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HomeMy WebLinkAbout18120-z y, FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCDPANCY No Z-23946 Date OCTOBER 12, 1995 THIS CERTIFIES that the building ADDITION 725 PRIVATE ROAD #lA & Location of Property 120 PRIVATE ROAD #31 SOOTHOLD NY House No. Street Hamlet County Tax Map No. 1000 Section 77 Block 3 Lot 24 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NAY 12, 1989 pursuant to which Building Permit No. 18120-Z dated MAY 17, 1989 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate ie issued is A SECOND STORY ADDITION TO AN ERISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DANIEL J. WEST (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N179799 MARCH 22, 1991 PLUMBERS CERTIFICATION DATED OCTOBER 3, 1995 HARDY PLDMBING & HEATING ~ \ uilding Inspector Rev. 1/81 goau 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) N ° ~ 8 G. ~ Z Date ..u~~ ~ 19.~~ Permission is herebygra~nt~e~d to: to a ises located at ....7.~:d`."....C~'-7.:~ County Tox Map No. 1000 Section Block Lot No........ ~.Z pursuant to application doted 19...~r~, and approved by the Building Inspector. ~ Fee $..~:r.:/..t... . ~j...g..... g.Inspector Rev. 6/30/80 dorm lo. ( GfOS ~.3U vtif/.~3r"' U "CU'~7N OF SOUTIIOhD 6UIL,DIN6 OGPARTMGNT TOWN HALL BLDG. DEPT. 2+ 7 f~ 5-! B U 2 TOWN FSOUTHOLD npPLlcn~uorl roR craTlr~lcnrL of occupnr,ct A. This application must be filled in by typewriter OP, ink and submitted to the building inspector with [he following: for new building or new use: L. Final. survey of property with accurate location of all buildings, property Lines, streets, and unusual natural or topographic features 1. Final Approval from pealth Dept. of water supply and sewerage-disposal(S-4 form). 3. Approval of electrical installation Erom board of Fire Underwriters. Sworn statement from plumber. certifyin¢ 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 certiEicate.oE Code Compliance from architect or engineer. responsible for the building. , 6. Submit Planning Board Approval of completed site olan requirements. 6. For existing buildings (prior to April 1457) non-conforming uses, or buildings and "pre-existing' land uses: 1. Accurate survey of property snowing all property lines, streets, building and unusual natural or topograpni.c features. 2. A properly comp.Leted application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, Che 6u.ilding Inspector slcall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling 425.00, Additions to dwelling SZ5.00, Alterations to dwelling 525.OU, Swimming pool 325.00, Accessory building $25.00, Additions to accessor}~ building $25.00. Businesses 550.00. 2. Certificate of Occupancy on Pre-existing Cuildine - 5100.00 J. Copy of Certificate of Occupancy - $20.OU 4. Uodal'ed Certificate of Occupancy - .¢50.00 5. Temporary Certificate of Occupancy - Residential/~41~5.00-, Commercial 315.00 Date ....'t.:t_V-. SL~~~f New Construction........... Old Or Pr/~e'-existing Build~i!ng........ Location of ProperCy...~~'~ ~~':°."'~;E',•?+:C,.~,.,,.. faouse No. ( r Street ,,e, Hamlet Onwer or Owners of ProperCy....~~c~~`.J.,c!~e'^e' l'~"'"Q-~' " 7 7 ~oun Cy l'nx Map No 1000, Sec lion....!.!....... L'luck.....~.,........LoC....'.^?~~ Subdivisi.on ....................................Fpiled PI;cI~............L t..... /'/p............ :'ermit No ~~~°?~~....Date O( PermiC.... ~`~r~...AppllC;cnr.i!tiG~`!"~'..... ~IealUc DepC. Approval ..........................Underwriters Approval............. 'tanning board Approval ''e quest [or: '[empornryycCertificate... Final Certicale........... -ee Submitted ~ 4 . . ~~c~0 ~~aagu u THE NEW YORK BOARD OF FIRE UNDERWRITERS s''~"~'^ lEIC>05 L7 r BUREAU OF ELEGTRICITY 65 JOHN STREET, NEW YORK, NEW, YORK 70038 MARCH ~2,'t.94)'i FIb96°i8tD1II~a Pd t ~7y~a - Dare APPlication No. on file THIS CERTIFIES THAT only the electrical equipment as described 6elou+ond introduced 6y the applicant Homed on the above application number in Lhe premises of RAN1'F7, p}"r;S°i', Fl69 L",'(9t75;=; t;N1;i;1; 7,~tt~h1, SCftJ'f'flt)C:LI, rd~Y, in [he following loco~~~~l.