Loading...
HomeMy WebLinkAbout23849-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25116 Date JULY 7, 1997 THIS CERTIFIES that the building ADDITION Location of Property 380 PLATT RD. ORIENT, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 18 Block 5 Lot 20 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 25, 1996 pursuant to which Building Permit No. 23849-Z dated DECEMBER 9, 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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ANNE S. HOPKINS (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-423759 - JUNE 25, 1997 PLUMBERS CERTIFICATION DATED JULY 28, 1997- KING PLUMBING Building Inspector Rev. 1/81 FORM 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) N° 23849 Z Date ...........UV ..................... ....................... 19... .. Permission is hereby granted o: .......... ?.. .... 1..S �c:."........................ ..................... p,.... ...................-...................... �, ....to� ��1�.... - .� 4� ... .., . .. .. .41...V.- ........�'..... ............................................. atpremises I ated at ............................ ..... ...1 . ...........:............................................. 400 ........................................................................a4%' .............................................................. ................................................................................................................................................................. County Tax Map No. 1000 Section ..........If..... Block ........`5�........... Lot No. ...�`r.�.............. pursuant to application dated ......................................................... 19 ., and approved by the Building Inspector. Fee $... ............... ......... ...................................... t... ....................... Building Rev. 6/30/80 Form No. 6 9 TOWN OF SOUTHOLD BUILDING DEPARTMENT MAY TOWN HALL 765-1802 BLDG.DEPT. : 1111A '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. y. 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 - $20.00 4. Updated Certificate of Occupancy - $50.00 5. ;Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 / Date . . . . . . .. �� i 7. . . . . . . . . . . . . . . . . . . . . . New Construction—/ . . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . . Location of Property. . . . �/. �. . . . . . . . . . . . . . /'O'� ! .T . . . . /.e-d . . . . . . . . .Cple-. E/�!. !. . . . . . . House No. Street Hamlet Onweror Owners of Property. . . . . .4/.`:N,4. . . . . . . . ...; ... . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . .. . . . . . .Block. . . 3:. . . . . . . . . .Lot. . . .. 0. . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No.Z 3. . .`.� 9 .Z .Date Of Permit. �.°.`�. z ?. . .'�Applicant. . HealthDept. Approval. . . . . ./. . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . !`/ . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $. . . . . . . . .?. . . ... . . . . . . . . . . . . . . . . . . . . . .APPLICANT . . . . . . . . . . . . . . . C o--Za5V 6 THE NEW ':'YORK BOARD Of FIRE UNDERWRITERS PAGE 1 11950�9.. • BUREAU'Of ELECTRICITY F 85 JOHN STREET, NEW YORK, NY 10038 Dace JUNE' 25,1997 Application No.on file 14140897/97 N 423759 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of A.S. HOPKINS,: PLATT ROAD., ORIENT, N.Y., in the following location; ❑ Basement El Ist Ft. El2nd Ft. OUT Section Block Lot was examined on ` ' 1$`1997 and found to.be incompliance with the National Electrical Code. t FIXTURE` FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ECEPTAClES SWITCHES OUTLETS INCANDESCENT1 FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. I K.W. AMT. H.P. 1 1.2 1 i 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 1 3© 2 600 SERVICE DISCONNECT _ NO.OF S E R. V. -1 C AMT. AMP. TYPE EQUIP. A 7W �,3W 3 B 3W 3 X 4W NO.OF CC COND. A.W.G. NO.OF HIdEG A.W G. NO.OF NEUTRALS A.W.G. EOUIP. PER B OF CC.COND. OF HIdEG OF NEUTRAL OTHER APPARATUS: SPECIAL .RECEPT; AMP.30-1 G.F.:C.1 3, JIM SAGS.; ELEC. INC. LIC.