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HomeMy WebLinkAbout17148-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20583 Date MARCH 10, 1992 THIS CERTIFIES that the luilding ADDITION Location of Property 1955 HENRYS LANE PECONIC N.Y. House No. Street Hamlet County Tax Mag No. 1000 Section 74 Black 1 Lot 6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 20, 1988 pursuant to which Building Permit No. 17148-Z dated NNE 21, 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 TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. 'Phe certificate is issued to RAYMOND & KATHLEEN LEONE (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-093527 - SEPTEMBER 25 1989 PLUMBERS CERTTFICATION DATED MARCH 3 1992 - RAYMOND LEONE - Building Inspector Rev. 1/81 roaas 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) ~ 01714 8 Z Date %~tl.&,....... ~:1 19..4...4 Permission is hereby grant to: 8 i J" 4t,S ....a..~:~..........N.:y :.....!.~.~i~:.~........ .~:.....~n...~j.M-~.....lMe...~ to ....~-~.psi.~i..~...-.~;4:".....~....s~..d.eR:~~,. at premises located of ....J..4.a~....x° ..:~:4~?').~.Sr............................... ........................................................................V....................................................................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tox Map No. 1000 Section ......4?~...T....... Block Lot No......C!' pursuant to application dated .....~..d.try:to.+.•._•...`r3.r®•..•••.•..•.•., 19.g~., and approved by the Building Inspector. ' Fee ;...1~?~.... ~`.n'~' uiI ing Inspector Rev. 6/30/80 Form No. 6 TObiN OP SOUTI[OLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OP 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 Pire 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[.J00, Commercial $15.00 Date ...?/~~.!l' New Construction........... Old Or Pre/-existing Building Location of Property..,I,9SS.-.....!!E'.?Rj~f.. LA.?F.......~EGOi?SG House No.' Street Hamlet Onwer or Owners of Property...~!~~Mbf~~//...:~:..~f9!NLFE.? „~.~o.?C County Tax Map No 1000, Section...d .~.T:.....Block... D.~..........Lot.....n ~ Subdivision..~C.~'oiJ~c f/'anfs -SEe..Z...,,Piled Map..°~038~...Lot..:3S .~.~~~g.......Date Of Permit.Su:~f.P?~~.~98$.Applicant.~A~i•~Qi?9 LEo~?C,,.,,.. Permit No. „ Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Pinal Certicate..~ Fee Submitted: °7`r~, , C a ~ ~ 17J~ O J APPLICANT ~~FFp~ C TEL. 7G5-1802 ,ol.~ o,, To~vrr - or so u~~o~.~ fa~ < OFFICE OF BUILDRQG INSPECTOR ~ e; Yom. sn ~'_~1.~I„~., P.O. BOX 728 v%~ c•, t.:~'r~i ~ TOIVN HALL ;.~1 ~ yp0 SOUTHOLD, N.Y. 11971 C E R T I F I C A T I O N Date ~ - ,3 - 90~ Building Permit No. ~ 71cf $ Owner~flYMn.J/~ r rl~f/LC `Eo.