HomeMy WebLinkAbout18444-z FORM NO. 4
TOWN OF SOUTHOLD '
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19626 Date DECEMBER 31, 1990
THIS CERTIFIES that the building NEW DWELLING
Location of Property 630 CLEARVIEW AVENUE SOUTHOLD, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 70 Block 9 Lot 62
Subdivision FAIRVIEW PARK SEC 1Fi1ed Map No. 3388 Lot No. 28
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 18, 1989 pursuant to which
Building Permit No. 18444-Z dated AUGUST 30, 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 ONE FAMILY DWELLING WITH ATTACHED GARAGE & PORCH
The certificate is issued to JAMES A. & DEBORA L. GINAS
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 88-SO-75-DEC. 17, 1990
UNDERWRITERS CERTIFICATE N0. N-161632 - NOVEMBER 20, 1990
PLUMBERS CERTIFICATION DATED DEC. 31, 1990 - JAMES A. GINAS
7
r' ~ ,
B ilding Inspector
Rev. 1/81
gossi 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°- x.8444 Z Date ......rY/3~ 19..R..r~
w Permission is hereby granted to:
~.~~~~~c.....1'~!..`.~
` ~2....
f0 .~sc~.lll,C.
~~...~r............
........a ..............1..~i....
at premises located at ........~..u~
...............~.eG~,ri:~n~.~.-~.!:~....4~ii:7.............................
County Tox Map No. 1000 Section .........~T.Q,......,. Block Lot Na.........SU.~...
pursuont to application doted,p.~~~C.~~~~~......:~..~j.//..~~......., 19..~.~, and approved by the
Building Inspector. ' `~'G
~ ;yo
Fee $..~.t,3
Bu ding for
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD ~
BUILDING DEPARTMENT S!
TOWN HALL
765-1802 ,,s
~ TOWN
OF
SOUTHOLD
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.
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, 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, Commercial $15.00
Date
New Construction...... Qld Or P e/-existing Buil/d~ing I
Location of Property... !P ~(J....... ~.l•eC?~(.~,1~;`;
....1;4,u :t : ~~`::~a. 1~..........
House No, n Street f Hamlet
Onwer or Owners of Property.....~.~``.`77:~rr~~«...'.! [`l`?~.. ~j.~?: va~ ~.l!. ~~!::!~:5......
County Tax Map No 1000, Section...(.!........Block......[.........Lot......`.:'?............
Subdivision.....(.~
........................~(...2.~Filepd Map............Lot.................r....
Permit No. ~ 1 `......Date Of Permit.. V...~l`: o ~ .Applicant...~.~Y:~!~~...h~..~ hl!~:S
Health Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval
Request for: Temporary Certificate........... Final Certicate...........
Fee Submitted: $...S~~t~} ~
ate. y?o~ q _ .
CO ~ ~96ap APPLICANT '
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1000307 BUREAU OF ELECTRICITY
83 JOHN STREET. NEW YORK, NEW YORK 10038
NOVEMBER 20.1490 APPliceticnNo.onfile 58809590/90 N .1616.32
THIS CEFTiIF1E3 THAT
only tM e4ctrlcdy~uipment Y described helow utd introduced by Lhe opplicent FFOmed on the Ofrooe app?intfon nu+nher in the premises Of
NR./MRS. J. JANICE, CLEARVIEA AVE, SOUT80LD, N.Y.
