HomeMy WebLinkAbout16652-z FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. . .?- 168.9.7 . . . . . . . Date . . May 23 , 1988. . . . . . . . . . . . . . .
THIS CERTIFIES that the building . . . . .ONE. . . . .FAMILY. . . . . . . . . . . .DWELLING. . . . . . . . . . . . . . . . . . . . . . . . . .
Location of Property . , , 1575 Sterling Road Cutchogue , N.Y .
House No. ' ' * ' * . . . . * . . . . . . * I ' * I I Street I * * I * * I * * * I I I * I I I I I I * * *Hamlet
County Tax Map No. 1000 Section . . 04. . . . . . .Block . . .02. . . . . . . . . .Lot . . .??. . . . . . . . . . . .
Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office dated
November 25 , 1987 16652 Z
. . . . . . . . pursuant to which Building Permit No. . . . . . . . . . . . . . . . . . . . . .
dated . , November 25 , 1987 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 . . . . . . . . .
ONE FAMILY DWELLING WITH ATTACHED DECK AS APPLIED FOR
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The certificate is issued to . . . . . J N DEMPSEY
. . . . . . . . . . . .(own' a�ed )X. . . . . . . . . . . . . . . . . . . . .
of the aforesaid building.
Suffolk County Department of Health Approval . . . 8 5-S 0-24 1 - April 20 , 1 9 8 8
. I . . . . . . . . . . . . . . . . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE NO. , ,N010618 - April 28 , 1988
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
PLUMBERS CERTIFICATION DATED_ May 6 , 1988 - T & G Plumbing
. . . . . . . . . . . . . . . . . . . . . . . .
Building Inspector
Rev. 1181
"Itm NO. 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)
NO- 1 6652 Z Date .... !....1�►+ ..........
Permission is hereby grante to:(_ A �J
... .R+....................
V. s.°C... ). 1... .................vv...............................
........... \
to ..0..4`^..... n!L!�l.f ......4..(�`f�u. .J..1.� .�...(.cklrU!l...v..ke 1. ......U, 4.�..
Q5 !}�.�-aJ. o ............................. .. . ...................................................................................
at premises located at .�s�.7.........w)rW 1....�'.......... .rJ .1 �................
` �.... ,... .-.......................................................................................................................
.. .. ,, //
County ox Map No. 1000 Section
.....a..Q.q...... Block ......4 -...... Lot No. ......
�-r2-- .....
pursuant to application dated ......... 19.A.I., and approved by the
Building Inspector.
Fee $. �t S-.
/..�. .. .................... •.........
Building Inspector
Rev. 6130180
FORM NO.e ,
TOWN OF SOUTHOLD 1'
Building Department
Town Hall'
Southold, N.Y. 11971
765 - 1802 .-
APPLICATION FOR CERTIFICATE OF OCCUPANCY
� Instructions' `
A. This application must be filled in typewriter OR ink, and submitted n 1nw �to the Building Inspec-
tor with the following;for new buildings or new use: I
1. Final survey of property with accurate location of all buildings, property lines, streets,!and unusual
natural or topographic features. -
2. Final approval of Health Dept. of water supply and sewerage disposal—(S•9 form or equal).'`,
3. Approval of electrical installation from Board of Fire Underwriters. v
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings ;and installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building
S. Submit Planning Board approval of completed site plan requirements where applicable.j
B. For existing buildings (prior to April .1957), Non-conforming uses, or 'buildings and "pre-existing",
land uses: i s! 1;;,,
1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or -
topographic features.
2. Sworn statement of ownerlor previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code;or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees: Additions $25 . 00 ,
1. Certificate of occupancy New Dwelling $25.,QO, Accessory ,$,10.00 Busines'sv $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50 .00 j I
3. Copy of certificate of occupancy $ 5 . 00 , over 5 years $ 10 .00
4.Vacant Land C.O. $ '20 . 00-
5.Updated C.O. $' 50 . 00 Date . . . . . '. . .. . . .
NewConstruction O �
. . . . .,Old or Pre-existing Building . . . . . . . . . . . . Vacant Land ; � . : . . .'. .
Location of Property .1575. 4terl.i yag. RQad,. .CutChQ'gue,>. X.. X% .1�9.3 . . .. .
House No. Street . . ,- ;. ,; Hamlet,.-
_ .f
Owner or Owners of Property .JOhA .Dempsey. . . . . . . . . . . . . . . . .. . . . . . . . ._`.'. . . .:
County Tax Map No. 1000 Section .104. . . . . . . . . Block .2. Lot kc
Subdivisiod'Map.of .Wal3Aa4.j'A=s!!.. . . . . . . . .Filed Map No 1179 . Lot No. .
