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Home My WebLink About23524-z FORM NO. 4 l TOWN OF SOUTHOLD BUILDING DEPARTMENT 'Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25483 Date: 01/12/98 THIS CERTIFIES that the building ADDITION Location of Property: 505 SKIPPERS LA EAST MARION (HOUSE NO. ) (STREET) (HAMLET) County Tax Map. No. 473889 Section 24 Block 2 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 3, 1996 pursuant to which Building Permit No. 23524-Z dated JUNE 19-, 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 SECOND STORY ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The. certificate is issued to SHEILA S BACHMAN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N409302 01/21/97 PLUMBERS CERTIFICATION DATED O1/10/97 PERFECTION PLUMB.&HEAT. Building Inspe or Rev. 1/81 FORM NO. f TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL n COMPLETION OF THE WORK AUTHORIZED) N° 23524 Z Date ............11l.. ...1../............................. Permission is hereby granted to: ......................................... %�.. :: '......... �..�...s' ...................................... .... % ..... � ..:........................... to .� ::�?: Gl."....... ..... ,✓�J fz� .....S.... G11.f .c .......� .......�... iJr�/5 ............9. ............................... -� at premises located at ..................��.........../. /.1. 5...... :................................... ..................................................................®rofc�t�� i....................................................................... ................................................................................................................................................................. County Tax Map No. 1000 Section .. ............ Block ......Oz........ Lot No. ...044............... pursuant to application dated pp ................... 19.. 1 and approved by the Building, Inspector. Fee $........................ ........... . ..... •••• ..:. ........................ '.ding nspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD 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 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 Buildine - $100.00 3. Copy of. Certificate of Occupancy - .25y,,. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ,��° . .`� Date .�.1cva r . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing Building.`/. .. . . . . . . . . . Location of Property. . . . . . . . . .. . . . . . vsti?. . . . . . . . . . . . . . . . . . . . . House No. r✓/ / Street Hamlet Onwer or Owners of Property. . .\ ./A-C11,JC,.. . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. v . . . . . . . .B1ock. . . . . . . . . . . . . .Lot. . ..� . . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . ... . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. Date Of Permit. . . . . . . . . . . . . . . .Applicant. 77QI-,tiS.0 . . . . HealthDept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certif.icate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . APPLICAN THE NEW YORK BOARD OF FIRE UNDERWRITERS nmai 1 1195099 BUREAU OF ELECTRICITY F_ 85 JOHN STREET, NEW YORK, NY 10038 Date JANUARY 21,1`-97 Application No.on file 13165297/97 N 409302 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 WI11IA14 B.ACFfl ViN,0 06 sKIPPERS L?f14E, ORIENT, N.Y. in the following location; ❑ Basement ❑ Ist Ft. 2nd Fl. Section Block Lot was examined on JA.idUPRY 16,1997 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. I K.W. AMT. H.P. 7 13 4 7 1 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECPT 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. N.P. NO.OF FEET "T. WATTS SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP. TypE METER �,4W 1 0 3W 3 0 3W 3,0'4W 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 HI-LEG OF NEUTRAL OTHER APPARATUS: PADDLE FAN-1 1110TORti:1-F 11.P. SMOI{E DETECTORi--3 .JI14 ,SATE ELEC. INC. LIC.