HomeMy WebLinkAbout18481-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 196302 Date SAN. 4, 1991
THIS CERTIFIES that the building ADDITION
Location of Property 9500 SOUNDVIEW AVE. & 2855 Kennys Rd. SOUTHOLD
House No. Street Hamlet
County Tax Map No. 1000 Section 59 Block 07 Lot O1
Subdivision KENNEWOOD Filed Map No. 2180 Lot No. 27
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 30, 1989 pursuant to which
Building Permit No. 184812 dated SEPTEMBER 13, 1989
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 ADDITION TO EXISTING ONE FAMILY DWELLING.
The certificate is issued to WILLIAM MANOS
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. H019499 DECEMBER 4, 1990
PLUMBERS CERTIFICATION DATED WILLIAM MANOS DECEMBER 27, 1990
Bu lding Inspector
Rev. 1/81
sows xo. a
~ 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)
NQ ~~nt~1 Z Date ......1~~3 19..~c7
Permission is he eby ranted to; '
to . ~ ~~'r,~..
~
G
.~2~.~~:.........4d........ .
.
ct premises located at .......e~.P~fb711/~G.~G!~.~G(l'~..os,~~~.`:~
............................................fem.. ~1..`F ,~k~~........'4 C/.t................ ~..t'uc ~ u.~~.....
Caunf`j Tax Map No. 1000 Section Block ............,7...... Lot No..........?..
pursuant to application dated ........~~.y.~~ 19..V./, and approved by the
Building Inspectar.
Fee ~0...
s~
~ Buil 0 Inspector
i~%~
Rev. 6/30/80
Form No. 6 5~-
4~ ~ ' TOWN OF SOUTHOLD 2`Z ~ `f
iij'p Pi
'r.f~ I BUILDING DEPARTMENT ~
OGi~ ~ ~ ~ TOWN HALL L~'~ ~Z ~
76s-LSOZ ~ ~y ~ i
TOWN
OF Sp(1~jOtp
LIGATION 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.
s. 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
t 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 $2s.00, Accessory building $2s.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 s years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ~2 7 ~q CJ
New Construction....:' Old Or Pre-existing Building........... .
Location of Property. 9~?a'~:'. Sod?N'~_~i~[.=ZJ , A~;C~ SoL~ j ffC L 7~ -
House No. Street Hamlet
Onwer or Owners of Property...w~L~;/.~1Mqq n7:~/~/o.S
County Tax Map No 1000, Section... S.J......Block......7.........Lot
Subdivision...;~~iv/~/F~.~~~ ..............Filed Map..Z/~O...Lot.2?..................
Permit No... ~.k~.~ .....Date Of Permit.. ~~.....Applicant.`~~~LL//-?/Yl /~1~~/~/O S.
Health Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval
Request for: Temporary Certificate........... Final Certicate...........
Fee Submitted: ~G~.
yra
//~/~1 APPLICANT
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE. 1
8027228 BUREAU OF ELECTRICITY F'
83 JOHN STREET. NEW YORK. NEW YORK 10038
Dote DECEMBER 04,1490 qpp ltcutionNo.Dnfile 69577590/90 A 019499
THIS CERTIFIES THAT PERMT.T NO. 184817.
only the electrical equipment er described 6ektrs and introduced 6y the applicant named on the oboes epplicstion number in the premises of
GREG HUNT, 9500 SOtJNDVIEW AVE., SOUTHOLD, N.Y.
in thefollouinq lrfcetion; ? Basement ~ lat Fl. ? Ynd Fl. .Sertiun Bloek Lot
uoa a:amined un NOYENBER 26 ,1.990 and foand to be in romplianee uith the reyuir¢ntents of thu Buord.
gxrun RXTURES RANGES COOKING DECKS OVENS DISN WASHERS EXHAUST FANS ~
OUTLETS BTACLES S1D17CNE5 INCANDESCENT flllOaFS[ENT OTNEn AMT. K. W. AMT. K, W. ~ NAT. K.W. AMi. K. W. AML N. P.
