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HomeMy WebLinkAbout20249-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26867 Date: 01/03/00 THIS CERTIFIES that the building ADDITION Location of Property: 540 MILL CREEK DRIVE SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 135 Block 3 Lot 43 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 31, 1991 pursuant to which Building Permit No. 20249-Z dated OCTOBER 31, 1991 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 KITCHEN AND DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to CHARLES A VANDUZER & WF. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. PENDING 12/27/99 PLUMBERS CERTIFICATION DATED 12/28/99 PECONIC PLUMBING & HEAT. Building Inapec r Rev. 1/81 1fO16M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT tTH15 PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N° 2 0 2 4 9 Z Dare 19..x.,1... Permission is hereby granted to: t to ,~....:..~........~r..?-1~.... ~ ..~~r~,~..<<-r.. of premises located ot ............./~.1~...::.:~1.1.~. .......,1~.:~ ~'l~ll..:~............. . County Tox Map No. 1000 Section ...~..,,~„S. Block ......3 Lot No. ~Q~ / pursuant to application doted ....l..t.......X../ 19~{, and approved by the Building Inspector. Fee 5 Building Inspector Rev. 6/30/80 _ -_-_.____u~____.,.__.__._._._..____~.__._.___...~_~,.__~___._.__.~____._..~_....._....~___~....._..n_.~._v...,.e._....___.. i ~ ~ . C+`,~r ~ ~ f t'~_ C' _ t~ ~ ~ t~rtCJ~ Sri ~y a, e ~ A2,~'.Ff.7 ~rv~. ~ t' t IIU ~ tv' rv ~ ~ r~7 i ~ ~ `T(A7. L~:'CL'~: ~ . ~ I~ ! a~ Q: ~ ~~l/~ 3 ~ ~iz'~ FiY. ~l 1. ~ r C ~ ~ ~ ~ p, ~ ~ ` ~ .f.~ ii; .(..-e ri ^v^ t t i.. r' - I~ LTyms^'"`~ a T'~„ r - ~,.~f wt ! ~ ~ dy~ i 7 @~~ ~ y~ ~ ~ ~ # 3 it t ' ~ ~ M~ { rR W iff1'. i ~~j ~.t ~ F" ~4 ~ {jam ~y~ ~ l ~ ppw.. I ~ ~ ~ ~ t ~ ? m...~.~.im~.d. >w _ a3~ - ~ Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~.,1 765-1802 i APPLICATION FOR CERTIFICATE OF OCCUPANCY ~ ~ i~_ A. This application must be filled in by typewriter OP, ink and sub fitted f'o"the bu,lc~ing !..:w . 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 buildir 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 an '.'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 Buildinc - $100.00 3. Copy of Certificate of Occupancy - .29G. 4. Updated Certificate of Occupancy - $50.00 S. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date T`~~o~t~S/ ~ New Construction...........yyO''ld Or Pre-existing Building Location of Property.....~Y`:...........~?GG/.~.~lZLs7~...f.~. .........~~.~f:~~L~.......... House No .,~yy Street Hamlet Onwer or Owners of Property...4:!~L.~~...!~lt~.~!~ DUZ~??d-,~(~;,,,,,,,,,,,,,,,,,,,,,,, County Tax Map No 1000, Section...~'.~~?~........B1ock.....~.........Lot...~~ Subdivision. ......................Filed Map............Lot................... Permit No.......DII^atrre Of Permit.. seal. ~~....Applicant.~~~.~°.