HomeMy WebLinkAbout19673-z R
r FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Ha11
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20343 Date NOVEMBER 13, 1991
THIS CERTIFIES that the building ALTERATIONS & ADDITION
Location of Property 50 WAMPAN WAY SOUTHOLD, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 87 Block 2 Lot 31
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 14, 1991 pursuant to which
Building Permit No. 19763-Z dated FEBRUARY 19, 1991
was issued, and conforms to all of the requirements of the applicable
provisions of the Taw. The occupancy for which this certificate is
.issued is ALTERATIONS & ROOF DECK ADDITION AS APPLIED FOR.
The certificate is issued to FARHAD KAZEMI
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N-210380 - OCTOBER 30 1991
PLUMBERS CERTIFICATION DATED N/A
wilding Inspector
Rev. 1/81
108M 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 G 1 ~ 6 ~ ~ Z Dote .....~~.l 19..~~...
Permission is hereby gmnted to:
.
to ~~.~1......~~~r ..............:~~......~~i.....
..~r~~~•
at premises located at .....s.~~,..~'°~ ...................~'s(~`~~~...'...........................................................
................................................~lJ... .G....(./...................................................................
County Tox Map No. 1000 Section Block y.......... Lot No. :,~yl
pursuant to application dated ..........`:~~~y7` 19~~ and approved by the
' Building Inspector.
Fee $.t.:~1.7.....,
~ .:fem
r
Iding Inspector
4
Rev.6/30/80
Porm No. 6
~ TOIJN OF SOUTIIOLD x~1 / ~J ~ D
BUILDING DBPARTMGNT I.L~G~">~/~
TOWN BALL USG
765-1802
APPLICATION POR CERTIPICATI; OP'OCCUPANCY
This application must be filled in by typewriter OF, inlc 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 Pire 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 C~;mpliance from archi'_ect or engineer
responsible for the building.
y 6. Submit Planning Board Approval of completed site plan requirements.
For existing buildin s
g (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-existing land uses:
1. Accurate survey of property s}totoinp, 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.
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 $2.00. 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
Date No~.~v -•./.~9./...
ew Construction........... ~
Old Or Pre-existing Building.,
ocation of Property,,,,,~1',°••........!~R~.Pqu"1....~7:'.~`1 '
House No. JOu'7~{Ul~
f- Street Hamlet
twer or Owners of Property...... A~f~/~./) ~~.4~~,~.j/~ . • - • • .
,unty Tax Map No 1000, Section..,";9 uJt ~ •
. .......Block..... Z .......Lot.....
bdivision..
.Piled Map.. .Lot..
rmit Nn. Jqb 7~ /
• • ,....Date Of Pcrmi.t. • 7~/~
.:L:1.~.......APPllcant „ y~ * ~/~a?
.
ul[h Dept. Approval..... ~
" " •••••••••••••....Underwriters Approval...... .
ginning Board Approval
,u csC for: Temp ra ry Certificate.....,
Final Certica
Submitted: •
C~,tac.Y2ti~P7 _
~ oz, a 033 •APPLICANq'' .
is
fA
THE NEW YORK BOARD OF FIRE UNDERWRITERS
1015638 .4
BUREAU OF ELECTRICITY
E4S JOHN STREET, NEW YORK. NEW YORK 10038
OI;TORF"H x0,'1991 14)85'191/9',1 ro 'I.,?~38U
Date Application No. on file f
' THIS CERTIFIES THAT
awly the elsetrbd equipment a ekaleribed helots and introduced by the applicant noFned on the ohoeK: application num6ar in tke premises eEf r
F'11RHFA fCA7IME, 5p VAMPi4M MAV; pC14P; i., SUQTHOLD, N.N.
in the olbeein l~c~~Eg ~ I , E `l I. A'I"7' ~ /OI i'1'
f R IK;~OR4. 21., L`l `f ? /et Fl. ? 2nd Fl. .Sertiun Blork Lut
eats examinee! un and found to he in complianrr with the reyuirements of thu Buord.
RRr{NE AQEf AWrt:XFS RIfTIMEf RANOES tXtORlN/i oetlcs OVENS OfSN.M EXHAUST fANS
OYTlE1S NCANDtEClM FIUORESClNT OTHER AMT. K.W. AMT. K.W. AMT. K.W. NAT. R.W. AMi. X.F.
