HomeMy WebLinkAbout20183-z FORM NO. 4
~ '
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22544 Date AUGUST 23, 1993
THIS CERTIFIES that the building ADDITION & ALTERATION
Location of Property 14755 SOUNDVIEW AVE. SOUTHOLD N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 50 Block 3 Lot 7
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. 20183-Z dated OCTOBER 3, 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 ADDITION & ALTERATION TO EXISTING ONE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to MICHAEL & JOAN REGAN
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. PENDING - AUGUST 16 1993
PLUMBERS CERTIFICATION DATED AUGUST 9 1993 - THOMAS J. TROSCLER
e
O r r
s
ui ding Inspector
Rev. 1/Bl
sosac xo. a
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 01$ 3 Z Date ..1..~,~~ 19.
Permission is hereby gronled to: ,
J....
,
of premises located at ..17.,~~..5~/.:! ..~...........f
County Tox Map No. 1000 Section
BIOCIC ........:.Y....... LO! NO...........L......... a
pursuant to application doted /~.~•~•f• 19........, and approved by the
8uildfng Inspect~o,lr.~
fee S••;~;21i.
""~f:~'" .t~'r.~l
ilding Inspector
Rev. 6/3Q/80
Form No. 6
~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT J GCJJCi~~L
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OP' OCCUPANCY
A, This application must be £illed in by typewriter OR ink and submitted to the building
inspector with the following: for new building or new use:
I, Final survey of property with accurate location of all buildings, property lines,
streets, and unusual natural or topographic features.
2, Final Approval from Health Deft. 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 - Residenti`aJll $15.00, Commercial $15.00
Date a6 ~9 3 ,
New Construction.........~./ Old Or Pre-existing Building
Location of Property... ~.7~~..`~......~=?~a~~Jlc.~:..!~J2 :............Sov'j~oLD
House No. Street ~ Hamlet
Onwer or Owners of Property..... M,IG ~AQC~....~q~ ~
County Tax Map No 1000, Section.,,,;~,~,,,,,,Block.,~ „.........Lot....
Subdivision... ...Filled Map.........A./..Lot./......~.7-..
Permit No..,ad, ~.~,~....Date Of Permit. l.J./! p. ...Applicant ./:r~; ~'~~-A'~n vo'~~,.~~',~,A.L~
Eiealth Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval
Request for: Temporary Certificate........... Final Certicate.~
Pee Submitted: $ ~
c~.~.,y4G~8~
AP LI`,~..
TEL. 765-1802
~c~V~~QC{tC® '~'~Wiv Q~1F $®iT ®LI9
OFFICE OF BUILDING INSPECTOR
~ P.O. BOX 728
~ TOWN FIALL
'YO~a®~ ~~®`r SOUTIIOLD, N.Y. 11971
C E R T I F I C A T I O N
Date 9 3
Suildi.n~Ag IPermit No. a y ~
Owner M Ic~ ~~+F~ ~ Jy~~, 1`~'Q ~
(please print)
Plumber_
j "/bri/~5' ~--T;LL~~C,LP~
(please print)
T certify that the solder used in the water supply system
contains less than 2/7.0 of l~ lead.
~
( umber's signature)
Swo~ to before gee this
day of
Notar Public
Notary Public,~b~_County ,
LINRA 1AC0880N
NOTARY PUBLIG, 8fate of New YorN
No. 486762A, S~.`tolk Cody
Commission f.~p~es: 1
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765-1842
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ )ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ FINAL
REMARKS=
DATE ~ INSPECTOR
~lg~
T65-i$02
BUILDING DEPT.
INSPECTIQN
[ ]FOUNDATION iST [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ INAL
REMARKS: r/~'~Z ~ -"~-tie~
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DATE ~ INSPECTOR
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765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ FINAL
REMARKS:
DATE INSPECTOR r~'~J
r
TsS-lsoz
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST f OUCH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [)FINAL
A t
REMARKS:
• Ar
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DATE ~ INSPECT
T65-1802
BUILDING DEPT.
1 NSPECTIC~N
[ FO DATION 1ST [ ]ROUGH PLBG.
[ FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS: t~-.~~ ,~/,~r~
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DATE ~ ~ ~ INSPECTOR
.
T65-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
FOUN ATION 2ND [ ]INSULATION
FRAMING [ ]FINAL
REMARKS:
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DATE INSPECTOR
T6S-1802
BUILDING DEPT.
1 NSPECTION
[ ]FOUNDATION 1ST [ ROUGH PLBG.
