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HomeMy WebLinkAbout20178-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25996 Date: 09/29/98 THIS CERTIFIES that the building ALTERATION Location of Property: 285 EAST GILLETTE DRIVE EAST MARION (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 38 Block 4 Lot 10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 26, 1991 pursuant to which Building Permit No. 20178-Z dated SEPTEMBER 27, 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 INTERIOR ALTERATIONS TO EXISTING ONE FAMILY DWELLING & ATTACHED GARAGE AS APPLIED FOR. The certificate is issued to GERALD S. & BETTY J. WELLS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N234189 05/06/92 PLUMBERS CERTIFICATION DATED N/A Building Inspect Rev. 1/81 IFO16M 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 AUTHORIZED) N o 2 017 $ Z Date `~~a~...1 19:~l Permission is here ~ granted to: to .~r..~.y!`~~f ......~.~~1.~,.r~.....:~ .....fir.. .....~a~..- at premises lotated at .,°..:.~.~.~~G'.T.. .:~....t::.~~ County Tax Map No. 1000 Section Block Lot No..../.~............ pursuant to application dated ........1~~.~a 19.~~ and approved by the Building Inspector. ~ ~ Fee v~ . . . . Fez., • ilding Inspector Rev. 6/30/80 Form No. 6 C~'~~ ~~~-s~~~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the built inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lir streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-O fox 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contain less than 2/10 of 1~ lead. 5. Commercial building, industrial building, multiple residences and similar buil 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 "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 applic: If a Certificate of Occupancy is denied, the Building Inspector shall state th< 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.OC 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 - .25~. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date New Construction........ r/. Old Or Pre-exCisting/B/uilding.. Location of Property....P`~~........s:-.~!.42~,~~~C~eE:..~cs~~.....~!d~':./.~!"~~::nw.. House No. ~ Street / Hamlet Onwer or Owners of Property.. ~.~.~~/~?.~.lc>.~/~$. ..i~..:~/~./~~, County Tax Map No 1000, Section.C7~S~S.'~~....Block.®y.Q.L).......Lot....CF2... __.Subdivision ..............................G.•.....~~Filed Map............Lot.......... Permit No.~.©.~,~ ,,,,.Date Of Permit../~ 7./.7.~ ....Applicant Health Dept. Approval ..........................Underwriters Approval.................... Planning Board Approval Request for: Temporary Certificate........... Final Cer i ate.... Fee Submitted: $ SS'19 ~ is . ~,9.Q',. APPLICANT CD-~-~S9~~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~,~e>~ 11115077 BUREAU OF E4ECTRIC.ITY 88 JOHN STREET, NEW YORK, NEW YORK 10038 Dote HA'l. Prf,7.99? AppliwtionNo.onfile 76952792/9'7. N 7,39Lt13 THIS CERTIFIES THAT only the elec[rical equipment as described below oral introduced by the applicant named on Lhe above application number in the premises of CsfsRflGO 63FiLCl:i, ?.85 1;Au~' fi1CIGCiT llR7VFit NY4' ~7„ C"ASJS' Flf1R70NT N,Y, ' in thefollou•ing location; ©BaYement ? txt F'I. ? 