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HomeMy WebLinkAbout21105-z r~ FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23361 Date NOVEMBER 21, 1994 THIS CERTIFIES that the building ALTERATION 375 FIRST STREET & Location of Property 2665 JACKSON STREET NEW SUFFOLK NY House No. Street Hamlet County Tax Map No. 1000 Section 117 Block 9 Lot 31 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 16, 1992 pursuant to which Building Permit No. 21105-Z dated NOVEMBER 27, 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 FOR ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to GEORGE & LAURA MAUL (owner, lessee or tenant) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N292116 OCTOBER 12, 1993 PLUMBERS CERTIFICATION DATED NEW SUFFOLK PLUMB & HEAT OCTOBER 17, 1994 Building Inspec Rev. 1/81 r "RX 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) N 2N9 21105Z Date ...1? .7 19.9 Permission is hereby granted to: ire..... ir7,7- ro ~ rr.! ` at premises located at ....,..7 ° ,0 .........................................................rr............................................................................................... County Tax Map No. 1000 Section ..1.................. Block .....49........ Lot No....~a pursuant to application dated ~ 19. and approved by the Building Inspector.' 1111,~'I92- Fee $..107.jt® . G ............:~~t~.............. uildi Inspector Rev. 6/30/80 Form No. 6 v1° ?i7 c TOWN OF SOUTHOLD w BUILDING DEPARTMENT ~9~4 TOWN HALL 765-1802 DEFT. rove of sOU-rwai APPLICATION FOR CERTIFICATE OF OCCUPANCY 1. 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. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 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. 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. 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 - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15..00, Commercial $15.00 Date ©45^:._~) (s.1.9.9A ew Construction........... Old Or Pre-existing Building.. ocation of Property ...4?~P . , l4Cl C r4W..&A. 0A V . House No. ! Street Hamlet nwer or Owners of Property... „ ~q~CtcRJ ounty Tax Map No 1000, Section 1 0.....Block...... .{......Lot.................... ubdivision ....................................Filed Map............ Lot...................... ermit No,')1105 Date Of Permit.) J ).Z,7. Applicant. c?~5,`t ealth Dept. Approval AJ/,',,,,,,,,,,,,,,,Underwriters Approval... ..Cr,9 ll~r/j,,,.,,, tanning Board Approval d S1 q3 ....1.J/a equest for: Temporary Certificate........... Final ee Submitted: Wit APPLICANT tyraw:a~wuv5cr?a^Wx.~~=. y!eiiC„»,,.--,...z•«.,.r..d-.xrvn._ s... _ ..,.e.•mo-nM,..a... rt, m..na.~..a~.,__.,..o.,,«_~,,.. xw.;aa,~b~:vi~w.~-.:-a: e INSPECTORS SCOTT L. HARRIS, Supervisor W Southold Town Hall Thomas Fisher Building Inspector P.O. Box 1179, 53095 Main Road { ry `s Southold, New York 11971 Gary Fish /'A 4.t a;JS Fax (516) 765-1823 Building Inspector Telephone (516) 765-1800 Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE : Building Permit No. .-2I 1O 7 Owner: Gr.,^)C4C:, ry 111Ic/-CA YY\rt (please print) Plumber: It- i,"A.L lun-&iY l MG>~~Uq ~~cjt~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. ~F ( Zr ,ignature) Sworn to before me this day of Q~~JQ/~, 19~. Notary Public, County (a4 r 4ary Pub c c ml In 9G n~omm OCT 7. I n9A lELD 1:::..7 1 i%:i LNT~ p~ OUNDATION ^(1st) H k OUNDATTON (2nd) o~ ;OUCH FRAME & .PLUMBING 6~u 49 1 N 1. LL "a, 4 n =17SULATIOY PER N. Y. STATE ENERGY CODE Fz;raL m x I 07, N r~ r r. z- - -o H ~O~OgpFFO(~~OGy o ~ Town Hall, 53095 Main Road y Z Fax (516) 765-1823 P. O. Box 1179 W Telephone (516) 765-1802 Southold, New York 11971 ~.j. O! viol ~ ~a OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD October 18, 1994 Mr. & Mrs. George Maul 111 Hewlett Avenue Patchogue, NY 11772 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xx An application for Certificate of Occupancy is not on file. (Enclosed) xx No Underwriters Certificate on file. xx The check is not on file. $25.00 No Health Department Approval on file. No final inspection has been made. xx No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 