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HomeMy WebLinkAbout17483-zt' FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17857 Date MARCH 16, 1989 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 11222 SOUNDVIEW AVENUE SOUTHOLD NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 54 Block 6 Lot 2.5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 27, 1988 pursuant to which Building Permit No. 17483-Z dated OCTOBER 3, 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 ONE FAMILY DWELLING WITH GARAGE & ATTACHED WOOD DECK The certificate is issued to ROBERT W. JOHNSEN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 88-SO-133-FEB. 1, 1989 CERTIFICATE NO. N-062085 - MARCH 9, 1989 PLUMBERS CERTIFICATION DATED FEB. 22 1989- ROBERT JOHNSEN Building Inspector Rev. 1/81 goaas 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° 01748.5 Z Date .Q.c~ :..................~.................., 19.~... Permission is hereby granted to: ...~~........ w....~ :, .......... .~?:~P..~-...a.:. t.rq.~..~.......... to . c~: r.,~a~.IA.:'....~....~..' :~... a ~:--~....,~.~-~.~~... «.~9....... at premises located at ~.~~.~.....~.~-!~^:~`1.".a-r!)...:.......... ~?:`v`~'"":.`..`.'.~--•.....•.•• ................................................................................................................................................................ ...........................................................................``.''................................................................................... County Tax Map No. 1000 Section`~ .....Q.~....T..... Block ..... ©..~R........ Lot No....v~.'.~........ pursuant to application doted ..C`~.4.t12iJ.1'!-:~:~!r4....~:.7........, 19~.~., and approved by the Building Inspector. Fee $...~.~Q~..:. r. ... .~.~~..C Inspector Rev. 6!30/80 r TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTflOLD, NEW YORK 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCIIPANCY DATE...~~.~oE:V~.... M,. NEW CONSTRUCTION ....OLD OR PRE-E%ISTING BUILDING......VACANT LAND........ J/ y ~` ~ Location of Property..1J.~~r°:.. a~:. .°Y4C/..~~j-,Q.,..... ~Cs,L~~y~~f.~......... HOUSE N0. / STREET HAMLET .Owner or Owners of Property....~~l~.t'~1...~~q~LS.Fa7,,,,,,,,,,,,,,,,,,,,,,,,, County Taa Map No. 1000 Section ..~,~. Block .0..... ~ Lot .~. ~. Subdivision...[[~~~Qlx:R?~,TQh$~:'!.'...... Filed Map ........Lot...... /....~ Permit No. ~.77.~~..Date of Permit ..........Applicant .f.~)~+6J'('C..3/.~?/1k~g~J„ Health Dept. Approval ~.~.' ............. Underwriters Approval......._...... Planning Board Approval .- .. Request for Temporary Certificate ....... Final Certificate Fee Submitted: $....,~.~ -,,,,,,,, APPLICANT. R-Q.e, 3 ~$I ~ Co ~ -~ss~ rev. 10/14/88 TEL. 765-1802 ~' z u~'~ rn ~ ., ~ , g o~~ol ~ ~~o~- Building Permit No. ~ ~ / 78~ Owner ~o~ek ~ -.,~,~~ s ~ti (please print) Plumber ~ ~. T j<a~» Seti please print) Date ~ - ~ ~ °~ I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber'~~ signature) Sworn to before me this ~_day of ~,c,P- 19~. Notary Public,~~~Q~~/[f County TOWN OF SOUT~OLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 C E R T I F I C A T I O N Notary Public HELEN K DE UOE NOTARY ~UBLiC, Stato of New York Na. 4707878, SuRalk Ceudty Teem Expires March 30,18~~ :'1SLD II:SPSC:iU:J I ~Uiiin ~ UOa`iMENTS „ I m ~ ti . _ _ o y L _ FOUIJDATION (1st) a (1 c 2 rOUNDATIOIJ (2nd) ' - m t 2 . z o ~ N ROUGH FRAME / ~ N N PLUMBINC7 /G ~Cl~t ~'~C~'y° H ~' 3 . rn m C IIJSULATIOPI PER N. Y. • • H t T STATE ENERGY L O C DE x -~ /~ .