HomeMy WebLinkAbout17322-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Ha11
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19903 Date MAY 10, 1991
THIS CERTIFIES that the building ADDITION
Location of Property 4845 PINE NECK ROAD SOUTHOLD N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 70 Block 6 Lot 33
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 1, 1988 pursuant to which
Building Permit No. 17322-Z dated AUGUST 16, 1988
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 & DECK ADDITION TO EXISTING COTTAGE AS APPLIED FOR.
The certificate is issued to ROSA HODGSON
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRTTERS CERTIFICATE N0. N-120143 - MARCH 23, 1990
PLUMBERS CERTIFICATION DATED NOV. 9, 1989-K&K PLUMBING & HEATING
~ ~
Building Inspector
Rev. 1/81
roast xo. s
TQWN 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~ ~,1a32~L Z Date ....(~.~~'r' 19.FE'
Permission is hereby granted to:
a'iL
of premises located at T.f~T...J~........... ~G:..... .../...!•1..
County Tox Map No. 1000 Section ........,,r..l.~.......... Block ...........k~...... Ltt~~ot No ..............3..~
pursuant to application dated 19.l~u and approved by the
Building Inspector.
Fee $..,3(7i,. ~O
. V
. . ~ . . . . . . . .
Build Inspector
Rev. 6/30/80
Form No. 6 J~ 57~~
TOWN OF SOUTAOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
t,:;
~((1~")f APPLICATION FOR CERTIFICATE OF OCCUPANCY
,.57
A. T `~~ppl~atiy~bnr;must be filled in by typewriter OR ink and submitted to the building
i ct wit~',;t•(i~e following: for new building or new use:
''"e/Fines su~ve,y of property with accurate location of all buildings, property lines,
~CS~;.st ~etsy_a~8 unusual natural or topographic features.
F1 Ap~~lxoval from Health Dept. of water supply and sewerage-disposal (S-9 form).
~'~=:3,a.,,, A ro~aZf electrical installation from Board of Fire Underwriters.
w~4;:~~~ Swor~'~~° Cement from plumber certifying that the solder used in system contains
-lessTt ~ 2/10 of 19 lead.
5. Cotn~ler al building, industrial building, multiple residences and similar buildings
and i"~ctallations, 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 .`pf 991
New Construction........... Old Or Pre-existing Building...... X.........
Location of Property........484~,Pine_Neck.ROadt Soutkaold:.New York
.
House No. Street Hamlet
Onwer or Owners of Property.....,R~~.a Hodgson
County Tax Map No 1000, Section......D7.0.....Block.....Q~.........Lot.....~~
Subdivision ....................................Filed Map............Lot......................
Permit No.....01.7.322Z..,Date Of Permit....8-~&.:$$....Applicant...Ca~Z~~t~,~1,,,,$~~~pgR,}lrchitect
Health Dept. Approval.....~la .................Underwriters Approval.......~~23/.~Q..........
Planning Board Approval
tequest for: Temporary Certificate......,.... Final Certicate.......?{...
gee Submitted: ~5 .00 C-~~~~°k_'
~~c„~JIo.S~i APPLICANT..
Ca ~-1990,3
TEL. 765-1802
~p Ol, TOWN OIL' SUYJT~3[OLi~
~ : Y. ~ OFFICE OF BUILDING INSPECTOR
a= P.O. BOX 728
v' ~ ~ TOWN HALL
y0j~o~ ~ ~,~p`t- SOUTHOLD, N.Y. 11971 .
C E R T I F I C A T I O N
Date ~ ~ ~
~ Building Permit No.
Owner ~Q~1
(please print)
i Plumber ~ (Y~~.(~ ~ ~C`~~1
(please print)
Z certify that the solder used in the water supply system
contains less than 2/10 of Io lead.
~ ~g
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~~~/t-C!
Ji i~~ ~ ,
` (plumber's signature)
I'• Swornpto before this
day of l/'~~~2~,' j
19~. (G/
Notary Public
Notary Public County
I~r IIm9N11
lanpry 1,1
THE NEW YORK BOARD OF FIRE UNDERWRITERS RACr
~.(1,Og37fl BUREAU OF ELECTRICITY
SS JOHN STREET, NEW YORK, NEW YORK 10038
Date r1ARCH 23,199(7 Application No. on file 60697889/89 N 12(1141
THIS CERTIFIES THAT
only the electrical equipment as deacrJ6ed beloEO wnd introduced by the wpplicwnt nwmed on the wbooe wpplicwtion number in the premises of
ROSA HOOGSON, I_IGH1n'HOUSF_ MANOR, SOU1"H(7LD, N. Y.
in thefollouinq brration; ~ Raxement ~ Ixt FY. ~ 2nd Fl. OU1 Sertion Block Lot
uns examined on I`EBHl1ARY 'L'2, 1990 andfound to be in consp/ianre with the requirementx of this Roard.
fl%TURE ECEPTACLES SWITCNES FIXTURES RANGES COOKING DECKS OVENS DISH WASNERS EXHAUST FANS
OUTLETS INCANDESCENT NVORESCENi OTHER AMI K.W. AMT. K.W. AML. K.W, pMi K.W. AMT. H P.