21105-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. q U-- 111 Hewlett Avenue Patchogue, NY 11772 November 11, 1993 Town of Southold Building Dept. Town Hall Southold, New York 11971 Attn: Building Inspector Dear Sir: We would like to request a six month extension on our building permit No. 21105Z. Due to the fire last year at the New Suffolk Post Office, we were forced to change the order of our projects; therefore, we have not been able to complete construction as planned. Sincerely, (`f ~ 0 George Maul 11 r ' ' t ~Y H a i . r TO ti OF SOUTf iOLO M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU TION FRAMING [ INAL REMARKS: _9,~i /4,-" o' DATE D / INSPECTOR t Y 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: , x 0, If- DATE INSPECTOR r 4a f M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. } F NDATION 2ND [ ]INSULATION [ FRAMING [ ] FINAL REM RKS: DATE J INSPECTOR THE NEW YORK BOARD OF FIRE UNDERWRITERS PA(38 1 X 91.(35092 BUREAU OF ELECTRICITY _ F 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date OCTOUf'.R 12,199,1 Application No.onfite 0523269'!93 N 29?116 THIS CERTIFIES THAT only the electrical equipment a r described below and introduced by the applicant named on the above application number in the premises of GEORGE; & [.AURA HAUL, 2665 JACKSON STREET, POLE-NYT-S, N9W SUFFOLK,, N,Y. in thefollominq location; ? Basement © Ist Fl. ? 2nd F7. OUT Section Block Lot was examined on OCTOBER 0 7 , 1, 9 9 3 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER PMT. K W. AMT. K W. PMT. KW. AMi K.W. AMT. H.P DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AML K. W. OIL H. P. GAS H. P AMT. NO A. W G AMi. AMP PMT. AMPS. TRANS, AMT. H P SYSTEMS AMT. WATiS NO. OF FEET SERVICE DISCONNECT NO. OF S E _ R V I _C E AMT. AMP. TYPE METER , RW I 03W130 3w 3,e dW NO OF CC. COND A. W G nN001EG A W. G NO. OF NEUTRALS A. W' G EQUIP. PER 9 OF CC. COND OF 11 LEG OF NEUTRAL 150 C[' i Y 1. 7. i I. OTHER APPARATUS: PIIW ELECTRIC L7.C.#+11;31_E `~~%9 P.O.boxrax 84[ FORT JEFFERSON, NY, 11777 GENERAL MANAGER 1.1. 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. N/F VICTORIA S 83°5/'E 50.71' CM Fd. N 0 h 0 17.3 8.2 STUCCO STRUCTURE 13.5 25.6 2 J 26.2 74» 17.1 y WOOD FRAME Y BUNGALOW U (ELEVATED ON 23'2 ^~7 _ BLOCKS) - Q p -17.4 c) h CL a -LL B o z- m Guarantees indicated here an shag tut only to the person for whom tM survey W 14.0 ~z.T 16.2 is prepared, and on his behalf to the 11 and ui ,,r 3 tide company, Govermentai Agency, Q lending institulio, if listed hereon, and Q 2 STORY N to the cssignees of the lending batif" WOOD FRAME o Guarantees are not transferable to ' o u RESIDENCE 0 additional institutions or subsequent owansm ~ y - O 30.3 6.2 h a; CELLAR a i'nauthorized ahsroNon or addition to this Wive I.P R1. ENTRANCE - y is a violation of Section 7209 of N 8.3° 51'W 50.66 Now York State Education Law. JACKSON STREET Copies of this survey map not bearing the Land Surveyors embossed seal shat not be considered to be a valid true COPY. TM 1000-117-09-31 MAP OF SURVEYED: 27 APRIL,1991 SCALE 1° = 20* CM Fd.: Concrete Monument DESCRIBED PROPERTY Found I. P. Fd.=Iran, -Pipe Found. SITUATE HAMLET OF NEW SUFFOLK TOWN OF S.OUTHOL,D, SUFFOLK COUNTY, N.Y. SURVEYED FOR: GEORGE LAURA MAUL GUARANTEED TO. SURVEYE-0-„~IY; GEORGE', LAURA. MAUL STANLEY J ISAKSEN, JR. TICOR TITLE GUARANTEE CO. - P,0- BO)(294 - TOWN OF SOUTHOLD NEW SUFFOLK,N.Y., 11956 516-734 ,3 LICEN AND VE OR'" N.Y.S. IC NO.,'a9273 91 R 456 (~4 1, BOARD OF HEALTH FORM NO.1 3 SETS O~PL \:IS TOWN OF SOUTHOLD SURVEY . - - . . BUILDING DEPARTMENT CHECK r TOWN HALL SEPTIC FORM SOUTHOLD, N.Y. 11971 13€ ssf. isTEL.: 765 1802 NaT I FY y d '+'OWN Car I THOt.C a,-.. - CALL .VM-!...a3 Examined . , , , , , 19 / MAIL T 0 : • • • • . Approved , 19;F,.2 Permit No..J~ . . Disapproved a/c _ ildi ector) APPLICATION FOR BUILDING PERMIT Date Orm•. i.~ , 19 CR.Q 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 ar'''eas, 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, buildin e, io ing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspe ,pfibn . (Signature of applicant, or rename, if a corporation) 4 TO (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. QLt)(1~' Name of owner of premises ..c.,aocc~e -T. ~-.Ovvvor f~CwA (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ....&J/l4.... 6.tkiJJC r . Plumber's License No. I Vtq ` i . Electrician's License No. NR Other Trade's License No. 1. Location of land on which proposed work will be done. .................C . . - ~Ve~r..S~ ~ 1 ~ : Ja0on y House Number Street Hamlet County Tax Map No. 1000 Section l.{ .7......... Block Lot Subdivision 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 ......~~`y/c CLl7L~~ _ ;.;`z, . b. Intended use and occupancy / 2~ ( End m em: 3. Nature of wor check which applicable): New Building Addition Alterafion . Repair ;val Demolition Other Work (Pe,¢ption) 4. Estimated Cost ~ Fee . . (to be paid on filing this application) 5. If dwelling, number of dwelling units ) Number of dwelling units on each floor:....,I, . , , , , , , , . If garage, number of cars I .ialA . . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use : 7. Dimensions of existin structur$ e ' g , if any: Front .5C) j.5 Rear , : .4 Depth 5! . Height . . . . Number of Stories n2.......... . Dimensions of same with alterations or additions: Front ...31?. Rear ~S.S . Depth r;5P .y . Height Number of Stories ....14?......... t . 8. Dimensions of entire snewtconstn ction: Front Q.:. 3 E Rear ~ 15 Depth ~v?•.y Height Number of Stories 9. Size of lot: Front ,$C7. Rear .....550...71...... . • • Depth • . • • . 10. Date of Purchase (o%? pretJ.G! Name of Former Owner ...f.-f."0A .MlrraAl , , 1112. . Does Zone or rouse district in which o any zoning law, ordinance e o or regulation: 170 13. Will lot be regraded regraded construction is are situated. . l~cun! . n . e. r) io1 Will excess fill be remove from premises: Yes No 14. Name of Owner of premises 0a0CgC • M. 0_(4.... Address 41.1. i.-4.eW)e.h1 . A4YPhone No..H.7~T:4C273.... Name of Architect Kew. f3c%b.1i:S Address 175s. Cr+robciP_ j.C_F!1Phone No. (7ab; Name of Contractor t ocgC .f lcu~~...... , . , Address to. 1-4VQCV.)e*AVe-.ne No..5/.-IsS.:9:7 . 15. Is this property within 300 feet of a tidal wetland? *yes;,,,,,, No... *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. Sew o,- c~ STATE OF NEW,,VQS2K, S.$ COUNTY OF. . Sfil ru ` apo'rN of~individ al signing . • . • • • ' • • • • • being duly sworn, deposes and says that he is the applicant contract) above named. He n is the • •1~. • (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly i}uthorized to perform or have performed the said work and to make and file this application; that all statements contain $d in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner srrt forth in the application filed therewith. Sworn to before me this L. da~~y of.. . U..., IA?_ Notary Public, , • • . ounty CLAIRE L GLEW Notary Publio, State of Now York No. 4879806 (Signature of applicant) Qualified in Suffolk Co emy Commission Expires Decomw 8,191 REVISIONS SV rrv.e w L 0 , AN D-LE A LLN[ SYSTEM PLUMBER CERTIFICATION ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY SOLDER USED IN WATER I 91 SUPPLY SYSTEM % LEAD. ' EXCEED 2/10 vi ne~-, 4 g ~ fi ONDERWREQUIRED~IFICATE UNLAWFUL .~4 T V4,jTd jo `T CERTIFICATE OF OCCUPANCY rL==-' ` NO S' U ~ l .y.. t %50 t , I; slab 6.1 -V~:,~1[7`~Mo;` evi l~, i~ K q'a P1 1 Y--.. ~1 - v c~ O below l 4% ti,.. k J All~ __A'jr4~' oFt _r as Show n. 71fe' a. =Y.sta11 hbsek~o<tv~-~4trauaLtou~J 3. All w c rk, *o u yt ! w ~fi . I NFp _•sta~lavas awd local cC'8ez; 4. lv~ "tate howiel +0 COMP13 vi&iN Rl`!~cd `iefi1caa~ f+ - ,.~..dlcS.t~ r'~~'~ 1~--t-1~ra~ln. ra~"f'. ~ ~..~t--_._...L.~.~~ I _ ~_N/ } Liv,"c APP OT AS NOTED _ DATE!/j4 Z 9 B.P. N r/ FEE: BY, NOTIFY RU/`?IL G DERAR E T AT x. a onn cnG THE ,i^5~ LaV. 1. r - f- S(?L*1ah FOLLOWING INSPFCTTWO / O 4 N 1 FIiIUNDAi16J~ TWO FlEOUIRe`C1 i ~ , ? FOR POURED CONCRETE f na 2. ROUGH 'FRAMING & PLUMBING CK O ddrr 7 \ „r'9 Y.P 9 INSULATION 4. FINAL - CONSTRUCTION MUST ALL CONSTRUCTION SHALL MEET ACA~LE "'T TS OF 'THE N.Y. A'~ THE REQUIREMEN . R STATE CONSTRUCTION & ENERGY CODES. 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