HomeMy WebLinkAbout23914-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24936 Date MARCH 17, 1997
THIS CERTIFIES that the building HOT WATER HEATER
Location of Property 1565 MEDAY AVENUE MATTITUCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 113 Block 9 Lot 6
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 15, 1997 pursuant to which
Building Permit No. 23914-Z dated FEBRUARY 10, 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 INSTALL NEW OIL FIRED HOT WATER HEATER AS APPLIED FOR.
The certificate is issued to VINCENT PISANO
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Building Inspector
Rev. 1/81
FORM NO. f
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)
° 23914 Z ................................... 119.27
n
Date ......
Permission is hereby granted to:
. yG1`..r:✓. ....!• •'!':!'�.i...................................
/. � .'......; �'i ...,r..`,�. ...................
to .....................��-�........ ......��.
......... .........................................................
.............................................
at premises located at X5�`�
...................................................... ...... ................................................................................
.................................................................................................................................................................
County Tax Map No. 1000 Section ../<, 1............. Block ��............. Lot No. ...®5�...........
pursuant to application dated ..........J ..,.. ....../'�... ....., 19././.., and approved by the
Building Inspector.
Fee $........ .....
.... . . ... ...........................
4 in or
Rev. 6/30/80
_ Form Nu. 6
TOl•1N OF SOUTHOLD
BUILDING DEPAR•ITIEN-r
TOWN HALL
765-1.802
APPLICATION FOR CERTIFICATE OF OCCUPAMCY
A. This application must be filled in b t .
inspector with the Eollowiii e building
or OR inlc and submitted to the building
B= for new building or new use:'
1 • Final survey of property with accurate location of all buildings, property lines,
streets, and unusual natural or topographic features.
2• Final Approval from liealth Dept. of water supply and sewerage-disposal(S-9 form) .
3• Approval of electriccul installation from Board of Fire Underwriters.
4• Sworn statement from 'plumber certifying that the solder used in system contairs
I
ess than 2/10 of 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildings
` and installations,1%a certificate of Code Compliance from architect or engirieer
responsible for the building,:
6. Submit Planning Boa,r,d .Approval of completed site plan requirements.
B. For existing buildiftgs' ' (prior to April 9,pre-existing" land 1957) non-conforming uses, or buildings and
" uses:
1 . Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2• A properly completed application and a consent to inspect. signed by the applicant.
IE a Certificate of Occupancy is denied , the Building Inspector shall state the
reasons therefor in writing to tile_ applicant.
C. Fees .
1. 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 - $1OO.00
3. Copy of Certificate of Occupancy - $20.00
4• Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00• Commercial $15.00
Date . . . .
flew Construction. . . . . . . . . Old Or PBuilding1 ',\\ . .
/ Pre-ex
isting . . (1�. � ,
Location of Property. . . . l�/-ram. • I%� . . . /�
House No. ./ /. :. . •G/�. . �/• r���
treet Hamlet
Onwer or Owners 1,f Property. . ./ l• • • . S I �
County Tax Map No 1000 Section. . 1 9 / .
. . . . . .Block. . . . . . . . . . . . .Lot. . . . Y�
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I'i.l.cd P1:rI). . . . . . . . . . . .Lot
. . . . . . . . . . . . . . . . . . . . . .
Permit No. . . . . . . . . . . . . . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . .�.'�� �J. . . . . . . . . . . . . .
Health Debt. Approval. . . . . . . . . • •
. . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
lequest for: Temporary ertificate. . . . . . . . . . . . • •
Final Certicatc• • Y
ll
lee Submitted: $ . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . .: :: . . . . . . . . . . . . . . . . . . . . . . .
Tow_ n Hall,53095 Main Road ? y. Fax (516)765-1823
i� rl v
P.O. Box 1179 �•" � •� Telephone (516)765-1802
Southold, New York 11971 _
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C E R T I F I C A T I O N
DATE:
Building Permit No.
Owner:
(please print)
Plumber: 4 L::, d /� AKS0
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead..
(Plumbers Sig ture)
Sworn to before me this `--
a--
day of ✓ 1997 `^
Notary Public, 9 -,'.�� Coin
KEROH A MIOK
NOTARY PUBLIC,Stag , `,ew York
No.01M15040174. Snffoik Cou tY
Term Expires Marc}6. 197
765-1802
BUILDING DEFT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IySULATION
[ ] FRAMING [ VFINAL
��
[ ] FIREPLACE & CHIMNEY
REMARKS:
G
DATE 3 �7 / � INSPECTOR
1 1011 l EVOR I- 1)ATH. CUtlhll;tl'1';i
k---: `r --------- ---------� ___ ---- -----
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y
II II
II ✓t
FUllt•!nA'!'I.UPf ( zNn) II
R(111(;11 FRAM,'
it...... .I� . ._.._...._ .. .... ..
I N.`IM-AT I ON PER N• Y . I I
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;-1•ATF. F.NICRCY I
CODIF.