[ ] F,~IUNDATION ZND [ ]INSULATION
[,/]/FRAMING [ ]FINAL
REMARKS: C~ ~ _
DATE ~_INSPECTOR
THE NEW YORK BOARD OF FIRE UNDERWRITERS e~h>•
11.3hI?~4~5 BUREAU OF ELECTRICITY
BS JOHN STREET, NEW YORK, NEW YORK 10038
$ate AUDUSi'.~ 25,1993 AppltcatFonNmunfile •76R5R5~2132 4.3 2s7453
TNiS CERTIFIES THAT
only the electrical equipment as described below and introduced by the appffcane named on the above application number in the premises of
PtTCNt~Ftf, ftFl6Rt11 E/C IfYAT1: C.D,&~ueL} L! Y7fIPt RD.; >,[LCO ~,1t SQ[ITi{D[,D, N. Y.
in the following location; 0 8aa¢ment ~ 1st Fl. ~ 2nd Fl. ~1 ~111`fDfJD~' Section flock Lot
was examined on A Uh D 9 ~ F I T ~ ~'7 and found to be in compliance rtith the National Electrical Code.
FIXTURE ECEPTAClES SWITCHES FIXTURES RANGES COOKING DECKS OPENS DISHWASHERS EXHAUST FANS
OUTLETS INCANDESCENT FW00.ESCENi OTHER AMT K W. AMT N W. AMi. KW AMi K.W. AMT. N P.
ZS 29 2I. .I }..4
DRYERS FURNACE MOTORS RUTURE APPl1ANCE FEEDERS SPECIAL REC'PI TIME CtOCNS eHL UNIT HEATERS MULTI-OUTLET DIMMERS
AMT K. W. OIL N. P. GAS H. P AMT NO A W. G. AML AMP. AMT AMPS. TRANS. AML H P SYSTEMS AMT WAITS
No. of FEeT
i Y
SERVICE DISCONNECT NO.OF S E R Y 1 C E
AMi. AMP TYPE METER L Ar tW 1 p' 3W 3 ,a EW 3,e' 4W NO OF CC CPND A W. G. NO, OF HIdEG A. W. G' NO OF NEUlaAl3 A. W G.
EQUIP. PER ,e' Of CG.COND. OF NItEG CIF NEVipAI
OTHER APPARATUS:
Pi09'OR8:1~~3 f1.A„9.-F Ei.P,
PACIElS,DQ2tF3t eY-I C:Ck. GCAT'i-~:a C'1R. ?~U_
~f,QC. WA'L'IfP. Ff&RTN.iRiv o 1 ~4,5 K,W.
$NlOK1; DI;`1'ECT()R z ~ 1
T$RCR L'[G,ffTi:PtGs-,1
~RFINt:TS R, EtdCAFFFRY trZL'.#7145 $ G/~~~~
710 i0 13k'CDGf3 I~ A . 1 19:1'1
00ryKx~~ yy1~~.45 ~y,v qt 16 EiENERAE MANAOeR y
1~~11„fl~r]U.~li f9Xt A.1C1.).! 11 J•
Per
This certificate must not be aMered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by Lbeir credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
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NOTEI gURVEY FOp `
aurEV'oilEC couNMVinx
M~'i,
~~PfPE MtCNAEI REt3AN d JOAN REOAN
d9t 0 OSECT ¢Q BLOCKQ~1'LOTQ~
AT SDUTNDLD DATE' MAa.zr, Iasi
TOWN OF SWTHDLD SCALES 166.40'
SUFFOLK COUNTY! HEW YORK No. aT•D9ae
NUNYrxMt[[p urCRfbpN OR Netmpx m mn OUAR0.NTEED T 1
MerViegi erirKKiw~ rdowii~ x ttp/ rt TN< MICHAEL pf NEIB i
Mtpl[! pY Tq! MV[Y NOr RtRMt 1N[ UMp xIDAI~ REf{A
tYNVLgpY M%kp Yll. pp [M+OMtp I[IL tN\LL ARf.$ MORT,~.4rE IKC.
N9T![<pxsmul[pry+ttvatrp rout co[r
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iM Rx/px Ipl NNOx TXt lYRV[Y If xRxlt[p
txo a of KW,u m 1Nl not <tNFwr, t[vux. N ORK
ptxm lfaxer tto uxexl! q+trrpnM uene
Np[Ox, LMp 1p rH[ FMIFMI1IR1((f Or M[ Nxp11N ~r
IO rttplnO~ll~tLx111li1rpfM110N [Y1fT[W[[Nilpl[ ,
ppM[xt
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rotnfnxt Fn VtNNU UtIM l1K<Int
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MONCMI Uxt+ M lUt M! tRLCtroR a IINt[f ~1?
YOUNG ~ YOUNG ~n°~no",~wvoa E
0.LDEN W.`NUND, PROEE5910N4L CMDINEER
AND UND SVRYEYOR N Y9 UCENSE NO.IES4S
NOWARO W YOUNd, LANG SUIIVEYOR
N.Y.l. LICENSE N0.49S9S
NRXxen • tau[ Ixc Iwe ~ F
BOARD OF HEALTH
FORMN0,1 3 SETS OF PL\:SS
TOWN OFSOUTHOLD SURVEY
BUILDING DEPARTMENT CIICC2 : .
