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HomeMy WebLinkAbout24241-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32259 Date: 03/26/07 THIS CERTIFIES t~at the building WATER HEATER Location of Property: 4805 ALVA, S LA (HOUSE NO.} (STREET) (HAMLET) Co%%nty TaxMap No. 473889 Section 101 Block 2 Lot 22 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 3~ 1997 pursuant to which Building Permit No. 24241-Z dated JULY 11, 1997 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 INSTALLATION OF EVERHOT S30 GL WATER HEATER AS APPLIED FOR. The certificate is issued to EALLOCK E TUTHILL (OWNER) of the aforesaid building. SUFIK)LKCO%~TYDEPART%~ENTOF~R~LTHAPPRO~-AL ELBt-~ICAL c~KTIFICATH NO. PLU]~B~ c~ucrIFICATION DA'r~u 01/26/97 7360 o8/08/97 LAWRE CB TEAPASSO Rev. 1/81 TOWN OF SOUTIIOLD BU tI.D lNG I) EI'AI','['I IEHT TOWN IIALI, 765-1802 APPLICATION FOIl CERT[FICATI.: OF OCCUPAP,'Cy A. This applicatioa must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new buildieg or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, a.d unusual eatural or topographic features. 2. Pinat Approval from Ilehlth Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electric~[ installation from Board of Fire Underwriters. 4. Sworn statement from 'plumber certifying that the solder used in system contairs less than 2/10 of 1% lead. 5. Comnvrcial buildiog, industrial bnilding, multiple residence~ and similar butld aod ~nstallations,~.a certificate of t'~'. ~ ,' ~ ' ings responsxbie for the building I c from architect or eng~oeer 6. Submit Planning Board Approval of completed site plan requirements. B. F~r existiog buildings (prior to April 9, 1957) non-conforming uses, or buildings and '.pre-existing land uses: 1. Accurate survey of property showing all property lioes, streets, building and unusual eatural or topographic features. 2. A properly completed application aud a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building -Iospector shall state the reasons therefor in writing to the applicant. C. Fees ~l. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.O0,-- Alterations to dwelliog $25.00, Swimming pool $25.00, Accessory building $25.00, ~' Additions to accessory buildiag $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildin~ - $~OO.00 3. Copy of Certificate of Occnpancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupaocy - Residential $15.00., Co~ercial $15.OO' Date .. ~ ew Construction ........... Old Or P~in~ Building.. .~... Location of Property..~... ........... ........ ............ . /////. . ~ .... . ~o~.~y ~ ~..o ~000, s~=~o....M.~.Z .... B.,~ .... ~ ........ [o~ ..... ~ ........... Subdivision ..... ............................... Filed Mnp ............ Lot ........ . ...... Permit Mo ................ Date Of Permit ...... Annlic'mr ~~ Ilealth Dept. Approval .......................... Uoderwriters .................... Approval ..... ?lanning Board Approval ........................ ~equest for: Temporary Ce~ttfic~te ........... Fiual~rticate...~... ~.~p.%0Wq .... . .... 24241 Z TOWN OF BUlL[fiNe DEPAJiTMENT TOWN HALL $OUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED] Date .,,,.JLILY ............... 1.1. ................. ~ ......... 19.97, .... Permission Is hereby granted to: ....... l-~ L LO C IL. ~--.. ~J'JI~,H,T~ L ........................................ ....... RR,..2...4--~0~,..AL,VJ~S...LAN~'- .............................. ....... ~J~CJ-~UE .. I~¥...~ J.985 ,, .................................... to .....-T I~ C~ALL...E~.EI~-IQ~.. ~80.. GL ..W~R ..H~JI,~E~.. Jk~..A~.I~L.T.~-D..FOR ............................ at premises located at ................ 480,.~....~V,~-I~..,T~I, .......................................................................... County Tax Map No.....~7.,~88g ...... Section ...1.05 ............. Block ....000.2 ......... Lot No. (~2,2. ................ pursuant to application dated...,ZU.T.¥ .................. ~ ........................ 19.....,~'Z ...... and approved by lhe Building Inspector. Fee $ ........ 25.~0 ..... Rev. 6/30/80 OIL BURNER Certificate of Inspection N ame:~l' P;'141! [. API:~ 17360 4508 ALVAHS LANE, CUTCHOGUE,NY Loc4dJ on: PETRO INC. Applicant: Address: P.O. BOX 788, SMITHTOWN, NY 11787 TeL No. 686~1954 Ur. No, 2901-RE Expire~: ELECTRICAL INSPECTION SERVICE, INC. 375 DUNTON AVENUE EAST PATCHOGUE, NEW YORK 11772 TEL: (516) 286-6642 Town Haft, 53095 Main Road P. O. Box 1179 Southold, New Yo~k 1 ~971 Fax (516) 765-1823 Telephone {516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD CERTIFICATION DATE: Buildin. g Permit No. own.r: (please print) Plumber: (please print) I certify that the contains less than 2/10 solder used in the waker supply system of 1% lead.. Sworn to before me this - ~~~' County Notary Public, ~ .... ~-- ~-KENN~H ~. MIONE NOTA~ pU~IC, ~ ~ N~ No. 01MI5~174, S~olk ~m Expires Match 6, 1~ 765-1~02 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] I~JLATION [ ] FRAM'NO [~'I~#AL [ ] FIREPLACE & CHIMNEY DATE _* _ INSPECT~ Nassau Lic. No. 1"I3600630000 Suffolk Lic. Nm.. ;o~ ,-/~/.~ -$~ -OF SOUTHOLD ~ PiiOPERTY, RECORD CARD OWNER ' STREET /-.//'c~),5 VILLAGE DISTRICT SUB. LOT ~. ~,}~; S~S. VL. FARM COMM. ~IND. I CB. MISC. I Est. Mk,. AGE BUILDING CONDITIO~ NEW J NOR,MAL I BELOW ABOVE FRONTAGE ON WATER Farm Acre Value Per Acre Value FRONTAGE ON ROAD liable 1 ~--/ ~o o /~ · ~ BULKHEAD lable 2 DOCK lable 3 3odland ' ampland Jshland ~use Plot / fa 0 tal .~! 0 0 ~ ~:~- Both ?'/',:L?' ': ' InteriorFinish Porch Roof Type Porch Rooms 1st Floor Rooms 2nd Floor Dormer Foundation Basement Extension ! ' 2 " ' I Extensiop ~ ~ X /0 ~ 7J(~. ~Z ~- Ext. Wails --: '- ~/~ '~ '~ 3~ Patio Driveway Breezeway Garage FORM NO. 1 TOWN OF SOUTHOLD ' BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N Y 11971 TEL.: 765-1803 · : ' ·. (Building Inspect ~ 3 SETS OF PLANS ...... · .... SURVEY" ClIECK . - t:Ol! FY = . CALL ~ ............... ~.. HAIL TO: INSTRUCTIONS 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 pubilo or areas, and giving a detailed description of layout of property must be drawn on the diagram which is par ?f this appli- catiolL ¢. ' The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this appBcation, 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. ¢. 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 [S_JrIEREBY MADE to the Building Department for the issuance of a Buildin§ Permit pursuant to the Building Zone (2~u~El~e~l~r~{~'~uffolk County, New York, and other applicable Laws, Ordinances or Regulations, f~/~l~ffOl~~'I~k~'°r alterations, or for removal or~demoB~on, as herein desc~b~d. The applican~e,~.'-~s~,C--!ll~Z'~'l~,~Jt~,!b~'t~.fl,~t~,s~ ordinances, building code, hous/~g code, ~regulation,, and to · -- SU~/.Y _~v~ T~/l~ P~t AIA/~'t'r (Signature of app]icanr,~r name, i~a corporation) , . ' . (Mailing address o f. applica~/ . State whether applicant is ow_.w_.w_.w_.w_.w_~r, lessee, ·agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises · O ~..P-.~ If·applicant is a corporation, signature of duly authorized officer.' i' NOTIFY BUILDING DEPAffi'MENT iT UNDERWRITEIB CERllRC~IE 765-1802 SIM ?0 i PM FOR II-IE , , REQUII~ED FOLLDWING INSPECTIONS: (Name and title of corporate officer) 1 FOUNDATION - ~ REQUIRED ' ~uilder's Lice.se No · OCCUPANCY OR , ' ...... L"; L'" ;'7, ..... USE IS UNLAWFUL t m~um~.