HomeMy WebLinkAbout23551-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25649 Date: 04/16/98
THIS CERTIFIES that the building ACCY
Location of Property: 895 JASMINE LA SOUTH/PEC
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 69 Block 3 Lot 24.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 12, 1996 pursuant to which
Building Permit No. 23551-Z dated JULY 1, 1996
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 AN ACCESSORY GARAGE IN REAR YARD AS APPLIED FOR.
The certificate is issued to FREDERICK R WEBER, JR.
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. PENDING 04/15/98
PLUMBERS CERTIFICATION DATED N/A
Building Inspect
Rev. 1/81
FORM NO. f
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)
No23551 Z Date ............... ......... ../......................
Permission is hereby granted to
........... ..........
........... ..... ..........................
at premises locate at
................... .. ...5 .. ...........................
.........................................................................//........................................................................I..............
County Tax Map No. 1000 Section ...........4 .. .. Block ........�........ Lot No. .. .7�..(..
- / p
pursuant to application dated ................ . . ...... ..�7. 19.,1 and approved by the
Building Inspector.
C;,>�j�0
Fee $4.6ji................
..1..:. ..... ... . ... ... ...........
Building Inspector
Rev. 6/30/80
Form No. 6 -
5_5_v 72
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802 NPR { 6
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 buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
6. Submit Planning Board Approval of c6mpleted 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 Buildin¢ - $100.00
3. Copy of Certificate of Occupancy - .251�.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
. .
Date lj?Ia s. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
New Construction C'�` �' 0ld Or Pre-existing Building. . . . . . . . . . . . . . . . .
Location of Property. .Rjf . . . .. . ...q?�! W lwe [.-A Sov'CKO�
. . . . . . . . . . . . . . . . . . . . . . .
House No. Street Hamlet
Onwer or Owners of Property.. . . . . . . . . . . .``II. . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. .V�.Lsgq.O.Block 03 ,��. . . . . .Lot. Q:'A ,00 . . . . . . . . .
Subdivision. . . . . . . . . . . . . . ... . . . . . .. . . . . . . . .. .. .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
Permit No.2355.177.Z. , , ,Date Of Permit. . . . . .. . . . . . . . . .Applicant
Health Dept. Approval. . . .. . . . . . . . . . . .. . . . . . .. . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . .. .. . . .. . . . . . . . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . X . . . . .
Fee Submitted: $. ..ZS:^'-: . . . . . . . . . . . . . .. . . .
. . . . . . . . . . . . . . . .
APPLICANT
Rech 5` 303
M-1802
BUILDING DEPT.
NSPECTI®N
[ OUNDATION 1ST [ ] ROUGH PLBG.
] FOUNDATION 2ND [ ] INSULATION
[ J FRAMING [ ] FINAL
[ ] FIREPLACE & IMNEY
REMARKS:
DATE INSPECT
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE '
8070668 BUREAU OF ELECTRICITY
F 40 FULTON STREET, NEW YORK,NY 10036
Date APRIL 23,1998 Application No. on file 15825898198 H 059590
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
FREDERIC WEBER JR. , 395 JASHIE LANE, SOUTHOLD, NY
in the following location; ❑ Basement ❑ Ist FL ❑ 2nd Fl. GAR Section Block Lot
was examined on APRIL. 15,1998 and found to be in compliance with the National Electrical Code.
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS 11EWDCSCENTJ FLUORESCENT I OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS I SPECIAL REC'PT.j TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
AMT. K.W. OIL H.P. GAS N.P. T.AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMH NO.OF FEET AMT. WATTS
SERVICE DISCONNECT NO. S E R V I C E
METER NO.OF CC CONa A W G. A.W.G A.W G
AMT. AMP. TYPE E61UIP. 1 0 2W i 0 3W 3 0 3W 3 0 CW pER 0 OF CO.COND. NO.OF HI-LEG OF HI-LFG NO.OF NEUTRALS OF NEU1RAl
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.