4 ? 4
DRYERS R1M/A07 MOTORS wrW AMUANCE fBOMS SMgkI REC/T TIh1E tXt)t:ll4 ~8! 18Ri HEATERS MUtT40UtuT DIMMERS s
AMT. K. W. Oll N. F. OAt N. F. AMT. NO. A. W. Cp_ AMT. AMP.' AMT. AMFb. TR11N5. AMT. N. F. NO. O/ r AMT. wARS I~_~
i
1 li(1i;
lRRIIIC7 EMCONSIECT tp.Of S E R V 1 C E
AMT. AAN. TTF[ 1 / TV 1 / TV 9 / TM 3 f AW NO' ~CRC,COND. OF Z'C. CGd1D. Of N4lEG ~ ~ NO.OF NlUTRAlS OF ~~uTGPAI
R
OTHER AMMl11TUk
i
f G
t
~ G & G F:LFtCTR?:C LtC.#x7:43 L~R~~^-`/~~~~~ ~
78 A.LAND.tNG ND
HAMPTON RpVS, NV, ?.?.946 OE/MeA1
= Per
This. eiElTifieole mull ttN M alNred in qtly manner; rMUrn to tM office of 1lla Board if intorrM. Mspecton may bs idetltifiad by their credentials.
COPY PAR lUIIDNIG DEM1tTAKIfT. TiNi COPY OF CFRTFFIGTE; MIO? dE ALTlR#D IMI AMY M1iMER.
,,W.~_..~.___„ ,
~mir~ TEL.~,7G5-1802
~~~Fa~xc
~p t OG 'I'01VN OF SOUTIIOLD
~ ~c OFFICE OE BUILDING INSPECTOR
~ P.O. BOX 728
~ '~i"~ ~ TOWN HALL
~y~ ~a~~ SOUTHOLp, N.Y. 1 19.71
1 ~ 'A
JUNE 28, 1991
J. DOUGLAS PEIX, ARCHITECT
BOX 333
SOUTHOLD, N.Y. 11971 RE: FARHAD KAZEMI & WIFE
To P7hom This May Col~cern,
We are unable to complete your Certificate
oL- Occupancy because of the following reasons.
/_a// An application for Certificate of Occupancy
s not on file. '(ENCLOSED)
/ / No tJnderwriter~ Certificate on file.
Tlie check is (e~~iaYE~~l/not on file.) $25.00
No health Dept. Approval on file.
No final inspection has been made.
Pleaae contact our office on this matter.
Thank. you far your cooperation.
BuildS.ng Permit II 1 9 6 7 3` Z
Buildi.nq Dept.
No Plumber Solder Certificate on file.
( all pcrmit~ involving plumbing being
.i^.sucd after April 1,1984 )
~
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION iST [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ INAL
REMARKS: __C~
DATE ~ ` ~ -INSPECTOR
765-1802
BUILDING DEPT.
f NSPECTIC~N
[ ]FOUNDATION 1ST ( ] ROUGH PLBG.
FOU ON 2ND [ ]INSULATION
[ FRAMING [ ] FINAL/
REMARKS:
t
4
DATE ~ ~ INSPECTOR
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~1::LQ If:SP?CT1UN ~~U_ ATE ~ OOMMENT° ~
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FOUNDATION S1st) -.p)
a I~1~1~~,U
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FOUNDATION (2nd) - ~
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ROUGH FRAME B~
PLUMBING
N~
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3.
IIJSULATIOP! PER N. Y.
STATE ENERGY
CODE
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ADDITIONAL COMMENTS: ~
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PEIX & CRAWFORD
A R C H I T E C T U R E
' 208 FIFTH AVENUE NEW YORK
- NEW YORK 10010 (212) 683-9888
D C~ C~CICYIC~ i~
E~i1 ~ ~ ~9t ~ A€
KAZEMI+OPPER - FILING g~Or°`I;i;°~°;~ "'~°''~A
[RED 1 / KAZ-i] TOWN O: 50Lt5F40i.~ g
~ .~.u o„n~
6 February 1991
Southold Building Department
P.O. Box 1179
Southold, New York 11971
F2 a . F2 a o-F [7 ®c F~ -F o r
F _ 1{az~emi Se J _ CJpp~ar
at SO Wampum Way. Sou-Cho'1 d
Dear Sir or Madam:
Enclosed is an Application for a Building Permit for the
construction of a new roof deck at the house above mentioned. As
required, this application has been notarized. As the architect
for the Kazemis, I am submitting this form.
