HomeMy WebLinkAbout31057-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-31298 Date: 11/22/05
THIS CERTIFIES that the building ALTERATIONS
Location of Property: 240 AUGUST LA GREENPORT
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 53 Block 4 Lot 43
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated — APRIL 12, 2005 pursuant to which
Building Permit No. 31057-Z dated APRIL 15, 2005
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 "AS BUILT" ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to CONSTANCE M CROSS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 2065275 08/02/05
PLUMBERS CERTIFICATION DATED 10/12/05 GARY STAHL
ori �i Sigy(ature
Rev. 1/81
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. 31057 Z Date APRIL 15, 2005
Permission is hereby granted to :
CONSTANCE M CROSS
PO BOX 730
CUTCHOGUE,NY 11935
for
AS BUILT ALTERATIONS TO AN EXISTING DWELLING AS APPLIED FOR.
ADDITIONAL CERTIFICATIONS MAY BE REQUIRED.
at premises located at 240 AUGUST LA GREENPORT
County Tax Map No. 473889 Section 053 Block 0004 Lot No. 043
pursuant to application dated APRIL 12 , 2005 and approved by the
Building Inspector to expire on OCTOBER 5 2006
Fee $ 300 . 00
IN
*2 - -
Abthorized Signature
ORIGINAL
Rev. 5/8/02
Form No.6 C)
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department
with 11w fqllowing:
A. For new building or new use:
I. 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.
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 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
I. Cer-tificate of Occupancy-New dwelling$25.00, Additions to dwelling$25.00, Alterations to dwelling $25.00,
Swimming pool $25.00, Accessory building$25.00, Additions to accessory building $25.00, Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building- $IW00
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
Date. I I I a I ( (D S
New Construction: Old or Pre-existing Building: (check one)
Location of Property: 7- 46 A U Q U�,� L_0�
House No. S6,6et Hamlet
Owner or Owners of Property: & K "r 0 C�P_
Suffolk County Tax Map No 1000, Section Block Lot
Subdivision Filed Map. Lot:
Permit No. <0 Date of Permit. S'6 Z-W 5"Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
Applicant Signature
B WE M.rL3 rL3 MPML3 ffl3rE3J1 ill, IrWryll ffiiryl IVP INE M
BY THIS CERTIFICATE OF COMPLIANCE THE
NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
40 FULTON STREET — NEW YORK, NY 10038
CERTIFIES THAT 51
Upon the application of upon premises owned by
ROSLAK ELECTRIC CONNIE CROSS
P.O. BOX 164 270 AUGUST LANE
CUTCHOGUE, NY 11935-2453, GREENPORT, NY 11944
Located at 270 AUGUST LANE GREENPORT, NY 11944
Application Number: 2065275 Certificate Number: 2065275
Section: Block: Lot: Building Permit: BDC: NS1 1
Described as a Residential 600- occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located in/on the premises at:
Basement, First Floor, Second Floor, Outside,Attic,
A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed
herein, was conducted in accordance with the requirements of the applicable code and/or standard
promulgated by the State of New York, Department of State Code Enforcement and Administration, or other
authority having jurisdiction, and found to be in compliance therewith on the 2nd Day of August, 2005.
Name QTY Rate Rating Circui Type
Appliances and Accessories
Dish Washer 1 0 1.2 KW
Furnace 1 0 Oil
Wiring and Devices
Outlet 36 0 Fixture
Fixture 36 0 T
Outlet 81 0 General Purpose
Receptacle 55 0 General Purpose
Switch 33 0 General Purpose
Dimmers 1 0
Receptacle 2 0 20amp Laundry
Receptacle 4 0 GFCl
seal
1 of 1
is certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
1 11 1 P111. � 012 1101ily, 2DO-PRIVEJ 1111
5 1
0 ffrii i en imii 0-01 0 0 0 0 0
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
ROSLAK ELECTRIC CONSTANCE CROSS
P.O. BOX 164 270 AUGUST LANE
CUTCHOGUE, NY 11935-2453, GREENPORT, NY 11944
Located at 270 AUGUST LANE GREENPORT, NY 11944
Application Number: 2024029 Certificate Number: 2024029
Section: Block: Lot: Building Permit: BDC: NS37
Described as a Residential occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located in/on the premises at:
Basement,Outside,
A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed
herein, was conducted in accordance with the requirements of the applicable code and/or standard
promulgated by the State of New York, Department of State Code Enforcement and Administration, or other
authority having jurisdiction, and found to be in compliance therewith on the 3rd Day Of August,2005.
Name OTY Rate Rmt� Circuit Type
Service
I Phase3W Service Rating 200 Amperes
Service Disconnect: 1 200 cb
Meters: I
seal
I of I
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
4
Town Hall, 53095 Main Roar! Fax(631) 765-9502
P.O. Box lh79 Telephone(631)765-1802
Southold, New York 11,971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATION
Date:
Building Permit No.,
Owner:
(Please print)
Plumber: ('� W y '5 iz�� (
(Please print)
I certify that the solder used in the water supply system contains less than 2/10 of I%
lead.
