HomeMy WebLinkAbout25622-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28572
Date: 07/08/02
THIS c~KTIFIES that the building ALTERATION
Location of Property: 9625 MAIN RD
(HOUSE NO.)
County Tax Map No. 473889 Section 31
Subdivision Filed Map No. __
EAST MARION
(STREET) (HAMLET)
Block 3 Lot 21
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 19, 1999 pua~suant to which
Building Perm/t No. 25622-Z dated MARCH 18, 1999
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 REMOVE 2ND FLOOR KITCHEN, ALTERATIONS & WOOD STOVE ADDITION TO EXISTING
SINGLE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to PATRICIA GAPJtBRANT
(OWNER)
of the aforesaid building.
SI/FFOLK CO~ DEPART~ENT OF ~RALTH APPROVAL
N/A
ELECTRICAL c~KTIFICATE NO.
1058136 06/14/02
PLUMBERS CERTIFICATION D~i'~
Rev. 1/81
06/02/02 MARK BAXTER
'~' Authorize~ Signature~
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. 25622 Z Date MARCH 18~ 1999
Permission is hereby granted to:
PATRICIA GARABRANT
10 ALDIN LANE
LEVITTOWN~NY 11756
for :
REMOVE A SECOND KITCHEN AND MINOR ALTERATIONS TO AN EXISTING
SINGLE FAMILY DWELLING AS APPLIED FOR.
at premises located at 9625
County Tax Map No. 473889 Section 031
pursuant to application dated FEBRUARY
Building Inspector.
MAIN RD EAST MARION
Block 0003 Lot No. 021
19 99 and approved by the
Fee $ 75.00
- Authorize~ Sign~ure
Rev. 2/19/98 COPY
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter OR ink and submitted to the buildin
inspector with the following: for new building or new use:
1. Final survey of property with accurate location of all buildings, property linea
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 buildi
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings a
'!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 applican
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-existinR Buildinz - $100.00
3. Copy of Certificate of Occupancy -
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . --~?F~-.. J.7.J. ??Q~ .............
New Construction ........ ~.. Old Or Pre-existing Building .................
Location of Property... ~. ~.~.~7 ............. Z~49~...~. ..... ~,.--~. ~/~.~, ~...
House No. Street Hamlet
Onwer or Ow-mers of Property .~/-~/~.~. .~.~.~,~ff~
County Tax Map No 1000, Section...~.J ......... Block..3 ............ Lot...~.~ ............
Subdivision .................................... Filed Map ............ Lot ..................
Permit No ................ Date Of Permit ................ Applicant .........................
Health Dept. Approval .......................... Underwriters Approval .....................
Planning Board Approval ........................
Request for:
Fee Submitted:
72
Temporary Certificate ........... Final Certicate...w~. ......
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Fax (631) 765-1823
Telephone (631) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATION
Date: ~ ~ ~._~ 2 2 6 0-2_
Building Permit No.
Owner: ~o,-]cvlcl~. Cca. v~va~x Jf
(please print)
Plumber: tt~ot v ¢ ~2)c4 ~Jfq?~
(please print)
I certify that the solder used in the water supply system contains less than 2/10 of 1%
lead.
Sworn to before me this
day of
Notary eublic,,~~x__ County
(Plumb ers Signature)
LYNDA M. BOHN
NOTARY PUBLIC, State of New York
No. 01 BO6020932
Qualified in Suffolk Count~ ..,
Term Expires March 8, 20 ~
BY THIS CERTIFICATE OF COMPLIANCE THE
NEW YORK BOARD OF FIRE UNDERWRITERS!
BUREAU OF ELECTRICITY
40 FULTON STREET- NEW YORK, NY 10038
CERTIFIES THAT
Upon the application of upon premises owned by
= GARABRANT PATRICIA PATRICIA GARABRANT '
9625 MAIN RD 9625 MAIN ROAD
E. MARION NY 11939 EAST MARION, NY 11939
Located at 9625 MAIN ROAD EAST MARION, NY 11939
Application Number: 1058136 Certificate Number: 1058136
Section: Block: Lot: Building Permit: BDC: NS11 '
Described as a Residential occupancy, wherein the premises electrical system consisting Of
electrical devices and wiring, described below, located in/on the premises at: '
Basement, First Floor, Second Floor, Detached Garage, Outside,
was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was
found to be in compliance therewith on the ]4th Day of Ju~e, 2002.
