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HomeMy WebLinkAbout20035-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT 0€fice of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20768 Date JUNE 3, 1992 THIS CERTIFIES that the building NEW DWELLING Location of Property 420 POND AVENUE SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 56 Block 1 Lot 2.31 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 18, 1991 pursuant to which Building Permit No. 20035-Z dated JULY 19, 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 ONE FAMILY DWELLING WITH ATTACHED GARAGE AS APPLIED FOR. The certificate is issued to HENRY P. SMITH: JR. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 91-SO-47 - MRY 29, 1992 UNDERWRITERS CERTIFICATE N0. N-236258 - MAY Z1 2992 PLUMBERS CERTIFICATION DATED MAY 26, 1992 - H.SMITA PLUMBITTG & HEAT". G ~ ' ~ Bui ng Inspector Rev. 1/81 t 1P013M 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 AUTIiORIZED) N 4 3 5 Z Date ............~........1,9 Is.9.l.. Permission is hereby granted to: ~.....~.t......... , ...?.~.9~n~....... . . j ~ of premises located of .....Q.~.d.....~s;nil .........................GSL`::-:~.. i j © X70 Lot No....~ f County Tox Map No. 1000 Section .............`til........ Bioek pursuont to application dated 19.9/..., and approved by the Building Irupector. . Fee 5..~~~.:5..a... . j Bu~ding Inspector I l Rsv.6/30/80 i, ai°(~;y +e~~a ~.~`.['J;'~:,,.~~"'•~\i /b•3 `~&O ~LI" Ct.a'~~a'~. ~~e i ~ - Form No. 6 { k ~AAV ~ 3 f; ~ _ TOSJN OP SOUTIIOLD t BUILDING DLPARTPIENT ~~,.,~,..,a.,,,m LLL Es1.Ee:~, fjY,e~l°°""'` ~ TO[JN iIALL TCW~ f%E:ii:SSTd°!1`39_E3 $ ~ 765-1802 .....~....~.~M . _.,,,,ti~a.aa APPLICATION POR CCRTIFICAT); OP OCCUPANCY ~r~ 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 - Residentia~l• $15.00, Commercial $15.00 Date ,;SUii/G~ ~ f C~~ cZ. Idew Construction... Old Or Pre-existing Building....... Location of Property...,7,e?;~~,,,,,,,..... ~(~,[J~l n ~ House No. Street..:-GZ.Z Hamlet Onwer or Owners of Property..!?.~:v~'Y„/~uL J~. . County Tax Map No 1000, Section „ ~~,Ln= l C......B1ock....~J.~.........Lot.. ~:~5.. _ Subdivision. LC~~;. pl1;U ..~•~.r~. ~ ~ ,C.~, Tt 5" .Yf'C-,u.Filed Map........... .Lot. Permit No.°~. C'~b3S..~ ..Date OC Pe ~~e'~J2. rmit.~.`.~q.:.r?.j..Applicant. f'.!'.S:~IT.t~';~.~ Iicalth Dept. Approval...,,?,,,,,,,,,,,,,,,,,,,,,Underwriters A pproval.. Planning Board Approval Request for: Temporary Certificate........ L Final Ccrticate.,~ 'ee Submitted: d ~ C0'~a07~0 D APPLICANT , INSPECTORS ,Y~`r`~`x`' Victor Lessard ~ -„~g~B ~~q Principal Building Inspectrn hY~~~u. ~ Curtis Horton Y'+ ~ • ~ `~"~e,~~ SCOTT L. HARRIS, Supervisor Senior Building Inspector ~ ~ ',J~j i. y~~` Southold Town Hall Thomas Fisher P.O. Box 1179, 53095 Main Road Building Inspector ~ ' ~ : k* Gary Fish Southold, New York 11971 Building Inspector ~ ;"a ' sJ¢ 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 29, 1992 HENRY P. SMITH, JR. HOBARAT ROAD SOUTHOLD, NY 11971 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: IO;x An application for Certificate,of Occupancy is not on file. (Enclosed) x%x No Underwriters Certificate on file. %%x The check is /not on file.)