~' t ~ m 4. 0 ~ ~'e-~."' ` . ri F I iJ A p• ~~ ~~ '--,( // ( ~ .~ £ j 0 DITIOPIAL CO ENTS: ~ ~ e9yi .~ ' -~. Ta7 a%~.~o - ~~. i. ~, ro ~ •- H ^ ~ .~ 9 y _ H o -.L z O x « ~ o a • r ~ H x y d 0 r~ ~ ro H r ~~.. ~- $ 1 -- ' 'r 'S ~ ~~ - - -- ~ - --~ ~- ~- - ~- - -- -- - - - ~- ~ ~ ! ~ --c ~ C~ z - - l o --- u ~ ~ - ~ S IfN ~ ~- ~ ~ ~ ~( -.--E~ ~ ~ -- - - - ------ 0 ~i ~ ~ ~; - -- - ~ ry z . - - -' ~ _ t ~ _ _ . .__ _ _ _ __ _ _ _ _ _ ~ .. _ - - - - __-_ ___. _, s-.-.__ _~, _- -- - ,.-..-_~........,~--.~._--~ _ 1.~ _ ~~ ~.._. __ _,._. _ _ . __.~ k ... ~.. '. .. ~..rrrmar... ,... , . _. .. Jv ~~~ -~ b ~. ~~~'-~ 17 ~~3 ~~.~BOZ BUILDING DEPT. L~ , INSPECT! N~ ~ ~~~ ~~- ~. [ ]FOUNDATION i5T ( ] ROUGH PLBG~.. 1~~ [ ]FOUNDATION 2ND [ ] INSULATION~~~ [ ]FRAMING [ AL ~~G/ r REMARKS: ~~ ~; . ~~ (/ / DATE INS E~CTOR l 7 ~C~~ 755-1802 BUILDING DEPT. f NSPECTION (]FOUNDATION i5T [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [~SUL.ATION [ ]FRAMING [ ]FINAL REMARKS: _ n r 1 DATE dl ~ S'"`~ INSPECTOR (,('~/~~ o C rss-iso2 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [~OUGH PLBG. [ ]/FOUNDATION [/] FRAMING ZND [ ]INSULATION [ )FINAL • ~~~~ ~ p. , mil' /© • ~~ DATE ~` INSPECTOR ~sS-isoa Du~~D~NO DEPT. INSPECTION [) FOUNDATION 1ST FOUNDATION 2ND [ [) RAMINQ [ ~~ DATE ) Rou~H P~e~. ) INSULATION FINAL INSPECTOR REMARKS: ~ ~ ~ R' ~~!' ~~~ -•• --- tHE NEW YORK BOARD QF F1RE IiNI]E PARF i IVVlU/I _ BUREAU Of ELEGTItlCiTY 8S JONN STRlET. NEW YORK, NEW YORK 10088 MARCH t~4,i9S4 568111788/88 N 062Ui35 Date .4pplicotion No. on file TNIf GERTIf1E8 THAT Onfy tkaalltE.'[fiCd agaipmant v daaeribed 6alote ertd inboEklcad by tM afplican[ nomad on tM abode appNeatiws nuasbar Ira [ke pMmiN1 of _ RpBERT dpNNSEN, 112 2 S pUNDV iEW AVE, SUUTHpLD, N. Y. 2 ]] e ~ ~ g ~ L to thsfoibt !wd FI. Section dock Lot i"e Fl. lnp lacgt~o®RUflTTY L4~Yf4 uw examined tns and found to 6e in rnmplianee uith the reyutrementK of this Bosrd, ~~ MYf fYY1TOIRS XT{Ma WORIIq RNKS MAIgT NWS OUTERT{ INWIOEECEM ~ NUCM![CEM OTXEP NAT. K. W. AMT. K. W. NAT. K.W. NAT. R. W. AMT. H. t. 26 4 42 24 _ 12.1 1 1.2 3 F _ _ _ _ __ RRYMf IUR/IAC7 MOTORS IUIUMklNIAN01RilN SIld1UR1CrT TYM ClOC1IS Rpy UNIT tIfATMS MNMT40UM * Olhlht/RS = AMi. K. W. Oll X. ~. OAE M. r. AMT. NO. A. W.O. AMT. AW. AMT. AMrE: TRAyS. AMT. M. t. ~ T AMT. WAIN :3 F 1 34 > 9MCONtRICT ~• « S ! R V I C E AMT. AIN. 111E ~~ 11 SN I 1 ]W ] / TV ] 1 Av ~' R~ dCONO. A. pp~~ OE CC ~ Ot1D. NO. Or N4IEG OF M • O. NO. p AIEYNAl6 OF NW!VIOMI 1 zoo ce 1 x 1 sra 1 ~~~ oTNa ktMRATVS; 3 7pN AIR CQNpITION to AIR HEATER-1 6. F.C.Ie-3 SNOKE pETECTORa-'2 T ~~ v u a,unl nrrVl Vn enx 215 SOUTHOLD, NY, 11471 Ire alrorad in l.~c.eo/a % ~ U return ro tM oHia of M WILDING D[fARTMENT. THIS OOl•Y OF li Per _ iI incorrect. Mspectors may ~~~ b~tkltir cradanHak. ~~ ~°- CAfI ~ Al1T ~.. __.,...~,m~.~_-.. ~ ~ ~., ~, R, O~ ~ _~ ~ P~ ~ ~ o o - *~ A _.. .._..._ 9 ~~, A ~ __~ I _2x8 c'eA !c"tee ~ i _ .. . I_i ~ ~ 9'~ " - ,o --_- .. .. - 3 -~'-__ fi 1.. `fib„ 1J _... y~ 5^~ Io .. ..~_., SL, .. _. .. _.. _..._. _. .__..