Name QTY Rate Rating Circuit Type
Additional Charges '
detached garage is storage building
No vismtI defects: an elctrical survey has been made of the exposed electrical equpment in the premises indicated. No obvious unsatisfactory
condition was found.
seal i .
1 of 1
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
OWNER
TOWN OF SOUTHOLD PROPERTY RECORD CARD
VI LLAGE
W
FORMER OWNER
LAND
. i0~o
'/660
AGE
NEW'
FARM
Tillable 1
Tillable 2
Tillable 3
Woodland
Swampland
3rushland
-louse Plot
SEAS.
~oo
NORMAL
Acre
FARM
TOTAL
DATE
BUILDING CONDITION
IST. / SUB.
^CR. '~F
TYPE OF BUILDING
LOT
DEPTH
BULKHEAD
DOCK
rotal'
BELOW ABOVE
Value Per Value
Acre
FRONTAGE ON ROAD
FRONTAGE ON WATER
COMM. CB. MISC. Mk(. Value
REMARKS '// '~ ;4¢/",.~00 '~' ' 0"
COLOR
,Idg.
~sion
~sion I ~k f~ 30:
~sion
~zeway '~ I~j J I ~
;ement
Bath
)ors
Place
Roof
:reation Room
)rmer
riveway
Interior Finish
Heat
Rooms ]st Floor
2nd Floor
~ge
o
3.
al
Robert Bohn Con tractin91nc
$outhold,
.7bS-1119
LICENSE # 7541-HI
2/19/99
TO: SOUTHOLD TOWN BUILDING DEPT
53095 MAIN ROAD
SOUTHOLD, NY 11971
ATTN: MR JOHN M. BOUFIS
RE: PAT GARABRANTS
9625 MAIN ROAD
EAST MARION, NY
PLEASE SEE ATTACHED DRAWINGS.
UPSTAIRS:
1. REMOVED UPSTAIRS KITCHEN
2. REMOVED DOOR BETWEEN BEDROOM & KITCHEN.
3. REMOVED DOOR AT TOP OF STAIRS.
DOWNSTAIRS:
1. STI~IPPED PLASTER OFF OF EXISTING CEILINGS & REPLACED WITH SHEETROCK.
2. REMOVED WALLS (NON- LOAD BARRING.)
3. CONSTRUCTED CLOSET IN EXISTING HALLWAY.
4. PUT DOWN NEW OAK FLOORING THRU-OUT HALLWAY.
5. PATCHED SHEETROCK WHERE NECESSARY.
PLEASE CALL IF YOU NEED ANY FURTHER INFORMATioN.
TI-IANKYOU,
SHELLEY FINNE-KEI-IL
ROBERT BOHN CONTRACTING INC.
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] ~AMING [ ] FINAL
[ ~/]/FIREPLACE & CHIMNEY ~
REMARKS..~~~.~.~'~ ~,,'~
765-1~02
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION l ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ].~JLATION
[]FRAMING [ t.,~ FI NAL ~./~'/~"'-'/~--'~. )
[]FIREPLACE&CHIMNEY ~ ~'
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INS~..ATION
[ ] FRAMING [~-~'J~ FINAL
[ ] FIREPLACE & CHIMNEY
R EMAR K S: ~--/~'-/,~*~-=_ ~//~ /~~--~--~
DATE
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUG~.~G~
[ ] FOUNDATION 2ND [ ! ~ATION
[ ]FRAMING [,~"FINAL
[]FIREPLACE&CHIMNEY
INSPECTION REPORT · DAT[~
)UNDATION (IST)
#
II
#
II
Il
II
II
II
II
I!
II
II
II
II
II
II
It
II
II
~I$III~TION P~R N. Y.
STAT~ ENERGY
CODE
II
II
II
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#
II
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II
II
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......................... __==__ ~j~plT!Olta. L, C~S: .....................
/ /- × . -1 .~
FORH NO. I
.... ~ ,~ -- TOI~i OF SOu'r~OLD
Jki~ rED ~ ~"c~'J !~,] TEL: 765-1802
Disapproved a/c ..................................
INSTRUCTIONS
SURVEY ............
SEPTIC FORH ...................
