HomeMy WebLinkAbout17021-zNo Z-17979
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southo~d, N.Y.
CERTIFICATE OF OCCUPANCY
Date APRIL 28, 1989
THIS CERTIFIES that the building
Location of Property 3325 YOUNGS AVE.
House No.
County Tax Map No. 1000 Section 055
Subdivision
ADDITION
SOUTHOLD~ NEW YORK
Street Hamlet
Block 05 Lot 2.3
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated M~Y 6, 1988 pursuant to which
Building Permit No. 17021-Z dated MAY 20, 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 ADDITION TO EXISTING ONE F~ILY DWELLING AS APPLIED FOR
The certificate is issued to GARY & JOAN REMPE
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-065422 - APRIL 7, 1989
PLUMBERS CERTIFICATION DATED APR. 24,1989-K&K PLUMBING & HEATING
Rev. 1/81
· OR~ NO. 2
TOWN OF $OUTHOLD
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~ 01702! Z
Permission is hereby granted to:
...~.~.~...~" ~.:~.: ...... J..L~.~..s.'. .........
~.....~z~....~.......~.....~: ..... .: ........ ~.: .......... ~. .......... ~....~...~. ....................
at premises located at ...~.~....~.......~.~.....~.: ......... ~-..~L~ ..................
x..~..~...~.~~e....: ........................................................................................
County Tax Map No. 10(70 Section .... .(~..~,..~., ....... Block ..... .(~.~,. ....... Lot No....c~*.~ ...........
pursuant to application dated ...... .....~.....~.....~.. ......................... 19.~..~...., and approved by the
Building Inspector.
Rev. 6/30/80
TOWN OF SOUTHOLD
BUILDING DEPARTHENT
TOWN HALL
SOUTHOLD, NEW YORK
765 ~,1802
11971
APPLICATION FOR CERTIFICATE OF
OCCUPANCY
NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........
HOUSE NO. HAMLET
county Ta~ Hap No. 1000 Section .P.~3X Eloek ..~.. Lot ..~..3. ....
Subdivision ....................... Filed Hap ........ Lot
Permit No .......... . Date of Permit . .Applicaut .. ........... . .. .. .
Health Dept. Approval .................. Underwriters Approval ..............
Planning Board Approval ................
Request for Temporary Certificate ....... Final Certificate ................
F S b itt d: $ ~ ~
rev. 10/14/88
FIELD I~.SPECTION COMMENTS
~-~
FOUNDATION (1st)
FOUNDATION
2.
(2nd)
ROUGH FRAME
FLUMBING
INSULATION PER N.
STATE ENERGY
qODE
FINAL
ADDITIONAL COMMENTS:
TOWN OF SOUT[IOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHO£D, N.Y. 1197l
CERTIFICATION
TEL. 765-1802
II ll '""'"'
~F__SOUT~,fOLD .~..81.DG. DEPT.
Building
(please print)
Plumber ~
(please print)
certify that the solder used in
Contains less than 2/10 of 1% lead. ~
the water supply system
(plumber's signature)
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE
1.125065 BUREAU Glf= EL. ECTRICITY
· 85 JOHN STREET. NEW YORK, NEW YORK 10038
o.t~, APRIl, 07,1989 ~l.z, li~atlo. Ho. o. ft~ 59259488/88 ~ 065422
THIS CERTIFIES THAT
only the electrical equipment ~ ~scribed below and intr~uced by the appllcaat ~med on the above ~p{i~t~n number in the premiss of
~-ARY REMP,r., 3325 ¥Ort~G'S AVE.~/pOT'K#~v~'~ 22, SOUTH0I'D, N.Y.
in the foflotrmg location~ ~ Basement ~ lst FI. ~J 2nd Ff. .~ect~(m Blocl~
t~sexumi~*edon I~RRCH ~6~989 andfoundtobeD conpla~ .eu'it! thereq,lreme~ts~fthlsBoard.
Loc
FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS
FIXTURE ~WlTCHES
10 10 10
DRYERS FURNACE FAOTORS
TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
NO. OF FEET
SERVIC'~ DISCONNECt ' , ..... $. E R V I
OTHER APPARATUS:
4
NEUTRALS
4
A, WG
OF NEUTRAL
FEEDERS:l-4 ~ 3 BASEMENT., TO BASEMENT
FEEDERS:l-4 J 3 BASEMENT TO BASEMENT
PANEI'BOARDS:i-14 CIR. 100,1-7 CT.P,, 100
G.F.C,I:-i
SMOKE DETECTOR :-2
LAKE ELECTRIC
17 FOREST TRAIL
RIDGE, NY, 11961
hlC.'#1845 E
GENERAL
Pff-
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.
