Loading...
HomeMy WebLinkAbout27600-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28005 Date: 10/09/01 THIS CERTIFIES that the building ADDITION Location of Property: 1800 MINNEHAHA BLVD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 87 Block 3 Lot 63 .1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 10, 2001 pursuant to which Building Permit No. 27600-Z dated SEPTEMBER 10, 2001 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 ADDITIONAL BATHROOM IN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to J LOUISE MOYLE (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. H-072903 10/02/01 PLUMBERS CERTIFICATION DATED 09/17/01 MUKE JACOBI PLUMBING utho ized S gnature Rev. 1/81 FORM NO. 3 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) PERMIT NO. 27600 Z Date SEPTEMBER 10, 2001 Permission is hereby granted to: J LOUISE MOYLE 1920 MINNEHAHA BLVD SOUTHOLD,NY 11971 for CONSTRUCTION OF A BATHROOM TO A SINGLE FAMILY DWELLING AS PER EXPIRED BUILDING PERMIT #20454 at premises located at 1800 MINNEHAHA BLVD SOUTHOLD County Tax Map No. 473889 Section 087 Block 0003 Lot No. 063 . 001 pursuant to application dated SEPTEMBER 10, 2001 and approved by the Building Inspector. Fee $ 150 . 00 7A�� i .-Aiithorii4d Sign ture ORIGINAL Rev. 2/19/98 ---------�--- o --- o THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 8085434 BUREAU'OF ELECTRICITY 40 FULTON STREET, NEW YORK, NY 10038 Date OCTOBER 02.2001 Application No. on file 1.3135503 X01 H 072903 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of J. LOUISE MOYLE, 1800 MINNEHAHA BLVD. , SOUTHOTL i. , NY in the following location; ❑ Basement ® 1st Fl. ❑ 2nd Fl. Section Block Lot was examined on SEPTEMBER 17,2001 and found to be in compliance with the National Electrical Code. FIXTURE AMT. H.P. FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCE FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS M SYSTEMS T DIMMERS AMT. K.W. OIL M.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT• WATTS NO.OF S E R V I C E SERVICE DISCONNECT METER A.W.G. A.W.O. AMT, AMP. TYPE EQUIP. I 2W 1 3W 7 0 SW S't!4WPER NO.OF :OND. OF CC..G. NO.OF HI•LEG MI.Mp HO.OF NEUTRAUS OF NEUTRAL OTHER APPARATUS: "NO VISUAL DEFECTS: "An electrical survey has been made of the exposed electrical equipment in the premises indicated." "No obvious unsatisfactory condition was found. i � L J. LOUISE MOYLE 1500 MINNEHAHA BLVD. GENERAL MANAGER SOUTHOLD, NY, 11971 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. rMENISM WWII MA rnov T:nR RIIII.OING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY NNER. - - Form No. 6 _ TOWN OF SOUTHOLD BUILDING DEPARTMENT' TOWN HALL 765-1.802 APPLICATION FOR,CERTIFICATE OF 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 Fire Underwriters. . 4. Sworn statement from plumber certifying that the solder used in system contains less-than 2/10 .of 1% lead. 5. Commercial building, industrial building, multiple. residences and similar building and installations, a certificate of Code Comp..lianoe 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: l: 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 Occgpancy is denied, ,the Building Inspector..shall state.the reasons therefor 'in writing'to the applicant. C. Fees d 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 2. Certificate of Occupancy on Pre-.existing' Buildi.niz - $100.00 3. Copy of Certificate of Occupancy - . .2f 4. Updated Certificate of Occupancy - $50.00 5: Temporary -Certificate of Occupancy - Residential. $15.00, Commercial $15.00 .Date ...c;7;oyy�.�:�. .g�i.'Z:Q.��...... . :. ... .. . New Construction.:. ... .. . .' Old Or Pre-existing Building. . ?.... . .. . Location of :Propertq.,�L2.�V.... ...�:111�:15/. 1iu:�..��.L�..U..., �!.G.�J��.��J:.. . . .. ... .. . s House No. Street Hamlet Onwer or. Owners of Property../.