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HomeMy WebLinkAbout16922-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17667 THIS CERTIFIES that the building Date JANUARY 10, 1989 ONE FAMILY DWELLING Location of Property 7986 SOUNDVIEW AVENUE SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 59 Block 9 Lot 5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated April 8, 1988 pursuant to which Building Permit No. 16922-Z dated April 26~ 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 ONE FAMILY DWELLING WITH GARAGE & ATTACHED ROOFED PORCH The certificate is issued to BERIT CARROLL ( owner ) ~ of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 88-S0-32-12/19/1988 UNDERWRITERS CERTIFICATE NO. N-049552-12/12/1988 PLUMBERS CERTIFICATION DATED 12/9/88-BERTSAND PLUMBING & HEATING Building Inspector Rev. 1/81 ~OB~ NO. B TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No 16922 z Permission is hereby granted to: ...~......~ ............. ;~. ................................... . ...~~/...~.~.....~.zz ...... ::::::::::::::::::::::::::::::::::: o,~L'7~;'71'i~.....i.~i~!....~~....~ .............. County Tax Map No. 1000 Section ......... ..~.Z~.. ...... Block ....... ~ ........... Lot No ............... pursuant to application dated ............ ~.../~.. ............................. , 19...~.., 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 m ~ 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-iS-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- t/OhS, 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. Certificate of occupancy New Dwelling $25.Q0, Accessory ,$ ]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ I00.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.C. $ 20.00 /._l{.f /.~.?/' /~'~' 5.Updated C.C. $ 50.00 Date ................ NewC°nstructi°n ./. Old orPre- .... existing Building ............ Vacant Land ............ . Location of Property ...... House No. Street Ham/et II ' Owner or Owners of Property ............................ . ............. County Tax Map No. 1000 Section ..~ ........ Block ....~. .......... Lot.. ~.. .......... Subdivision .~.~, ............................. Filed Map No; .......... Lot No ........... Permit No./,,, J,~,,~,, Date of Permit ~,/~,~,/~, .Applicant, ,~, ,f,>,~, ~--/~,~, ,f,/~, ,~//, ,' ..... ',' ,,, Health Dept, Approval .................. Labor Dept Approval Underwriters Approval ........................ Planning Board Approval ....................., Request for Temporary Certificate ..................... Final Certificate ,,¢/, .................., , Fee Submitted $..~..OZS., .~.O.. Construction on above described building and p~rmit meets all applicable codes and regulations. A P P ) ica n t/t', ,L~,"~-/, ~'~/~, ,~ , , ,~~ ...................... Rev. 10-10-78 9UI~D~TION ~'~( DUNDATION 2nd } )UGH FRAME & ,PLUMBING !SULATION FER N, Y. STATE ENERGY CODE -L FINAL TOWN OF SOUTttOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 1197t TEL. 765-1802 CERTIFICATION Date Building Permit No. /~/~ Owner L~f/~ ~/~ff(3// (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. / (p~umbe~r- s signature) Sworn to before me this ~ ~ day of '~c_~ , 19 Notary Public, ~'~/< County EII. EEN M. ROACHE Notew Pubt~, S~e ~ ~ NO. 4826~ Notary Public THE NEW YORK BOARD OF FIRE UNDERWRITERS SUREAU OF EL.EC;TRIC;rT¥ !P,;('~',~i~:~ t 2 t ~RJOHN STREET. NEW YORK. NEW YOR~lO038 THIS CE~IFIES THAT ~ examln~ on and~nd to be in complionce wlt~ the ~qui~ments o~ thh ~rd. RX~ / I I RXTU~S I ~ I~l~ O~S 1 OV~ ~ W~ IXHAUST FA~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [/] FINAL REMARKS: ~ ~ 765"t 802 ~/ BUILDING DEPT. INSPECTION REMARKS: DATE 765-1802 BUILDING DEPT. INSPECTION R~~OUGH PLBG. FOUNDATION ~IST FOUNDATION ZND [ ] FRAMING [ ] FINAL INSULATION INSPEL'~rOR~,~/ 76S-1802 ~.