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Home My WebLink About20132-z 4 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20731 Date MAY 14, 1992 THIS CERTIFIES that the building ADDITION Location of Property 290 PRIVATE ROAD #4 SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 66 Block 1 Lot 33 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 4, 1991 pursuant to which Building Permit No. 20132-Z dated SEPTEMBER 10 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 2ND FLOOR ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to THOMAS & SOANN WALKER (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N-234360 - MAY 7 1992 PLUMBERS CERTIFICATION DATED APRIL 20 1992 - DONALD SFatt7nT0 .~Fti _ B ilding Inspector Rev. 1/81 rows xo. 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_ 20132 Z O Date V~;~?,1,9~;;} 1. 19.9.. Permission is hereby granted to: vv ....:~:,.......K . .A~............ ~ ~ o to ...:-~1.::~:!:: ~:fll.......°!.^.:1...e.Q4:G~l-~on..(. ~!u,c^~.. ~Jfz...' ~'~y .1... Y.°.....~!^.~ ....~srw.Srr..~,ra`... P.Y4~4,:.~.....1...1. u.^.f~71~!'~ y....~... .••....I 1 . . / ax ` of premises located at ..a.`1~..k....Y.P...~.J...~O.`.`.~....}~ County Tax Map No. 1000 Section ....~.~.~f?...... Block Lot No......~'~...~'~.t.......... pursuant to application doted ~..P..~:1~.,...~.........., 19 9.1..., and approved by the Building Inspector. Fee S.Y~~.... Building Inspector Rev. 6/30/80 ~ Form No. 6 TOWN OP SOUTIIOLD ~ ~-~~~+w.~~"-" BUILDING DEPARTMENT ~ TowN xALL ~ MAY 14 f?~2 76s-laoz g APPLICATION FOR CERTIFICATE OP OCCUPANCY TOt+'P~!( ~ A. This application must be filled in by typewriter OF, 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. vB. 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 Dates~8~92 New Construction........... Old Or Pre-existing Building „ Xes,,,,,,.,,,,, Location of Property.299.T46fi,-H3rbQF~Tgrrace ,,,,Southold.. House No. Street Hamlet Onwer or Owners of Property......~'hPWsaS.&,Jpann.Walker . County Tax Map No 1000, Section.....Q~~:.....Block.... 1...........Lot.,33,,,...... . Subdivision., ...................................Filed Map............Lot...................... Permit No...... ?.A.1~2.,-2, , .Date Of Permit...... ~I~O/91. „Applicant.. ,Ben. Krupinski_ Jr... , !{ealth Dept. Approval ..........................Uiiderwritcrs Approval......................... Planning board Approval Request for: Temporary Certificate........... Final Certicate...~ Fee Submitted: $ K3$3 ~~-~~-.~li. . C~.~ao")~J ~ APPLICANT - - _ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~'AG& a I9N1.NS3 BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK,,NEW YORK 10038 e Datr I'IA~ 07r13s32 ApPliFntionNa.onfile )5GG7~93./9I N 2.3986(3 AQ6" THIS CERTIFIES THAT only the electrico! equipment os described helow and introduced by the applicant named on the above application number in the premiaea of I'FIUHAS WAtLKPki, i'UWN NAk?13UR I:ANhI, SUUTNUI,D, N. Y. t in the following location; ®Baxement ? Ixt FL ® 2nd Fl, QNT Section Block Lut g was examined on A~NI~ 'I~ + I ~ y 2 and found to be in cornplianrr