HomeMy WebLinkAbout19184-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20884 Date JULY 23, 1992
THIS CERTIFIES that the building STRUCTURE
Location of Property 898 ELIJAHS LANE MATTITUCK N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section LOS Block 3 Lot 5.45
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 9, 1990 pursuant to which
Building Permit No. 19184-Z dated JULY 11, 1990
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 AGRICULTURAL BUILDING AS APPLIE? FOR.
The certificate is issued to JOSEPH SHIPMAN
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL C10-90-007-JUNE 28, 1990
UNDERWRITERS CERTIFICATE N0. N-180337 - MARCH 26 1991
PLUMBERS CERTIFICATION DATED JUNE 22, 1992 - JOSEPH P. SHIPMAN
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B ding In ector
Rev. 1/81
rosax taoe s
TowN oP soclmoLD
OUILDING DEPARTMENT
TOWN HALL
souTHOLD, N. v.
tUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N ~ 1 ~ ~ ~ ~S ~ Date ........1 ~ )9.5.v.
I.
Permission is hereby granted t
.....9..$~'....... ~
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at premises located at ......................4r"~'~~....~~:!'!:~:.......~..~.......................
.....................................................................~.J..........................................................................................
...............................................................................................................................................I~.s:..........
County Tox Map No. 1000 Section Bglock ......Q..~....... Lot No....~r..,.•.........
pursuant to application dated I........d 19.~.v., and approved by the
Building Inspectar.
Fee 3.~~....:
~U-L Q-l
Budding Inspector
Rev. 6/30/80
Porm No. 6
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TOWN OF SOUTIIOLD t ~ y°°~s--... a?.~
BUILDTNG DEPARTMENT
TOWN HALL " r -0 ~ JIJ~ Z Z ili~~,~
765-1802 ; i
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APPLICATION FOR CERTIFICATE OF OCCUPANCY °r",`.°:'
a. This application must be filled in by typewriter OF, 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-4 form).
' 3. Approval of electrical installation from Board of Fire Underwriters.
k. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 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, 1457) 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.
. '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 Certif/icate of Occupancy - Residontial $15.00, Commercial $15.00
' / Date ~i ~`~~'~~~2-
.
ew Construction....,./...pm.. 01d 0 Pre-existing Building.....~.~.j..........
ocation of Property...A.~~...~~1.~~.1~1,5....L.iV:.......!:l~~.l.r.lT?C.Cs
lIouse No. Street Hamlet
nn
ewer or Owners of Property.... o,SC~.I~...V...`S~': Fly!~/~,l!
aunty Tax Map No 1000, Section...,~~~......B1ock....U._~.''. ......Lot....... ~.3f.........
bdivision ....................................Filed Map............Lot......................
C
-rmit No ................Date Of Permit...~~~/ <.~....ApplicanC~.~.`.~(P.~f.~s~'.'~d'~..1`7.~...
alth Dept. Approval.........~~?-...........Underwriters Approval....^~~
anning Board Approval...................
quest for: Temporary Certificate........... Final Certicntc.......,...
_ Submitted: $
~~~yy1 G.'.:~R~~:~~
t' a9 ~~n~~~ ~ APPLTCANT
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TEL. 7G5-1802
~a5N~~0~~1p~,l TORN OI' SOiTTIIO'LD
/ ~ ~c OFFICE OF IIUILDI2~IG INSPECTOR
• a u., . ~:'Y1 . P.O. BOX 728 f~~ a
:aytk~k ~ T01VN1IALL ~ ~9~~`"~~t;r~~~„
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`'O/~~ ~~'T- SQUTIiULD, N.Y. 1 1971
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C E R T I F I C A T I O N
Dateu~• j ~ ~ ~
Building Permit No. `i ~ ~
Owner ~
v5 ~•J~n~ Ot, w ,
(plea e print~)7
P l u:..b e r ~j
t~ 5 ~L U' •S09 ,-v~,ytra,
iplea5 printf
I certify that the solder used in the water supply system
contains less than 2J10 of to lead. „
~
o~~~' - ~
(p umber's signor rc)
Sworn to befar^_ tris ~
2"~-- day of ` W - ! /lam
19 • tart' Public
notary Public, ounty '
JQYCE M.1HlUCtNS .
