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HomeMy WebLinkAbout23880-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25065 Date June 3, 1997 THIS CERTIFIES that the building ALTERATION Location of Property 500 LITTLE PECONIC BAY ROAD, CUTCHOGUE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section III Block 14 Lot 12 Subdivision Filed Map.No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 17, 1996 pursuant to which Building Permit No. 23880-Z dated JANUARY 3, 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 ALTERATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DANIEL KOHN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-420339 - MAY 19, 1997 PLUMBERS CERTIFICATION DATED MAY 22, 1997-MIKE JACOBI PLUMBING Bui ing In for Rev. 1/81 FORM 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) rT0 23880 Z �6 Date ................... ..............................., 19....... Permission is hereby granted to: " . .. .. ............. ..• .• •... .• •. ................................. T to yr.. ...... • . ...!.........5'. .• .......... .................................... •............................ at premises located at ......./.. ........... 1. �P..l-��. ? ..1` ................... .......................................................... . .. ..... :—....................................................... ................................................................................................................................................................. County Tax Map No. 1000 Section ........ /. ...... Lot No. pursuant to application dated .............. ...... .z7..... 19 5�, and approved by the Building Inspector. Fee $... . ........... .... .......................................... .......................... Building r Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPART`ENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final surrey Of .property with accurate location o.f 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. Q� 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, 1557) non-conforming uses, or buildings and "pre-existing" land uses: 1 . Accurate survey of property showing all property lines, streets, bui-lding and unusual natural or topographic'features. 2. A properly completed application and a consent to inspect signed by the applicant. If 3 Certlf .11 icate of Occupancy is denied, the Building inspector sha state the reasons therefor in writing to the applicant. t . C. Fees 1 . Certificate of Occupancy - New dwelling 525.00, Ad�tog $25.00 Alterations to dwelling 525.00, Swimming pool SZaing $25.00, Additions to accessory building 525.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildinz - $100.00 3 . Copy of Certificate of Occupancy - .25G. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $1155.00, Commercial 515.00 Date . . . . : /. . .Z... . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . Old Or Pre-existing Build Location of Property. :. .. .... �. . . L. . . . . ..7 O . . . . . . . . . . . House No. Street Hamle� 79 la Onwer or Owners or Property.1 . . . � . . . . . . . . . . . .. . . . . . . . . . . . County Tax flap No 1000, Section. . . . . . . . . . . . .Block. . . / . . . . . . . . .Lot_ 1. �. . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . .. .Filed 'Map. . . . . . . . . . . .Lot. . . . . . .. . . . . . . . . . .... . . . z 3 8 8 4 Z .�9•? 3 /997 �Li om cr r ,Sa riI r �rcl f Permit NO . . . . . . . . . . . .Date Of Permit. . . . . . . . . . . .Applicant. . . . . . . . . D . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . ..Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . .. . . . . ... . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicace. . . . . . . . . . . Fee Submitted. $ . . . . .a . . . . . . .