~C (ppJ,ease print) Plusber_ /~/.J /iha.?D L%'p„/'_ (please print) I certify that the solder used in the water supply system contains less than 2/10 of to lead. (plumber's signature) Swto befcro m~ tt:is day of q 19 ~2 ~c~~w 1 Notary Public notary Public,~_~~~j ~Count~ CUURE 4 GlktN ryopry public. Ststa of Ne~wYosk No. 4879505 Que~Hled io guffolk County ~{eslon Expves December 8,19 ~ 'r'1ELD i;:Sl'SO:=U:i IIUii?E ~ COMMENTS I ~ -o , J ca a ~ H ` H ~ FOUt7DATI0N (1 t) ° S'}.i 7 ~y _ ~ FOUNDATIOtJ (2nd) _ ~ P~ 2. D a?Xln z o „D ROUGH FRAME~'& / ( PLUMBING! ~ ' p 3. - ~ I1ISULATIOP! PER N. Y. y STATE ENERGY CODE ~ a g ~ ~ .may 4 . FIiJAL o E d ADDITIOPIAL COMMENTS: x~ ~ x 'r H N H H O ~ 2 t*1 a • r H x d b H ~~i~~ r~.~s®2 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [v]~ROUGH PLBG. [ ]FOUNDATION 2ND [ INSULATION [ ]FRAMING [ ]FINAL REMARKS: i i i DATE D INSPECTOR ~ Ny~U 's ~ ; . . )~i~~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST 6:000H PLBG. [ ]/FOUNDATION 2ND [ ]INSULATION [ ]I/ FRAMING [ ]FINAL REMARKS: -Lam-.-- I ~y DATE INSPECTOR 1 a _ h ~t 765-1602 BUILDING DEPT. iNSPECT~®N [ ]FOUNDATION i5T [ ] ROUGH PLBG. [FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~r-- i i f DATE u INSPECTOR f 1~-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. (]FOUNDATION 2ND [ ]INSULATION [ 7 FRAMING [ 1 FINAL REMA KS: ~~~,crr~ G11 s~(/ f l k z DATE ~QI , 7 1NSPECTO e . ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ 1 f}?,5U2 f BUREAU OF ELECTRICITY BS JOHN STREET, NEW YORK, NEW YORK 10038 Dote $f.'P'l'1~2~fHT;R15,798~ APpNmHonNo.onffle 63.C135h$~3(S9 21 093h27 THIS CERTIFIES THAT only the electrical equipment as deacrihed 6ebw and introduced 6y the applicant named on the shove application numher in the premises of I RRY L,~;t)P3R, 155 Y~3JS NFN~Y'S bAi~F:, I'~,%~iVT.f„ Id.Y. in thefollowinq location; ®Basement © lat F(. ? 2nd Fl. Sertion Blork Lat was exornined on ~~,k'T'~Mf3H,R f'I~' ~ arzdfound to 6e in compliance wfth the requirerneaLs o/this Board. FI%TURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FIUCWEECENT OTHEN PMi K W PMT. K W AML KW. AMT. K.W AMT H P DRYERS FURNACE MOTORS FUTURE APPLIANCE FlEDERS SPECIAL REC'PT TIME CLOCKS lEll UNIT HEATERS MULTI.OUTLET DIMMERS SYSTEMS AMT. W. OIL M. P. GAS N. P. AMI. NO. A. W. G AMT. AMP AMi AMVS TRANS. AMT. H P NO. Of FEET AMT. WAiiS SERVICE DISCONNECT NO.OF $ E R V 1 C E AMT. AMP. TYPE MITER I 4W 1 p 3W J d 3W ~,F 4W NO. OF CC COND. A. W G. NO OF HI-LEG A' W' G. NO OF NEUitALE A. W. G EQUIP. PER .9 Of CC.COND OF H4lEG OF NEUTRAL OTHER APPARATUS: Xl11BI"~'I~f)(~ CII'~J,Y-.1 HTL1dK'S L1Llat~TRTC: LCG.I#21i7!"i~ ' 1 :I SNF~.E;P PASTI)Rl; K13 SF:'d'AtiA till', N4, 'tI7J : OENfRAC-M„f~IAGER 'l. a. ,r``j~ I Per This certificate must not be altered in any manner; return to the office of the Board if incorrect, Inspectors may be identified by 9heir credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST N07 BE ALTERED IN ANY MANNER. ~ 7~. d1 ~ ~ ° ~ 2~ pfd t-- . ~s~ ~ ~ ~ ; ~c " . e _N j _ ro~., ..._..,w , . ~ t` ~ e~'' - ~v pa -pll ao =~,~~147 ~i N •e Cw ~ M 3 7 Od { N Y w n~ga 4, Q ~ 9 ~ . ~ ~ ~ V N ~ ~ 4 N I~.YI bd4 ~ ~ N ~ Z a~ ~ 0 " ' Nl K1 ~ ~L ~ 'N Z ~ ~ ~ ~ ~ th ~ v ~ ~ Q ~ m 7 li.