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In
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Annl•1-IONAf• GU�IHIfNT.'i:
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O
C�1
J BOAFD ' OF HEALTH,,
FORM NO. 1 : 3 SETS OF PLANS .... . . . . . . . .
TOWN OF SOUTHOLD SURVEY . . . . . _ _ _ . . . . . . . . .
BUILDING DEPARTMENT CItECK - . . . . . . . . ..
..AN TOWN HALL SEPTIC �roRrl * _ . : . . . , ,
SOUTHOLD, N.Y. 11971
,�7 TEL.: 765-1802 t:DT Flf
. ... ���!. . . . ., 19(/�.� - CALL
rfAIL TO. . . . . . . . . . . . .
Examined . . .Approved . . . . . . ., 19 LJ Permit No. .Q`��. . . . .1
: .,Disapproved a/c . . . . . . . . . _ _ . . .ti . . . . .
. . {
(B iId'ng Inspector)
APPLICATION FOR BUILDING PERMIT
Date . . . .. . 7. . . . . . . 19/
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, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
... . . . . . : . . . ./�4 Via. . . . . . .. . . . . . . . . . .
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, 'agent, architect, engineer;•general contractor, electrician, plumber or builder.
2. . ...-. . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . .
Name of owner of premises . . . . . . . . . . . . . . . . .
(as on the tax roll or latest deed)
If-applicant is a corporation, signature of duly authorized officer.
. . (Name and title of corporate officer)
Builder's License No.
Plumber's License No. . . 3. �. , , . ,
Electrician's License No. . o?c2U : ,
Other Trade's License No. . . . . . . . . . . . . .. . . . . . . . .
i, Location of land on which proposed work will be done. : . . •. . . . .
House Number Street Hamlet
County Tax Map No. 1000 Section . . . :�/ : . . . . . . . . Block . . . . • Lot .
'/'•
Subdivision . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . 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 .OA-TR (i/L, , � ,, , ;. 1 C-0-1 . . . .
".�3. Nature of work check which a �
( applicable): New Building., c . . . . . . . . Addition . . . . . . . . Alteratio.;;�(',
Repair . . . . . . . . .. . . . . . Removal . . . .
.. • • . . . . . . . . •;.,Demolition . . • . . . . . . Other Work" . . . . .
4. Estimated ��� . (Description) .
, . ated Cost . 1. . . . . . . . . . . . . . . . . . . . . . . . .'. . . . . . Fee . . 7< . . . . . . . . . . . . . . . . . . . . . . . . . . . .
y,.,.. . (to be paid on filing this application)
S. If dwelling, number of dwelling units . ... . . . . Number of dwelling units on each floor .
If garage, number of cars . . , , , , •I,r:,-�.'
6. If business, commercial or mixed occupancy, specify nature and extent of•each type of.use • • • • .
7. Dimensions of existingstructures
,if any: Front . . . . . . . . Rear
. . . .`. . . . . . . . . Number of Stories . . . . . . . . : . .'. . . .', . . ... . . . . . . . . . Depth . . . . . .
Dimensions of same structure with alterations or additions: Front • • • • :;�'',;'.+ ` ' • ' '
Depth . . .. '. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . Rear . . .
Height . . . . . . . . . . : Number of Stories .
8. Dimensions:of entire new construction: Front . . . . . . . . . . . . . . .. Rear . . Depth • .'
Height . . . .. . . . . . . . . . . . Number of Stories.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . .
9.., Size of lot: Front . . . . .'. . . .: . . Rear ' " .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10. Date of Purchase . . . . . . ... . . . . . . . . . . . ... . Name of Former
Owner
Depth . . . . .
oomer 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 ��. . . . . . . . . . ... . . : . . . . . . . . . : . .
-- . Will excess fill lie" emovxk�
rom premises: Yes o
14. Name of Owner of premisesO/MC=N/ . ,Y,�S ;�(� Address ��� v? Phone No.S li.:
Name of Architect . . . . . . . . Address '
/ — —� Phone No.
Name of Contractor 1 �1 N�. . �r�. ... . . . , Address !�(,�, / ..,�cF yl a No.
15.` Is this property within 300 feet of a tidal wetland? *
Yes.. . . . . . . . .No. . . . . . . . .
*If yes.,- Southold 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..
APPROVED AS NOTED
`
dv
NOTIFY BUILDING DEPART, ENT AT
Ttia qti r-"J3 TO 4 PfA FOR THE
FOLLOVI:IAIG aF,,IS ECTiONS:
1_ FOUNDATION - TWO REQUIRED
FOR PDQPED CONCRETE
2: ROUGH - FRAN!iNG & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST 1
13E CONIP'LETE FOR C.O.-
ALL. CONSTRUCTION SHALL MEET. .
THE -REQUIREMENTS OF THE: N.Y.
STATE 'CONSTRUCTION & ENERGY,':,,,
- CObES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
STATE OF-NEW YORK, } :,, , .•.
