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HomeMy WebLinkAbout17797-z w. FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATH OF OCCUPANCY No Z-23763 Date JULY 12, 1995 THIS CERTIFIES that the building ADDITION Location of Property 1150 SMITB ROAD PECONIC, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 98 Block 3 Lot 27 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 28, 1989 pursuant to which Building Permit No. 17797-Z dated FEBRUARY 2, 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 L. P. GAS HEATING SYSTEM & BLOCK FOUNDATION UNDER EBISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DONALD A. DOBRMAN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ' UNDERWRITERS CERTIFICATE NO. PENDING - JULY 10, 1995 PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 FOSM NO. D TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MU5T BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 017 7 9 7 Z Date 19f>..~ Permission is her y grant d to: cY premises located of OlliJ..a Q„w%~t4y County Tax Map No. 1000 Section .........C...~...... Block Lot No......~'..l pursuant to application doted ......r...!y-.~ 19~~., and approved by the Building Inspector. Fee $.......1..af.:I.... uildi I actor Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD rid~µ5 l t~'V .I,~ ' BUILDING DEPARTMENT ~ ~'1 _a,_ 765N1802L ~ ~ ~ ~ ~ ; i ; j . ~ APPLICATION FOR.CERTIPICATE OF OCCUPAN TOWN OFSOUTHOI.p ,k 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. Accuratic 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 for foundation Date „February 9; 1995 New Construction.lf......... Old Or Pre-existing Building Location of Property........Smii;h.Road,,Peconic,.NY . House No. Street .Hamlet Onwer or Owners of Property...DOna1d.A. Dohrman County Tax Map No 1000, Section.. 98 .........Block.. 3 .............Lot.. Subdivision ....................................Filed Map............Lot...................... Permit No..I.7797.........Date Of I Permit... ..........Applicant Health Dept. Approval ..........................Underwriters Approval......................... . Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: $....?5.00. _ . /Q/~ry~G~ ~9 ~D~ APPLICANT ' Iwi~~n¦~~ . lELD I;:.$:'EO;IU;J ~~UATE ~ %OMMLNT° ~ m ~Q i z~ ~ p~-dam y ® ~ , r~ ~ FOU2dDATION ~ (1st) - Utu,~~ ~LaGK a 9 ~ FOUNDATIOtd (2nd) m 2. z r . ~ v` ROUGH FRAME & ~ PLUMBING ~ ~ ~.5~ 2~i._.. - C'-~ /,vl1~+.+ /x.af av. H 3 . m m y ~ I1ISULATIOPI PER N. Y. STATE ENERGY CODE x a r--~ 4, ~ l •-~y FI;JAL `~l p ADDITIONAL COMMENTS: ~ z~- x~ ro H ~7 y W\ H M O U 2 . C1, a A • r H - ~ p. H ~ I INSPECTORS Victor Lessard $UFFO(,~ Principal Building Inspector 0~0 ~pG Curtis Horton y~ SCOTT L. HARRIS, Supervisor Senior Building Inspector y Z Southold Town Hall Thomas Fisher ,s. P.O. Box 1179, 53095 Main Road Building Inspector ~ • ~ Gar Fish 'J'~fj O~ Southold, New York 11971 Y ~j * ~`a Fax (516) 765-1823 Building Inspector Telephone (516) 765-1800 Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspectar OFFICE OF ]3UILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD November 20, 1991 Mr. Peter Dohrman 1150Smith Road Peconic, N.Y. 11958 Re: Premises at 1150 Smith Road, Peconic, N.Y. Suff. Co. Tax Map #1000-98-3-27 Dear Mr. Dohrman: Enclosed Certificate of Occupancy #Z-20358 for Building Permit #18710-Z for the above property. Please be advised that Building Permit #17797-Z for a foundation for the above premises has expired and a Certificate of Occupancy has not been issued. In order for the CO to be issued, a final inspection must be made and the enclosed application filed with this office along with your check in the amount of $25.00. Kindly call this office so that we may set up an appointment for the final inspection. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Gary J. Fish, Building Inspector GJF:gar encl. ' WARREN A. SAMBACH, SR. CONSULTING ENGINEERS PLANNERS P O. BOX 1033 ~ 7fi75 COX LANE CUTCHOGUE, NY 11835 (518) 7347492 May 9 1995 Rev. Don Dohrman P.O. Hox 224 Smith Road Peconic NY 11958 Don: Examination of the cellar lally columns and zaood girders reveals the following: 1. Where the wood girders 2-2"x10" are not made of continuous members, the ends of the wood beams will have to have three (3) 3/8" bolts wittz washers and nzzts installed as per the diagram submitted with this report. 2. Provide a lally column on the end of the wood girder as per the diagram. 3. All lall.y columns to have #]2 wood screws (9/column) from top of lally column plate to the wood girder above. Plans and 'applications will have to be filed for the wood deck at the rear of the residence with the Building Department, Town of SouY,hold. S' cerely, Iu?w.~Ct. ~a.Q. ~u , Warren A. Sambach Sr. P.E. was:s encl. ,FF~~:%` n~~J 'AS's ! ~ 'ro n~ "fJ') 2 .ry a. U~ ~j`~ .k ,E i WARREN A. SAMgACH CONSULTING ENGINEERS ~oB 3 %S !/G~.V l,~L~/J/f~h/ - P.O. nox 1033 Cox Lane CutChogue,N.Y. 11935 sHr:Errao._______._______-7!or=_~--_... 516-7347A82 CALCULATED BY_._________-,.L~~~ DATE _S'y'~S ' CHECKED BY DATE---_.__---- - , SCALE Tiff ,!~~l~t~r~.. I(f,G?//JI ~ ! .i i ....j.. I . . ! ! . i i , ! ! ~ ~ i f I, ( etc /l~. ~ 1 ~ , . _ . _ i . I i i . `I i i........~ . ; . .r k ! ~~/!1- 7,l~wl~,i~s II ~ ~El I~ L~X~I~~... ~,..~y.~.......'~~.. .~.521,io~ i . i f...._i~..,..._;..... fs1L'~laei2- LON'~e-;( .-%/31n~ I ~.`...2;ic/4 i. > {1•l 35 ra ; ! .L~ y':,?:~"`~' F..... , : i I ~ IYcr~p~ `.i ...~C~IA~~ I '........I. i i I I I I I !'1 ^I X/~1:. f ~ 13 ? : _ ! ~ KZi•~ f ~.1. i l~OV9E'y~~. L ~nl~c^67 ~ c~Jy(:.:rl /*~.l,4ir: 'a%~ -}i,•,~/~n! `o~ /I/ON ._~D.~r7iytlf/ ~5 1,3~Xty . i I ! 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I ~ . :....................I......!....~... i i... i.. ~a , • t ~ ; f i I ...i i I.....I. i I ~ i i I i . . i i .i ....i ....i , .i i 519 Snltlh I UN:V r•Invrr I nnr A11111 i1Y Ili illl fSq~p9 ~I'i1011P Of Filx~ 101) !1fiR Ud;11 Vd;t[?tl`-_[V `~P.t:4~'i'.~. i~ ~.