~ ?11 ~ ~ ~ 4 r: ~ , ~ ~ ~ ' 0 4 1~ ~ ~ ~ f{~ ih N ~ ~ ~ ~ M ~ ~ ~ Q h ti K1 N h V Z z 4 ~ 1s ~ ~ ~ b ~ ~ ~ ; O ~ ~ ~ ~ ~ ~ ~ ~ ~ d ~ ~ yD 0 N E z+t ' ~ ~ , ~ b ~~~~W ~ ~ _ N BOARD OF HEALTH 3 SETS 0~r PLANS FORM NO. 1 SURVEY . TOWN OF SOUTHOLD CHECK ~ .~Q~S.' . BUILDING DEPARTMENT s>;PTic FORM ' TOWN HALL SOUTHOLD, N.Y. 11971 NOTIFY ~1 TEL.: 765-1802 CALL .~.~y-.~.oF ~.y........ . MAIL T0: s Examined ..~iL!'i'!R. 19 g.. ~ •,4~~ Approved ...~~~?/R.....1.., 19~~Permit No........ ^ T° Disapproved a/c U /O/z~~~ .w a • BLDG. DEPT. TOWNUFSOUTHOLO (Building Inspector) " APPLICATION FOR BUILDING PERMIT j j j Date .....~°i./ ,J 0.. / 15 INSTRUCTIONS 11 a. Tltis 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 to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspec ions. • . ` . . e~(Signa[ur of applicant, or name, if a corporation) • (Mailing address of applicant) • State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder. ©!.(i.JEA! Name of owner of premises ....~i4yMe~1,e~, • ;F; 1~~`en)• • ~ G 7~.t.~t;' (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. 7~~.~~. - H r......... . Plumber's License No . . Electrician's License No . . Other Trade's License No . . 1. Location of land on which proposed work will be done . . House Number Street ~ Hamlet County Tax Map No. 1000 Section . t .~q.......... Block ~H¢'~ Lot ~G........ . Subdivision . ~"~O.-~:~~s .~~."?C-f f +ti-+ Filed Map No. o.~d 3 g'...... Lot ~ o . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............./.~~.~..~p~..~-.-............................................... . b. Intended use andoccuparicy .•••••••••••1,~•~^^~~^••••••••• 3. Nature of work (check which applicable): New Building Additionl. , , Alteration . Repair Removal Demolition , , , . , ..Other Work . ~j GCS (Description) 4. Estimated Cost ~O. S. Qd ~ ~ ~ . . Fee , , . (to be paid on filing this application) 5, If dwelling, number of dwelling units Number of dwelling units on each floor . If garage, number of cars . . . _ 6. If business, commercial or mixed occupancy, specif na~ure and extent of each type of use , . , j , , , , , ; , • . 7. Dimensions of existing structures, if any: Front ~?r... , , , ,Rear , , , , , , , , Depth z-~, , , , , , , , , , Hti~ht ' • e Number of Stories , C , , . Dimensions of same structure w7)h alterations'or`5dditions:-Front ...7.....~L Rear ..~].1r.......... . Depth Height Number,of Stories , . 8. Dimensions of entire new construction: Front . Rear ....7~, ,Depth , , , Height . . Number of Stories . ~ ~ • ' ' • ' ' • ' 9. Size of lot: Front ! 0. Rear ..