2nd F'1. ~11~ .Sertion Bork Lot uns examined art AI'[2IC, 2`f f ~ ~ ~ and found to be in cornplianre with the rrquirements q/'this Roord. FIXTURE ECEPTACLE$ SWITCHES RXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT fIUORESCENi OTHER AMi. K W AMi. K W PMi K W. AMT. K. W. AMi. H P 1~ DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CIOCK$ gEtt UNIT HEATERS MUlTI.OUTU?T DIMMERS ,r'~ OMT. K. W Oll H. P. GAS H P. AMT NO. A. W G AMT. AMP. AMC AMPS TRANS. AMT H 4 NO. OF FEET AMi. WASiS 3 wh.. , ~y{; jl~,~l SERVICE DISCONNECT NO.OF 5 E R V I C E }f;$• t METER NO.OF CC COND. A. W. G. A W. G A W G. Ami. AMP. TYPE EGUIP 1,9'1W I,e'DW 39 ~W 3,a'4W PER .6' OF CC. COND. NO. OF HbLEG OF~HI-LEG NO OF NEUTRALS OF NEUTRAL ifit 2 lo3A C13 L fi 2 4 1. 4 OTHER APPARATUS: R05LAK h;Lh;CTLTIC T,1C,#9677°C P.O,C70$ 169 CUTCtCt1GN6, NV, 1.'!Y:>5 GENERAL MANAGER Pert ~ 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. 1\ CO Y F I DING E RTM NT. IS COY F CERTIFICATE MUST NOT BE ALYERED IN ANY MANNER. ~ 765-1802 ~ BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ]ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU [ ] FRAMING [ AL [ ] FIREPLACE & CHIMNEY REMARKS: DATE ~ INSPECTOR 7::LJ i;:.`',: r,:.1J:i ~~ii:,:c I~ .:Gi1i9t.NT~ ~ I m \ OUIJDATION (1st) I ~ OUNDATIO;J (2nd) _ _ m OUCH FRki~IE & PLUMBING 1 . y y m NSULATI021 PER N, Y. n STATE EPJERGY I CODE I ~ ~ ) . m • ~ r H I FI;IAL I t~ I _ o . ~ Cv ADDITIONAL COMMENTS: m !O x - • ~ x 'a~ M S O \ T m a ~ r -1 x • v. m -a H ~ 1 II~~ t)NDEItiNRlTERS CERAFICATE 'I REQUIRED 111111 ~ ' W ~,rpo E ~ ~ ~i9 \ _ ` ( ~ /Y ~ ~(d OIL ~oK ~ ~ - ~ ~~~„D01= ~~<< ~N S ~ t_A-7~ Cx~~- ~,2~ v~~-~~- i ~ , , ~ ~ pp ~ 1 _ - ~ - - ~ - _ ~ E ~ C~~/l r~ ~,y~ UNDER RIEpUiREO TIFiCn7E ~~""'n~ ~l G1'r ~ ~ - - - E - - r / ~ ~~E~ - _ - -------y--- - ~-XF l~ Q.L oK - - - - - - - Cn - '.1 _-T__-_____ q. ~ _ - _ ~I ,'C~ ~~l iii - _ -__.__."'r._~ - - i I ~ - _ _ _ _ _ (n~ _ . __I II~ _ h~fff II-- _ ~l. - .M'~~. J: - _.._w~,.,-.___ - - - _ - ~~S__~/z5T t ~ _ ~ ~ _ _ ` ~ _ ~ BOARD OF HEALTF{ i},`~ ~f~?~(.`~v~l~V/ P~F°''~Ij FOAMN0.1 3 SETS OF PL.I.{S ,r, "~.N.~~ . I; ~ ~ TOWN OF SOUTHOLD SURVEY _ . 'I ~ i ~ ~~P 1 BUILDING DEPARTMENT Cf1CCR . , . i ~4d 261991 ~ TOWN HALL SErrlc roam _ d(.~U~ SOUTHOLD, N.Y. 11971 .~~`<j RLGC. t7E'!~'T. ~ j TEL.: 765-1802 P:OTIF`f 7_ __l-C1NJ4ti :r 4t~UTNt:~t;C1 y / CALL'?~T.~ . Examined ~g.~a, 19q~~ © Pf A I L T 0 : ~ ~ Approved . /%.7...... , 1X.~Permit No. ~>~.J. ~7~>.~ . . Disapproved a/c (Kuildi ~ Spector) . APPLICATION FOR BUILDING PERMIT Date . 19 . 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 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 tegulations, for the construction of buildings, additions or alterations, or for r oval or demolition, as herein described. Clie applicant agrees to comply with all applicable laws, ordinances, build' e housin c e and re ulations and to g' • g > #dmit authorized inspectors on premises and in building for necessary inspec s. . ...r_i • . . . . J . . . . . . . . - (Signature of applicant, or name, if a corporation) (Mailing address of applicant) /~SJ j Stale whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Vame of owner of premises Ur'~H/~ .S' ~~s ~i`, ~ ~ ~1~-~15 (as on the tax roll or latest deed) It 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 . . I. Location of land on which proposed work will be done. ....o~~~...