HomeMy WebLinkAbout18733-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Ha11
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 219249
Date JULY 27, 1990
THIS CERTIFIES that the building ADDITION
Location of Property 18305 SOUNDVIEW AVE. SOUTHOLD
House No. Street Hamlet
County Tax Map No. 1000 Section O51 Block 09 Lot 10
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JAN. 12, 1990 pursuant to which
Building Permit No. 187332 dated JAN. 17, 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 DORMER ADDITION OVER KITCHEN & ATTACHED GARAGE.
The certificate is issued to JOHN & DOROTHY FELDIS
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N132360 JUNE 1, 1990
PLUMBERS CERTIFICATION DATED HENRY J. SMITH & SON INC. 6/22/90
Y _
` uilding Inspector
Rev. 1/81
noses 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)
u x.8733 Z ~
N _ Date ....... ....a...l.........., 19....~
LZnsr.4~eG~
Permission is hereby granted to»» ^IJp-
...~r ....... .......................4Ar...........
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....
to ..~.~z:...~. An:s,r~:-:....4~:..L3!? .!?-~-~-tort.-...!?u:~cL......~...~-~-~...~`;•.~`.. °~0~-..
of premises located at
..~.~ .. ~_q_-
County Tox Map No. 1000 Section .......5~.~~.;-:.~... Block// ...:.......p. Lot No...:...~a
pursuant to application doted ...~..QsH,rtt..csra~t.,}... ~ Vx..........., 19./..~ and approved by the
Building Inspector. 1/!~"
Fee $..~~..... /~
Rev. 6/30/80
Form No. 6
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 2/10 of 17 lead. r
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 piau 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, Comme/rcial $15.00
Date .. n':n1JL".. ~.5. (. ~ ~......
New Construction...... Old Or Pre-existing Buildin~. ~.......
~~ii g C,
Location cf Prcperty.. /. P.•%.:~. S~...... ~1 .1,~~.~-~.?.:.... ;~~:"~L~
House No. ~) Street Hamlet
Onwer or Owners of Property.~,°~~~/;1~t?~i ,,,`~,.Q,~(~.~,h;,;,,,,,,,,,,,,,,,,,,,,,,,,,
County Tax Map No 1000, Section. ,~ .~. ,~, , , , ,Block,.d..~.., ,,-..Q.L ..Lot........ ^~.... ~Q... .
Subdivision ....................................Filed Map......... .Lot.. ,,,,
22 4p1 / / ~~jj-- z
Permit No.. ~.~ .~.s i .~ ZDaPPte Of Permit V ~~~ ~~,(.( Q. ,Applicant 1~.~~~ .~~ n~~~f :'~:r... .
Health Dept. Approval..:. ill .:-i .:- .....(.......Underwriters Approval.~~~ ~!Ut~~G~, , , , , , , .
Planning Board Approval..~.:~..~ .............. !'"
Request for: Temporary Certificate........... Final Certicate...~......
Fee Submitted: $...~.~!. ~~ ................. ,
7/°'~7~9a APPLICANT •••••••••••
_ __
THE NEW YORK BOARD OF FIRE UND~RWRIYERS FASO 1
10(11 f)?i BUREAU OF ELECTRICITY
83 JOHN STREET. NEW YORK, NEW YORK 1003!
pop, JUNE 0I, 19911 ApplicotionNo.onfile 67730?9tl/9p N 13'1360
TFIIS CERTIFIES TXAT _
Doty the a/ectrlenl egnignsnt v deecriked below and Introduced ny the oppliawt nomad entks e6trw soon nuEn6actn the proTn4n of -_
FELOT$, t830S StlUNOVTEW AVENI)E:, SOUTHOt.I), N. Y.
in tka foBowityt location; ^ Basement ^ I At Fl. ®End Fl. A T T ! ( .Sutton Block Lot
wee examined on NAY Q /, 1991) and found to lEe in romplianre with tke reyuircmente of ekie Bard.
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CiRYNB RJRNAC! MOTORS RITtIRi ArruAtlCE RY/IK st~kt luc~n TIKY Q.000S .~ ItNIT INATNf ~ ONAMlRf
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AMT. K. W. dl N P. GAS N. P. NAT. NO. A. W. G. AMT. AAN. AMT. AMPS. 'TRkNf: AMT. M~ P ~. ~ ~T AML WAITS
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SNOKE OETEt;TtlR:-1
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BUX 215 -
SOUTIIU4D, NY, 11971 O~AIMAiiAOM
Per va-
Tkµ. atrtiNeab must not ba shared in any manner; return to fhe offiu of tlTe 8oord N iRwrract; 'r cndentiok._
---
COPY FOR BINLDING DEPARTIIlNT. 71115 COPY OF CERTIflG IAKT . ,. R. '~:
HENRY J. SMITH & SON, Inc.