$25.00 %%IC No Health Department Approval on file. No final inspection has been made. ]IXX No Plumber Solder Certificate on file., (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 20035-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGN 1 10010'I1 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date MAY 21,1992 APPlicationNo.onfile 75365031191 N 236253 THIS CERTIFIES THAT only the electrical equipment as described bebw ¢nd introduced by the applicant named on the above application number in the premises of HENRX SMITH, 420 PGNO AVENUE", 5GUTHQLDt N. Y, in thefollouinR location; ®B¢sement ® Ise F1. ? 2nd Ft. GARl ATTTCIOt1T .Section Block Lot uws ex¢rnined on MAY 1fi, 1992 arzdfound[o be in rmnplianre with the requirerreents q(this Board. FIXTURE ECEPTACtES SWI7GNE5 FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDFSCENi FWORESC£NT OTHER AMi K W AMi N W. AML KW. AMi K W. AMi. H P. 30 5fl 36 29 E 1 P DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS FELL UNIT HEATERS MULTbOUTLET DIMMERS AMi. K. W. Oll H. P. GA$ H. P. AMT NO. A. W. G AMi. AMP. AMi. AMPS. TRANS. AMi N. P. SYSTEMS qMi. WAISS NO.OF FEET i 4 a 1. 2 lz 1 ze 1 SERVICE DISCONNECT NO.OF S E R V 1 C E MIT. AMP. TYPE METER L IIW L ~ DW ~ 9 9W 9 ~ AW NO. OF CC COND. A. W G NO OF HI-LEG A. W. G NO. Of NEUTRALS A. W 0. EQUIP. PER .a OF CC.COND OF MPLEG OF NEUTRAL 1 zae ca 1. a 1 210 2 zi0 f OTHER APPARATUS: aACCUZZT-1 MGT0R5t2°k H.P. G.B. C. T:-7 i 5M0Kh 0&THCT4Rt-?, I 4 f ;4 ~ Q G & 3 CGNTRACTQR LIC.#578-E G/~~~ `~'A` BOSi 215 SOUTHOLDr NYr 11971 GENERAL MANAGER Perl 1 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. i COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTEREp IN ANY MANNER. H. SMITH PLUMBING & HEATING, INC. MAIN ROAD SOUTHOLD, N.Y. 11971 (516) 765-3690 C E R T I F I C A T I O N Date May 26, 1992 Building Permit No. 200352 Owner Henry P. Smith Jr. Plumber: H. Smith Plumbing & Heating, Inc. I certify that the solder used in the water supply system contains less than 2/10 of 1~ lead. - enry P. Smith Sworn to before me this 26th day of May , lg 92 . Notary Public, Suffolk County /c~P.cnc~d.¢-ZZz,~~ct~Q-e-.~ Notary Public yERNAUEfTE L TAPLIN NOTARY 4lt9LlC pggA4893 State of New York Residing in Suffolk CourdY nrmissan Expires Sept 30,1(`-. c1BLD i;:SP~C.iU;J ~~Un;E I i;OMMENT° ,i• b__~; v 0 _ ~ N V' FOUtlDATIO:J (1st) y U _ ~ ~ ~ i 0 ~ FOUNDATIOtJ (2nd } $ y ~ vt. m d 2. z o P,OUGH FRAME & l~ ~ C •PLUMBING y J y 3 . ~ _ IIJSULATIOhJ PER N. X. ~ ~ H STATE ENERGY ~f S i CODE ' G~ ~ ~ ' .e ~ ti H FIiJAL ' o ADDITIOtlAL COMh1ENTS: x • ~ 1 d' r rn ~ ~S ~ • x ~ N ?7 ~ R+ •.D . H ~ H ~ yf ~ /tA7 P] Y ~ • r t. • H N x ~ ~ m ' - H mss' ~ ~ ~l~ ~sS-iso2 i BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG, [ J FOUNDATION 2ND [ ]INSULATION FRAMING ~]-FfIGAL i REMARKS: ~ i f _ i DATE Z INSPECTOR ,P, i F E __b ~ ~ s 2-~3.