with the rrquiremen is of this Roard. a FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS ECEPTAClES SWITCHES INCANDESCENT FIVORE$CENi OTHER AMT. K W AMT. K W AMT K.W AMT. K. W. AMT. H P ~ ~ G DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'?T TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K. W. Oll H. P. GAS H. P. AMT. NO. A. W. G. AMi AMP. AMT. AMPS. TRANS. AMi H p SYSTEMS AMT. WATLS NO. OF FEET 2 G~4i SERVICE DISCONNECT NO.OF $ E R V I C E MAT. AMP. TYPE METER I A, 4W I 3W R 9 3w ]A' <W NO.OF CC COND. A. W G. NO OF HbLEG A. G. NO. OF NEUTRALS A. W. G. EQUIP. PER .(T OF CC. COND OF HbLEG OF NEUTRAL I 225 CB 1. F 1. ;i/k3 I 3l0 ~ a OTHER APPARATUS: a ~1TUN A.C. UNI4':I~-?. ~ HUTOi2912-P H, P. ~ ~~"l [tUY KING /13['ktINt>3 Ei,ECTt2IC t.LI;.A135G-E G~~~~ 66 3ANI)RA liUAD SAS'P NA@L k'TUNr NY, I1937 GENERAL MANAGER PerII b 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 N07 $E ALTERED IN ANY MANNER. INSPECTORS z Victor Lessard ®~uFFO(~C Principal Building Inspector ®G Curtis Horton SCOTT L. HARRIS, Supervisor Senior Building Inspector n -'6 Thomas Fisher € ~ Southold Town Hall ~ 4' ~h "r P.O. Box 1179, 53095 Main Road Building Inspector ~ ~ ~ Gar Fish ''~d+ Southold, New York 11971 Building Inspector ®1 ~ Fax (516) 765-1823 Vincent R. Wieczorelc Telephone (516) 765-1800 Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD ~ r." o ~ ~ a ~'--v,7 MAY 6, 1992 •g;,~ ~ t ~ a M/~Y 1419? x>. BEH IERi1PiASRI, JR. l~g BO% 1470 TOwIUf ~ AMAGANSETT, NY"". 11930 RE; THOMAS ~ JOANN WALKER To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: %R% An application for Certificate of Occupancy is not on file. (Enclosed) x%% No Underwriters Certificate on file. The check is ,________,not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 20132-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. CC: THOMAS 6 JOANN WALKER INSPECTORS z,; Victor Lessard ,~~FFO(`f~~ Principal Building Inspector ,5~' ,r, Curtis Horton ' ~a SCOTT L. HARRIS, Supervisor ~ .1. Senior Building Inspector c~ r x x.',, ~ Thomas Fiaher W '-,';~tq ~6'~~ ~ Southold Town Hall Building Inspector ® ' ' ~i P.O. Box 1179, 53095 Main Road Gary Fish '~~'r,1~1 ~~~~b So goo (516) 765- 823971 Building Inspector Telephone (516) 765-1800 Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD MAY 6, 1992 BEN RRUPINSRI, JR. BO% 1470 AMAGANSETT, NY, 11930 RE: THOMAS S JOANN WALKER To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: %%R An application for Certificate of Occupancy is not on file. (Enclosed) Q~ ffi No Underwriters Certificate on file. ~ The check is not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. {All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 20132-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. CC: THOMAS S JOANN WALKER oc,~Ff~(,(-~o TEL.7G5-1802 l., TORN OI' SOtJTEYO~.D z • l~ ~ ~ OFFICE OF IIUILDIt•IG INSPECTOR o u, ' ,°r, E=7~ ~-T. P.O. BOX 728 ~O'. ~ TOtVN H,~LL '/~~l ~ ~b0 SOUTHULD, N.Y. 11971 C E R T I F I C A T I O N Date ~2U~J L- Building Permit No. ~ ~ L_ Owner ~ ~ ~\(please print) P1L:C.ber~LJ C9 , c ~i~/' ~Q FFsz ' ~Jj (please