-- ~ .. ~q I _, .._ ... __ , _ ._._ ... ... ~a __- ----__---------~ - - - -- -- - f ~---- i -y~/" ~ -, 1 J _' _ i N ' Is ~~ N K -, ~ R ~-,, WF~ N 3 fir' W =-Y r ~ s N ~ ~ ~ ~ o > x , S _ G ~ u -. -~ k Cp c ~ w s -~+ r `e- Ip. t ~ ~~ P ~ (~ •=) o ~ 1p ~ s r~ ~-, ) ! °- ~ ~o J~ ~~ ~~ w ~o ~r, --( BOARD OF HEALTH .. y/, ~~r~ 3 SETS OF LANS ~ .. FORM N0. 1 SURVEY .. .., TOWN OF SOUTHOLD CHECK •~IO~ BUILDING DEPARTMENT SEPTIC FORM ............: TOWN HALL IFY SOUTHOLD, N.Y. 11971 7G~. ~ fg5 TEL.: 765-1802 MAIL To: Examined .Q~4?~4...~i.., 19 Approved CT:c~~~!~.....'~-.., 19~ gPermit No. ~ ~ ~ 8 ~ -2~ Disapproved a/c ................................... . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . ~'.. v~. ~ ........, 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. Plat 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 fo emoval or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, build' g ode, ho sing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspe ti s. (Signature of a13p icant, or name, if a corporation),q ....~. ~.°~? ...~r!u~c~~F g ~. ,l~v :e..`~',c.UC~eCcY .. . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .....~~.4.V.1<i EI~' ................................................................................ Name of owner of premises ...~O.~~CA'l.....~{~?.K3A%M ................................................ . (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 CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No. ..... ~ .3 .i.4.G ..l--t' /....... . Plumber's License No. .... ,~-!f. ~.~. Y~ ......... . Electrician's License No . ..................... . Other Trade's License No . .................... . 1. Location~o[f~l`a~nd'~on w]iich proposed work will be done . ....................................... . ........ . House Number Street `` Hamlet County Tax Map No. 1000 Section .. ~. >3 .~,~-, ........ Block ..... ~a ........... Lot .. ~~. ~. s ~ ..... . p .............. Subdivision .....~~sR.~... ~° ~'` ~P1`•`• • • • ......... Filed Ma No. Lot ..........., .. . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Ift~t_rr:,f ,,,-,,,--,.„ ......................................... b. Intended use and occupancy ..... ILF'.Sir'tic.~ ......................:............................; 3. Nature of work check which a'plicable): New Building ,, „, ( p • • • l~ ... Addition .......... Alteration ..... . Repair .............. Removal ..... , ........ Demolition ......... , ....Other Work .............. . (Description) 4. Estimated Cost .......I~P.~•o.°°^ ............. Fee ..................................... . (to be paid on filing this application) , 5. If dwelling, number of dwelling'iunits .....~ ......... Number of dwelling units on each floor ..-'.-:........ . If garage, number of cars .... { . ,~.. . . ............................................................. . 6. -~€-13xsi_ness, commercial or mixed occupancy, specify nature and extent of each type of use .....' ....... . ....... . 7. Dimensions of existing structurEs, if any: Front .......:.:.:... Rear ........... , .. Depth ::. , .......... . Heighti : : :......:...... Number of Stories .................................... ~................... . Dimensioris'of same structure with alterations or additions: Front ................. Rear ................. . &. DimenBi , ........ln . `Nut i ..Height ....................... Number of Stories ..... , ............... . Hei htr ons~of~e`ntiie n~vr~ ruction: Front ...... aY...... Rear ....S .