in thefolbtcinq location; ®Boeensent ® Ist Fl. ®Ynd Fl. GAR/ATTIC/OUT Section Block Lot
uws examined un NOYEHBER 13 , 1490 and found to be in compliance with. the requirements of this Board. -
gxTUR! RXTURRS RAN06 CODKINO EECKS OVNK WAfiffLRS EXIlAUST FAPB
OUrilTS AGES SWITCHES INGNnlSCFM FIVOtFSCENT OTHER AMT. K. W. AMT. K. W. NAT. k.W. NAT. K. W. AMT. N. P, s
s
4i 0 55 52 .3 3 F
DRYERS R/RNACR MOTORS lUTURE ARUANC! RRSERS 5?ECIALRK'?i 1WEtSACKS .may WNT HEATERS kMtgFONTtIf DIAt1ABRS
AMT. K. W. Olt N. P. OAS N. P. AMT. N0. A. W.O. AMT. AMP. NAT. AMPS. TRANS. AMT. N. P. ~OF ~T AMT. WAITS i
i
3 F 6 14 1 i0 3 600
SlRVKR DKCOlNlKT NO.OF S E R V 1 G E
AMT. AAV. TTPF ~ I N t\Y I X tW 3 R 3W J R AW NO' NX
+.coNO. OF CC . O. NO. OF IILIEG Oi NI'IKS N0. Q NENMlS OF 'NWEUfON/.l
r 2DO cB 1 x 1 aio 1 z~0 -
orNER AlrARATUS:
PANELBOARDS:I.-26 CIR. 200,1-8 CIR. 1.00
G.F.C.I:-6
SNOICE DETECTOR;-1
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FROI[NOEFER JOSEPH J. JR. LIC.~462-E G~j;6~
P.O.BOX 817 R? 25 -
SOUTROLD L.I. , NY, 11971 o~IIRAI AAAFIAOY
11
Per ~~l-A~
Thu certifiwb mutt tat be ahsrod in any manmr; return to the office of the Board if incorrect. Inspector; M identified by HN'R erodetttiok...
COFY FOR Wil~ltlf. OlFARTMli1T. TENS COF1f OF CERTIFIGff IM1St t10T Ikt AS. , IN.A$IY,MA~R,
_ ~ n
c~~F~~(~,`, TEL. 7G5-1802
~O O,, TOWN OF SOYJTIIOE,D
O „ r r
• < OFFICE OF BUILDIPdG INSPECTOR
~ ; ~
~ , P.O. BOX 728
$ TOWN HALL
~/y~ol SOUTHOLD, N.Y. 11971
C E R T I F I C A T I O N
Date~~,31 ~ 9
Building Permit No.
Owner Jja~vreJ ~ C~a-+,~{-S
(please print)
Plumber D~~ef
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1~ lead.
f
_ ~
(plumber's signature)
Sworn to before me this
_,~i~ day of ~p~ rr11
Notary Public
flotary Public,^~,~~a~ -County .
HELEN K. DE VOE
NOTARY PUBLIC, State of New Yurk
No. 4761979, Suffolk CauntY-y ,
Term Expires March 30,19
~cuFFOLkCO
HENRY P. SMITH, Presid TELEPHONE
~ ~
JOHN M. BREDEMEYER, Vice-Pres. ~ ~ (516) 765.1892
PHILLiP j. GOUBEAUD ~ ~
ELLEN MKLARSEN JR ~~I ~c ~~0~
BOARD OF TOWN TRLJSTEES "
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York 11971
June 12, 1986
Mr. Rudolph H. Bruer
Edson 6 Bruer
Attorneys at Law
Main Road
Southold, New York 11971
~l
Re: Dempsey from Smith
Lot No. 28, Fairview Park
Southold, New York 11971
1000-70-9-62
Dear Mr. Bruer:
Pursuant to your request for a determination on the above captioned
matter, please be advised that the Bay Constable has conducted an on site
,inspection of the subject property and has determined that no permit is
required at this time.
I
If the proposed house plan is amended to a distance 75' or closer ~I,
then another determination will be necessary,
Thank you for your continued cooperation in regard to these matters.
We look forward to serving your in the future.
Very truly yours,
Henry P. Smith, President
Bo~ar~d~of~Town Trustees n
Ilene Pfifferl ng, Clerk
HPS:ip ~
Attachment
cc: Trustees ~
file
=1~:LJ i;:S:~O:'_~;: ,~U„TE :;~.~fML,NTv
=~'4
1. ~
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FOUI7DATION (1 s"t)
c~
FOUS7DATION (2nd) m~~
c D '
2.
z ,z
o
ROUGH FRAME &
PLUMBING Y~`
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3 . ro
~ ,
IS7SULATIOPI PER N. Y. • •
STATE ENERGY
CODE
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FI;IAL
• Lp ,
.
ADDITIOStAL COMMENTS: xth
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765-1802
BUILDING DEPT.
INSPECTION
[ FOS,JNDATION 1ST ( ] ROUGH PLBG.
[ FOUNDATION 2ND [ ]INSULATION
[ ] FRAM{NG [)FINAL
REMARKS: ~~a
DATE lO INSPECTOR
l~ r~-isoz
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T (~OUGH PLBG.
