HomeMy WebLinkAbout23008-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23881 Date SEPTEMBER 18, 1995
THIS CERTIFIES that the building ALTERATION
Location of Property 6760 GT. PECONIC BAY BLVD. LAUREL, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 126 Block 11 Lot 3.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 11, 1995 pursuant to which
Building Permit No. 23008-Z dated SEPTEMBER 12, 1995
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 GARAGE "AS BUILT" AS APPLIED FOR.
The certificate is issued to DOROTHY C. GRANNEMAN
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. PENDING - SEPTEMBER 11, 1995
PLUMBERS CERTIFICATION DATED N/A
ilding Inspector
Rev. 1/81
t
FORM NO.3
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)
Date ............��'.�.................................... 19.. ........
�
NR 23008 Z
Permission Is hereby granted to;
A/. l��o C • C � ,� 1
C . . ... >..... 'Q:....rx...... ..................................
h'1.!T t.rzcr ..�.../✓�. .�.../.l.�.SL.......................
-�, .......� ...... '�...... ......��- ........�..��� . �-....... c
ems...... -'e i ..... ./ c .-........................................................................................................
..................................................................................................................................................................
..................................................................................................................................................................
............................................/....,....,........................../...........................,.......,p...`.........................................
at premises located at.........4760..�`z :T...b-Cp��; ..4. ....!U.1 �...................................
....................... .................................. ................................................................... , ............
County Tax Map No. 1000 Section ....(. .0......... Block.......`Z............. Lot No. ... `.. .............
C G}.
pursuant to application dated .......151 ;.07..........0....................... 19.....1. .., and approved by the
Building Inspector.
Fee $.........................
. .. ......... .................................
7)
Bu ding Inspector
Rev. 6/30/80
4
P'
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.
L. 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 Aoril 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 �Q_00.
2. Certificate of Occupancy on Pre-existing Building- .$100.0
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 . . . 1 . . . . .) . .� C . . . . . . . . . . .
New Construction. . . . . . . . . . . Old Or Pre-existing Buil/dingy ./. . . . . . . . . . .
/
Location of Property. 67G`' - /e.Gc ;C _3 /G c!� /r• a. c�s
Rouse No. Street Elainlet
Onwer or Owners of Property . .�or^v . . �. . . . . �) . .c'. . . . .4.�'l. . . . . . . . . . . . . . . . . . . . .
lounty Tax Map No 1000, Section . . .1.d.�. . . . . . l;.lc�cic. . . `� . . . . . . . . . .Lot. . ✓ . . . . . . . . . . . . . . . . . .
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FJled map . . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
:'ermit No. . . . . . . . . . . . . . . .Date Of Permit. . . . . . . . . . . . . . . .A p p 1 i c:In t St'-• • . _11:(44. ,
HealLh Dept. Approval . . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval . . . . . . . . . . . . . . . . . . . . . . . . .
'landing Board Apnrovol. . . . . . . . . . . . . . . . . . . . . . . .
request for: Tempornry Certificate. . . . . . . . . . . Fin;il Certicate. . . .�. . . . .
-ee Submitted : $ . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
03$ 1
LNUMM
8056225
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
BUREAU OF ELECTRICITY
F 85 JOHN STREET, NEW YORK, NEW YORK 10038
Date SEPTEIIBER 15,1995 Application No.on file 10109295/95 H 04701.3
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
�I S. DOROTHY GRANNEKAN, 6760 PF.CONIC BAY BLVD. , LA.UREL, N.Y.
in the following location; ❑ Basement GAR/OUT
aEPTEMFiER 11,19� ►st Fl. ❑ 2nd Ft. .Section Block Lot
was examined on and found to be in compliance with the National Electrical Code.
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT, K.W. AMT. K.W. AMT. H.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. qMT. H P SYSTEMS AMT. WATTS
NO.OF FEET
SERVICE DISCONNECT NO.OF S E R V I C E
AMT. AMP. TYPE METER 1 7W 1 0 3W 3,0'3W 3,0'4W NO.OF CC.COND. A.W.G. NO.OF HI-LEG A.W G. NO.OF NEUTRALS A.W.G.
EQUIP• '� PER% OF CC.COND. OF HI-LEG OF NEUTRAL
OTHER APPARATUS:
*NUJ VISUAL DEFECTS: "An electrical
survey has been oracle of the exposed
electrical equipment in the
premises indicated. " "No obvious
unsatisfactory condition was found.
DOROTHY GRAN14EMAN
101 PARI� AVENUE
C/O h7EIZ,Y DR` E & W. ESGS GENERAL MANAGER
NEW YORIC, NY, 10173
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 BUILMN113 DEPAfRIf°MENT. TM8 C DPV OF CERo FMATE MUST NOT BE ALTERED aN ANY MANNER.
Stype Brothers Real Estate, Inc.
MAIN ROAD, MATTITUCK, NEW YORK 11952
(516) 298-8760 FAX (516) 298-5779
September 11, 1995
Town of Southold
Building Department
Main Road
Southold,NY 11971
Attention: Gary Fish, Building Dept.
Re: C.O. on Granneman workshop/garage
SCTM# 1000-126-11-3
Dear Mr. Fish:
Enclosed is our check in the amount of$25.00 to cover the fee for a
Certificate of Occupancy on the above noted structure.
Sorry for the confusion, and thanks for all your help.
Regards,,
/gaerny d'W-alker
MMW:btf
Enc.
d-3ooP�--
765-1802
BUILDING DEFT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE 8 CHIMNEY
REMARKS: C Xelt e-O
DATE INSPECTOR
��
BOARD ' OF HEALTH . . . . . . . . .
FORM NO. 1 3 SETS OF . PLANS . . . . . .•. . .
TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . .
BUILDING DEPARTMENT CHECK . . . . . . _ . . . . . . . . . . .
TOWN HALL SEPTIC r• ORH _ _ . . . . . . . . . . .
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined Q( . . . CALL . . : . . _ . . . . . . . . . . . .
199�, tIA I L TO
Approved . . . . . .51 Z . . . ., 19 !Permit No. . '�300�� . . . . . . . . . . . . . . . . . .
. . . . . . _ . . . . . . . . . . . .
Disapproved.a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
di .,)Inspector,
APPLICATION FOR BUILDING PERMIT
SEP
Date . . . . . .. 195k-.
BLDG.DEPT.
I"N_OF g0t00_Ln_ = INSTRUCTIONS
a. This application must be completely 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.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public.street;
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
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,
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.
APPLICATION IS HEREBY MADE 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 authorized inspectors on premises and in building for necessary in ections
G. . . `. . . . . . . . . . I . . . . . . . . .
(Sion ture of a plican r amne, if a corporation)
/a Say6 /'o rOc
(Mailing address of applicant)
State whether applicant is owner, lessee agent architect, engineer; general contractor, electrician, plumber or builder.'
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... APPROVED.AS NOTED
�y oA B.P. . .
Nance of owner of premises . . ��?,l� 7as
��,�•tf,�y�.-J. ,
y
on'the tax roll or Iao�QQE,,,* �'
Nfl� JILDING DEPARTMENT AT
If applicant is a corporation, signature of duly authorized officer.' 765-1802. 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
I. FOUNDATION - TWO REQUIRED
(Name and title of corporate officer) FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
Builder's License No. . . . . . 3. INSULATION
0' ' ' ' ' ' ' `' 'UNDERWRITERS CERTIFICATE ' 4. FINAL - CONSTRUCTION MUST
REQUIRED BE COMPLETE FOR C.O.
Plumber's License No. . . . S. . . . . . . . . ... . . . ALL CONSTRUCTION SHALL MEET
�P THE REQUIREMENTS OF THE N.Y.
Electrician's License No. . . . . . .�. `a. . . . . . . . . STATE CONSTRUCTION & ENERGY
Other Trade's License No. CODES. NOT RESPONSIBLE FORDESIGN 'OR CONSTRUCTION ERRORS.
1. Location of land on which proposed work hone. . . . . . . . . . . . . . . . . . . . . . . . .�. . . . .
I-louse Number / Street Hamlet
County Tax Map No. 1000 Section . . . :. . . . . . . . Block . . . Lot �. . . . . . . . . . . . . . . .
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 . . . . . [�L/.O�'!C S/? . . , , , (`t�� �� e< /ef�. . . . . . . . . . . . . . .
l
b. Intended use and occupancy . . . . . . . . . . . . . . . . . . : . .. . . .. . . . . ... . . . . . . . . . . . . . . . .
-3. Nature of work (check which applicable): New Building \
Addition Alteration
Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . Demolition . . , , , , , . . Other Work . . . . . . . . . . . . . . .
vG
4. Estimated Cost : . .? 7. (Description)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 . . . . ./, , , C�• • .
6. If business, commercial or mixed occupancy, specify nature and extent of•each t/pe of use
7. Dimensions of existing structures, if any: Front . . . .%l.� Rear .,/� . . . .
Height . ./,a. .... . . . . . . . . Depth . .c,?r�?, �. . . . . . . .
g • • • . . . . . . Number of Stories . . . . ��9:P
Dimensions of same structure with alterations or additions: Front ./,�,
Depth . . . . . .•.�a /a . . . . . . . . Rear . ./ . . . . . . . . . . . . .
Height . . . :. . . . . . . . : . .. Number of Stories . . . �!1: r
8. Dimensions of entire new construction: Front . /✓r. � ����, ; Rear // De th
.Height . . . . . . . . . . . . . . .. Number of Stories . .�CJa! �/ !�r7c�^:.oy9 . . . . . . . . . . . . . . .
9. Size of to Front ;.
t: F ✓4.�. . Rear. . . . /,t./. . Depth `� .
�?... i
10. Date of Purchase ��?ls` . . . . . . . . Name of Former Owner e�
11. Zone or use district in which premises are situated . . � � � ..
jj
.12. Does proposed construction violate any zoning law, ordinance or regulation: . . . 4. .
13. Will lot be regraded . . . . . • ,�o, '_, •i "
r Will excess fill be r�emoXed f� `prernises t -§`Yesti 1 No
14. Name of Owner of premises 01 o `y (�rcr.9!)�MQ,)Address �3,0 , „ ,s. !,,phorie`No::. �9aL .���?,
Name of Architect QG�A . . . . . . . dress A3. . . . . . . . . . Phone No.
Name of Contractor .Qc.-.?c r . Address Phone No.
15. Is this property within 300 feet of a tidalwetlan ? *Yes. .-. , No, " " " " " " " '
*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.
i PA
Of
1
'TATE QF;•NEW.Y:ORIC;
;0UNTYOF _ ; :S.S
.. .. ..`_ '~ . . . . . . . . , being duly sworn, deposes and says that he is the applicant
(Narrie'of ihdivid'daP sign r g�.contract)
bove
,e is the . . . . . . . . . .
. . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(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
?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.
worn to before me this
day of 19 .l�
rotary Public, . . . . . . ',w/ ounty
CE M.WILKINS . . .1!
Notary Public,State of New York �j(Sigjnatiurte . .applicant.Rio.495224.6,Suffolk Count
Term Expires June 12, 99�7
10:44 5162984214'
WILLIAM C GOGGINS PAGE 03
09/08/1995 „
C.: 4
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