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HomeMy WebLinkAbout23473-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25132 Date JULY 11, 1997 THIS CERTIFIES that the building ALTERATION Location of Property 14909 MAIN ROAD EAST MARION, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 23 Block 1 Lot 2.3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 8, 1996 pursuant to which Building Permit No. 23473-Z dated MAY 31, 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 NORMAN H. WHITEHEAD (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-406248-12/18/96/ & H-55669 - 6/16/97 PLUMBERS CERTIFICATION DATED JULY 10, 1997-MIRE JACOBI PLUMBING & HEAT. Buil g InspeApr 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° 23473 Z Date ............. ...��..............................., 19..OV Permission is hereby granted to: J2..... ?!�/1�. �..../.. ...... � to ...' 1 ...............41-4^ ...... . .'.`�.......C/.f^�. .......1-: �.. ..... . ...... ... . .• . iG •.iM.. iI.• ......R...i1..e �...... •.....• •....•• fff �� at premises located at ........l/. J.r... ....... . . / ....i��... ........................................................ .................................................. . : .:........ ................................................................. ................................................................................................................................................................. County Tax Map No. 1000 Section .., ............. Block .....Q ....... Lot No. ......... pursuant to application dated ....... ... ........� �................. 19.�.. ., and approved by the Building Inspector. Fee $...��.til:............ .�J.. ........................ild' g Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD 'f 7 BUILDING DEPARTMENT TOWN HALL 765-1802 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_plumb.er certifying that the solder used in system contains less than 2/10 of 1% lead. 5. _ Commercial building, industrial.buildi.ng, 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 Buildins - $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 . . . . ..711 .�97?. . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . .+. . . . . . . . Location of Property. /. Q�}9.'��... . . . ... . ..�`?f'�2./1� . l7:P . .. . . . . . . ! . ./ljowl% . . House No. Street Hamlet Onwer "or Owners of Property.. A r.—MAHMAP . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . .Z.�.;... .. ..Block. .. Q J. . .. . . .. .Lot. . . . . . . . . . . . . . . Subdivision. .'. . . . . . . . . . . . . . ... .... . . . . . . . . . . ..Filed Map. . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. 2.S. . . . .Date Of PermitAo.//¢6. . . . . .Applicant.A/Poiote6�.8 Health Dept. Approval. . . . . . . . ... . . . . . . . . . . . .. . .Underwriters Approval. . . ?!. . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . .. . .. . .. . . . . . . . . . . . 'Request for: Temporary Certificate. . . . . . . . . . . final Certicate . . . . . . . . . . Fee Submitted: $. . . . .9. r. . . . . . . . . . . . . . . . . . . f. ... . . . . . . . . . . . .. . . . . . . . . . . . . . 6Q_�_ . 5313 APPLICANT TEL. 765-1802 TOWN OF SOUTH Ob,D 0 •::� =,c OFFICE OF BUILDING INSPECTOR " - �, �..