HomeMy WebLinkAbout22266-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23800 Date JULY 27, 1995
THIS CERTIFIES that the building REPAIR
Location of Property 6580 NEW SUFFOLK ROAD NEW SUFFOLK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 117 Block 4 Lot 33
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 29, 1994 pursuant to which
Building Permit No. 22226—Z dated AUGUST 15, 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 EXISTING COMLERCIAL BUILDING AS APPLIED FOR.
The certificate is issued to JAMBS G. NEKERMAN
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL INSPECTION CERT. #7288 DATED FEBRUARY 23, 1995
PLUMBERS CERTIFICATION DATED N/A
//Building Inspector
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................... 1r............... 19..g.Y
N° 22266 Z
Permission is hereby granted to;
James G. Nekerman
..........................................................................................
George Rd.
..........................................................................................
New Suffolk, N.Y. 11956
..........................................................................................
to ..... .�AIR AN EXISTING CONCRCIAL BUILDING AS A)?PLIED FOR.
......................................................................................................................................
...............................................................................................................................................................
..................................................................................................................................................................
..................................................................................................................................................................
..................................................................................................................................................................
at premises located at.....,,6580 NEW SUFFOLK ROAD NEW SUFFOLK, N.Y.
........................ .......................................................
..............................................................................I..................................................................I............
County Tax Map No. 1000 Section ........ 1.�............ Block.......................... Lot No. .....33
JULpursuant to application dated ........ g..29 ................................. 19.......9...4 and approved by the
Building Inspector.
Fee $..11-5d......................
......... ... .. . ... ...............w... .... ....... ....... ........
2�
Building Inspector
Rev. 6/30/80
l�c�rrn No. 6
: - Tol-m or SOII'I'IIOI.0 �CQ
�1
f i IUuL 2 61995 )I I L I /11t I ti L N I e jLC� _ ►;��1,'
1,'1A 1`, TOWN HALL
765-11302
AV Pt.1.CAT1oN FOR C[;tZTH'ICAT , OF OCCUPANCY
A. This application must be filled in by t:Ypec.,ri_ter OIZ ink and submitted to the hu1.J.ding
.inspector with the fol.loaf.ing: for new bttild:ing or neIl use:
1 • Final survey of property with accurate .location oC a.L1 buildings, property .lines,
streets, and unusual natural or topogr.aplt.i.c features.
2. Final Approval front Il"lt'It Dept-. of wetter supply and sewera9e-di.^posal(S-9 lot-in).
3. Approval of electrical. installation front hoard of Fire Underwriters.
11 . Sworn statement from "plumber:• certifying that: the solder used in system contai.rs
less than 2/10 of 1% lead.
r 5• Commercial buildill�' industrial buildin
and installati.orts,;a cer. ti_ficate of Code,Compli_ancele rfrornQarchitectsorllar enl; necrclinl;s
responsible for. the building.
G. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings
cc (prior to April 9, 1957) non-conforming uses, or buil.di.ngs and
pre-existing" land .uses:
' 1 • Accurate survey of property showin 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 , llte Iluildi.ng Inspector. shall state the
reasons therefor in writing to the applicant.
C. Fees
1 • Certificate of Occupancy - New dwelling .$7.5.00, Additions to dwelling $25.00,
A.lterati.otts to dwelling $25.00, Swi.ntrni.ng Pool. $25.00, Accessory building `�25.OU,
Additions to accessory build.irtg $25.00. Businesses $50.00.
2. Certificate of Occupancy on pre-existinp, Buildine - $100.00
3. Copy of Certificate of Occupancy - $70 ()0
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Itesiderit.i.al $.15.00., Cotmmercial $15.00
Y Da t e . . . . . . . . . .?: � l
Pew Construction. . . . . . . . . . . . . . . . . . . . . . .
Old Or Pre-existing Iluildi.ng. . . . . . . .
Location of Property. . . . . . . ,� . .
S voC
• house No, Street . . . . . . • . . . . . . " • "
� A ` hamlet
Onwer or Owners c:f Property. . u.,<,��� . t�1.�L�u;M�. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Loultty Tax 1.1a1t No 1000, Section. . IA�;. . . .