(Plu��bers'��ign—ature)
Sworn to before me this
day of 4 1 20 ()-6 CHI'MMSEYMORE
Notery Pubic,Slat*of Now York
No.OISES131594
OAdbd In Suffolk Courgy
my.riminion E*=August 08,20 14
Notary Public, 4 County
JAMES.I. DEERKOSKI, P.E.
260 Deer Drive
Mat(ituck, N.Y. 11952
(6131) 298-7116
To: Town of,Southold
Re: Stral)l)iiig/l,r�ullill�.IJPIUIIII)iIIWIIISLIla(ioii Inspections
Constwice Cross
240 August La.
Greenport, NY
Permit# 31057Z
To Whom It May Concern:
This lc(ter certifies that all wind strapping on the above mentioned project is in tact, mid
ince(s all state arid local building codes. A Franiiiig/Plumbing Inspection was also
Perl'ormcd on this Structure, �uid all framin.-and Plumbing was donc correctly art(] also
mects all state and local building codes. A pressure (Cst was also performed on the
waste/water plumbing sys(ciris and (cstcd OX. All Insulation was installed correcth,as per
plan. Any(ILICStiODS please 1eci free to call.
'Ec
Sit 'crely
vn
-Z
janjan, I crkoski P.E.
It
0
AZT SO
rou
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECT N
FOUNDATION I ST ["ROUGH PLBG.
FOUNDATION 2ND [ 1�1�NAAiION
FRAMING / STRAPPING FINAL
FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION
REMARKS:
4�
DATE INSPECTOR
f,:JL"�Jp, f::P0Lt4AJcn — 4cfap— tr-75fo
W OF SOUTHOLD PROPERTY RECORD CARD
OWNER STREET
VILLAG
��ORMER(OWNER
N
ACR
r5czewS W TYPE OF BUILDING
RES. . /6 SEAS. VL. FARM Comm, �cs. MICS. Mkt. Value
LAND IMP. TOTAL DATE
REMARKS
4.44
bp
AGE BUIL WNG CONDITION
NEW NORMAL BELOW ABOVE
FARM Acre Value Per Volue -------------
Acre
Tillable !2
FRONTAGE ON WATER
)NTAGE WATER
Woodland
FRONTAGE ON ROAD
j
Mecdowland
DEPTH
House Plot I
--------------------- BULKHEAD
Tote %.o
DCCK
NONE Ems MEN
0 no 0 NNE
ON
0 ME ME M
MEN M ME M
MEN
MEN
ENE
0 ENE 0 0 M RON
NO ME MEN mi 0 m 0
MENEM MENEM MEMO 0 0
MMEMEM ENSUE 0
IN ONE
mmmmim
so KIM 0
min
MEN on 0 Ptuffilm 0
NONE ON
NEEN MENEM NUNN
M-
FIELD INSPECTION REPORT DATE COMMENTS
FOUNDATION(IST)
--------------------------------------
FOUNDATION(2ND)
-4-
ROUGH FRAMING&
PLUMBING
INSULATION PER N.Y.
STATE ENERGY CODE
K
7
FINAL
ADDITIONAL COMMENTS
0
/.3 )L)T-!S V 775
4 -t2
17
c-0
14 r
/,xf-uj c 1�
N
6zp ww� cyo
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N
4) no
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up �
ALL CONSTRUCTION SHALL
MEET THE REQUIREMENTS OF THE
CODES OF NEW YORK,PTA-FA
4)0
UNDERWRITER CERTIFICATE
REQUIRED
p
E A 00
V P
Y
CAT
FEE
F-
N OTX L
BUILDING Dsp 'OR THE OCCUPANCY OR
765-1802 8 AM TO 4 PM F
FOLLOWING INSPECTIONS: USE IS UNLAWFUL
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE WITHOUT CERT1176TE
2. ROUGH - FRAMING & PLUMBING OF OCCUPANCY N
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE ndl m
S OF THE CODES OF NEW PLUMBEPCEPTIFICATION . 4 1 1 1
13A
REQUIREMENT ON LEAD CONTENT BEFORE.N 4-
YORK STATE. NOT RESPONSIBLE FOR ll�
CERTIFICATE OF OCCUPANC
DESIGN OR CONSTRUCTION ERRORS.
SOLDER USED IN WATER
EXCEED 2110 OF 1%LEAD.
COMPLY WITH ALL CODES OF SUPPLY SYSTEM CANNOT 2`1
NEW YORK STATE & TOWN CODE EL
S PLUMBING-
AS E FD AND CONDITIONS OF ALL PLUMBING WASTE
10 &WATER LINES NEED
So,THOI D I WN Z8A
TESTING BEFORE COVERING lir
OV-OLD TOWN PLANNING BOARD
SOUTHOLD TOWN TRUSTEES
N Y&DEC
-o -
FLOOj) IIAIIA13E P
COMPLY'W THICHA�T�R 36w"
SOUTHOLD TOWN REVENTION
CODE.
'k — I(-0,j 0
IVA
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