✓. . . . . . . . . - A�2PLICANT lR/tie-_4 C o Z-?_506.5 VULA-C TEL. 765-1802 TOWN OF SOUTHOLD ►� '= < OFFICE OF BUILDING INSPECTOR P.O..BOX 728 TOWN HALL .SOUTHOL.D, N.Y. 11971 C E R T I F I C A T I O N Date Building Permit No. Owner f' 1(- �� (please print) Plumber d k� (please print) I certify that the solder used in the water supply system contains less than 2/10 of to lead. d (plumb ' signature) Sworn to before me this day of 19 ��� � Notary Public 11otary Public, County LINDA,J COOPER Notary Public,State of.NewYork No.4822563,Suffolk Coutrty(' Term Expires December 31,19.L r6s-ieox BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & C IMNEY REMARKS: DATE -S_ �J l�7 INSPECTOR 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN ULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CFIIMNEY REMARKS: DATE S f /� INSPECTOR_1�i2���� 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ /] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [V] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMA KS• ��/✓✓�� � DATE � ZC INSPECTOR 2,,'2000e 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROJ GH PLBG. [ ] FOUNDATION 2ND [ V]'INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE `'d' �� � INSPECTOR I:D. I I MV I'M I IlliAT I M.1 FOON D AT ION 2ND) ..,ter:-------- —----- - IMNILATION ill,'I( 11. y . STATIF COM., --------------------- --------- — ------- -- - ------- ------ I IIAL ------------------- ---------- ------ ------------------------- -------- - ---- --- 30 N 61 THE NEW YORK -,BOARD OF FIRE UNDERWRITERS -PAGE i 100109 3 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NY 10038 13501,897/97 'Application No.on file N 420339 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of DANIEL KOHN, SOW LITIM PECONIC BAY ROAD, POLE MA, CUTCHOGUE, N.Y. in the following location; 0 Basement [N Ist Ff. [91 2nd Fl. Section Block Lot was examined on MAY 14,1997 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENTI.FLUORESCENT I OTHER AMT. I K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 5 5 1 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. Amp. AMT. Amps. TRANS. AMT. H.P. NO.OF FEET AMT- WATTS 2 SERVICE DISCONNECT NO.OF S E R V I C_METER P - AMT. AMP. TYPE 1.0 2W 10 3W 3 0 3W 3 0 4W NO.OF Cc.COND. A.W.G. NO.OF HIAEG A.W.G. • NO.OF NEUTRALS A.W.G. EQUIP. PER 0 OF CC.COND. OF HIAEG Of NEUTRAL OTHER APPARATUS: r DOROSKI ELK. INC'. LIC.#2941-E L L 425 MONSELL LUTE CLUCHOGUE, NY, 11935 GENERAL MANAGER Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. BOARD OF print;ill . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOIi'x11Oi_.D SURVEY . . . . . . . . . . . . . . . . . . . . . . . . L; BUILDING DEPARTMENT CHECK . . . . . . . . . . DEC ( 7 199C �'��'.��'� TowN nni.1. SEPTLc FORM . . . . . . . . . . . . . . . . . . . . Still-1-1101.1), N.X. 11971 TEL: 765-1002 NOTIFY: /��/'7'! Ex<ntitied.. -, 19� MA11, TO: . . . . . . . . . . . . . . . . . . . . iJ Approved �.�:, 197 �� I'erni.t No.c�. .................................... Disapp ec /c .......................?CATION .................................... c(or)A BU11.DING PERMIT Date. . . . . . . . . . . . . . . . . 19. . . INSTRl1CTIONS F. a. 'Ihis application mist be cutiAetely filled :in lry Lype%-TriLer or in ink arxl sulrnitted to Lhe Building Inspector- with 3. sets of: plans, accurate plot plan to scale. Fee according to schedule. b. Plot: plan sliowing location of lot and of buildings on premises, r•elaLionship to adjoining premises or public streeLs or areas, and giving a deLailed description of layout of: property mist be drawn on the diagran which is part of 1.11is application. c. 