HomeMy WebLinkAbout18719-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23176 Date AUGUST 23, 1994
THIS CERTIFIES that the building RENOVATION & ALTERATION
Location of Property 30325 MAIN ROAD CUTCHOGDE, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 102 Block 2 Lot 18
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANOARY 4, 1990 pursuant to which
Building Permit No. 18719-8 dated JANUARY 5, 1990
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate ie
issued is RENOVATION fi ALTERATION TO ESISTING ONS FAMILY DWELLING
DAMAGBD BY FIRB AS APPLIED POR.
The certificate is issued to LILLIAN MSLVILLE HAMID
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-156980 - OCTOBER 22, 1990
PLUMBERS CERTIFICATION DATED JULY 8, 1994 - H.3MITH PLOMBING 8 HEAT.
Rev. 1/81
mast xa s
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 o 18 719 Z DateG/~~...-x-..........5..- .................... ~ 9..90
Permission is hereby grantged~to~: ~/~ ~ ~~~~
~s ~.~/.~.~ ... ................................
to ..
(u. ,.,~c.........c~.~~ ................................................
.....: ..
ct premises located at ............................................................ .....................................................
................................~./...~ .. ..~.... L./... ~.~.s.- ............................... ~.............
/h~
Caunty Tox Map No. 1000 Section ...~.~.~...... Block ......off Lot No.....~. ~a
pursuant to opplication dated ........L~%...........~........., 19.. ~, and approved by the
Building Inspector.
Fee S.•!••~`. I..~`.o
~~G ~G~~ ~~~• Buiding Inspector
Rev. 6/30/80
.,, Form No. 6
TOt•IN OF SOUTFIOLD
BUILDING llEPARTPIENT
TOS.iN }TALL
765-1802
G~ 7~~- .~~~~
.~"
e1PPLICATION FOR CERTIFICATI: OF OCCUPANCY
A. This application must be filled in by typewriter OP. ink and submitted to the building
inspector with the following: for new building or new use:
1. Final survey of property with accurate location of all buildings, property lihes,
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 17. 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.
B. For existing buildings {prior to April 9, 1957) non-conforming uses, or buildings and
"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 applicant.
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, Scaimming pool $25.00, Accessory building $25.00,
Additions to accessory building 525.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Euildine - $100.00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commerci~~iial $15.00
Date . ~9~~ .~qJ.: l7.~~ ............. .
New Construction........... Oldx Or Pre-existingg Building. ~.~..
Location of Property....J?O..Z/2~.. ~{~ A-l.. ~L~:4"1.........1..~1/."['Sill(.~_7O~!V............
House No. ~ Street HamSet
%~- ~
..~1~:'~?~:....~-ac~<-eel..
Onwer or Owners of Property. .........................
County Tax Map No 1000, Section.. ~ ~ .......B1ock..~...........Lot... ~~ ...............
Subdivision. (F....QQ ..............................Filed Map............Lot......................
?ermi[ No.l 4.7~ !.$f!....Date Of Permit ................Applicant............. ................
Iealth Dept. Appro////val ..........................Underwriters Approval.........................
'lanning Board Approval ........................
tequest for: Temporary Certificate........... Final Certicate...
ee Submitted: $ ............................ C
1
p ,~
-..y.JL~o2~ I ~ 1~, .. ' . _ APPLICANT-
THE NEW YORK BOARD OF FIRE UNDERWRITERS FAr,"'
0;7 ~ 09 3
BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NEW YORK 10038
t}CTi~})ER. '2.2,1'~9~ GR2'd~8901`~~ N 156'+~0
Date gppliratian No. on file
THIS CERTIFIES THAT
only the electrical equipment as deacri6ed 6ebm and introduced 6y the applicant named on the o6ove application number in the premLea of
r.-Hmr~Tn. 3032.5 MAr~ el,. Qf».r. ~5'in, coTe~f7taTr. IV.Y.
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and found to be in contplianee with the raquirementx of this Buard.
~~
, exTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
KEPTACLES SWITCHES
C7TLET$
INCANDESCENT Fll10RERCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMi. H.P.
r 47 ? 54 47 } F
DRYERS FURNACE MOTORS FUTURE A--UANCE FEEDERS $-ECIALRK'-T TIME CLOCKS BELL UNIT HEATERS MUITI.OUTIET
STE DIMMERS
AMi.
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AMT.
NO.
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MS
NO. OF IEET
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SERVICE DISCONNECT 610.OF $ E R V 1 C E
AMi. AMP. TYPE METER
EOUI-~ 1 a ]W 1 d 3W ] A 3W ] F ~W NO. Of CC COND. A W G. NO. OP H4LEG A. W. G. NO. OF NEUlgAlS A. W G.
PER d OF CC. COND. a HFLEG OF NFVTRAI
OTHER A-PARATUS:
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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.
i
- A,ArrL rwcwtwmvvcrwRlment. IntaE.~rT ura.eKnrluLlcMUJI NUI nEALTEREDINANYMANNER.
