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HomeMy WebLinkAbout20128-z FORM N0. 4 i TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22373 Date JUNE 4, 1993 THIS CERTIFIES that the building ADDITIONS Location of Property 1730 OLD ORC[~IARD LANE EAST MARION N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 37 Block 2 Lot 7.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 6, 1991 pursuant to which Building Permit No. 20128-Z dated SEPTEMBER 6 1991 was issued, xtnd conforms to all of the requirements of the applicable provisions o1.` the law. The occupancy for which this certificate is issued is ADDITIONS TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificaite is issued to BERNARD & MARY FISHER (owners) of the aforesaid building. SUFFOLK COUN7.'Y DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. H-034890 - MAY I7, 1993 PLUMBERS CERTIFICATION DATED MAY 28 1993 - A. GIULIANT Bui ding Inspector Rev. 1/81 FOIBM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) Na 2 012 8 Z Date 19..q! Permission is hereby grouted to: V a 3 Q~.o..~ x ro .s~... ...................~..°..:r~r................. ..1?'':1A.. . of premises located at ...~..~.ti~........~4~...~: ......:4MR........~. 9:~Q ........:Y.~.. . County Tox Map No. 1000 Section ....c~yy.,~~.s..1..pQ..'~..-~... Block .....Q.~:...... Lot No....~.:.~............ pursuant to application doted ....:l.~.^.^!`~?!h......~ 19.~..~.., and approved by the Building Inspector. Fee S••~•••• ng Inspector Rev. 6/30/80 5~ Form No. 6 ~ ~ ~ TOWN OF SOUTHOLD ~70~ BUILDING DEPARTMENT ~S1~1Y ~ ~ 4~ TOWN HALL 765-1802 b n~. ~e ~ 1. ~ ~ e 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 $1/5.00, Commercial $15.00 Date ..`S~`1~1.~ . New Construction........... Old Or Pre-existing Building.. Location of Property...f,7, 0 /F~ . ;cI ~ S~.. ~c; :':4 asf. : s ~~.!1......... . House No. Street Hamlet Onwer or Owners of Property..:73.$!;n<?': S`i. :`:L ..~z>:~ . County Tax Map No 1000, Section.... ~ o-?.~....Block..~.~:..........Lot...l!/ . Subdivision ....................................Filed Map............Lot...................... Permit No.aO !:a'~.......Date Of Permit. f ~~.:~!?~..Applicant Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: $ APPLICANT c•o~.a~373 ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~n„r; ~ F}(~;>i3982 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date FIAx 77,7.993 r. f• n o.o de_ 7'~454~s91/J1. l~t 03~£19~i THIS CERTIFIES THAT ~~~'e~~"~~1~ ~I~, 11113 only the electrical equipment os described 6ebty and introduced 6y the applicant named on the above application number in the premises of (;RGGG EITU'HRR, 1730 ,~--yOy~~LI7 URt.;ii~(tC:, E11;~T Odtlftl:ON, N,"'. in the following locotion• LJ Bo.ement ~ lat Fl. ~ 2nd F7. 1T1'TIG 3ertion Bloek Lot awa examined on M~ ~ 3 r 19 ~ 3 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES INCANDESCENT FWOREECENi OTHEn AMT K.W. AMT K.W AMT. KW, pMT. N.W. AMT. H.P 7r~ 1. 7..? ~ ~F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET DIMMERS AMT. K. W Oll H. P. GAS M P AMT. NO. A. W. G. AMT. AMP, MAA gMPS. TRANS. AMT. H. P SYSTEMS pMT. WATTS NO.OF FEET C;00 SERVICE DISCONNECT NOAF S E R V 1 C E AMT. AMP. TYPE METER ~ tW ~ 3W J 9 3W 3,e' 4W NO.OF CC COND A. W. G NO. OF HbLEG A. W. NO.Of NEUTRALS A. W G. FOUIP. PER .O' OF CC COND OF HLIEG OF NEUTRAL OTHER APPARATUS: srcoxr ne,r~c2'atl: - ~ n~,a~n.aa nr,s1lE,~t ' 53 BROOXNI0I,1} Rp. I1PI?.MON'PCGA.Ltt, P1J, 07@~13 GENERAtMANAGlR t.i Per ~I 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. S~FFQ(,{-~, TEL. 765-1802 p~° ~l% TO~IV OL' SO'JT~O'Lb ~ OFFICE OF BUILDII•IG INSPECTOR E 1' r>:nk P•O. DOX 1179 ~p ' ~ z TOWN HALL ~jO~Q~ SOUTHOLD, N.Y. 11971 C E R T I F I C A T I O N Date ~~~~°~`_--•--r-•~~- Building Permit No. ~U=_ Owner_~~rn~ print Plunber~?