Loading...
HomeMy WebLinkAbout20056-z l FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20669 Date APRIL 23, 1992 THIS CERTIFIES that the building ADDITION Location of Property 405 PRIVATE ROAD #3 SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 70 Block 6 Lot 15 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 28, 1991 pursuant to which Building Permit No. 20056-Z dated JULY 31, 1991 was issued, and conforms to all of the requirements of the apglicable provisions of the law. The occupancy for which this certificate is issued is ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DONALD & JOAN VON EIFF (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N-226432 - MARCH 2, 1992 PLUMBERS CERTIFICATION DATED FEB. 21 1992 - PECONIC PLUMB.& HEATING ' di Inspector Rev. 1/81 1FOB.ffi NO. f TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMR (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N 2 Q 0 5 E Z Date 3.1 19..~,/. Permission is hereby gmnted to: of premises located at .....~1.~...../.. ......................................4~.~... ' ..rS/. ~ L? O ~ .rZ..~f1 CJ d d~,~-(l ! yl ®~j~T! County Tax Map No. 1000 Section .......~a........... Block Lot No............~.J`...'... pursuant to application dated 19~~.., and approved by the Building Inspector. ~ .3/`~j ' Fee S...f " Buil g Inspector Rev. 6/30/80 • r Form No. 6 ~ ~ ~f~- 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 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 2J10 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 - ResidentialL/$15.0/0, Commercial $15.00 Date T~~!•%~ . New Construction...: ...`./.~O-ld Or Pre-existing Building.......... Location of Property.... T~il .~A,`%1~~f~G.'..~~~~.:~:~ ..~..~out~?,Qf~ House No. Street Hamlet Onwer or Owners of Property... ~~,o~u;l~/. ~ .JO~.i,J . [~%7~~ • . . . . County Tax Map No 1000, Section....p 7a'.....Block.....ar°........Lot....~~.~ Subdivision X..................Filed Map ...f:.......Lot...... X.............. o2GOS (o ~~G/~ pp v ./oar/. ~i7 ~FT, Permit No ................Date Of Permit.... ......A licant.. r~.7n . Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate..~..... O Fee Submitted: $...°7..: © < ~~C~ ~367q ate: ~y,//r~~~~~ to ~ ao~~q APPLICANT TEL. 765-1802 ~pS~~F~~~~0~,, TORN OF SO~JTIIOd.ID .ti:'~ ~ OFFICE OF BUILDIPIG INSPECTOR P.O: BOX 728 ~0~ _ SOUTHULD, N.Y. 11971 Ol ~ C E R T I F I C A T I O N , s Date Building Permit No.~O(7~~f-~ Owner (please print) Plumber~N G~iC ~~~o.~/~iN9 ~~/~r~i<!p (please print) / I certify that the colder used in the water supply system contains less than 2/10 of 1% lead. ( u er's signature) Sworn to before me /~is day of ~'~1-- ~ ' No cry Public ifotary hublic,~t/~~UL~ County BARBAM STEPNOWSq Wo1ery Pub9c. StoN of Now Yak Oee60e~dM S~uSloG~cCouny Canmission Expkes Sept. 30,14 j >a THE NEW YORK BOARD OF SIRE UNDERWRITERS rxfsr a. 109.077. BUREAU OF ELECTRICITY II 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date t4P.RG73 ~1~~1!'32 ApplirationNo.anfile 761~1G1!32192 11 ~?7.~s~32 - THIS CERTIFIES THAT only the electrical equipment as described below and introduced 6y the applicant named on the above application number in the premises of uotraz~l) vo~~;l~~>!, 1'r.~rR N~cx Roilnt ~1NarNN~)z,o, in thefallouing location; ? Basement Q lst FI. ~ 2nd Fl, Sertion Block Lot was erarnined on k'fi f3 N7 NNA[2£ ~ ~ t } ~ ~ ~ and found W 6e in contplianee with the requirentenls q(this Board. ctxruRE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHEfl PMT K W. AMi K W. PMT. KW AMi K.W. AMT. N P DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS gEll UNIT HEATERS MULTI-OUTLET DIMMERS AMi. K. W. OIL H. P. GAS H P. AMi. NO. A. W G AMi AMP pMi AMPS TRANS. AMT H P SYSTEMS AMi WAiiE NO.OF FEET 1 30 L 6(40 SERVICE DISCONNECT NO.OF S E R V I C E AMi. AMP TYPE METER I R 2W 1 d 3W ~ % 3W 3 q 4W NO OF CC CONp. A W G NO.OP HI-LEG A W G NO Of NEUTRAiS A W, G. EQUIP. PER a OF CC COND. OF HI-LEG OF NEUTPAL OTHER APPARATUS: fiNf)7'QrtS:1 7./2 NN, F. t;,.F.C.It-2 ~ SM~NCE DETECZ'tlR:-?. e i ~~~~E:ec-t~-i ~o'l G tr 9 uQtd9'RACT'OR GLC,&578_S BQ% 215 G//%~~ 90U1'}[pl,l7t lv'Y, 9.1871. GENERAL MANAGER Per 