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HomeMy WebLinkAbout23556-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24935 Date MARCH 17, 1997 THIS CERTIFIES that the building ALTERATION Location of Property 26700 MAIN ROAD ORIENT, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 18 Block 6 Lot 17.5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 13 1996 pursuant to which Building Permit No. 23556-Z dated JULY 3, 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 ALTERATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT I. & MARGARET M. SCOTT (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROV11 N/A UNDERWRITERS CERTIFICATE NO. N-408981 - JANUARY 17, 1997 PLUMBERS CERTIFICATION DATED DEC. 12, 1996-KING PLUMBING B ldinq Inspector Rev. 1/81 Foam N0. 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) NO Z / 23556 Date .............. . . ....... .... .................... Permission is hereby granted to 1?" t....... . ......................... ......... ...... X1.1 sem, :a .................................. ................ ,L lr, .. � .... ..:.. ..................... at premises located at .................PI. ... 11l?.f orf... ..wG .Q!J .......................... ............... ..................... .....................................................................................................J........................................................... County Tax Map No. 1000 Section ........... ff.... Block ...5�............. Lot No. ..Z ............ pursuant to application dated .................... ..... ............1 .......... 19..94 and appiroved by the Building Inspector. Fee $•. ... .......... .............. /..... Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 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 - .25C 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date12 q7. . . . . . . . . . . . . . . . . . . . . . New Construction. . . .. . . . Old Or Pre-existing Building. . . . . . (. Location of Property. . . . . .C.�a.Zq?. . . . MQiN . . P�. . . . . . . . . . .© ! :�-:^:)... . . . . . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property. . . �e1reC�. . : . .�C s.:�v . . . . . . . Q i County Tax Map No 1000, Section. . . ! 2 . . . . . . . .Block. . . . . . . . . . . . . . .Lo . . . . . i�:S . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .F/iiled Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No 4�Y:55.1-(. . .Date Of Permit. . 7� . ./ 1�G. . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . HealthDept. Approval. . . . . . . . . . . . . . . . . . . . . . . . .(.Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . PlanningBoard Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Cer 'ca e. . . . . . . . . . . r- Om . . . . . . . . . . . . . . . . . . n Fee Submitted: $ .. . . .�s.� �// . . . . . . . . . . . . . . . _ " " " "' i. . . . . . . . . . . . . . . . . . �,ac .s�26 3 A1�PrxcT-- - I THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1195099 BUREAU OF ELECTRICITY r 85 JOHN STREET, NEW YORK, NY 10038 I Date JANUARY 17,1997 Application No.on file 12927996/96 N 408981 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of ROBERT SCOTT, RT.25, ORIENT, N.Y. in thefollowinA location; ❑ Basement ® let Fl. ❑ 2nd Fl. OUT .Sertion Block Lot Loos examined on NOVEMBER 21,1996 acrd found to be in compliance with the National Electrical Code. FIXTURE RXURES RANGES COOKINGOECKSI OVENS _ DISH WASFIERS� EXHAUST_-FAN OUTLETS RECleTAOES SWITCHES INCAH,fXlM rIIIORESCEM OTHEfl AMT. K.W. AMI. t,w AMT. K.W. AMT. t.W..