PLUMBING, HEATING & FUEL OIL
MAIN ROAD
SOUTHDLD, N.Y. 11971
(516) 765-3690
C_E_R_T_I_F_I_C_A_T_I_0_N_
---.
Date__ June_22L1S~0___
H
Building Permit No._1S733Z _______
Owner John Feldis
Plumber Henry_J__Smith_&_Soni_Inc_
I certify that the solder used in the water supply
system contains less than 2/10 of 1% lead.
Henry P. Smith
Sworn to before me this
22nd day of _June ______, _r _ ~ '-/~ ~~
19_90 _. 'dry.c~swlz5~
Notary Public
Notary Public, Suffolk County
BERNAOETTE L. TAPIIN
J10TARY PUBLIC N~814893
State of New York
Residing in SuOdk County
Commission Expires Sept. 30,19
i,',i ,;
'OUiIDAT20:! (1st)
'OllNDATZOIJ (2nd)
~ /
ROUGH FRAME ~&
.PLUMBING
3.
IIISULATIOtI PER N. Y.
STATE ENERGY
CODE
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765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T [ ]ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ FINAL
DATE ~ ~ ,-INSPECTOR ~Gi~J~
REMARKS: ~_.~„~~s ~_~%-~- ~~
BUILDING DEPT.
INSPECTICJN
[ ]FOUNDATION 1ST ( OUGH PLBG.
()FOUNDATION 2ND [ ]INSULATION
[~MING [ ]FINAL
REMARKS:
"~
f- ~.~..-.~C~
DATE ~ ~1 ~ I_!~ __INSPECTOR
~~~~ ~ " ' 765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST ( ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ INSULATION
[ ]FRAMING
[ ]FINAL
REMARKS:
Y
DATE ~~/ INSPECTOR
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OrI 1CIi O[' IIUILU(NG IiJSPL•CTOR
i'.O. ISOX 7~3
"1'O~`JiJ IIALL
SO[J I'1ll7Li), N.y. 1 1971
Chester Orlowski
Box 949
Cutchogue, N.Y. 11935
Re: JOHN 6 DOROTHY FELDIS
To 47hom This I4ay Concern,
TEL. 7G5-1801.
1•ie arc unable to co;nplete your Cart-ificate
of~Occupancy because of the follouring reason:,.
/~// An application for Certificate of Occupancy
is not nn file. (ENCLOSED)
/-~//
P]enno contact: our office on this matter.
Thank you for your. cooperatian.
:70 !tnder:•rriters Certificate on file.
1 / The check .i:; (d[DRY<l~t~ci/not on file.) $25.00
/_/ Nn Health Dept. Approval on file.
/~/ Ilrr final inspection has been made.
:7uildinr, Permit II 1 8 7 3 3 Z
Quildinq UcpL-.
k ~hk/v/ f)o I,lumber Solder Certificate on file.
( all permits involving plumbing being
,
r isaue<1 afL•cr April 1,19fl9 )
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STURTEV,A~IT AA~II~~.W4RK :GOR~2 ,,..~,,
RS~ ~O~t CgMM,ER~IAI.~ & ~NS1t~[TUTI0I~IA
~F
~~,~,,,,~ ~ Come home to quality.
ComehometoMderseR.
STURTEVANT MILLWORK CORP.
75 N. INDUSTRY COURT
4EER PARK, N.Y. 11729
PHONE 516.667.6700
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BOARD OF HEALTH ......
3 SETS OF PLANS -......
FORM N0. 1 SURVEY - . - - .... - .
TOWN OF SOUTHOLD CHECK N.ol~ • • • -
BUILDING DEPARTMENT SEPTIC FORM .............:
TOWN HALL
SOUTHOLD, N.Y. 11971 NOTIFY
TEL.: 765-1802 CALL
""""""""
MAIL T0:
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19 Y.0 U LC. ~~- c~~
~ 7., 1941) Permit No. ~ .~ .7.x.3"`
Disapproved a/c ...... ............................ .
................................... . ......... .
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
J
Date . . G~^c./..?/......, 19 . .
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 code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspectio s. ~ ~ ~ j~
(Sibna ure of applicant, or name, if a corporation)
(Mailing ad ress of applican )
State whether applicant is ow()ner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.............?sue...(~.:................................/.~.n..........................
Name of owner of premises \~~-A'G~!l!`:.~ ~ G~....~-RJI~.~i° ..................... .
\\( (as on the tax rol r latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
ALL CONTRACTOR'S M~TST BE SUF OLK COUNTY LICENSED
Builder's License No. . /.~?~..~S . ~ .~"..~.~.......
Plumber's License No. .:~..~. ~ ... ~ ........ , ,
Electrician's License No. . ~. ~. ~.. ~ ........ .
Other Trade's License No . .................... .
Location of land on which proposed work will be done. ....... ....... ........ .
c/ ~ ~..