~ 765-1802 BUILDING DEPT. INSPECTION i [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN ULATION [ ]FRAMING [ FINAL A REMARKS: i i I DATE Z L INSPECTOR ~ - - - - ~ ~ rss-i80Z BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ INAL REMARKS: _ ~ DATE INSPECTO~ ~ s TS5-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND INSULATION [ ]FRAMING [ ]FINAL REMARKS: c,G~ff i f Cl r ~ i ' I DATE l ~ INSPECTOR ~ u=~ E j 7?65-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( OUCH PLBG. [ J FOUNDATION 2ND [ ]INSULATION [ ~MING [ ]FINAL REMARKS: t j ~c,e~ ~ ~C~. i E I i ' DATE ~ INSPECTOR , . 'VY°I 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [~OUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL i ~ REMA KS: A.-J { I I - f { f~ , , DATE ~ 1 ~ INSPECTOR NU ~ \ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL E ~ E REMARKS: 4 `f P Mkt Ip E C DATE l INSPECTO ` G~~ed'`~`~ iJ 765-1802 BUILDING DEPT. INSPECTfON ' [ FOUNDATION 1ST [ ] ROUGH PLBG. F [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL ~ l f ~ REMAR 5: ~ ~ I { < i t I DATE INSPECTOR t ~~}L?j_~~LI,~~'.1~~ BOr\S'.D OF HEALTH F-"~ ~ FORMN0.1 'J SETS OF PL.1N$ O•K.. ~ .SURVEY Q K~......... k~ U ~ TOWN OF SOUTHOLD ~ BUILDING DEPARTMETVT ~ CtIECt: . ~ I - . BLDG. DEPT. TOWN HALL SEPTIC FORM d_ J1 TOWN OF SOUTHOLD . SOUTHOLD, N.Y. 11971 TEL.: 765.1802 t7 t)T I FY ' S 3 6 S~.L CALL .........3~.~~.... Examined 19R.~. htnIL TO: Approved ~ ..I,9 19 91. Permit No. a~ QQ..~.S.'7~. • - . • • • • • • Disapproved a/c . (Building Inspector) APPLICATION FOR BUILDING PERMIT _ I f/ Date ~ (.~19 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- 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 tlfe 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 t' ns. pp - (Signature o a licant, or nam , if a corporation) ROSARY ROAD, SOUTHOLD, N.Y. 11971 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. OWNER Name of owner of premises , ,HENRY P. SMITH, JR. ' (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 . . Plumber's License No. , 537-P Electrician's License No. G&S' ELECTRICAL CONTRACTQR Other Trade's License No . . 1. Location of land on /w/hich proposed work will be done . . . . Q .........POND AVENUE .......................SOUTHOLD....... House Number Street Hamlet County Tax Map No. 1000 Section . , 056 . . . . . Nock ,1.............. Lot x'...97.°~ . LONG POND ESTATES 37 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 ..,NONE,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, b. Intended use and occupancy „?x?MESTIC•,,,,,,,,,,,,,,,,,,,,,, ~ ~A... , 3. Nature of work (check which applicable); New Building . X Addition Alteration . P ; 100, 000,0 a1 . Demolition ~ o Other W ~y . 4. Estimated Cost , Remo 0 (1~espition) $ Fee..-......~.............. (to be paid on filing this„gpp(icaK.ion) g~ g 5. If gdwelglin number of dwellin u~tits .....1 Number of dwelling units on each floor . If era a numberofcars ...2.:I 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use , . g ~ g Numb if any: Front 150::.., ...'...Rear .150'..:..... Depth . ?70' . Heirhtsionlafexistin structures,erofStories..l Dimensions of same structure with alterations or additions: Front Rear . e t g ~ .........Numbs. Height ......80 Num810eF of Stories 45ti . S Hemhisions of entire new construction: Front Rear .........'.......Depth . 18 er of Stories ...1 . 