11 r F 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. t COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANPIER. { ~v vv ~ 765-1$02 BUILDING DEPT. INSPECTION F NDATION 1ST ( ]ROUGH PLBG. (]FOUNDATION 2ND [ ]INSULATION [)FRAMING [ ]FINAL REMARKS: ~ INSPECTOR ~ ~ ~ DATE ~'~i r-_ T6S-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] F NDATION 2ND [)INSULATION FRAMING [)FINAL REMARKS: _ A~t~~~ L f G i/nrd.tn ~~i-`''~ ~ -~o DATE ~ INSP 765-1802 BUILDING DEPT. INSPECTIQN [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ FRAMING [ ]FINAL G RE ARKS: _ ~ v DATE 0` INSPECTO 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION iST [L~] "ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [~RAMING [ ]FINAL REMARKS: ro q%.,,,t ~ DATE ( ~ INSPECTOR i 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST f ] ROUGH PLBG. [ ]FOUNDATION 2ND [ INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~--~~~~9~-; . 4 ! DATE ~0'" 6 INSPECTOR A^~ 6 4 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION iST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] I SULATION [ ]FRAMING [ FINAL REMARKS: a DATE l~ INSPECTOR ~2~~~1 lELD Ii:S:`FC;iU;J ~~Ur',iE ~ ~OtYMENT° F ~ O S H _ H~ FOUNDATION (1st) ` _ FOUNDATION (2nd) ~ 2. z 0 ROUGH FRAME & 1 PLUMBING ~ .2~ x/c~ y 3 . ~ Y, y '1~ IIISULATIOt7 PER N. Y. STATE ENERGY CODE x 4 . jfJ 7!' - y ` FIidAL t o APDITIOI7AL COMMENTS: p i~~~ r ~ ~ ~ ' x ro v a ~ y O 2 A \ • r H - ~ ~l1 O. b H ~~nx.....~_~__ 1 1 s 7~q~oi3_a~`ar~'~a5'`~bY.~a_E~~i ~~`au uAS~E~.:IIk! aP. New York State De artment of Environmental Conservation I,~' Region 't Headquarters ~ ~ II'. SUNY, Building 40, Stony Brook, NY 17794 DP_TE: G~~ 3C7j?~~/ r.''', '~ivr. , ~ ~'1I.Li, ~c,... Nolr(`/( Re : ~ ~ ' __W` Thomas C. Jgriin ~ "I,„; com i t Dear. ~u.r--~'JZc~. l~irY~~4 - - - A review ha- been made of your 'proposal to: ~„~ititu-mr/ . cs. oL `J ~ce.of~sl~Ce~~ ~ ~ ~ c~rwQCe~L~ ~'~s'~-~" ?~~ti~.`,c~.lC~Ti~!sa~® -~?r1-6' . ~G~~.l~ /~kytiPL~'~5~^~y/ ~~-y mil ~~L. eC¢._.JZ. ~6/d _'24G~,,CU!E~~ 3as~the information you have submitted, the New York State Department of Environmental Conservation has determined that the parcel project is: Greater than 300' from inventoried tidal wetlands. _ Landward of a substantial man-made structure greater than 100' in length which was constructed prior to 9/20/77. 7~~/ Landward of the 10' above mean sea level elevation contour on a gradual, natural slope. _ Landward of the topographic crest cP a b1u>=r", c1iFt or dune which is greater than 10' in elevation above mean sea level. Thererore, no permit is squired under the Tidal Wetlands Act (Article 25 oc the Environmental Conservation Law). Please be advised, however, that no construction, sedimentation or disturbance of any kind may take place seaward of the 10' contour or topographic crest without a permit. Tt is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ' ground surface or vegetation in this area as a result o>=,your project. Such precautions may include providing adequate .work area between the 10' contour or topographic crest and the project (i.e. a 15' to 20' wide construction area) or erection of a temporary fence, barrier, cr ha Y bale berm. Please note that any additional work, or modification to the project as described, may require authorization by this Department. Please contact ,w. this office if such are contemplated. ~ - "~'~~~'~"~!I Please be further advised that this letter does not relieve you of the ~ responsibility of obtaining any necessary permits or. approvals from other ._~,;.I;; agencies. ~ ' Very truly yeurs, ~ i ~ ~,3,' ~i I ~ Deputy Regional ~ermit Administrator ;o BLDG. pf=;''!f. . TQWN t)F SOU"iHCYI_fi7 Aa..._s_._....,.,.,_ ; , 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [)FOUNDATION 2ND [)INSULATION [ ]FRAMING FINAL REMARKS: _ o d"7 4 J S DATE INSPECTOR `2~ • BO,IRt) OF HEALTR • • , , , / FORMNO.t 3 SETS OF PL1NS ~_~,_~5~jil~sil~~..aii; ~ TOWN OFSOUTHOLD SURVEY BUILDING DEPARTMENT SEPTIC FOIL CI P~1AY J ~ iJ~~ ~ ~ ~p TOWN HALL - • - • . 1~ - I SOUTHOLD, N.Y. 11971 E~ U~ .,~=W' TEL.: 765-1802 r:aT I F~ , 7~ s' _ S 6 ~L~ F?LCCi. t).?T. CALL Examin ~'~t'e„~F~,y.