131oc1,. . . . . . . . .Lot. .
iubdivi,ion. . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . I . . . .IFQil.ed Ntp. . . . . . . . . . . .Lot
.
ermit No z . . . . . Z-. . . .Date UC
Applicant. . .
i • • . . . . . . .leal.th Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . .
:'lattrtlrrf; Board Approval. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
le(luest for: Temporary Certificate. . . . . . .
Fi.t Ce cate . . . . .
ce Submitted :
$. . . ��:. . . . . . . . . . . . . . . . . . . . .
LFT-'at FO& vc4ut,<-,cu�c��v
--�� � -Q';B ® . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
- i
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
c a (516)286-6642 ELECTRICAL INSPECTION SERVICE INC. )
375 DUNTON AVENUE
c EAST PATCHOGUE,NEW YORK 11772 )
7288
APPLICATION NO. ON FILE )
c DATE: 2-23-95 )
c o ADDRESS: 6070 New Suffolk Lane VILLAGE: New Suffolk TOWN: Southold
a ISSUED TO: James Nekerman
o )
-INTRODUCED,BY: 'Brite Lite Electric LIC.NO. 483—E
ca )
c AREAS LISTED WERE INSPECTED ON: 2-23-95AND WERE FOUND TO BE IN COMPLIANCE WITH THE o )
cc NATIONAL ELECTRICAL CODE.
LOCATION: BASE XX 1ST 2ND 3RD ATTIC POOL
co o )
OUTSIDE,COMM. SMOKE DETECTOR DETACHED GARAGE
Service Change
ca )
SERVICE DISCONNECT
METERS AMPS PHASE )
1 200 OH
c o THIS CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER U HUGO S.SURDI )
INSPECTORS MAY BE IDENTIFIED BY THEIR CREDENTIALS. PRESIDENT
V V V V V V V V V V V V V V V V V V V V V V V V V V
r
j�
,65.1802
BUILDING DEFT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FO ATION 2ND [ ] INSULATION
[ FRAMING [ ] FINAL
[ ] FIREPLACE 8 CHIMNEY
REMARKS:
DATE � Y � INSPECTOR ��,
-765-1802
BUILDING DEFT.
INSPECTION
[ ] FOUNDATION iST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE Z INSPECTOR��
IID
"` i;OMMENTS 1-''�A
JIIDATION ( is t) --- '�
(2n )
-- c3
.. all, 5u
CID
IGH FRAM
o _
w• ` •PLUMBING
. .,.• • :ma's.+"'��- •T''•. - .. .. - I
I r y
M
MATION PER N. Y.
STATE ENERGY II
CODE
-FINAL I --
. �� • ' I Mom, _ _ o
ADDITIONAL COMMENTS : m
------------------
::.+'+`S-'rrr-d�'.^_•...YTa�-.c'+r.�+:---.+:+:.:os...r r:,;,3�- :,.:;:�•y ..,:, .. - `• - _ ._. .. � •_r/t.ytis. ,,
BOARD OF HEALTH . . . . . . . .
FORM NO. 1 3 SETS 0f.., PL\NS
TOWN OF SOUTHOLD SURVEY . _ . - . .
BUILDING DEPARTMENT,, ' CHECK. . . . . . . _ . _ - - - - _ . .
TOWN HALL .. -'_ ` SEPTIC FORK _ _ _ _ _ .
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined . ,� 19d CALL . . . . . _ . - - . . . . .
' NAIL TO .
Approved . . . . . . . o��'Z . . . . . . _
- - . . . . . . . . .
Disapproved.a/c . . . . . . . . . . . . . . . . . . . . . . . _ . . _ . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . �►0 p•�p16 '
(Building Inspector• °P ICATION FOR BUILDING PERMIT n
Date . . . . . . . . . . ., 1 . . .
INSTRUCTIONS
a. This application must be complot'ely filled in b � ` '"•� '
y typewriter or in`ink' 'aniid submitted to the Building Inspector,with
sets of plans, accurate plot plah�,to'scale Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public sheet:
or areas, and giving a detailed description of layout of property must be drawn on the dia-;tam which is part of this appli
cation.