/ i / (P 1- o a p i n t j I certify that the solder used in the water supply system contains less than 2/10 of to lead. j~ ,f ~ • (plumber's signature) Sworn to before.~mc this day of r./cfN~ 19 Q~7 , Notar• ~ Notary tic ! f ublic, JUf~OIK County f itl lAN B. YOUNGS: Notary h6114 3tato of New Vork, Quallie:l la Suffolk County, No. h2 G6P 8 ~ o! a~~- T65-1802 BUILDING DEPT. i NSPECTION [ ]FOUNDATION iST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING ( FINAL RE ARKS: DATE ~ ~ ~ ~ INSPECTOR :~'iilw~ i;:SPEC:_O;I ~~U;,;E ~ i;ONMENT° 1. ~ m o a~ - ~ , _ _ H FOUiIDATION (1st) ~ a c FOUNDATIOiJ (2nd) - _ m a 2 . D ~ a c~'1T, z 0 P,OUGH FRAME & ~ ~ ~ W C PLUMBING Q S1. r N 3. ~ ~ m c~ IIJSULATIOPI PER N. Y. y STATE ENERGY .z'" ~ CODE - I~ ~ 4 . _ _ ~ y e - ADDITIOPIAL COMMENTS: ~ 1 • _ t~ x w H b ~ _ 9 ~ H ~ O W Z M Z I*1 ro _ H i --~~--•=-r ass-iso2 BUILDING DEPT. INSPECTION [ ]FOUNDATION iST [ ] R UGH PLBG. [ ]FOUNDATION 2ND [ INSULATION [ ]FRAMING [ ]FINAL REMARKS- n CJ~"~ p DATE ~ v INSPECTOR 1 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROU PLBG. [ ]FOUNDATION 2ND [ INSULATION [ ]FRAMING [ ] FINAL REMARKS: C~ f DATE ! INSPECTOR G~ i L~ T65-1802 BUILDING DEPT. INSPECTION (i/~UNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: C''lc._ DATE ~ ~ INSPECTOR ~ " " ~ 765.1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ] ROUGH PLBG. [ }FOUNDATION 2ND [ }INSULATION RAMING [ }FINAL REMARKS: ~L-~-~ S-r ~ r v~ DATE ~ ~0~ INSPECTOR r~ ~l~ 765.1802 BUILDING DEPT. INSPECTION C: ] 'FOUNDATION i5T ROUGH PLBG. FOUNDATION 2ND .[)INSULATION MING [ ]FINAL rREMA ~~KnnS~~ i^^ 'wv~ ` DATE ~ INSPECTO i Gary Fish Building Department Southold, NY Dear Gary: Here is the letter requesting a six month extension for our final inspection for the property located at 1730 Old Orchard lane, East Marlon. Our permit numer is 20125, issued to Bernard Fisher. Thank you for all your help. Sincerely, Bernard Fisher G~~9/~~~~ 765-1802 BUILDING DEPT. ~ INSPECTION [ ]FOUNDATION 1ST ( ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ l FRAMING REMARKS: ~ ~ t DATE ~ INSPECT /r - t 11 ~ ~ ~ I Iii ' ~ : ~ i li; --i-. i ~ F-. i lS]i i ~ C~~ " ' '~i rn, , i J (J Ill ~ 1 ~ ~r~ C 1 I I 1 . I „ c iu L, q ~ ;i' u ' ~°a_ 1. 1. is I U.1. . ' .v c `o c ~e n C' i ~ ~ ~ ~ ~ ~ I l1 ~i'~'_~.~~ ~-:n "dim mc~cc~~~ t~I`Yi t_~~ ~L' ~ ~u i u.h t , ~ ~ ~ ~ o."'a t~'ncr:, ~.~me \ ~.II IUi v. in~l TAG f~ ' r a c ~=rm ~ 'fl ~I Q,1 v' Cr c. pc n y pi £ c: ~ yyci ~ o` ~ lR i +-1' a V! 4 V ~ IJ A C 6 C ~ L~ 4 ~ r I , f. ! 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TOWN OFSOUTHOLD SURVEY BUILDING DEPARTMENT CIIECF TOWN HALL SEPTIC FOR:I SOUTHOLD, N.Y. 11971 TEL.: 765.1802 t: oT I FY ; CALL Examined. .:,~„19q,~, tInIL TO:...._........... APProveet.~., 199~.PermitNo.o~,0/o?$'~L. Disapproved a/c . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .~J.~~tC 19 :7 l INSTRUCTIONS a. This 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 ;hall 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 ;hall leave 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 2egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. Clie applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to idmit authorized inspectors on premises and in building for necessa inspections. _ _ . ~.'