NOTIFY:
.~.~..~..~...<~;~: .....
a. ~his application ,~mt be cu~letely filled in by typewriter or in ink and sul~itted to the Building Ins~ctor
3 sets of pl~, ~e~wate plot plan to _~_~!e. Fee __aeeo__rding to
· b. Plot plm sho, d~ locatim of lot and of buildings m praises, relatio~hip to adjoining praises or public
streets or are-s, un8 givir~ a detailed ~escripCion o[ layeut of property ~mt be dra~n on the diagrm ~hi~h is part of
'this application.
c. The wrk co~ered by this applicatio~ my not be c~,.,..-m:ed before iasum~ce of Building Pemit.
d. Upon ~o~al of this application, the lhilding Inspector vi11 isaue a lh/lding Pemit to the ~licant. Such
pemit shall be kept m the p~e~l=- available ~or inspection throngbeuC the ~o~k.
e. lto building mSmll be oco .ruled or used in ~hole or in ~nurt for any purpose dnatever tmtil a Certificate of
Occt.-~ey shall have ~ ~ted by the ~,ilding ~nspector.
APPLICATI(I/ IS I~tr ~ to the Building ~epa~.,.-nt for the issumme of a l~uilding Permit pursuant to the
Building ~-<~ Ordlnsnce of the To~ of Southold, Suffolk County, ~ York, and other ~e,21icuhle L~s, Ordirumces' or
Regularly, for the _c~mtruction of buildings, ,~8itions or alteratiotts, or for L~..,~al or demolition, as herein
described. ~be applicant _~ees to ~t?ly vith all applicable laas, ordi,umces, building code, housing code, and
regulatiet,% and to ua~it mthorized inspectors tm premises and in building for neceeat~ry inspections.
..........
(Signature of ~yplic~mt, or ~lf a~cor~o~ rati.~)
. .....
~[~OlR£O o~aili~g -~ess of applic~t)
~~~..~~.... ......... ,. ..........................................................
o, --, o, ........................................................
(as on the ~ax ~oll or late_~t
/
If applic~ i~'a eorporati~, sisaalj~re o[ d~l~
ON LEAD CONTENT BEFORE
'~t CERTIFICATE OF OCCUPANCY
~,~, Li~_~ ~ '7,5 z./ /_ /4_/_/_/_/_/_/_/_/_/_~- SOLDER USED IN WArER
.......................... SUPPLY SYSTEM CANNOT
P~=, u~- ~o ......... . ................ EXCEED 2/10 of I% LEAD.
Eleccrici~ Li~ No ......................
Other Tr~'s License Itu .....................
I. location of l~a on ~hich ~oposed vofl~ vi11 be d~e ..............................................................
..... ..... ..... ...................................
Bouse l~r~er Street l~let
Co~ty Tax llap ltD. 10O0 Section ................ Brock ................ Lot ................
Subdivision ...................................... Filed Hap 1~ ................ Lot ...............
$ existin~ use ~na oeo of Pr~'ses and mt'~t~,use ~ .,~' .-~tlon'
2. tare __ ~
,. ~,,,~ ~ -~ ~.-~ ...... ~-- 7j.,..~:..~.../~...'..~.~. ~T ~~;,- ~ .............
b. Ilat~~! Lt~ m~4 __~:o~_ ~ancy ...... ~ o ;.-' ....... ~ ...............................................
PLOT DIAGRAH
Locate clearly and distinctly all buildings, ~heth~r existing or proposed, ~d indicate all set-back di~msions
p~,~erty lines. Gi~e street ~d block ~m~ber or d~scription __~cco~ding to ~c5, ~ ~ street n~es ~nd indicate
~l~ether interior or corner lot.
o[ ~id mr m mrs, ~ is ~ly ~ri~ to ~rbm or ~ ~rb~ tim ~id ~ ~ to m~ ~ [ile this
*~lieatim; ~t all star--ts =tai~ in ~iu *",Ii=tim m t~ to ~ ~st o[ his ~1~ ~ ~lieli ~
flint ~ wA viii ~ ~rb~ in tl~ ,,~,.~r ~t Mth N ~ ~llmtim [il~ ~t.
~m to ~[om m ~is
................. ~ ~e~ ..... ~7..,,...:$~. ~ ~ ~ ,
~T~ PU~C, S~of ~y~ ,.
~ OlST~I~.~~
T~Ju~.~'
~ )
.)
I~tFPA Minimum Clearances
P'or Safe Installation
slove pipe
non.combusQb!e %v:]j
stove pipe:, crimped c::d d.av.,n
non'combus:ib!e floor prolection
........ . Corn bu.stibles A. [.isled 'Wood Heater
Side, [ack 36"
Top 36"
t~. Single W.-:II Cannectr; Pipe 18"
(24 gau;~c or lm~v~cr)
C. Chimne~ llcJ~hI 3 ~eel hi~hcr Ihan tool;
2 loci higher lhan any ~arl of roo[
wilhin 10 fctt (mca:uteri horizontally}.
