HomeMy WebLinkAbout22253-z :1 FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23393 Date DECEMBER 6, 1994
THIS CERTIFIES that the building REPAIR
Location of Property . 1075 NAVY STREET ORIENT, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 25 Block 3 Lot 6
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 12, 1994 pursuant to which
Building Permit No. 22253—Z dated AUGUST 12, 1994
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 . REPAIR FIRE DAMAGE TO EXISTING ONE FAMILY DWELLING AS
APPLIED FOR..
The certificate is issued to SHIRLEY A. REITER `
(owner)
of .the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-325769 — SEPTEMBER 1, 1994 &
N=334155 - NOVEMBER 21, 1994
PLUMBERS CERTIFICATION DATED DEC. 5, 1994—BERTSAND PLUMB. & HEATING
Building Inspect/
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)
r
Date •• ..1 -••..•••••••••.•..•.•..•••••••.••.......••••, 19P ....•
Np 22253 Z
Permission Is hereby a ted to: 'Ao
••.•.•..•..... ...Y.. •.••••. .�
r . •. .a....... .... .... .........................
/11V..........
......•.••.......•...: •.. .. ........... •••.•••.••••••••••••••••••.•••,•.•,•••.•••••••.•.•.••.•••••••••••••.•.•.•••.....•••.•...•........
......................•...•.•..•.........•..........•..........••............•..•••...................•.•••••••••........••.••••.•••.••.•.•.•..••••••••••••••••.••
••••••••••••...•.••.••••••••.•.........••••.•.••.••••••.•...••••••••••••••••••••••••••••••••••••••••......•.•••..•.•....•..•.••........•....•..•...•••••••••.•••••
........................:••••••••••..•...•................•••••••••••••••••..••••.•••..••....••..... ••..•••..•...•.••••.•••••••••••••••••."".••••••••••••••••••
at premises located at...,� .�,�..........i�. . .....................................•......•••....•...•..•..•...
cSz ............................................................... I
County Tax Map No. 1000 Section ......................... Block......P............... Lot No. .. %.••.•...•.••.........
pursuant to application dated .. ...... .... °'�• 19,,1 ......, and approved by the
Building Inspector.
Fee$• •�/ ••.•
••• (� r •.•• .... ':'•... ......................•.,,..........
Building Inspector
Rev. 6/30/80
Form No.- 6
TOWN OF SOUTHOLD
1601
BUILDING DEPARTMENT
,D®C
TOWN HALL
765-1802
- mow.D
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.
o•
B; For existing buildings (prior to , April 9, 1957) non-conforming uses, or buildings and
it 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 - $20.00
4. Updated Certificate of Occupancy -' $50.00
5. Temporary Certificate of Occupancy - Residential $ .00, Commercial $15.00
Date . . . . . . :� . . ¢ .�.�.`. . . . . . . . . . . . . . . . . . .
New Construction. . . . . . . . . . . Old Or Pre-existin Building. . . .t�. . . . .
Location of Property. . . . .
. .
_. . .. . . . . . .� : . . . . . . . . . . . . : KI-0 .L�. . . . . . . . .
House No. treet Hamlet
Onwer or Owners of Property. . . . . .���ktt; „�,�;1, +ek , , , ,
County Tax Map No 1000, Section. ... . . . . . .Block. . . .0 . . . . . . . . .Lot. . . .6. . . . . . . . . . . . . . .
Subdivision. . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . ..
. . . . . . . .
Permit No. .; ;�951.ZDate Of Permit. . . . /�2�. .Applicant. . .`,04e :P.l�c'Ccr1G,. .
Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . �. . . . . . .. . . . . . . . .
Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .
Request for: Temporary Certificate. . . . , , , , , , , Final Certicate. .: . . . , .
Fee Submitted: $-.. . . . . . . . .... . . . . . . . . . . . . .
. . . . . . .ry
S__:.�..�V�:,:�!E..v.+hh�$L ri•..c ._:F»_.AP��,.,•a,..,. _ ...•-.,. .,:.:.:_< ...._.:. ... .. .......-.......�..- ��..•oeJ'.� sw-,, a i�e,s.._;-saastG.:...a.ixs.+.:.....iw_e i,.�''^;<"3 ..Yi d..rvW- �Yf:.'1iWs.T
JOHN 1. JOHNSEN, P.E.
