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Home My WebLink About23827-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY , No Z-25232 Date SEPTEMBER 3, 1997 THIS CERTIFIES that the building ALTERATION Location of Property 695 EDWARDS LANE ORIENT, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 18 Block 3 Lot 21 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 7, 1996 pursuant to which Building Permit No. 23827-Z dated NOVEMBER 27, 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 ALTERATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to BARBARA BLOOM (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A B'Gilding Inspector Rev. 1/81 FORK NO. ! 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) �y q? N? 23827 Z Date .............. .. . ........ ................... 19/n. Permission is hereby granted to: J A ...................................... ........... ....1��.�. ..... to .. . ...�.�. ........ .. atpremises located at .................... .r.. ... .1........................................ ................................................................. ....... ........................................................ ................................................................................................................................................................. County Tax Map No. 1000 Section ........./-F.... Block .......... ..... Lot No. ..: `............ pursuant to application dated .............................��....7........ 19..1..0 and approved by the Building`Inspector. Fee ....�..G/! $• 71/ /i Building Inspector. .................... Rev. 6/30/80 dorm No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT Al TOWN HALL 765-1802 �J'86 119 97 APPLICATION FOR CERTIFICATE OF OCCUPANCY BLDG.-DEPT , A. This application must be filled in by typewriter OR ink and subm� 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 �m 0 CD pre-existing" land uses: . I 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 Buildinz - $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 . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . .. . Old Or Pre-existing Building. .:. . . . . . . . . . . . . �.�7�r' :Te Z f .. . . . . . . . .. . .. . . . . Location of Property. . . . .. . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property.��r/J,4MI4. .�IeM.-4 .. . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . tion. .L . . . . . . . . .Block. . . . . . . . . . . . . to 21 County Tax Map No 1000, Sec o Lot. . . !-.-.//. . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit NoBU 221--YO :. . .Date Of Permit//_2"� Applicant. . . . . . . . . . . . Health Dept. Approval. . . . .. . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . Planning Board Approval. . . . . . ... . . . . . . . . . . . . . .. Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . .V-Z Fee Submitted: $ . . . . . . . . . . . . . . . . . . . APPLICANT J 3 2- O��SpFFO��co c� Gy'c Town Hall,53095 Main Road y Z Fax(516)765-1823 P. 0. Box 1179 ;yb • Telephone(516)765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD June 27, 1997 Barbara Bloom 10 Leonard St. New York, N.Y. 10013 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons : XX An application for Certificate of Occupancy is not on file. (Enclosed) / No Underwriters Certificate on file. XX The check is (not on file. ) $25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 23827-Z (FEELEY) Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. Lp! % DA*R I'MINDATH N I'MINDATION 2 HD C:3 ul-7- N% ROUCH FRAHR 111.11t.111 I NG, ---------- I Off III'-It ti. y STATR ----------- ------ F I HAI. ------------------- =--------,inn-arm-------- -------------------------- ADD I.TIONAL COHMENTS: ----------- L'a r7 Joseph Fischetti PROFESSIONAL ENGINEER HOBART ROAD/PO Box 616 SOUTHOLD, NEW YORK 11971 516-765-2954 Date: November 5, 1996 Reference: 695 Edwards Lane Springer's Contracting PO Box 80 Aquebogue,NY Dear Sir, With regard to the Bloom home at 695 Edwards lane. The design of the Structural Member to support the loads above the room is a Steel Beam W 6 x 25. All fabrication and construction to be in accordance with NY State Building Code. ��,�� OF NY � Very truly yours, FISCy �P,F A St A � f 4u . �2 4/. �0. 