#3635 LL 350 MARINE PLACE GREENPORT, NY, 11944 GENERAL MANAGER 11 1_ �ft 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. imigimmom ® rmusroW MIERM 0 COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. o��gOFFO��-c O co 2 Town Hall, 53095 Main Road p • Fax (516)765-1823 P. O. Box 1179 y� �� Telephone (516)765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD January 16, 1997 Charles Thompson, P.O. Box 71 Peconic, N.Y. 11958 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) XX 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 # 23524-Z (BACHMAN) Please contact our office on this matter. Thank you for cooperation. . SOUTHOLD TOWN BUILDING DEPT. � ,FFO CM Town Hall, 53095 Main Road Fax (516) 765-1823 P. O. Box 1179 �G, _` Telephone (516) 765-1802 Southold, New York 11971 4/1 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE: / /Drd Building Permit&4M19"a'A-) No. Owner: 4/1 (please print) 9 Plumber: (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers Signature) Sworn to before me this 104(" day of j- A%kAtv 19 q 7 Notary Publ ' County ROBERT 1.SCOTT, NOTARY PUBLIC,St �of N.Y. No.4725089.Suff k Coin�y, Term Expires M 31. 19 BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ �INSION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: � DATE Iq INSPECTOR T6S-1802 BUILDING DEFT. INSPECTIO" [ ] FOUNDATION iST [ ROUGN PLBG. [ ] F�FIUNDATION 2ND [ ] INSULATION [�FRAMING [ ] FINAL [ ] FIREPLACE HIMNEY REMARKS: Vw DATE INSPECTOR \� 70.1802 BUILDING DEFT. INSPECTION �- [ ] FOUNDATION iST [ ] R GH PLBG. [ ] FOUNDATION 2ND INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLA 8 CHIMNEY REMARKS: t��%��..�fn^ /Y9f� JM. DATE INSPECTOR I �'I'I�.li•„I''I:il'f:l,ll.11ll Ill:l'Illll Uf� ll�: .. .. ...... ... .. .... PIjiIII DA I I OII _...__ .. ........_. r•uulnlnrlull ( 11n1) -.... .......... ......_ ....._._._...............__..._...-----------...__.._..... , ... �-. Ilf)111;11 fllAllli R ..... ................ ..._. ..._._._.__.___..._ _.. iW�- - 11'I111,�1'l l)II I'I;It tl . Y . STAIg M06 ,A 1 5 � I' IIIAI. - -- - ..�,.......,..�,�..,...a,...,.�...,,�,...._... ..,........_........................�........, nUl)LI IOIlnl•` CUIIIII!IIIc,�.,..'_....._..._.,..........,....,,..._...,,...., �' I 1 I.; fl .n oar, S.63 ToCa✓gsr i3s Z5. /29.OQ VI JUN -319� Q' oP TpW OF•1) N SOUT�OLD ` (^ (Unaufiorizsd a!te,�Joa or a,:digon to this a rrvey is a Vio;V�cn of SeCJcrt 7�Jc'cf the New York 3taiA S 6�c�Sr.4OaW.- Edu.a on�,w. *2•g/ Copie.9 of ihyab sl, the!?rd wrvvyorss;r re=ct cr w:,p _ to be ssod soa!stta!not be.Oru-:daredJ a eaW true�; oys�cr- f�on4'S./�'/%SfOr-/Ca/ Socic� oV2t�1eearnmcatedt:anaanshttrun y y to the parson fcr whom tto surray y. prarar a,ar:d an his behalf to the z Me cDMi I--, r a 6erd;'r, govemrrsn�l a,{:ncy and -to tha 9 f, 1 here?n and MAP OF PR 0 PE R TY i- * to rct tr rzfa Qd Jo..0�:L..._. CJR YEYEO cu src;uet�t T yip , � Com�oc�ny otid .�'oulfio%� Sa v�.r� s-f3ohk os:sclrvc / yS /962 r'4.1ys No.LS 25MPJ� �!„o '•YS/.';: 17r7 T FO4AND5 • L is cns®d . .�Al7t� Sui'vG ors G/'ccnlac,�rf N, Y BOARD OF HE.M.rll . . . . . . . . . . . . . . . FORM NO. 1 3 S1.TS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOUTHOi.D SURVEY . . . . . . . . . . . . . . . . . . . . . . . . HU11.D1NG DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN HALL. SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOII'1'IIOLD, N.Y. 11971 765— 1£]02 NOTIFY: i'sxacninecl.... ....C/'!�- 19.!.. ttAIi. 70: . . . . . . . . . . . . . . . . . . . (;Approved.- / tU. 19.j. Permit No. �. .................................... Disaiproveda/c .................................. .................................... ...................................................... (Ikiildi g 'hector) APPLICATION FOR BUILDING PERMIT `.r iNS'rimurIONS a.. `Ilis application mist be coitlnletely filled in by tylvwriter or in ink an(] sulmiCted to the ikiilding Inspector with 3 sets of: plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing IocaCion of lot: acxl of Wild.ings on prenises, relationship to adjoining premises or ixiblic streets or areas, anti giving a detailed description of layout of property mist be dr<- 4n on the diagram which is part of this aiplication. c. 1le work covered by this application Pray not be eminennced before isstknnce of Wilding Permit. d. 11pon