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HomeMy WebLinkAbout17533-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18413 Date SEPTEMBER 26, 1989 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 645 HICKORY ROAD SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 54 Block 9 Lot 2 Subdivision Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 7, 1988 pursuant to which Building Permit No. 17533-Z dated_ OCTOBER 14 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 ALTERATION & DECK ADDITION TO EXISTING ONE_FAMILY DWELLING The certificate is issued to JOAN A. JOHNSON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-081099 - JULY 18, 1989 PLUMBERS CERTIFICATION DATED 9L22/1989-JOHN RIGNEY PLUMBING & HEATING ~ - / Building Inspector Rev. 1/S1 croaas xo. s 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° 617533 Z Date ....Q..CL'...°.~r.....~..7 .............. 19.,~~ Permission is hereby grant~e/d to':. ~ C..~........... ~ ............. ...,.... s.....:~......' ...~...... ct premises located at .. ~.`{.~.U.~^~c,4~~q...~ ........... ... .... ....,,......................... Counhj Tox Map No. 1000 Section .....Q.~.~........ Block ...,.a~.......... Lot No....d..~-- .............. pursuant to application doted ......Q.s-`r....Z .................... 19. ~.~, and approved by the building Inspector. Fee $. ~.0~.:~Y."... ......(. v ~ .?"5,.. ............... Building Inspector Rev. 6/30/80 • i '~ .~~. TOS7N OF SOUTIIOLD BUILDING DEPART:fEt7T TONN ^ALL ;, SOUTIIOLD, NEN YORK 11971 - ,. ~ i~ ; ~; 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPAL7CY DATE.. ~~ ~ 2 ~ ~~.. NEST C0:7STRUCTION ..___„ OLD OR PRE-E$ISTIttC IIUILDING....._VACANT Location ~C(' ,/~ LAND........ of Property.. .. ... _ .:. 11 ~~~©~_~ L[O_ STREET -""•' 1 ,,t NAMLET Ovncr or Ovncrs of Property-- v © ~ )V-_.~_'_- ~ ~.t~l/V~otil..... County Taz Hap No. 1000 Section ~ ~ •••• , -Block ...~.. Lot' .~.....•..... SuSdivi:ion.. -_•••••.••._..._ Filed Map ......_.Lo[. Pcrni[ tfo. ~,~,~7.,,?J•-D3tc of PcrmiC w j,L //~j~ ,-/~/-~-~•_ ~1 Applicant ./. l'. ~.~~$G~.. iicalth pept. Approval ..... 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P aIIlcaanasd ;o ParoQ moa; uot7rlir7snt iro?a]aaia ;or?enosddy 7 '(~O3 6-S irsods? pur 6lddns aa7rn 30 '7da0 y7TraQ 3° Icnoaddr -£ -saan7ra; a?ydra3odo7 so Iean7ru irnsnan par 's aaa7s .Z `saa?i S7aadoad 's3n?pitnq Iir 3° vo?7r~oi a]rano~r q7?n d7aadoad ;0 6anxns7 ':asn naa irotg •r 3ar to a ao s3a?pitnq naa ao; ;3u?noiio; ay7 47?n xo7~adsal Pi. 4 t'7 07 pa77tyugns pur xa? 210 aa7?anadd7 u? Pai?3 a4 7snm uat7rotiddr s?yy, •V $NOIyDR21J.SNI bONV3II0D0 30 B.LVDI3Iy2I83 2103 NOISVDI7ddV zosr - sit izvu Nnoy yN~ZL2IVdH0 ONIOIIIIII 070[LL[lOS 30 NMO.L 9 'ON W2i03 ,~'5~F F OL/,-~, o ~,. ,., O~ TOW1V OF SOYJTBOE.D +~ (,;;: ~~ ~• < OFFICE OF BUILDIPIG INSPECTOR a c-, o .