The URL can be used to link to this page

Home My WebLink About33103-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32399 Date: 06/12/07 THIS CERTIFIES that the building HOT WATER HEATER (STREET) Block 1 SOUTHOLD (HAMLET) Location of Property: 50605 MAIN RD (HOUSE NO.) County Tax Map No. 473889 Section 70 Lot 8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 4, 2007 pursuant to which Building Permit No. 33103-Z dated JUNE 4, 2007 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 NEW OIL FIRED HOT WATER STORAGE HEATER AS APPLIED FOR. The certificate is issued to CHARLES W & HELGA MICHEL (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N-352375 05/19/95 PLUMBERS CERTIFICATION DATED 05/03/95 LAWRENCE C. TRAPASSO ~ho~e Rev. 1/81 ~ ~ n w rn1 / . ~!~ :-.. 2CJJ7 Bi....O~~. OEPi. __JC'''''N OF S'" 'THO'-'l___ ' Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ~ CB.Q.63OY 105 ~('/J-9- /Iq, 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: 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 2/1 0 of I % 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. 13. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: I. 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. Certificate 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 - $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 Date. New Construction: Old or Pre-existing Building: (check one) Location of Property: ,(O0(!)'l /1JA--/4/ /7) ~cJff,*,hP House No. Street Owner or Owners of Property: O~LP- f $LM m I C&C Suffolk County Tax Map No 1000, Section 7 tJ Block / Hamlet Lot? Subdivision Filed Map. Lot: Pennit No. Date of Permit. Applicant: Health Dept. Approval: Planning Board Approval: Underwriters Approval: Request for: Temporary Certificate Final Certificate: (check one) ..- Fee Submitted: $ OlJ'r t:7<7 ~ ~gnature ~ IJ-ft,q~ c:ot..3,3H 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. 33103 Z Date JUNE 4, 2007 permission is hereby granted to: CHARLES W & HELGA MICHEL P.O. BOX 105 SOUTHOLD,NY 11971 for : INSTALL OIL FIRED FURNACE & HOT WATER STORAGE AS APPLIED FOR. (THIS REPLACES BP #22543-Z) at premises located at 50605 MAIN RD SOUTHOLD County Tax Map No. 473889 Section 070 Block 0001 Lot No. 008 pursuant to application dated JUNE 4, 2007 and approved by the Fee $ 75.00 Building Inspector to expire on DECEMBE Authorized Signature ORIGINAL Rev. 5/8/02 ---_._-_._--~ --- 10- \- "2lSL THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 Dotf> BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK. NEW YORK 10038 MAY 19,1995 Applica.ion No. onfil. 86444694/94 N 352375 1185077 I THIS CERTIFIES THAT only the electrical equipment at: t:leuribed beloul and introduced by the applicant named on the obove opplicotWn number in the premiH. oj CHARLES MICHEL, 50 605 MAIN ROAD, SOUTHOLD, N. Y . in thefollolCing location; 0 BG3ement 00 ht Fl. 0 2nd #'t. OUT Sertion Block Lot U'G' examined on MAY 15,1995 andfound to be in compliance with the National Electrical Code. FIXWH OUTLETS KEPT ACLIS SWITCHES FIXTURES I"""'NDESCENT FlUQltESCENT OTHER RANGES ANiY. K.W. COOKING Dl!CKS AMT. ICW. OVENS AMT. K.W. DISH WASHERS EXHAUST FANS AMY. K. W. AMT. H. P. 6 13 2 AMY. K.W. H.P. GAS AMT. .... W. G. AMT. AMP. AMT. AMPS. BELL UNIT HEATERS MULTI.ouTLlT SYSTEMS TRANS. AMT. H. P. NO. OF FEET DIMMERS DRVERS FURNACE MOTORS FUTURE APPlIANCE FEEDERS SPECIAL REC'" TIME CLOCKS on H.P. NO. AMT. WATTS 1 F 3 600 AMT. AM'. TYPE NO. OF S E R V MITER EQUIP. 1.l2W l.l3W 3}13W 3.14W NO.O~Ei'.wCONO. OF~C~CgNO. NO. OF HI-lEG C E rJ. :'Jh NO. OF NEUTR"'lS A.W.G. OF NEUTRAL SERVIQ DISCONNECT OTHER APPARATUS: PANELBOARDS,1-6 CIR. 100 G.F.C.I:-1 TRACK LIGHTING:-30 ROSLAK ELElCTRIC p.O.BOX 164 cUTCHOGUE, NY, 11935 LIC.#3677-E ~~~ GINIRAL MANAGU 11 ./ p" This certificate must not be altered in any manner; return to the office of the Boord if incorred. Inspectors may be identified by their credentials. ~-~--------------------------- COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. ---_. .._.,_.~- ---- - Town Hall, 53095 Main Road P. O. Box 1179 Southold, New Yorl< 11971 ( ':.~.;"':';'::;-.-. ~",-_.....i-l';n..~' '~>~ . ,...").~ '~"'{l;)...c~,\ 'J ),. .