HomeMy WebLinkAbout29458-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29861
Date: 11/21/03
· ~{IS CERTIFIES that the building ALTERATION
Location of Property: 900 YENNECOTT DR SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
Cowry Taxx Map No. 473889 Section 55 Block 6 Lot 7
$hatx~ivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JIrNE 5, 2003 pursuant to which
Building Perralt No. 29458-Z dated JUNE 5, 2003
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 AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
Ge certificate is issued to JACQUELINE A & RALPH LOMBANDI
(OWNER)
of the aforesaid building.
SUFFOLK COLR~T~fDEPART~WENT OF~R~J~]Y~APPROVAL
ELRC'~RICAL CERTIFICATE NO.
PLOq~BERS CERTIFICATION DATED
Rev. 1/81
N/~
1179825 11/14/03
11/21/03 MIKE JACOBI PLUMBING
Authorized Si~at ~r~
FORM NO.3
TOWN OF $OUTHOL.D
BUll. DING DEPARTMENT
TOWN HALl.
SOUTHOLD, N.Y.
No_
BUILDING PERMIT
ITHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF 'rilE WORK AUTHORIZED)
23429 Z Date ................ , ,~..~...~. ~'. ~.. ..................
Permission Is hereby grant~ / (~ /
........ ~.~~.~...~.~~ .......
~~~..~,~....~~~ ..............
at premises I~at~ at ....................... ~....'~~
,...............,..,,.,,,,,,,,,,,.,..., ,,....,....
Coun~ Tax Map No. 1000 Section ....... ~.., Bilk ....... ~ ............. LotNo. ~ .....................
pursuant to application dat~ ..................... ~~.~1 9....~., and approv~ by~e
Building Insp~t~.
.................... ......................
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. 29458 Z Date JUNE 5, 2003
Permission is hereby granted to:
JACQUELINE A LOMBARDI
900 YENNECOTT DR
SOUTHOLD,NY 11971
for :
CONSTRUCT AN ALTER3~TION (LAUNDRY ROOM & BATHROOM) IN THE ATTACHED
GARAGE OF A SINGLE FAMILY DWELLING AS APPLIED FOR. REPLACES BP 23429
at premises located at
County Tax Map No. 473889 Section 055
pursuant to application dated JUNE
Building Inspector to expire on DECEMBER
900 YENNECOTT DR SOUTHOLD
Block 0006 Lot No. 007
5, 2003 and approved by the
5, 2004.
Fee $ 150.00
Authoz~zed S ig~'~t ure
COPY
Rev. 5/8/02
Form No. 6
TOV~N OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
q ?fin'~
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. 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.
1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic
features.
2. A properly completed application and consent to inspect signed by the applicant. Ifa 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'i Alterations to dwelling $25.00,
Switmning pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00.
2. CertificateofOccupancyonPre-existingBuilding- $100.00
3. Copy of Certificate of Occupancy - $.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
New Construction:
Location of Property:
Old or Pre-existing Building:
(check one)
Soo -
House No. Street
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section
Hamlet
Lot
Subdivision
Permit No.~-[~/~/~~-
Health Dept. Approval:
Date of Permit.
Filed Map.
Applicant:
Underwriters Approval:
Lot:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ ~,,,~1~
Final Certificate:
//
(check one)
~t~plicant Signa~'~ure
ToWn Hall, 53095 Main Road
P. O. Box t t 7g
Southold, NeW Yo~k tt971
Fax (5t 6) 76~-t 823
Telephone (516) 765-t802
C~FFIGE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
CERTIFICATION
I certify that the solder Used in the water supply system
contains less than 2/10 of 1% lead.
(Plumb~ Stgnat~r.)
Sworn to before me this
Term txpim luly 7, 20 D~
County
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
JACQUELINE FIELD JACQUELINE FIELD
900 YENNECOTT DR 900 YENNECO'~I- DR
SOUTHOLD, NY 11971 SOUTHOLD, NY 11971
Located at 900 YENNECOTT DR SOUTHOLD, NY 11971
Application Number: 1179825 Certificate Number: '1179825
Section: Block: Lot: Building Permit: BDC: ns11
Described as a Residential occupancy, wherein the premises electrical system consisting
electrical devices and wiring, described below, located in/on the premises at:
First Floor,
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 14th Day of November, 2003.
Name QTY Rate Rafin~ Circuit Type
Appliances and Accessories
Exhaust Fan I 0
Wiring and Devices
Receptacle 6 0 General Purpose
Switch 9 0 General Purpose
Fixture 4 0 Incandescent
Receptacle 1 0 20 amp Laundry
Receptacle 1 0 GFCI
Dimmers 1 0
sea:
I of l
This certificate may not be altered in any way and is validated only by the presence of a raised seai at the location i~dicated.