9. Size of lot: Front . ,150' .Rear . ,150'• , Depth .270' 10. Date of Purchase . , 4/23/91. , ss Name of Former Owner BAYVIEW',L'AND CORPORATION 11. Zone or use district in which pre arises are situated ..M?MESTIC 12. Does proposed construction viola)e any zoning law, ordinance or regulation: . . 13. WIl1 ]ot be re radedp NP Wi11 excess 611 be removed fro4m premises: Yes o Name of Architect SAME P. SMITH, ~JIt. ~ • • ~ ROSARY ROAD; SOUTHOI~ 516 765 3642 ...........s Address one No.... . 14. Name of COontra for remisesHENRY, • • • • • . • • • • . • • .Address ...................Phone No............... . . ....Address one No. ` Y 15. Is this ro ert within 300 feet of a tidal wetland? *yes........ No .x....., P P Y *Tf es, Southold T'wn 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 corny,*. lot. V _ c V~ • II STATE OF NEW YORK, SAS COUNTY OF s (Name of individual signir3 ~ • ~ ' ' ' ' ' ' • • • • being duly sworn, deposes and says that he is the applicant g contract) above named. He is the (Contractor, agent, corporate officer, etcJ of said owner or owners, and is dulyl,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 wilt be performed in the manner Set forth in the application 61ed therewith. Sworn to before me this .....day,~o/f.I~.. G~//........., 19.9 Notary Public, t~:'4'~. , !1 ~I~,?, ;C„ , , , , County Nd.EN K DE YOE y~~-2~ NOTARY PUBLIC, S~~u~taa of NewttyYyO~~~M~ . . Term~FiT~res M'uch3o Cloun9...1°~ Signature of applicant) - F_ , f.. `off ;w, LEWq `10 7 v rJ_ ti0 ~ ~ s ~ r'174~i~i~J~ * ~ c/` < ~ j ~ ~ . •1p~ ~`0 mar/ ~ ~•Qf. ~ 1 ~ s , w ~ L~? v i,~geyyo.`i ~b ~~x ~ ~ i `odt~ - ~ I' ~ f I~ ,.r L Mu.!ae '__._-_'_S___.__~ V I am famUiar with the Standerda for ApQroval and Censtructien of Su~urfiscs SewaUa D!s osal S ste SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES for •:iittci!e Fan^!!y F;;zsi€?'rnc&s ar:d wit! ablrie by the ccr?clitions sc~ torYh fheroiri acid on the permit to fOR APPROVAL OF CONSTRUCTION OF oonsiruct. ~ Single Family Residence Only ;.r3,i~,. x,., 9ipnature - ...DATE HS REF. /fee=/~A~~ S/1t• j~~f~ ~ , APPROVED ~a~2~ EXPIRES TWO YEARS FR D E OF APPROYAL soy~~o ,d, .may ,i9~r ~ - Low 37 `~~6" ~6~' .379.5/ ~'/~5- ~ r _ JUN 17 1991 / ,q~~- # r'r.' ~ R6•.7"s ~i ti1.+~w~'I~?L~7a~AwM~i~ev' avA L5-s rT-S Sc~- lilkf0 .~!'/~'1!/r~ ,COiC r..~(iuwww~!fr+Awtss~~+~' .t/,Y ..firrsatwrtt~v.!/. Y. ..Nr M ~ wc~w~r _ ~ ' ~ _..._f"__ ~.o o Mdl ~ / o.r~t" ~ ,~s' i i a~?.,t fi fi ~ ~u a ifl LANO 8 ~=ocy w. ~ewq,~oo~ ~p 1 ~ . j 3/ Loy 37 N~ 1>~ 33698 ~ Op NEW ~ i s'~rs~e-' agG~.~? /~k'11.~,w!'J~'L~7wP~WrJSEuie~'i" ~.'~'.~v vt«. I~Vr'•.A~MY`r1~.~' r i `-T ~ `rt" I --t3~' d, Z'~ , V L ~ ' I ^y~y l I ~ ~ ~ ~ ~ 37 _ . Q ~T SUR COUNTY GEPA,RTMENT OF HEALTH SfRVICES $tNGLE ErikAllY 6WELl1NG ONLY V GAT HS. REr. iYO. _ e'r ~hF! SP .v r~ISOD ~ I~ W'0?'f ctif. T3C~IIQ!2S f'.tl ?utS rc~~ ` , focaG~n h~~2 he,en ,n<I .cted L~ tl Gt.pa'tncnt andi or ~ _,,'4s~ ~ ~ ! e?!ter a e~,~es ~;d ta.~ ?o be ~sfac~4y. MAY ~9 1992 ~ iei of e' urean of Wastawat-erVM'a-i'~agement a c. r. D'~; T. OF ` SERVICES 6~$g0 LAq 8` ~~~y.N• LEWgyo9~ FO O~ p ,i ~ * L ~ T _ i 3/ DoT 37 9~, 33698 + ~~~NEW YDP~ ~ 1! T G ,yM'rr,~{? * .EL6AA4i1~ ~~If!>Ar~'I f~/TL ~i,~-_