- AMr. H.r. 6 10 8 6 1 1 1.2� -( DRYERS FURNACE MOTORS FUTURE APPUANCE REOERS SHOAL RWPTj TIME CLOCKS BELL UNIT HEATERS MULTI.OUTUIT DIMMERS ---- AMr. K.W. on KF. GAS H.P. I AMT. I NO. A W.G. I AMT. I AAv. I AMT. ants. TRSYSTEMS ANS. AMr. H.t. NO.OF RET 2 — � � r 3 60� SERVICE DISCONNECT NO,OF S E R V i CLC E AMT. AMr. NR MICU P* 1,e m 1/TV 313W 3,9 �' K*CGeCON,. Of A., CON,. rb,F H4IEG pj'HFlEO 4NO Or NEUTRALS I M nEU t OTHER APPARATUS: PADDLE FAN-1 MOTORS: 1-F H.P. G.F.C.I:-2 JIM SAGE ELEC. INC. LIC.#3635E 350 MARINE PLACE _ - GREENPORT, NY,, 11944 GISMRAt MANAGu: a5 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 credeittiols SFO Town Hall, 53095 Main RoadV3 ze Fax (516)765-1823 P. O. Box 1179 �+- .� Telephone (516) 765-1802 Southold, New York 11971 �`��">itYlY17 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE: Building Permit No. Owner: 6- tJe,-f (please print) / Plumber: AL'vS (pl se print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers Signature) Sworn to before me this jay of 191� Notary Public, u ty CLAIRE L.GLEW Nof¢ry Public,State of New York Old( No.4879~05 Qualified in Suffolk County C Commission Expires December 8,19 ail. ==095 Main =.cac . .79 a!ecrcne51"0'. �:2-:802 Souinctc. 'few V'�7fK "=i' OFF?CE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C ? F T I r I C 3 T I 0 3 DATE - /0 /G SU It_.aa perm.t Nc . �7fSS� ~� Cwner : ( P-Lease Cz kj ceL'L_=T tZcL t:e solder ased _Il t_2e wema= SlieD_'i S JSLam _ont311s less CTcR .nL/ ! eflC . � �111SI1LE�5 J' CR nu:.:1 ?� Swcr- to before me t._s 9 �,L day zfbiz Gv Lac z- _3 � LCc= (2�te OPER Notary Public,Ststs of New York No,4822563,Suffolk County' Term Expire$December$1,1 9 FIELD -MPEGTION REPORT DATE COMMENTS ii ro II II FOUNDATION ( IST) II II , --- --- — ---- -- -- II II C FOUNDATION (2ND)______ --- II/ II �p f�s��,s� � '♦� ROUGH FRAME --_—_-- PLUMBING ---- R-� INSULATION PER N. Y. n — R-____-___ -_-__ STATE ENERGY u u conE tt---------Ili------------- ------- n n 117 II Il < ILII � _ II FINAL. IIIII COMEN====s=-===______�__= ADDITIONAL COMMEN'CS: ea --------------- H H H O x r ca ---------------------------- -------------------------- ro H ENERGY CODE CALCULATIONS (Por Non-ElecLric Beat) Design Criteria 6, 000 Deyree'.Days O.A. UOF S .A. 7UOF FUR: a /' Lv� �Gb�7 PER: pfhby k*n cw 'Cy0V o joi. DA'Z'ED: ) d SUBSYSTEM AREA DESIGN TEIERMEL REMARKS 11 U RATING ExL'erior Wali/s (Opaque) LL b d� "r Z7 Glazing " i3 " 4zv f� _ ,1 e p„e'I Doors Ceiling/Roof (Opaque) 2- Z- �� U O Skylights 8 Floor Foundation Walls Slab Insulation TOTAL T b Notes: Building f:nvelope Systems to meet requirements of: 7015 . 2 IIVAC Equi.pement to meet requirements of 7(315 . 11 11VAC Systems Lo meeL• requirements of 7015 . r2 Duct Systems to meet requiremeuLs of 701.5 . 13 VcnUlaLions Systems Lo meeL requirements of '7015 . 14 Insulation of Piping Systems to meet requiremenLs of 7015 . 15 Service Water L3eaL•ing Systems & Equipment Lo meeL- requirements of '7015. 21 Electrical & LighL-iny systems & EquipmenL- to meeL requirements of 701.5 . 31 To the best of my knowledge, OF NE*). bellef, & professional judgemenL•, L-hese plans are iii compliance with the code. J r 0c W t �(w� Wl { ���/ � 3 765-1802 BUILDING DEPT. INSPECTI®N [ ] FOUNDATION IST [ ] RO H PLBG. [ ] FOUNDATION 2ND INSULATION [ ] FRAMING [ ] FINAL [ ] FIREP ACE CHIMNEY REMARKS; DATE INSPECTOR C72 � 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] F /i►TION 2ND [ ] INSULATION [46";,"F! FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: __�L i DATE j ' INSPECTO BOARD OF HEALTH . . . . . . . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . • . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . • . . . . •• . . . • . • • . . . . . .. TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: 9/ CALL . . . . . . . . . . . . . . . . . . Examined..... . 