~.......: Depth :: i' t~.G...... . g .... nber of Stories ..... ~.......... , :............... .......... . 5 10. Date oflPnrchase~":... a9. 3,~.r :......... r Rear .:..,.~.3.a~' ......:...... Depth .. /..~.~.............. . 11. Zone or use district in which r~ ' ' ' ' ' ' ' - • • Name of Former Owner- :........................ . ~ p emises are situated ... /Qeg ......................... . ................... . 12. Does proposed construction vio?ate any zoning law, ordinance or regulation: ..,~tl ............. . ............ . 13. Will lot be regraded ../i/o.... ; ...~ .............. Will excess fill be removed from premises: Yes 14. Name of Owner of premises . ~'46ne. (, , ~{,rns-? ~, , ,Address ............ . ......Phone No... ,`%G 5-,//,6 ~ , , , Name of Architect ... ..........Address ...................Phone No... .. . Name of Contractor .. RabPtP.l! , , Tm Ia µg,e.y, , , ...Address ....:..............Phone No... r/.4 S.: !> ~ S . . 15. Is this property located',within 300 feet of a tidal wetland? *Yes ..... No .Ll' *If yes, Southold Town Trustees Permit ma be required. PLO DIAG).tAM Locate clearly and distinctly alt buildings, 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 „A STATE O COUNTY OF/~ .............. . . J.J ~/s~`)~'~/aT..~T4h.h9Pt~'~ ..................... being duly sworn, deposes and says that he is the applicant (Name of individual si Wing contract) above named. He is the....... QW.~ ?>~...1 ................................................................... I (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duXy authorized to perform or have performed the said work and to~m~e 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 ............. v7 7........day of .. .~'~..... , ......, 19~!~ ~/~~~~ ~/ ~ ~~ O Notary Public, ... •/~ ..1.1.-. . ~.. v~:....... County / J / HELEN K DE VOE'' NOTARY PUBLIC, Stote of New Yolk Na A701878, Suffolk CJun Tsrm Expires Moroh 80, ,v, r.' . ....: ...... ... 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A ~ -~ ~yJ m v { m ~ m a _ z o ' _ ~' , z 6 ^ D v p i m ~ Z y N i ~ m z ~ ~ i - ~ o m m N ~ ~ < 8 f m = r n y m r r { n O 2 D y r 2 00 m -I O A r E N ER~Y CODE CALCULATIONS Fo.a PEA• 0\vNy~ DATED (FG1 NON-£G EGTRIG -X.~Ae~' ~ES/ry~J ~C/TEA/a t'o 000 DeyA.EE bars SYSTEh~ - ~ AREA Q L)es/a.~ ' ' ,4ttowip ~eSiyu A[.towEp TUN QE/\\AQhS - UB . _ U U BTU B EXTE~2/~Q \VALLS (!a/S~SS) O./7 EXTEQI~Q \VALLS (OPdQUE) ~ OJ `~ E 4 O.oS ~ r s'' f,,GAZ/Nfi °o jLIO 0.58 /~ /c9~ p C~~ /~.S tf C 0.40 / 1 O D G E/G/NhS ~ /1c~F 1 301- 1 9 O.'OS 3 9; J FGOO.Q J3°v ~4 O.o3 •34/J 2NF/LTLIATION f/nt~r~c> /6 c3` J~ OO/8 / ~ ~ y,, bLE Cz~ cF/'*J b~ Fl/CF L3L~ )N /~ - Cd 8ri~! /+ z„ crN Cfcr '_ , / iU~TES Tc-rn GS 7~ 7 / O ,,~E CF NFN~Y Ltd' ct M r ~9 / ~''~~ Ga ~ 1) HEATING EQUIPMENT TO MEET 7813.23 - 755 EFF. TO THE BEST OF MY KNOWLEDGE; ~"~ a % ~ AND PROFESSIONAL ~ BELIEF 2) HEATING CONTROLS TO MEET 7813.13 - , ~ x JUDGEMENT THESE PLANS ARE , / ~ w RANGE 45 TO 75 DEGREES FAHRIIdHEIT. V IN COMPLIANCE WITH THE CODE. _ `" 3) WATER HEATING PER 7813.31 THRU .38. ao a3I259-1 0V 4) PIPE INSULATION 7813.19 ~ ~ pq 5) WINWWS -DOUBLE GLASS. ~FES510NP 6) CONSTRUCTION TO MEET N.Y.S. ENERGY CODE. - . - ~ e~ ~~' I