HomeMy WebLinkAbout23515-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24674 Date OCTOBER 7, 1996
THIS CERTIFIES that the building ADDITIONS
Location of Property 715 SHORE DRIVE GREENPORT, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 47 Block 2 Lot 19
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 28, 1996 pursuant to which
Building Permit No. 23515-Z dated JUNE 17, 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 PORCH & DECK ADDITIONS TO EXISTING ONE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to MICHAEL & STELLA ANESON
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-398532 - SEPT. 30, 1996
PLUMBERS CERTIFICATION DATED N/A
r�c
Building Inspector
Rev. 1/81
FORK NO. f
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° 23515 Z Date ............. .....................�................. 19. �r
Permission is hereby granted to:
......:71. ... ��....................
..... . .:. . ........
........
01
to �.. ;o,�ar�� l.(1J? ., . .... ....... �J .. ... .............%'ram
. ... ......................1 ........... ....... / ..........s..............................
atpremises located at ........ ...: ...... ........ ...............................................
.....................................................� . ....... ................................................................................
.................................................................................................................................................................
County Tax Map No. 1000 Section ......... ..... Block ...1-21
............ Lot No. ...4.9...........
pursuant to application dated ................................... ...... 19.9..C?and approved by the
Building Inspector.
Fee $...L. ..............
....... . .. ................RS .....
.... ........ ..............
Buildin I for
Rev. 6/30/80
Form No. 6 gLpL
� �q
TOWN OF SOUTHOLD l 0_
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 ttte`bu ldii g=--=•-
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 - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. .Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . . . . .iQ/3./.96. . . . . . . . . . . . . . . . . . . . . . . . . . . .
New Construction. . . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . .
'I Shore 'Rd. Greenport
Location of Property. . . .? 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . I . . . . . . . . . . . . . . . . . . . .
House No. Street Hamlet
Michael Stella Aneson
Onwer or Owners of Property. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • . . . • . . . . . .
County Tax Map No 1000, Section. . . . . . . ..... . . . .Block. . . . . . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
Subdivision. .Greenport .Shores. . . _ �.7��. , , , .Lot. . 4
.Filed Map. . . . . . . . . . . . . . . . . . . .
Permit No�3..�.r�. . . . . . . . , ,Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . .�Iichael. Aneson . . . . . . . .
Health Dept. Approval. . . . . . . .. . . . . . . . . . . . . . . . . .Underwriters Approval#!#! 5�896�96. . . . . . . . . . .
Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .
i
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . .
�5
$. .
-00
Fee Submitted: . . . . . . . . .. . . . . . . . . . . . .
. . . . .
�� . ...Inland .1Jo].es .111s... . . . . . . .. . . . . . . . . . . . . . . . . .
APPLICANT
THE NEW Yrr�� ,O/(R, K BOARD OF FIRE UNDERWRITERS PAGE 1
TY
� 195099 ���l5�, —co Z � 'JOIHN STREET,, NEW YORK,BUREAU OF INY 10038
Date SEPTEMBER 30,1996 Application No.on file 12251896/96 N 398532
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
MICHAEL ANESON, 715 SHORE DRIVE, GREENPORT, N.Y.
in thefollowing location; El Basement u 1st Ft. ❑ 2nd Ft. OUT Section Block Lot
was examined on SEPTE14BER 26,1996 and found to be in compliance with the National Electrical Code.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS ECEPTACLES SWITCHES IR INCANDESCENT1 FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
6 5 5 6
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECTT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
[OTHER
MT. 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
1 600
SERVICE DISCONNECT NO.OF S E R V I C E
AMT. AMP. TYPE METER �,7W .i!3W 7,B'3W 3,e'AW NO.OF CC COND. A.W.G. NO.OF HI-LEG A-W G. NO.OF NEUTRALS A.W.G.
EQUIP. PER Ar OF CC.COND. OF HI-LEG OF NEUTRAL
1 200 SW 1 X 1 4/0 1 2/0
APPARATUS:
PADDLE FAN-1
MOTORS:1—I' H.P.
G.F.C.1:-1
m
JIM SAGE ELEC. INC. LTC.#3635 E : � � L L
350 MARINE PLACE
GREENPORT, ICY, 11944 GENERAL MANAGER
11
_ SS 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.
/ELJ) TpJSPECTION REPORT DATE
COMMENTS
II "�
II H
FOUNDATION ( IS
II
FO[JNDATION (2if
- — -
I _
ROUGH FRAME & ii e G ( y-1
it
PLUMBING I�-- —II!-G� _�� 2�✓1 /�-
n
57
-� I'
INSULATION PER N. Y. -
u
STATE ENERGY II
conE ii it
ll---------II
II _
II If
II
H
.r II II .--•
I11
I 2/9
FINAL.