Attached to the form is a check for $50.00, made payable to
the Town Clerk. The deck will be less than 850 square feet.
Also enclosed are three copies of the drawings describing the
work. These include sheets 1 through 6; I have signed and sealed
them all. Finally, please find a copy of a survey of the proper-
ty that the owners found with their papers.
Please-~ advise if there is anything additional that you may
require. ~~ilin- a r~ e~~~~~~~~d~<~~,abov~l,,=x,
~ - J "x . ee rs.. ,°a"P# .rte
,~Sinc/erely yours,
~J. //?l ,
J, Daugl Pei
cc: Mr. F. azemi
Ms. J. Opper
4.
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• BOARD OF HEALTH
" ` 3 SETS OF PLAYS
`J. L~~~_1~~~.'~ `~i~ FORM NO.1 SURVEY
' T04VN OF SOUTNOLD CIICCI:
;''„t, a I•Q~,
(31 ~ ElU1LDING DEPARTMENT SEPTIC FOR:1
x~~~~a,.~ ,~..,~.,~w:-. u'F', TOWN HALL
7l.'s;r. 4sf f. f SOUTHQLp. C~LY_ iLII7L t:0: I FY ;
TOWfVO ~£}iJTt-tGi!tY TEL.:7G5-1B02 CALL
:xamincd , R~~,~~~1.,.~..~, .~..~~(9~ / t•IA I L T0:
\pprovcd ..1~/.~........, I~Pctmit No./..~~~~~ .
)isapprovcdaJc
(But ng lnspcctor)
APPLICATION POR BUILDING PERfv11T
Date ..I4.Eeb._lg$1.....IS.
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspcctnz, wiL`
:ts of plans, accurate plot plan to scale. Fee accarcting to schedule.
b: Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public strc:
r arias, and giving a detailed description of layout of property must be drawn on the diagram which is part of this apr
atioia.
c. The work covered by this application may not be commenced before issuance of IIuilding Permit.
•d. Upon approval of this application, the Building Inspector will issued a Building Permit to the appiicant. Such perr,
hall be kept on the premises available for inspection throu_hout the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupant
hall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building pe^:it pcrrsant to t:
wilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Latvs, Ordinances
.c:ulations, for the construction oC buildings, additions or alterations, or for removal or demolition, herein describe:
'he applicant acrees to comply with all applicable laws, ordinances, building code, housin, code, ana r.^ul [ions, and c
emit authorized inspectors on p:cmises and to building for necessary inspi:c on .
•(Signature of plic gg, oor name iCa carpor• tan)-
• • • -S,Ilouglas. Pe' SB44~3~ain•Rd. •Southold, NY I
.
114ailing address of aapp cant)
208 Fift Ave., NY, NY lU~l~•
fate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber oz builder
Architect
fame oC owner of premises Farhad Kazemi C, Jane Opper
••••••.•--•--••--•.•--~••(ason the tax roll orlatcstdeed) •
'applicant is a corporation, signature of duly authorized officer. •
• • • • • • - (Name and title of corporate officer) • ~ • • • • • •
Buildci s Liccnsc Na.. _ uD.i%!?'_ sSl: cte;., - , , , - , ,
• n
Plutnbcr's Liccnsc No . . .
Electrician's Liccnsc No . .
OlltcrTradc's Liccnsc No .
Location of land on which proposed work will be done;
„ -,,,,,,,,,.50. Wampum Way Southold, NY
.
Ilousc Number ~ Strcct • ' • • • • • • • - • • • • •
- •Haurlct
County Tai \Irp No. 1000 Section ...087...........: IIluuk 2, , , , • 31
Lot. .
Subdivision . , , Nunnakoma Waters F.ilcd Alap No, 5126 L • • ~ • • - - - • • • • •
•(rl:uncj ot.
o '
Stzte c~istin^ ttse and occupancy of premises and intended use urrd oeettpancy of proposed constrttctian•
A. Existing use and occupancy..... ..Friarate.ResideaGfr,,,,,,,;,,,,,,,,,,,,,,,,,,,,,,,;,,
B. Incended use and gecupancy - Private Residence
3. Nature oCwork (check which applllcable Peck XX .
Repair , , F New OuilJinS • • A~ilitien • • • • • • .Utcration .
