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HomeMy WebLinkAbout23308-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26295 Date: 02/23/99 THIS CERTIFIES that the building ADDITION Location of Property: 1305 LIGHT HOUSE RD SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 50 Block 6 Lot 5.9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 13, 1996 pursuant to which Building Permit No. 23308-Z dated MARCH 15, 1996 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 RAISED PATIO/PORCH ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOSEPH T. & SUZANNE ANDREJACK (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N-457993 07/06/98 PLUMBERS CERTIFICATION DATED N/A Build g Inspe or Rev. 1/81 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 COMPLE11ON OF THE WORK AUTHORIZED) Date .............. �l�.L. ... ................ 19Z ... ........ Nf 23308 Z Permission is hereby grante to: ............... ' .�... ...>. . ....................................... to ...�� '............ .. .......... .✓�. ..j t,............................. �. . . ... ..:... . : .....a-K-.. :.. ................ AzLe.................... ��.... "....-..................................................... .................................................................................................................................................................. ................................................................................ I.................................................................I................ at premises located at.........�.. dJ�......./`...J��c -. .......F ._............................................ ....................... .......................... ®.s�, - .. .............................................................. ........... County Tax Map No. 1000 Section ....... Q....... Block.......6.............. Lot No. .. .cc .:............. pursuant to application dated ...................... ... .1 .:.... 19..16....... and approved by the Building Inspector. Fee$...M...,-1........ CG�Z 9....:p... . .. Buildin Ins ctor Rev. 6/30/80 BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY �L �� 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 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 2/10 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land 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 Building spect signed ector shallthe a applicant. If a Certificate of occupancy is denied, thethe reasons therefor in writing to the applicant. Fees 1. Certificate of Occupancy - New dweling $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 Buildine - $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 ..�:� 1 .. . . . . .. . . . . .. . .. . . . . .. . . . . . . . . ,w Construction....' ..•. Old Or Pre-existing Building... ........ . 13U 5 I- i I:t;► ?:w'd........... .. . . .. ...•+A�-4��� .. . . . ... . . . . . . . •cation of Property.. .... •-,� Street.•••. • . • Hamlet House No. rater or Owners of Property.�a�� �l • T - nine .kt.c�r2���k .�. .Block.. .. .Lot. . .JC.�. . . . . . . . . . . . . . . . ,unty Tax Map No 1000, Section. . �•• •• ••• • • ••- -" �. . . . . . . . .. . . . . . . . . . . . . . . .. . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . ibdivision. . . . . .c . �3.�C�.�Z. 3 ` j -qk0 .. . . .Applicant.,44W��-�J 7�� , . . . . . . ermit No. . . . .Date Of Permit. . :alth Dept. Approval. . . . . . . . . . ... . . . . .. .. . .. . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .anning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . &quest for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . to Submitted: $.. . . . . .. . . . . . . . . . . . . .. . . .. . . . . . . . . . . . . . . . . . . . . . . . APPLI��f��N� cd� o? T-5 k- PAGE 1 THE NEW YORK BOARD OF FIRE UNDERWRITERS -• . , ,,, BUREAU OF ELECTRICITY 40 FULTON STREET, NEW YORK, NY 10038 JUIZ 06 1998 15094097/97 N 457993 Date f Application No. on file THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of JOE ANDREJACK, 1305 LIGHTHOUSE ROAD, SOUTHOLD, NY in the following location; ® Basement ❑ lst Fl. ❑ 2nd Fl. OUT Section Block Lot was examined on 'TUNE 19,1998 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT1 FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 3 1 3 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS SELL 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 SERVICE DISCONNECT NO.OF S E R V I C E- METER NO.OF CC COND. A.W.G. A.W.G. A.W.G. AMT. AMP. TYPE EQUIP. 