House Number Street 5 amlet
County Tax Map No. 1000 Section ...~. S . ~•`• .~` ~.. Block ~.4-. ~~.... ~....... Lot ....~ . ~~.........
Subdivision ..................................... Filed Map No. .............. Lot...............
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
~~,
a. Existing use and occupancy ..R~!~."::'^."`: ~ :. +i4~•'a1'."z: ".. ~ .......................................... .
f~" _,
b. Intended use and occupancy . J • O. • .~^: vk~ . k- . ................. 'F r,"~!`',".`;``:~-('.~........ .
3. Nature of work (check which a~Yplicable): New Building .......... Addition .....:,......Alteration '~ ...... .
Repair ...... .. Removal ..... . ........ Demolition ..............Other Work .............. .
.......t,~......... ~
4. Estimated Cost . l.~F d~!-rJ . ~; ......................... Fee .............:.. .....:.
` (to be paid on filing this application)
5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ............... .
.. ...
If garage, number of cars ... .................................. ............ ................. .
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use '...:`.:' .............. .
7. Dimensions of existing structurgs, if any: Front ......, . , ..•. , ... Rear :.............. Depth ... ~........... .
Height Nuifiiber of Stories .....:'.'.'..'....:. ....:....` ..............~.......... .
Dimensions of same structure with alterations or additions: Front ................. Rear ................. .
Depth ................... ',...Height ....... ~ ..............Number of Stories ..................... .
8. Dimensions of entire new construction: Front ............... .Rear ...............Depth .............. .
Height ............... Nuijiber of Stories .....: , ..........., ..................................... .
.. , .
9. Size of lot: Front ......... .... , ..:::' Rear ........... ............. Depth ..................... .
10. Date of Purchase .......... ' ...................Name of Former Owner ............................ .
11. Zone or use district in which premises are situated .................................................... .
12. Does proposed construction violate any zoning law, ordinance or regulation : ............................... .
13. Will lot be regraded ..... ' .Will excess fill be~}'emoved from premises: Yes No
14. Name of Owner of premises .. :o:-~u+^..~,(,~ .. Addresp~~: ~ ~.WA~¢ra-.~..: Phone Nc~~~:.S%( -: t/'/..37•
Name of Architect ..'.......' .................Address .~?j.x~e~r.-~':YL1.'~!.. Phone No............... .
Name of Contractor ........' ..................Address ....:..............Phone No............... .
15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No .....
*If yes, Southold Town Trustees Permit maY be re uired.
PLO"I' DIAGRAM
Locate clearly and distinctly al} 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.
STATE OF NEW YORK, S.S ///~/c~a
COUNTY OFD..... ..... .
.. , , , , , . ~!,~:r:?-k..ti.. ~~G, :tJt,~O^. d~:~:4 ............. being duly sworn', deposes and says that he is the applicant
(Name of individual signing contract) HEIENKOEVOE
above named. I NO'T'ARY PUOLIC, State of New York
No. 47078"78, SuNolk CouMY,..
((~ -~.y ~ Term Expires March 30,1
I (Contractor, agent, corporate officer, etc.)
of said owner or owners, and is dujy authorized to perform or have performed the said work and to make and file this
application; that all statements contained in this application are true to the best of his knowledge and belief; and that the
work will be performed in the mann~i• set forth in the application filed therewith.
Sworn to before me this
.........................day of .....................,14:..
Notary Public . ................'.................. County
r
~~~~~~~~~~~~~~~~~~~~~~~~~~~(Signature of applicant)
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LL ff 765 7902 A ar~q TO n r"'V, fOF THE
1 1 ~ ' ' ~' 1'' ~~. ~, i , ,,- - PA~G`I CR FoLlowiNC, u.~ °ECTions ~~
j`~I P' f ' aCCU q~IA~EUI a. FouNOarion~ -Two REGUiaEO
'~~ ~ ~ _ '~ (,1 ~ F ' .US~ ~rj U ~~~~(`pTE FOR PQURE6 CONCRETE
.F _ r,.~ ~I __ ~_ ~_- } ~ } UU~ C~A ~ 2. HOUGH •~FRAh11N0 R PLUMBING
1t - - - „f ''- 1 !'~, / ~ c ~ ~~ _ ' _ ~~TU QC``UPpNC 4. FINAL~TIO CONSTRUCTION MU 7 _ ~''
,.- ~~'~ -y-. ~,~ ..~ _ _- .,.. ---. Ate. Q1~{~TAUC7lON_.SHA4L-MEEP"~ - y .
~.~ ~ -'; * ~le -' THE fl€Q(11REMENTS~ OF THE N.Y. •~~' ~ ,
~f l 4~ fr4 ; - ~, T., ~ ~ - . - ~ STATE CQN~ HESPONSIBL-E EKOH ~ `' ~ _
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