��!. '�'►��r ,--;, P.O..BOX 728 TOWN HALL . SOUTHOL.D, N.Y. 11971 C E R T I F I C A T I O N Date /0 Building Permit No. Owner�Y ) ✓• eq, (please print) , Plumber K k r% Gp 6 r (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% . lead. (plum �e ' signature) Sworn to befo me this G6 day of ,* 19f Vo&ry Public 11otary Public , County JOYCE M.WILKINS Notary Public,State of New York No.4952246,Suffo qlk County Term Expires June l2, 194/ 3 i THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1175003 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NY 10038 Date ' DECEMBER 18,1996 Application No.on file 12788696;96 DI 406248 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 NOP1-LAN WHITEHEAD III, 14909 MAIN ROAD, E. MARION, N.Y. in thefollowinq location;- ® Basement ❑ !vt Fl. ❑ 2nd F(. OUT .Section Block Lot was examined on DECEMBER 13,1996 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES OUTLETS ECEPTACLES SWITCHES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS k INCANDESCENT.FLUORESCENT OTHER AMT, K.W. AMT. K.W, AMT. K.W. AMT. K.W. AMT. M.P. ' DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. SYSTEMS A NO.OF FEET MT. WATTS SERVICE DISCONNECT NO.OF S E R V I C E METER NO. CC.COND. A.W.G. AMT. AMP. TYPE EQUIP. 1'9 ZN/ 1 7W 3W 3,B'4W NO.OF HI-LEG A.W'G. NO.OF NEUTRALS A•W.G. 7 PER H OF CC.CONO. OF HI-LEG OF NEUTRAL 3 1 200 CB X 2�0 t 7 - _ 2/0 OTHER APPARATUS: � _ t I I Y Q.C. ELECTRIC INC. LIC.#3823 P.O.BOX 518 LAUREL, NY, 11948-0518 GENERAL MANAGER -• x+ 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. 8066406 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 F— BUREAU OF ELECTRICITY Dace JUiQE 16,1997 85 JOHN STREET, NEW YORK, NY 10038 THIS CERTIFIES THAT Application No.on file 13058196/96 H 055669 only the electrical equipment as described below and introduced by the applicant named on the above application number in the remises NORMAN H. WHITEHEAD, 14909 MAIN ROAD p of. ' EAST MARION, N.Y. in thefollowing location; ❑ Basement NNE 09 1 ® !at F!. ] 2nd FI. >c as examined on , 997 .Section Block Cot FIXTURand found to be in compliance with the National Electrical Code. OUTLETS FIXTURES OUTLETS KEPTACLES SWITCHES RANGES COOKING DECKS OVER:: DISH WASHERS EXHAUST FANS INGANDESCENT.FIUORESCENT OTHER AMT. K,W, 12 2(� AMT. K.W. AMT. K.W. AMT. K.W, AMT. H.P. 14 12 DRYERS FURNACE MOTORS 3 F FUTURE APPLIANCE FEEDERS SPECIAL RK'Pi TIME CLOC AMT. K.W. OIL H.P. GAS H.P. T. NO. A.W.G. AMT. . A KS B DIMMERS ELL UNIT HEATERS MULTI-OUTLET 1 MT. AMPS. TRANS. y�T, H P SYSTEMS AMP NO.OF FEET AMT. WATTS ! 2 20 F SERVICE DISCONNECT NO.OF i AMT. AMP. TTPE METER 5 E R V I EQUIP. 10 2W 1 0 3W 3 AT 3W 3,st'AW NO.OF CC.COND. A.W.G. � E { PER B' OF CC.COND. NO.OF HI-LEG A.W G. NO.OF NEUTRALS A.W.G. OF HI-LEG OF NEUTRAL OTHER APPARATUS: rq' i PANELBOARDS: 1-8 CIR. 125 "r G.F.C.I:-3 SMOKE DETECTOR:-12 s a NORMAN H. WHITEHREADIL L ,III ' BOX 337 EAST MARION, NY,. 11939 I GENERAL MANAGER er— . 11 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors mapbe identified their credentials. 234-13 � 7rs.iso2 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 ULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: �� � �• /�C/✓`�c^cf.7iw (?f4%n%�1KLa� /�leaLG.aBu DATE 7/7 7 INSPECTOR G�� rss.iso2 BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ��, j�;;- u� DATE 2� 97 INSPECTOR 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] F NDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: z& / //Ie ji4:�2 , DATE INSPECTOR 3 765.180Z BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION �RAMING [ ] FINAL [ ] FIREPLACE 6 CHIMNEY REMARKS: GL � DATE � INSPECTOR rlullnl .A..Vi 0 11.... FUMIDAT I Ol I _lam ' -l- ............ & -------------------- - STA I'li V I I lilk y CODH ..00l ......... .......... ....... . 1; 1 IIAL .................. ADD ITIMIAL O U BOARD OF HEALTH / . . . . . .. . . . . D FORM NO. 1 3 SETS OF PLANS �/. . ... . . . . . . . . . . a TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . t �A ee BUILDING DEPARTMENT CHECK I. Aq. . . . . . . . . . . . . . . . . . . MAY v TOWN HALL SEPTIC FORM SOUTHOLD, N.Y. 11971 BLDG.DEFE TEL: 765-1802 NOTIFY: TOWN OF SOILITHOLD CALL �?