HomeMy WebLinkAbout33634-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32923
Date: 03/11/08
THIS CERTIFIES that the building ALTERATION/ADDITION
Location of Property: 45 OAK RD
(HOUSE NO.)
COUnty Tax Map No. 473889 Section 110
(STREET)
Block -L- Lot 9
NEW SUFFOLK
(HAMLET)
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
JANUARY 16, 2008 pursuant to which
Building Permit No. 33634-Z
dated
JANUARY 16, 2008
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 2ND STORY ALTERATION & ADDITION TO AN EXISTING SINGLE FAMILY DWELLING
AS APPLIED FOR.
The certificate is issued to LAUREN T KRUG
(OWNER)
of the aforesaid building.
SUFFOLK COUlIITY DEPARTMERT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE 1lIO.
N-418463
04/24/97
01/07/08 ANDREW CASE
PLUMBERS CERTIFICATION DATED
/
Rev. 1/81
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. TOWN HALL . " , I J1AN '
765-1802 WWL. '1 I 5 . 0 Y...I
APPLICATION FOR CERTIFICATE OF OCCUPA~CY '",.' . "'.. _~....J I
This application must be filled in by typewriter or ink and submitted to the Building Depa~:~:~:;h-thd:on'~
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
A. For new building or new use:
I. Final sltrVey 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 211 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.
B. 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
7Date. ~<>j IA.. "-->
Old or Pre-existing Building:
Location of Property d-< () 'is!.> G P. A '1\, vJ (') L L ~ A-I\
House NO('I:'-P.c"IC RD'''l 0~treet f--
Owner or Owners of Property: L A Gl/~ C. ..J f'-.. fL{_.LA~
Suffolk County Tax Map No 1000, Section I I D. DC) 0 i3 Block _.-c::...D..~ Lot
Subdivision ~A Filed Map. _Ld~._ Lot: . )..jA
Permit No. ~t~~~~nli~1~li~/1!r Applicant_._L&LUl-.E~ f( ~i()
Health Dept. Approva!: ._.. Underwriters Approvn!: _.. ._.
~
I
~o??
New Construction:
( chcck one)
lVc2AA) '-~.AA~() 0<-
Hamlet
Planning Board Approva!:
Request for:
Temporary Certificate __
Final Certificate:
_.. /.
,'" <::- -----
Fee Submitted: $ ---< J
G\u:.7 n,1 r
COz 3J9~
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.
33634 Z
Date JANUARY
16, 2008
permission is hereby granted to:
LAUREN T KRUG
PO BOX 587
NEW SUFFOLK,NY 11956
for :
CONSTRUCT A SECOND STORY ALTERATION, ADDITION TO AN EXISTING ONE
FAMILY DWELLING AS APPLIED FOR. THIS PERMIT REPLACES BP 23875.
at premises located at
45 OAK RD
NEW SUFFOLK
County Tax Map No. 473889 Section 110
Block 0008
Lot No. 009
pursuant to application dated JANUARY
Building Inspector to expire on JULY
16, 2008 and approved by the
16, 2009.
h9rized
Fee $
75.00
ORIGINAL
Rev. 5/8/02
?
l.fi
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 I'
1000121 i
BUREAU OF ELECTRICITY
r- 85 JOHN STREET, NEW YORK, NY 10038
Datp APRIL 30,1997 Application No. onfilt> 13229797/97 N 418463
THIS CERTIFIES THAT
only the electrical equipmeAt .. dtncribed belou1 and introduced by the applicant nGmed on the above application number in thepremiM. oj !;
JOHN GRANT, 2980 GRATHWOHL ROAD, NE~I SUFFOLK, N.Y. ,
in tlieJollowins location; 0 Baement 0 /RtFt. [] 2nd n Sf'f"tion Block Lot
was examined on APRIL 24,1997 and found to be in compliance with the National Electrical Code. I
FUCTun FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS ECEPTAClES SWITCHES INCANDESCENT FLUORESCENT OTHER "'T K.W. "'T K.W. "'T KW. "'1. K,W, "'T. H.P.