~ ;-;:, P.O. BOX 728 ~Es'~ '~ l" -c TO1VNHgLL ~/+, ~~ SOUTHULD, N.Y. l 1971 ~1p1 ~ y~i> C E R T I F I C A T I O N TEL. 765-1802 Date ~ '~ z. ~ ~~ Building Permit No. ~ r Owner__J(y.~~~ ~bNAlse~snl (please print) / Plumber ~O u,, ~Jgrac~ e ~~G',6y-~p6~~ (please p int F-'`=~ I certify that the solder used in the water supply system contains less than 2/10 of to lead. _ ~ t~ (plumber's iyn ure) Sworn to before me this ~~~'~day of ,~T- ,. 19{~f. ''TT'- Not ry ublic Clotary Public ~//F.~~l ou t ~arwcs r. s~;~n~ IpYNtY PUF3tdq s~+e cf P~ .v !ac Pto. °~a r,~~ y~~ ~4~a_~a.i~l%ed is Su:6a:k ~, ~r y ORP¢+~~ Fxyltot dlmrzk bJ, i~ DULY ~''~ "~~~rF~~`, '~~c¢ s To~~rr ,or sou~oL~ ~~1~w276¢;t~~ `' ~ OPfiCIi OF BUILDING INSPECTOR ~`~"~`j ~' TOWN IlALL ~,yy0 ~~~' SOU"I'IIOLD, N.Y. 1 1971 ~~ ~ ~ as, ~v89 S ~~, ~,~. To {4hom This, May Concern, ~; TEL. 7G5-1802 47e are unable r.o complete your Certificate of-/Occupancy because of the folloc~~ing reasons. ~`"` / ' / / An application for Certificate of Occupancy ~i /// is not nn fil.c. ~ /~No Undcrc~~ritcrs Certificate on file. /„_/ 't'he chcc:}; .i:; (~I-feat on file.) ~o?S,o"a /_/ D}o llcal.th Rcpt. Approval on file. /_/ D:o final inspection has been made. Pica:;e r_ontact: our office on this matter. Thank you for your cooperation. Iluilclir.<J Pcnni.t'. II [_ .Z ~ ~ ~ Z Duildi~n { Dupt-. ,,- ' `~/// tlo Plumber Solder Cert.ificatc on file. T. ~ - ' ( al.l pormits involving plum}ling being i~sucd after April 1,1984 ) 1cLD II:SPEC; iU,d ~~bAiF, ~I %OMMENTS .,~' . - 1 . .~ , ~ .. _ H ^OUI7DATION (1st) _ _ y Z ~ ~ f ,~ r OUNDATIOtJ ( 2nd ) _ _ c~ q ~ z . 3 .3 k z o ROUGH FRAME iC.GLA ~ ~ ~ PLUMBING G 3 ~ ~ ~ ~ ~ y p . y ~--Y ItJSULATI0P1 PER N. .. ~3 STATE ENERGY CODE 4 m . H F I;J AEG o ADDI OT] COMMENTS: x~ Q ~~~ -tin X ro • -F H ~ ~ ? ~ '"3 H O .,0 z ' 0 , ~ m r H x t C7 +1 _ ~ + b H ~._ :. ~l v ~. r C ~~ ~ .~~ 7G.ri-1802 BUILDING DEPT. iINSPECTION [ ]FOUNDATION 1ST [/~]~OUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~~'~~-~.~i-~- ~~~ DATE ~ INSPECTOR 12~ 33 765.1802 BUILDING DEPT. INSPECTION (]FOUNDATION iST ( ] R GH PLBG. [ ]FOUNDATION 2ND ( INSULATION [ ]FRAMING (]FINAL REMARKS: G DATE ~~ INSPECTOR 17~~ ~ 765-1802 BUILDING DEE~T. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ RAMING ( ]FINAL REMARKS: ~~-t.~~- DATE 31 ~ INSPECTOR ~,3 ~ ,x.1802 BUILDING DEPT. 1 NSPECTION [ 3 FOUNDATION 1ST ( ] ROUGH PLBG. [) FOUNDATION 2ND [ ] 1 ULATION [)FRAMING [ FINAL DATE INSPECTOR FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL vDUTHOLD, N.Y. 11971 TEL.: 765.1802 Examined Q.Z~'".~+..1.~l.., 19 Approved D9,~i>~`.°:~..? ~ I ., 19~ ~. Permit No. ~ .7s~.~.~.~. . BOARD OF HEALTH ............ 3 SETS OF PLANS ,........... SURVEY ..................... CHECK ...................... SEPTIC FORM ................ NOTIFY ~ '7~~~ CALL ...... < .............. MAIL T0: ,~'~~-~ ~9~. Disapproved a/c ................................... .................................. .......