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HomeMy WebLinkAbout23417-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24599 Date SEPTEMBER 6, 1996 THIS CERTIFIES that the building ACCESSORY Location of Property 925 GAGENS LANDING ROAD SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 70 Block 10 Lot 30 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 23, 1996 pursuant to which Building Permit No. 23417-Z dated MAY B, 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 ABOVE GROUND SWIMMING POOL FENCED TO CODE AS APPLIED FOR. The certificate is issued to LOUIS & MARY ANNE MESSINA (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-390406 - JULY 3, 1996 PLUMBERS CERTIFICATION DATED N/A Building Inspect Rev. 1/S1 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) Date............. % .... .................. 19 Y N® 23417 Z Permission Is hereby granted to: e r . .... . s �� ........................ to .... ...... ..... . .........................q...... .. Lj�� r . ... . .......: .. .r. .. . ........ ................. .. .... . ... .. . . . ..... . .... .. ..... . ............... .C1. ........ . . .. ..... . ..... ... .............................................................................................. at premises located at................ 9. ... ..... .......................... ...................... ......................................... . . County Tax Map No. 1000 Section ......... ...... Block..........1.. ...... Lot No. .. ®................ pursuant to application dated ............ ...... 19.. ...So..... and approved by the Building Inspector. Fee$o`..��.. Building Inspector Rev. 6/30/80 i Form No. 6 TOWN OF SOUTHOLD �� r BUILDING DEPARTMENT TOWN HALL �- 765-1802 ff�ve /T 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 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. B. 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 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 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 - $100.00 3. Copy of Certificate of Occupancy - .25,il. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $ 5.0 , Commercial $15.00 Date .1, . . . 8 �.19� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . .. . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . Location of Property. A!lj-&e, eh. . . . . � . . . . . . . . . . . . . . . . . . . . . . . . L . . . . . . House No. Street Hamlet • . Onwer or Owners of Property. !":© ?�. �: .`'` 1�?:v�: . . .� 5.�� 4 . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . ... . . . . . .Block. . . . . . .`q. . . .Lot. . . . a. .0 . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ./. . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . Permit IN . .. :Date Of Permit. . J(. . . . . ,l.y'',� ah ! 0�aL��TeSs­il t r1 ��° .Applicant Socz ' '� Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . ."'. . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $. . :::�t .L.?'. . . . . . . . . . . . . . . . 17 : . . . G '•: �• . • � �. . . . . . . . . . . . . . . APPLICANT Cd ?1�4 5 71 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1025088 BUREAU OF ELECTRICITY F_ 85 JOHN STREET, NEW YORK, NY 10038 Date JULY 03,1996 Application No.on file 11970596/96 N 390406 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 MESSINA, 925 GA.RGENS LANDING, SOUTHOLD, N.Y. in the following location; ❑ Basement f g 1st Fl. El 2nd Ft. 0U1 Section Block Lot was examined on JIM' 26,1996 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENT1 FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 1 1 1 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K..W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. N SYSTEMS O.OF FEET AMT. I WATTS 1 20 SERVICE DISCONNECT NO.OF S E R V I C E AMT AMP TYPE ME ER �,7W �,3W 3�•3W 3,0'AW 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 MIAEG OF NEUTRAL OTHER APPARATUS: SWI1,1MING POOL-1 TITRE CLOCKS 40 AMP-1 G.F.C.I-i (SWI�IIIING POOL) This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to ro have frequent test/and or repairs made by a qualified person. . L <<< Continued on Page 2 »> GENERAL MANAGER a:l 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. THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 2 1025088 BUREAU OF ELECTRICITY F— 85 JOHN STREET, NEW YORK, NY 10038 Date JULY 03►1996 Application No.on file 11970596/96 N 390406 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 MESSINA, 925 GAIRGENS LANDING, SOUTHOLD, N.Y. in thefollowing location; ❑ Basement ❑ lst Fl. ❑ 2nd Ft. OUT Section Block Lot was examined on 'UNE 26►1996 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES 1COOKING DECKS OVENS I DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENT1 FLUORESCENT OTHER AMT. I K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 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. T. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP. PE METER TYPE 1.072W 1.03W 3 0 3W 3,9 IW NO.OF CC.COND. A.W.G. NO.OF HI-LEG A.W G. NO.OF NEUTRALS A,W.G. EQUIP. PER b' OF CC.COND. OF HI-LEG OF NEUTRAL OTHER APPARATUS: RETHEL ELECTRIC LIC.#t•�88t�E ` 1. L 138 MILL ROAD MANORVILLE, NY, 11949 GENERAL MANAGER 11 Per g` 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. 07 T65-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLB [ ] FOUNDATION 2ND [ ] INSU ION ( ] FRAMING [ INAL [ ] FIREPLACE & CHIMNEY REMARKS` e `O V DATE INSPECTOR ITUf 1.o I I It 1..1. mv I* D A,r 1; lit fK I Oil ------- ....... .......... Fut)I I D A,I*I of I --------------- -------- ------------------------------------ ---------- ROUGH FUME A, .............. • -------------------------- --------- ----- ------------- ----------------------- 1 WHILATI Oil Ill.-It 11. STATIF CODE. F I IIAI. -------------- ------------------- ---------------------------- ---------------------------------------- ADOVI'l0l(Al. ------------- ----------- s N- .. ----- ---------- ----------- ,\ J $1AUTNORIIE!)ntlb;wNvn to THIS SURVEY IS �OFIII� I �r.. A YIOLwiIGh I )e..JON 7709 OF THE NEW 7OjX ST IM ATION LAW_ wT6 4% i \ C^•71 S OF THIS SLjj jcy N.A,� blAA, - !N 7O:t'S ';J LiA J 1 l.•-,%SSi0 SEAL SHALL MJr Al.COF�ytx;•.irr. I Q ,..� �.�.-.f' - - , B� Ci A VALID T:Uz Cr.,^ J I � •'�„ ins Y. 111 _) - -�•�°v. �.c-t::(�..; -VIT O �� (n L- �l I _._________ C • i [{?i.E ccw; i,', :.•'±��Lai�<u:;:LAlif i0 C7LL ` - n � U.�ZHG IMTLTUTIO AGiNG� •.rD _ VV I .i?MEJ.cOH �^'1 C p t c L AC L T D E' C.1 ?Z•t: :.7 W i LO A!E AsafcNt '� uHE J ` -- 7C ._ L-1 0� ES CF THE IFf:A1NC tr6>r:. f ODZ "-L____ ' N 'tf I =IIOK GUARAHTJ S ARE NOT rk^x3Kp'dL; Q pa n) � , aaarncc;�L INS'i4i!slOs.c nt SLH[FI-f.!a• J c-�rre .TJr�, Lu I O ZY CL �' 1 '0 ��6.5IG � u _Ln ,� D ID US i Z I'_ �L87 Q5-90 SUr-r.CC,TA�( MAP—DATA-10ai--M-I AVE I E MAIP OF P20P F 1 Y Li SUF,, EYE;1 Fu'FZ ! L 1L � I A, �� . : c;:• L- � ,-/', -'!T' 1 t~ r'+ L. 'rE "J. HOME A✓ ---� - :�� v`rl�� �S � -As 5u2",ls=v1=G AUG.z 1954 Of SDU7' t J BOARD OF HEALTH . . . . . . . . . II FORM NO. 1 3 SETS OF PL.1'IS C TOWN OF SOU THOLD SURVEY • - • • - - - . - + �1 APR 2 3 19 ? BUILDING DEPARTMENT C11CC1; . . . . . . _ . . . . . . TOWN HALL SEPTIC FOR"1 . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 �- TOWN p SOU HO TEL.: 765 1802 t:OT ILF'f ; CALL :xamined . . . . . ., 19 :,W MA I L TQ: . . . - . . . . . . . . . . . . \pproved . .... . . . .. 19"'0. Permit N /q,� .�/� lN�l/ fELLs L� )isapproved a/c . . . . . . . . . . . . . . . . - . . . . . . . . . . . . . A . . . . . . (Building Inspector) APP ATION FOR BUILDING PERMIT Date . . . . .qf. . . . . . . . , 19Gj`:t� INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 is o 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 areas, and giving a.detailed description of layout of property must be drawn on the diagram which is part of this appli- .tion. 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 all be'kept on the premises available,-for inspection throughout the work. e. No building�shall'ibe foyccuped or•used in whole or in part for any purpose whatever until a Certificate of Occupancy all have been granted by fhe"Building Inspector. APPLICATION IS HEREBY MADE .to the Building Depar-tni'drit-fo the',=issuance of a Building Permit pursuant to.the iilding Zone Ordinance of the Town of Southold, Suffolk C0114f,:-New,Yorle and other applicable Laws, Ordinances or -�ulations,.for the construction of buildings, additions or,alteratibris; or for:iemoval or demolition, as herein described. re applicant agrees to comply with all applicable laws, ordinances, buil ' g c de, housing code, and regulations, and to .mit authorized-inspectors on premises and in building for cc so t'. . (S' ature ap licant, or''name, ' a corporation)) G. . . .. . . . . . . . . . . . . . . . . . . � (Mailing address of applicant). ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . ! ��. efdr . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ime of owner,of premises /—UUIS. /�, igw!� . . . �� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed applicant is a corporation, signature of duly authorized officer. . . . . . (Name and title of corporate officer) . Builder's License No. . . . : CO/. �, ?, ,1 , , , , , . Plumber's License.No. Electrician's License No. Other Trade's License No. . . . . . . ... . . . . . . ..... . . . . Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . Ilouse Number Street . . Hamlet . County Tax Map No. 1000 Section . . . . .ZD. fiW. . . . . . . Block . 7G. : , , , , , , Lot . . . o. . . . . . . . . . . : Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . 6� 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 . . :� . . �frGY1 i.�v . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Nature of work (check which applicable): New Building . . . . . . . . . Addition . . . . . . . . `'F~ A1tefation`.I. }�\ Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . ., . . . . . . . . . Other`�or�Cy� Vl?ilA?!,_e• 4. Estimated Cost . . . . . . . �� .'�: + ;;° :(ilork D,escription) . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . .�. . . . . . . . . . . . . . . . (to be on aid y Alin a k"` P g;¢fris•a� : lcation) 5. If dwelling,number of dwelling units . . . . . . . . . . . . . . . If garage Number of dwelling units on each flovi; '' +:�• .` g G , number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each t • • • • • 7, Dimensions of existingstructures, type of use . . . . . . . . . . . . . . . . . . . res, if any: Front . Rear Depth- Height . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front • • • • • • • • • • • • ' ' ' ' ' ' ' Depth . . .. . . . . . . . . . . Height . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Number of Stories . t, 8. Dimensions of entire new construction: Front . Rear • • • • • • ' • • ' • ' Height . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . Depth . .\.. . . . . . . . . 9. Size of lot: Front . . . . . . . . . . . . . . . . . . . . . . Rear . ... . . . . . . . . . . . . . . . . . .Depth . . . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase • . . • . . . , . Name of O Former• wner H. Zone or use district in which premises are situated , • • • • • • • ' ' ' ' ' ' ' ' ' ' ' ' ' ' • ' • - 12. Does proposed construction violate any zoning law, ordinance or regulation: • • . 13. tiVi11 lot be regraded , Will excess fill be removed from premises: • • • es • • • C 14. Name of Owner of premises 4�G�s -D?Ra�V�'V-41e-5 11 ,�1' o • • • - • • S ./address ,r�,7;,s;G�5';=5; Phone No. .2�.J,:$3!t�. • Name of Architect .Address ' Name of Contractor � �':Q!�?'; -l• pL s • • LTJ ' • • • • • . Phone No. . �• .Address. :1. i��'SV �469. . . .Phone No. �.d'7;�c• �Z t 15. Is this property within 300 feet of a tidal wetland? *yeS,•• , • • • • -� No �/ • . . *If yes, Southold Town Trustees Permit may be required. c 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. UNDERWRITERS CERTIFICATE ' REQUIRED i "IMMEDIAT'ELYRF ENCLOSE POOL TO CODE UPON COMPLETION AP�PIVEMA"NOTED BEFORE"WATER" DATE: B.P.# ✓� l� FEE• ._, BY DE.• _ .. NOTIFY BUILDING DEPA 766-1802 9 AM TO.4 PM FOR THE J FOLLOWING; INSPECTIONS: I. FOUNDATION - TWO REQUIRED UP FOR POURED CONCRETE OR 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. fF3EjAL - CONSTRUCTION MUST �5 F Irl M �,a ' fI "�,, ' , F�aI;is� Q •'� COMPLETE FOR C.O. �Ii:af3 t"" ALL CONSTRUCTION SHALL MEk? . Y t9 &; � � ia F1 ' % THE REQUIREMENTS OF THE III;.1!, STATE COIVSTRf9CTION & ENERGY Ar CODES. NOT RESP0I,1ES1E'1,E � DESI.QN:O_,F3 COI R�1CTtQtr i �` STATE OF NEW YORK, -0 �NTY OF . . . . . . . S.S being duly sworn, deposes and says that lie is the applicant (Name of individual signing contract) bove named. L feis the . . . . . ! . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) • • • f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file• • •• Pplication: that all statements contained in this application are true to the best of his knowledge and belief;and that the" 'ork will be performed in the manner set forth in the application filed therewith. worn too before me this .d y of. . . . . . . . . .. 1994�. otary Public, . . . . . . ,�o • • • •\. Cou y FRANCES FRISZOLOWSKIt NOTARY PUBLIC, State of New Yo No: 4709862 Qualif&d in Suffolk R#y ' Is (Signature of applicant)