~(Q,.,/`f , , , , , , • • . Depth .~~~;•~`f, • ~ • • • • • • • • 10. Date of Purchase , , i • • • • • • • • 1'•8x• • • • • • • • • Name of Former Ownerl• Q 11. Zone or use district in which premises are situated , , , , , , , , , , , , , , , , , , , , II 2. oes proposed construction violate any zoning law, ordinance or regulation: ./.?s~ _~.n 13. Will lot be regraded !?O. .....Will excess fill be removed from premises: Yes 14. Name of Owner of prem' es le?,l,.~na~ ,L-Eo~?C', , • ,Address ~S,T..KF;~ti~i;, ~R; ,phone No. ~.3,~(; $;2r,7;'~, , , , Name of Architect !'~NN`(• L~r•, }3C;rL , , ,Address . !'......Phone No.... , . Name of Contractor !~QN'?. CD,.?itinCF~NG , , , Address'~t~°.~P?'.S..Y~, ('~.T'~4'v?S-, Phone No. 7~•~`J 1,~...' . 15.Is this property located within 100 feet of a tidal t+etland? *YES...~T *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate cleazly and distinctly all buildings, whether existing or proposed, and, iindicate 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. ,,~(G~-yDti- t;~, f y ~ I f ~ ii b-r ~ S L 3l'1 ~ 3 • jz.>~ 'p' ~I~~ fir' ~Q. ~ ° StFATE OF NEW YORK, I ` Cl?UNTY OF ...J:'.~. •~L. ~ , , , , S.S JZ/~J!v~pr~Q , • LC;~,,,i CG , , , , , , , , bein dul sworn de ,'ores and says that hey„is the'?appiicant (Name of individual signing contract) g y ~ p above named. - - He is the a's"`..'~ p (Contractor, agent, cor orate officer etc{a of said owner or owners, aid is duly authorized to perform or have performed the~sai~i ivork and to ih'ake'and file this application; that all statements contained in this applicatiolt are true to the best of_hs knowledge and belief; ahd that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ' ` ~t ~ aC ~C .dayof..~/~// 19~Y Notary Public, , , (/Ot?, County NELEN K. DF. YOE NOTARY PUSIIC, State of New YYoyrkq . TaNm Exp~es~Ma ch 30,18 nt_._rt~ (Sigri3turB Of applicant) i E N ERG pY) CODE CA~CU~~,o,TIONS (Foa NpN-EL EGT/i~G -4~EAr> FpQ / to 000 ~E§.O EE ~dY3 ~oB />o hh PEE1. ~wNy3: 1`ehh} /I27 ~E3/S.N ~C/ZE?iA ~ i ~ATEO - S~L~ / ~ O~A. ~ /O F S. A~ ~ 70~F ~UBSYSTEM AREA Q. ~ES~~J ~l~o~~ac DESiyN At~a"'Fp ~En\,4RKS "U" U BTU-1-! 6TUH ~ EXTE.2 \VALLS (l~A.p55) O. /7 EXTE.Q/~Q \V,4LLS (OPAQUE) 7 ~1 D / q O.OS 2 3 7 l,.GAZ /N!a T' % 2 o Z 0.58 76 3 D ~ Doo/as 3G o.qo G.E/L/NC,,S ~,G1ppF /1 b'f ! O.'03 3 Y n' ~FG~R /J by" t~' - 0.05 344° SNF/LTQATl6N (1/ui.lr,t 93/x] OO/$ /a~S,I iU~ TES Tcrd.c s 2 7 z~ o . pF NEW y0 . 1) HEATING EQUIPMENT TO MEET 7813.23 - 75~ EFF. TO THE BEST OF MY KNOWLEDGE, y ?E , 2) HEATING CONTROLS TO MEET 7813.13 BELIEFr AND PROFESSIONAL ~ J Sf RANGE 45 TO 75 DEGREES FAHRENHEIT. JUDGEMENT THESE PLANS ARE ~ J w e 3) WATER HEATING PER 7813.31 THRU .38. IN COMPLIANCE WITH THE CODE. 4) PIPE INSULATION 7813.19 <"p °~225'~"~ 5) WINDOWS -DOUBLE GLASS. p~~FES51CKPy 6) CONSTRUCTION '1D MEET N.Y.S. ENERGY CODE. -