]FOUNDATION 2ND [ ]INSULATION
I!i! rRAMING [ ]FINAL
REMARKS:
DATE ~
C~ INSPECTOR
New York State Department of Environmental Conservation
Building 40,/-~SUNlY, Stony Brook, New York 11794 p pt~
J c t't • t7 l DATE: D/f~`o /
~1a m F, ~ p / Cy
O~~Ci~ ~Q~ K ~11 tt~~U////~I~ pQ.. Re: ~O O ~ )`T/~~It~n7 /
~(X~l~}C~t~( Icy ~ ~ 15~ ~~~~~/VC~V 7~`~Yr~mmssonerling
Dear ill ~-1~ II~J. `
A review has been made of your proposal to: ~~/~S~'~ > 5~~j~/ ~ ~~i
ci~~~~/~/~ lccs~" revlse~0 3/3//~y /o~'Qf~c~pr~ C'~iu~<<
~e.n v 5~ v~(-tea `c~ ,
Based on the information you have submitted, the New York State Department
of E vironmental Conservation has determined that the parcel
project is:
Greater than 300' from inventoried tidal wetlands.
_ ' Landward of a substantial man-made structure
greater than 100' in length which was constructed prior to 9/20/77.
Landward of the 10' above mean sea level elevation contour on a
gradual, natural slope.
_ Landward of the topographic crest of a bluff, cliff or dune which is
greater than 10' in elevation above mean sea level.
Therefore, no permit is required under the Tidal Wetlands Act (Article 25
of the Environmental Conservation Law). Please be advised, however, that
no construction, sedimentation or disturbance of any kind may take place
seaward of the 10' contour or topographic crest without a permit. It is
your responsibility to ensure that all necessary precautions are taken to
prevent any sedimentation or other alteration or disturbance to the
ground surface or vegetation in this area as a result of your project.
Such precautions may include providing adequate work area between the
10' contour or topographic crest and the project (i.e. a 15' to 20' wide
construction area) or erection of a temporary fence, barrier, or hay
bale berm.
Please note that any additional work, or modification to the project as
described, may require authorization by this Department. Please contact
this office if such are contemplated.
Please be further advised that this letter does not relieve you of the
responsibility of obtaining any necessary permits or approvals from other
agencies.
Very truly yours,
~ fi
~;h~-~tv,.~. Cam-,
~ Deputy Regiona Permit Administrator
~ne1'
BOARD OF HEALTH
3 SETS OF PL.\NSi , • • •
FORMN0.1 SURVEY • ~ •
TOWN OF SOUTHOLD CHECK ~ , , ~ ,
BUILDING DEPARTMENT SEPTIC FORTI
TOWN HALL ~ ~ ~ ~ ~ • ' '
• SOUTHOLD, N.Y. 11971 NOTIFY ~7 r~
TEL.: 765-1302 CALL ?I/. ; ~~i,o~~• • .
Examined ..0... 19~/, ` b1AIL T0:
7~~-
Approved Q 19~. Pcrmi[ No.1 ~7:
Disapproved a/c ® ~ C'7 ,S ~ itn ~y
Auc i s ise~
( ildin Spector) j'°'°^-~N px
g0~pH0(.p ~
APPLICATION FOR BUILDING PERMIT
Date ....7..`.~?~......, ISP`!
INSTRUCTIONS
a. Tlus application must be completely filled in by tgpevvriter 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 stree
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appl
- 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 perm:
shall be kept on the premises available for inspection throughout the work.
e. No building shalt be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupant
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 th
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describes
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and tc
' admit authorized inspectors on premises and in building for necessary inspecti s
- - ~ - - - - _ r
I (Signatu pof apppplicant, p am~e/, if~aLorpLorarro`nl) •
~./(9r7.. ~~9;^!t!• ~l,e-~ !'%g:/J(/.~tG/.t. y. lY,y
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
®W rye-
Name of owner of premises ~~~t?.t . Lie ~?o~r~ • .~~n,q~-.
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No . -
Plumber's License No. . • , , ...~~!~?`.~'L~.. , , . , , , . ,
Electrician's License No. ~ .
Otter Trades License No . .