- 4 10 4 4 ~
DRYERS RJRNACE MOTORS FUTURE AMBIANCE F@DERS S?KIAL RECIT TIME CLOCKS EG4 UtNi NEATNS MULTLOUTUiT DUAMlRS
AMT. K. W. ql M. P. GAS N. P. AMT. NO. A. W. G. AMT. AMP. AMT. AMPS. TRANS. AMT. M. P. N Oi
~T AMT. WATfS
1 3a ~
SERVICE DISCONNKT NO. IN 5 E R V 1 C E
AMi. AMP. TYPE AWE' 1 A ]W I ~ ]W 3 H ]W 3 / AW ~pER H'C~D. OF CC. COND. Of NI-LEG NO.OF NEUTtA15 Oj NEUOIAL
OTIIEE AhARATUS:
kIRING FOR INTERIOR EXTERIOR ONLY-7.
c,.F.c.I:-2
IiILLIAN NANOS
40-20 22]ST STREET
BAYSIDE, NY, 11361 ONNRILL MANAON
. 11 1~Z7 ~ ~ Rf
Per
This certificate must not be alterod in any manner; return to tM office of the Board if incorrect. Inspectors may bs idaMified by their cndantials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFIGTE MUST NOT BE ALTERED IN ANY MANNER.
_
, - .
TEL. 7G5-1802
uF !l,
~pl% TOWI`i OF SOt3TII0bD _.,,:qa
~~c OFFICE OF BUILDID7G INSPECTOR . r
o t'• P.O. BOX 728
TOWN HALL
`'0~~ C° ~ ~`r SOUTHULD, N.Y. 11971 ~ L ~
~:i,
C E R T I F I C A T I O N
Date /y
Building Permit No_ ~~~$/z
Owner {'I/ LC,C,4p-+m. ~Y?1 (.-wo-+l~
(please print)
Plumber C,uyytti?
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of to lead.
.,t~ ~u~. r~tit ~ Y V~~ i
(plumber's signature)
Sworn to before ,,rrm~~e this
19-(=• Notary Public
tlotary Public, County
HELEN K DE VOE
NDfARY VUBLIC, State o4 tdew Yolgk ~
7e m~Expres~N~larch 39.~no
' ~1~,~ TEL. 'GS-180'
` `~c~J~FO(..'fcG/~ TO~Y'P1 OF SOUTIIOLD
l~ ~z~ f;;, ~ or4~ICI: or >}uItDINC INSr'r•.craa
u ,4 (~~~'~w ~ ,
1'.O. I30Y ] 17 9
~ F• j ~ Tdlli~ t4ALL
,y SOUTIIOLD, N.Y. 1197!
Deember 26, 1990
Mr. William Manos v~~q
9500 Soundview Avenue t !
Southold, N. Y. 11971 ~ ~
3 1 i
To 41hcm This May Concern, ,
~
4.e are unable ro complete your C,.=t:a~icatc
of Occupancy bccaus: of the following reason.
An application for Certificate of Occupancy
is not nn fi].c.
/X3t Dto IJndcr~:rriters C~:rtificate on file.
/}(I[ 'Phe chccFc .i:: (~a*~dss~~t}t~ti/not on file.) X25.00
/ ( No I]cal.th Dept. Approval on file.
D:o final insE'~ect'.ion has been mace.
Plaasc contact: our office on this matter. '
T:;ank you for your cooperation.
Ilit.ilc3ir;r1 Penn.iY. II "1. 8 4 8 1 2 Z
IIuile3iny Dept.
**k/~/ do I'lc:mbcr Solder Ccrt.ificate on file. ~ '
{ all p~rmit~ invplviny plumbinr3 briny
~~L~/~' iscucct zftnr :'tpri.l 1,198A ) 1ot~8/pp
Fvccas~ ~S .z-~-? Z ~~a
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ROUGH FRAME & I
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STATE Ei1ERGY
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ADDITIOIIAL COinMEP:TS:
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BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST ( J ROUGH PLBG.
[ ] FOUNDATION 2ND [~'11VSULATION
[ ]FRAMING [ ]FINAL
REMARKS: ~ d~
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- _ .
DATE / ~ INSPECTOR
_ _ _
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rss-zsoz
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ FRAMING [ ]FINAL
REMARKS: ~~P C~
DATE INSPECTO ~"vG
765-1802
BUILDING DEPT.
INSPECTIQN
[ ] FOUNDATIO 1ST f ] ROUGH PLBG.