FREDERIC WEBER tdw L 2,
895 JASHINE LANE
SOUTHOLD, NY, 11971 GENERAL MANAGER
11
EPer
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.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
765-1802
UILDING DE
INSPECTION
[ ] FOUNDATION 1ST [/IFIINAL
OUGH FLOG.
FOUNDATION 2ND [ SULATION
] FRAMING [
[ ] FIREPLACE & CHIMNEY
REMARKS:
p"7,. _
DATE INSPECTOR
=�o��gUFFO(,�coGy�
Town Hall, 53095 Main Road
P. O. Box 1179 y Z Fax(516)765-1823
W Telephone(516)765-1802
Southold, New York 11971 cp •
4,ol
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
March 9 , 1998
Frederick Weber
895 Jasmine Lane
Southold, New York 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.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984 ) .
BUILDING PERMIT #23551-Z GARAGE
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
R
FIKLIF INS'f,ECTION REPORT DATE COMMENTS
11 1 b ^
0 1
u._
FOUNDATION CI T) n II
I �
II �
FOUNDATION ND) It
n
ROUGH FRAME S ' It
J1---------- ----------------------- lb
PLUMB ING l JI------------------------- — /I
II '
II 'I N
INSULATION PER N. Y. It II ca
STATE ENERGY
CODE u-------��------ -- �'C
_ u -_6
A------ ��-------- -----
_________________________
II
II II
II
II � cJ
FINAi. n n
)44
_-- --______---- O
—ADDITIONAL. COMMENTS:
Lu
z
a
r
---- -- -----------
i
• IIj
. ASM/NE
SURVEY OF
`IDLOT 1
m�a~ "MAP OF SOUT! O-I D !/a'LAS, SFCTICW TWapo
-
N U'u
2ps 0p.-�. 9° A T SOUTHOLD
�. o TOWN OF SOUTHOLD
fZ 02
T - _ ~ SUFFOLK COUNTY, N. Y.
1000 - 70- 01-P/D6
Scale: 1"= 40'
L , a Mar. 15, 1993
nor � Q*c_ ,. o � •\ � . u_ r.. . , "-.,F:. .`... ..ifGf,�:;cyT
41
n
Z07-
ti 3 O ti �p. O ..
_• �. Cd
r^ Nt•,l�os r4. �
cCni�. i p !h
f• h � � 99lGLE FI,11L.X MUM ONLY
N/O/F re0 00, M01W DA
THREE YEARS TE OF APF' 01
AZOW yRt -- � 1993
The locolions of we9s and cesspools CORP - ,S•C.
shown hereon are from field observations AREA = 17,661 Zq ft. f,6Qjl SrT �
and or from dols obtained from others. - B'ICE �ptE�F I'L,YL•
FFOLK COUNTY DEPARTMENT OF HEALTN SERVICES The water supply n-•I s.wno- dioposal
rOR APPROVAL OF CONSTRUCTION ONLY systems for this r.tld�nro •'h, cwdorm N�jF
!o the standards of 1 hn ctd,nq County
rtF� 3 0 la�.l Department of Health Prepared in accordance with the minimum
standards tar title surveys as established P C
by the L.LA.L.S. and approved and adopted PECO
4 EL EVA rMS ARE RErFREACEO (, p / t l %. i• r`111L( tar such use by The New York Stale Land fSlBl 7
TO AN ASSWED DATUM. f1/�1�-r 1•r- r• ' ' ;I Title Association F. O. BOA u�
novEn MAIN ROAD
,_ SOUTHOLD, ,N.Y. 11971
;ruin roux)UA;t,'.t1�1I4 Alm N0. 1 �3 SRTS OF PLANS . . . . . . . . . . n . .
•$.1 " .__ L"-FOACdN''*U'1'NoLO �^IIRVRY : : . : : . . . . . . : . . . . . . . . . .
nrNtq !.:I(FIFi i M�lhPAE'fttENT CIIRCR . . . . . .. . . . : . . : . . . . . . . . .
(Il gni;.i4i.f vlaJA.1.]'( N HALL SEPTIC FORM . . . . . . . . . . . . . . . . .