1. Location of land on which proposed work will be done. •
/ OeI~ /
(~J C~a/vle~ /71/.x:... , ~o+~~ho~~
House Number ~ Streets ° ' • " " " " " •
p Hamlet
County Tax Map~No. I OOO Sec\tion v........ Block Lot
SuUdivision !tlKVl4~.. J !1!!t Filed n[ap No. ..~e_! 7, Lot ~j?........ .
(Namej y
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ......~M%~~.. L~'wd.
•
b. Intended us ~ i/[~ ~ 1 1/~_ '
e and occupancy T,l.Iw.an1...!`~:~ S1ngLS . 1W.w11,~?
d J 1.•
' 3. Nature of work (check which applicable): New Building • • •r!• • . • Addition Alteration
;Repair Removal Demolition Other IVork .
(Description)
4. Estimated Cost ~~Q.l Fee .
5. If dwcUin nurnbcr oC dwcllin u ~ ~ (to be paid on filing this application)
1~J 6
g. g 'nits S!N Number o(dwcilin units on each floor .
earagc nurnbcr of cars 7 .
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use • , , , , , , , , , , • • ,
7. Dimensions of existine structures, if any: Front , •Rcar Depth , , , , , ,
Height Number of Stories • , , , , • '
• Dimensions of same structure with alterations or additions: Front Rcar . -
Depth r:........ . IIeight i Number of Stories . • .
8. Dimensions oCentire new constntction: Front . .~t?.'.~~~ Rcar . • Depth ....`t.~.~,r.: -
Height - r Number of Stories f,~,Ta.. • ~ • • • ~ • • • • • ~ ~ ~ • • •
9. Size of lo't: Front ~ 1~,.0. L . Rcar I,I O; .S~
J'. ; .........Depth ~/a: O• .
I0. Date of Purchase • , C) 9,-;Q6.
; •P~• • , , , , , , , .Nam of 'o cr Owner am Cf'
gg,, rr~
11. Zone or use district in which prcfnises are situated , ,',/J, . ,/reyY! ,~ti f~~ ~o~,,~,,l/wa• ~ • •
oes ro one construction vtold
~ p p ~ to any zoning law, ordinance or regulation: •!Yo .
13. N~eotobe regraded Will exec s ill be remove r n
14. Name of Owner of r nines /{d, ~;'1 e • ;a ' ~ • ~ ~ premises: Yes No
P ~j ,4s'. ~ ~ .~7r~a5.. Address ..~-.9~{.. , f~dr1': ,Phone No. a~?9~. J,;?;~,P
Architect ..r?4 i~t~;~ fk: , • , , • , • Address . QM~,0.I4`d 1~.~.d.' .Phony No. a7 9?; ; S9~ci
.wn
Nameyof ConPtrac~or y ;e
.
:....:.........Address r- ...........Phone No...:-... .
IS.Is this ro ert located within 300 feet of a tidal wetland? *YES....NO~.~
*If es Southold Town',Trustees Permit may be required.
PLOT DIAGRAh1
Locate clearly and distinctly all ,buildings, whether existing or proposed, and. indicate all set-back dimensions from "
property Iines. Give street and block r}umber or description according to deed, and show street names and indicate whether
interior or corner lot.
S'wc ve~ ~F~.e~ -
~ ~ ,
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- •
II
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STATE OI \E\~ Rf~~ S
J~ ~
S ~of~ '
• ' ' ' ' • ' ' ' ' • • • • • • • • • • • • • • • • • • • • being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
[fc is the ........~JCClYl.2 ~
(Contractor, agent, corporate officer, etc.) ~ •
of said owner or owners, and is duly,l authorized to perform or~have performed the said work and to make and file this
application; that all statements contaihted in this application arc true to the best of his knowledge and belief; and that the
work will be performed in the manner set forth in the application tiled therewith.
Sworn to before me th/is(~-~. '
1.~1.....day of '~,1.~~., 19 1
r
Notary, Public, • ~•I!,.. County ( ,
ClA1fiE L. QLEW .
Notary Public, Stag of New York
No.4S99606 (Signature of applicant)
Qualified in Suffolk County ~Q
Cammissian Expires Ooasmber 9, 19
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765-1802
BUILDING DEPT.
1 NSPEC7'ION
[ a FOUNDATION 1ST ( ] ROUGH PLBG.
[ a FOUNDATION 2ND [INSULATION
[ ]FRAMING [ ]FINAL
REMARKS:
DATE ~ j ~ ~ INSPECTOR
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