'Ilie work covered by this applicaLicnr r,vey not be camiieuced before issuance of Iliiiloing Permit. d. Upon approval of this application, the lluilding inspector will issue a Building Permit to the a0fAicant. Such ix_rmit shall lie kept cxi the lrrermises available for inslx--eLion throuo, i uL the work. e. No building slial.l lie occupied or used in wl►ole or in part for any purpose wiiaLever until a Certificate of Occ.upnxy sliall. have been granted lry the iluildint; Inslier_tor. A11PI.1CA'.l1Ck1 IS IEl-llY MADE to the ihiilding Departmmnt for the issuarx:e of a ikiilding Penni.L pursuant to Lhe Nii1ding Zotie Ordiiiaix.e of the Tcxwri of Southold, Suffolk QxTnLy; New York, and other applicable laws, Ordinances-or llegulations, for the consLruction of: buildings, additions or alterations, or for reinoval or dermlition, as herein described. The applicant agrees to comply with all. applicable laws, ordinances, 1xii1ding code, Imsing code, and relnilations, and to adtiAL autliorized inspectors on premises and in lxiildirli, for necessary inspections. 4.. .. ......................... (Signature of nlipl ic:ant, or naiie, if: a corporation) (1•iniling address of applicant) State wlredwr applicant is cxwrrer, lessee, agent, architect, engineer, general contractor, electrician, pltmber or Wilder. '01 ......•............................(,Vd�T........._........................................... Nave of caner of premises ....ewC C.5-Ax l ,1D,0/VIEG...k-lb-Y'!'......................................... (as on Lhe tax roll. or latest ,deed) If applicant is a corporation, signature of only authorized officer. ......................................................... Mine aix] title of corporate officer) C�-,iUT�c7d1V, IV07- Ikii1ders License No. ......................... ®ill 1frU19-P-,C? Pimiwrs License No. ......................... Electricians License No. ..................... OLher 'Trade's License No. .................... I. Vocation of land on wlriclr prolioseci work will. lie ck)ne...........�....�".`!.....Dl�V ......................... o f -7--1-9 PE0k::3'V1 0— kO O Ctk7`C1�4 l0 VF Uo a l ..........................•............................................................................................ Ibuse Axiber Street // Il``anlet. County Tax Kali No. IOQO Section .../W......... 111occk ....!:T........ LoL ._..li ........ Srilxlivisirxi .. �!r4-Fjo �0/ 7.......... riled tLrp No. ............... T.nl ............... (N<•me) 2. State existing use and cx.cUIXITxy of premises and intemled use and occupancy of proposed consLruction: a. Existing use and Occupancy .................... ... :c` ........... ... ....... 1). bitemled use and Occupancy ................................ P...................................... .a !. MAllre of walk (dieck %A► di al,plicahle); lk:%4 Ik►!ldlnll ........ . . ArkliLio(, .......... Alteraeloo Itepair ............ ... Ik:►x�l fL'ior► ............ Other IJork ....................... .. ._ (DescrIption) 4. Est ink►t ed U)sl' .. 0 ................. fee .......... ... ... .. ... ... .. ..... ............... (to be Iaid on filing this applicaLicx►) i. It eAxa I inll, rxuber of ek4ell irrg units ..0�� /2GL tAni►er of d.ael I inl; uoiCs cx► each floor ................ 1f garage, ►rnlrer of care► ........ .. ..h .................... . G. If Ix►al►►ess, comercial or mixed oc:cul►a►u:y, specify nature a►d extent: of each LyI►e of use . ......... 7. IlLiwnsicx►s of/exlat//hng strerc ores, if any: 1?►cx►L....��`��,-.^�! hear .. s. . I)el►ll► .. Jr. .!... Ileig1it: ..c l�...D! i,;'......... Rm i►er of St:or'ies ..[wo ....... . .. . Dimensicx►s of scnke st:reu:Cure with all'eraLims or a(klitions: Front: .4-29-0:4-?r. .... hear ... � -.... I):IAl► ..4P ......... Ik2ig1►L .. . ..lS'cL-*K -....... U Aiber of StorIe:r ....