°.. Health Dept. Approval....l~.f~ pp ............../.Underwriters Approval... Planning Board Approval..... .y: ~J Request for: Temporary Certificate........... Final Certicate... Submit~ted: $.....2t.J :...................l~P~~........f~V 5:~/~ ~n ~ APPLICANT ~~o~OgOFFO(,~cOGy o Z Fax (516)765-1823 Town Hall, 53095 Maln Road ~ Telephone (516) 765-1802 P. O. Box 1179 p ~ Southold, New York 11971 ~Ol ~ Sao OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I CAT I O N DATE: I~ 99 Building Permit No. ~°a`~ 9 ~ owner: (~~~I'I~Gt'S .~'//~v~?ZL''7T ~GL//~~ (pL~lease print) R I ~/ry) 1~ Plumber: I l'~ 1 ~(R.WLA71~'A~r ~ b'~~~`L' lC'r (please print) V ~,J~ I certify that the solder used in the water supply system contains less than 2/10 of 18 lead. lu rs ignatur Sworn to before me his D p ~ ~ ~ day of 191..,2 Notary Public, ~iiG ~f~-CMG County ~~~a~~. r:ouiryP~Mo,~MM . No.01~TM117E! ~m ~IeWaiE>pnt~~r~ ~ ' .'1cLJ 5;::.': _ .1J:i it .;~.`ti•tLNr~ { Ic'~*~~Q~ aH`41". I 1 . r ~ I'" 1:ou77DaTION Gist) ~ ~ °N i c OU71DaTI071 (2nd) _ 2. Q 'OUCH FRki•IE & I ~PLUhiSING I Q ' I ' . I ~T I ti~ J, ~ y m II If7SULATION PER N. Y. I y STATE EflERGY II CODE II / II 4 ~ ' I F I;lAL I n • I o~ ADDITIOfIAL COMMENTS: x~ • x~ ' H a ~ ' o a i . - - O I m -v H . ~ J O~~gOFFO(~-~o Gyp Town Hall, 53095 Main Road p Fax (516) 765-1823 P.O. Box 1179 W ~ Telephone (516) 765-1802 Southold, New York 11971-0959 Oy ? ~~1 ~ ~~O BUILDING DEPARTMENT TOWN OF SOUTHOLD December 27, 1999 Charles Vanduzer 950 Mill Creek Dr. Southold, NY 11971 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) 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 # 20249-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. DE.~`+ICN CRITERIA 6,000 DeEree IIa~e (FOA NON*ELECTAIC NEAT) O.A. 10°F LA. 9O°E " __:~._.,___.~..~w _ > r J~~ ,S J ~i A 2 E d U t-s, °r~a~R ti~ i . R F M.~ R ae s ~u~• RAaiNG , _ f. ~-,~r,-~_..,, E~iterier Wallr '(Opaque) 2 v ~3 o 3 3 ~ . _ C"laring 2d _96 6~ Ys3 ~/3 N~,?~S~ lL- ~~a~~°e""`" ITaern ZU .Nu _ U _ _ C~ilina~Rerf (Opaque) o ~ 0 ~....e...___.._ _...._m____ ._..T... / > SkViiahtn ~ ~ - /U 3 r ~ /jH 1~ F~ l P_ FJr„ , p ,.....-.,.-_~,_.w._.,..._._,... , . ._.____.r ...-.-_-F.._ 1'1~°r lug , o~ fibvndatien Ma11r _ ~ _.._.._._.e._..._..___,_. .___m_.~_________~.~________._.__...~__ Siab Tmmvlatim ..__~__n.____.~.~._.n_._..A~.a,.~~r. _ . - T(YfAL ~ _ Netert ' Dailding Eeveirpe S.rettme t° Maet requlremente ®f 9M1,~~~ ' HVAC'Egnipment t® meet regriremente of ~idlg.ll" HVAC'S'~etemn to meet regilremrnte of 7~15.1t , IIict S~rtemr to meet regnlrementr of 9855.13 Vtntilr.tiene $~etemn t® nest requirements"®f 7E15.14 , Insulation of Pipina Systems to meet requirements of 7H1'S•15 8ervler. Mater. Keatln~t Systems and Etinipment t® meet Requlrehents of 7815,f.1 Electrical anA Lighting S,rstems and Equipment t° meet requirements of gt315.31 Tb tie bbrt of m~ Knowledge, belief, an~i prefessi®naI .~~;QFA1€~Y ~ydaement, there plans arP in 3~'~cc~~.rGO~~ ermpliance Nith the code. ~ ,S,~r a Ay ' Si~ r ~ :.iJf W_ ~ N(` 0322541 Gs~ ~~9®AESStOJ~'~~~ I 0~0 ~ y~~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ] I ULATION [ ] FRAMING [ FINAL [ ]FIREPLACE 8 CHIMNEY REMARKS: ~ /l oa~ ~~~C'-~.s ._,,e¢ fir,-, O ~ o .