-, 9 5 2
~
DRYERS FURNACE MOTORS POTUR! ArPUANCI FEEOIRS SPECIAL IEC'PT TIME CLOCKS II" UNIT HEATERS MULTI.OUTL.ET DIMMERS
SYSTEMS
"'T. K.W. Oil H.P. GAS H.P. "'.. NO. A.W.G. AMY. "'P. "'T "''' TRANS. "". H.P, NO. OF FEET "'T. WA.TTS
2 600
. ~.__ICR-,QI_N_"... NQ...Of .. " .. .. .5., ..E .. . ", ,y .' . 1--.- "..~, ,., E.-..---~..--
Mm. NO, OF cc. COND A..W,O. NO. OF HI.lEG A.W.G. NO. OF NEUTRAlS A.W.O.
"". AMP. TVPf EQUIP. lA2W l,3W J13W 3.14W "... Of ce. CONDo Of HHEG Of NEUTll:AL
OTHER A,PP"IATUS:
G.F.C.I,-l
':;HOKE DETECTOR, .1 i
., I
j'
-
AMOUNT
45 (X~ ~_ _T IT CHRCI( OR _
ORDII TO THI ~R Of THR
BAL: ,i{i0 YOlK IOAIOOP fin UNORW.=
PAUL R. BURNS LIC.#3897-E AS CASH SlNT IT MAIL WIll . AT
RISK Of SlNDII. I
PO BOX 1061
SOUTHOLD. NY, 11971-0932
11
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--------------------~
THIS IS youa IIU FOI5IIVlClIINDIIID AND IS NOT A atnNCATI Of COMPLIANCI. THIS IIU 'AYAIlIA' THI NIW YOlK OMa, 15 JOHN STRUT, NEW YOlK, N. Y. 10031
B2/B6/2BB8 18:41
631-73.<1-7B1B
a.JTCHOGLE LI BRARV
PAGE B3
Town Hln, 53095 Mlin Iload
P.Q..BoI1179
Soulhold, New York 11971.0959
'fax (631) 765.9502
TelephoM (631) 765-1802
BUILDlNO DBPARTMENT
TOWN OF SOUTHOLD
CERTIFICATION
Date:
/A;{;r
Building Permit No. Jip 1f 3.31ft3 4 -?
Owner: L A €A.. f.l..W 1<1:1 t.. j
(please print)
PlumbeLkA'f!!...,) &k-
(Please print)
lead.
1 certify that the solder used in the water supply system contains less than 2/10 of 1%
(Plumbers Signature)
Sworn 10 before me this ~._
:jeb ,~ ,,0
-~~
Notary Public, ~~.county
nw:ev A. FOX
NalIlY NllIc. SlaIII of..... York
No.01F08122ll38
QuaIIIed ~ SutIoIk ~
eommilllan Expilet FIb/UIIY 28. 2009
33'S R-.
TOWN OF SOUTH OLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRUCTION
[ ] ROUGH PLBG.
[ ] INSULATION
[~
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRAnON
CC
REMARKS:
--
'.
DATE
INSPECTOR
. ).5F20- -c-
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I
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [] R~ PLBG.
[ ] FOUNDATION 2ND [ v(lNSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: ~ij ~
rs-~,
INSPECTOR
o c
785-1802
BUILDING DEPT.
INSPECTIO
[ ] FOUN nON 1ST [
[ ] F NDATION 2ND [ ] INSULATION
[ ] FINAL
DATE t
INSPECTOR
~
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FORM NO. I
TOWN OF SOUTIIOLll
IIUII.llING OIlPARUIRNT
TOWN IIALL
SOUTIIOLll, N.Y. 11971
Till.: 765-11102
IIOARll OF m,AI.TII ...............
~ SilTS OF PLANS ...............
'SURVIlY ........................
/CIIIlCK .........................
SIlPTIC FORM ...................
..
Permi t No. .
NOTIFY:
CALI. ..................
MAIl. TO:....................