�.:-'1.s .� . .G/., . ..:. .. . . . . . . .. . . .. . . . . .. .. . .. . . . .-. . County Tait Map No 1000, Section. ...!. . . . .B1ock. . , ::3. . . . . . .. . .Lot. . `3 .. . . . . . . . . . . . Subdivision. . .. . ... .: . . . . . . . . .. . . . . . .. . . . . . .. .Filed Map. . . . . . . . . . . .Lot. . . . . . . .... . . . . . . . . . . Permit Nord. .�� . . . .Date Of Permit.�.��: d. .... .Applicant : . ��,G . ... . . . . . : . .. . Health Dept, Approval. .. . . . . . . . . . . . . .. .. .. . ...... nderwriters Approval. . ... . . . . . . ..... . . . . . . .. . Planning Board Approval. .. .4 .4 . 44 .. . . . .. .. . ... . Request for: Temporary Certificate. .. .. . . . . . . Final Certicate. . . . . . . . .. . tee Submitted: .. . . . . . . .. . . . .. .. . . . . . : �o . . . . . .� 444 :4 . . .. .. .. . ... . . . . . . . � s- Town Hall,53055 Main Road Fax(516)765-1823 P. Q. Box 1179 P ,e Telephone(516)765-1802 Southold, New YPrk 11971 OFFICE OF THF OVUM IN$PFCTQR TOWN OF $OUTF1MP C E R T I F I C A T I O N DATE: ?4z&r Building permit No, 27 oQ Owner: y O G (please print Plumber (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. t (Plumbers S gnature) Sworn to before me t ' s 7 day of Notary Public, � rc County ELIZ NOTARY P g�Stat o NIeSw York No.01ST6008173Suffolk COu Term Expires June 8, O z Gyp CO3 Town Hall,53095 Main Road0 • Fax(631)765-1823 P.O.Box 1179 1. Telephone(631)765-1802 Southold,New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD September 13 , 2001 J. Louise Moyle 1920 Minnehaha Blvd Southold, NY 11971 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons : XX An application for Certificate of Occupancy is not on file. (Enclosed) XX No Underwriters Certificate on file . XX The check is (not on file. ) $25 . 00 No Health Department Approval on file . No final inspection has been made . ✓ XX No Plumber Solder Certificate on file . (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 27600-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. Print Key Output Page 1 5738SS1 V2R3M0 931217 SOUTHOLD 04/17/96 14 : 18 : 19 Display Device . . . . . . X5 User . . . . . . . . . . . CLAIRET NYSRPS ASSESSMENT INQUIRY DATE 4/17/96 473889 SOUTHOLD SCHOOL SOUTHOLD SCHOOL ROLL SEC TAXABLE PRCLS 1 FAMILY RES TOTAL RES SITE 87 . -3-63 . 1 TOTAL COM SITE 1800 MINNEHAHA BLVD ACCT NO 08 OWNER & MAILING INFO ===I=MISC l________ ______ ASSESSMENT DATA MOYLE J LOUISE !RS-SS ! **CURRENT** RES PERCENT MINNEHAHA BLVD ! 1 !LAND 2, 100 **TAXABLE** SOUTHOLD NY 11971 ! BANK !TOTAL 6,800 COUNTY 6 ,800 **PRIOR** TOWN 6,800 ! !LAND 2, 100 SCHOOL 6 ,800 !TOTAL 6,800 ==DIMENSIONS =__!______= SALES INFORMATION ACRES .40 !BOOK SALE DATE 00/00/00 !PAGE PR OWNER ==TOTAL EXEMPTIONS 0 _____________!_= TOTAL SPECIAL DISTRICTS 4 CODE AMOUNT PCT INIT TERM VLG HC OWN CODE UNITS PCT TYPE VALUE !FD028 IPK070 !WW020 !SWO11 F1=NEXT PARCEL F3=NEXT EXEMPT/SPEC F4=PREV EXEMPT/SPEC 75 . 10- 03-013 F6=G0 TO INVENTORY F9=G0 TO XREF F10=G0 TO MENU M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 CATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: C� 1 DATE INSPECTOR AAA '�'� 1:,LD 1:.✓. c.�V:� jlJni jl ^ lJ:IIIENl ^. J; ^�V FOUNDATION _ ( 1st ) FOUNDATION ( 2nd ) _ _ c , c 2. ., . ROUGH FRAME & -PLUMBING N 3 . y m INSULATION PER N . Y. rn STATE ENERGY I CODE 4 1 7/;jm FINAL ADDITIOPJAL COMMENTS : • x • H V` 0 ' r y m H a i T- r, BOARD OF HEALTH . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . _ _ . . . . . . . . . . . . �7 TOWN HALL SEPTIC FOR: . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 N oT Z FY , :xamined . . ..� 19 9 CALL . . . . . . _ . . . . . . . . . . . . MAIL T0 : kpproved . . . . . . . 1 'rPermit No. a!