~~, .SJ, ,~•;°j`~;!T.e;~ , , ~~t~l ~'.V , , , , Ilouse Number Street Hamlet County Tax Map No. 1000 Section ...:-mss .~C Block ......:Ll.......... Lot l U.......... . 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 ...........Q~~. ~ GUgl~k ~ ~"~-i°'s ~ - %"gyp , . /~.r ~ S b~ s J h :FYt. . b. Intended use and occupancy ~ i ~.....l~-/n e~¢j.~~ ~s.a._:s~,r<,-. ,-,~.;a;,;,,;.r)€~, t ..w.. ~ ei~ :a:#7#>Fip}.:`~+r: it t ~:d ft'? :$,illif~;."$ 3• Repair of work (check which applicable): New Building , , , Addition Alteration v/ • • • • • • Removal . Demolition , . , • ~ ' ' ' ' • ' ' ' .Other Work . 4. Estimated Cosy , . b©d, (Description) Fee .......~'.P~,`....'......:.......... If era a number of cazs g (to be paid on filing this application) g' I • • • • • • • • • • • , Number of dwelling units on each floor . . 6. If business, ommer oal o`remixed occ' . ' . Hei 1 ~ Fancy, specify nature and extent of each type of use . 7, Dime ~~ions of ex~stmg structures if ny: Front . . . . . .Rear De th . , . g •••••••••.,....NumberofStories, P imensions of same structure with alterations or additions: Front Rear P 8 Hem Ysions of entire new construcho'eight . . . . . • • • , , Number of Stories . n: Fr'ont Rear.............. De th g Number o ....'f Stories P . 9. Size of lot: Front , Rear . . 10. Date of Purchase Depth ' • ' • • ~ ..Name of Former Owner ~ • 1 1. Zone or use district in wl2ich premises are situated . . . . . . . . . . ~ ~ ~ ~ • ~ • ' ' ' ' ' ' ' oes propose construction violate a ' g ~ ~y zoning law, ordinance or regulation : ~d 13. Will lot be reraded ~ • • • • • • • • • • , .Will excess fill be removed from premises: Yes No 14. Name of Owner of premises Address . . Name of Architect • ~ ~ ~ ~ • • ~ ~ ' ' ' • • .Phone No . . ••••••......Address. .PhoneNo.. ) Name of Contractor .............'i...... , ......Address . • • • • ~ • ~ • , ,Phone No.. • • • 15. Is this property within 300 " " " " " " Y feet of a tidal wetland. *yes•,,,,,,. No......... ` *If es 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. p~~p aov a as ~uorE® PATE: A o°L ~ 9.p. # ' FEE: ~ ~ M1IOTIFY BUIL. NG OEPART T 7 7EiS-1802 9 AM YQ 4 PM FOR THE FOLLOWINti INSPECTIONS: 1. FOUNDATION _ 'NVO REQUIRED ' FOR POaJRED CONCRETE 2. ROUGH ° FRAMING & PLUMBING INSU1.ATloN 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR CA, " ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY ~ CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS iATE OF NEV~ORKQ,Q S.S i (~Nam~e ~f individ a1 si ni~ s • ~ • • ' ' ' ' • being duly sworn, deposes and says that he is the applicant g g ntract) hove named, fcisthc (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 file this :~plication; that all statements contained in this application are true to the best of leis knowledge and belief; and that the ork will be performed in the mannerset Forth in the application filed therewith. worn to before me/thi~s J otary Public, r.S.•-.~*S .ti'•t,C . C,~, , ,~~=~unt " ~ Y ' GAIRE 1,. GLkW • ~ ~9'~~2~2 S-~.. . NotNy Publla 8tata of NewYak . . No.4B79606 QueiNlodlnSuHotkCauMY I ~j~~., (Signature of applicant) Cwnmissbn Expires Docem4a 8,19_. ' - -