`~'..~va ~~~:......... µ~-:-~ .. . (Building Inspector) APPLICATION FOR BUILDING PERMIT ^7 ~~// 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 appB- 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 to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in builduig for necessary i spection . (Signature ot" applica~r name, if a corporanon) ~~15 lrlrclca~e't 1/ yZ/ (Mailing address of applicant) State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder. O W A!~ l(.. ........................~..{.........nn......................(,.f................./..................... Name of owner of premises ..`': ~!`1.~ ..T, . ~. ~ ~~~°. ~~• . • . ! : EI"g`~~ r L" ..JO H~/8d~ .................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. .............................................. (Name and title of corporate officer) / ~i;~~ g~ Builder's License No. ~.q'L .~~ ~ .~ ~N~~. ~..... 1 ~ I {~ ~( I L el+a Plwnber's License No. ..~$~~.':C .............. ~~ ` T1 dal r ~r,,.y-r-aC~oT W IL`' Electrician's License No. ~a~:'.~............ _ Other Trade's License No . .................... . I. Location of land on which proposed work will be done . ............... . ................................. House Number Street of Hamlet County Tax Map No. 1000 Section ... ~ ~~ ......... Block ..... ` Z-- ............ 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 .... ~..r'.~M'.L~ • .~. ~GS.rD>rn.E.~=- .............................. l rr7~ «~t ~Est~~ticc;.,-.;~ ,,. ~. b. Intended use and occupancy .................t.......................:......:................... . 3. Napure of work (check whicRh applicable): N~w Building .....'..... Addition .. ~.... Alteration ~ , , , Re air , , , , , . ri)oval ... , , , , , , , , Demolition .............. Other Work •~ .« . ,., .....;. , ..... 4. Estimated Cost .. ~ ~ ~l POR.'.'~...... li .............. Fee ............ ~ ..... ,.«r.,,~ ~1' ari{ , g, units.....I' .~ 0:i7;,iia! . a..,_. 5. If d =allennumber of adwellin ~ (to be pa~1~i'ti1~Pa lcld'It-n) ........ Number of dwelling units on each floor ..... , .. . g g .., ~ ................ ........ ....... 6. If business, commercial or mix~d occupancy specify nature and extent of each type of use ........... y........ . 7. Dlmgensions 2 existing structures, if any: FrpnY ... 3 `;~ ........ Rear . ,~............ Depth .. ~G, , , , , , , , , . Hei ht 7-r........ Number of Stories ........~.. Dimensions of same structure ~yith alterations or additions: Front ..•`S!`~!"~t?: ,Rear ..~!1!°?f•°. , , , . ....... ...... Depth ....~7.A.^.'lG........!,... Height . ,Fl.PI~Q?d(.. ?~ ~ ....... Number of Stories .... s=-•~ ............... . ruction: Fron 8. Heinhtsions of entire new const• ..... • ' • . t , , , , , , , , , , , , , , , Rear ............... Depth .............. . g • ............. Number of Stories .... ~ . 