05200 Joseph Fischetti, P.E. %FEsslo�IXV J _ L2x _ t zm) Sue 2 X -�- -� � S 5 crt. Ank' 0 4,1 6E7 765.1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOyNDAT10N 2ND [ ] INSULATION [ GYFRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ,�'h2� 1 DATE I i -INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ } FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ c.]-PI AL [ ] FIREPLACE 8 CHIMNEY REMARKS: - DATE � INSPECTOR BOARD OF HEALTH . . . . . . . FORM NO. 1 3 SETS OF PL.VNS . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CIIECK . . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FOR:I . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.. 765 1802 ttoC l FY ; � 772-/ Examined . . . �1 19!� CALL - - - - - • - . . . . . . . ��jj'// t•I A I L TO : .lpproved . . . .JJG ��:, 19GS�?PermitNo. -�.� � . . . . . . . . . . . . . . . . . Disapproved a/c . . - - . .. (Building Inspector) - C�PPrvi: UVIL UIwLi PERK. -- Date . ��. . .��!:. .. . . ., 19 y INSTRUCTIONS a.. Tlus'applicat*ion must be completely filled in�by typewriter or in in and submitted to the Building Inspector, with 3 :ts 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 r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ition. 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 call 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 ;all 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 silding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or e-ulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ze applicant agrees to comply with all applicable laws, ordinances, build. geode, housing code, and regulations, and to !mit authorized.inspectors on premises and in building for riecessary;irispec ons. . . • (Signature of applicant, or name, if a corporation) • . (Mailing address of applicant) 'ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . :(� r... ..�. . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . amc of owner of premises . !/. -. . .- A)al"--`L". . . . . . . . . . . . :. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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. . . I.T '. , , , , , , Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . qqq _ Electrician's License No. . .4:,/.��'. . . . ... . . . ' Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . Location of land on which proposed work will be done. . f. . , r!/• ��f Ls�J� � ! � .. . . . . .�l�s -- House Number Street . � Hamlet County Tax hlap No. 1000 Section . . . . . . . . . . . . . Block . . . . , , , , z / Lot . . . . . . . . . . . . . . Subdivision . . . . 0 . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . .�. . . . . Lot . (Name) . . . . . . . . . . . . . . . . State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . . , , , , - , • , , , ,fly/ b. Intended use'and occupancy . .�. [ /. ' 3. Nature of work (check which applicable): New Buildingl Addition •Alteration Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . . . . . (Description) 4. Estimated Cost . . . Fee 5. If dwelling,number of dwelling units . , , , , , . . .1 S (to be paid on filing this application) . . . Number of dwelling units on each floor . . . . . . . . . . ... . . . . If garage, number of dars . . . . . . . . . . . . . 6. If business, commercial or mixed occupancy, specify nature and extent of each type.of use . . . . . 7. Dimensions of existing structures, if any: Front . . . . . . . Rear Depth Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . Rear . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . . . . . . • • • • . Number of Stories . 