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HomeMy WebLinkAbout19768-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-19925 Date: 05/21/91 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property: 3070 PECONIC LANE PECONIC (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 74 Block 3 Lot 15 ' Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 18, 1988 pursuant to which Building Permit No. 19768-Z dated APRIL 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 ie ADDITION WITH WRAP AROUND DECK AND ALTERATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate ie issued to EDWARD D. & JUDY L. DART (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N 168303 01/08/91 PLUMBERS CERTIFICATION DATED 03/27/98 KING PLUMBING & HEATING C` u' din Inspector Rev. 1/81 1O8M NO f 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) N°_ 1976 Z Date .9.~/.. 7~ ~ Permission is hereby granted to: .....y~...~~:~ ......~~o-..... at premises located at ...r~...~7...~~,~...... s.............................................................. County Tax Map No. 1000 Section ......~/TP,/...... Bloek .........rte........... Lot No.........1.~`..J...... pursuant to application doted ......../-'...//.,,lti 19~J~ and approved by the Building Inspector. c~ ~v Fee S/~cG.rl.~.l ~ / ~ , ildi I for Rev. 6/30/80 y Form No. 6 ~ ~ U TOG3N OF SOUTHOLD o;e BUILDING DEPARTMENT ~ '{i0 ~ TOWN HALL 765-1802 BLDG. DEFY. 70WN OF 5®UYHQLl3 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 Che 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 - Residential $15.00, Commfercial $15.00 Date ......~t~~D... Cl New Construction........... Old Or Pre-existing Building. Location of Property........~0 7 ~ ~ec 0 Vl ! L.. c~ Y1 1 House No. Street Hamlet Onwer or Owners of Property.....~.~~~ : ~ ..:/.~.V. ~ 22 County Tax Map No 1000, Section........ ...Block.....J..........Lot....1.5 Subdivision .Filed Map............Lot..... Permit No.~9.~~,~,~,,,.Date Of Permit{.~~~~~........Applicant...~~~:'..../?~t!'.~......... N 1 Health Dept. Approval.......... .............Underwriters Approval..... r----" Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... ~as Fee Submitted: $ ~ I ~3 y . " Co ~ ~5~25 APPLICANT. THE NEW YORK BOARD OF FIRE UNDERWRITERS ! 1 C)(11 {l~1 ~ BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 :flaiV4r,",tlY 0~,l94;7 Er'~:k•1~t~;f3ft/~t~ hi '~kLti'e.il Date Application No. oro file THIS CERTIFIES THAT only the electrical equipment as deacrihed 6ebw and introduced 6y the applicant homed on the above application number in the premises of L;It_ft~i?'S", k`}'1~'11N~iC IL~IT„•+}IA.N;, (~p;i',i1r,U'Ir~(', 1`1.Y. r~ ~a in the following location; L"1 Basement L"J" 7st Fl. L`J 2nd F'L. JI! f .Section Bfoek Lol 15? Dl;t.N~f~Sfih;~t 4],'I'a~ltl was examined on and found to be in corotpliance nith the requirements of this lJoard. FI%TURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT RVORESCENi OTHER AMT K.W. AMT. K W PMT. K.W AMi K W AMT. H