�'� -.. it. Diar:nsicx►s of entire new constrnca:irx►: Frexll: . ...!L.A,....... Itc:ar . . ... ...... Depll► ... .. .... Heil)kt: .......1.L10L ............/. Mciber of Scorien . . .. ...A?-ar..... .... 9. Size of lot: Frcx►L ...95.. Z �...... hear ..../.' Q •.• &00 �j .. Dept It .. . IO. Dal e of Hrrchase ..�f`.f Act........ Mxwrc of Pointer (kaiser .....kS' T/i. .(/D L( / ...... ......... I. Ze-x►e or use dist:rlcl' in wl►icl► [trellises are situated .......{,- . . .. ...... . ......................... ..... .. 12. Ikxas pfo)posed ccx►sLruc:ticx► violate ac►y ux►ing law, ordi►►a►►ce or regulaLicxl: ....... j I:). Will lot: lie regrrxlecl ..... NCB......... Will excess fill be renoved from Inemises; YI,S Q 14. Nailles of Owner of [trellises ,���/J?�! ............. Acklreas a AW. q_,'eq?nzG P:.... Nxxx: No.��a'� 4-✓C���.. Ntnie of Arc:l►i LecL �5'9n?t�EL�S ��T� {7......... Acklress 9�`��',�1�/A-c ft_' :.......... Illone N:ili►w of t'.cxiLractor ............... .................. Aeklress ................ ...............Move No. . ... ......... 15 is this pmlx:rLy within 300 feet: of a tidal wetimul? * yl:S ....1!..... ND ........,, *1F YGS, 'XX111KXD '1Cl1dN 'MISIl1:S 11-AMI'1' MAY IC Itl:(�llltlJ). N-01' D CAGRAN Locate clearly a►x1 distinctly all Ix►ildings, %A►etl►er existing or prolxrsecl, a►xl irxlicaLe all seL-I>aek dimensions fruu prol►erty lines. Give street: aryl block rridrer or ek:scription accorrling Lo deeds a►d sl►ow street names a►d irrlicate tkelher inferior or corner lot. VXACO O��Gy /S MDT 11VO�' POALT/01V rnu: c1r ra"W vtN ss UA&IIY. U '-� 77.60 Pn,/qLS C ......C\\� ✓�-QED I i y 1 1 I I . ..• .. .. ...•-• .•. . ...... . .. ..Ixaing c c I swc►rn, c elx►ses :six Gaya l u►L ►e is the appl icanl. (N;n►e of i►)(lividual signing contract) a1mve ►called, Ik: i Lhc! ... ........................... .......... � &-C ..... .... .......................... (lbnLracl or; nigenL, corlxwate officer., eL(:.) of raid caa►x-ir or cxaxirs, aml !s duly aul.horized to 1)erfons or have lx.rfonired I.he said ixrrk arxl to ngdce aril file mil appl icaLlou; that: al.1. sLatc31leuLs conLaic►ed in 1.11is appl ical:ion are Lnxa to the 1x:s1: of his kilo%Aedge aixl Ixil iePI and that. Lhe 4n>rlc will be perfornxed in the u4wi►er seL forth in Lhe apPlAt:al:ion filed therew► h. ikon► to before on this ..............7....day of .........? .... 19.��G... L.�L -� Ncx' bllc ..... y . .. . . ............ .............. (SigitaCur,e of Appl.icarrl) UNA FORAM Notary laltblio,Slate of Now Yolk No.49M63,Suffolk Count Term Expires Sept.3,191 CONI - r ��o�. thy, ", • .,. . `�{ - - • sir 9 4� Rio CCI tlf:F �YY�cYu1<1Y c:.�•rYV<., f t7- ,P',— L r. 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"3 c • *. 4', c ,� ye ;i i FQAMIr ��. ��` {'FO✓lJf NEW GI2p,,S - F k; —F To NEb•1 GXTI:I.10r, L.tALL, T� I R !"M A NI H E'4AP� IA 1'qyv� r �..a.W••eiil iL :,i if '.'",�"n Ii J 7 ooM , .i. AE' R YED AS VOTED L i r ``" - I w J � � > r. • Z , DATE: 13A PROVIDE i'EN G FOR I O IFY GUILD1NI G RTI�IEiUT AT w . w ,r fh�ERGEf C'� ESC AS_.. _ cz: 4 I _ ?t��-iS�2 � AtUI TO t9• �+ 01'd T�tE _ V---,.�{ �-- _ �.nn�;T: 4 OF- i —+ FOLG.�?�'Ir�ING INSPECTIONS: i - f N.Y. STATE BUItDtP:G CODE. j 1. FOUNIDATION, - T O REQUIRED , — I OIL POURED COI"CRETE '' 1 PLUMBER' CFr,TO��dCAT10hi ? 2. ROUGH - FRAMING & PLUMBING , I � I ! ��J � z F- ! LEAD CONTENT BEFORE 3. I vSULATION �, 4. FINAL CONSTPUCTION MUST I 1 I C f Td'�'��CA OF O ;CUPAAf��CY I` BE COMPLETE FOR C.O. ._.. I, /ALL CONSTRUUCTION SHALL MEET f 1 O�.O / US " '54TE- I ; THE PEOUIREMENTS OF THE N.Y SUPPLY,SYSTEM, CANNOT STATE CONSTRUCTION & ENERGY J�! I; �. 'CE� /,C of �° CODES. NOT RESPONSIBLE FOR ����. 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