SOI/TIIOI.TI, N.Y. 11971
TGL: 765-I1102 NOTIFY-
�
/� CALL , 5P� . . .�
Examined... ... ..., 19.`.I& Permit
"All. TOt:J.,Ct:M' [3�. . . .
Apnpcoved ./.. 191/ Pe[miYNof/).✓✓//11 � .......
llisapp a/c .......'................... ...................,..........
......................................................
. ..... . ....... ....
ilciirg Inspector)
`' AP CATION FOR BUILDING PRRMIT
l�N p 4v1 SS1oNS:. iV GC 1 F ' Date. . . . ?� . . . . . . . . . 19 `
�1�EOErc.�c1� wE13�(Z 4CEP1=R �
INS'T'RUCTIONS
�i �1Z-3245
n. Thin application mist be coapletety filled in by typewriLer or in ink and solmitted to Lite landing Innpectu
3 sets of plans, accurate plot plmn to scale. Fee acatrdhg to schedule.
b. Plot plan slxn+ing location of lot and of buildings on pronfres, relationship to adjoining premises or rxWIE
streets at areas, and giving a detailed description of layout of property must be drawn on the diagram vbich is part
this application.
c. The work covered by this application may not Ile conseo:ed before issuance of Building Permit.
d. Upon approval of this application, tine Dodding Inspector will issue a Ikrilding Permit to the applicant: W
permit Omit he kept on the promises available fur inspecLioo th"mol ut Ute work.
e. No building stall be occupied or vwed in wix>le or in part for any purpose whatever until s Certificate of-
Occupancy stall leave been Wonted by Ute Building inspector.
APP1.ICliIM IS IEWBY WUi to tine building Department for the issuance of a fkrilding Permit pursuant to l.he
Iknilding Tote Ordinance of Lim Town of Southold, Suffolk County, New York, mxl other applicable la", Ordinancesor
Re ulntiona, for lite construction of luildingn, mWitiam or niterntiots, or for removal or nkmolition, no Inerein
described. The applicant agrees to coa{dy with all opplicobte laws, ordinances, building code, lxuslng cock, and
regulations, and to mlait authorized inspectors on premises and in building for necessary Inspections.
.. .14....(!.l!iCY.'k................
(S. ,mhsre of �plicrmt, or nave, if n corporation.
(Miling address of applicant)
State AwLber applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plunher or lui
flp�%V;ANX ...I..�....Gu-?N. R ..........'.I................................................I..............
Nare of owner of premises ...Eb:'4tl���Ck...�..WA4.P K� ...............:............I......................
(as on the tax roll or latest deed)
L
If applicant is a corporation, aignature of duly autlarized officer.
.............................................. pa W
(Mane mx1 title of cori)orate officer)
g:.
launders License No. ......................... j 2 Coati Li 1-
Pludnero License No. ......................... NBLD
(i.T7EAi, i
Rlee-Lriclans License No. ..................... $O OLD
Other TYnxle's License Mb. ....................
I. IncaLlion of land on wtnidn proposed work will be drwue....'.�.�t. ....�A .L ......�-^. .:...... 4V.
�.V.......1A.9.11..........................................................................................
ikuse Mkrrber Street -•///kS Ml l N6_ nA � Ilamlet}} So.t T n1 oLt'
Comty Tax Map No. 1000 Section ....�.6ft. (Hock .........:]...... Lot .....,�:�� ltA .
Sulxfivision
.........:............................ tiled lisp Na: ............... Lot ...............
(flame)
2. State existing use and occupancy of premises and intended U.se aril occupancy of proposed construction:
a. Existing use and occupancy ..............................I.......:
b. Inteoied use and occupancy ....klcf E. .........:..............................
p.
3. Nature of work Wieck wltidi al'4Aicable). Ckxr Ikrildhig .10 A.klitino .......... Alteration ......... .
RalwiI. ............ Hatteval ............. DawlILIot ..........., Other Wit: ........I.........................
��• J "� `1 ................... (llsscripkion)..'.,
`J 1lutiwated Cast ..,...�.✓,.�,v,......... fee ,.......
(tn ire paid tui fi)irig this al.4ilication)
5. if dimellingr mailer of haeljing tants ............ Umber of il.elling resits of earth floor ................