�T. . . . . . . . . . . . . . . . . . . . . disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . r Ouildin spcctor) • %T 1'41`1 iJ„ BUILDING t'Ct' Mi i v r Date INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 As 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 r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ition. 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 call 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 call 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 uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. he applicant agrees to comply with all applicable laws, ordinances, building code, housing code,nigulations, and to imit authorized inspectors on premises and in building for necessaryinspections. -.... . . .?. --2 . -. .. . . . . . . . . . (Signature of applicant, oi-12; .e, if a corporation) . . . . . . . . . . . . . . . . . . . . . . . . . (Mailing address of applicant) tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . `ame of owner of premises . .'��1 /�. . I -f a y'� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) applicant is a corporation, signature of duly authorized officer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License No. ,f?A-/)yEQ Plumber's License No. y . /�. . . , . , • , • • • • , Electrician's License No. ,14. . . . . . . . . . . . . . . . Other Trade's License No. .A'' . . . . . . . . . . . . . . . . Location of land on which proposed work will be done. . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . f 9 a. . . . . . . /�!�I✓� , / �. . . �. w . . . . . .moo v 7 House Number Street Hamlet County Tax Map No. 1000 Section . . . 02. . . • , • • Block . . . .3. . . . . . . . . . . . Lot . j�(:3-14aa. . . , , , , Subdivision . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . . 5 • , . . • • . . • • , . . . . b, Intended use and occupancy . . . . , , , . , , 3. Nature of work (check which applicable): New Building Repair . . . . . . . . . . . . . . ' ' ' ' ' • • Addition . . . . . . . . . . Alteratior� :�. . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . , , , • , • , . . Other Work ?? 10 (Description) 4. Estimated Cost.. . . . . .-3 O(}0. . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) S. 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, specify nature and extent of each type of use 7. Dimensions of existing structures,if any: Front ..-7.... . . . . . . . . . Rear . . . . . . , . . . . Depth . C3 • Height . . . . . . . . . . . . . . . Number of Stories . 'c ., ' ' ' ' ' ' ' ' ' ' Dimensions of same structure with alterations or additions: Front !? Rear Depth . . Wil. . . . . . . . . . . . . . Height . . �� !�7;.. . . . . . . . . . . . . Number of Stories . .S�l!7 . . . . . . 8. Dimensions of entire new constriction: Front Rear . .5 /7 . . . Depth • Height /7. . . . .S4/7 . . . . . . p S,�r7� . Number of Stories . 9. Size of lot: Front . ./. 7,�;' . . . .1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Rear . . 14.6. . . . . Depth �a 10. Date of Purchase . ./9:x`9. Name of Former Owner 11. Zone or use district in which premises are sites ted 12. Does proposed construct n violate any zoning law, ordinance or regulation: t`'.n ' 13. Will lot be regraded ./�`� . Will excess fill be removed from premises: Yes • No 14. Name of Owner of premises' ©�'� � ,/`j o Y� , , Address/. �d./'��N1�, , phone Na�7 =3Ql.j, Name of Architect • . . . . . . . . . . . . . . . . . . . . . . . . . . Address . Phone No. Name of Contractor . Address . Phone No. l5. Is this property within 300 feet of a tidal wetland? *YeS.X . . . . .• No. . . . . . . . .• • . • • . • • • • • • • . *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all 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. 3.OAviT1,�i,v — AP ROv D AS NOTED DATE: ` 2 13.P.#t FEE 6 BY. NC IF DEPARTM AT 6-5-1802 S AM TO 4 PM FOR THE FOLLOWING1 INSPECTIONS: 1- FOUNDATION TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRANJING 8e PLUMBING 3. 