~~c~/ ~ DATE< ~ INSPECTO r ^ 8 _ THE N1E1N YORK BOARD OF FIRE UNDERWRITERS PAGR 1 L901.071 BUREAU OF ELECTRICITY 88 JOHN STREET,~NEW YORK, NEW YORK 1003$ Date APRIL 13,1'393 Application No. on file 7&N55s392/92 N 2729;31 THIS CERTIFIES THAT only the electrico! equipment as described 6ebw and introduced 6y the opplicont named on the ofwee application number in the premises of CHARr.ES ttAN 17UZ6R, !TAN W, C{ILLI CRRGCf DRLVF,, SO(C9'NOL,D, N,Y, in the following bcotionT ®Boaement ® let Fl. ? 2nd F'l. 01I`.(I - '.Sertion Block Lot MA R C f{ 7.6 , 1 ~ and ound to be in com Iwnce with the National Electrical Code. was examined on P FIXTURE ECEPTAClES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER MIT K.W. AMT, K.W PMT. K.W AMi K.W. AMi H.P. 16 1I. 7 9.5 1 1 i..N ' 1 1.~ DRYERS FURNACE MOTORS FUTURE A?PLIANCE FEEDERS S?ECIAI REC'PT 71ME'ClbCKS gEll UNIT HEATERS MULTI.OUTUiT DIMMERS SYSTEMS AMT. K. W. Oll H. P. GAS H. P. AMT. NO. A. W. G. AMT. AMP. NAT. AMPS TRANS. AMT. H. P NO. OF FEET AMT. WATTS 9 60r0 SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP. rypE METER I p, RW I S. 3W 3,9' $W 3$ 4W NO.OF CC COND. A. W. G. NO.OF HbLEG A W G' NO OF NFUTRAlS A' W. G EOUIP. PER .a' OF CC COND OF MbIEG OF NEUTRAL OTHER APPARATUS: G.F.C.T.c'2 G & $ CONTRACTOR LIC.tfS'TB..G 130X 31Pi ~ G!~~~ 50NTN0LID T NY, 11971 6ENERAI MANAGER Pere This certificate must not be altered in any manner; return to the office of the gourd if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT,BE AhTERED IN ANY MANNER. ~ , ~ BOARD OF HEALTH FORM NO. 1 3 SETS OF PLd:7S , TOWN OF SOUTHOLD SURVEY . . BUILDING DEPARTMENT C11CC1: _ . TOWN HALL SEPTIC FORM SOUTHOLD, N.Y. 11971 TEL.: 765-1II02 tlOTI FY ; CALL Examined/ . 19 , rtn z L TO • • ~ . :\pproved 19~,~ Permit No..~dO`',~ . . Disapproved a/c _ , . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date , 19 9~ INSTRUCTIONS a. Tlvs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets 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 Mall be kept on the premises available for inspection throughout the work. e. Iv'o building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy hall 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 3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ?cgulations, for the construction of buildings, additions or alterations,-or f r removal or demolition s herein described. :Ire applicant agrees to comply with all applicable laws, ordinances, bu' g co hou ~ ode, • d regulations, and to .dmit authorized inspectors on premises and in building for necessary i p ions (Signature of applicant, or na if a corporatio ) .....~yo~?~f/~~~r~~x~i~~... , (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. \ame of owner of premises ...~iUl,f1721c°5../.-l.. (l~l:A-?.. y~d1'~.~Y? . (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. ....Sf°L~ Plumber's License No. ..~~(!