print) I ccrti£y that the solder used in the water supply system contains less than 2/10 of 1; lead. - (p1um~ r''s signature) Sworn to before me this ~daY of ~ ~ ~ ~ tlotar• P ~ I' Notary Public~~ 1 ublic,~u~~-n t~ County CI.AIREI.GLEW Notary PubBc, State of Nosy y,~ • Queitikd j~ g~~ k County ~q++ Commission ~tpirea peoember 8,18,(,, c1~:LD 11:S:iAC:'_U:J ~~Dr.:a I COM~hGNT~ ~~'m~ -~O _ ` _r FOUIJDATION (1st) y N FOUNDATIOIJ y~'' (2nd) _ m ~ 2. / i -G P,OUGH FRAME & PLUMBING /L u ~ _ _ q 3. ~ ~ ~ IIJSULATION PER N. Y. ~ H STATE ENERGY CODE j y S/ y ~sf , FIIJAL `-rr ' G o s ADDITIOPIAL COMh1F.NTS: x ~ . 4 • ~ - - ~ I M x b F-1 b ~ ~ C H H O 2 u/ i P7 pp ' 4 • y ~4S x ' d..~ m..' ro H ~j3z T65-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~cu'~`~`--~ Z DATE ~ INSPECTOR ~3~ 765.1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ] ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL REMARKS: A.~/) S~ DATE I ~ INSPECTOR ~/~3 v ass-iso2 BUILDING DEPT. INSPECTItJN [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL REMARKS: ~j_ DATE / ~ INSPECTOR RpR~05~~91 1Q~47 rw. P.3i3 R~.~V'IM.W...T4J~..wwA..T.~.y~Y ..M i... F.ww.~ w~_...yw,.w ....ww....,r~......r... _.r._ ~ ~/o'ri vrl~'+c A r sdd~~ 'S ~ ~ ~ q?~ ? r...-~ . . p r7ry 6d" ~ aA ; ~ ~ ~ fi . I ~ ~ ~1. h 1` . ; ~ . t ~ ` (C ~ VS ~ ' • of ~L ~i R ~C ~ i QUO ~ • ~ '1, ~1 ~ ~ 1~ W W Q A ~ ~ ~ ~ ~ ,j ,C ~~fir ,r~i ~ ~ . , s k, t je~~ p l__L ~ ~ , 4 i IZ • ~-------•~J~ ~ j 1 VO~~ M. ~ ,.f du; 4 Yl y t .i ~ ~ ~ O 1 ~ ~ ~ ~ a A N • ~ ' c ~p I O ~ Z' a~A ~ ~~~1~ ~a ~ i ~HO., deex 6u/k.:wsaa ~G ~ ~ ~ ~ A ~~~~w~~ ~p~ rc i a e1C A~ai.eo~~~ :i.~p~. 4GNrl'si' au~r:r. a ' r n. ' , . . ! 1 a.~ e" .4 i ' BOARD OF HEALTH .f........ FORM NO. 1 ~ SET5 OF PL.I:IS ~ TOWN OF SOUTHOLD SURVEY • • BUILDING DEPARTMENT CtIECt: /~Q°~' TOWN HALL SEPTIC roam SOUTHOLD, N.Y. 11971 TEL.: 765-1802 t:OTI FY ; e_ CALL Examined .~~A~!a~.~4, l9`1.( MAIL T0: :~pproved~~~!+ti.~!~4../, f~., 19.°1 Permit No~O 1, a:~;~ . Disapproved a/c _ . ~r• ~'~a t a f'~ ~ (Building Inspector) a.. APPLICATION FOR BUILDING PERMIT " Q ~9g~ Date 19 . TOWN O gp~7w0 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 coveted 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 (fall 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 nave been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the tuilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or tegulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ,'lie applicant agrees to comply with all applicable laws, ordinances, building code, hous~c ,and regulations, and to dmit authorized inspectors on premises and in building for nece ry inspec'. ' ns (Signature of applicant, or name, if a corporation) (Mailing address o applicant) hate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Vanfe of owner of premises I Y1.On~a~S . 4.. ~ q.n E1.. ~"~t Iker- (as on the talc roll or latest deed) f • ~ t i ~ r oratfo~sign e of duly authorized officer. • (Name and title of corporate officer) Builder's License No. . ~ y.3,1 I-fZ Plumber's License No. ..