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HomeMy WebLinkAbout18915-z ~ FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCDPANCY No 2-24362 Date MAY 14, 1996 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 855 MARLENS LANE LAUREL, NSW YORK House No. Street Hamlet County Tax Map No. 1000 Section 143 Block 3 Lot 23 Subdivision Filed Map No. Lot No. conforma substantially to the Application for Building Permit heretofore filed in this office dated MARCH 23, 1990 pursuant to which Building Permit No. 18915-Z dated MARCH 28, 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 ie ADDITION & ALTERATION TO E%ISTING ONS FAMILY DWELLING AS APPLIED FOR. The certificate is issued to NICHOLAS & MAIIREEN DEEGAN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-168270 - JANUARY 8, 1991 PLUMBERS CERTIFICATION DATED MAY 9, 1996-EJ'S PLUMBING & HBATING INC. Q ~ i ing Inspector Rev. 1/81 roses xo. s 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) 1$95 N _ Z Date .....r~' ° ~ y 19..0 Permission is hereby grant t ~~.~Q,':'..... ~8 to .G~P7r~~2. G~~~ ..................,d~tio:?yd ..:~'.-Gtr.... .~i at premise~~ted"at .....l~i.~.~~..~..........~~.,2.i1B,........... ....................................................~~z4r~.e-I:.•••..................................................................................... County Tox Map No. 1000 Section Block ......:3........... Lot No.....~~..:3.......... pursuant to application dated ..........~~/f?~..v~ 19.9, and approved by the Building Inspector. Fee $ `.'39~' FS. r.. uildin nspector Rev. 6/30/80 Form No. 6 TOWN OF SOL'THOLD BUILDING DEPARTMENT TOWA' HALL 765-1802 ApPLICAT_ION' FOR CERTIFICATE OF OCCUPANCI A. This application must be filled in by typewriter OP. 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-disposai(S-9 form). Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certif}>ing that the solder used in system contains less than 2/10 of 1% lead. 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. 3. For existing ouildings (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. Fees 1. Certificate of Occupancy - New dwelling 525.00, Additions to dwelling $25.00, Alterations to dwelling £25.00, Swimming pool 525.00, Accessory building 525.00, Additions to accessory building 525.00. Businesses 550.00. 2. Certificate of Occupancy on Pre-existing Buildine - 5100.00 3. Copy of Certificate of Occupancy - .25C 4. Updated Cert;ficate of Occupancy - 550.00 5. Temporary Certificate of Occupancy - Residential 515//00, Commercial 515.00 Date,,' . ~V dew Construction...../... Old Or Pre-existing Buildi gJ~../.,~ vocation of Property...~~~ ................../~...f~c~...G,.~.•......~G'`~u........ House No. Street Hamlet inwer or Owners of Propert}>..~~~i°~~.~.~?~~...~. ~ounty Tax Map No 1000, Section.~.:{.~.......Block...J............i`~~ subdivision ................................./...F/fled Map........../.~.Lot...................... 'ermit No.`.d.-J,f,y~r,.,Z„Date Of Permit.~./..?~1..~.C~...Applicant..4`<~^~~.•C</~~ ~2--~ / / l / -?eaith Dept. Approcal......(/ ..................Underwriters Approval...U . 