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HomeMy WebLinkAbout16819-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17432 Date OCTOBER 20~ 1988 THIS CERTIFIES tkat %he building. ADDITION Location of Propert~ 19855 MAIN ROAD ORIENT House No. Street Hamlet County Tax Map No. 1000 Section 17 Block 1 Lot 11.4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 7, 1988 pursuant to which Building Permit No. 16819Z dated MARCH 15~ 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 SECOND STORY ADDITION OVER EXISTING ATTACHED GARAGE. The certificate is issued to C.W. THOMPSON (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 7/25/88 N039273 MICHAEL DAWSON Rev. 1/81 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) N°_16817 z Permission is hereby~rartted to' .~.~.~.~.~...7~....~ ........................................... ,o~...~.~.~:.;.~...~..~~..~..~... ..... ~"'"~"'"~~'"'~:::::"'~ .......................................... : .......... i ........ at premises located at ...... x..~...v ........ :: ....... ~.~;......'.~-'~ ................................................................ County Tox Mop No. 1000 Section ........... ../,..,~,. .... Block ................ ... ',~g Lot No. ....... ./../,~, ~ ..... pursuant to opplication dated ..... ..~.../~.. ...................................... , lg.~.g~., and approved by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y, 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ --- to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3.Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5.Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic .features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certif~cate of occupancy New Dwell~ng.$25.O0, Accessory';S10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 NewC°nst;z'ucti°n ...... OIdorPre-exisdngBuilding ............ Vacantkand ........... .. Hou~ No. ~;tre;t ............ /Yam/et Owner or Owners of Property Co gJ , County Tax Map No. 1000 Section ....(~, .I,~.. ..... Block ...... t Lot. Subdivision ................................. Fired Map No ........... Lot No .............. Health Dept Approval Labor Dept Approval Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .... ~ ............. Construction on above described building and permit me~ts all appticable, cg~s ancJ~e~d'rations. Z'- '- .... .^ ~ , Applicant ........... ~ /~-'~-'~."''~ ~ m d c, '-'";,7 ' .............. ............. Rev. 10.10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. Owner C, ~-~, 7~/+0'~ ~~/~'/ (please print) Plu~er ~/~ ~ ' (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber' s signature) Sworn to before me this ,~.~/~day of ~L/c; , Notary Public,~c~J~O~. // County Notary Public UNDA lC DAWSON No~W Pu.b, lic, State of New r~o. 4694688 T Qualified In Suffolk Cou~tt~f ~- ~ erin Expires March 30, 19 TOWN OF £OUTtIOLD OFtqCI'.' OF BUILDING INSPECTOR P.O. BOX 728 TOWN IIALL SOUTIIOLD, N,Y. 11971 July 6, 1988 TEL. 765-1802 R & R Home Improvements & Building, Inc. Box 676 Greenport, N.Y. 11944 Re: C.W. Thompson To Whom This May Concern, We are unable to coalplete your Certificate of Occupancy because .of the following reasons. /_-/ An application for Certificate of Occupancy is not on file. /~/ No Underwriters Certificate on file. /~/ Thc check i::(outdated/not ou file.) /~/ No Health Dept. Approval on file. /-~/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit t~ I 6 8 t 9 Z Duildlng Dept. **~/_~/ Ho Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME~// .PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDIT%ONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST I- ] ROUGH PLBG. FOUNDATION 2ND [ ] ~JLATION FRAMING r//] FINAL REMARKS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST ~- ] ROUGH PLBG. FOUNDATION 2ND ~NSULATION [ ] FRAMING FINAL DATE _ ~////~//~r(~/ / INSPECTO~ 765-1802 BUILDING DEPT. INSPECTION ],FOUNDATION 1ST [ ~ROUGH PLBG. j FOUNDATION ZND [/~ INSULATION FRAMING FINAL DATE~ "~/'¥/~ /(~ INSPEcToR~',:~~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ~ ,~OUNDATION ZND [ ] INsuLATION FRAMING [ ] FINAL REMARKS: DATE, INSPECTOR THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ B5 ~HN ST~. ~W Y~K. N~ YORK 10038 ' ~ THIS GEKFIES ~AT ~WESII.