approval of this application, the ik.nilding inspector will issue a lknilding Permit to the applicant. Stich permit sl►all be kept on Clw premises available for inspection thrcxnglxxnt the work. e. No Wilding, shall be occupied or used in wlale or in part for any Ixirpose whatever until a Certificate of Occupancy shall have been granted lry Lite lkdlding Inspector. APPI:1CNVION IS IT-Mi""By JW1E to Cite Iknilding Deik-trhnent for the issuance of a lknilding Permit pursuant to the Wilding Zane Orctirtance of Une '1'otnr of Scxntlald, Suffolk1bunty, New York, and other applicable laws, Ordinances or Relulaticxns, for the ccxnstnnetiort of lxnildings, acklitions or alterations, or for removal or demolition, as herein described. 'ile applicant agrees to comply with all. aililicable laws, ordirnanwes, Wilding code, lousing code, an(] regulaticxts, and to admit atnUarized inspectors on premises aixl in Wilding for necessary inspections. (Signature of applica or name, if a corporation) .11-58 (Mailing a(klress of applicant) State ubether aiplicant is owner, lessee, agent, architect, engineer, general contractor, electrician, pltnber or Imilder. -flr�C. ................................................................................................... Nai>L of: owner of premises ......t)'C d-C,...�, .LVA C11 fin a VN. ................................................. (as on the tax roll or latest deed) If aphl.icant is a corlaration, sigrknture of duly authorized officer. ......................................................... (Nave acxl title of corporate officer) :I BLDG.DEPT. Lkrilders License No. ..,��3�,� .17. ..... TOWN OF SOUTH_OLD PltnbersLicense No. ......................... Electricians License No. ...................... Odner 'trade's License No. .................... 1. iocation of land on wlnicln iroposed work will. be clone.............................................................. Ikxrse Nxiber Street ILlnlet (cxuity Tax Map No. I(xlo Section .. Al ....... illock ....,,�......... I.ot ...�2 .......... Sulxlivision ...................................... Filed Kip No. ............... iot ............... (Name) 2. State existing use aril occupancy of premises an(l intended use aril occupancy of proposed construction: a. Existing use anti occupancy .... 'thrj/e_. ..vcxr. �7..671Gfie li/�� C............................... V /�/ > 5 b. Tnterded rise acxt occupancy ...vi.1' �..:f.9,/�»d./� -... /w., /.. ............................. 6( J ). 1.•►Irrre of ►.xnk (cax_ck ikic:l► algrlicahle): Kn4 Ikrilclinl. .... . ... . . Acklilion ..iZ.. Alteration - ... Itepair ............ Itoiloval .......... ... I)Ulfol itioil ............ Other Worlc ... . . ......... . (Description) 4. Esl.inkrted Cost ..... fee ... ................. .. ........................ (Co lie paid cxr filing this application) :i. If ckrel l iog, ncnlrer of ckaell ing units ............ 11rrlrer of ckael I ing uni Cs cx► each floor ................ Ifgrrrcrl;e, ►xnl►er of ears .......... ..... .. .. .. ............. .... h. If Ixrsiness, cxannercial or mixed occuliancy, sl►ec.ify oahire arxl extent of each type of use...'........... ........ 7. Dimensicx►s of existing sCr►uaures, if auy: Front.. ........ ...... hear ..... ..... .... . Depth ................. Ikdoit ......................... Pirrlx!r of Stories ......... ......... .... Dinx:nsicx►s of sane st.nrcture with alterations or ixklilioos: Front: ..... . ......... Rear ............... Ik!pll► .................... Ileil)►L .................. .. fitfidx.r of Storie[: .......... ..... tl. Dimensions of: entire rx-a Coust—A icx►: FronL ...... .......... Mar . ... ... ........ 1)epl.h ... ... ........ Ileihl►l: ... ........... ..... Mviix r of licorien . , .: ......... 9. Size of 1of: Frcx►t ......... Itear ..... .. De[It 1► .....�............. IO. hate of l\rrchase N Xrx! of Forller (t'n►er ..... .... .. ............................ . II. 7Ax►e or use district in r.A►id) premises are situated ..................... ... ............................ 12. 