~,Vith 3~.~' masom9, wall or 2.1 gauge
sbt rectal with l"airspace
12"
12"
CHECKLIST FOR YOUR CHIMNEY
PROJECT
LXI~L'LATED CHI.~L"I Eli' PIPE
3' LE.\'GTH
6' L~X'GTH ITl)) __..
5C° INSULATED ELBO~,S IT-EL3~ __ . _
WALL SUPPOIJV KIT LT-WSK) . __
FIKISH SL"PPOgT IT-PSP) __
FL'~I.SH SUPPOBT (T-~m: __ __
ROC~,'~ TOl' (T-C~.. __ _
ANCltCR PLATE ~T - _.M~, __ . _
2."t 2 TO 6:t~ ....
AI~L~I'ABI.£ FLASI'ING (T-.AF ;2:
sro~.~ COOl. AR (T-SC) ....
~ ~'Igl';'l'~L~t COLt,AR [T-TCS) .....
RI~ ~3P;XVALL SlT~CER (T-W$.~ .....
TOTAL ....
II SELKIRK
~,METALBESTOS AN r. I~
P. O. ~ 372, ~ampa, ID 83653-0372
AOfOIb ~;I 5;90 c 19~O SELKIIIK ME T.,M ,B,~Sll)S.!
SELECTING THE RIGHT
CHIMNEY SYSTEM
Masonry Fireplace using a
Chimney.
The chiraney for >'our fireplace or stm.~ will
ptubably take one of the following configurations.
Each of these chimney s3,~ems requires a different
com~inafion of parts to complete a satisfactoD'
chimney assembl): These fittin~ are illust[ated and
lal~ed for your convenience. It is important Sat
)~u have the correct combination of parts and
sul~ient chimney pipe before you start
in..~al~ion. Be sm'e to lead and follc~' the inatruc-
tions afilfi ~x~ur fireplace or stm, e for any spedal
chimney needs and other installation requirements.
~ ON ell~l~l£V/s~Ol~ ri',- ~ONNIK'nON$
~ tl~ shaw Model ~ Chimney system5 ~onnecled to
~ double waJI smoke ~pe using the .~&Mel I~ Chinmey
HOg Adapter pa~t. Model S$]] Chin~e~ m~: bc connected to
singte ~all stove pipe using the IMples$ Smoke Pipe Adapters.
W..00~ ~ with chimney offset to avoid Basement Heater with Tee-suppo
Fr~er,,.. ~ .k~/(r'AF'lO'tr'/~r'~'~ Chmsp~/ '~ l '--
'*"'-""-"-"" ,,. *'""' ":"X Iq
' .... 'V-I!;
SELECTING THE RIGHT
CHIMNEY SYSTEM
~ chimney for)mr fireplace or sto~e will
~ly ~ one ~e foll~ wnfi~mtio~,
~ ff~e~ c~mney ~e~ r~s a ~nt
combinafi~ ~ ~ complete a sat~fac~
~ ~emblg ~ finin$ ~ i~ustr~ ~d
a~ mr~ur minuend. It ~ impo~nt ~
~ve ~ co~a co~i~ ~s and
~t cn~ney ~ ~fom ~ ~
~fim. ~ ~ m ~d and gl~ &e imtmc-
t~m s~vur ~a~ om~e for any ~c~
c~y ~s ~do&~i~m~ requ~.
NOTE ON CHII~I~V/SMOI~ lq~E CONNECTIONS
Most diagrams show Model ~ Clinmey ~tem.s c~
,~n~e wmi st~ve pipe ~n~ fl~e l~ipleu Smoke Pi~
Masonry Fireplace using a Model SSI!
Chimney.
Solid FuelA
a short vertt
ppllance with
:al ddmuey.
Wood He~e£, with its chimney
fluough an upstairs enclosure,
Wood StOVe with chimney oflE~e~ ~o avoid
rid~.
:'-"~." ,, i~q
Basement Heate~ with Tee-supported
outside chitonS.
~acaflon A-Fra~ne with its cbt m~
on a.q~ep pitch roof.
FMm~q
Combfna~ou of Purnace and
WaW He~r on onethlnmey.