47 39 36 43 4 1 12.6 2 I
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPFCIAI REC'?T TIME CLOCKS pELI UNIT NEATERS MULTI.OUTIFT DIMMERS
AMT. K. W. Oll H. P. GAS H P. AMT. NO A W. G AMT AMP NAT. AMpS. TRANS. AMT. H p, SYSTEMS AMT WARt
NO.OF RET
1 5.6 5 1
SERVICE DISCONNECT NO.OF - S . E.. .....p. ...._,.._y,. 1 ~ G E
AML. AMP TYPE METER I,6' 4W I •e' RW 3,e' 9W 3,e IW NO.OF CC COND. P. W. G. ~ - ~ _ a, w G. A. W G.
EQUIP. PER .e OF CC.COND NO.OF MIdEG OF HI-LEG ~~Of NEUlRAlS Of NEUTRAL
1 200 CFS 2 X 1 1/p 1 3/(1
OTNER APPARATUS:
SfRV1CF. DTSCONNECI' 1-10U-CB-1
S'I Kl1C f URE ONLY-2
MOi'OR:i:I-D.75 H.W.
G.r.C.T:-2
IkAfK LIGHfIN(',:-36
5Y8Vki',S tLt./Sl"P:. ALf3E:RT. LIC.#3494 ~i~~/~~'/
N. (l. 130X 1268
SOUTNOLD, NY, 11971 OENERAI
11
Per _
• Th'rs ceut~bate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by thwiT gt4(fg6lip~t•
~Z Z ass-isos
BUILDING DEPT.
INSPECTION
[ FOUNDATION i5T [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ 7 FRAMING [ ]FINAL
REMARKS:
J~
DATE ~ / ~INBPE~C'TOR
u .
73 Y~ tss-isos
BUILDING DEPT.
INSPEC7'IC~N
[ ] FOU ATION 1ST [ ) ROUGH PLBG.
[ OUNDATION 2ND [ ]INSULATION
[ ]FRAMING [)FINAL
REMARKS: ~
DATE ~ Z y ~ v INSPECTOR
ei _ .e~-
/73~a~
ass-isoa
BUILDING DEPT.
INSPECTIQN
(]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ] INSULATION
~MING [ ]FINAL
REMARKS: ~
-ry,J ~
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r
DATE ~ INSPECTOR ~
l~3LL
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST f!/J ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [)FINAL
REMARKS:
DATE LL ~ INSPECTOR
J,~LL 765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST ( ) ROUGH PL6G.
[)FOUNDATION 2ND [INSULATION
[ ]FRAMING [ ]FINAL
REMARKS:
f
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DATE INSPECTOR .
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765-1802
BUILDING DEPT.
1 NSPECTION
[ ]FOUNDATION i5T [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS: ~
/r
e
DATE INSPECTOR
~~~~v
765-1802
BUILDING DEPT.
INSPECTI®N
[ ]FOUNDATION i5T [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ]FRAMING FINAL
RE ARKS:
r
DATE ~C ~ 0 INSPECTOR
r'lELD IGSi'FO:iU:J ~~U6Tc ~CtKMENT° ~
-o W
11 i
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FOUIJDATION (1st) ata, r
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FOUNDATIOIJ (2nd) - ~
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H
IIJSULATIOP! PER N. Y.
STATE ENERGY /
CODE x
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FIIJAL
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ADDITIOI,AL COMMENTS: x
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GARRETT A. STRAND' J~~ ~ $~9 ~Iri i~
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BLDG. D~~,_,r° Mnm Rono, P. O. sox ia12
MOWN OF xCUTHOLD SOUTHOlO, NEw YORK 11971
518-785.5456
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f January 17, 1991
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` Mr. Gary Fish, Building Inspector
Town of Southold
Main Road
Southold, New York 11971
Re: Hodgson, Building Permit I~017322Z
Dear Gary:
Pursuant to our recent telephone copversat.ion with respect to
the thermal rating of the double door, I am submitting the
~ following tradeoff substantiation for Code Compliance:
Based on Table 6-3 of the Energy Code, the glazing area of
the, referenced door is 25 sq. ft., with- a U subscript "G"
rating of -13.
As per Table 6-l, the roof area. of 1,080 sq. ft. with a U
subscript average of .032, provides a thermal tating of +17.
The difference is +4, which exceeds Code compliance.
For the record, the remaining doors are-in.the process of be-
ing',fitted with storm doors. When the units axe in place, I
will call your office for a final reinspection, so that the
Certificate of Occupancy can be issued:
If you have any questions with respect 'to the above calcula-
tions, please contact me at the office.` Best regard's.