P 1R `A J h tl i. L) 1 i , 1. ^ DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS EgLL UNIT HEATERS MULTI.OUTLET DIMMERS AMT. K. W a1 H P. GAS H P AM5 N0. A. W. G AMT. AMP PMT. AMPS TRANS. AMi H. P SYSTEMS AMi WATTS NO.OF FEET 9 1i' i '4 "t sl S. 1 f1 ~ t; 0 SERVICE DISCONNECT NO.OF S E R V 1 C E AMT AMP LYPE METER ~ YW ~ ~ aW 3.d JW 3 %4W NO. OF CC COND. A W G NO. Of HLIEG P. W. G. NO. OF NEUiRAlS A. W G EQUIP. PER .a" OF/CC.COND OF HbIEG OF NEUTRAL ! 1,0(1 Cfl 4 X 1 hf i '),fi) OTNER APPARATUS: a GAit,Y 1)Ui2t7ik{ f l,,i ~ZL1<i;f -li; %5 fi'C!{V7il~;Lf1 ItAMi: [`t Pt'C1f{,C%if~, hY, ll`a ~i'l 6ENERAt MANAGER i Per ~ t ' 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 COP OF CERTIFI TE MUST NOT BE ALTERED IN ANY MANNER. 1 0 S~FF~L` Cdr TEL. 7G5-1802 TORN OF SOYJT~Ob.D ~ . ~ OFFICE OF BCIILDIA7G INSPECTOR y` rn P.O. BOX 728 -r TOWN HgLL . SOUTHOLD, N.Y. 11971 Q! ~ ~ C E R T I F I C A T I O N Date ~ Building Permit No. ~7a(e 7' Owner ~~,gq,~~ (please p//rint)~/ / Plumber ~nl ~~uKj ~JinJ ~L f7e~f7-?gI ~ n,)G, (please pr nt) I certify that the solder used in the water supply system contains less than 2/10 of to lead. (plumber's s~'gnature? Sworn to before me this ~7~ay of ~C(_h.~~ T 19 Notary Public Notary Public, / County HELENE D. HORNE N018ty PubtiC, S4ate of New York No. 4951364 CotttmissionaEzpi Asffjyojik C~~i~,~~ i..5~.as, . ~ ~ ~ ~ .e... 1ELD I::S:'SCilU.7 ~~llATE ~ COhtMLNTS ~ ~ 1. Qo s FOUNDATION (1st , - t FOUNDATION (2nd) _ _ 2. o ~I.1 O DOUGH FRAME & ov PLUMBIW'G ti H 3 . x' m H ItdSULATI0P7 PER N. Y. ' STATE ENERGY CODE x fi~ o 4. ~ i/ FIi4AL 'LdYN~J ADDITIONAL COMMENTS:////JJJJ _ x V Q ~-8-' S~ D ~ ~ 1 ~ ~ x ro• M p~ ~ Y3 z x ro a` r d~ m H ~ 7~~ ~ ~ BUILDING DEPT. 1 NSPECTIt~N 4 [ ]FOUNDATION 1ST [ J ROUGH PLBG. [ J FOUNDATION 2ND [ ] INSU TION .f [ ]FRAMING [ INAL :i REMARKS: L - P. 4 e i Ii i DATE d ~ INSPECTOR _ _ _ I 17~~f~ TsS-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ]FRAMING [ ]FINAL REMARKS: __~~~s9~i-~~ ~ DATE ~ ~ {NSPECTOR i~ 17Z--Ce 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [)FRAMING [)FINAL RE11AA KS: DATE ~ INSPECTOR l7y ~ y 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION [ ]FRAMING ~j [ ] FINAL/ , DATE ~ INSPECTOR ' X65-1802 GUILDING DEPT. INSPECTMAN [ ]FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~ c i j c. DATE ~ ~ ~ INSPECTOR ~~'V r yr~ A ay ~ 0 sl W7~~0®L BtJILDlNG DEPT. INShECT1®N OUNDATION 1ST [ ] ROUGl~ PLRGo [ ) FOUNDATION ZND [ ]INSULATION [ ]FRAMING [~_~_F_I_N_AL REIYIARKS: d~ ~ ~~~~i/~~_ t r i DATE ~rS INSPECTOKf D ~~~Od~ ~ ~ Edward D. Dart BLDG. DEPT. Peconic Lane TOWN OF SOUTHOLD Peconic, New York 1195F3 ,~~f~G ,Suwf''W"t~~ 1/~r'~ / ~Q: ~Ym~~ 172~~ ~ ~ ttte~ . ~ ~ - /'J - Fosas xo, a TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERM17 CfH1S PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORITED) 0 01.7 2 6 Z Date 19.~.r. Permission is hereby granted to: . C/~ . y~~~-~'i~ ~....~i ct premises located at .~f~..~~.....X,lr.~r.:.....:~ Caunty Tax Map No. 1000 Section °,r..~..... Block .......,..`,3.......~L~ot No.....~,?~ pursuant to application doted ...7~~ 19CI..r,?., and approved by the Building InsQpector. / Fee $.l~l.° .....~=~~?~••4r ~c.. ildi I for Rev. 6/30/80 d/yB ~ Mtax~ 3 rvz~,o " - ~ FORM NO. 7 .x, ,~+r (8 ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT 4„.....~.......__.,_.~_x_..~._.._~._.. I TOWN HALL i•r'~t~+'v f ~y;,, r.tt7~ r> 3 SOUTHOLD, N.Y. 11971 ' " ' ' TEL.: 765.1802 Examined 19~U Received........... , 19.. . Approved 19~~Permit No.~.~!?~'. . Disapprove a/c ~ p K. ding Inspector) APPLICATION FOR BUILDING PERMIT f Date 19 . ~ IAISTRUCTIONS ' 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 the 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 cod and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. G~v~ . (Signature of applicant, or name, if a corporation) . ~~4~.h ?.G.. {.G~.....~~G~.t~ 1 C. i.~ .7....... . (Mailing address of applicant) 9 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..LK:rtt/~4:.. ~ ~ ..~'lQ... ~ ' ! . (as on the tdx roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corrporate officejr.)~~` Builder's License No. ~ l,l.~!'-" Plumber's License No. .~.J~ . Electrician's License No.~'/P?4~..~P'~!R~-~ Other Trade's License No `~..-.C1„/1.4~ . 1'. Location of land on which propo d work will be done. ..~r:eJGly~' . ...............t~h. is L ic............................. . House Number Street ~ Hamlet County Tax Map No. 1000 Section /`"r i Block Lot Subdivision . Filed Map No. Lot . (Name) - 2. State existing use and occupancy of premises and pintended use and occupancy of proposed construction: a. Existing use and occupancy ~...~~Ir...~.\(~~~... . b. Intended use and occupancy /:V.1.../~~. ..~4.c~,.,..c; !~N,t!i: , , , , , , , , , , , , , , , , , , ~-2-C~e.,~. tea;:. k . 1" _ ~ _ /tom .e-_ i.._ L'. 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AC,~ PECONIC, LON~ 15LAND, MEW ~DW'A~.D AND JUDy DAE,T 765 1~8, > (~6) 7&~- 5E CONb FLOO~ c~ DE~/~ OLITJC)N F~LAN 1 1 { WAY.Ur' F'LAc~ NEW ".(Ot~l<..., N,% 10005 (_~-I~.')~;?ZZ, 51 /(Zlt) 777-7DoO r .Il I~ ,T'LITCH f'I-A'ITr-':IrC-A~ 115 P--OlSEI;~T T, IS.~,I'L~Y AIA, t i WAVF___t~,.LI' PLACE NJESW yOF4,J<.. ~ N,Y, 10003 (2.-1&'}'~'~5-2m$l /(Z~2_) 7'77-78¢3O F-.DW~P..I) AND JUD'f bAET r. I- ('12..E~F O~ 'l,-.t-~__._W ~F-F--AT FLOOR yOF<.K. ~ EC. ONB ~CA LF__ : t P-..~,-15TI NF-I JG ~T'nC.. J~7-15TIN (1 t .,0 ToF oP F--~I~T, KIT, FL-. 00 "/.e-P-,[ Y -r ~ P~OBER.'T T. ~T'LF-_T AIA, A~ClflITF_-GT I1 WAVER. Ly PLAC~ NEW YOR..F.,., N.'f. I0o0~, (zlz) 995-Z~ ,(zlZ'~ 777- 7~ao DART P,.E.,~I D ~N, IC ~ PF-.CONIC., LONG I.~LA, ND ED~VA,~.I::~ ANIID JUDY F:~R_ONT To SECTION AND WALL '~,=--..C, TIOI',,I I if R. O6E~T T. IBAYLEY AIA~ ARCHITECT II WAVER. LY PLACE ~ Ew YoR.~, N.Y. IO0OS (Z12.)9%-2_~5~/('ala) 777-'7800 bART R..ESIDEN C E ?ECONIC., LoN..~ ISLAND ,. NEW EDWARD Al'ab .JUDY DAP..T (~ 76~-1818/, (SKo) 7~os -zsl~ 'TOP.. -1'- I FI - LEVA-TIO N $ ~ DECTION ,~