19�j� MAIL TO: . . . . . . . . . . . . . • . . . . . QQ- !� Approved.. .. 4.... .. 19.l. Permit No. ................................. D ............................. •.. .................................................. ... .. JUN 13s ding Inspector) m BLDG.DEPT. AP ATION FOR BUILDING PERMIT TOWN OFSOUTHOLD rr,, Date. . 13 3t�+x+, 19- .I+ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b- Plot plan slowing 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 application. c. The work covered by this application my not be cc mienced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue 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 UKP M, MME to the Building Department for the issuance of a Building Permit pursuant to the Building lone 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, ordi es ilding , housing code, and regulations, and to admit authorized inspectors on premises and in b uildi :ry nspections- ...... .......... .. ............... (Si tore of �hpp-icmrt•,-- ,---if-a rporation) L?e .-[ (Mailingaddres Ofapplicant) �lQs7 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plurber or builk '?�??�( y-:•-.....y.-..-•.•.-...-.....•....`. .........-..•............... Name of owner of premises (as on the tax mll or latest deed) If applicant is a corporation, signature of duly authorized officer. ......................................................... (Name and title of corporate officer) Builders License No. .....................•... Plumbers License No. •.....................••. Electricians License No. ..................... Other Trade's License No. .................... 1. Location of land on which proposed work will be done............................................... ..•.•...-..•-......"t n0'1 . .�.. ............................. .� . ... ........••..-...... House Number Street }lamlet Canty Tax Map No. 1000 Section .......1.�...... Block ....... ...... Int ...... .f•.`�-... Subdivision ...........................••.......•• Filed Map No. ............... Int ............... (New) 2. State existing use and occupancy of p(reemises and intended use and occupancy ofproposedconstruction: a. Existing rase and occupancy .......y.'��!^-h4-�.`{...... £s1 aC.2..... T.4�.... .....--. b. Intended use and occupancy .................... ........................................................ 3. Milure of work (dwck wliidi applicable): IJew Ruildi+gl ....-./ Auklition .. .... Itepiair ............ ltrniwal ............. Ielmlitiai ......Y... ._ filler Work ...rf��"'''r►�\O�\�... Al llkscr i�ltilxi} y �ti 4. Estinrited CnsC Wool. .-............. fee .......... .................................... (lo be paid on filing this application) 5. If rkaelIini" uxnier of dwelling %amts ...y........ llinler of dwelling units our eatcli floor .............. .. Ifgarage, uxnier of care ...................................... 6. If Iwsiress, coanercial or mi>nxl occupancy, specify nature and extent of eadi type of use................ 7. Diiensions of existing structures, if any: Front_...�? ......... Rear ......... Depth ....... .......... height .......... —.--....... Nudier of Stories .........i............ Dinensiars of sale ___acture with alterations or alditions: Front ... .. Rear ....... depth ._......... Ilei4it .................... N.xdier of Stories ............... 8. )dimensions of entire new construction: Front ... .......... Rear ...2 U ....... Depth .............. 1� \trtti2 Miduer o . Stories .�..--.q....._ 9_ Size of lot: Front ....k�......... Rear .....4�..1.,........ Depth .......?A.. ... 10. Dale of Puurdiase ...M4.(.@A,..