! t
0
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
March 22, 1996
Mr. & Mrs. Ralph Lombardt
900 Yennecott Drive
Southold, NY 11971
***** SECOND NOTICE *****
Re: Premises: 900 Yennecott Drive, Southold
Suff. Co. Tax Map #1000-55-6-7
Dear Mr. & Mrs. Lombardl:
It has been brought to the attention of the Building
Department that work is being done on your dwelling that may
require a Building Permit.
Please contact this office as soon as possible so this
matter can be resolved.
I thank you for your anticipated cooperation.
Very truly yours,
JMB:cmt
(Cert. Mail)
~HOLD TOWN BUILDING DEPT.
Boufls ~F
g Inspector
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FO~j~ATIoN 2ND [ ] INSULATION
FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
DATE/~//~/~/~/~
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 2ND [ ] SULATI N ' ~.~,,,~
[ ] FRAMING [
[ ] FIREPLACE&CHIMN!
765-1802
BUILDING DEPT.
INSPECTIO
[ ] FOUNDATION 1ST ~,ROUGH PLBG.
[ ] FOUNDATION2ND [ ]INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE/&'~i~IMNEY ..~
REMARKS: ~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [/] I/~LATION~
[ ] FRAMING [~] FINAL
[ ] FIREPL~&f~HI~ //~ ~
DATE
1 N STIU. ICT 1 ()NS
II(}^RI) OF IIl~,Al,'rll ...............
3 SE'I'S OF I'I.ANS ...............
SURVEY ........................
CIIECI~ .........................
SEPTIC FORtt ...................
ti^ I I, TO: ....................
a. 'llsla alq~lical;ios~ saint I~ couplelely filled in by tyl~,~riler or iu i~k m~l mll~nitt~l LO the ~liltling hml~ctor wilh
sets of plmm, accllrote plot plon to vA:ale. Fee nccording to ~chedule.
h; lqot plm3 ~i,~ I(x:ntl(.i of lot: n.~l off I~ildi~,gs (m pro.ir~s, relnl Jonship to mljoinlnfi preni~e~ or ix,bile
e. A) I~,ildi~ ~dmll I~ ~oq~iol or usol in ~lole o[ in ivsrt for any l~.lxme ~miever until a (~rtificol:e of
(k:(aqms~:y fl~all have 1~11 Brm~t~l Dy I1~ li~ilding hml~ctor.
I~l~ulatit.m. for tl~ mmt~ti~m of I~ihlinB~, ~kliti~mn or nlterntlosm, or for s~ol or demlition, os herein
(1~.~ alii title oE coq~orate officer)
Ilt~ildero I.icens~ Il) ..........................
I'h~,l>er. l.icense fro .......................... -~
Electrieian.~ 1Acense Ilo ...................... --
Other T~.~'o l.icen.se I'~ .....................
a. F. xi~tit~l use. af~l octN~lW.~:y ............................................................ ...~
t,. ~,,~,~] ,,.~ .~,~ ~o,~,,:~ ........~.~~.....~...s~....Y?...: .... .~..~.._..../~...~...~. ......
6.
1.
Il.
.......... , ,- APPROYED AS NOTED . ~ /
~ ' ,? ~ ' ':': '~ ~ ' ;~ ~ O~ MENT AT
CERT/FICAFE Oh OCCUPANCY. '~,~--~ ~ ~ ~ '~ 7~-mo~ e AM ~ 4~FO~ TH~
SOLDER USED IN WATER
SUPPLY SYSTEM CANNOT
EXCEED 2/10 of 1% LEAD.
If copper tubing is used
for water distributing
system; piping shall be
of tYpes K or L only
....
ALL PLUMBING WASTE
& WATER LINES NEED
TESTING BEFORE COVERING
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL CONSTRUCTION MUST
BE COMPLETE FOR
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE
STATE CONSTRUCTION & ENERGY
CODES, NOT RESPONSIBLE FOR
DESIGN OR CON~TRUCI'IO~ ~
Il(! il; ll~e ................. ~la ~/~,,~L~P..f..'2~.J,~v... ..................................................................
........ ,,, .....
... ,oj?~,,~.~~ ..
I ~ lc, SlBie of NSw
~ '-'~ .... ~-.,.~,., , No 4879505
APR 2 4 1996
BLDG. DEPT.
TOWN OF SOUTHOLD