[ ] F~~ 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS: t~~~,
/
w
DATE `4 ~ y INSPECTOR
~
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765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION iST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [FINAL
REMARKS: ~
DATE ~L ~ i INSPECTOR
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~I.'~~Cl~y T0~'I`! Or SOUTIIOLD
f~~~~ Y;~ ~ OI'I'ICI? OP GUILDING INSPECTOR ,
ru ti~[~~'}'1r.~t4 ~n P.O. QO)C 1 1 79
u ~ r)°`'~ TOC1N [SALE
''yC',y~~ SOIJl'iiO1_D, N.Y. t 1971
~ ~i= r
Deemher 26, 1990
Mr. William Pianos
9500 Soundview Avenue
Southold, N, Y_ 11971
'to S•7hcm This'May Concern,
47e are unable r.o complete your Certificate
of OCC11paIIC1' becausa of the follocuing reason.
An application for Certificate of Occupancy
is not nn file.
;to Undcr:arit-crs C~:rtificate on file.
/~1' 't'he citcc}c i:: (SmcvEa?;atic~cl/r.ut on file.) $25.00
Dto ttcal.th Dept. Approval on tile.
Nn final insi'~r_ct:ion ham been made.
Please contact: our office on L-hia matter. •
Taank you for your cooperation.
?u.ildir;<1 Pcrmi.P. If 1 8 4 8 1 Z Z
ilttildiny DupL-.
~'t*/~/ tlo i'lt:mbcr :;older Cert.ificatc on file. '
( all permit:: involving plumbing being
i~sucd after April 1,1J89 )
Ye.r V.. Yw..rna
..Y..e....s.. u... _ ~ n.r ~ •S.>!.~~-5. 4f.Y~ ~ i . ~ _
`1 ~u. i~i~uMSma
w~ASfe
~ ac M64TER 4iNE$ NEED
~ ~ TESTING BEFORE COVERING ~
Et
~RRTIfICATE
~ ~3
a ~i,~ A P OVER AS ROTED G
DATEI'1' ~ ~ B.P. # ~~~a l
NOTI
BU~ DEPA NT AT
~ 765.1802 Q AM TO 4 PM FOR THE
E FOLLOWING IP! 'iCTICNS:
" V t. FOUNDATION - 'IWO REQUIRED
J ~ FOR POURED CONCRETE
IN ~ 2. ROUGH -FRAMING & PLUMBING
3. INSULATION
ca ti 4. FINAL - CONSTRUCTION MUST
BE COMPLE-. FOR C.O.
T ~ ~ ALL CONSTRUCTION SHALL MEET
- THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION ~ ENERGY
~ \ CODES. NOT RESPONSIBI"'E FOR
N DESIGN OR CONSTRUCTION ERRORS
~ ~ rn ~ ~ ~ ~F~~~~U~ ~ ~
~ ~ ~1
; PLUMBER CERT/F/CA
~ - ~ ON LEAD CONTENT BE.
~
f ~ £ERT/FlCATE OF OCCUf
4~ ~ ~ SOLDER USED l~' 4~!,!E
~ J~ ~ f r,SUPPLYSYSTs~~~ r.~~^~r
/k ! ~
I~ ~1 ~ ~ ~
if copper tubing is used
N N C for water distributing
'~`I ~ ,c ~ system; piping shall be
- ~ of types K or L on!
~ ~
0 s_ $~x
a y, a/
Yh V}
~ -
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~ S,~y L (C~ td `C 11..1 ~ ~
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BOAKD OF HEALTH
3 SETS OF PLANS
FORM NO. 1 SURVEY
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FORM
TOWN HALL NOTIFY /
• SOUTHOLD, N.Y. 11971 7~•~:? jCc ~ • •
TEL.: 765-1802 CALL; '
C~ ~~jj L T 0
Examined 19.`:,!
Approved 19~Permit No...la.Y~~
,
1 .
~~i , , ,
Disapproved aJc
AU6 3 p 1985
j
C"":. .?'L". ot.DG. DENT.