~.QQ,y;P , , , , , , , , , , , , , , Electrician's License No. ~ 5 6 E Other Trade's License No . . Location of land on which proposed work will be done . . a9 Q . ~•~fi.~~.#.4. - 70w. ~ . I~'!b o!~ I ~ rrc. ~--.........~.4 4?~:I~,s~~tr.~-- . [louse Number Street Hamlet County Tax Map No. 1000 Section ~ Block ~ Lot ..~J~'-~........... , . Subdivision Filed Map No. Lot............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...SI,l~.4r-, qty t ,~r.tV?~:~t,~, , !';e~1GQw~r~-_:.. , , , , , , , . 4P~?';z vius' . Sq,w~t_ G;/~„g. i`r°W`g`~.1Y4at.,i?,~3I_i?1t.'~b`~@1'~31 b. Intended use and occupancy ~?-4:- ..................YID;tKti.~.7t3T'1ti~;g:y,'~ri,;~ tly~...... . 3. ATature of work (check whiRemoplicable): New Building Addition Alteration epair• al Demolition Other Work . _t (Description) 4. Estimated Cost...~.?J.~ .QPQ. ~ Fee ....~nc~Vr~~oL (to be paid on filing this application) 5. If dwelling, number of dwelling ynits . , O , , , , , , Number of dwelling units on each floor . , D,h If garage, number ofcazs 6. If business, commercial or mixed'', occupancy, specify nature and extent of each type•of use . . . . . . . . . g 7. Heinhtsl~l f ~xistin stru Nums', if any: Front 6.2<. , , ;Rear tf.'7 . , Depth 4'~ . ~ berofStories...~- Dimensions of same structure wi( p h alterations or additions: Front ~ 3 • F{-; , , , , , , , , Rear . ~ ~ . . De th ....t}~r.~~ .Height 1.~:. 6 !~h,~....... Number of Stories . . 8. Dimensions of entire new constn4 • • • ' • ' • ' ' ' ' ' ' ction: Front . ~ . ~.i:r,rl,~.ys Rear a ,8,i,wrpv~, ,Depth Z.I:W-:.......... Height ~.~k . ~ ! K c~ . , Numljer of Stories . , , , , , , , , , , ...................~r.~.. 1 Rear . J ~F9r9~,- Depth ..'-t ~ . 9. Size of lot: Front . f .~C~.• , ,Name of Former Owner . . 12. Does ro osed construction viola ises are situated . 11. onepr upsecd stnct in which pre to any zoning law, ordinance or regulation: .V.l.ZJ , t4't,;,,t , . g p • ~ I$ q~ . .Will excess fill be removed from premises: Yes No 14. Nameoof Owner of remises c~s4mas.(,44~~(<:et~:... Address x(.60 ~?rkhve; fJ~f, , , ,phone No.ai.~.42,'1~9?9.... Name of Architect ~Prq.4.~o~~-, , , , , , , , , , , , , ,Address 14`1. !?.•,`f0+`` New,y,~.k, phone No.212. 6~:7, osp~': Name of Contractor .~J,Idh, A. ~.1,.ec, `!',Sqv~, , , , , ,Address f36 ~gkwovzl .4wy.~4vf1'hone No.SIL, ~7z.4o1:7, , , 15. Is this property within 3(70 feet of a tidal wetland? vcyes,,,,,,,. No......... *If yes, Southold Tpwn 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 comer lot. n STATE OF NE YORK, S S COUNTY OF ~u'~,!'=q `K. • • • • • • • • • • • • • • • •~!V • •g ~ • • • • • • • being duly sworn, deposes and says that he is the applicant (Name of individual si Wing contract) ibove named. 'le is the....... A~SI'c~~N.7^ I' (Contractor, agent, corporate officer, etc.) >f said owner or owners, and is duly 2uthorized 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 vork will be performed in the manner set forth in the, application filed therewith. Sworn to before''m!!e_/thQis Jotary Public, ...l.~.l. ~,C,X~~ , , , , County AIAR1t RYAN ~ ' NOTARY PUBLIC, STATE OF NEWYORK . IE~RAI ~ (Signature of applicant)