38 Cormorant Dr.
Hampton Bays, N.Y. 11946
Design • Construction • Management Tel/Fax (516) 728-5095
September 26, 1994
Peter DeNicola Professional Builder
P.O. Bog 841
1695 Chablis Path
Southold, New York 11971
Re: 1075 Navy St., Orient
Build. Permit # 22253
Dear Mr. DeNicola;
Per your request, I have inspected and evaluated the three double 12 inch
'Microlam' beams which support part of the roof system at the above refer-
enced one story dwelling. The beams are of sufficient strength to support
the dead and live loads as per the respective New York State Building Code.
This letter may be presented to the Southold Town Building Department and
shall serve as my certification that the subject beams have been properly installed
and comply with the structural building code.
If there are any questions or if I can be of further assistance in this matter,
please let me know.
Respectfully submitted,
Jo n I. Jo nsen, P.E.
}3 i� o
LDG ADEPT.
'` TOWN OF SOUTFlOLD
TVA.. 7 .S-1Q
00 �o TOWN OF SOUT$OLD.
OFFICL OF BUILDING INSP=OR
P.O. BOX 728Lf
k
.r0 TOWN HALL
SOUTHOLD,N.Y. 11971
C E R T I F I C A T I O N
Date December 5,. 1994
.Building Permit
•,, .owner_ �e`1�2C2 ' .
(please print)
Plumber Bertsand Plumbing & Heating, .Inc.
.(please print)
I certify that the solder used in the
water i�upFlY �Y�r.�t
contain8 lase than 2/10 of 1i 'lead.
• plumrjer'a cignatu�s�)
Sworn to before me .this
5th —day of De�cem_ber
1994
Notary Public '
Notary Public, Suffolk county ,
Notary P blic,Sia eo Chew York
No.4826942
Qualified in Suffolk Count�i
Commission Expires January
THE NEW PORK BOARD OF FIRE UNDERWRITERS PAGE I
1065081 BUREAU OF ELECTRICITY
F 85 JOHN STREET, NEW YORK, NEW YORK 10038
Date NOVEIRBER 21.,1994 . . Application No.on file 85707'194/94 N 334155
THIS CERTIFIES THAT
only the electrical equipment as described beloio and introduced by the applicant named on the above application number in the premises of
SHIRLY RIOTER, 1075 F4 AVy STREET, ORIENT POINT, N.Y.
in the follotcinlg location; ® Basement D Ist Ft. ❑ 2nd Fl. ATTIC,'/OUT Section Block Lot
teas examined on Nbv MEER 17,1.994, and found to be in compliance with the National Electrical Code.
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
TCHES
OUTLETS INCANDESCENT1 FLUORESCENT OTHER AMT. K.W. I AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
28 31 27 28 1 F
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS
I F, 1 2/14 HOC 1
SERVICE DISCONNECT NO.OF S E R V I C E
AMT AMP TYPE METER EQUIP. -,ZW 1 a 3W 3,0'3W 30 4W NO.OF CC.COND. A.W.G. NO.OF HI-LEG A.W.G. NO.OF NEUTRALS A.W.G.
EOUIP. PER 0OF CC.COND. OF HIAEG OF NEUTRAL
1 1.00 Cis I. X 1 11 1 4
OTHER APPARATUS:
ViOTOR S;4-F H.P. /
G.F.C.1:-9
S110RM DETECTOR: -3
P'RW KiECTRICAL 1,IC,ik4405-F
SERVICES, INC..
P. 0. BOX 1.154 GENERAL MANAGER
RONKONK%1A, NY, 11779 11
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.
r9l�25 3-6-
THE NEW YORK BOARD OF FIRE UNDERWRITERS iACE 1
1000955 BUREAU OF ELECTRICITY
F 85 JOHN STREET, NEW YORK, NEW YORK 10038
Date SEPTEM3ER 01,1994 Application No.on file 35363894/94 N 325769
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
REI:TER, 1075 NAVY STREET, ORITIMT VILLAGE, N.Y.
in the following location; ® Basement ❑ I st Ft. ❑ 2nd Ft. OUT Section Block Lot
was examined on AUGUST `9,1994 and found to be in compliance with the National Electrical Code.
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENTI FLUORESCENT I OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. I K.W. AMT. I H.P.
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
SERVICE DISCONNECT NO.OF S E R V 1 C E
METER NO.OF CC.COND. A.W.G. A.W.G. A.W.G.
AMT. AMP. TYPE EQUIP. 1.B'2W 1,B'3W 3,0'3W 3,B'�W PER b- OF CC.COND. NO.OF HI-LEG OF HIAEG NO.OF NEUTRALS OF NEUTRAL
1 i.00 Cr3 1 x .s 4 1 4
OTHER APPARATUS:
TEI'VORPRY FIRE RE;—COONECT ONLY-1
BI—COUNTY u1,ECTRIC CORP. LIC.#330
-79 JERU SALE 111 AVENUE
NORTH BELIMORE, NY, 11710 GENERAL MANAGER
11
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.
��SQFFOL��o
_° °yam►
Town Hall,53095 Main Road y a Fax(516)765-1823
P. 0. Box 1179 Telephone(516)765-1802
Southold, New York 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
November 30, 1994
Mr. Peter DiNicola
P.O. Box 841
1695 Chablis Path
Southold, NY 11971
Re: Shirley Reiter
Prem: 1075 Navy Street, Orient NY
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.
xx No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984) .
BUILDING PERMIT # 22253-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
c2
765-1802
BUILDING DEFT.
INSPECTION
[ ] FOUNDATION 15T [ ] ROUGH PLBGS,
[ ] FOUNDATION 2ND [ ] INSU ION
[ ] FRAMING [ INAL
REMARKS• /--;577 &ea
DATE INSPECTOR
� r2
i
i
BUILDING 1 / --
INSPECTION
FOUNDATION /
FOUNDATION I 1
'FRAMING FINAL-
:t�
DATE INSPECTO
74
BUILDING DEFT.
INSPECTION
[ ] FOUNDATION 1ST [ SOUGH PLBfi,
[ ] FOUNDATION 2ND [ ] INSULATION
[ FRAMING [ ] FINAL
REMARKS:
DATE ! �� 6 INSPECTO
i
rAn; ' 'WE
POP-
• I ICI ►�1 �
_ ' 11
fl O BOARD OF HEALTH . . . . . . . .
IJ FORM NO. 1 3 -SETS OF PLANS . . . .
TOWN OF SOUTHOLD SURVEY . . .
AUGIl f,21NOW BUILDING DEPARTMENT CIIGCE _ . . . . . _ . . . . . . . .
TOWN HALL SEPTIC F0RN _ . . . . . . . . .
BLDG.DEff. = SOUTHOLD, N.Y. 11971
TOWN OF SCadfrHOLp TEL.: 765-i 802 t:a<<F7
ti �,�Q CALL
Examincn
rtAiL TO .
�'' _ 9 . ``?� ^' . . . . . . . . . . . . . . . . .
Approved 19 . . . Permit No. ,�—s ..3
Disapprove . . . . . - - - - - . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . - . . . . . . . . . . .
±:
( ilding)Spector
APPLICATION FOR BUILDING PERMIT
. Date . . . . . . . . . :. 199 d.
n
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted tothe Building Inspector, with
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 permi:
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 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:tiuildin-1 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 inspecti' s.
r
.Signat •
( b e of applicant, or name, if a corporationly
(Mailing address of-applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
. . . . . . . . . . . . . OVV- .L. . . . . . . . . . . . . . . . . . . . . . : . ... . . . . . .
Name of owner of premises rt(e. . ... . . . . . . . . . . . . . . . . . . . . . . . . .
(as on thejtax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.'
• . . . . .
(Name and, title of corporate officer) ,
BuiIder's License No �® . C. : :
PIumber's License
Electrician's License No. . . . . , .
Other Trade's License No. _
1. Location of land on which proposed work will be done. ; , , , , , , ; _
.�. . . . . . . . . . . . . . . . . . . . . . COWILT . .
House Number Street ' ' ' ' ' -
Hamlet
County Tax Map No. ]000 Section '. . .0 �. . . . . . . . . . Block . . , oz . . . . . . .. : . . . Lot . . . . . . . . . . . . . . . . .
Subdivision
. . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. Lot
State existi"b use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy . . . .. .
�
use and occupancy
. . . - •�.` ;-kt� . . . . . . . . . . . . . .
b. lntend �, . . . .
.>;: .
• . z� - ass+.._ .. _..
•3. Nature of woo• • .heck which applicable): New Building
Repair . . . , . Removal ' ' ' ' ' ' .addition . . . . . . .t n�`: 'Alteration
. . • . • . • . . .. .. Demolition Other }
prk'
4. '• '�'
Estimated Cost . . . Q .off (DescripItion)
S. If dwellin^ nu / • • • . • - • • • - FCe • • • • •(to•be,paid'on G1 ngsth�sfi p� licat�on
b,number of dwelling units r p )
' ' ' Number
If garage, number of cars of dwclli,ng,units on each-floor
6, If business, commercial . . . . . . . . . . . .'. . . . . . . . - . . . . . .
or mixed occupancy, specify nature and extent of.each type of,.usel. _,:'
7. Dimensions of existing structures, if any: Front
Height r . . . . . . . . . Rear . . Depth . . . . .
• • • • • • Nr�mbcrofstories p ' • • • • • •
Dimensions of same structure with alterations or add' • • • • . ' ' ' ' . ' ' ' ' ' ' . ' . . ' ' ' . . • • . . • .
Depth . . . . . . . pions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . .
8. Dim Height . . . . . , . . , ; . . Number of Stories . .
Dimensions of entire new construction: Front . �2I-! ' ' ' ' ' . ' • .
Height . . . - - - - - - Rear . . . .� . . . . . . . Depth . . .
�r P. . . . . . .
. . Number of Stories f,
9. Size of lot: Front . . . . . . . : Rear , . . . . . . . . . . . . . . . . . . . . . . . . • . . . . . .
10. Date of Purchase " " " • • • • - • • • • • • • • • Depth
III Zone or use district in which r . . . . . ' ' ' . ' . • . Name of Former Owner . . . . . . . . . . . . . . . . . . . .
premises are situated , _
12. Does proposed construction violate any zoninglaw, o • • • •. • . . . . . • • . . ' ' . ' ' ' ' ' ' ' ' ' ' ' ' ' • • . • .
13. Will lot be regraded , , or or regulation: . . , , , , , , , , , , , . • _ _ . .. . ' •
14, �' ' ' • • • • • • • . Will excess fill be removed from premises:
Name of Owner of p rem ises$' &'tee. , , Address . ./,�7V- (�Cli�• �/.— Yes O
Name of Architect ' ' •S.. - f4Oil'.9 . . . Phone No. . , . ,
Name of Contractor •�•', - ' • • • • • • Address . . . . ... . . . Phone N , , , ,
15. Is this property thin 300 fe �`��" ICPe�ddress . .�66�. del' . •�.4� hone No. • •
t of a tidal wetland? ��... .�
fIf yes, Southold Town Trustees Permit may be required.
• • '•• • No j: . • ,
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing
or set- ack dim ensions fro
property lines. Give street and block number or description according pto deed, and show streeroposed, and.indicate t namesand indicate whether
'interior or,corner lot.
-to w•a`��� �X r 9'}-c►•,�
• (�Y../W/Z RE.� •�4g91It �0�� �`� IA^C�>, �^X I S�ti•h S
rJ
$� REQUIMWE
RED
AP
F ems' '
ll� I r l�alfr + GEPAR-TTME,
!'W4`0'2.9: Adel, TO, 4 PM FOFI, TIE
EIQ"":l OWN"G`INSPECTIONS:
7': F DI INDAT I+ € TWO REQUIR'
FOR POURED CONCRETE ED
OCCUPANCY OR ROUGH - FRAMING & PLUMBING
U-SE IS M.WFUL S. INSULATION
VVITHOUT CERTIFICATE 4. FINAL - CONSTRUCTION MUST
RE COMPLETE FOR C.O.
OF OCCUPANCY ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.y
STATE CONSTRUCTION & ENERGy
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
TATE OF NEW K ,_ •
OUNTY F . . (,C S.S
• • • . . . . . , being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
)ove named.
is the . ... . . ,
` (;Contractor agent, corporate officer, etc.)
said owner or owners, and is duly autllonz'cc— oa l)*crfornr 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.
•orn to before me this
. . . . . . . .lam ay of. �.� .�!L. . S.`� I9l .
Lary Pu ic, . . /. . . .�. County
CLAIRE L GLEW / J
Notary Public,State of New York �%
No.48a85t)5 . . . . . .
Qualified in Suffolk County q (Signature�ffl .of app licant)
Commission Expires December 8,1 S L
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