}so pubtlo, State of Newer
pa~g62249, Suffolk t
7~„ ffrpiraeJune 12,1 3
THE NEW YORK BOARD OF FIRE UNDERWRITERS Is~r,i=.
~ ~i71 'f if ~ BUREAU OF ELECTRICITY
63 JOHN STREET, NEW YORK, NEW YORK 10038
Date EIAfr'fi'F7 ~~"~N~).I Application No. on fife ~l)."/ith1~)Q,~/~G1 Pij ;4 £SD'~,37
THIS CERTIFIES THAT
only th¢ electrical equipment as described below arul introduced by the opplicont named on the above application number in the premises of
,ic3;IF,1rib SfY7€trikYel, T';l+iFi!t}1'5 'tIAPfF;, P(711N~ rf'£%r h1t~'9"1'3'('DCX.; tI_Y.
in thefollowinq /ocotion: ? Basement ? l.at Fl. ? 2nd P'h Section B/oek Lot
T4ARd't1 'l 1 ja a 1 artd found to 6e in eornplianve with the r¢yairements of This Berard.
was examined an
FIXTURE ECEPTACLE$ SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS {NCANOESCENT FLUORESCENT OTHER AMi. K W. AMi. N W. AMT NW. AMi K.W AMi H P
~ : Z J. S k ~h 1. P,
DRYERS FURNACE MOTORS FUTURE APPItANCE 4EEDER$ SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULT60UTLET DIMMERS
AMi. K.W. OIL H.P GAS H.P AMT NO A W.G AMT. AMP qMT AMPS 7RAN5. AMi. N P SYSTEMS AMT WATiS
NO. OF FEET
? `G' ~ T)r)
SERVICE DISCONNECT NO.OF S E R V 1 C E
METER NO. OF CC CONp A. W G. A W. G A W. G
° qMi. AMP. iTPE EQOIF Le' 1W t q 3W 9,e' 3w 3,e' 4W pER .4 OF CC. CONp NO. OF M.LEG OF HbIEG NO Of NEUTRALS OF NEUTRAL
OTNER APPARATUS:
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,li>I7Y ~1Fi•L1"(Il_Iti i,l.,; ~~3~O~r'E
I Pf i`f'I"1'I T17taC. 1~Y: '1. RH ~fo GENERAL MANAGER
7'~.
Per L`
This certificate must not be altered in any manner; return to the office of }he Board if incorrect. .inspectors may be identified by their credentials.
' COPY FOR BU{LD{NG DEPARTMENT. THFS COPY OF CERTIFICATE MUST NOT 6E ALTERED IN ANY MANNER.
r'lELD I1:S:'_".C710.! IIUniY, ~ COMMENTS
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FOUI7DATION (1st) ~
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FOUNDATIOiJ ( 2nd ) ~
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PLllMBING
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I1ISULATION PER N, Y, ~ • •
STATE ENERGY
CODE
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A DITIOPIAL COMMENTS: x
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765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ OUCH PLBG.
[)FOUNDATION 2ND [ ] INBULATION
[ ]FRAMING [ ]FINAL
REMARKS:
DATE ~ C® (7 IN8PECTOR c `-~r`J~
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765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION iST [ ] ROUGH PLBG.