Ifgarage, ixaler of cars ......................................
b. It Imaiess, camiercial pr mixed ocragwricy, specify rwture rail extent of each type of use—, ........
7. llhieasiorw of existing atrrncnires, if any: Frorc................ hear ...I.... ... ..., Depth .................
height ........7................ Nrd,er of Stories ......................
Dimenatoa of sane scruccure with alteraciona or arklitions: lrro.r ............... Rear ...............
Depth .................... IIaiijX .................... Umber of Stories
R. Divanurinw of entire, new construction. trrott hear 11epth
IILJLJit ......................... Mricer of Storles ........ .............
9. Size of lot. ltrort ......I.............. Itear .................... Depth ..............:.....
10. bate of llrrdwse .......... ........... Haw of Vanier Omer .............•......... ................
11. 'Lrxw or use diatrlec In WIWI pruulaeu are aittwceil t............................................................
12. Does prolurseil eowtriwtion viglare wry uxring IL.Q. ordinance or regulation. ........
11. 11111 lot he regraded ..................... will excess fill lie rairn.ed frau praaiues; m 1X1
14. Mmlo a of iknwr of prrsaises ........................... lnxlress .............................. Pixie Ino, .........,
Mule of Ardiltect ......•r• ••,•.,•..........:•..... Address 1ltone lb. ....
t
Nnlrie of Coprracror ................................... MWraso .................,.............lion lb. ..........
15. ,lu this property within 3N) feet of a tidal wetland? 'A. VM .......... 1X1 ..........
Alit YM* t.Y1 ni"D 71711"I 'lldisi 3S PLIwa MY Im isapPlt191.
vw'r 111AC.RAM
Incace clearly aril diatinci:iy all lurlldinge, whatlwr existing or propased, and indicate fill aeL-beck djwenninou
frau property lines. Give street aril blotto nater or description according to .lead, and slim street rumen and lndicata
idetler interiar or toner lot, _
tJ
!iTATE 111. HIM YORK t SS
COUNTY Ott . . . . . , . \�� . .
........De-( ........... 1wing Aily oworn, deposes and says that lie is [lie applicant
(Pkat of inlividaul PIRA a C.cxlfrtlsi)
alxwe tusm'd, .
dk: is Ilia ........ . ., ....6 W�r-......... . ........
Wma ract'or, agent, corloruce officer, etc,)
of said wrier or niters, and in ikily aialxrrixetl to perform or Iwve perfonaed the said toric ant Co tuake a,d file thin
aiglicacim; that all atacwrent4 contained In this atililication are trte to the Twat of his knowledge and belietj sal
iliac ilia wnric will iia perforued in lie manner set forth in tie mpplicutior filed tierewicli.
Sworn co liefora cue thin
19...............�� ' ;tr. .lay of ....... ��.......... > ....
rrtte,�.
Ric iaa' rxxRf�PERT1.SCOTT,A
{ NOTARY PUBUC.St Y.
D Ma 4725089.Sttifoik ;.... .... ..• v ;•••. ... ............
Term Expires May 31,
°. r
0c�
OUPANCY OR
US IS UNLAWFUL
I vee.,�o
f
''';`FT'UCUT CERT'IFICATE +
J11 OCCUPANCY
— -- ------_,- -
I I
mPngtoveo as VT .ri ° 1
TF 13 PA
FBF fg1l�GBY,
CEJ:
NOTIFY BUILDING DEP " 1E
I2 T+;Cf'Cy 765-1nn2 9 AM TO 4 P� FOR THE
O�- FOLLOWING INSPECTIONS y
1 FOUNDATION - TWO REQUIRED
- FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING -
I
j S. INSULATION -
- ! 4. FINAL - CONSTRUCTION MUST .
i BE COMPLETE FOR C.O
ALL CONSTRUCTION SHALL MEET _
I THE REQUIREMENTS OF THE N.V.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
j ! DESIGN OR CONSTRUCTION ERRORS
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CCAzxG , q .�I1 MIN i-F " POV CONICPETE >
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