~ • • • • • TOWN OF SUti?iiOlq
~Bu' mg Inspector) '
APPLICATION FOR BUILDING PERMIT
. Date . 19a
INSTRUCTIONS
` a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, wit
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 str
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this ap
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 pee
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 Occupa~
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
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance
Regulations, for the construction of buildings, additions or alterations, or for al or demo tion, as herein describ
The applicant agrees to comply with all applicable laws, ordinances, building o , housing c e and regulations, and
admit authorized inspectors on premises and in building for necessary " ectt
(Signature of icant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is(~owne~r, lessee, agent, architect, engineer, general contractor, electrician, plumber or build
~!CY'r-Q, 1~... ti,W~~dV\l.'I?-!G1GT(P?t_ .,..I .
Name of owner of premises ..W !.~-1~t.a.AJ . ~l~j A~(~SU.S .
t (as on the tax roll or latest deed)
If applica a corporat' n, signature o ly authonzed officer.
. ......5.........
(N me and title of corporate officer)
ALL CON RACTOR'S MUST BE SUFFOLK COUNTY LICENSED
Builder's License No. !~`,'.~tq. .
Plumber's License No. ....`l.lA?:N.~.......... .
Electrician's License No. (~''~'~CA1.~_ .
Other Trade's License No. . S„).~{~t ~!L• • • • , , , , •
1. Location of land on which proposed work will be done. *~`S~.S~....: `.FL.NN~~S... .
House Number Stnreet Hamlet
County Tax Ma`,p//No. 1000 Section ....p~. n Block .....7.... , , , , , , • Lot
Subdivision ..!l~l~U,/1.I~V.~~Q Filed Map No. YQ....... Lot 2.~.......
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy !'}7 ~T A.4 ~'?•.ti~• J,~~:+~-i0 . • , • • .
ft eM
b. Intended use and occupancy ~ 5r. • • • • • • • • , • • .
, ,
3. Nature of work (check which applicable): New Building Addition • . • Alteration , ,
Repair Removal Demolition Other 1Vork ,
~ (DescripIioi
4. Estimated Cost 1 QQ{'~ Fee .
` (to be paid on filing this application)
S. If dwelling, number of dwelling units b Number of dwelling units on each floor .
If garage, number of cars
6. If business, commercial or mixed occupancy, specify n turq and extent of each t e of use .
7. Dimensions of exiting structures, if any: Front ~ , ~ Depth .
l a Rear
Height ~ r~, Number of Stories .
.
Dimensions of same structure with alterations or additions: Front Rear .
Depth ~...ti . ............Height ......................Number of Stories .
8. Dimensions of erY~~fft'e new construction: Front ....a"......... Rear Z-..~F.:::::::: Depth : ~ , , .
Height l b........ Number 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: A1.0 .
13. Will lot be regraded ,.1 ~.0 ..........Will excess fill~e removed from gremises: Yes i
14. Name of Owner of premises~N.l~1~!{ . t~Aalel~.... Address ,ri.~Q~.. S3:v:+1lQt(e.Gt~... Phone No. ,7.4.F' :
S~`~'~.
Name of Architect , . Address ~j.... Phone No........... .
Name of Contractor . \?+4E~ . , , , , , , , , , ,Address a~.G.:r3~ .Is'j', Sa,ciWpltone No. Z ~,t-0. ' 5~:~.~.
i5. Is this property located within 300 feet of a tiidal wetland? *Yes No
*If yes, Southold Town Trustees PermitPLO~ DIAGRAM ed.
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions fro
property lines. Give street and block number or description according to deed, and show street names and indicate wheth
interior or comer lot.
STATE OF NEB' OAR / S.S
COti\'TY OF . ~~-LL~It.. .T~.<~.. .
ame o mdi~~ ~ ~ ~ ~ ~ ' ' ' ' ' ' ~ • being duly sworn, deposes and says that he is the applicar
aJ vidual signing contract)
above named. f`
He is the
Contractor,lagent, corporate officer, etc.)
of said owner or owners, and is duly authorized
to perform or have performed the said work and to make and file th
application: that all statements contained in this application are true to the best of his knowledge and belief; and that th
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
1~ .day 19
~ , ~ t
~ ~ ~
Rotary Public, '~!S-Y.~~-,(~......-:... County
.
NaMtY~~ ~~Y~ (Signature of applican
Qwlifted in Suffolk County C1,>
Commfeakm laWires Decemuar 8, r