]FOUNDATION 2ND [ INSULATION
[ ]FRAMING [ ] FINAL,~
REMARKS: ~^'~~~vvw~
0'~~ '4l~'~f"`
I
DATE INSPECTOR
t
De619n IRfOI]llatiOR Tc(D+L1~ 47.0 PsF 5 Plating information TPI k
BC(D+LI= 10.0 PSF
DWO SR87-09710-T(0250804 TL(D+L)= 570 PSF 'JT. CHORD STZE AT JT HYDRO-NAIL NOTE LOCATION(INI
SHT NO. 14 DATE 2/20/89 STRESS INC = 1.15 N0. 2X9 2X6 PLATE SIZE --X-- --Y--
2 Maximum Chord $ Ft.-in.) J-1 24- 3 20- 9 2 1/1 X 6 PTX A 0 D/0 0 0/0
~S ( 29- 2 23- 1 3 X 6 PTX A 0 3/9 0 0/0 '
}8-10 26-'2 3 X 8 PTX A 0 0/0 0 1/8
I~LUMBER aRAD6 TOP CNORD BOTTOM CHORD A6- 3 27- 9 3 X !0 PTX A 0 0/0 0 3/0
.SOUTHERN PINE( 2X4 2X6 2X9 2X6 A7- 0 32- 4 4 X 10 PT% A 0 1/9 0 0/D
c;; ~NO 2 KD-15 23- 5 34- 7 30-31 39- B 41- 1 5' % B~PTX A 4 5/B 0 0/0
NO Z HD-15 DEN 25-.9 37-11 34-10 45- 4 ~ 97- 0 5 X 12 PTX AB 2 1/4 0 0/0
NO 1 KD-15 26- 5 39- 0 35- 0 47- 0
N ~NO 1 XD-IS DEN 28- B 42- 4 39- 7 47- 0 J-2 24- 6 24- 6 2 1/2 X 4 pTx 1 3/4 2 1/2
SEL STRU KD-15 28- B 41-13 39- 9 47- 0 30- 7 35- 5 3 X 4 PTX 1 1/Z 3
_._t DN SS STAU RD15 30- 0 94- 2 45- 1 47- 0 47- 0 3 X 5 PTX 1,1/2 3
i; ~ ~.~S650F-1.5C MSR 25- 0 38- 6 33- B 47- 0 SJ-2 30- 7 5 X 5 PTX 5 1 1/2
l~1800F-1.6E MSR 26- 3 40- 6 36- 9 47- 0 47- 0 8 X 8 PTX B 2 1/2
1.,950F-1.SE MSR 27- 6 -02- 6 40- 6 47- 0
- 2~1 OOF-1.8C MSR 2B- 9 44- 6 43- 8 47- 0 J-3 30- 1 30- 1 3 X 4 PTX 3 2 1/2
' ~ ° 2250F-1.6E MSA 24- 9 45- 9 46- 8 47- 0 30- 7 38- 4 ; X 5 PTX 5 / 1'2 ~
2400F-1.7E MSR 30- 7 47- 0 47- 0 47- 0 47- O q X 5 PTX 5 2 1/8 ~
•REQVIP.ES 2Xfi 3EAAING BREQVIAES 2%5 DEARINO
J-7 31- B 31- 8 3 X 8 PTX i
3 Web Requirements (Ft.-in.) ai_ 0 42- 9 3 x lD PTX ~
47- 0 4 X 10 PTX ~
UNBRACED BRACED SJ-7 29- 9 5 X 8 PTX 3 3/9
2X4 WEES W1' W2 W3 W1 41- 7 5 x 10 PTN 1 3/4 `
' 3KD15-SP 17- 0 28- 3 97- 0 47- 0 38- 0 47- 0 47- 0 7 X 10 PTH 3 3/4 ~
2KD15-SP 47- 0 2B- 9 47- 0 47- 0 38- 9 47- 0 49- 4 8 X 8 PTX 2 3/9 ~
2KD15DSP 47- 0 29- 6 47- 0 47- 0 39- 6 47- 0 i 47- 0 8 x 30 PTX 2 3/4 j
lKD15-SP 47- 0 30- 0 47- D 47- 0 40- 3 47- 0
J-8 47- 0 97- 0 1 X 3 PTX ~
i
SJ-8 28- 3 5 X 5 PTX 5 1 1/2 ~
36-10 S X 7 1/2 PTH 7 1/2 1 1/2
47- 0 5 X 30 pTN 30 1 1/2
~ 9 Force Information L=Span (Ft.) 47- B B x B PTx B 2 1/2
CHORD FORCE9 WEH FORCES JOINT LOADS CHORD SPLICE OPTIONS ~
C 1= -132.6E W lm S.SL J 1= 15.1E C-2 30- 7 47- 0 3 X 4 PTX
C 2= -90.1L W 2= -43.OL J 2= 23.SL C-7 25- 3 28-11 9 X 4 PTX
C 7= 125.9E W 3= 34.9E J 3= 22.2E 3B- 8 Z7- 9 3 X 7 1/2 PTN
C e. 1I5.9L J 7= 4.BL 47- 0 37- 0 4 % 7 1/2 PTH
REACT= -57.OL J e= S.1L 47- 0 5 X 7 1/2 PTH
DESIGNED 2N ACCORDANCE WITH TPI-BS AND NDS-e6 NOTES: A. SPAN SPECIFIED LS FOA BOTTOM CHOAD
B. REQUIRES 2X 6 TO P';CHORD
GAOSS PLATE RATINO(PSI) FOR PTX=25B(SYP) j
GAOSS PLATE RATINC(PSI) FOR PTH=207(SYP)
Note - See Tabls 3 for Web Lateral Bracing Requirements
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' I SPRN . L ~J r` 800
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TPI CODE 2'- 0^ O.C.