Disapproved alc
I~.ildinll Inspector)
-
5199)
CATION FOR IlUII.llTNG P!;RMIT
'Date.D.e..;.-.. ':f......., 19.~G,.
INSTRUCTIONS
R. "111is application Rllst be cDnpletely filled in hy type.uiter or in ink nod subniued to the nuilding .Inspector witl
J sets of plans, accurate plot plan to scale. Fee according to schedule.
h. Plot plan showing location of lot and of buildings on premises, relationship to adjoining p['€lIlises or plallic
streets or areas, and giving a detailed description of lity{XJt of property Rust he drawn on the diagran whidl is part of
this applicatiOl1_
c. n... work covered by this application I'"a}' not be cOlTrenced ,...fore issuance of &.ilding Permit.
d. Upon approval of this application, the Iluilding Inspector "ill issue a Iluilding Permit to the applicant. Such
permit shall he kept on the J!['€IIIises available for inspection thru.'l~hout tI... work.
e. No building sh.,ll I... occupied or used in tJlOle or in p<,rt for any pl.rpose ..Jlatever until a Certificate of
Occupancy shall have lleen granted by tI... Iluilding Inspector.
APPI.lCATIOO IS IIlRllllY mE to tile &.ilding lleparllrent For tI... issuance of a Iluilding Permit pursuant to the
Iluilding Zone Ordinance of tile Town of SoutllOld, Suffc1k CounL)', Net, York, and other applicable Laws, Ordinances or
Regulatims, for the constnICtion of buildings, additions or alterations, or for renvval or denolition, as herein
described. n... applicant agrees to clJltlly with all applicable laws, ordinances 'Iding code, llOUS' code, and
regulations, and to aduit autllOrized inspectors on J!['€IIIises and in I il r nec ry inspecti s
(Si ture of appl" ant, r l1EIre, if a cOTJxRation)
.ro.. B.~~. .~TZ... (1-T.Jxq:!JIM-!Ny.J.I.7. (3l>--
(Mailing address of applicant)
Slate ~Jether applicant is owner:t lessee, agent, architect, engineer, general contractor, electrician, plud>er or huilder.
.......... CJw.t>-I~.............................................................................................
Hane of ~ler of premises ....~.~~~~~.~~~~~.d~i...................................................
1 f applicant is a corporation, signature of duly authori?ed officer.
(Name and title of corporate officer)
Ik.ilders I.icense No.
CO/JIP..A~" \(&&e%f ~lu G,,,",~ -4->v
L-ICQ.i'--''''--' fi;. '7S41 -HI-
Plurbers License No.
Electricians l..icense No. . u...................
Otl...r Trade's License No. .................... ('
I. J,ocation of laod on tJ.ich proposed work will be done. :N.~ ..~~k.......................................
... ..c}..q.~.Q..... &A.J\lv.oLL. .K9.1H)............ NCN.. :C~f:.cU..,..... N .'J..... .1./.1 n"...............
Ihlse lUdJer Street I~{et
foOlmty Tax H.~ No. I!XXI Section ...lLCl........llIock ...~........... tot ..q............
Subdivision ...................................... Filed Hap No. ............... lot ...............
(Name )
2. State existing use and occupancy of premises and intended llse and occupancy of proposed construction:
a. F.xisting m;e and occupancy.. f.l.\,tV.~.. :b~~.......... ..~................................
h. Intended use and occupancy.. :~.~.f::................................................................
,'-
It.
tl3J Iklilding .......... hkliliOll .......... t\ltenltion ../.
IlenI)1 it ion ............ Other \-l:n-k ......................... _. . . . ... .
fee .~~~.~...............~~~~:~~:~~.....
(to he paid 'HI fi ling Ihis al'l'licat ioo)
~. If ck...elling. 1ll.Jlher of (kvelling unils ..1.......... IlJllher of ("'.Jelling lUlil"s on each floor ....._..........
ICsti"..ted cos~l.~.Q<;:)Q..............
J.
~"I"'e uf ""uk (dtet:k .....id, awlicuhle):
Hepa i r ............ Henvva I .............