'lanniag Board Approval ;eauest for: Temporary Certificate........... Final Certicate..~! 'ee Submitted: 5.....~,5 ^,~Q,,,,,,,,,,,,,,, a~13~~ APPLICANT zE~`~. ~~~SUFFd)(X~oG yti~ y~~ ~a ~ u Town Hall, 53095 Main Road ~j 2 ~ Fax (516) 765-1823 P. O. Box 1179 ® ~ Telephone (516) 765-1802 Suuihold, New York 11971 y O~ " ~QI ~ .~a OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE : ~ ~ Building\\Permit Not/ Owner: ~l r~lV (please pnrint) Plumber: ~ ~5 1'~uWI~ 1 W ~rj~~,+~'i'I Vt) `9 IN~C (please print) I I certify that the solder used in the water supply system contains less than 2/10 of 1$ lead. (Plumbers Si atur ) ~ i Sworn to before me this , 19 day o f Notary Public, Scc~=r~,~~ County ~1 ~ UIhMIM a.mnod to surron~ caAny MYCornmisslon Expires Feb 22,1998 L$,1-D IIJSi'~~Qt~l IId~1~T~ iM CO~t:~t~ VT.S n\~ o OUIIDAT20;I (1st) 'OU!1DATI0;1 (2nd) _ C~, DOUGH FRAi•1E & PLUMBING ~ ~ i y 31 3. ~ I11SULnTI0i1 PER N. Y. ' STnTE E1IERGY ~ CODE m 4. F::IAG S ~ I ~1 . o \ m ADDITIOPIAL COMMEPlTS: x~ to H • N o m a .9 H ~ ~i(i r , , x r, • ~ _ , IE MARTIN F. SENDLEW8K1 A.I.A. ARCNirecr-oeaa~en ,~bcar~: 24, 199., Town of Southold Diit idi nq DeparCment. F'.0. Ro>: 72H Southold. New York 114'1 ~'e: B~~~ildinq Fermi t. k !b?15 ? ice,. Nicholas Deegan H55 Malverne Lane Nl.attituck, N. Y. 119°_~? Fl~a~ae note that. as tF~,n ~r~:t•~! tn~ct, of ~ °cord I have reviewed the door framing change over the nei•a hasement lor_ation which utilized ~ 1/_"' TJI framing pe~rpe~ric~~'.-~r to the original framing direction =r,oo-,n on the original p]?np nF ?he abr•~.~o note residence for which ar.~ ±Y~e Architect of rn~;~rd, .i~,r~ +inri said~r,snge in compliance i t h t by N. k. State Code ~ euui ement-. ' F-. Sendlewsk i ; . J. ! ~ C: ~ ter, { r~l ~~iyO. 01 o ~ F OF NLW yU 8 ROCKY POMIT ROAD ~ 1NDDLE 18LAND, NY 71883 ~ (8'18) q8~~8 i~~ ~ -_--_v_...,._...~____ - J ~r H boa • ~~,r~~a' ,f~ ;!v o~cscnb~r~ ti i ~ I i ~ j°on vri u f ~ ~ ~ 9B-,st i J 1 / sf°''Y 3 0 L t lyy ~ N ~ ~I Z ~ 4 3 T ~ r,~ ~ J /i i c/ ~ r' 4 y, s -i l~fa c Lcllar~ ~'M ~ i I ~ ~ ~ ~ Mf-7. OF" G'~'oP~F?TY ~ UR vCYaE o s*-ora ii'r' i T.i `.YrY OF SOClYHOL- O ~ $U.OPF'OL k D. N. y -I 7 d / G 'i,i ~uar'anl`e~.d >ZC T.~•a'T.Y(~` i =r~,~Hwrn:-rrt G'uarar~7'GCGarr-,~%ya~u~~o i S~ f fv/>F CaKr, ty NaT/ona ,3crr~ ~ os sc~rv!yC.:~~1pr; ~ /956 i ' Licensec/L:~ndSurveyar•s Grecn~o~-t~ N. Y. . ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS }i;e~3r1 .1 ICI@UL325 BUREAU OP ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date ~JX'-t~llkl24'' fi}y,l~y~f_ APPGcationNo.onfele e~ti~~~~x~jjt'Ij~t~ t~E )lifil'~t0 THIS CERTIFIES THAT only the electrical equipment as deacrihed below and in[roduced 6y the applicant named on the ohove npplication numher in the premises of LY _t f:~f i~(rT,ti f7f'ii~(iA nl, li!