Tennis•Court••'""' RFmov~l Demolition ,,,,,Swimming Pool.
AGCessory building. " " " " '
4. Estimated Cost ' ' ' ' ' ' • • • Fence .......Othec.ytp~~ ,~,~y,•j~ . • •
....$5,000............ Fee.....$50.00
(tn be paid on filing this application
5, lC dtacllin„ number of dwelling units , 1
iCgarage, number of cars - • Number oCdwefling units on each floor....... .
6. If business, commercial or mixed occupancy, specify nature•and extent of ea I t c of use . • • • • • • • •
7, Dimensions aC existi structures, ~f any: Front . 4 , ~b. ~P ~ ~ • ~ • " • • '
1-Icieht ~ 25.6' ..50 • ~ Rear Depth ..35.9' • . ,
- • • . Numbci of Stories . ~ _ ~
Dimensions of same stfucturc with~lalterations or ad i ions: Front • • ,~0.4' ~ ~ • • • • ' '
Depth , , 35:9 34 9~ F Rear •~Q:4:....
.i Flcight , .Number of Stories . ? • • • •
8. Dimensions of entire new constntction: Front , • • 22; Ot • ~ 22.0' • ~ ~ ' ' ' '
Hcicht . 9; ,3; . Numbe~• of Slorics • ' , • 2' . • • Rear, Depth 74; 5.. , • • „ .
9. Sizcoflet: Front .185.5Z'.
10. Date of Purchase ' • • • • • • • Rcar • , , . , ; 245:0.. • • Dcp th ..163.38:.... .
• • •Max'2„ •l'98Q . • . • • • .........Name of Former Otvncr Theodore A; , K17~F4s......... .
1 1. Zone or use distric. it tv)ric}t remises arc situated . . . . . . . • , , , _ R-40
~ P
I Docs proposed construction violate any zoning law, ordinance or regulation: ..K4 . • •
13. iVill lot b^ regraded .NO'. . .
Will excess fill be removed from premises: Yc:..,,r~0, X
lA, Name oCOwner of premises Fiard$~'~il~azemi ~$J2ne_ O~Id~~css SD.N'aptp>a>P Way, Sot}thgil4lonc No.. 5}6; 765-5442
Name of Architect , J. Doug a ,
ec ~ • • • • ° • • Address5~o~~5ho~1~}q,Rd •Box333 phone No..y~16, 765; 5123
Name of Contractor To, be. S@1, ,ted • • -
15_Ls this propert i • • • • • • • • Address .......Phone No .
y Located within 300 feet of a tidal wetland? ^YES....1t0.X...
*IE yes, Southold Town trustees Permit may be required.
• I PLOT DIAGRA,\i
Locate clearly and distinctly all byy'ildings, whethcr'existing or'propascd, and.indicatc all setback dimension' it
property tines. Give street and block nu3rtbcr or description according to deed, and show street names and indicate w;x::.
'.nterior or comer lot.
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° 3UF~OLK CO,TAXMAP fXa816NAT10Nt
TATCOF\EIVYORf:, ' pIST 1000,5EGT.08?, BL.IC.2, 1X1..91.
OUNTY OF S.S i
rovc•namcd. ' ~ ~ ,Dgyglas, Pe ping ~ • ~ ~ ~ • ~ ~ ~ ° • • ~ ' • being duly sworn, deposes and says that he is the applica:
• (t\amc ofindividua! si^ ~ • ~ • ontract) ,
eisthe Architect •
• • I (Contractor, agent, corporate officer, ctc.)• ~ ~ • • ~ • • ~ • ~ • • • • • • • • • •
said owner or owners, and is duly adthorizcd to perform or have performed the said work and to make and file tl:
~plication; that all statements contained in this application arc true to the best of his knowludgc and belie!; and that t::
ork will be perl'omtcd in the manner sctlCorth in the application filed therewith.
vom to bciorc~.~•, Iliis L}•
~~.~.daya~r.,~.lpi~~
(JG~h,........, 19.L/
nary Public. :"!:::':':C....:.L':`: S:
~Y CJ
County
MARLENEJACKSON ^ • , • G~ • • • . • ,
Notary Public, 8tata', of New rlotk • • • . ,
Cualifi~ in
Kings
County (Si;na[ure of applican'
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