� F.' ??14 . . . . Examined...... ...., 19l.� MAIL TO: 377- , - - - - - - . . Appmved.......x, 19,1� Permit No. ........ ....... .............. 15!!ID.......... Disapproved a/c :..... .......--. ............... �Y/Ndl_e�u').�:�%......... I.A. - //989,033� ...................................................... . . .......... y. (Bu�.g..DSpeCfor) APPLICATION FOR BUILDING PERMIT / Date. . . . . . . . .. 19.q� INSTRUCTIONS a. a a. This application must be--bompletely 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. µ b_,: Plot plan showing location,,9f lot:and of buildings, ;z(?n premises, relationship to adjoining premises or public streets or, areas, and giving a detailed,description of layout-,,of property=)st'be drawn on the diagram which is part of this application. 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 v7ill issue 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. o APPLICATION IS HERE6Y MATE 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 autborized,.,inspectors on'premises and in-,building for necessary inspections. `•!:b!..! .............. .............. -(Si tune of applicant, or name, if a corporation) I3e tk33 P /is 9&V 14-q cm A-040 r"s r /'y/qI zoA.., - ............ .. -- (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, 1 6W&A�y Ur builder. ...OWzu-;A................................................................ .OAT . tg.#,{ ' Name of owner of premises /.VQ? �!V..J:�....w T t �--.�.+.� .........FEE:.s' `�l Y�YY� (as on the t t NOTIFY BUILDING DEPA TMENT AT tfP ,I� , Y R 765-1802 9 AM TO 4 PM FOR THE If applicant is a corporation, signature of dub �� 1 f cf"a1f EI FU FOLLOWING INSPECTIONS: __ ,-,-,, ../v ..�,, ,,,,„,,, „ 1 FOR POURED COIUCREOEREQUiRED ' ) ..--WITH UT CERTIFICATE 2. ROUGH - FRAMING & PLUMBING (Name and title of corporate officer) `� 3. OF OCCUPAN 4• NALA- CONSTRUCTION MUST Builders License No. S�� ""-"""""',r BE COMPLETE FOP,C.O. "-""" ALL CONSTRUCTION SHALL MOST Plumbers License No. ..... .a!t.f....C.Cnr _0 THE, REQUI�EMtNTTS OF TF,".E ,N,.Y. ,* ' STATE' C' ' STRI_i�'1";NN E�'JitRGY ' Electricians License No. ..4!*-'F............. COMES. NOT R SP0N-;';1B1_E FOR Other Trade's License No. ..&/'q............ DESIGN OR CONSTRUCTION ERR.ORS', 1. Location of land on which proposed work will be done.............................................................:. ... /-`!'XA9 ....../ 2 V..iZ0?1p............................1���. ..................................... /yAQt,24�V House Number Street Hamlet Canty Tax Map No. 1000 Section Ai:Z.-,O d.... Block ..... bet .qp-R t 3 . 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'. F-�!T! G. T N:S C!/"�rj'C/ ............. ........................... b. Intended use and occupancy ............ G ................. N�c XA ena�'� Fa°•°{ivev�w Ci�e'l�i'ii.5 ri�fY,1'?�Y 3. PAture' bf work (dieck vAdch applicable): New Building .......... Addition .... ..... Al.terat'-ions'.;: Repair ............ Removal ............. Demlition ............ Other Work wsu R (I>escripi'.ai)`A 1 ict•R &VOct� 4. Estiurated Cost .3�X 000,; . ........ fee ............................... r. F=1iF d47/���rl (to be paid on filing this applicat)'iiri)�?;.x:: 5. If (keel l irig, rrinirer•<oh dwelling units .... ....... Umber of (kael.l ing units on each floor _.. ...._...... Ifgarage, -nunher of cars ...................................... G. If buMni e'ss,- ebmrrercial'6r'mixed occupancy, specify nature and extent of eadr type of use...................... 7. Dhii nsions of existing `stfuctures, if any: Front.. 21C.......... Rear ....�5....... Depth _.3.. .......... lle(ght ............... Number of Stories .....!3............... Dimensions of sane structure with alterations or additions: front ..... Rear ....... Depth ...'S!