-e Y'Y Tf t;,lt ~l rl';f~f~ ii~,~l•i'°t)L~It f~'hr 1, fir. 44.7:'."t`3TIId~t~, iT in the following location; ? Basement 0 let F'l. ~ 2nd FL, tIt11 Ser[ion Block Lot T1 k1f:1~;7~7111~; R_ ~ ~3 , '1 tD la f~ was examined mt arzd foand to be in coniplianre uith the requirements of this Board• i FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS gqOUTLETS ECEPTACLES SWITCHES INCANDESCENT pwoRESCENT oTHEH Amr. t w AMT K w, AMT a.w AFT a.w AMT. H P. ]y ~E I a f~ ° DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS gEL1 UNIT HEATERS MULTI.OUTLET DIMMERS SYSTEMS AMT K W OVl H. P GAS H. P. AML. NO. A. W G AMT. AMP AMT AMPS TRANS. AMT. H p NO. OF FEET AMT WAiiS t r s. x ~ SERVICE DISCONNECT NO.OF S E R Y 1 C E METER NO OF CC COND. A. W.G A W G. A W G. AMT AMP TYPE EQUIP 1$ ]W 1 $ JW 3 $ 3W 3 $ 4W pER % OF CC COND NO. OF HFLEG OF HbLEG NO. OF NEViRAlS OF NEUTRAL 1. t b*D l a C [ 7 9 OTHER APPARATUS: SMOkF: gkYi'FI("Pt}g ~ i i5 ~Ti?t;rlt~llt N111h;(:'PR~7`412, f,c,z',~I~'4~+'7~5~1 ;Ilfj€~ M'.h;ll~Cfati}'7N1 A~'F. iZ01VlCt>~!Kt'}pj~r 1,dY, 'I d.`7 GENERAL MANAGER 2i Per 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 COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. ~.0 ~G / ~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] RO GH PLBG. ( ] FOUNDATION 2ND [ INSULATION [ ]FRAMING [ )FINAL REMARKS: G~~ DATE ~ ~l INSPECTOR 1 ~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ROUGH PLBG. [ ] FO NDATION 2ND [ ]INSULATION FRAMING [ ]FINAL REMARKS: ~T, C~~ ~ DATE ~ INSPECTOR 6 T65-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION I l FRAMING [ FINAL [ ] FIREPLACE ~ CHIMNEY REMARKS: ~ r..c DATE © INSPECTOR r BOAFD OF HEALTH 3 SETS ~L.\NS fOAhA N0.1 SURVEY TOWN OF SOUTHOLD CHECK 1~-~~' .L°J~O........ , . BUILDING DEPARTMENT SEPTIC FOR21 TOWN HALL $OUTFiOLD, N.Y. 11971 NOTIFY ; 74r` `•T- • . • . 4 • • ® q TEL: 7G5~180~ CALL J `t Ir l ~~yU 19 PfAIL T0 . o . Examined . • • • • . . Approved .erg 19 Permit No.~~~~~ ~ . , , . r GJ Disapproved a(c ~.-~""a`.~, IV1 3 ;3 . N~ , , ,w.~ (Boil g Inspector) ....~~[3t_Cr D~ ~t~OiV~> 70tNtV OF ,,~1U~„„,.,.,, ,,m....,c APPLICATION FOR BUILDING PERP~11 Date .?.~"4.~~......., IS,°~~ INSTRUCTIONS 111 a. This application must be completely filled in by typewriter or jn ink and suhmitted to the Building Inspector, with ~ sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showins location of lot and of buildings on premises, relationship to adjoining premises or public, str'eerts or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this aappli- cation. e. The tvork 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 peatztit 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 shail have been scanted by the Buildin; Inspector. `APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Buildins 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 ail applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessa~fry ins eciio~/~~`'s. (Signature of apglican , or name, if a corporauon) ~?O.. l~~. so38 _~vc~ ~'nlr~.T..11.~. t t 7.7 (Mailins addr~s of applicant) State whether applicant is owner, lessee, anent, architect, engineer, general contractor, electrician, plumber or builder. ...........o.~~.e.~?:... o e Name of owner of premises ../~.~~C-~...1i1/•.~ • • •~!(!~~°!~G~`e~'!l?• • C~'~• • • • • • • • • • • • • • e o ~(as on the tax roll or latest deed) ICapplicant is a corporation, sisnature of duly authorized officer. (Name and title of((c~~orporate officer) Builder's License No....t,,lts.