COUNTY OF . . . . . . . . . . . . S.S
• • • •� �� �� ,: S•S� . . . . . . being duly sworn, deposes and says that he is the applicant
.. (Name of individual signiflg contract)
above named. `
He is the . ... : �./v. !/�. . .d. . . . . . . . . . . . . . . . . :. . . . . . . .
(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;'an d, hat the
work wilt be performed in the manner set forth in.the application filed therewith. "I' '''' °" `•` '
Sworn to before me this
07
.. . . . . . . . . . . . . . .day of L1 2 . .`. ... . ., 19 /
Notary.Public, . . . . . . . . . . . . . . . :" o .. . . . . County .
KENNETH A.MIONE
NOTARY PUBLIC,State of New York-
No. • • • • • ' ' ' ' • ' ' ' ' ' ' ' '' • ' ' ' '
01M15040174,Suffolk Coup (Signature.of applicant)
Term Expires March 6, 19
I
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Al
D Roughing-in'Dimensions and General Specifications
C - COLD HOT ' pEL1EF STORAGE STUH MAXIMUMRECOVERY 3IIIPPING
MODEL A 0 C . 0 INLET OUTLET DRAIN VALVE CAPACITY INPUT FIRINGRATE ATIOVIUSE VYEIgItY
32E' 61" 20" G" 11" x" 32 GALS. 104, 0 .75 GPM 10z GPH 279 LHS.
00
t �30ES' 37" 24" 6 `1 l'. 1", t' : 'lt" i�' 28 GALS: ,84.000" .60 GPH 96 G;4i I 269 Los...`
$ SOPS 52" 26" 6" 13s" 1" tif" %" K" 50 GALS_ 140,000 1,00 GPH 130 GPH 394 LISS.
51E 59" 24" 6" 11 1" i" 3S W 50 GALS. 152,000 1.10 GPH 138 GPH 364 LBS.
p_. 71E 66" 26" fl 13b" 1" 1'r1" X 1%" 70 GALS. 173,000 1.25 GPH 157 GPH 494 LBS.
Available with foam irlsulafion as 32PP.."Optional t%"inlet with bushing and drain valve Installed.
rtressure%all:Test piea§ure.300 PSI;working pressure,150 PSI,Standard voltage.all:120V.60HZ,i P.
Other voltages available.TSP valve furnished;nipples supplied tar top connection—all.
Warranty,all-Tank,5-year gimited).See Certificate of Warranty.MEET ASHRAE.STANDARD 904111.1969.
Warning:Do not Install on combustible Hooting. Installation should be in accordance with all local'cedes and NtFPA 31:7Ast0llatiotn
of QU Hurniny EquOmen "Ca.MHtpn.The recommended water temperature setting for normal residential use Is 1201F.
Where headroom
is at a;premium The Standard Of Oualjty
Research toward the improve- improvement enhances Turbollue
ment of every integral component performance appreciably—leav-
-and of-construction processes ing all other heat exchangers
and assembly methods—is con- Even further behind in every area
stant at Bock. Findings in our of thermal efficiency.
own therwda laboHatay and ekhaus- The Bock 32E is the standard
tive testing prove-out Bock engi- of quality by which every com-
neermg:concepts. Latitudes for petitive oil powered residential
. . improvement are narrow,but never water heater is compared.The
theless existing. It's why we say 32E, in fact, is incomparable for
"improved"instead of perfected. the day-in; day-out provision of
No theoretical innovation is hot water to an average Amen-
ever tested in the marketplace. can household. It is an invest-
Nor is any integral component ment in quality that pays real
regarded as merely adequate. It dividends.From the moment it is
is either the hest,or it isn't Bock. operational, the.exceptional'
After all;quality water heaters are thermal efficiencies of the 32E
our only business. begin to pay proven per day.
LO-BOY The original concept of a mufti- savings 1n economy of operation;
MODELS 30ES AND 50ES finned flue interior was produced economy that makes cheaper
The 30ES(shown)can be by Bock in,1955 and improved to units actually more expensive to
installed wherever headroom a point of optimal efficiency in own. What's more, realistic sav-
limited to 4 feet;the room 1960 when it was patented as ings continue throughout the
is
is limited
feet, Both are naturals Turboflue.Since that time,subtle long trouble-free life of every
for architectural restrictions improvements have been contin- Bock 32E. They are, indeed,-the
uous and made tactical.The latest standards of quality—.
and space limitations.The
smoke outlets are sensibly on Because Quality 15 Standard. -
top making installation and _
servicing far easier than
older,less efficient units with
rear outlets.All the hot water c�
required daily for average and
larger homes.Bock quality Bock Water Heate riN ii1C.. I
throughout The 50ES l5 P.O.Box am i 110 SOUTH DICKINSON ST..MADISON,w1`53700.8632 a1CM257.2225
available with optional dual
controls for the provision of Quality Water Heaters SIM* im
180°F water.
FORM NO.101 B•REV.2f94
4
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