#3635 L; � � L L PO BOX 38 GREENPORT, NY, 11944-0038 GENERAL MANAGER 11 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 BEDDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 15T [ ] ROUGH PLBG. !✓ � D� FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE � INSPECTO � i?� 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ZIROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ZFRAMING [ ] FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS: DATE INSPECTOR 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] R GH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS: DATE 2 �� INSPECTOR-(� 765.1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE_1����7 INSPECTOR ,� �d �� o y 1.'1)I1111)A'Alm FOUNDATION_ & 11I.M.111 I NO - ------- --- III-SULATION Pi-ilt I,j. STATE COD R.. F I HA I. ------------- L o -------------------------- ---------- 43 J, li,rS\ Otjr�Co Town Hall, 53095 Main Road `� y z N Fax (516)765-1823 P. O. Box 1179 v- .V 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. O/Z 3 S 61Il Z— Owner: / yo fj 4F oaf Kr VIJ S (please print) Plumber: (p easlearl e print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers Sign ure) Sworn to before me this ZR-- ` day of -�3 U�LY 19q Notary Public, Cr�ol County -- -F,- ROBERT 1.SCOTr JR. Notary Public,State of Newyork "Iified in Suffolk County NO.01 SC472W2 Expires May 31. MACDONALD 'WOODWORKING CORP. P.O. Box 145 Hog Pond Road • Orient. New York 11957 (516)323-2716 (516)323-1235-Fax Ken Strachan Jr.. President TELEFAX COVER LETTER DATE: TO: NAME: f T- ,O 7- FIRM: ----- ---- MESSAGE: P G�/� l' �•� c�s'J' _ c' ca r o �c -- TOTAL NUMBER OF PAGES INCLUDING THIS COVER LETTER T6 3E)Vd NYHOYdiS N371 SEZTEZE9T9 TZ:BT 966T/Z6/tO FP`r7 Sr+,C� 7 C'\r el r� �� l s( //`�(� fZF�� L 0 ,r c O n LO Ax .� S •r� lt�r� 0 m O � ��� poT/i✓G— A o a. _ PC C2[ d ►l vo u � Z R r r�?5.a 0 v o �- z t Parccr VU 7cx�rl�r ot= .SouT�rcx_�,t�l:j. Ci a,fhis survey lva vlotatb;of / r/ S Section 7208 of the New York atay ! Fd:cetion Law. qar ' Cepioc o"his survey map not bearhq the land surveyor's inked seal or elt ossed Seal shall not be considered S± • 1 to to a valid true copy. =7r"�P t ,� i`� C G.:aan;e_s indicated hereon shal r.� .`a ar'j r-the person for Ntiom the sur•.gy and on f:is behalf to the l ager.cv WW l .,r.and f1� ' tc the _.. .:. tuticl _ ....... ...;i.i tr].l5f w-jb f oada.,.,n;.l orsub;equcrX wrrws 'Zheds s S3`I Z'GG MI. - ? 50-i folk GO -ax NI L�ssr�xrf'r�r: SI4 NS a. Izo3/08 C Pnr+trr � S i o 0 © C3rxyrrrrr��( ,F� K V. VnN to � s } _ -� 49.5 LfGErr SEr� L�xrxaf �c.ar'v n�f✓ti��. 56�m �o� v BOIVL ..NC-.S�— J f'�E'hf�OY t New Ybek I aNu BOARD OF HEALTH . . _ . . . . . . (` FORM NO. 1 3 SETS OF -PL.INS . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . _ _ _ _ . . . . . . . . . . BUILDING DEPARTMENT CIIECI; 5 , -' TOWN HALL SEPTIC . F0R:1 . . . . . . . . . . . . . . . _ SOUTHOLD, N.Y. 11971 TEL.: 765-1802 N I FY . . ., Examined 19 .�� CALL . 7.3. �. 2- 7'I C. . � P5XI MAIL T Approved . . ,1 . . ., 19�Permit No.9� . /�® . �.Y. . . . . . . . . . Disapproveda/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ?ICATION Building Inspector) AP FOR BUILDING PERMIT / Date . . ! !,/ . . . . . . . . . . ., INSTRUCTIONS / a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector,with 3 ats 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 on ,r areas, and giving a detailed description of layout of property must be drawn the diagram which is part of this appli- ation. 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 hall 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 Nall 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 ,uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or :egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. 'he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmitgautthoriized inspectors on premises and in building for necessary inspections. .AE%tdI`61>'rlyn d,i': 17 �; 00 L d d (Signature of applicant, or name, if a corporation) (Mailing address of applicant) �tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Q�. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . :. . . . . . . . . . . . . . . . . . . . . . . . Tame of owner of premises . .f�!'!'� , , ,.�; , /�!o ,r i N J (as on the tarp roll or latest deed) applicant is a corporation, signature of duly authorized officer. . (Name and title of corpo' rate officer) Builder's License No. Plumber's License No. . . . . . . . . . . . . . . . . . :: . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .7 7 . . . . . .�. . . . O,c Ems,, . . . . . . . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section . . . . . . .�F . . . . . . Block . . . . . S, , , , , , , , , . . Lot . . . . . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 . . . . !� :".! . . . .�? .f .i.O�i✓ T ` . . . . . . :. . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . /a OoiN o- Z 3, Nature'of work (check which applicable): New Building . . . . . . . . . . Addition .`. . . . . . . . Alteration Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition .4.... . , . _ , • . . Other Work . . . . . . . . . . . . . . . 4. Estimated Cost . . . . .�.°9.9.. (Description) . v . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 5. If dwelling,number of dwelling units . . . . .! . . . . . . Number of dwelling units on each floor . . .! . . . . , If garage,number of cars . . . . . . . . . . . 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 . . . . .T.k✓ o. Dimensions of same structure with alterations or additions: Front Rear . Depth . . . . . . . . . . Height . Number of Stories . . 8. Dimensions of entire new construction: Front ./A ' ' ' ' ' ' ' ' ' ' ' ' ' Height . . . ' . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . /. z '. .. . . . . . . 9. Number of Stories . . . . . ®!•! . .Size of lot: Front . . f:.f < , il•'T!¢c!RG•� Dear�-, Y� Depth 10. Date of Purchase . . . . . . . . . . . . Name of Former Owner 11. Zone or use district in which premises are situated . . . . . .tenc d N r /V . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation:. !�! Q 13, Will lot be regraded . . . . . N� . . . . . . Will excess fill be removed from premises: Yes -"' No 14. Name of Owner of premises 'Oy? • , , , Address ."49r7 o 9�'�r:7phone No. Name of Architect . . . . . . Address Phone No. Name of Contractor"A,; .o.-!fc; o .;.o da,.o,t�.�Address o.cif 7 .Phone No. . . 15. Is this property within 300 feet of a tidal wetland? *Yes. . . . . . . . *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. /9 T 7 /9 rr zc Vio Y l v% .� C- ,y A t x- ? / G UNDERWRITERS CERTIFICATE REQUIRED (.Fa q/r��.p` ��3 APR AEU AS 6�Q'��/,E[D CIE N v�6' y9C I F .a / V t/ C CUPAIVCY ?. , n ,. , , N �t�i �.`�7 vim/ OL I� F� ��� Qt Gs'«z% E`, a `'' r FEE. O By r,� �A " � , � .� r�IC� IFY BUILDING DEPA AT -y SyS7_E�`� g `I ' '' i , �t "s `�� � �?� "�� , ��-i BOZ S At1iI TO d P11P1 FOR THE e { , .� a &. 'a 4> �f�I<.LOWING INSPECTIONS: ���C' � /fir O, I% LEAD. � � i� „— C` � rar4,S 1. FOUNDATION TWO REQUIRED r j iF JF; r La E7°;:� ti r FOR POURED CONCRETE 2. ROUGH - FRAMING & 1'LQ.INIBING 8. INSULATION PLUMBING 4• FINAL, w CONSTRUCTION MUST ALL PLUMBING WASTE BE COMPLETE FOR C.O. &WATER LINES NEED If Capper tLibing iS used ALL CONSTRICTION SHALE. MEET TESTING BEFORE COVERING for water distributing THE REQUIREMENTS OF THE N.Y. shall be STATE CONSTRUCTION & ENERGY a/�st?f01," piping shall NOT RESPONSIBLE FORTATE OF NEW RK of t�eR�s � - DESIGN OR CONSTRUCTION ERRORS 'OUNTY OF . . S.S ' ' ' ' ' ' '� r tXi° S '�,<c JI. e. . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) '')ove named. eisthe . . . . . . . . . . . . . . . . . . . . . . .(Contractor, gent, corporate officer, etc.). ' ' ' said owner or owners, and is duly aut 'z.ed - erform or have performed the said work and to make and file this )plication; 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. vorn to before me this ,) . . . . . . . Jday of. )tary Public, . . . . . . County CLA,rRE L. EW Notary Public.State of New York r- No.4879505 . . . . . . —; ��. /� — ;applicant) Qualified'eat Suffolk County . . . . . . . Corvsmission Expires Deeeanber ,99 (Signature