__.. Hire of forner Dwner ...V1Skh+t4A.. 11. Zrxre or use district in which premises are situated .............................................................. 12. toes proposer) construction violate any zoning law, ordinance or regulation: ..... ©:.............. 13_ Will lot be regraded .................... Will excess fill be reaxived fran premises: YES �Ce\ 7G'$^l5 M. Nilesof Owner of premises ..•ar. !(. luklress ..A-(PPV -)`OQJQ P-1 one `323^2 .... Name of Arduitect .................................... Address .............................. )lion No. ........ Name of Contractor ................................... Arklress ........ ....... ; ........)tide Flo. .... ......... IV 15. Is this property wid0n 3O0 feet of a tidal wetland? * YES .......... ND ...... *1F YES, Sp(IIIUD MM II(I)SIM; PERMIT MAY 1% FrIVIRI:D. PLOT DIAGRAM locate clearly and distinctly all lioildings, whether existing or proposed, mrd indicate all set-back dimensions fran property lines. Give street and block oodier or description according to deed, and sliot street nares and indicate u,lietler interior or corner lot. ag-o.c" �04 P-t,ulk A`0 1ae G . k�, SfA'N; (N' MEW...YMK, I \ ........ ININIY (N' ..... .. .........�.'X2`B2i'�. ..........beiog duly &nano, deposes and says Owl: he is the spill ivAnt (MFVLB of i+dividuai signing contract) alxrve Iunxxl, Ile is Clic ............ ...........�...r........................ ............,..._.._......._..... (Contractor, agent, corporate officer, etc.) of said c mer or rxmx:rs, and is duly :nthorized to derfonn or have perfon+r_a1 the said work and to nuke and file this application; that ail staLerents coitaiixvl in Lhis aplilication are titre to the lies[ of lois limmledge mal belief; and that Lhe work will lie perfonued in the ironer set forth in the application filed titerewitli. .%torn to before no this .......« .....(Jay of .....� r rkilary 1'ulblic .... ...... .. CLAIRE LMEW (S' ,Iuitore of Applicaot) i Notary public,State of New York No.4879505 Qualified in Suffolk County / Commission Expire9 December 8,19 /�`// 3a1e1, 4hZ - OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICAJE o(; „ �� NEw '` 5 OF OCCUPANCY s 12t W 3`z --_ T UNDERWRITERS CERTIFICATE REQUIRED a ` \ i Lam : , �rL y \ \ LxIS-r routi, r,p-,low Id APPROVED AS NOTED _v 13�. 6 IaL5 L I'L yL6pLf O '`0 _ DATE: B P.q1�� 1 gocw fn rt 151 Ott BY: INOTIFY BUILDING DEPA TMENT AT 2Y 4 au% fFl of �r,W I , 1c[pic 766-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 'SSI ` 'r., _ q�" 1. FOUNDATION TWO flE0U1R ED f ; ply I ♦II v FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING H ^> >! 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. Cfgq� ---- --- - - -- i 0 tZ ALL REQUICONSTREMENTSUCTION SHALL MEET �' THE REQUIREMENTS OF THE N.Y. F qq v', Q �^ STATE CONSTRUCTION 6 ENERGY tri _<-e157 .C1;If LP'I ICI: __ - - . - _ . i p'y 3 CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS CROSS SECTIiSN, I Ai'.evro4 , uy 1 .I r rnt,cH ,+�,r. N. � DPT, PLUMBER CERTIFICATION � wII+DoW guccni�nu a ON LEAD CONTENT BEFOG 10 t\1 PLA &AfIF/CATE OF OCCURA 1 UUNL�TAI "i I «i m —.—•� AI I _� "'/ ;r � 'l SOLDER USED IN N14" —I •�' SUPPLY SYSTEM CA! EXCEED 2/10 of 19f chi � PLUMBING _ I ALL PLUMBING WASTE x I; BI YIMTER I-INES NEED fIAUn1UF^( 72rc TESTING cME COVERING � I Of NEWY r _ --- •�Rek� `'•%moi 2 DC4 W 2 pAOFESSIOH11 _fter qua >TOFWMQ RQ in used vWing d BhBII be OF 1YPes K or L onhf uNDERwRrtERs cExrffM REWIRED �I +j I I v � ____r_--- ---___ - - _ -..- .� _ _—_ I 1 - � � LII _ _--__� II -._ .. - _ 11B t;,"yi �`( r•rt'. ( � 114 /.1 t1, � Lil .� LN,. F , . ' � Y. I Q.ltil �L` L F :. , r. `' ' a'` ._.ply .•-;w- e,.,... .,..a-�: