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HomeMy WebLinkAbout22958-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23899 Date SEPTEMER 20, 1995 THIS CERTIFIES that the building ALTERATION Location of Property 435 HUMMEL AVENUE SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 63 Block 2 Lot 16.4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 4, 1995 pursuant to which Building Permit No. 22958-Z dated AUGUST 22, 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 FINISH 2ND FLOOR OF EXISTING ONE FAMILY DWELLING AS APPLIED FOR "AS BUILT". The certificate is issued to ROBERT ADIPIETRO (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-327835 - SEPTEMBER 22, 1994 PLUMBERS CERTIFICATION DATED SEPT. 30, 1994 - TANDY PLUMBING & HEATING Buildin nspect r Rev. 1/81 ' 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. .... NP 229581 Permission Is hereby granted to: ... ...... ................ .......... ...... 1 ,�� . ... ......e'� ..�"��� 0C-4 ® ....... to ...... .......7.7m, .�e, �...... ..... ... . ......................... r I :.. fi. ...�................... .................................................................................................................................................................. at premises located at.......... .... ... ... :� ......• .. ................ � .......! ..t`. ... �................ . ............ County Tax Map No. 1000 Section .......... .. .. Block............. ...... Lot No. ./.... ...... .......... pursuant to application dated ............. r. ... ...Y................ 19... ........, and approved by the Fl Building Inspector.__ Fee $....� ............ ........ .. ..................... ... . . .. .. Building Inspecto Rev. 6/30/80 T RR RR M _ O Cm 0. 6 I, TOWN 0 F SOUT► O LD BUILDING DEPARTHE•NT TOWN HALL _. 76 -!g02 I: BLDG.DEPT. _ TOWN OF SOUTt�OLD 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: I . 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 Erom Board of Fire Underwriters. 6. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 17 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 I . Certificate of Occupancy - New dwelling $25.00 , Additions to dwelling S25. 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 - $20.00 4 . Updated Certificate of Occupancy - $50.00 5. Iemporary Certificate of Occupancy - Residential $15.00•,/ Commercial t15.00 Date . . �� . .!.��. .f 519. . T. . . . . . . . . . . . . . . . . . Mew Construction. . . . . . . . . . . Old Or re-existing Building. . . . . . . . Location of Property. . . . �6 :3 ��� . . �V . . . . . . . . . . . 54 :/r'�'�`jG`_ .f..✓ " . .//1. . 1 . House No. Street llamlet Onwer or Owners of Property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ounty Tim Map No 1000, Section . . . .✓. . . . . . . B.l1.,cic. . . .�. . . . . . . . .Lot. .)Z! . . . . . . . . . . . Subdivision. . . . . . ..Q. . . . . . . . . . . . . . . . . . . . . . . . . . . . . F'i led Mi11) . . . . . . . . . . . .Lot. . . . _ . . .1. .... .e. . . . . . . . . ermit IN. © �+`. r�+'. . .Date Of rermitZ/. C. ����.App.Iic;lnt .�Ot ilenith Dept. Approval . . . . . • . . . . . .Underwriters Approvul . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 'lanning Boord Approvol . . . . . . . . . . . . . . . . . . . . . . . . / ?equest for: Tcmpornry Certificate. . . . . . . . . . . Fin;'1 Certicate. . . . . . . . . . . ee Submitte°�' : 5 . J1, �.> . . . . . . . . . . . . . . . . . . `4 . . . . . . . . . . . . . . . . . . . . Town Hall,53095 Main Road , :74 :4 Fax (516) 765-1823 P. O. Box 1179 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 . z Owner: Pv l.. Uver V tr j'J^�S��'v'G(? a kJ(' ,please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Q` (Plumbers Signature) Sworn to before me this 5 day of 404=/ram 197"/ Notary Public, ��� ��/� County RICHARD G.SMITN NOTARY PUB UC,STATE Of NEW YORK Qualified In Suffolk Co..No.$2 4510158 Commission Ex0res AjoV30,19.� THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1.015026 BUREAU OF ELECTRICITY F 85 JOHN STREET. NEW YORK. NEW YORK 1003E Date SEPI'EMBER 22,1994 Application No.on file 84475594/94 N .327835 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 PINE GROVE CONSTRUCTION, 435 H014140L AVENUE, SOU` HOLD, 11.Y. Cp3— ' — `�—o ' in the following location• El Basement Ellst Fl. U 2nd Fl. OUT .Section Block Lot acas examined on SEI:STEMER 19,1994 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT1 FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. 12 44 19 12 1 .1.2.4 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 F 1 20 SERVICE DISCONNECT NO.OF S E R V I C E METER AMT. AMP. TYPE EQUIP. 1,0 YW 1.03W 30 3W 3,0 IW NO.Of CC.COND. A.W.G. A.W.G. A.W.G. PER b OF CC.COND. NO.OF HI-LEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL 1 :100 CB 1 X 1 4 1 4 OTHER APPARATUS: S14OKE DETECTOR:--2 PEAK ELECTRIC SERVICE LIC. #712--E 54 STRATLER DRIVE SHIRLEY, PLY, 11967 GENERAL MANAGER 1.1 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. O��g�FFO�,�coG CO 2 Town Hall,53095 Main Road 0 • Fax(516)765-1823 P. 0. Box 1179 y �� Telephone (516)765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD September 15, 1995 Mr. Robert Adipietro 435 Hummell Ave Southold, NY 11971 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) 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 # 22958-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. h 765-iS02 BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PL G. [ j FOUNDATION 2ND [ ] INSU ION [ ] FRAMING NAL [ ] FIREPLACE & CHIMNEY REMARKS: . /dG�� 10 k�� a4,6 ,-e� IV DATE � }� INSPECTOR 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 ULATION [ ] FRAMING [ FINAL [ ] FIREPLACE HIMNEY REMARKS: /bYvC2,- DATE � f INSPECTOR q\ FIELD INSPECTION REPOR'1 DATE COMMENTS I II ro FOUNDATION ( 1ST) FOUNDATION (2ND)--------------- -II it —�— I II ROUGH FRAME & PLUMBING -- Itt - II -- fl N INSULATION PER N. Y. STATE ENERGY CODE II --- - ta I p FINnt. -_---_____ADDITIONAL OMMENTS: __________ (__ ___ -- 9 - ___ _______ H - H z a ro B0ARD ' OF HEALTH . . . . . . . - FORM NO. 1 3 SETS OF PLANS . . . . . . . . TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . _ _ _ _ . _ • • • • . TOWN HALL SEPTIC FORK _ _ . . . . . . . . . . SOUTHOLD, N.Y. 11971 QQ TEL.: 765-1802 N0i I FY Examined G /f CALL - - - • • • . . . . . G 1 / MAIL TO : -� � s . . . Approved 19/. f. Permit No�. . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ _ . . . . . . . . . . uilding Inspector) I LICATION FOR BUILDING PERMIT t I. L -- - - --- Datei4c Iry C. f . . /. . . . . . 19 . . . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink arid submitted to the Building Inspector, with se6 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 permii shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole Win part for any purpose whatever until a Certificate of Occupanc} 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 inspectio.-s -- Z . . . &ne, . .�. '. . . . . . . . . . (Signature of applicant, o a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, 'agent, architect, engineer, general contractor, electrician, plumber or builder. . . .►� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . .. . . . . . . Name of owner of premises . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) I5 d v Builder's License No. . . . . . . . . . ). . . . . . . . . . . . . . . . Plumber's License No. o l ,~,—r, , , , , , , , , 7.J.Electrician's License No. . . . . . . . . . . . . .� � Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land n which proposed work will be done. . . . . . . . . . . . . . . . . . . . 17. . . . .��. . . . . . . . . . . I-house Number Street Hamlet's County Tax Map No. ]000 Section . . . . . . . . . . . . . Block . . . . . . . . . . . . . . . Lot . )41. . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) ?: State existing use and occupancy of premises and intended use and occur-y"of proposed construction: a. Existing use and occupancy . . . .�. • , m LV • , �I � e b. Intended use and occupancy �'`A . . . j'Q S ✓. . . ..G! . . . . . . . . . . . ( f s 4a d a �.,' �`� f . . . . . . . . . . . . . „ .C..�,'!N$1 L�:,�.•tT �f'yt'r.Rf,R�''!sfit�a^7t• ,3. Nature of work (check which applicable): New Building ' ' ' ' ' • • • • • Addition . . . . . . . . . . Alteration Repair . . . . . . . . . . . . . . Removal �� • . • . . . . . . Demolition . . . . . . . . . Other Work lJls . , = �d•°c't" (Description) 4. Estimated Cost `�'. ; F ee . . . . . . . . . . . . . . . . . . . . . . 5. If dwelling, number of dwelling units . , . • (to be paid on filing this application) If garage, number of cars Number of dwelling units on each floor . . , . . . , . 6. If business, commercial or mixed occupancy, . . . • . . . . ' . ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' • • • • • • • • • . 7. Dimensions specify.nature and extent of•each type of use . , of existing structures, if any: Front �a Rear �..�?Height . . . . . . . . . . . Depth . . Number of Stories • • • • . Dimensions of same structure with alterations or additions: Front Depth . . . . . . . . . Height . . . . . . . . . . . . . . . Rear . . . . . . , • • • • ght . Number of Stories . 8. Dimensions of entire new construction: Front:._., .Height Number of Stories _Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . 9. Size of lot: Front . .)'�• " " . . . . • • • • • • • . . . . . , . 10. Date of Purchase 0�, . •�7�3 ""' Rear . De th a ,t� ame of Fo ] I. Zone or use district in which r er Owner �l. tj1,n/i/aQ, , 1°SL premises are situated . , �,�,51 12. Does proposed construction violate any zoning law, ordinance or regulation: 13. Will lot be regraded .AJo lV.© . . . . . . . . . . . . Name of Owner of remises j /��e Will excess, fill be removed fro premises: Yes. S 14. P J�P t� .��.°✓. �v . . Name of Architect Address /�Ir�1� °�. . .41A?l; ,phone No. '� Name of Contractor ' ' ' • • Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . Address ' ' ' ''�' ' }5. • Is this property within 300 feet of a tidal wetland?� � *Yes.. . . • Phone No. . . . . . . . , ,.. . : : . . *If yes., - Southold Town Trustees Permit may be required. . ..• " No . . . . . . . . PLOT DIAGRAM a 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. -FATE OF NEW YOR , OUNTY OF ..� V.P.. S.S . . . . . . being duly sworn, deposes and says that lie is the applicant (Nannc of individual signing contract) )ove named. is the . ... . Cont ractor, agent, corporate officer, etc. . . . . . . ... . ) . . . . . . . . . . . . • 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 )rk will be performed in the manner set forth in the application filed therewith. porn to before in this i ., 19 Lary Public, County # Lz trok /L�v` . . . . . . . . . . Signature of applicant) congnlpioe� Jung t8,1� , x c t Al ' . 03 do :s'i E{ Y ¢ Af ATS PLU _ r t 1_ - 3' ...., ..,T..- Off NT NOVIFY BUILDING OF . ,' P. i=' �-— _ H tFOR THt ` > z.. L > __- ro toes O MUSS Rap.COWL09 FOR W. r _ L-_' - ALE. MEET- ,AL - r : s THE (jwpw - STN a 1 1 3fARWild tIts i .[ ffff ` J^ . s i C. € ` _ — •.:.• __`—. _. .... .. r{._ �C r_. '= _ _. s'-' .. {a"y�-k" -_ a •t.: {yam` �_l+.-t. ,Y.7 NS..-. 4.. ` 3 - t. 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BY ---- —-- NOTIFY t3LtILDING I�EP�RT�IE�4T AT GIs -i 802 9 AM TO 4 PM FOR THE I"'OI<.LOWING WSPEC'TIO S: , FOUNDATIONIf1At�REQUIRED ' 01* FOR POUR EC CONCRETE .�tt=TE r C_y `f`� !'" IeZ74.L 2. ROUGH -- FRAMING & PLUMBING _ --------- - � 4. FINAL • CoNSTRUCTIQtV MUST BE COMPLETE FOR C.O. -r 'T ALL CONSTRUCTION SHALL MEET � ��F� I " a THE RECZUIREMENTS OF THE N.Y. 1� -Tklt e-,"'T opA tIT STATE CONSTRUCTION & ENERGY nh1P e iTlar.i� ( T t r CODES. NOT RESPONSIBLE FOR h�1 rrt4 -Tt� , ' DESIGN OR CONSTRUCTION ERRORS