(Stir......... height .....5-4.t........ Umber of Stories ..!s!'�!�C...... 8.. Dimensions of entire new construction: Loom' ..S.!4!y 9..... Rear .. ?'9? ..... Depth ..S 9!r!F..... 11ei0it ..S!g1`!!=:.............. Umber of Stories ...s q!7Y.......... 9. Size of lot: Front .................... Rear .................... Depth .................... 10. Date of Rrrdrase ..' .. f ._..... Name of l oriwr Owner N*1021 .R�f !!..!V kT 'k-H_a�...... 31/�,,f-9'�. p kc 11. Zone or use district in irdr premises are situated ....�....�l:'_. ...................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ../.VP................. 13. Will lot be regraded ......A.0#1?......... Will excess fill be removed from [remises: YES ^44tT*rat cr4c446 C s 14. Names of Owner of premises A!�R!(l! �!!.!`'�:14'VV?!#4 Ii Address �!i!tR .v G?dwj� _ �. Phone No.4W'.'r`'�../ ._. Name of ArduitecL ...../"..11.4......................... Address .............................. Phone No. ............. Nine of Contractor .....M1 4......................... Address ... ..........................Phone No. ............. 15. is this property within 300 feet of a tidal wetland? * YES ...✓....... N0 .......... *Lr YES, S(UPIILHD IU4N 'IR)=-—3 PERMrr MAY RE REQ(JIRM, . 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 ember or description according to deed, and show street names and indicate iihether interior or corner lot. ,(� u2•'�D V*1r'1DV W4P COMO 8s0 SQL lzr o S['A Ili Ol7- NEW Y(xtK, SS O(X1NIY OP. ....... ... .. . , .� . ............being duly swwrn, 'deposes, and says that he is the applicant (Nave of individual signing contract) above rumied, lieis Lhe ........................ © 1ift ......................................_...................... (Contractor;,,.,agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work arxl to make and file this application; that all statements amLaine.d in this application are true to the best: of his knowledge and belief; and Lhat the work will be perfonri6d-in ilie manner set ford 'in the application filed therewith. Sworn to before me this ............ ..day of _. 19 ?.. Notary Public .... ............. • ;. BERTI�SCOT3.ydR, ��SiprMAIre'df.Applicaril) '. NOTARY PU18 C.State No.47250' .Suffolk 'u Term Expires May 31. 19 C� 1 ilk co t FuH baik i b(;j floor'\ �- 116�' ir C9 >( S' - I csivC-OR TI .. .. . ... .. .....•. ...-.......��.._. _....... .. .._._.-._.... .. ...... ... .._•___.. __.._.... -..y,.__-..�...... .�.. ._ .. ... ......_.... ...n... .._ _. .s-.--.u...... ....r F. ..d-..sY.wr......NrM.ur..Jw... , y� L J I 0 x} i t 44 C> 1 Nil C o �Jr�� btr Jlj 71 GA .S r Nj,,QZf0N i � U; x N9orlc�rtt�.tf O/k (.O. 7 OiS F'O✓rG eft /OOQ 5o, � v�/rster Su��ly and s�twcpy�rt Dr��Erodcr/ • , , ' ' o t5r�6tama �'o mte�`' �f'.andarr-�d �x N0 /01- to be eh-Cf- .su1PdrJlVrd'dd: ii - - �B, aoQ „ r�. :. _ � , _ �orler�'ck- Ya�> r'�►�1, �:i�•; . t tb f, zo 4 ada O Fe it er, . t� b __ -_"_ DidC. 6, TIA _ �CK Vqy \ Z OAS^ \.` • T L11+atAlorteed eltendbn,+ �_,.-.. to this eumW b a vloleUon ejl't�- �l 1 w �_._` 1 — l� ,` . 6ectbn 72 0l e»Naw Yadc gteltt .� Education La Law, ` �"� � � I ; � Cbpleso(lhlalUNgyntapral6BarNp (i land w-yoft WMNOI of �meboeeodttealNta/ntit6eooneldaled muarudeeJeMd YMhantlrotf � ' ; H ir) only to ale person taedtam flu eurv�ulr• �. As prepared turd on htf befmlrro ato thle Company govemmmtfalegancy 1 •p I ti/j C- C GN/11i E r r lending insteutton fisted hereon artd JS to the assignees of the lending Instb lullon.Guarantees ere not translerobla 80 I to additional Institutions or subsequerd vatn dad: _..._. d'pO , Y Jam,. •-:..:�"1 - ..