1 0 2W 1 0 3W 3 0 3W 3 0 4W PER 0 OF CC.COND. NO.OF HI-LEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL OTHER APPARATUS: SOUTH FORK ELECTRIC LIC.#4080 f Lam, 562 PLEASURE DRIVE FLANDERS, NY, 119 1 GENERAL MANAGER Per 11 This certificate must not be altered in any manner; return to the office of the Board If Incorrect. Inspectors may be Identified by their credentlals. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. T65-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE l INSPECTOR 1;(;L LOU I(EVORT DATII,* FOIINDAT I ON I UQU III)ATI ON VI & MAIN H I H(: jl INSULATIOU 11E.It t;. y . STATE Cl ---- --------- ------------ ----------- ---------------- --------------------- Al)[)t,r101IAI.. comiurrs:------------ --------- nt HOARD OF HFAI.TN . . . . . . . . . . . . . . . FORM No. 1 3 SINS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOUT110I.1) SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN IIAI.I. SEPTIC FORM . tQ: . . . . . . . . . . . . SOU'1HOLD, N.Y. 11971 TELL 765— 1802 NOTIFY: CALL Sue Andre j atk �/ '765='3281"Or' '7.37-7114 tiuirmined���1014-Ke ..., 19�0 MAI.I, TO: M/M. Andrej.ack. . . . ( Post Office Box 1682 Approved....��� 19� Permit 130. .. , ... Southold Disapproveda/c .................................. ... .. 1..... ......... ....................................... -- ....... lkuilding Inspector) A P ICATi.ON FOR BUILDING PERMIT Date March .12th _ . 1996 . 1 INSTRUCTIONS a. 'Ibis application must be cam[iletely filled in Iry typo..7riter or'in ink and submitted to Lite Ixuilding Inspector with 3 sets of pl.ans, accurate plot plan to scale. Fee according to sduedule. 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 crust be drawn on Lite diagram vkidu is part of this appl.icaLion. c. 'Itue work covered by Otis appl.icaLiott my not: be caunenc:ed before issuance of Ixrilding Permit. d. Upon approval of this application, Lite Ikuildinf; Inspector will issue a Ikrilding Permit to Lite applicant. Such permit shall be kept on Lite premises available for inspection Lhrouglrout Lire work. e. No building gall be occupied or used in whole or in part for airy purpose whatever until a Certificate of. Occupancy shall have been granted by Lire Ixilding Inspector. APPI.ICATioN is IiL iuw PWIC to Lire Building Department for Lite issuance of a Ixilding Permit pursuant to Lbe Iluilditt 7.(xw 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 rentaval or demolition, as herein described. 'lire applicant agrees to coaluly with all applicable laws, ordinances, building code, housing code, and regulations, and to admit auLborizecl inspectors on premises and in building for necessary inspections. ..................................................... (Signature of applicant, or name, if a corporation) P. O.Box 1682 , Southold, NY 11971 ................................................... (Mailing address of applicant) Stale wlretirer applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, picnbrer or builder. ....................................owner.............. _ ............................................................. &--me of over of premises Joseph T and Suzanne Andrei ack (as on the tax roll or latest deed) If applicant is a corporation, signature of duly audtorized officer. . • . -.••(Mine arxl title of corporate officer) Builders License No. ......................... J ! MAR 13 - 19,06 k I Pl.mbers License No. d Electricians License No. ..................... Outer Trade's License No. .................... 1. IocaLion of larxl on wlridr proposed work will be dorm..Lot 3 . Subdivision Map of Too Bee Realty '1305 Lighthouse Road, Southold, New York 11971 ....................................................................................................................... [louse Nrnirer Street Hamlet C(xrrrLy Tax Map No. 1000 Section ..... ........ [hock ........ ....... I.ot ......5..9...... Subdivision Too Bee Realty_ at Southoldt-..Iled Map No. 9396 _ lvt p/o Lot 5 Mwe) 2. State existing use and occupancy of premises and interxied use arxl occupancy of proposed construction: a. Existing use and occupancy ......one-family_.dwelling.......................................... 1). Ilntended use and occupancy ......one-family, dwelling - patio/,porch: addition '1. N'llure of: wotk (dleck wl)idi nlq)licable): New Nil Milli i ......... . Acklil'ion .x........Alferation .......... Itepnir ............ Removal ............. IkttnlItIoil ............ 011ler Woric .................................. (UescrIption) 4. 1sstillk►ted cost .. 3r Q QQ.'............. fee .............................................. (to be paid on filing; this allpl.icnl'ion) 5. If IA4el1 ing, txsnber of (ltaetl iog units ., one I&nl)'er of chvel I ing unil-s cx1 each floor ................ if garage, Ixnl)er of cars .............tKQ.................... 6. 1f Ixlsirless, comlercial or mixed occupancy, specify nnLure alxl extent of eadi type of use...................... 7. Uimensiomi of existing sl'nlchlres, If any: Front.....80 8°.... Rear . 80.E 8 ...... Depth . .44.'.4... ....... Heil l)C ....._24 ' -25!......... limber of Stories „one and a half Dimeosioos of: saine st:n►r_ture with alterations or Fxklitions: Front ..80.'.8n Rear .80'.8.. .....: Depth ....44�4°......... lleigltt ..24 '-25" tJnl)er of Stories ....?.......... 8. I)iutensions of entire new cxostnictio►1: Front ....... Rear :..34......... Dept1) .18 ' 4" Ileijoit ...16' -3................ Nrd)er of Stories ................. 9. :iize of lot: bunt .180.:Q........... Rear ..._ Q ........ Ik:pt11 45a. 52 10. Dal-e of I'ltrchane .9-27-9$.......... NFnte of Fortner twiner To Q..Bee•,Realiry,.Corp........... II. Zcx)e or use district in width premises are siLuated .......................................................I....... 12. Does prolx)sed cotlstnx;tion,violate any zcmiog 'law„ordina►ce or regulation: ....A9?jp..kn?gmji..... 13. Will lot he regraded ......n2........... Will excess fill; he romwed frail pr'canises: YM 1J0 M. Nails of (krner of 1)renises ...Andrejack ... Ackiress P 0 Box 1682,'..Southollq(lxx, IIo 765-3281 Nt.tte of Ardiftect: .GecLrge..F1shez............... A(kir'ess ......Souuthold•........... 11101le 130:7.65-3654.. N/n►e of t',orll:ractor .... ...Qvne4.................. Acklress ...............................111oc1e No. .............. 15. is this pmpert:y within 300 feel' of a t1dal wetland? * YluS .......... K) .......... *1F YIiS, scX111KNI) 1"m 'I141sirmS 1'L1urr my RI's M. ll itlil). PLOT DTAGRAM lcx;ate clearly nrxl distinctly all Ixlilditlgs, cA)ether exiSting or proposed, nix] irxlicate all set-back dimensions frau property lines. Give street arxi block rxnl>er or descripL'icxl according to deed, and s11ow street names ntxl irxlicale %Aietller inferior or corner lot. S9ection: 50 Block: 6 Lot: p/o 5 1305 Lighthouse Road, Southold, New Yolck 11971 ($p r r O V9 MAlli tM" "M YORK, - I cl(71ItJIY (N. ...,Suffolk ....... .... SEPkn1 beillf,� 60y twcrrn deIx)ses axl td s lhnL he is the F ) LIcn11L (N,rte of i►xlividt►Fll. signing; contract) nlxwve 111N11c:d, Ik! I!-, the ..............owner......................•...................................................... (lbnl:rncLor, FgieoL, corix)r-nLe officer, eLe.) of: paid otAx:r or owixmn, ntxl is duly nulhoriv-41 to lxarfonu or hnve IM140111ed I.he nnid cork atxl to nrdce arxl file Ibis nppl ienL'ion; Unit nil. sLaterenLs contained in Lhis nppl icatioo are Lr11e to the lient of: hin klx)wledgie mxl Ixil.ief; 1110 Ihal. the m)rk will W perfomecl io Lhe nvltiner set forth io the npplicnl:ioo filed Iherewil.h. :1bx)rn to before ue this 13 ............day of .....?`rr-b. ...19.96..... (inFd:ure of Appl icnoO 1_lNDA J.COOPER Notary Public,State of New York �� No.46225453,Suffolk County Term Expires©ecembsr 31,19 SUFFOLK CO. HEALTH DEPT. APPROVAL I g3 SO .7 7 H. S. NOkill 1 Q J, t I > , l :n Z ' ! ? Z STATEMENT OF INTENT f, i + THE WATER SUPPLY AND SEWAGE DISPOE _ p SYSTEMS FOR THIS RESIDENCE W CONFORM TO THE STANDARDS OF 1 SUFFOLK CO. DEPT. OF HEALTH SER V IC APPLICANT �- S.IscrlC _ d. .f - i _ ; I SUFFOLK COUNTY DEPT. OF HEAI _ \ a } SERVICES — FOR APPROVAL t CONSTRUCTION ONLY DATE: LL LL H. S. REF. NO 93-207-1 •� i _ 1 -- -- , t;7 u3. :` i �' t' --. .. APPROVED: ] V � f an.C-'12 C�sG. v^Wit.. � ate`.►:4N 6`� ` �.. �t is � ``— SUFFOLK CO. TAX MAF DESIGNATION. DIST. SECT. BLOCK PC OWNERS ADDRESS: �" — — - - - - - - � I - --_ — t � DEED: L. P. • TEST HOLE STAMP -_-. Lfreuthoiiz^d a!lefcllon oredd!tt • 4'L I to f`:s survey it a,^.:icl.3n of 5=:!i3n 72G3 c!t`=Now York SI • ` - _r.:ion Law. _ ✓i �.�•:,� Cr.-:rs of this survey mza ro:b; t^v I_rd sunmors inked sea!or c-rbossed seal shah not be an; rabea valid true copy. -- ----.-•_—�_ C_' --•1 .-- ^� f c i ` fit' _`{ Q.rara the on for .-torn Lie sh a%ly to the person for Whom Lhe. 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