ADDITIONAL COMMENTS
vi
- H a
9
r
ro
H
02B 57/6-�
ass-isos
BUILDING DEFT.
INSPECTION
[ ] FOUNDATION iST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INS ON
[ ] FRAMING A'-FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS•
ZcK
DATE INSPECTOR
765_1802
BUILDING DEFT.
INSPECTION
[ j FOUNDATION iST [ ] UGH PLBG.
[ ] FOUNDATION 2ND INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARK.n..
xl
DATE �/ INSPECTOR
765.1802
BUILDING DEFT.
INSPECTION
[ ] F
DATION 1ST [ ] ROUGH PLBG.
DATION 2ND [ ] INSULATION
ING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
�Qic6C 7 c
DATE —INSPEC
pr EC
,65_1802
BUILDING DEFT.
SPECTION
[ F UNDATION iST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE 8 CHIMNEY
REMARKS: �
Z J
DATE INSPECTO
BOARD OF HEALTH .
`. FORM NO. 1 3 SETS :OF PLANS• Y VE
TOWN OFSOUTHOLD SURVEY
. . . . . . ' ' ' ' ' '
OUI-LDING DEPARTMENT CIIESEPTIC .1FORr. • __ _- . . . . . . .
TOWN HALL " . . . . . . - - . . .
SOUTHOL-a,L\Ly_t1-q7t NOr Z Fy :
Q/ TEL.: 765.1802
Examined . . . .1� .�,� '. CALL ;MAIL TO : . . . . . . .
Approved . .. . . /� • 1.9 •- . . . . . . . . .rmit NoI . . . . . . . .
Disapproved a/c . . . . . . . . . • • - - . . . .
42 7r�
W,
l! I (Building•inspccto. '
PLICATiON FOR BUILDING PERMIT
i MAY 2 819% ate
BLDG.DEPT. j • . ...... . ..
I5
r TOWN OF SOUTHOLD INSTRUCTIONS ;
a. This application must be completely
sets of ptam,a=urate plot plan to scale. filled in by typewriter or in ink and submitted to the BuiIding.j�
b. Plot plan showing location of lot arcec h Qb�uildino schedule. P=t.nr,wig
or areas, and giving a detailed description of layout of property must
relationship to adjoininZ premises or public strt•
cation. P P y must be drawn on the diagram which is part of this ap
C. The work covered by this application may
-d. Upon a y not be commenced before issuance of Building shall be kept on the premises available tfor, the insp Building
throu;}tou Permit.
Inspector will issued a Building Perrnit'to the applicant_ Such per
e. No building shall be occupied or used in whole or in parttfo any purpose whatever u
shall have been granted b ntiI a Certificate of Occupar,
y the Building Inspector.
APPLICATION IS FIEREBYMADE to.the Building
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and
Department for the issuance of a Bt•rldin�
Regulations, for the construction of buildings, additions or alterations, or for removal g Permit , Ord pursuant Ordinances
t
TI1e applicant agrees to comply with all applicable laws, ordinances, building other applicable Laws, Ordinances
admit authorized inspectors on premises and in building 1 or demolition, as herein describe
code, housing code lations
for necessary inspections. ' and rc� and
- Siena - - .ture or appIi nt, or '
7 f � Si-tole a corporattonj• -
State whether applicant is owner, lessee, agent (Mailing address of applicant).
architect, ens , general contractor, electrician, plumber or builder
�Lt pincer
Name of owner of premises MI.CH/� . .. . . . . . . . .. . . .... . ... . . . .. . . .
If applicant is a corporation, signature of duty authorized (as on the tax roll or latest deed) - • •• •' ' ' ' ' ' ' '• . -
officer.
• (Name and title of corporate officer)•
Builder's
License No_ .. . . .'. . _�wN�� . . . . . . .
Plumber's License No. . . , , , • ,N�• .wc _
Electrician's License No. . . , , , , NI✓ • . • _ .
Other Trade's License No.
Location of land on which proposed work will be done;
House Nuni bcr �7�1� D .i, . .Street. • . . . .
County Tax Map No. 1000 Section ¢'7 Hamlet " • • • • • -
Subdivis • . . . . . . . . Block . . . . . . .Z , t�
ion . , , • . . • . . . . . . Lot . • , , , , ;
State existing use and occupancy of premises and intended use • . • • ' ' ' ' Lot . . . . .• , • .
.,nd occupant I' . .