Very. truly yours,
~ ~
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{ b/ arrett.A: Strang
Archateat .
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~ BOAKD OF HEALTH
3 SETS OF PLANS
I/,T fORMN0.1 SURVEY
TOWN OF SOUTHOLD CHECK • • aY~
BUlLD1NG DEPARTMENT SEPTIC FORM
TOWN HALL NOTIFY
SOUTHOLD, N.Y. 11971 CALL _
TEL.: 765-1802 •••'7~5•^'••••-
MAIL T0: s~/S 5`
Examined 19
Approved 19 Permit No. X7.3 2 Z ~ n 1 jy
Disapproved a/c u J
~ ~ 6
~ ®ter~ic~~.11
(B ildin nspector) k
APPLICATION FOR BUILDING PERMIT
Date Au.4~ . ~.~..1 988.., 19 .
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 BuBding 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 demoliti a#~, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing cod hd regulations, and to
admit authorized inspectors on premises and in building for necessary ins ns.
(Signature of applicant, or name, if a corporation)
Garrett A. Strang, R.A.
, . „p,O,.,BOx, 1,41 2,,, ,Southold,,, N,Y., ,11971„
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Architect
Name of owner of premises P,OSa. II4d9s.on .
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
ALL CONTRACTORS MUST BE SUFFOLK COUNTY LICENSED
Builder's License No. . ,Not..Se7.ected, Yet .
„ „ „
Plumber's License No . .
„ „
Electrician's License No . .
„ „
Other Trade's License No . .
I. Location of land on which proposed work will be done . .
...,,...484.S.Pine.Neck,Road„, Southold
House Number Street Hamlet
County Tax Map No. 1000 Section 07 0 , , , Block Lot , , , 33
Subdivision Filed Map No. Lot .
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed constnrction:
a. Existing use and occupancy ......Single Family Residence
a ,x.
b. Intended use and occupancy .....Same,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
3. Nature of work (check which appl;~icable): New Building Addition X....... Alteration .
Repair Removal , Demolition Other Work , .
(Description)
4, Estimated Cost 4 8,, 0 0 0.0 0 Fee , .
` (to be paid on filing this application)
5. If dwelling, number of dwelling units One • , , , . , , , , , Number of dwelling units on each floor .
If garage, number of cars
6. If business, commercial or mixed pccupancy, specify nature and extent of each type of use .
Hai ht ~ Numb if any: Front 35 Rear 35 De th ~ .
7. Di gensions of existing structures>er of Stories Ome , , , • , . , • I?
Dimensions of same structure with alterations or ac(drtrons Front 3?.~ Rear 36' ,
De th , t.
- 8. Dimensionstbf ~tirew constru Height 8. Number of Stories ,One, , • , • , • , . , .
Gtion: Front . Rear Depth .
Height ...............Number of Stories........................................................
10. Date of Purchase MaX,q]Z . • • Rear .:......SPA.'.......... Depth ~.1, 00', , , , , , , , , ,
Size of lot: Front ...1.$0. • • ' ' • ~19.7.Q , , , , , , , , , ,Name of Former Owner , Pollert
11. Zone or use district in which premises are situated A Residential-Agricultural, , , , , , , , , , , ,
12. Does proposed construction violate any zoning law, ordinance or regulation: , , No
13. Will lot be regraded .........N'4 Will excess fill be removed from premises: X Yes No
14. Name of Owner of premises .Ros'a..~OdS~on..... Address .Southold , , , , , , , ,phone No..~65-3793, , , , ,
Name of Architect Gaz~•ett, iA,., ,Strang, , , , ,Address .Southold , , , . , , , ,phone No..~65-5455
Name of Contractor , ,Not Sl,elected , , , , .Address Phone No.. .
15. Is this property located w~.thin 300 feet of a tiyidal wetlandl *Yes .X... No
*If yes, Southold Town Trusltees PermitpLOXI'DIAGKAMed.
Locate clearly and distinctly ail ljuildings, 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. i
S'ee Attached Site Plan '
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STATE OF NEW YORK, S.S
COliNTYOF....Sui;fo.l.k....
(Name of individual signi ~Og • ' ~ ' ' ' ' ' • • being duly sworn, deposes and says that he is the applicant
rig contract)
above named.
He is the , ,Architect
(Contractor, agent, 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.
Swom to before me this
............o~..........day of''................,19.~~
Notary Public, /~-~i~!.. If':.. ~Q:.U:~.... County
NOIAR`f PUOLIC, Sate of .
K• ~ Nevr YMk
No.~707870, SuHol~'~ouab~q (Signature of applicant)
' Term Expire: March X0.11.....-/
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Main Road P. O. Box 1412 Southold N.Y. 11971 DATE ,,,-.,,~.4
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