~. ~ . • • • • • Plumber's License No . Electrician's License No . ' Other Trade's License No . . 1. Location of land on which proposed work will be done; ~G?e%l~~ . ~5~ ..................~i. j12~~~.~~.~°..L.~:........................~1~1.1; Flouse Number Street. Hamlet 2 County Tax 11ap No. 1000 Section . , • Blvck , :3 Lot ? , , Subdivision Filed Alag No. Lot . (Nvnej . State existins use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....~j/~ b. Intended use and occupancy ~:(..q.tl~, ~ o ' (h h PP 4cable): New Ouilding AdditicnCl......... Nteration L . 3. Nature of w rl. c eck whit a 111 / )tepair R~mov~l Demolition ..........Swimming pool........,.... Tennis Court Ae~cessory Building..........Fetlce .......Other [fork.. $stimated Cost~l~.c'O. t' . flee ' (to be paid on filing this applications If dwelling, number'of dwelling urj g ~f arage, number of cars , , , , , , its Number of dwellin units on each door . g • 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use , f Rear .r . 7. Dimensions of existing structures,~,if any: Front . ~ , , , Depth .7n.~(, . . I-Iufght Numbci of Stories 1".......... ~ , . . Dimensions of same sEructure'withP alterations or additions: Front Rcar . Depth . ,~si(~ I Ileight ............Number of Stories . QS Dimensions of a ~e~v nstrtrction: Front . Rcar .3.~(........... Depth . l eight tuber of Stories ...r . . 9. Size of lot: Front ! Rcar bepth . 10. Date of Purchase ................Name of Pormcr Owner . . 6 1. :Zone or use district in wlticlt premises are situated . . . rt ~ to any zoning law, ordinance or regulation: ~7 l T1•anteoof Otv ero fa tremisen //.c~a r ~ ~ ' ' ' ' ' wilt excess fill be removed from premises: .Yes , No , . P ilxt•. .Address ...................Phone No. ,Zs:(.4j.-.!•$f-~G ~Pdame of Architect'~a~„~pryl~,r~ytip~~, ,Address . ..........Phone No. :.3G6f=..... . I+1ame of Contractor ...C~.1~/./$.~,~ . .Address ...................Phone No..... Ir.ls this property located within 100 feet of a tidal wetland? ^Y>;S._..NO~ ~If yes, Southold Town'Trustees Permit may he required. PLOT DIAGRAM Locate clearly and distinctly al] buildings, whether existing or proposed, and. indicate all set-back dimensions from sropcrty lines. Give street and block dumber or description according to deed, and show street names and indicate whether ntetior or corner lot. , i~ I STATE OP NHtiV YORE, I COUM'Y OF . jS.S • • • • • • • . • • • • • ~ . being duly sworn, deposes and says that he is the applicant (A'amc of indivrdual sig ing contract) , above named. , ffcisthc ~ .1. (Contractor, agent, corporate officer, etc.) of,said owner or owners, and is du'y authorized to perform or have performed the said work and to make and file this application; that all statements contained in this appiitation arc true to the best of Iris knowledge and belief; and that the w9rk will be performed in the manner set forth in the application tiled therewith. , Sworn to before me this ...day o~' ~4~:~ l9 Notary Public, , , . , , rte,'., • ~ ,Y.~: , County ! NEIEN IC DE 1bE • ~ ~ r . NOTIIRYPUBtIC,StafeofNeWYorlr r/ tSi;natureotapptica+rt) No. 470187R, Sutfolk Coin Term Expires Nerch 80, t