~,5~/~~•~:°;a19... MAIL T0:•~¢''K~~2c~.ma-c.~-• Approved ....7~-3i/ 19 Permit No..i~~0;J•~',?,~~ - • • • . . Disapproved a/c 4~,~1J.~~L ...'';~?e~~r,,~~~n-v,• . . al.t ~ L° de, . . Id ng In..ector) APPLICATION FOR BUILDING PERMIT Date •.5./:2.-~ 19 . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 >ets1of 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 z~reas, 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 pazt 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 othAr applicable Laws, Ordinances or Zegulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. I•Ite applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspectio s. (Signature of applicant, name, if a corporation) y~FoFf ..ate .~d~%~~4... ,~.o u~No~:o (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. u.~F.O./#~ Nante of owner of premises ...~d:`~..:'..~ a ~ .I. GF . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. • (Name and title of corporate officer) Builder's License No. ~ 5... ~.p2.~~ Plumber's License No. ?,~C~c-s...///~1.co/5/..~G^' Electrician's License No. . ~~i7..~!. pLg,Q~/. ~-Q " G °'S L: LIYC%,~~ Other Trade's License No . . 1. Location of land on which proposed work will be done. Flouse Number T Street Hant]et G County Tax Map No. 1000 Section d 7Tj......... Block J'~`-, J Lot Subdivision . Filed Map No. Lot . (Name) State existing use and occupancy of premises and intended use and occupancy o~fiproporsed construction: a. Existing use and occupancy ~G. ~'~~G~~L.... ~ ,(~.s~~ ,~j,~'~,~`, ~ . b. Intended use and occupancy :n~~?~: ~ , , , , a (1/~^, /r,~~: , , , , , , , . . ~..f~r s : ~ ,.._..,t;,,f I 3. Nature of work (check which aplylicable): New Bullding Addition Alteration . Repair Removal Demolition Other Work . (Description) 4. Estimated Cost ~.<.7? . . co~ , Fee . g, number of dwelling u (to be paid on filing this application) 5. If dwellin a inns Number of dwelling units on each floor . . If garage, num her of cars 6. If business, commercial or mixed~,occupancy, specify nature, and extent of each type of us 7. Dimensions of exis~ ing structuresr if any: Front 5(~. Rear ...'3. f Depth ~,Z,>, ; , , , , , , Height . , ~ , , • • , , , , Nutnl~er of Stories /.:ate . . p ~ g h alterations or additio~ts: Front S~'~ z /p~'~ • Rear 7 . He htstons o same structures wit Height , . , , , , ,Number of Stories . r it e t a , ..action: Front ....ar.2 ..`d.... Rear 5.7.. /.4..... Depth l0. DateeoftPu co entire new constru • • • • • . , 9. Size of lot: Front ,,erofStories.....~'Ly.......... a, opi.. .....t........... a a........ Numb.......... Rear ~ Depth .....7..Q hose ............i Name of Former Owner ] 1. Zone or use district in which premises are situated , ~.r;5,, , , , • • , , , • • • 12. Does proposed constructor! yt~a~e any zoning law, ordinance or regulation: y ~ . . 13. Will lot be regraded .......Will excess fill be rem ved from premises: Yes 14. Name of Owner of premises`~~:~.`tilaA~. Ud.~!~/•G,G, ,Address 0~ u' Phone No. 71~.:.~0~.6 Name of Architect e./-l.d<<. ~/.d:+:~-,/~ ,a, , , , , ,Address <}i,~ e~ ~%x~"~Phone No.~Y•~'• 1~a29 . . Nante of Contractor ~d/~ .~0.~16v.^!%s........ . Address ~ ~v,¢Ty;/~pl,~agTN?~Phone No...~G~ 1~:. J~(.~?', property within 30 LS. Is this yes, Southold Too feet of a tidal wetland? ~cyeS„ , , , No, • *If wn Trustees Permit may be required PLOT DIAGRAM i' Locate clearly and distinctly a]I i?uildings, 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 ]ot. j ~I III i 'OUNTY O ~~"'1'-''cc77 c S•~ • g! ~ • • • • • • being duly sworn, deposes and says that he is the applicant (Name of individua si mn 'icontract) hove named. [e is ttte , II (Contractor, ant, corporate officer, etc.) ~ ~ • ~ • ~ • ~ • f said owner or owners, and is duly a~tthortze o 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 Iris knowledge and belief; and that the ork will be performed in the manner sek forth in the application filed therewith. worn to before me this I otary Public, .~`'_~~y.rv"t--e. ...~i.. ounty ~ • • CtA1R@ 4 GI.~W \ Notary Publ{e, State of NeW Yb~k . ~ 4879 / (Signature of applicant) QuslKled in $uf(dI CeU v ~ommhabn Expires t~,'~ 19