8. Dimensions of entire new construction: Front . . . .Rear . Depth. . . . . . . . . . . Height •:. . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . `. . . . . . . . . . . . 9. Size of lot: Front . . . . . . . . . . . . . . . . . . . . . . . . epth . . . . . . . . . . . . I. . . . . . . . . 10. Date of Purchase . . ./.4:L�:1,•Y.9. . . . . . Rear . . N me 0f* . . . . . . . . . . . . Depth . . . . . . . . . . . . . . ... .. I L Zone or use district in which ' ' ' • • • • Name o ormer caner . . . . :P� . . . . . . . . . . . . . . N f F O .�- T ��/ --c prem,,�Pc;are situated . O 12. Does proposed construction violate any zoning law, ordinance or regulation: . . .zz%1 P. . . . . . . . . . . . . . . 13. 'Will lot be regraded 444.1 . . . Will excess fill be removed fro premises: . .. . .Yes • . . 14. Name of Owner of premises•��.'N.��.�/�� 9 E*f G��•- Name •�• • .Address �. 1�. 4I �� . . . .hone of Architect .Address . Phone No. Name of Contractor . . • . . . . • ,,(��,�,i!✓�f .r ddresspP. 0 X.j!B �A��l�phone No. 15. Is this property within 300 feet f a t' dal wetland? *YeS, ,•, , , , , , No. .✓. . , , . . Z •1• *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. s • UNDERWRITERS CERTIFICATE RfQU1R APP M, a AS WOT ) DATE. A# r2� �=EE: Iry NOTIFY BUILDING DEPIAR T t �r:, � �Q� e�� ' �t'a5-�83�2 R �41�3 TO 4 P l�,` `U FOLLOWING INSPECTIONS: FOR TEE I. FOUNDATION - TWO REQUIRED �A C� L! 7 d i(��,�f{.:a i �• p x fl" 3i w '1 `s FOR POURED CONCRETE 2. ROUGH - FRA IL�I1lVfa Pse PLUMBING INS- 3. ULATION B 6{i.n `� c E� 6 �5Ag 0- 4. F1.NAL CONSTRUCTION MUST.., ' % BE COMPLETE FOR C.O. t E, I° F;,S . ,; %�,!'a•„Y ALL CONSTRUCTION SHALL MEET TIME REQUIREMENTS OF THE N.Y STATE CONSTRUCTION Ill; ENERGY CODES. NOT RESPONSIBLE 'FOR DESIGN OR CONSTRUC71ON ERRORS STATE OF NEW YORK, COUNTY O: . . . .UtI(V. �p mil- - S.S . . . . . . . . . . . .��r� rt'' . . � -'"z . . . . . . . . . . . . . . .' being duly sworn, deposes and says that lie is the applicant (Name of individual signing contract) lbove named. •le is the . . . . . . . . . . .6W�? .'. . . . . . . . . . . . . . . . . . (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 this pplication; that all statements contained in this application are true to the best of his knowledge and belief;and that the' vork will be performed in the manner set forth in the application filed therewith. worn to before me this ' . . . . . . . . 2 . . . . . . .day of. . . . .��. ��. . . . ., 19 .df. ;otary Public, . . . . .C[ �, :U:'!-! .! . . . . . . . . .. , , , County KAY P. CHOW Notary Public, State of New York , , , , , , . . . No.24.4950562 . . . . . . . Qdalified in Kings county , (Signature of applicant) Term Expires May 1, 19. Sirf;oIL o0un ti r Il TtYa�,,ltiR,t�jb. roDo-018- �--21. 'Ile-enc k j Of 410 : $ `�. C�1 S• 2�'•49 f0 k 1 slate walls ; a - ;�7 -_-��' (IV } v ,. qp f . fr: house � � l ce r f�rrrret a k.I L41 i ri `SCttC� ,r _ M4P of PeoPe12�! t Z t S042VEYED FOG 1 qg_ Sheol ?SOWN of SoUTr-4a-0, N.Y. � ', - - .} . tatlttAhorteM r+�+:t7+a+►+M�w'_' _ f fi m f ft Mvey Is a vblatio`n of 3edion 72M of the New Yodclif" 1 rkhmation t&tia i Sect!� : S ! " i Q0 Copies ofthissurveymapnotboift �. 1 (� Area= Z.314 rxG_ eMe mb' mvioes ossedsealshalln�aeeeOwWdraa NW or to be a valid true . . . N a = motrurrreHf ooPY• ttt j o Guarantees indicated ltoraon tdtai M13 (v 1 ory to the person torwhan the stt<vey 5 prepared and on his behalf to the Me company. mnst to onvernm listed hntrexya* lendigw and to the ccslgness ct the lending instf• L�' tuticn.Guarantees are not transferable T(+109 NO, VA 2.471 S to additional instiazlions or subsegM t { OM9°rs- f - coo -- Gucrrcxrfd fo the Camrrrorrw�alFFr i - �,,��,,.� Lartcf Tif(e lrtsurarrce Corrr�anrf amid — -f-o Yerrksre A6sfaaccf and -At, 46e - f -- owners , er5 -4.srve d Nov.5, 1992•. h. 2�2. 6-7 E o•�vv. 2OPSOICk AN?uYL, P. C. � ¢ pHAlvlAl'�;' �. f Greenfof4 blew York