0NSULATION K 4. FINIAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS TATE OF NEW YORK, 'OIJNTY OF . . . . _ S.S �•• • �' • • • • • • • • • • •�� • • • • • • . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of ind idual signing contract) )ove named. eisthe . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) • • • • • • • ' ' ' ' ' said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this )plication; that all statements contained in this application are true to the best of his knowledge and belief;and that the ork will be performed in the manner set forth in the application filed therewith. vorn to before me this . . . . . . . . . .. . . . . .day of.. . ..c.. 19V )tart' Public,?�a, . . ,-A- d County f r` 2 • . Signature of applicant) ri A , rr_ SA 4a�� vnY�r S J 7 I• Q Jo .010 91.q-� } - ,til JO 13#1 FFP mom no MEN no Eno m ON M NEE 0 NONE M � e ; mome MIMM MEMO MMMM$mom mi M 11 mmmmmm ON ME ME MMMMMMI�e � MMUMMM II 11111 MI� ll!lll,IIM iPP� MMI m HE ;f r . PLUMBER CERTIFICATION ON LEAD CO _ LATENT BEFORE CERTIFICATE OF OCCUPANCY �..•`��' SOLDER USED IN WATER SUPPLYSYSTEM CANNOT 7 v,LFr, s�tix s EXCEED 211 ' OF 196 LEAD. OCCUPANCY OR USE,IS UNLAWFUL SoT-i.c. WITHOUT CERTIFICATE OF OCGUPANGY AP R D AS NOW DA a p �Ep ARcy��, FEE SY: �5 c,Z U RGFS. NOTIFY BUILDING DEP w { ' T 765.1802 9 AM TO 4 P FOR THE' FOLLOWING INSPECTIONS.- I. NSPECTION& 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 02.�'�y 2 ROUGH -:FRAM INQ A PLUMBING TF a INSULATION OF NE �► :FINAL.- CONSTI�UCTI.ON Must BE COMPLETE FOR C.O� ALL CONSTRUCTION JH: MEET PROVIDE A�-BCgt 0 ANp/OI� ; THE REQUIREMWNTS OR THE N,Y� STATE .WNSTRUCTI011 s ENERGY 'rNERMAE 3 ( PREVENTING; CODES. ;NOV RESPONSIELE FOR DEVICES:AS Tp PART. 902.6(x) . bESIG'N OR!CON$T#i=ON ERROR' I!Y. STAYS Ult trot CODE. REQUfREs E i , ff cbppev Wit iB.used forwatet dish , i ributing , ' system;pipipg shall be , PLUMBINd ol`ryPii k-idi L!only AIt FLUMBIN WASIT f t . &WATER,IkS NEEd E3TING BEFORE COVERINS ; 1"l o,,(� ESP,-TVA 1'�IYELT I )). 1 ,INN��NA tsLvo IFE�9193 PC Souz Ml t_.Ir� My I I q j' ftHAd W.NY 11963 FORK N06 2 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) W20454 Z Date 9................................... 19. Permission Is hereby granted to: .................... ........ 25.—0. ............................. t a 4 411, IAk'.z .. .......................................... ...... .........I.�-/ . .a-if......^. - atpromises located at ........ ..... ............................... ................................................................................................................................................................ ................................................................................................................................................................. County Tax Map No. 1000 Section .........Jfz...... Block ............. Lot No. pursuant to application dated .... A 9--. fa......................................... 19.fp and approved by the Building Inspector. Fee ...... ... . ............ .... ..... .............................. Ing B Inspector Rev. 6/30/80 „ Oc� FF�(�•CO/ TEL. 765-1802 TOWN OF SO�JTDOLD �c OFFICE OF BUILDIIIG INSPECTOR P.O. BOX 728 %510 TOWN HALL . SOUTHOLD, N.Y. 11971 C E R T I F I C A T I O N tD . APR - 6 ,1992 Date Building Permit No. 2 o L/ 2, Owner �G U ,S -e,- Q ,(please print Plumber 1 I L--'—e (;�plprint) I certify that the solder used in the water supply system contains less than 2/10 of to lead. (plumber ' signature) Sworn to beforo me th ' day of 19 1 N Lary Public notary Public, County JOYCE Puwl%��NNoowY k No. 224,gum Cou Twm 6i* June 12,1 !.' :t� .. w -�. ••• :v .��•�;� l.r.. •_. :� ..1SY �•�'�..1 t��' '',j�� jC � •:�•.�7... w•t•• j( .tr hi.��l�-t• .' _. _ /01 13.5 70 �� 3 ' � GAS -moob .� 1 40