H. SMITH PLUMBING & HEATING, INC.
MAIN ROAD
SOUTHOLD, N.Y. 11971
(516)765-3690
Plumbing Lic. No. 537P
July 8, 1994
C E R T I F I C A T I O N
Building Permit No. 187192
Owner: Mrs. Lillian Hamid
Plumber: H. Smith Plumbing & Heating, Inc.
I certify that the solder used in the water supply system installed
on new renovation after the fire contains less than 2/10 of 1~ lead.
Sworn to before me this
8th day of Julv 1994.
Notary Public, Suffolk County
Notary Public -T
BERNADETTE L. TAPLIN
NOTFRY PUBLIC N15t1b3
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H. SMITH PLUMBING & HEATING, INC.
MAIN ROAD
SOUTHOLD, N.Y. 11971
(516)765-3690
Plumbing Lic. No. 537P
July 8, 1994
C E R T I F I C A T I O N
Building Permit No. 187192
Owner: Mrs. Lillian Hamid
Plumber: H. Smith Plumbing & Heating, Inc.
I certify that the solder used in the water supply system installed
on new renovation after the fire contains less than 2/10 of fro lead.
Sworn to before me this
8th day of July 1994.
Notary Public, Suffolk County
~~~~~~~ ~ r~~~
Notary Public ~-
OERNADETTE L. TAPLIN
NOTARY PUSLIC M48Mfl3
Sake k NeN York
Retidine m SuRdk Coungr ~
;ammisaon Expires Sept 30, 1912
VICTOR LESSARD
PRINCIPAL BUILDING INSPECTOR
(516) 765-1802
FAX (516) 765-1823
,~'~EFOIk~~
~ ~
y~~'01 >~. '~~~~
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
Mr. & Mrs. Esmond Hamid
30325 Main Road
Cutchogue, NY 11935
March 16, 1990
Re: Building Permit # 187192
Dear Mr. & Mrs. Hamid:
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Please be advised that the Building Department needs the
license numbers for the builder, plumber and electrician for the
above building permit.
Work can not start until the license numbers have been
submitted to the Building Department.
Thank you for your cooperation.
Very truly yours,
Southold Town Building Dept.
u~~ ~ ~-
Vincent R. Wieczorek
Ordinance Inspector
(Cert.)
i O~N ~ Ot/ ir`II "\
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(~ ,~r ~S -
WILLIAM J. JACOBS
BUILDER
DEPOT LANE
Qrtchogue, New York 11935
734-5815
Mau,,. 7, ~~ ~~.
hMR 15 t9A0
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TOWN OF SOUTHOLD
~f~~a~ic Lcarl~rna~k
amid mouse
This structure has been designated a
Landmark that contributes significantly
to the heritage of the Town
~oe~fFt~`~ ( Town of So o d, e York
~~1 ~`r I,~ndmark Preservation Commission upervisor
~'
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765-1802
BUILDING DEPT.
INSPECTION
.~
[ ] NDATION 1ST [ ]ROUGH PLBG.
[ FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING
REMARKS:
[ ]FINAL
DATE 7 IN8PECTOR
~~7t ~ ' ~~-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T [ ]ROUGH PLBG.
[ J FOUNDATION- 2ND [ ]INSULATION
[~MING [ ]FINAL
PATE ~02 ~ INSPECTOR
REMARKS: r .r
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [f] ROUGH PLBG. ~""d'~
] FOUNDATION 2ND [ ]INSULATION
REMARKS:
G
DATE ~ V INSPECTOR
[ ]FRAMING [ ]FINAL
765-1802
BUILDING DEPT.
INSPECTION
[FOUNDATION 1ST [ } ROUGH PLBG.
] FOUNDATION 2ND [ ]INSULATION
DATE INSPECTOR
[ ]FRAMING ~ )FINAL
j' ~ ~ / ~ 765-1$02
(J, ( BUILDING DEPT.
1 NSPECTION
[ ]FOUNDATION i5T [ ]ROUGH PLBG.
] FOUNDATION 2ND [ SULATION
[ ]FRAMING [ ]FINAL
MARKS: ~ ~~
RE
~'~~r
DATE /Y l/~ l 7~ INSPECTOR
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~6S-1a02
su1LDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ] SULATION
[ ]FRAMING ]FINAL
REMARKS:
s
DATE 0 Z
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~~~~~~
~~.~
suILDING DEPT.
t NSPECTtON
[ ]FOUNDATION 1ST [ )ROUGH PLBG.
]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING FINAL
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FORM NO. 1
TOWN OF SOUTHOLD
BUILDING OFPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 1171
TEL.: 705 1802
Examined . • •~ ..., 19 qd
Approved (/..~!~.. ~..., 19 /.Permit No./.O. ~I.~,~
DisaPProveda/c .....................................
BOARD OF HEALTH ............
3 SETS OF PL.\NS ............
SURVEY .....................
cNecx ......................