~:Y I'HOHPSON, HAtN ROAD, /POIE ~Ot [, OH[~:NT, N.'(. :-::::' ENERGY CODE ~:'~ : . :. 1) ~T!NG ~P~ ~ ~ 7813.23 - 75% ~F. 2) ~TING ~OLS ~ ~ 7813.13 ~ 45 ~ 75 D~ F~IT. 3) ~T~ ~TING P~ 7813..31 ~U .38. 4) PIPE iN~TI~ 7813.19 5) ~ - ~LE ~S. 6) ~N~U~ION ~ ~ N.Y.S. ~ CODE. BOARD OF HEALTH :~.... FORM NO. 1 TOWN OF SOUTHOLD ' BUILDING DEPARTMENT SEPTIC. FORM .............. TOWN HALL SOUTHOLD, N.Y. 11971 , TEL.: 76~-1802 CALL 7;:'~ ~ ~'~'  MAIL Examined ~ 19 ~ = ...... - Approved ................ ~J 19~gPe~it No../k~(.7..~ .............. -llll Disapproved a/c ..................................... - ~ ~ ~''~ ................................................ ~ ~ TOWN OF,gOU~OL~ APPLICATION FOR BUILDING PERMIT Date..~.~..~ ...... 19~ INSTRUCTIONS a. T~s application must be completely filled in by Wpewfiter 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 pl~ showed location of lot and of build,ds on premises, relationship to adjo~ing premises or pubUc streets or areas, and giv~g a det~led description of layout of prope~y must be drawn on the diagram which is pa~ of this appli- cation. c. The work covered by t~s application may not be commenced before issu~ce of Bu~d~g Permit. d. Upon approval of this application, the Building Inspector will issued a Build~g Pemit to the appRc~t. ~uch pemit shall be kept on the premises ava~able for ~gpection throu~out the work. e. No build~g shall be occupied or used in whole or in p~t for any purpose whatever until a Ce~ificate of Occup~cy shall have been granted by the Building Inspector. ~PLICATION IS HEREBY MADE to the Building Dep~tment for the issuance of a B~lding Pemit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, ~d other applicable Laws, Ord~ces or Regulations, for the construction of build,ds, additions or alterations, or for removal or demolition, as here~ described. The applicant agrees to comply with all applicable laws, ordinances, buQd~g code, housed code, and regulations, and to admit authorized ~spectom on premises ~d ~ build~g for necessa~ inspections. (Signature of applicant, or name, if a corporation)~ . .. 7h ' (Mailing address of applicant) State whether applican, t is owner, lessee, agent, architect, enCneer, general contractor, electrician, plumber or builder. ........... [3.,,. . ,. l b. e. .~. ........................................................................ Name of owner of premises . ~.,..~...-...'~.O 1¥~.{~.O/O ............................................... (as on the tax roll or latest deed) If applicaX~ is a corporatl~n,~gn, atur~,o~duly authorized officer. ALL ~CTOR.,,'~S }(IUST B?~i~SgFFOLK COUNTY LICENSED Bui~er;~[i~se No.. Plumber's License No ....... .~..(?.~.. Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ........... , ................ ~ ...................... ...... .o ........ .................. House Number Hamlet County Tax Map No. 1000 Section ..... ~. J..~ ....... Block .......... ~ ....... Lot .... .~. }1, ¥ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... t...~.~-'3, o[ ...... ~..~. ?. -~.- · ......................... b. Intended use and occupancy ....... [....~..~..vY~.. t .~.~ ..... .~..~..$).~..~..~...t~ ..~,..W/;z0~..~ ~.~.~, ..... 3. Nature of work (check which applicable): New Building ' .. Addition .......... Alteration · I/...... Repair .............. Rem6val .............. Demolition .............. Other Work I (Descriplinn) 4. Estimated Cost ..... , ....................... Fee ..................................... ~' ' (to be paid on filing this application) 5. If dwelling, number of dwelling ~nits ......... ~, ..... Number of dwelling units on each floor.. ~ ...... If garage number of cars ~ '"- . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... 7. D]menmons of existing structures ~f any: Front ............... Rear .............. Depth .............. Number of Stories Height ...................................................................... Dnnenmons~a~c'"~t~ru~elure with alterations or additions: Front ................. Rear ................. Depth ~ Height Number of Stories "-8. Dimensions of enti/e new construction: Front:::: .