dated MARCH 26, 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 SCREENED IN PORCH ADDITION & ALTERATIONS TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to WILLIAM C. FISHER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PENDING - MARCH 30, 1992 PLUMBERS CERTIFICATION DATED N/A ~i Building Inspector Rev. 1/81 FORM NO. $ 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 °-N 9 2 05 0 6 2 Date ? 191.. Permission is hereby granted to: /0 eief at premises located at 1 a4.l...... .....U County Tax Map No. 1000 Section f.Z........ Block GG t1............ Lot No...1,K........... pursuant to application doted 19..~~ and approved by the Building Inspector. Fee s•••< / B ding Inspector t Rev. 6/30/80 3q- S ILI Lf ~-j7il/~J'~.F° { Form No. 6 LI \ C TOWN OF SOUTHOLD MA BUILDING DEPARTMENT R 2 61992 TOWN HALL 765-1802 BIZ ' C1E:1''."' TOWN if: O: fV4o1,n 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. 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 New Construction........... Old Or Pre-existing Building J Location of Property !OJT Sr,.... ~t/cy~J ??r/aLC House No., Street Hamlet Onwer or Owners of Property. County Tax Map No 1000, Section..~~7'.~,,,,Block ...?'.Co....... Lot. coz Subdivision ....................................Filed Map............ Lot...................... Permit No ................Date Of Permit Applicant Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: $ SRC. --a4 ~t co -?-ao6a[ APPLICANT d F . J L] M o' d ^ H • IVi~\ d. X SSN3WWO0 jvfd0ISIGaV o _ I 'IVCI3 , ~ _ GGG II a ( 3000 II XDH3IS3 3SV13 '.L 'N Had NOISY INStfI H E DNlswn~a• o I $ 3WVHd HDf o0 z • '2 PUZ) f:OISUQNl10 N 4 L) NoIS`vaNno Q ~ C v a , 06 THE NEW YORK BOARD OF FIRE UNDERWRITERS ITA<;E, I U~,t 1'(RES BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date HIM, 03,1952 Application No.onfilo 62813b92792 1X ~2°1952. THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of WIT,YJAR ei'SIIPIR, 'M I'IRS'T STI?EE2', NLSW SULOFOLh, N.Y. r in thefollowinq locution, M Basement ® lat H. El 2nd FT. OUT Section Block Lot was examined on RAR C U ",to , 1') f 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 FIUORESCENi OTHER PMT K W. AMT K. W AMT KW AMT K W AMT H P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECTT TIME CLOCKS SELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT K, W Olt H. P. GAS H. P. AMT. NO A W G AMT AMP. AMi. AMPS TRANS. AMi H P SYSTEMS AMT WATTS NO. OF FEET SERVICE DISCONNECT NO .OF S E R V I C E NO OF NEUTRALS O.W.O. METER NO. OPEC COND A W G. A W G AAMT. AMP TYPE EQUIP t.e' YW i $ 3W 3A' 3W J$ CW PER .e OF CC COND NO OF 11 LEG OF 11 LEG F NEUTRAL OTHER APPARATUS: 814OVM DNTE CTORt - I. *NO VISUA.L DNFEC'l,Sk "Alb eleCtl:lOal survey l s heea wado of the: exposed elect.cica't aquipawut in the orelRise6 IudiCiateQ." "klo ob-v'iolls unoat;i;;tactory condition walS found. WILLZAE! Fl'2RER 705 FIRST STREW. NEW 9(IFFOLK,. AY, '11.9'ab GENERAL MANAGER d1. VI 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. 3. Nature of work (check which applicable): New Building Addition Alteration . Repair Removal Demolition Other Work (Description) 4. Estimated Cost . x /I um Fee 0 . (2/Q-on f filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use , . 7. Dimensions of existing structures, if any: Front Rear Depth Height Number ofStories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front ................Rear Depth Height Number ofStories 9. Size of lot: Front Rear...................... Depth 10. Date of Purchase Name of Former Owner It. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation: 13. Will lot be regraded Will excess fill be removed from premises: Yes No 14. Name of Owner of premises Address Phone No............... . Name of Architect Address Phone No............... . Name of Contractor Address Phone No. 15. Is this property within 300 feet of a tidal wetland? *Yes........ No.X....... *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. A 11 As ar, DATE: J ~ r3xp NOTIFk T U N CB 0E6'ART - T T 765+-1802 9 AM TO 4 PM R THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.1? STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS STATE OF NEkVOR1r~7 / S.S COUNTY OF. , . • • • v ~k~ 1 • Ai,a. vy.~_' •(2'.. r Yom' being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the p..c~?Y> 2 (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 19q 2 c9~ . . ~ CLAIRE ...d ~ y of Notary PubliG~,1 , . County GLEW Notary Public, State of New York No. 4879506 / • • s!.." • " • • • Qualified in Suffolk CountY 2 / (Signature of applicant) Commission Expires December 8.19 r r BOril 5~~~~i~ ' FD OF HEALTH FORM NO.1 3 SIiETS OF PLANS TOWN OFSOUTHOLD SURVEY MAR CHECK pl.rsr;,gt_ ~t;•~ 30UTHOWN AL 1r1971T SEPTIC CORN TOWN OF SOdJsHOU) TEL.: 765-1802 NO J-4 FY i ••-7711 CALL t J SI~ Examined,? 19 .7r MAIL T0: • • . Approved , 19!~ I?~. Permit No. ~ 6 Disapproved a/c (Bu ding Ins a or) APPLICATION FOR BUILDING PERMIT . . .A..R.c.......,19 °102 Date . 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 ofi 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- cation. 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 insp~ectiof s. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..............................................................1....... Name owner of premises .......i~ Q SMz l (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ....................i................. (Name and title of corporate officer) Builder's License No. ........I Plumber's License No. .......I,................. Electrician's License No. Other Trade's License No. li 1 Location of land on n which .proposed work will be done . ................................................I F............ i ..............r~t House Number Street pp Hamlet County Tax Map No. 1000 Section Block ZAX0......... Lot . ~!t pop Filed Map No. Lot............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ! pVSO , , . si' a'•' y .&:~41. . . e?. u~, i^ art r ; b. Intended use and occu ©,ti. y U.. v panty of ,,S,6ra•?:... , . a. d~a14;i~,aFR«.2:?ti.nritf.a rtc+da-.atrrws'S ?r ~ i ,r~~~99~~i~A~y4J'7w1,~ Q`t~ Yti~ G yv. 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