1 f gllrnl~e, ,.."hel- of caTS ...... _. . . . .. . . .. .. . . . . .. .. . . . .. . . . .. .
6. If husiuesB, (,"(.lUllercial or mixed occupancy, specify nature and extent of each lype of use.._...................
J. nill'ellsions of existing sln.clures, if any: Fronl...c?'-!.......... Henr .H.......... Depth ..~.9...........
15cighl ......................... N.llher of Stories ....~............. 0-..-
ninellsions of afire struclure witl. oller-ations or iw"litioIlS: Fl'"ont .S~nG,.....-'.....near ..~~....
Ilepth .. ~AJh<.,......... lleigllt .. ..s:~......... thlller of Stodes ... ~AA.(../...
n. nill"~lIsi()ns of entire HL"W conalnll':l:ion: Fnlul .~:C.<:..... l~lIr ............... llept.h ..............
lie itdll ........................ _ N.llher of Stor iea .....................
9. Size of lul:: I'ront .....$:9............ Ileal' .....sf?........... Depth, ..~s?...........
10. I~lle of l'In:II",,,, ...?.7'~~:-.!7.,...... H....e of l'orner ().joeI' ..G().LF.('W.OlS,,;)...~M.I.~.
11. 7.oue or use district in ,.hkh pf"E~miseB are situated ..............................................................
40'
12.
n.
II..
noes proposed cOlIslruclion violate allY z()ning lUl.'t urdinance or regulation: .j..J.O...................
will lot be rel~r8(led ...hJQ............. Will e)((~ess filllte renoved fron premises: YF...!, N.l
Hmes of Owoer of l>ranise. .Lf.\Ih~..t~..... ^'klre,.. ./?1.~e:.~N9t-['..N9.... nlOf>e No.
H;llte of Arcllitect .............................._..... ^tld,"es9 .............................. PlK>lle li1.
time of r~H'l:ractor R9.l'l~.~;l\!0.6>N~j... Mlress M.q~..~~(..A.N.y.......nKlI>e It,.
1. Ihis I'ml>erLy wilhin JOO feet of a tlda1,,,,II,,,.1'I * WE .......... m ..........
*IF yl~~. &llllnD 10~ 'lllIJSn'.llS mllMlT H1W IV~ IlEC~nrum.
Mj,-. .
')[3. '1.'7. .~~..
2,~;:.mr ..
15.
\'1.0'1' IlTAGItAH
locilte cleady and distinctly all huilding9, ,..hether existing or prorJOsed, and indicate all set-hack dimensions
hUll property I iues. Give street and block 1_,II.>er or descriptifMl acconling to deed,' and sllGl street IllJIlf!8 and indieate
,"'-.ether interior or corner lot.
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.... ....... ...... <e 0...G (~........ . ... .IHdllll dilly
(Halle of individual signing l:ontracl)
ahove nlllll:..'1.I,
flworu, deposes 8I1f1 nuys thnt he in the nppl kunt
Hl'^'m OF
.. . . . .. .. . .. . . .. . . . .OWY.le. L .. . . .. . . . . .. . .. . . . . .. . . . .. .. .. . . .. .. .. . . .. .. .. .. .. . .. . .. .. .. ..
(r,oulroclor, ngent, c:oqx)rnl:e of[ice~, ete.)
of fmid owner ur uwners, und iR duly lRflhodzed to ()(!rfO"1l or have ped'orll~J the said work DlKI to unite und fi Ie Ihi"
Bllpl katiou; ..hut nll 8late~nlH contained in tlds nppl ic:alion fire true to the hest uf his knuwlec.1ne ulKI bilief; nod
Ihat. the work wi II he per-forne<l in the IIIi'UI1~r set forth in the applieHtion fi led I herewith.
Ik~ ill lhe
NlltnTY
CLAIRE L. GLEW
Notary Public. State of New York
No. 4879505
Qualified in Suffolk County Q /
Commission Expires O.cember 8, 19 tJ,tP
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