~/'~)~'N -~7D/~'nJair~~(... - JOfI covst~~rtwc~ r-r~c,I~Er-_~s ' P.O. E3ou 1~3 Gox Lade snr_errfo. oF_'~----- . Culchopue, N.Y. it935 CALCULAlEU BY-_. _.._.._~G_~Ll-. DArE ____~~~""r . sis-7~~~sa CHECKEDBY__ DATE - SCALE ~ ff tir tGfl - ---~9 I; ~ i i it i f._...i . i.... I..... I. . i..... ....I.. - ! I I I I ~ i i ~ j i i ~ I I ~ i I 1. . - I . . I~ . - i i t.. - i 1 ~ -iyy I f I : s~. i ~L.. 1 I i...... I ...I....~I [ ~i. I.... i.....i..'~~ . i ...y. i.... .....1.. i. _.,..I i. i ! ~ 1j ~ I ..~I _r, ! ...I-~i..~i.-._.~.. _.Y I..-. ~ I i f I ice' ~ ~W,~' I i I I.i ; 4 4 I~ f x I I _ s...,,., I. ~,......I ~ dl i I I_..._ ; 1 _ , _ L.- i _l.Li I _ L.... f :.~i~ is _I ,r ~ ,~I _ i . _L . i I :.-L _ ~ t . I ~I - ~ _ - ..NL.... I r.._ L . _ ~ . _ ~f. ~ i K.... I.. ~ I. ~ , . ~ f r~ n ' ~I ~i _I_.. ~.._..I._- I - L . I ; I i 1 ~ ~ 1 i ~ ~ ~ i I s i I I......~.. 1 I . I i _f:~ i C I _..1.-.- t i._. i .I ~ ~ i _ ~ ~ I.. t i . ` . .1 ; . (i i 1 ~n i ! L. * ~ i i I.. I..- i... I.....i • ' • ~ • ' .~~.~~...1.......1........1.......1..... .....J...~.. ....N......-L...... 1.... ;~19 Snnlh 1 urlw Clover I miC ~MUfl~;ly', Ulnh A41?'1 ~ Phmlr, m F,u' (R(171 b(I!t fl fill INSPECTORS Victor Lessard gOFFO(k Principal Building Inspector 4~0 CGG Curtis Horton y~ SCOTT L. HARRIS, Supervisrn Senior Building Inspector o Thomas Fisher `n 2 Southold Town Hall Building Inspector O ~ ~ P.O. Box 1179, 53095 Main Road p! Southold, New York 11971 Bu ld ng IFnspector ~ Fax (516) 765-1823 Vincent R. Wieczorek Telephone (516) 765-1800 Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD November 20, 1991 Mr. Peter Dohrman 1150Smith Road Peconic, N.Y. 11958 Re: Premises at 1150 Smith Road, Peconic, N.Y. Suff. Co. Tax Map #1000-98-3-27 Dear Mr. Dohrman: Enclosed Certificate of Occupancy #Z-20358 for Building Permit #18710-Z for the above property. Please be advised that Building Permit #17797-Z for a foundation for the above premises has expired and a Certificate of Occupancy has not been issued. In order for the CO to be issued, a final inspection must be made and the enclosed application filed with this office along with your check in the amount of $25.00. Kindly call this office so that we may set up an appointment for the final inspection. Thank you for your cooperation in this matter. Very truly yours, SOU OLD T"AO',W,',NvBUILDING DEPT. Gar J.~ri, Bu lding Inspector GJF:gar encl. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION iST [ ]ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INS ION [ ]FRAMING ( y INAL [ ]FIREPLACE & CFIIMNEY REMARKS: 6 ~ > _~___1_,~__~ DATE ~ INSPECT ~ ~ ~ '65_1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ]ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~/nP ~ ~ ~ ~ DATE ~ ~ ~ ~ INSPECTO ~J D ~f ~ ~ ~ S u~- ~ ~ i2~, ~ rss-lsoz BURRING DEPT. INSPECTION [FOUNDATION 1ST [ ] ROUGH PLBG. ~3~o~~C , [FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~b i j~ ~ ~ ~©l,u ~ ~ ~ DATE ~2Z ~ g INSPEICTOR U l7~ 2~ ~ tss-isoz BUILDING DEPT. NSPECTION [ FOUNDATION i5T [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~''G~~'..r~iC~. c DATE ~ v INSPECTOR ~ ~ o ~ ass-isoa BUILDING DEPT. INSPECTION ~ [/v]~FOUNDATION iST ( ] ROUGH PLBG. [t.~ FOUNDATION 2ND [ ]INSULATION [ l FRAMING [ ]FINAL REMARKS: 1 ~ l 5 ~ L4 ~ ~ ~ ~_~DD 1' . . ,~~2 U,l ~ 11~ ~ lry ~ ~ ~ ~ l ACS (~.G l DATE 2 g INSPECTOR THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1125105 BUREAU OF ELECTRICITY 88 JOHN STREET, NEW YORK. NEW YORK 10038 Date 3tYLY .1.4 ,1995 Application No. on file 073$2395195 N 35$064 THIS CERTIFIES THAT only the electrical equipment as described 6ebw and introduced 6y the applicant nomad on the above application number in the premises of DONAL)) A. DOHRMAN, 7.1~i0 SMTTfi Rt)AD, PECflNTCt N,Y. in thefollouing location; ®Basement ? Ist Fl. ? 2nd F1. Section Block Lot uns examined on SLY 1©Y 199J and found to be in compliance with the National Electrical Code. FI%TURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT K.W. AMi. K. W AMT. K.W, pmi K.W. AMT H P DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT 71ME CLOCKS BELL UNIT NEATERS MULTI-OUTLET DIMMERS ,I AMi. K. W Oll H. P GAS N P. AMT. NO. A W. G. AMi AMP AMi, gMPS TRANS. AMi R p SYSTEMS AMT. WATTS I NO.OF FEET SERVICE DISCONNECT NO.OF 5 E R V 1 C E AMT. AMP TYPE METER ~ ]W ~ ,e 3W ],a 3W 3,e' 4W NO. OF CC COND. A. W G. NO. OF MI-LEG A. W G. NO OF NEUTRAl1 A W. G EOUIY• PER % OF CG COND. OF HIAEG Of NEVTRAt OTNER APPARATUS: DEFECTS REMOVED AS PER 06-05-95~-1 i G!~%~'-c~~ TIADFMANN ELEC. TNC. LTC.#k4141 E 1625 STTLLWATER AVENUE CUTCHOGUE, NY, 1193.5 GlNERAt MANAGlR " 11 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 [iU1LDING DEPARTMENT. 7HIS COPY OF CERTIFICATE M4~7 NOT BE~~LtER~D IN ANY MANNER. - - - r . , n I ~ ~X~ .s ~i~r °"r G°`' of N d~-~-- ~ ® ~ r~ ~ e bo~'a~ p i BOARD OF AEALTH 3 SETS OF PLANS i FORM N0. 1 SURVEY . r TOWN OFSOUTHOLD CHECK 'BUILDING DEPARTMENT SEPTIC FORM ' TOWN HALL - SOUTHOLD, N.Y. 11971 NOTIFY TEL.: 765.1802 CALL y MAIL T0: Examined . • . • • • • . 1~ . ~ Approved 1~. Permit No. ~?74s~ ~ ~ p ~~~Y..~. Disa proved a/c ~ ~ p, JAN 2 1989 (Bud .ddi Spector) ~ ..__.....m.•_..r,~~tsTN~f-,~......~ APPLICATION FOR BUILDING PERMIT Date _ 15... INSTRUCTIONS ' 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~t 1~ gJ~;~~l yapplicable laws, ordinances, building code, housing code, and regulations, and to admit authorized ins t rntses artd in building for necessary inspection+ Q -.,,..,..r.,...... ~ ~ .4 . N~ - . 1r5 , ' Sin re or"applicant, or name, if a corporanon) vAr ;ar~-t P,K'e 4: ;Yt' t.G" G' +,''~'~t~` 1~.~..b/~f~.~l~.vl~:°F..i...v/•~/./obi/~L14 ^~~it: ~ ~ ~ (Mailing address of applicant) Ygjd S~~"y.t4 k:?."r`~"63kAy} ;t.'i 4i4S.i`•F~ State whether applican4"~I~`ot~e~r;ll~e°~s~e,,,a`ge~tt, architect, engineer, general contractor.; electrician, plumber or builder. , rta~~ . ~p.,~~~ ,tJ 517 ~ n., ~ , Name of owner ofpremises•': ,~C'~1~~.~"~....~®.~l/.C!10a.~<...,-~.r.:..:.-.. r„ mss, _ (as on the tax'roll;br latest deed) $.6i3 ~}t ?c: } If applicant is a pg~,p4xatj~pn;,~signtuGetS•e of duly authorized officer. ~.;.°'.a~tt .'v 4 (Name and title of corporate o(f}ficer) T' Builder's License No. ~ f..~. z • ~ .S_. • Plumber's License No . . Electrician's License No . . Other Trade's License No . . 1. Location of land on which proposed work will be do e . . House Number Street Hamlet County Tax Map No. 1000 Section ........7 • • • • • • Block ~ 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 .....~•{J• S•••••••••••••••• b. Intended use and occupancy • • •`~'z • t", . 3. Nature of work (check which applicable): New Building , .'..~..~,Addition Alteration a Repair oval • • , • • • •`l ,e~nou_~'dQt Other Work . ,~r~ ~GBtG?y Rif (Description) 4. Estimated Cost ~ ~.....e Q Fee I (to be paid on filing this application) 5. If dwellin number of dwellin units Number of dwellin units on each floor . g, gl g If garage, number of cars ~ 6. If business, commercial or mixed occupancy, specify, nature,and.extent of each t .pe of use . 7. Dimensions o exrstin structur Hei ht . ~ g.... Nums, if any: Front ...~j 6....'...:. Rear . Depth ..a . g berofStories.....,~ DDimtehnsions of s me structure with alterations or a ttions: Front .C Rear ~G............ . p Hetght ~ pp . $ Hemh~sb~is o entire new const ' ' ' Number of Stories ~ . ' juction: Front Rear .~.(o........... Depth ~,y' , g Number of Stones : . 9. Size of lot: Front ..........j.........:. 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 removed from premises: .Yes No 14. Name of Owner of premises . Name of Architect ~ ~ ~ ~ • • ' ' ' ' ' ' ' • • • • Address ...................Phone No............... . .................Address ...................Phone No. Noma of Contractor .................Address ...................Phone No............:.. I PLOT DIAGRAM Locate clearly and distinctly all! buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blocklnumber or description according to deed, and show street names and indicate whether interior or corner lot. I S ~ R~ _ , ~a ~,t`I ~ AP A$ Nd1ED GATE: II.P. N 7 0 r `~..9 Npj'1 ~ G 0~ 78b-1802 9 AM 'Ip 4 F'Ali FOR THE FOLLOWING INSPEC'f10N8: - CCUPANC pR i. FOUNDATION . wwpEa~nREo FOR POURED CONCRETE 2. ROUGH - FRAMINf3 A pU1M81NQ USE IS UN WFUL INS~~,~~N 4. FINAL ~ CONSTRUC~pN MUST ~41THOUT CERTdFICATE 8E CAMPLETE FOR C.FJ. ALL CONSTRUCTION SHALL MEET S ATE OUNSTRUC'ffON lti ENERGY F aCCUPANCY ~~pES. NOT RESPaNSlali: FOp DESIGN OR CONSTRUCTION ERRORS STATE OF NEW YORK, COUNTY OF MS'S . ~....J. . tr/~i-. Name of individual sig~~ ~ ~ ~ • ~ ' ' ' ' ' ' ' • • • being duly sworn, deposes and says that he is the applicant ng contract) above named. He is the • • • • • ~ Contract ent, 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 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 manner set forth in the application filed therewith. Sworn to before me this ~ o~ /a.,~~ .......day of''..~C~~c~......., 19 Not~arjyQ~P~u,,b~li~c, County L'INDAJ. CQOPER ~ (Signature of applicant' Notary Public, State of New York', 1I No. 4822663, Suffolk Count~+~ Term Expires December 31,18