~!p~//-r~,,,,,,,,,,,,, Electrician's License No. ~/Lr~~!l/6 , , , , , , , , , , , , Otltcr Trade's License No . . Location of land on which proposed work will be done . . . ~~o ~~~pl~ Ilousc Number Street Hamlet County Tax ivlap No. 1000 Section ..~,3Jr.. Block Lot . Subdivision Piled >11ap No. ../.3~~.',~:.ri~Jry.. Lot . (Name) State existing use and occupancy of premises and intended use and occupancy oCproposed construction: a. C•xisting use and occupancy .....~N, ~ , , ,~t~~/~n~ fix? r~ t ...,~,r`,~ i,r . •,~SCpY e~; 4;~,^, '9 .p2e ,ti..a xtrUP%hv~ y b. Intended use and occu anc e tlA.~ 3. Nature of work (check which ~Pplicablc): New Building Addition Alteration ~ Repair Rerpoval , Demolition Other 1Vork . 4. Estimated Cost . ~ ~p0© (Description) Fee .~~d 5. IC dwelling (to be paid on filing this application) o, number of dwellin~ units Number of dwelling units on each floor . If garage, number of cars . 6. If business, commercial or rnix~d occupancy, specify n turc and extent of eacf typc„of use 7, Dimensions of existing structurics, if any: Front . >.~~,a, ' ' ' ' ' r ' ' ' ' i• • • • • • Height r~~c'......... Nun Rear "•F Depth . r~ y . ' ~tbcr of Stories , Dimensions of same structure tyith alterations or addition~ront • , z • ~j• • • • • • ~ ~ • ' • ' ' ' ' ' ' ' ' Depth ......y:(7 Height Rear 8. Dimensions of entire new const~~ttction: Front , , t 3"r' ' ' NLQttber ~ ~~ories .....2.. . l Height , , Rear, ..c~~......... Depth . f(~........ . . • , Nurpber of Stories ' 9. Size of lot: Front, ]0. Date of Purchase Roar Name of Fo DePth , • • ~ ~ ~ rmer Owner ,(,({~g,~'lf~~...,~/ 1 Zone ar use district in which pr miles are situated , , , , , • , 12. Does proposed construction vio~ate any zoning law, ordinance or regulation: , ~ • • • • • • 13. Will lot be regraded .........I 14. Name of Owner of premises i , , , , , , , • • Will excess fill be removed from premises: Yes No Name of Architect ""'•••..Address ,,,,,,,,,,,,,,,,,,,PhoneNo.. NanteofContractor.•••~•.• •~~~~~~•••""'••Address,,,,,,,,,,,,,,•,,,,PhoneNo..•.••••~••~•~~• I5. Is this property within X00 feet of a tidaldwetland. • •,t • ~ • • Phone No. . v *If yes, Southold own Trustees Permit may be required. No " " " " ' ~ 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 umber or description according to deed, and show street names and indicate whether interior or corner lot. sW~,.~„ I - ~I I I 11 M III G1TE OF NEW~YflRK • • • • • • being duly sworn, deposes and says that he is the applicant ' • • (Name of individual si nin • ovc named. g fig. 1Contract) is the I~-1.M.l;l,.k, d-....... (Contractor, agent, corporate officer, etc.) • • • • ~ ' ' ' ' ' ' ' ' ' ' ' ' said owner or owners, and is duly au~thorizcd 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 othis knowledge and belief; and that the irk will be pcrfomtcd in the manner set (forth in the application filed thercwitlt. orn to before me this ,.,t_ ~ (..day of . 99 Lary Public, .1~~ Co ~ unty CLAtRff L 6tEW ~ Notary puNo. 8786D6N~wMk . Qualified in Suffnik Cout~ly G~,t, Signature of applicant) Commission Expires December , 70