SEPTIC FORDS ................
NOTIFY 'a
CALL .....................
MAIL T0:
(Building Inspector)
APPLICATION FOR BUILDING PERNlIT O
Date,~~... ~......., 15 ~ .
INSTRUCTIONS
n
a. Tltis 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 be commenced before issuance of Building Permit.
d. Upon agproval of tltis 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 shalt 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
Re¢ulations, 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 code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary ins~,%c
.. . fit! ......... ,
.- '(Signature of applic n~, ~ r me, if a corporarton)
............... ........
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
................................................................................................
LI~IRnJ aE~MdNL~ ~~M~D
Name of owneroCpremises ..........................................................................
(as on the tax roll or latest deed) ~`~~d ~~
IC applicant is a corporation, signature of duly authorized officer. ,~/ ~ ~ ~7
.............................................. nn p,~ nT
(Name and title of corporate officer) - ~,,,t,~0i~'~` rd ~ ~ /~~~,n
Builder's License No . ... ...................... l I/~-~-wn~~ "',
~~ _~
Plumber's License No. . ~ ... .. ............ tM.t G~~J"`~~Z~
!~~
Electrician's License No. ~.~~~k ~~ ...... .
~~//
Outer Trade's License No . .................... .
1. Location of land on w/hic-h proposed wor`k,/will be done; -
House Number Street. Hamlet ~~
County Tax \tap No. 1000 Section .. 1. ~. ,.~..~-i . • • • . Block ...... Z ~ ~ ''
......... Lot .............. ..
Subdivision ............... .............. Filed Atap No. .............. Lot ...........
(Name) ....
=. State cxistin^ use and occupancy of premises and intended use and occupancy of proposed construction:
o _
a. Existing ~ 1~~9'kj / ~~.. G~l r n„ci
> use and occupancy ... ........... ... ..... (,j .... ...................... .
b. Intended use and occupancy .................................. .............................
3. Nature of work (check which applicable): New pudding .......... dditicn .......... Alteration .......... .
......
Repair .............. Removal .............. Demolition .. .....Swimming pool. .. .....
Tennis Court ... Accessory Building.......... r,ce,J.~.....Other WorkYy°~~T~
~i d 4p'p ................ Fee ~~.'4.1a~~J......................•
4. Estimated Cost ..... / P/
(to be paid on filing this application)
-~__
5, iC dwelling, number of dwelling units ............... 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 t e of use .......... .~~, .
.. ...
7. Dimensions of existing structures, if any: Front .~5. ~.1..~. .. Rear .1~. ........ Depth ...~~ ........... . .
Hci_ht ova:........... Number of Stories ... ?~ . ~ .'.,[ • •y .......
Dimensions of same structure with alterations or additions: Front .:~~~r • • • • • • •
Depth ...................... Height.................... b ro St .......................
8. Dimensions of entire new constnuction: Front ............... Re ............. Depth ............... .
Height .......... qNumber of Stories . .... ..................... Y .......... .
9. Size of lot: Front ... ~7l. s. .`f.7........... Rear l ~~ ................ Depth .?..............
10. Date of Purc'.,ase ...:..........................Name of Former Owner ............................ . .
12. Zone or use district in which premises are situa[eci .................................................... . .
12. Does proposed construction violate any zoning law, ordinance or regulation : ................. . ............. . .
13. \Vill lot he regraded ....... ~~, . ....... ... 1Vi11 exce s fill} arc from premises: Yes ... No . .
14. Name of Owner of premises ~S,~Qr!n ;~,~! ~~~"'; ~?h~~.ddress ~°~'^: ! `.-:~...~~~^-.'Jrz^Plrone No.~3 y: ~.~1 !~ .. • .
Name of Architect Address Phone No. . .
Name of Contractor Gf~-. . ................Address~iT~t • ~c'.zir~-„phone No.7?.y.~.~~~.~.
/ ,! •~ •
15.Is this property located within 100 feet o a tidal•vetland? *YES...:NO.t,.~:.•
*If yes, Southold Tovn Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street ;tnd block number or description according to deed, and show street names and indicate whether
interior or corner lot.
.,
~~ L l "
STATC- OF\E~RI:~~(~~S.S
COUNTY/ OF .. . C.A. ! ...... .
,(({vj~{ ~!1, , , .J :..~I ~~.~f.S .................. being duly sworn, deposes and says that he is the applicant
• (A'amc of individual signing contract) ~-
abovc named.
(Contractor, agent, corporate officer, etc.)
of said 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 [rue to the best of his knowledge and belief; and that the
work will be perfomtcd in. the manner set forth in the application filed therewith.
Swom to beiorc me tl}is '
/~ L ~ ~
Notary Public, ./~. ~.~.. .County G~~`( ~ ~~
CLAIRE L OLEVN . ~. • . • .. • .. • ........ .
frolwy Publk. Stale of New York (Signature of applicant)
No. 4879606 .
Iluelified in Suffolk County ~J
Commission Expires December 9.19!