TOWN HALL SEPTIC FORlI
SOUTHOLD, N.Y. 11971
TEL.: 765-1802 t:PTIFY;
Examined 9 CALL . l" / ,
19.~ 1'SAZL TO:
APProved . ~Qr~ 19~. Permit No.. ~ .
Disapproved a/c . .
. ',Y~ ~ , ~ ~V: T.
, ~ ( gI ector)
~;,_+:~,...~JkPPLiGATlON FOR BUILDlNO-Pfi;141tT
„`G:..
. ,
k~ - .€;-,zrJi Date ]9...
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-
;aEion,
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
luilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Zegulations, far the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
Elie applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
dmit authorized inspectors on premises and in building for necessary inspectionn~. R n
..........l:!r !Y
(Signature of applicant, or name, if a corporation)
...1.`1;1,55 ~,,J~~SJjew ~JL ~j e~J l~.al'.
{Mailing address of applicant)
hate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
p W+'a P-
.
game of owner of premises , . M«~~L ~1~'`F'' QeG A~
(as on the talc roll or latest deed)
f applicant is a corporation, signature of duly authorized officer. •
(Name and title of corporate officer)
Builder's License No. e`~
Q~~
QS
Plumber's License No . .
Il
Electrician's License No.
Otl~cr Trade's License No. I
Location of land on which proposed work will be done . .
~`j~55~ $aou~Viet,J RJe--~ S~d(~,o~~
[louse Nwnber Street Hamlet
County Tax Map No. 1000 Section , Block . , . a,3........... Lot .
Subdivision Filed Map No. Lot .
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy R~S,oeA"`
b. Intended use and occupancy ~e~t ~2.?~e_ '
. `'k . , . ,
,.,,ure of work (check whicRh~ta op~icable): New Building Addition Y...... Alteration
Repair ~1 . Demolition , Other Work , . .
4. Estimated Cost ..~`~I~;': ^,~'5,~4°`~, • • (Description)
.Fee
~ g {to be paid on filing this application)
S. If dwellin number of dwellin units , , . , , , , , , , , Number of dwelling units on each floor , ,
- Ifgaragc,numberofcars
usmess commercia or mixed o0
cupancy, specify nature and extent of each type of use , . c . . . . . . . .
g , , g.. , .Number any: Front V:°..... , .Rear . al~.......... Dc th . a 4.... , .
' P
7. Hem~nsronsofexistm structures 1f of Stones.,.1,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,•. .
•
Depth sions off same structures with alterations or additions: Front . . . Rear . uy.. , , , ,
d,
P . I-);eight . , Number of Stories .
8. Dimensions of entire new construction: Front . ~,A!N,..., , , , , , , , Rear Depth
Height Number o,f Stones . • • ' ' ' ' ' ' ' ' ' ' ' ' '
9. Size of lot: Front . i,$.~;39 Rear ..~~.a-r ~6 . . . .........Depth .d~1,8,~~ .
1 lO. Zone or usecdistrict in which remises ' ' ' ' ' • • Name of Former Owner , Gt!f".Te;t,s .
....p .....laresituated
12, Does proposed construction violate any zoning law, ordinance or regulation: ,
13, Will lot be re raded 4
g • .........Will excess fill be removed from premises: Yes p
14. Name of Owner of premises ..f~!zG:~. , ~~~A, ti; , , ,Address ,l
i~7, 3 r s,~oAO,ew ~`'.eI'hone No. 765 ~
Name of Architect , .....Address . . .Phone No............... ,
Name of Contractor . . PhQn~e No.
15. Is this property within 300 fe '•••Address
y gt of a tidal wetland? *Yes........ No.1.C
*If es, Southold Town Trustees Permit may be required. ~ "
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate alt 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.
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TATE OF NEW S;5
Qal•.........
' ' ' • • • • • • • I , , being duly sworn, deposes and says that he is the applicant
{Name of individual si g contract)
,rove named. '
e is the .....Q;il ~u,e~;( •
(Contractlor, agent, corporate officer, etc.) ~ ~ ~ • ~ ~ • ~ •
'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 his knowledge and belief; and that the
ork will be performed in the manner set forth in the application filed therewith.
vom to before me this I
>tary Public, .County
~i,
ROBERT t. ~ OTT, JR. .
NOTARY PUB C, State of N.Y. Si nature ~ ~ ~ ~ ~ • ~ •
pa4~250119,Sufioik ( g of applicant)
Term Fxphes 1+4Y X1,18