~/~ ~ BUILDING DEPT. INSPECTI ) N [ ] FOUNDATION 15T [~ ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION DATE_, 765-1802 BUILDING DEPT. INSPECTION [[_ ~Fo~NDATION 1ST [ ] ROUGH PLBG. NDATION 2ND [ ] INSULATION FRAMING REMARKS: FINAL DATE INSPECTOR 76S-1802 BUILDING DEPT. INSPECTION [ F~OUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING FINAL BLDG,'DEPT, ' ..... __ TOWN OF SOUTHOLD J THE NEW YORK BOARD OF FIRE UNDERWRITERS P~mE 1 /.2350[8 BUREAU OF'ELECTRICITY [--- 85 JOHN STREET, NI=W YORK,'NEW YORK IOO38 1).,. DECEMBER 12.1988 ~pplicatlon~o. on.file 55152188/88 .~- ~ 049552 THIS CE~IFIES THAT ~ER~IT NO. 16922 - ~ JOHN CARROLL,' 7986 '~.0.~. OFF OF :SOUNDVI~W ~.VE, SOUTHOLD, NJY. a~s examined on DECEHBER 05,1958 and flound to be in compllance wh h the req.lrements q[ this Board. 34 54 30 . 34 1 1.2 9 F 1 200 CB I X I 4/0 1 2/0 :SMOKE :',,DETECTOr: ~1 '> . :[ EOCKY POINT, NY, 11778 GENERAL ~AGER , FORM NO. I SURVEY . .' ........ TOWN OF SOUTHOLD CHECK . .~. B.G.~... BUILDING DEPARTMENT SEPTIC 'FOYM' .0,.~"': ......... : TOWN HALL Exanfin~ ed ........... ,19 Approved. ~./.~. · ......... ,19 .~'.~. Permit No./~. ~..~..~.~. Disapproved a/c ..................................... NOTIFY $OUTHOLD, N.Y. 11971 TEL.: 765-1802 CALL MAIL { uuild~v~ Inspector) APPLICATION FOR BUILDING PERMIT TO: INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter 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 plan showing 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 appli- cation. c. The work covered by this application may not he 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 shall be kept on the premises available for inspection throughout the work. e. No building shall be occnpied 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 HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o~ 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, ordinances, building comte, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspectio~ . .i. (Signature o~ applicant, or name, if a corporation) · .... (Mailing address of applicart{) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...... .................................................................................. Name of owner of premises .... I.T. ..... Q ...................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of co.orate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License 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~ ................................................. House Number Street Hamlet County Tax Map No. I000 Section ..... 5.~. ......... Block .... ~ ............. Lot .... ~ ............. 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 ......................................................... b. Intended use and occupancy · S F~Le ~[[}L,~. bt~L ~ ........... 3. Nature ofwork (check which applicable): New Building .......... Addition .......... Alteration .......... t~epair i .............. Remoyal .............. Demolition .............. Other Work ............... i' (D ripjfi ) , est on 4 Estimated Cost l I ©, C2Ct'~,!Cy-D Fee ....................... i' " (to be paid on filing this application) 5. If dwelling, number of dwelling pnits ..... [ Number of dwelling units on each floor... If garage number of cars ' 6. If business, commercial or mixe~ occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structur{s, if any: Front ............... Rear .............. Depth ............... Height ................ Number of Stories ........................................................ Dimensions'of same structure with alterations or additions: Front ................. Rear .................. Depth i Height Number of Stories Dimensions of entire new construction: Front .... .