THE NEW YORK BOARD OF FIRE UNDERWRITERS
8~ JOHN STREET, NEW YORK, NEW YORK 100~8
Date
the following Jocation: [] Bese~.~t
examined on ~'~.~U'~{ i (, i ';~
[] Ist Fl. [] 2nd FI. Section Block
attd found to be itt cotnpliance t~,ith the req t retnents Qf this Board.
FIXTURES RANGES COOKING DECKS OVENS
Lot
EXHAUST FANS
RXTURE
OUTLETS SWITCHES FLUORESCENT OTHER
DRYERS TIMECLOCKS
SYSTEMS
NO. OF FEET
R
NO OF CC COND.~ A W G,
PER ~' ~ OF CC. COND
C
NO OF HI.LEG A W G, NO OF NEUYRAL5 A, W G,
OF H~-[EG OF NEUTRAL
E
OTHER APPARATUS:
GENERAL MANAGER
This certificate must not be altered in any mariner; return to the of{ice 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.
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL,: 765-1802
Disapproved~ a/c ...................... ~ .............. ....D
.... ............................ ......
(Building Inspector)
,APPL CATION FOR BUILDING PERMIT
INSTRUCTIONS
BOARD OF HEALTH .............
3 SETS OF PLANS .~ .........
SURVEY .....................
CHECK ......................
SEPTIC FORM ................
NOTIFY
CALL .....................
MAIL TO:
~ a. This 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 lhyout of property must be drawn on the diagram which is part of this appli-
cation.
c. The work covered by this application may not be 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 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 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 or
Regulations, for the construction of buildings, additions or alterations, or for/'emoval or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
(Signaqare"' ~ ~o{' applicant, or name, if a corporauon)
..
'' (M ailing ~o f applicant )~ 2 )
State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder.
Name of owner of premises . :i,.~ ¢.~./~..~... ~.~..~., 5/ .... /~.'q.~-~ ) .....................................
· ' /(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No ..... ~.'.e. 7.'.~. .............
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
1. Location ofland on which proposed work will be done .... ~.0..~ P/.~..~"../.~'..t2..~.-?..:.~J..~"/~q../.O]'. .......
· ~.'~ .¥.~7 .............. ~.o. ~.~.~ ~ .... ~..~. ¢, ............. ~';;,. ~ r/.~. ~./~.&..~.~. ~ ...........
House Number ' Street Hamlet
County Tax Map No. 1000 Section ........ . .~...-,~.... [ Block ~ Lot. c~, 3
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 .~'?. 5. } c/xo l¢C. ~-~ .co~.?J~-~. ~
d'~.....~ ' ~.,,. ~d-.l~,~
b. Intended use and occupancy . · ~.'.~ .s. t .~e'~ ...... G. .~. . .1~ .......................
epmr .............. Removal .............. Demolition ..............
i " (to be paid on filing thisapplication
5. If dwelling, n~wellingiunits ...... / ........ Number of dwelling units on each floor ................
If garage, number o~,. ............................................ ; ......................
6. If business, commercial or m~X'ed~9~cupancy, specify nature and extent of each type of use .. ' i .....
7. Dimensions of existing s}ruc, t. ur , ont ....... '.....'..,. Rear ............. . Depth - . .......
Height' .... ~... Numb. er .o f St?~rer,.,<k.. .........................
Dimensions of same structure with site. rations or a~ions: Front .............. Rear .................
Depth ................... ... Height ......... ~ ........ Number of Stories ......................
Dimensions of entire new c~nt ......... . .~ear ............... Depth ...............
11. Zone or use district in which ,remises are situated ......................... ~-.~-... i.. iii'i ..... ii .......
12. Does proposed construction violate any zoning law, ordinance or regulation: ................................
W
13. ill lot be regraded ......... , .............. Will excess fill be removed from premises: Yes No
Name of Architect .
......... : ................. Address .................. Phone No ................ ·
PLOT DIAGRAM
Locate clearly and distinctly alii 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,
COUNTY OF ......... ;S.S
............................. ~ .................... being duly sworn, deposes and says that he is the applicant
. (Name of individual signing contract)
above named. .
(J (Contractor, agent, corporate officer, etc.)
of saki owner or owners, and is duly authorized to perform or have performed 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 manne? set forth in the application filed therewith.
Sworn to before me this
........................ day of
Notary Public ........... County
HELEN K. DE VOE ' ' ' .......
NOTARY PUgL C, State of New Y0dL (Signature of applicant )
No. 4707878, S4Jflolk
Term Expire~ M~rch
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