~ ~~B~s~tfe~nt LJ !xt h'i. ~ 2nd F'l. 3eetion Biock Lot uws examined an and found to be in cornplfanee with the requirententx q(this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES INCANDESCENT ftUORESCENT OTHER AMT K W. AMT K.W qMi KW AMi. K.W AMT H P. I DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT MEATER$ MULTI-OUTLET DIMMERS AMi K. W Oll H. P GAS H. P AMi. NO. A. W G AMi AMp. AMi. AMPS. TRANS. AMT H p SYSTEMS AMT WAii$ NO. OF FEET ,y HOQ SERVLCE DISCONNECT NO.OF S E R V I C E AMT. AMp, ttPE METER 1,e' ]W 1 p' 3W l.B' 3W 3 4W NO. OF CC. COND A. W. G. A W G EQUIP. ~ PER .e Of CC. COND NO. OF HLIEG OF HbIEG NO OF NEUTRALS OF EUTRAI OTHER APPARA7U5: ~,z~~l:~. f?dsoa~9 Hoax°E;li.Sr2-.,~, rr,u.,~~~~, ~.~r.,~i....1.zt~ ct.ra= ~;hF;t°: fiili,iki H1r,A'J'k~RS:'±=-~..'i H.41.,1-2u?"i H.,.W, f,-h.t; a't-'1. ~'t1UL R, fi131~Ni (,'tC,.#~2~31~-~; L~~~ 2`I?'i '3'nWS~ HAkFSt)R 1,ANt St>tJTH03,)7, i~`l, 329%1 GENERAL MANAG@R 1'I 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. a - TEL. 7G..-i 902. P~c.~ ; t" LJ` , '~-1~,Y. '`c Ok~FICF•.OPI3IIILDII(„T:V'Si'ECiS'OI't O/ SOTJTFiUL(), N.Y. 1 fl97fl ' '~Q~ ~ C G R T I F "1' C A T T O P1 Dat ~"~"~~S Building Permit Noe Owner (_pl' eanse pri(n~t'')~ I certify that the solder used in the water supply system contains less than 2!10 of 190 lead. (plumber's signature) Sworn ~o before me this ~ 2 ~ day of ~~P w~ , 19~~ ~ ~~e9~r~.~ ~ Ilota yt'~ Public Nota_° huhlic,~~uy~"~~ Coun:.y . Notary Public, Ste a pf N~ yyPir No. 48228ti3, Suffolk Co1nMljy Tartu Expires December 3t,1 . o~~gpFFOt~-~O o~ G~~ x Town Hall, 53095 Main Road p • ~ Fax (516) 765-1823 P. O. Box 1179 yjL O~ Telephone (516) 765-1802 Southold, New York 11971 7Oj ~ OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD September 15, 1995 Mr. Daniel West 665 Goose Creek Lane Southold, NY 11971 SECOND NOTICE To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xx An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. xx The check is not on file. $25.00 No Health Department Approval on file. No final inspection has been made. xx No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 18120-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. 4 ~a (516j 7 5~ 802 o~pSUFFO(,~-CO VICTORLESSARD,Principal Gym SCOTT L.HARRIS,Supervisor CURTIS HORTON, Senior y z Southold Town Hall VINCENT R. WIECZOREK, Ordinance p P.O. Box 1179, 53095 Main Road ROBERT FISHER, Assistant Fire y ® Southold, New York 11971 Building Inspectors ~~l ~a Fax (516) 765-1823 Telephone (516) 765-1800 THOMAS FISHER GARY FISH OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD August 11, 1992 Daniel J. West 665 Goose Creek Lane Southold, N.Y. 11971 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: XX An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. XX The check is (not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. XX No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 18120-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. -_~LD I;:SrE;,:iu:+ ~~UniL i;Ua`4MENT° 1. ~ m ~n _a t~ H 0 - _ H ?OUIJDATION (1st) ~ ~ ~d =OUNDATION (2nd) _ _ m~a~ ,w,// 2. C! ~ O~ o ROUGH FRAME & Cr, PLUMBING y 3. y ca m IIJSULATION PER N. Y. y r STATE ENERGY CODE ~ s v © y FI;JAL o ADDITIOPJAL COMMENTS: ~J x x ^o ` H ~ ~ • 9 y H O [~7 a ' r • - H [q 'o H £ i / 765-1802 V BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T ( ] RROUGH PLBG. [ ] FOUNDATION 2ND [d~ INSULATION [ ]FRAMING ( ]FINAL REMARKS: ~.;~~i~i 6iL DATE co J^ INSPECTOR I G~/~~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST (!~1 ROUGH PLBG. FOUNDATION 2ND (]INSULATION [~RAMING [ ]FINAL REMARKS: ~~C~ /y~ DATE ~ ~ 0 / INSPECTOR T65-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 15T [ ) ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ INAL REMARKS: ~ 7_. " DATE ~ © INSPECTOR 60.1RD OF HE.ILTH 3 SETS OF .1NS 1,~..... . FOHMNO.1 SURVEY ~ ~ ~ ~ ~ • . TOWN OF SOUTHOLD CHECK ..Iw:~ek,. p~; , , . . BUILDING DEPARTMENT SEPTIC FORhf .......I.~ , , , TOWN HALL SOUTHtOLD, N.Y. 11D71 NOTIFY - TEL,: 765.1802 CALL Examined 19~.~ MAIL T0: Approved ..