~..' ..... Rear .... ~ [e. ....... Depth .... ~.q ......... tteight .... ~ .......... _Number of Stories .... ~. .................... . ...... 9. Size oflot: Front .... [[e.~... i ........... Rear ....... ~.~fJ ............ Depth .... .~I~.Q ............. 10. I)ate of Purchase ...a~J~.~,~ ................. Name of Former Owner .~. [t~lOtg,. I~. 9¢~-!$ ........... I 1. Zone or use district in which pr~mises are situated. '.'/~."../.~9.~-~ t bhq'r..O ¢.. .u.c.r 403 .u. ................ 12. Does proposed construction viq]ate any zoning law, ordinance or regulation: ........................... 13. Will lot be regraded .... ................... Will excess.fill b [removed from premises: "~es '(~ 14. Name of Owner of pr¢tnises . .~ty...(~.0~.[,-C. Address(!L~~. ~,~iX....~.,~..C~.. Phone No. Name of Contractor .. ~¢~. ! .................. Address .... : .............. Phone No ............... 15. Is this property locatediwithin 300 feet of a tidal wetland? *Yes ..... No .~... *If yes, Southold Town TrUstees Permit maybe required. ~. I PLOT DIAGRAM Locate clearly and distinctly ail 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 STATE OF NEW YORK, i S.S COUNTY OF .................. being duly sworn deposes and says that he is the applicanl (Name of individual signing contract) above named. He is the ........................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is iduly authorized to perform or have performed the said work and to make and file thi~ application; that all statements c6ntained in this application are true to the best of his knowledge and belief; and that th~ work will be performed in the maianer set forth in the application filed therewith. Sworn to before me this ~" of. ./~..~ .......... 19 Notary Public, .~.. · i. .~. ........ County ~IOTJ~RY~PUBUC, State of New Yolt 'No. 47O78)'8, ,Suffolk TGrm Ex~ir~ March 30, (Signature of applican -' i' 4u SUFFOLK CO. HEALTH DI~PT. AI~OVAL '4 . ~'v EL,_h'~G ONLY ,~ EXPIRES TW() YEAR8 F~AOM DAffE OF APPROVAL ~> t H.S.R GREE~RT ~W Y~K ,> SUFFOLK CO. HEALTH DEPT. &pII~OVAL H.s. NO. STATEMENT OF INT,~NT THE WATER ~F~LY AND SEWAI DISPO~,AL SYSTEMS FOR THIS RESIDENCE WtLL CONFONI~ TO THE ST.~IBAROS OF TH~ SUFFOLK ¢O. DDT. M ~ALTH ~RVICE5.' S~F~K COUNTY ~PT. ~ HEALTH SERVICES -- FOR AFP~OVA~ OF C~T~T~N O~Y DATE: H. S.... NO.: A~VED: ....... ~,.,I~FOLK CO. TAX MA~ D~iGNA~ION: C.A. LC 0 L/%i I O ,%1 _5 · e' .Z'~,~,,/¢~, i~t O.A..' /0°~ I.A. : 70',~ ,~O /~$YS T£A\ ZzZ. L '±) SEATING EQUIPMENT TO MEET 7813.23 - 75% EFF. 2) HEATING CONTROLS TO MEET 7813.13 RANGE 45 TO 75 DEGREES FAHP~ENHEIT. 3) WATER HEATING PER 7813.31 THRU .38. 4) PIPE INSULATION 7813.19 5) WINDOWS - DOUBLE GLASS. 6) CONSTRUCTION TO MEET N.Y.S. ENERGY CODE. o.o~ ~,g7o 0.58, t i q2 0 O.z-IO ~ 0 0.05 Z{=oO o. o..g 5/ q / o 0.01,~ :go .5~ o -9 TO THE BEST OF MY KNOWLEDGE, BELIEF, AbD PROFESSIONAL JUDGEMENT THESE PLANS ~ IN COMPLIANCE WITH THE CODE. rT ~ If copper tubing is used for water distributing system; piping shall be of types K or L only. .~.,?~ _O~CUPANCY OR -OSE IS~'.UN~WFUL ?,/)THOUT CERTIFICATE OF OCCUPANCY PLUMBER CERTIFICATIOIV ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY SO1 r~ER USED IN WATER SUPPLY SYSTEM CANNOT EXCEED 2/10 of I% LEAD. PLUMBING ALL PLUMBING WASTE & WATER UNES NEED TESTING BEFORE COVERING ~,PPROVED AS NOTED, FEE: ~BY: .~,..~ NOTIFY EUI~I~NG OEPAR17,~.Nt" AT 7ES-lB02 S AM 1~ 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - ~ REQUIRED FOR POURED cO~CRE'FE 2, ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - C~NSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N,~L STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS 7'5'!" ' ,CO I", N-I "0" -f ©i 1