Permit No.1Ca652. . . . . Date of Perm itll/.25/$7 .Applicant . .jn�aD . Q r MQ. . '
Health Dept. Approval .4/?_Q/$$. . . . . . . . . . . . . . .Labor Dept. Approval . f'
Underwriters Approval PI01,0,E1$. . . . . . . . . . . . . . . .Planning Board Approval
Request for Temporary Certificate . . . . . . . . . . . . . . . . . . . . .Final Certificate . . a
{ f
Fee Submitted $2`5.40. . . . . . ; s
. .
Construction on above described building and permit meets all applicable codes and regulations r
Applicant . . . . . . . . . . . . . . . . . . . .
I
Robert E. Hi1tz Inland Homes, Iit .
Rev.10-10-78 j -
I �
cQa &C17 ,
TEL. 765-1802
�pc�VEFour�pG TOWN OF SOUTHOLD
y�c OFFICE OF BUILDING INSPECTOR
o rn P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
C E R T I F I C A T I O N
Date May 6, 1988
Building Permit No. 16652Z
Owner John Dempsey
(please print)
Plumber T. & G. PLUMBING Tom Azzera/Gale Kaske
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
�� — 1,1�,"ele-'I A 9�—
(plumber' s ignature)
Tom Azzera /Gale Kaske
M;SE S.DORAN
sworg to before Be this NoWy Public,Stateof Now York
No.4891481
day o f OualiBed in Suffolk County
(�� � Comisaion Exp rea array 4,198� ��
19�' j Notary Public
rB Notary Public, 6 C_ County
OMME,UIS
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FOUNDATION ( 1st )
FOUNDATION ( 2nd ) m
2 .
o
ROUGH FRAM & v�
PLUMBINe
3 . _ / m
INSULATION PER N .
H 2
STATE ENERGY �•
CODE *{
x
11
a
�/ s/ / r �°
IR m 1
FIN
ADDITIONAL COMMENTS :
m
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765-1802
BUILDING DEPT.
INSPECTION
[ FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ 7 FRAMING [ ] FINAL
REMARKS: 0',
DATE � INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOU TION 1ST ( ] ROUGH PLBG.
[ � FOUNDATION 2ND [ ] INSULATION
[ 1 FRAMING [ ] FINAL
REMARKS: 4 c �i
n�-
DATE INSPECTOR '
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST f ] R UGH PLBG.
[ ] FOUNDATION 2ND INSULATION
[ ] FRAMING n ] FINAL
REMARKS:
DATE a� �� INSPECTOR
M-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ROUGH PLBG.
( ] UNDATION 2ND [ ] INSULATION
] FRAMING [ ] FINAL
REMARKS:
DATE 9 N4Y INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST ( ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING FINAL
r
REMARKS:
DATE �� �� INSPECTOR
ZONING
1.� HULK AND PARKING SCHEDULE
i.
w A Residence District
19 y( 2 3 a s o za Two. Multiple-Residence
�e of FgF Family Districts Business Districts industrial Districts
Minimum Single-Family Dwellings Dwellings M M-1 B B-1 C C-I
Requirements A A-40 A-80 A-160 Light General Light General Light General
Total lot area(sq.ft.) — 40,000 80,000 160,000 40,000 80,000 20,000 30,000 40,000 2001000
Lot width(ft.) — 150 175 270 135 200 60 160 200 300
Lot depth(ft.) — 175 250 400
Front yard(11.) 35 50 60 60 60 50 35 36 W 150
One side yard(ft.) 10 15 20 30 15 20 25 30 60
Both side yards(ft.) 26 35 45 80 35 45 50 60 100
Rear yard(ft.) 35 50 75 75 50 50 25 35 50 too
Livable floorarea(sq. 860 860 850 850 See Artl- See Arti- —
ft.)per dwelling unit clelV cleV
Off-street parking spaces 2 2 2 3 See Arti- See Artl- See Artl- See Artl- See Arti. SeeArn-
per dwelling unit cie IV cleV CIe VI cleVII cie V111 Cie IX
Maximum
Permitted
Lot coverage(percent) 20 20 20 20 25 25 91�.Arti- See Arty Bee Artl- SeeArti-
13ullding height: Cie VI Cle VD COe VDI cie IX
Numbcrof stories 21Fi 23,t 2�x 2!i 2�,i 2�Fi 2 2 2 2
Feel 1115 15 35 35 35 35 30 :16 35 35 ,
1 Amended 5.29-73:5-16.83 by L.L.No.7.1983;8.9-83 by L.L.No.9.19831
'1 Amended 5 30.7.4 by L.L. No. 3.19751 ..