`.J~/~........, 19~ Permit No./~/O~) ~ Disapproved a/c ` ~ 2 ~ r~ ~ 1 i~ (Buil n~ Ins ector 1-~ APPLICATION FOR BUILDING PERMIT Date 15a~ INSTRUCTIONS a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate piot 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. t c. The work covered by this application may not be commenced before issuance of Bui]ding Permit. d. Upon approval of this application, the Buildin; 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 Buildin; Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the' Bui]ding 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- Tlte applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectots on premises and in building for necessary inspe ti ns. ..LLD _ //(Signatur//e o pplicant/or name, if a corporanon) tt? (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or b~der. ~G~ic e-t-~ ?lame of owner of premises ~ j % C~~ (as on the tax roll or latest deed) IC lp\\plicant is a corporation, signature of duly authorized officer. ....g (Name and title of corporate officer) Builder's License No. 2,~.W.NP~c' Plumber's License No . . Electrician's License No . . Otfter Trade's License No . -7a.~ 1, Location of land on which proposed work will be done . , House Number .......................Street.....................~~;~'~a'; ; -I Hanilct County Tax Map No. 1000 $CC[10? F Block , , , , , • , , , , Lot ....~y Subdivision Filed ~fap No. Lot . (Name) State existing use and occupancy ofpremises and intended use and occupancy oC proposed construction: a. Existing use and occupancy b. Intended use and occupancy ........~w~lL'~• ~'t`]~'fA~~~~x~`P~ . ' 3.'~st ~3~ta -F..,r' i i 3. Nature of work (check which applicable): New f3uilding ,Addition . ~ ~Vteration Repair Rer<toval Demolition Other Work . (Description) 4. Estimated Cost . .Fee . . . 6 / (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 ype of use . 7. Dimensions of existing structures, if any: Front : • ,Rcar Depth . Height .Number ofStorics. ~ Dimensions of same strpcture kith alterations or , zlditions: Front ~ ~ ~ • • ~ ~ • • " ' ' Depth rt .....L Ilcight . Rcar ' 8. Dimensio entire new construction: Front , .`p?~ ~ • ' ' ' ' ' • • • Nuntbcr of Stories Height Rear 8"....... Depth - . Nmnber of Stories . 9. Size of tot: Fzont I, Rear .....1~c7 ~ f6.............. . 10. Date of Purchase p~. • • • • • • • • • • • • • • • Depth . ....Name of Former Owner ~ ~ ~ • ' 11; Zone or use district in which cmises are situated • 12. Does proposed construction viola e any zoning law, ordinance or regulation: l3. ~Villlotberegraded ~v• • • • ..Will excess fill be removed fro premises: Yes d~SO 14. Name of Owner of premises . a~: ~ ; ;Address 6~~ . ~~'r-r ~-^ti~C~ 7 •J-,~ ~,-z~~ Name of Architect • • • • • • • • • • • • Phone No.. la . - .Address . .Phone No. . Name of Contractor r.~•c ~f , , , , , , , ,Address ~ • • • ~ ~ • ~ ~ • .................Phone No......,,.~~--++,, IS.Is this property located within300 feet of a tidal wetland? *YES....4,Lpi.., *If yes, Southold Towp Trustees Permit may be required. PLOT DIAGRAM ' propertytlines. Give s reetsand bloLklnbuildings, whether existing_ or proposed, and.indicata ai(_set-back dimensions from, - interror~rz..~...,.-,~.. - t tnf - - r - . - i i M II ~I I 1 \ I • W~~ ~X~b'1~rJGs I i, ~.p~ ~db:l~ard L g~'' 1 1 p~~II.N(. W W y ~4 a -~i- ~s.,_~~~y ~ ' ~t.~~lcvr ;yew Kh - - I COUNTY OF ~ _O/~ $.S - _ _ - - , .~~?Cr " • " •f~• • • • • • • • • • being duly sworn, deposes and sa s th ' (Acme of mdrvidual slgnu)g contract) Y at he Is the applicant above named. 4 liC IS the I ~C~~`--~-~- ~ (Contractor, agent, corporate officer, etc.) ~ ~ ~ ~ ~f said owner or owners, and is duly',authorizcd to perform or have performed the said work and to make and file this =pplication; that all statements contained in this application arc true to the best of his knowledge and belief; and that the •vork will be performed in the manner Set forth in the application filed therewith. iworn to before me this • 1981' rotary Public, „ , , , , , , , f County wry, ~,~y y~~ ~ ¦ C • i F, l~ NNE RFtNai , . . . , . , r~. . . • . , , . . , . . . Nota •~i' (Signature of applicant) _ No. b -812$860 8uffoMt 7irm Oot~Oer 81,1