~:~.~..~: Rear .... 5T ..... Dept.h ... :7. ~:! ...... Height .... J..'Z.. ....... Number of Stories ................................. 9. Size of lot: Front ....... ~.<z3~..~ ......... Rear ...................... Depth 10. Date of Purchase ........... -- c; .-....'~..~.lC...V~..~.... Name of~Former O~wner ......................... 11. Zone or use district in which pr~mises are situated ..... ~.'~..~.~.g. ¢..~W~...~..~... ' ' . ............... 12. Does proposed constructinn violate any zoning law, ordinance or regulation: ...'.~..O. ........................ 13. Will lot be regraded ......... i ................... Will excess fill be removea~ from premises: Yes No 14. Name of Owner of premises .('.,.~.:..'~lJ~o I~,~(~$.o.~... Address lYIngS..1~....~}'l~,.~.~. Phone No.. ~.~-~ .'T..~-.~.~/.'-- Name of Architect ......... ,~ ..... ; ........... Address .................. Phone No ........ Name of Contractor l~ ~ ~... 'i ~¥' ~.0 ~ ....... Address ~...0.: ~.#)q .~. '~ {;.. ~/~ ,. Phone No. ~.~.. ~/.': I ~i i 15. Is this property located iwithin 300 feet of a tidal wetland? *Yes ..... No ~ ' · If yes, Southold Town TrBstees Permit maybe required. i 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. STATE OF NEW YORK, ! S.S COUNTY OF ................. ~ ............................ , ................... being duly sworn, deposes and says that he is the applicant (Name of individual sigfling contract) above nam ed. He is the ..................... ~ ................................................................... i (Contractor, agent, corporate 9fficer, etc.) of said owner or ow~ters, and is duly authorized to perform'or have 'perfonned the said work and to make' and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the mann0r set forth in the application filed th.erewith. Sworn to before me this Notary Public ....... z~-~..~q..~ t~ffZ/d~. ·-· .... County ' ! fl£tE~ K. DE VO[ ,, -k ....... - NOTARY PpBLIC; Stste o! Hew Yog ~t) Ilerm Ex,res March 30,19-,----/ 1 GENERAL NOTES, 1. CONTRACTORS WORK 2. 4. 5. ! I ,-6 OCCUPANCY OR USE IS UNLAWFUL RF.~UlR~ IS TO CONFOR~ TO ALL LOCAL ORDINANCES AND NEW YORK STATE BUILDING AND ENERGY CONSERVATION CODES. LATEST EDITION ELECTRICAL AND PLUMBING WORK SHALL BE COVERNED BY ALL NATIONAL, STATE AND LOCAL CODES. LATEST EDITION CONTRACTOR SHALL VERIFY ALL FIELD CONDITIONS AND DIMEN:;IONS, COOPERATE WITH OTHER TRADES AND COMPLETE THE WORK IN A~CORDANCE WITH THE BEST STANDARD PRACTICES. AIL DIMENSIONS ARE NOMINAL AND TAKE PRECEDENCE OVER 8GALE. ( DO NOT SCALE DRAWINGS ) ALL ABBREVIATIONS ARE STANDARD. ALL ITEMS OF WORK ON THE DRAWINGS ARE NEW UNLESS 0T~ERWISE ~NDICATED. WITHOUT CERTIFICATE OF OCCUPANCY APPROVED AS NOTED NOTIFg St~fLDli',lG DEPAE'~E~T AT FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO FOR POURED CONCRETE BE COMPLFTE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REOtllRE~ENTS OF THE N. STATE CONSTRU~ION & ENERGY CODES. NQT RESPONSIBLE FCA DESIGN OR CONSTRUCTION ER~OR~ 6. ~ROPRIETORY NAMES IDENTIFYING ITEblS OF WORK ARE USED ~OLELY TO PRESCRIBE STANDARDS OF CONSTRUCTION. 7. ADL WOOD FRAME CONSTRUCTION SHALL CONFORM WITH THE AMERICAN INSTITUTE OF TIMBER CONSTRUCTIONS "TI~ABER CONSTRUCTION ~ANUAL" LATEST EDITION 8. ALL WOOD F~ING MENBERS SHALL HAVE AN ALLOWABLE ~"XTR~4E FIBER STRESS EQUAl5 TO OR CREATOR THAN STRUCTURAL GRADE DOUGLAS FIR, Fb = 1450 P.S.I. Fv = 95 P.S.I, 9. DOUBLE ALL FLOOR JOISTS IN ALL BATHROOM AREAS BELOW TUBS. 10. DOUBLE ALL HEADERS AND OR TRIMMERS AROUND ALL JOIST OPENINGS. PROVIDE SOLID BLOCKING IN ALL JOIST SPANS IN EXCESS OF 8' - U". 1%p o¢ FL Tg 12. 15, DOUBLE ALL FLOOR JOISTS BELOW BEARING AND PARALLEL PARTITIONS, ALL INSULATION SI[ALL BE KRAFT FACED WITH VAPOR BARRIER FACING WAP34 SIDE OF HOUSE. ALL WINDOWS SHALL BE INSULATED GLASS AS MFG. BY ANDERSEN OWNER SHALL PROVIDE SAFEGUARDS-(PLANTERS,SCHRUBS OR OTHER PROTECTIVE MEANS) TO PREVENT INO13RY CAUSED BY CONTACT WITH OPEN CASEMENT WINDOWS. CONTRACTOR SHALL CLEAN ALL DOOR AND WINDOW GLASS AND ~EAVE ALL FL00RS, WALLS AND CEILINGS FREE OF DEBRIS I~EDIATELY PRIOR T0 FINAL C0~PLETION.