k ZS 11
1 r, 1460
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
0
BUREAU OF ELECTNR�ICITyY�Bt�
APRIL 28,1988 BS JOHN STREET. NEW YORK. 7L 16YUi{7S 1GD38 N 010618
Date Application No.on file 1�ri
THIS CERTIFIES THAT
only the electrical equipment w described below and introduced by the applicant named on the above application number in the premism of
JOHN DEMPSEY, STERLING ROAD, CUTCHOGUE, N.Y.
104 2 12
in the following locaAORtL tBrMnt t Jet Ft. ❑ Ynd F!. Section Block Lot
was examined on and found to be in compliance with the requirements of this Board.
NXTUM A AXTURES RANOEf COOKING DECKS OVENS qSN WAfNERS !%NAUST MNS
OUTLETS fY1RTCNM IN(:ANDESClNT FIUMESCENT I MvW I AMi. I K.W. AMT. N.P.
20 12 21 20 i F
DRYERS FURNACE MOTORS MTIME ANUANCE REDM6 IVICIALMICTTI TIMECIOCKS I Rtl UMT NEATIM I AWl14WT1lT OWASERS
AMC K.W. 011 M.P. GAS M.P. AMT. MO. A W.G. "T. Mr. AMT. Mrs. TRANS. Mr. M.r. NO Di tEET AMT. WATTS
F
SlRVICt DIECONNlCY NF.N - S E R It I -C
SORT AMT AMI. TvvE I,e EW ,/fw 3 B TV f/.W �'KR;COND. OF C t0. NO.OF MELEE a'W.0. NO.OF NEanALS of NWEuTGMAI
C:
OTNM MMRATUS:
^..F.C.I:-2
SMOKY, DETECTOR:-1
SOUTH PARK ELEC. CONTR.
4 PARK PLACE
PATCHOGUE, NY, 11772 p�M
11 MA11110411
Per
This certificate muff not be altered in..c
pny manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY PoR oLgLm 6 DEPAR MENT. S .
« , - 67 -
(c) All insulation which is capable of absorbing water shall be
protected by a vapor barrier located on the winter warm side of
the insulation. Insulation shall be installed in a manner that
provides continuity of insulation at plate lines, sill lines and
corners.
(d) Insulation may either be installed in floors over
basements/cellars or in basements/cellars walls above and below
grade. If, however, comfort heating is provided in the
basement/cellar, the basement/ cellar walls shall be insulated.
(e) Slab edge insulation shall extend from the top of the slab to
either a minimum depth of 24 inches or to the bottom of the slab
then horizontally beneath the slab for a minimum total distance of
24 inches.
TABLE 5-1
THERMAL PERFORMANCE VALUES FOR
BUILDINGS REGULATED BY THIS PART
Non-Electric Electric
Comfort Heating Comfort Heating
Roof/ceiling Ur = OS Ur - .03.
Floor Uf = .OS Uf - .053
Exterior Wall UN = .b5 Uw a .04
Glazing Ug = .58 U9 = .39
Entrance Door Ud - .40 Ud - .40
Slab Edge Insulation Rf = 10.0 Rf = 10.0
8asement/Cellar Wall U, _ .09 Uw .09
1. At 7000 degree days and over U .04.
2. At 5000 degree days U .04:
3. At 8000 degree days aKd over Uf .04.
7814.3 AIR LEAKAGE
All buildings shall meet the provisions of 7813.5 of this Code.
BUILDING MECHANICAL SYSTEMS
7814.11 GENERAL
(a) All HVAC devices, components and their elements shall conform to
the requirements of sections 7814.11-7814.15 of this Part.
(b) Systems other than combustion heating equipment and unitary
cooling and heating equipment regulated from a single point of
control shall be designed in accordance with the requirements of
Sections 7813.11-7813.23 of this Code.
i C9
b�
1 �
y'
1
I
BOARD OF HEALTH :� . . .
3 SETS OF PLANS �. . . .
FORM NO. 1 SURVEY '.