TWO SIDED DOCUMENT HYDRD A/R 4/12 SLOPE PTX+PTN PLATES''
SEE REVERSE SIDE FOR ENGINEERING ~ ~ 5o PINE vacMSR
IMPORTANT INFORMATION t1 TH 40/ 7/D/los 57 PsF p 1.15
4d 1987, Nydro-Air En9lneerin g, Inc. Box 7359 St. LO Ula MO 63177 ~
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BOARD OF HEgLTH
3 SETS OF PL,1NS
FORM N0.1 SURVEY
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC r•oart
TOWN HALL
$OUTHOLD, N.Y. 17971 NOTIFY
TEL.:7G5-1802 CALL
MAIL T0:
Exanuncd ~J.., 19 q(~ .
Approved ..~.I.., 19 9~ Permit No..J.9./.~,~, .
Disapproved a/c j^y
U
I E i990 1~ ~
(Building Inspector) 8 Ci. pEPT.
7bWN OF SDUTHOLO
APPLICATION FOR BUILDING PERMIT
Date ..`~~Xr4~.. q......, 15 4!?
INSTRUCTIONS 11
a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Building inspector, with ~
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. I3o 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 Pezmit 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 code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
(Signature of applicant, or name, if a corporauon)
(Mailing address of applicant)
State wheth/.e~r~y'a/p~~~p~lOi~cant is owner, lessee, agent, architect, engineer, genera! contractor, electrician, plumber or builder.
f A^
Name of owner of premises `i-',(~,1:~..1~.tSJI! ~ vyl},v,J <p x r,:^~ # `~:1 .
(as on~the tJt~grotll o~ lataest,dae .1 >
~.P utTik ~ 3X ~$~.Y :P ~~aX SRS'~4~~
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No. .
Plumber's License No. i .
~:;.5s.. ,i,~ .
Electrician's,Licen'ste IVo': `°:":•'~`k?~=` `%i alt?
r TraQc.'s ~ic~~se'~1,o: " ' ~t'
,~Bt3
' 1. Location of lang9d,~opQn which proposed work will be done;
. .
House Number tree[. Hamlet
County Tax Map No. 1000 Section / ~ B1Uck Lot `S:~ ~ ~ , ,
Subdivision Filed Map No. Lot .
(Name) ~
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
e
a. Existing use and occupancy ~~.r~%... ~Ff lZ,~' .
b. Intended use and occupancy ....S.I. l~ ?:1~.~.~. • F4,2....~/'~v T yt~i, n.r~"'
. . . . . . . . . . . . . .
s .
Nature of work (check which aPPlicable): New Ouilding Addition Alteration
Repair Removal Demolition ..........Swimming pool........ , .
Tennis Court A,'ccessory Building..........Feitce .......Other Work............
4. Estimated Cost o'1~~ Fee
(to be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on each door .
If arage, number of cars .
' occupancy, specify nature and extent of each type of use~~!Q-~'. .
6, If business,commerc~alormixcdl'........•......•..,•.,..••..•......••......•. .•••Y•
7. Dimensions of existing structures4 if any: Front . Rear Depth . .
Height,. „r, --r•1*],uml~cr of Stories . .
Dimeh~siortis~i ~ W4th alterations or additions: Front . Rear .