~?'V~/~...~J~ . (Signature of applicant, or name, if a corporation) (Mailing address of applicant) ®7fl~ J`L ~Q~ Slate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......V.~.~.~~ Vame of owner of premises ~'~'I. ~ ~ (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 . . Plumber's License No . . Electrician's License No . . Other Trade's License No . . . Location of land on which ro osed work will be done. ~ ~ ~ ~ lJ~`~i~ t( f"(~ P P louse Number 2, ~J Street1 Hamlet County Tax Map No. 1000 Section . N. ? F, , , , , . Block Lot . Subdivision Filed Ma No. Lot . (Name) P State existing use and occupancy o(~f p~remise~sagnd intended use and occupancy of proposed construction: a. Existing use and occupancy , . ! u;~~ ~~ry i,'!,~, , , , , , , t° ~ , . .9il.R • •x~~ ~ • • • • • . b.In[ended use and occupancy . ..(Pf,~R • , . . rv. tP]epi Qa~'$,q 3. iVature of work (check which ap' licable :New Buildin p ) g Addition Alteration . P Remo Re air ~aI Demolition . .Other Work . ,~~--pp (Description) 4. Estimated Cost . :b I a~ f/ • . I ~ Fee ~ ~a~J i , ~ . ' ~ {to be paid on Sling this application) 5. If dwelling, number of dwelling nits , Number of dwelling units on each Soor . . If garage, number ofcazs g.~ If business, commercial or mixed occupancy, specify natu(e and extent of e c ty e1 of use , .p~ 7. Dimensions of existing structures, if any: Front , , , , , ;Rear ~ , , , , , , Depth :p~,~: D , , , , , , , , , Height ..1 ~ . , Number of Stories . . Dimensio oL~ dame structure with alterations o aldditions: Front ~ ~ ~ ~ ~ • Depth .~~~,'7....... jj~~ Re r . ~ • j .Height ..~!y . 8. , , , , , , , , Num~pller o~ Stories . 1...11..... . 9. Size of lot: Front -1~ . ction: Front . ,p~ ~ , , , , , , , Rear r~'p.'~ . , , . , , , ,Depth ~,t'R`y. , , , , . , Hei ht 1~4......, ~IumlerofStories..~.......,, fl / imensions f entire ne ~onstn Rear , , , , , , , , , , , , De th .i.`3®• . ~ ,.,.....p....... 10. Date of Purchase SN~ t9'a•~~,~ I, , , , , , , Na~pne, RQf,/~~o er Owner ~M1e.Cb~,/'~:. ~.l~~It~ 1 1. Zone or use district in which premises are situated . tV~.e?4 L~ ~ ( ~ ~ ~ ~ ~ • ' 12. Docsproposedconstr~t;jpnviolaitean zoning UU Y 1, law, ordinance or regulation : . 13. Will lot be regraded t , , .Will exces Sll re o d from premises: Yes No • 14. Name of Owner of premises ~ Q;1',t~ ,~j~~ ~ , , Address~~J , , ,Phone No~n~ :'?~f~°p.7. Name of Architect ................Address ..Phone No............... . ame of Contractor , . 15. Is thislfroesrtSouthdld T • Address . . ...........~ne No....... 0 feet of a tidal wetland? eyes,,,,,,,, No, ~ Y , bwn Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all l7uildings, 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, I~ ~ / ~ ~ 'i III i ry III Y 'OU, Y OF'-~'- ~tS n iTATC~... ~ S, 1~ t! l ' ' ' ' ' g ~ • • • • being duly sworn, deposes and says that he is the applicant (Name of individual si ning contract) hove named. ' fcisthe ' (Contractor, agent, corporate officer, etc.) " f said owner or owners, and is duly authorized to perform or have performed the said work and to make and Sle this hplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the 'ork will be performed in the manner s~t forth in the application filed therewith. wom to before me this I aY 19~. otary Publi .4. County ~ \ ~N1 r1 G~~~~ Npgtyl~blb St4ate ~Yotk ......"r'„D~~~ No.4878606 I Que1NMd in guMolk CouMY (Signature of applicant) CommMaloo E><Pk~ F,~omber 8,18?'