A. Existing Y of proposed construction:ing use and occupancy. . . . . . . .�- . . .F`�5, ,
. . . . . . . . . . . .
.:... . . ..B. Intended use and occupancy.: . . . . i. , , ��S /
3. Nature of work (check which applicable): New Building . . . . . . . . . . Addi`eicn . . x. • . • • • �Mtcration . . . . . . . . .
Re air. . . .. . . Demolition , X Swi nn _
P . . . . . . . . Removal
Tennis Court " " " • • • • • • • • . . . . . . . . . . . ing pool.
• • . Accessory Building Fence . . . . . . .Oth .
4. Estimated Cost . . . , -74De';O_ e'er' er Work . . . . . . . . . .
. . . . . . . . . . . . . . . . . . .. . . . . . . . . Fec . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(to, be paid on filing this avplication)
S. If dwellin„ number of dwelling units . . . . . .I. ' ' ' • • • • ' Num
If garage bcr Of dwclli►�g units on each floor . . • , , • • . • • • • . •
, number of cars . . . . . . FI� . . . . . . . . .
6. If business, commercial or mixed occupancy, specify natty e.and extent.of caclt•type of use . .NIA,
7. Dimensions of existipt' structures, if any: Front . S y0 '� Rear `? �: . . . . . Depth . .7, , L .rr
Height . . . . . . . Number of Stories ,( , - ' ' ' ' _ ' '
Dimensions of lain F • • • " ' • •r .. . . . • • • • • • .�:, .c st�uctur %v't t1t alterations or additions: Front � ',3�, 4 . • . , , Rear Depth . . . . .. - '--4- i• ,34..?�`L. . Height 10
. . .
8. Dimensions of entire new constriction: Front • . , 3�.C4-�Y- ' ' • - Nuittbcf oC Stories . . . .�. . . . . .
Hei;ltt kz? u • - Rear 3�„�;�•', , , , , Depth StZt�. .
. I�umber of Stories . �,
9. Size of let:•Ffont . . . . `l � '� . . . . . . y. . .t� . . . . . . . . . . . . . . . . . . . .� . . i1 . . . . . . . . .
0. Date of Purchase . . . . . . . .�,�,� . . . . . . . Rea- . . .. .� :. . . . . . . . . . . . Depth • . . y. `sue. . . . . . . . . .
i . . . . . . . . . . . . . . Name of Former Owner . . L-�I�:G�N��. . . . . . . . . . . .
1. Zone or use district in wliicll premises are situated . _ , , A, ? S! bJ�IC
Z Does proposed construction violate any zoning law, ordinance or regulation:- . . . • . • • • • • • . - . • . • -
3. �Villlotbereoraded • . . - - . - • - - - - • . . . . . . . . . . . . . .
•N4- - . Will excess fill be removed from premises: Yc; . , ,;
4. Name of Owner of premises Ko - -!x� ��
Name of Architect E��13f�7 •j3,� SS��� � `Addr{�_1z5 0;7jYF_-Phone No?�e .477—�ZS�r
Name of Contract ' ' . • • • • Aeress -p,,�E�,� -I I � Phone No?
Contractor :.G?�'�!J,► -:— . Address , Phone No.
5_Zs LIU.% property . .
. . . , . .
p pertp Located �rithin -3pp feet of• . . . . . .. . -- . .. . .a tidal wetland? '*YES. . . .110 . X. , .
*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 dimens-on—, ::
-operty lines. Give street and block number or description according to deed, and show street names and indicate «•:::;::.
.tenor or corner lot.
_� rJ
L_V F j2 M ra i2 p va
N
ATE OF 1E1V YO b10VC—
U,JTY OF . .�. �? .�JG. . . . . S.S
• • • _ • • _ • . . . . being duly sworn deposes and says that.tte is the applic�:
Namc of individual sig ^ '
�niiio contract)
we named.
(Contractor, agent, corporate officer,•ctc.). • . . . • . . • • • • . . • • • • • ' ' ' . ' '
;aid owner or owners, and is duly authorized to perform or have performed the said work and to make and file tl:
lication; that all statements contained in this application arc true to the best of his knowledge and belief; and that t::
k will be Performed in the manner set forth in the application filed therewith.
IM to before me this l
. . . . . . . . �� . . .day of . A . . . . . . . . . . 19 .�.
rrnn\\, �
3D' Public. . . . . . . •
• • • • . . . . County
A.JACOBS
Suft of Now YC'ek
No.47M900 . . . .
Qtt�alifl�t bt&ulit�ltCounty (Si;naeurc of appliean-
oil Boca Mweasi,16. -
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ALL CotISTRU
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