Depth ,;,.Height Nuntbcr o~ Stories .
8, Dimensioneptire r~~v c0 stnaction: Front Rear ...~J.a......... Depth .
Height' f4 .P.~',++ u~t per of Stories .
9, Size of lot: Front . Pb.' 'i . Rear Depth
10. Date of Purchase-;~.'; . ,~yr i)1.~. , , , , , , , , , , , , , Name of Former Oev r W~!?~G
??:.,~T.~,~~".~ .T~:.. . .
1 1. Zone or use dis4rict irrwliitarpr' raises are situated ....r!4~t
12. Does proposed construction viol to any zoning law, ordinance or regulation: ...fl': .
13. 1Vi11 lot be regraded , Mill excess fill be removed from premises: Yes , Nb'~
lit. Name of Owner of pr tses ,t~o~?',~TN~ SS,~I~omR~ddress . r,~PS;Et'~~I ~!~3. • Phone No. al'.9cf°': y6 ,
Name of Architect w?'t 4vi~'~ Address ...................Phone No................ .
Name of Contractor . ~A.n4~.'..... , , ...Address ..Phone No... . ~ . .
IS.Is this property locaCed within 100 feet of a tidal wetland? *YLrS....NO.~
*If yes, Southold Town', Trustees Permit may be required.
PLOT DIAGRAM
Locate cleazly 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.
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~ ~ . ~ I~ ~ pPPROVEO AS NOTED
~j OCCUPANCY Olt n o $.P r~,L9~~
DATE:
US~ IS UNLAW!•UL FEE: ~ -_-$Y, _1~.~-~
INITHAUT CERTIFICATE NOTIFY $llll..C)INC, ptl'~s37MENT A7
765~1$U2 9 APA rc. n i M i=ol? THE
~ 0~ QCCt1RANCY FoLLOwiNG IN~~>~ ~~Irr;
! 1. FOUNDATION T~~.1C'1 REQUIRED
` ~ _ . , ~ FOR POURED CONCRETE
A~ 2. ROUGH FRAMING Z3, PLUM$ING i
_ l~-~~_ 3, INSULATION -
4. FINAL - CONSTRUCTION MUST
STATE OF NE1V Y S.S BE COMPLETE FOR C.O
COUNTY OF Alt. CONSTRUCTION SHALL MEET
' n' THE, REQUIREMENTS OF THE N.Y.
bcing'dul sag d'NQN t~ttff~Eig~e applicant
(Aamc o ividu si,ning contra t) y CAOE$~ ~#~U
7 ON ERRORS
above named. DE$IQN OR Cf+wNB
Hcisthe ~i.,
(Contractor, agent, corporate officcr,etc.)
of said owner or owners, and is dt)ly authorized to perform or have performed the said tvprk and to make and file this
application; that all statements contained in this application arc trot to the best of his knowledge and belief; and that the
work will be performed in the manner set forth in the application filed therewith.
Sworn to bciore /me this I '
....day of . 19
Notary Public ~ _ • • • ~'t"County
INKt5LAU5 WINIAR2
Notary Public State of New York (Signature.oC applicant)
No. 52-9703725 Suffolk CaUnM '
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C-35 -CPU * t;AY=. = f'Ipo GAL. ~ - n : r ~ I~ E ' _'~!N L TME? F-' r.~ c- - FIiOM (11E DATE BELO I
- c= r~- v,_ , s:_, F~ m 1 e la r" 1 ~t, ors a ~ ~ I~ JUN 2 81990
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k -"',RQG.FKI.I~ E_ ~ - ~ °"-w6ty ~f 1 2 : fl\ rr 5T75TEMEMT OF INTENT
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~ r .~i Y _ 4 ~SVSREepS FOR THIS 'RESIDENCE WILL
' COMFt.1Rlt. TA THE ;STANDARDS OF THE
l s ~ St - ~ ~ - i f t iUFF06K CO. DEPT. OF HEA LTN~SERVICES-.
I P ARPLICAN~`",
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,y, _ ~ r ? SE R,N I[ES -FOR APRROV AL OF
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b „i t -1 ~ ~ ~ DATE',
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