<...... """" . < '.., ,..:'~ _, ._.~;~.'.':". ~~ ~~~~ . -(:............-.":).. /- ~'" : " > -:'f' ! ." Fax (516) 765.1823 Telephone (516) 765-1802 ""._:-::-:_-=_...'..r-" MAY - 8 rqq'j OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I FIe A T ION DATE: ~ ~-< Building Permit No. ~~~~'3 Owner: (please print) (please () L~c. * '3 \ 3l.t- P . Plumber: I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. ture) Sworn to Ij!! before day of 19fs County GERARD H. MAGEE JR. [':0 I ARY PUBLIC, State of New YIllll No. 52-2468120 C2fmn;;;slCO &~~I~~ed In Sutt~l~,~ounty 9..:J{). 97 33 103 Z- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION [ ] ROUGH PLBG. [ ] INSULATION o FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRAnON REMARKS: Ir~, ~, ~ 01(; F~~~ ~ ~ DATE 6-r.... 07 INSPECTOR ~ ~ I:;S~;::C::'0:~ liD t~ ~:: 'I :..; (h'1l\l [NT::: \ \Ii ;.' l:::Li) .." II '" - . '" <:) 1. :: ~ H " --I - I""" ::-OUllDATION -l's~ l'- - - ~) 1~~ ::-OUNDATIOll (2nd) ~~ 2. ?~ I ROUGH FRAME & ~ :nUMBING "\ .. .~ en ~ --I '" 3 . '" t':l I . . --I IllSULATION PER N. Y. " STATE ENERGY I ~. I CODE ~ . I - . Ib-1;- 17 p~ ~....." .,".a- ok J' ):::(/74 -rn-..vr 4. CRA~" l ~ >Ct. ./ ./ ./ ":M .~ I . . - FIilAL ~ I 0 i'\ .:': =: COMMENTS: t':l , ADDITIONAL '" ~~ '. - . . . . - . '" I~ H ~ ;';, --I , ~ H 0 - , , - - ~~ - ;i~ 0. t':l .." --I - . . "" -' .Ct' ~ ~ :\, ~ ... ~ ~ "'ir ,.~.~. . - .. -..,,_. ,....,;....: ....-,-............,;,;...,'~ - FORM NO.1 BOA~O OF HEALTH ......... J SETS OF PLANS ......... SURVEY....--__........... ClICCK ................... " SEPTIC FOR" .............. . " 1994 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765.180~ r:oC'r F"f: CALL.................. . HAIL TO: " Examined!~,..., ,'.',"",19.i!f' Approved., 1/3...",' ,.191hermit No, $P.f?;;.'f.3/ . . . . . . . . . . . . . . . . . . . . . . . . . - . . . . . . . . . . . . D' . lsapproved alc ,.,.",...".....,..." . , . . , . . . , , . , , . ..........HHH..H....H......;:7~~. APPLICATION FOR BUILDING PERMIT ...6!1!rij....19... Date 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 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 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 removal or demolition, as herein described. The applicant agrees to comply with all applicable laws. ordinances, bu' ding co~,' code, and regulations. and to admit authorized inspectors on premises and in building for neces! in.s ~t~~~~. ~V~. . . . , . . . . . .. . . . . . . . . . . . (Signature of aPW~, Vi name)! corporation) .71Y.~{.fq). "'1.1/711 (Mailing address of applicant (as on the tax roll or latest deed) I%~.li.C~~: :s. ~ ~~~~~r.a~i.o.n.. .s:g.n.a~~~e, ~~ ~~l.~ ~~~~~r:z.e.d. ~fficer. (Name and title of corporate officer) - Builder's License No. ......,.................. Plumber's License No. ...31.311. -: .P. . . . . . . Electrician's License No. . .':t7.c;.7.~. t1.f. . . . " ,",,!___."T".'.'.'I". '. _ U lUt;J J. J due :s LIl,;CnS,e 1'l0. . _' . . . . . . . . . . . . . . . . . . . I. Location of land on which proposed w&:{rk will e done. .,............... tiO(f)'Y.... .. .~... ... .. ....... .. .... ..... House Number treet Hamlet County Tax Map No. 1000 Section ...: .10 . . . . . . . .. Block ..... .1. . . . . . . : . .. Lot.... c:? . . . . . . , . . . . . ...... ... ... ...... '. Subdivision. . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. .............. Lot............... , ~=~ . 2, State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...:....,.,..............,............................................ b. Intended use and occupancy '" ... .0..... .......... ...... .................... ...... ............. ~ r.r~,j.l"-""ofw""""!'-(chi"""".Wh;ch"'''\pl:~_1..'''' "" B......... .1.:..ld't"ll Alt~ra'LI'" .J. ......1... ....~,.. ~,,~...,~ H....~.._ . ". . ~'Y ~-'''''<.l...He); !"H:.W ulluulg....:"..... i"'LU .I. J.U ........... '" .'~ ........ RepaIr ........... '4:k Removal. . " . . ... . .. .. Demohl1on ....;......... Other Wor . ',' . . . " . . " . . 4. Estimated Cost '.... .cf[?V0. r;??' ................ Fee...:I1. .7~ .QO....... .(~.e~~~i~~i~~~. (to be paid on filing this application) 5. If dwelling. number of dwelling units. . . . . . . . . . . .. .. Number of dwelling units on each /loor. . . . . . . . . . . . . . . . 