~ · Pinmber s ~i~¢nse .o ..... ~- ./: -~- - .~. · ./~'. · - · WITHOUT CERTIFICATI~' ~m^c. CON$'RUCnON MUSZ BE COMRL~ FOR C,O. Electrician's License No. ~'~ / '~' OF OCCUPANCY '~ co~mmucn~ ~ STATE CONSTRUCTION · ENERGY 1. Location of land on which proposed work will be 'done... Z~.~.-.O.~. ~/ Itouse Number . Street . . Hari~et Cot,~ty ']'ax ~ap No. 1000 Section '.: ./.~. ' .......... Block ...... ' Lot... ...... ;.. ..... Subdi'zislon..; ..... . ................ ...'.. ' Filed Map No ............... Lot ............... (Name) Stat~ existing use and occupancy of premises and intended use and occupancy of proposed constructioni a. Existing use and occupancy ... ~ .~. ( ....... } ..... __./. · · ............... ' ..... b. Intended use and occupanc . . ..... .3. ature of work (check which applicable): New Building . ~ ....... ,~,ddition ..... Alteratior, · ~?./. ~.. ~ Repair .............. Removal .............. Demolition ' . · .'''i '~ther Work,~.'~..~,'~/ · ~/g--/~fO ' . · · · ~/~..~.~ ._ (Description) 4. Estimated Cost · · .. ...... Fee .............. (to be paid on f'fling this application) 5. If 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 type of use ............... ~ .... 7. Dimensions of existing structures, if any: Frofit ....... ~ ....... Rea~ .... ........... Depth ....... '.. ~ ..... Height ............... Number of Stories ..... ~ .......... ~ ................................ .,. ,.'... Dimensions of shme structure with alterations or additions: Front ................. Rear .......... ........ Depth .... ~ .................. Height ....... ~ ·,: ........ :., Number of Stories .......... '. ~ .......... 8. Dimensions of entire new construction: Front ...... ~ ....... ; Rear ............... Depth ............... Height ' Number of Stories ' 'Size of 10t: Front Rear .................................. 10. DateofPurchase .................... . ........ . Name of Former Owner .. ...... ': ..... 11. Zone or use district in which premises are situated ...... ~ ~ ....... .12. Does proposed construction violate any zoning law, ordinar{ce or regulation: ..... ' ............................ 13. Willl0tberegrad~d ...... .ff..,z..z:~.r~._~,.../v ..... Willexp. essf. gl ~ re~0ve~l from premises: .Yes No 14. Name of Owner of premisesT',~-,~./ff.q~., g~?.//./ffff.. A d e-/~)o~ ,4z/~, -- .. dress ........... ~../'4Z... Phone No. ~.-q.. ~·.-.~. ?.?.~... Name of Architect ./.~ ...... ~ ....... ~'.... Address ................... Phoae No ...... · ./.. N, am.e,o.f Contractor~...~..~v..~.~../.,~.,q. ff.~..~... .. Address ./?.' 15.' x~ cn~s property within 300 feet of a tidal wetland? *Yes ........ No~.: ' / - · If yes, Southold T. own Trustees Permit may be required· "-~ ........ . . PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate ail 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. ~~x~~~ ........ . ..... *oa~~w~~o~t~t) .... b~in~ a~ly ~wo~n, d~po~s ~d ~ys that ~e is tho ~ppli~ant abov~a~$~S ~ · He is the., ~~/~. ~M7 ~ (Contractor, agent, corporate officer, etc.) of said owner or owne~, ~d is duly authored to perfo~ or have perfo~ed the said work and to m~e ~d ~1~ this application; that all statements contained ~ this'application are true to the best of his ~owledge and belief; and that the work will be perfo~ed in the m~ner set forth ~ the application filed therewith, Sworn to before me this ................. , ........... . . ~0~ ~aU~. S~ 01 Ne, Y~ · [ · (Signature of'appllc~t) T,~ Exuire, Mar,*'. 6. l~.