9. Size of lot: Front . ~/)O ~ Rear .... 1.4 0 ............. Depth . • ..~ :~D ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ • 101. Sone or usecdistrict in which p~ ~ ' : 1 ' ' ' • • • • • Name of Former Owner ..J. ~iM . H~ !Dd' [._ • emises are situated .................................................... . 12. Does proposed construction violate any zoning law, ordinance or regulation: . 13. Will lot be regraded ..... !t! P. , , , . , , , ,Will excess fill be removed from premises: Yes' No 14. Name of Owner of premises ~.~ /-(..JnhlN,' Sp;~ , , ,Address Gyy'.l-lickoY•4; R U• , ,phone No.. ~? q3.: 7,265; Name of Architect .. G N.'!! !zuxJ , ~ltf7-! , .. , . , ,Address ../~.t;~+iYf 4........ Phone No..73:f'7S!~}! , ~ Name of Contractor . .Address . ... ,Phone No. . IS.Is this property looted within 300 feet of a tidal wetland? *Y$5....NO.z/.:~ *If yes, Southold Towp Trustee's Permit may be required. _. PLOT DIAGRAM Locate clearly and distinctly ail buildings, hether 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 ,~ r v ~z` .9/JVis~sD jUvTE; 7~Fiis ~ltrT6i~A+ICIII/r~~>a~2. CoNST2uc.~-ro•J 0,0 G XisriuU i FOpN~Afid~Gl ~ [,~Yc&Pp' rv2 ', STATE OF NEW R .. S.S COUNTY OF . ~ ~~~ ~ (Name of mdrvidual signing contract) above named. He is the ...................C~~.?~ /Vcc,~l!.... . I (Contractor of said owner or owners, and is duly authorized 'to per aPplicaf ~ h I t " f~L ~,~ ~ LL L~tr (~ ~~C1e FJ r2 e~ ra. .... being duly sworn, deposes and says that he is the applicant agent, corporate officer, etc.) form or.have performed the said work and to make and file this ion, t at a 1 statements con pined m this ~pphcation are true to the best of his knowledge and belief; and that the work will Uc performed in the manna; set forth in ~he application filed therewith. Sworn to before me this ~ I . , . ........ d~Y ofI• ..... 19 ., Notary Public, . ~~_„k~ ,~G.,•,.F-!j-P,~~', ... .... County CLAIRtd 1. f3l Notary Publfo, State of~ w York \~\~ ... .. ...... . No. 4679606 (Signature of applicant) Qualified in Suffolk County Commission Exoirea December 9, 15...., c ' `~~• ~ r `~ ~. spa + ~ ~ s ", ;~ ~ ~~s .r +~'' .~ fi w a~ ' s r qrg , Rq e F r .h ~~ ~~ c+ a i d + x" +. ~ 1 -1~5....~ t ,q ~ ~, . ~' ~~ ~ ~ < F'. 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HO O o5 FLEA SNF/LTI~.ATI~N y yL o O.o/8 y7 ~~ Told s // ~ ~/ o /UL) TE S . . ~. ;., .._ - ;,LN ~~ +Y?~, .. 1) HEATING EQUIPMENT 1b MEET 7813.23 - 758 EFF. TO THE EEST OF MY [Q90WLEDGE~ F' (Y~~ _.~.~5` ~~'/r7 BELIEFr AND PROFESSIONAL P _ ~ ' ~ 2) HEATING CONTROLS TO MEET 7813.13 ' b J~ JUDGEMENT THESE PLANS ARE ~ i ~~~/' w RANGE 45 TO 75 DEGREES FAHRENHEIT. - IN CQMPLIANCE WITH THE CODE. / ~ 3) WATER HEATING PER 7813.31 THRU .38. 032 ' J 4) PIPE INSULATION 7813.19 ~a `~~ l/ ~ 5) WI6IDdr75 -DOUBLE GLASS. gOFE5S10~~~~ 6) CONSTRUCTION 1b MEET N.Y.S. ENERGY CODE. ~ ~ ;: - /u 3 /