TOWN OF SOUTHOLD CHECK J.3(cZ4�
BUILDING DEPARTMENT SEPTIC FORM , . . ,No ,
TOWN HALL NOTIFY
SOUTHOLD, N.Y. 11971 CALL
TEL.: 765.1802 MAIL TO :
f;xamined . . . . .� 19d.1
w
��� s 2.(P.� S'2't, h y(c� r r �Vl
Approved �. ., 19 7. Permit No. U ����,•�ryo
}
Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NOV 2 5 l it
1lbathnc _ r. r� ., n
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
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
,hall 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, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
INLAND, HOMES, ,INC. . . . . . . . . . . . . . . . . . . .
(Signature of applicant, or name, if a corporation)
Box 117, Mattituck, N. Y., .11952 , , , , , .
(Mailing address of applicant)
State whether applicant is,-owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
. . . . . . . . . . . . . G.eneral .Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Name of owner of premises .John .Dempsey. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
. . . . . .Robert. E, .Hiltz, . Fxesident. . . . . . . . .
(Name and title of corporate officer)
ALL CONTRACTOR' S MUST BE SUFFOLK COUNTY LICENSED
Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . .
Plumber's License No. .24512 . . . . . . . . . . . . . . . . .
Electrician's License No. . . . . .273F . . . . . . . . . . . .
Other Trade's License No.
1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15�5._.Sterling. Road.,. .Cutchogje.,. .New -York . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . ... ..
House Number Street Hamlet
County Tax Map No. 1000 Section 104 . . . . . . . . . . . . . . Block . 2. . . . . . . . . . . . . . . . Lot . .pal•, •22• • • • • • • • •
Subdivision . . Lot.No•'•s •refer• •Map -of. •)�jaMju • Filed Map No. . . . . .1?79 . . . . Lot . . . . . . . . . .: . . . .
(Name)
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 . . . . . l .Fami.ly. Dwelling. . . . . . . . . . . . . . . . .:. . . . . . . . . . . . . . . . . . . . . . . . .
3. Nature of work (check which applicable): New Building XX. ... . . . . Additr .,r y�h?fit Alteration . . . . . . . . . .
Repair Removal . . . . . . . . . . . . . . Demolition . .': . .t:3" ` .'•1:".'.'(Jther'Work . . . . . . . . . . . . . . .
(Description)
4. Estimated Cost . . . d . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
' (to be paid on filing this application)
5. If dwelling,number of dwelling units . . . . . . . . . . . . . . . Number of dwellinguunits on each floor . . . . . . . . . . . . . . . .
Ifgarage, number of cars . . . . . . . . . . . . . . . . . . . . .,. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . . . . . . . . . . . . . . . . . . . .
7. Dimensions of existing strucluresa if any: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . .
Height . . . . . . . . . . . . ... . NEberof Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
!
Dimensions of same structure ;with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . .
Depth . . . . . . . . . . . . `. t. . . . ... Height . . . . . . . . . . . . . . . . . . . . . . Number of.Stories . . . . . . . . . . . . . . . . .
8. Dimensions of entire new construction: Front . . .59 . . . . . . . Rear . . . . .59.. . . . . . . Depth . .28.'. . . . . . . . . .
Height . . . . . . . . . . . . . . . NU'mlier of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9. Size of lot: Front . . . . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . .... .'. ,.::�, : .Depth . ... . . . . . . . . . . . . ... . . . . .
10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . Name of Former Owner ..... . . . . . . . . . . . . . . . . . . . . . . . . . .
11, 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 . . . . . . . I . . . . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes No
14. Name of Owner of premises .John, .Dempsey. . . . . Address P.O.Box .5, . Cat. . Phone No. . •734,60.j8. . . .
Name of Architect . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . '. . . . . . . . . .
Name of
Con tractor
HOMES 1 . INC. . . . . . Address Box :11' -,Matt$tuekhone No. .298=19596• • • • .
1.5. Isthisproperty�locAated within 300 feet of a tidal wetland? *Yes No . . . . .
*If yes, Southold Town Trustees Permit may be required.
PLOT 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.
doe
` .
5'rATE OF NEW YORK, S.S
COUNTY OF . . . . . . . . . . . . . . . .
Suffolk, , , , , , , , , , ,ROber'ti. E/ Ji3 ; z, , , , , , being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
Ileis the . . . . . . . OontrAQtor.,. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(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.
Sworn to before me this
. . . . . . . . . . .25tl� . . . . . . . .day Ilof. .November. . . . . . . . . ., 19 .87
Notary Public. . . . . . . . . . . . . . . Suffolk . . . . . . . . . . County
Q . . . . . . . . . . . . . . . . . . . . . .
UiDAJ.COOt� / Robert E. Hiature of applicant)
Notary Public,State of New York ` (Si( pP )
No.4822563.Suffolk County o
Term Expires December 31, 19....,.
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