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: Front. . . . . . . . . . . . . . . Rear .............. Depth.............. Height ............... Number of Stories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same 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. . . . . . . . . . . . .. . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ' 9. Size of lot: Front. . . . . . . . . .. . . . . . . . . .. .. Rear...................... Depth ....................., 10. Date of Purchase ............................. Name of Former Owner ............................, II. Zone or use district in which premises are situated. . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law. ordinance or regulation: ................................ 13. Will lot be regraded ....... '. . .. . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes No 14. Name of OW'ler of premis~< . . . . . . . . . . . . . . . . . . . . ."'.ddress .. . . . . . . . . . . . . . . . . . Phone No. ...........;.. . Name of Architect ........................... Address . . . . . . . . . . . . . . . . . . . Phone No. ...........'.... Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. ...........'.... 15.' Is this property within 300 feet af a tidal wetland? *Yes........ No......... ' *If yes, Southald Town 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 and block number or description according to deed. and show street names and indicate whether interior or corner lot. ' , SV( S-t~ ,-\0 G.-lL 'TJ.;.c\; ~\\\'\\. \~~l~ \~*~\\~~UV\t UNllEllWRllERS CERTIfICATE REQUIRED ' r:' q~"':;.i:,T~ ~~frn~~~ - ,,'fp-f1~- RP. ~.~ ~sc.f '3 <f , Z.G~ fr)~,:;,,'I:~\T '.' :'i? ',;; .1i:'.:V\ Y\) :,:1. PI;","; ~OR THE , !,~'{lnf~1 I V.fe, nCC!UIREO i;<~';r.; r:p. C(';'-.:Cr.7E rE ,:,;;" f"c.!"'"" ~~+~,~\!\~;NG ~~: PLU~i1gj;\~G <, t .;IU.'~ >;;'~Li"'n~\~~?Tr;:UCTIO::\! f\/;' is'f fOR e.O. "!i cf){~~-:rp::UCTH)r,; SHALL f"lEET ''l[-QlIiREMENTS OF THE' ,';.'{, .':":/:,-;~ eOi"',(SrRtJCTlON &. ENEF{f-iY '.co; NOT RESPONSIBLE FOn "','i':\' Of; CONSTRUCTION ERROI<~3 :::',::m'd~",,'f'"d'"'d,,' ",,':' a . . . . . .. . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ' (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 true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. ' Swom to before me this ....... ... .....~.(.~~. ..dayof..Q.~:t:..... .........19~L'-! Notary Public. ........~.vl...\.~../~ County, ,,(')r ~ VITO E. FRACC'ALVlERI ' X . ... LU...{~ .. . .. . . . . . . .. . . . . N*'Y~~~2re=ewYOlt , (Signature of applicant) Qullifled In SuffoIIc CountY "Q I - , Commission Expiras Mlrch 30, 19~ being dUly sworn. deposes and says that he is the applicant .- 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) 3'3 J03Z- N~ 2254J z.- ' Date .t.~................................................. 19f?~ Permission Is hereby granted to: ' . . .......... ..V~y....7.J?f..y.......//......7.,:b ~ #" to.44..4~...~~.......J...&..,...~JY~",,~~ .N...........~/#.....~.................................................................................................. ..............................................................................................................................................................,... .................................................................................................................................................................. .........................................~.....~......~..........................:......~.)l'......................................................... at premises located at...dPt!.......s.........~......~(............................................................. ........................,........,.........Jdf.<<q~................................................................................ County Tax Map No. 1000 Secfton .......70........... Block ....../................. Lot No. ...S!..................... pursuant to appllcafton datedh:/fir:o/.......................... 19................ and approved by the Building Inspector. / / Fee $...7a:.~ ~4n'" ...B~II'dl~9:~SP~t~;...................... Rev. 6/30/BO