1)oes prolxoseel coosl:r►xaion violate any zoning law, ordirkvx.e or rel;ulaCioo: . ....................... F). will 1 ol: he regraded ...f. . ...._......y�Will/excess fill Ix: reiauvr�e4 fran prc-ini ses: YES 14. Mimes of (tamer of premises .t.SA,-j-'I�g..[�.�c�?. '?�. twress ��,15'�yciomj..L,n.,z'. l�lc:�� lf►a►e No. .3-23:�Y33 Mile of Architect ..:............... .................. Acklresa ... . .✓.... . .................... 11►olx! lJ). .......... Name of (cxrCracl:or ...C-4C+va/Cu.. .... Acklress .. CCdhiG�.. .......i1xx►e No. ��,�-✓�J7 15. is this property within W) feet of a tillall caeLlarxl'1 * YI:S .......... NO ... *1F YES, S(11ii11O11) 'IDIM '111llS11?E.9 PIi11Ml'1' NAY IV,? Ini p111E1). PLOT DiA(,ItAM IAx:ale clearly alXl distinctly all Imildiogs, uA►eCher existing or prolx)sed, aril irxlicate all, set-back dimensions frcnl prolx_rty lines. Give street arxl block rxXrlrer or clesc_ripli[xi according to cleecl, aril show street names and irxlicate ►Aielher interior or coaxal- lot. . SS......... (X111NIY (A� � ------c�h�li �c.�i...//76,k, D.�! . ..... ... ....... .....Imiry) duly swum, cle!Ixr,es taxi says; that he is the al;plicanl: (Mom of irxlividual. c.rgniol, con(race) nixrve n;rnecl, I k! in I l le ..... r _ J G vI......C.�f�ln �c �✓.`.. ............................. .... ((knrl.r'aclor, agent, corlmr-me officer, etc.) of said ewoer or ("wrs, arxl is duly noLhorizeA Co lxarfonn or have lxarforn►ed I.be said work aril Lo nvike arx) file ll►icr nppl ication; that: all. sCatunents conCairx!d in ll►is nppl ication are true Lo the bent of his krxxaledge aril Ixil.ief; alxl 111n1: the work will. be performed in the "u"Mer set focllr in the appl.icnl:ioo I"iled therewith. `kaon► to before ivy! thin ........�... ..._...clay of `... 19YZ ... Notary Mbtic ............... .. ....... HELENED.FORME (tiignature of Aplrl knot) Notary Public,State of Newyork Qualified in Surfolk County Commission Expires May 22, 19 G e PLUMBER CERTIFICATION To d $, v t � far i t?E P l' �, - !f Copper tubing is used !� ON LEAD CONTENT BEFORE . � ..,;r, Ht W 4ZS for water distributing <. CERTIFICATE OF OCCUPANCY system; piping shall be SOLDER USED IN WATER of types K or 1.onty , x _ 1 SUPPLY SYSTEM CANNOT UNDERWRITERS CERTIFICATE y � �� ___4_____ EXCEED 2/10 of 1% LEAD. REQUIREDIV , Od a w ' 411 fit._.7__-. 9 , PLUMBING SECTION r PROVIDEOPENINGS i OPENI - r r NGS FOR ; EMERGENCY ,, x , ESCAPE AS _ 1 REQUIRED BY PART. 714 OFF A�j N.Y. STATE BUILDING CODE. Nt C't l 6 0 IL �tS ELEVATION 3T, L ,fir p --- OCCUPANCY OR e � - 4,r-/1,'r ' t_�'t '.��;k r ,(�`�;i.. .w �t - rIIf1 „y �. �tf.yG' . lot USE IS UNLAWFUL WITHOUT CERTIFICATE I OF OCCUPANCY SECOND FLOOR PLAN APPROVED AS DOTED GATE: B.P.# FEE r�l , %-- BY. Th t2 ( ? NOT G DEPARTMENT AT I 765-1602 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION TWO REQUIRED $ --- ------ _ _ FOR POURED CONCRETE _ t 2. ROUGH - FRAMING & PLUMBING — - t ; i Ttt i71 3. INSULATION �t>~tu. 4, FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. -x I STI m4 ALL CONSTRUCTION SHALL MEET Y 1 i C.t i h THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR --- - DESIGN OR CONSTRUCTION ERRORS t I { Ott C/ - ,r r _ r` ; t SECTION G F N E R A L N O T E 4 y ! I . ALL CONTRACTORS TO VISIT JOB SITE ; CHECK EXISTING CONSTRUCTION AND CONDITIONS AND �p4_._.____� WHERE NEW CONSTRUCTION IS TO BF INSTALLED. -- 2 . ALL LUMBER TO BE 1200 PST MINIMUM. a( ALL PLUMBING TO CONFORM TO LATEST RULES AND REGULATTONS OF THE TOWN OF SOUTHOL,D PLUMBING t; CODE . J o IF F,5 LAW E I n 0 a 1 tFWT N� 11957 . , SAMBACN ASSOCIATES gofESS ENGINEERS, PLANNERS, ARCMITECTS ae r NR O. BOX 1033�COX LANE 0 A. ar CUTCNOQUE, N.Y. 11W5 DATE' MA'k# t REVS' EXISTING GOUND FLOOR PLAN OWN BY '6 r JOB No. i99(p SCALE: 1 /4"=1 'Om SCALE:AS SHOWN OWo NO. I OF 1- Onf fg t�v,� NMY'nan>Yw%✓ .gth.«M'YYW�W:+•n'mdW:s'yaWh�S9W{aWigvMPrt�4iJ.tX3iMwamxnKew:JR l 5 '4 Tom. Q r 1 CN a -- _ t Ix i .•,� �' , ,�' SO ELEVATION EAST EL.EVATION`., SCALE: 1l4"= 1 '0" W 4 L I A 3 U 5 1 I- " W L IN 11 I', 09-1 SAMBACH ASSOCIATES ENGINEERS, PLANNERS, ARCHITECTS P.O. BOX 1033, COX LANE Agra A. CUTCHOGUE, N.Y. l iQ35 . DAIE: Y)Av 14 1996 nEVS: DWN BY: aC aZF17 CIIK'D BY: 3V JOB NO. j q�z u SCA!_E:AS BROWN DWQ NO.2OF Z