C. The work covered by this application may not be commenced before issuance of 131,.�:' .';n.�:, Permit.
d. Upon approval of this application, the Building Inspector will issued a Building Permi: ` e 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 lae 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, ordinarices;;building''c`ode; housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary'inspe'ctions.
(Si
-nature•of applicant, or name, if a corporation
• .
(Mailing address of applicant)
State whether applicant is owner, lessee, 'agent, architect, engineer, general contractor, electrician, plumber or builder.
. . . . . . . . . . . . . . . . . . . . .C� �1(�.. . . . .C 1�? .t2�?,L• p,�i�2A c (z
Name of owner of premises . . . . -_Tpst 4-c?. . G. . . t%� �,-`��=- 2,,�. . . . . • . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . .
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
• . (Name and title of corporate officer)
Builder's License No. . . . . . . .
Plumber's License No. . . . . . !.
Electrician's License No. . . • . . , • •
Other Trade's License No. . . , . .
1. Location of land on which proposed work will be done. W l5 0 F •� �V �={jL�� �'��
.: •mac . •S 10. .61.E012.Q C k20(A( - tv�.,.� sv F OTC . . . . . . . . . . . . . . . . . . .
House Number Street . .
Hamlet . . . . . .:. . . . . . . . . . . . . • ..
County Tax Map No. 1000 Section . . . :.'.1 . , • • • • ; • q-
. Block . . . . . . . . . . . Lot . �J.�J- . . . . . . . . . . .
Subdivision . •
. . . . . . � . . . • • - Pile d Map No. Lot
. . . . . . . . . .
Name � . , . . . . .
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy.,., ' F'Ipt 1V[, � LS1Z) �• •SUo�• • . • . • • - - • • • • • • • • • . -
b. Intended use and occupancy . . . . . • , . ... S p� o� S ., • • • -
•3. Nature of work check which applicable):�S pplicable): New Building . . ,
Repair . ,7�,. . . . . . Re . . Addition . . . . . . . . . . Alteration 1►; .
moval Demolition __. . . . . . . , . . . . Other Work . . • . • • • - • • • - -
. . . . . . . . . . . . . .
4. Estimated Cost . . . . . • ,�'S•C�C�d,� �- (Description)
. . . . ... . . . . . . . . . . . . . . Fee . . � . . . . . . . . . . . . . . .
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. Ifbusiness, commercial or mixed• • • • • • • - • s
t ,� • - • • • • • � • - • • - ' • • • 'ex#ent• " 'of•cac- "li'-"t " "of use • • • • • •
' ' •� �• •�• • • • • • • • • • • . . - • • .
occupancypecify, nature and �
7. Dimensions of a sing structures, if any: Front . . . . -�-
Height . . . . . .qi• • • Number of Stories �: �' ' ' Rear - . : , • • . . . Depth . .�(�. • • • • • -
Dimensions of same structure with alterations or additions: Front • • • • • • • • • • • - • • ' '
Depth . . Height1®► ►. . . . . . Rear . . .— • . . . . .
8, Dimensions of•entire new construe ' • • ..Number of Stories . . . . . . . . . . . .
He construction: Front . . . r'(t - • • Rear . • . . . • • • • • •
fight . . . . , _ Number of Stories • • • • • • • • • • Depth 11
9. Size of lot: Front . . I C>1.1 Rear . . . . . . . . . . . . . . . . . . . . . • . . . . . . . . .
10. Date of Purchase . . • 4.3. . . . . ... . . Depth A . ?� . . . . . . . . . . ...
. Name of Former Owner . Lam. •1�.Id� .1:
11. Zone or use district in which premises are situated . • • • ' • • -
.12. Does'proposed construction violate an zonin law • • • ,Gt�}.d 1�'� e•Lr`.d?�4 • ' ' ' • • • , ' , ' ' ' ' ' • • • • • - • • . . . • .
13. Will lot be regraded . . • Y g . ordinance or regulation: C? • - • • - • • • • • • . • • • '
14. ' ' � • • • • Will excess fill be removed from premises: Yes
Name of Owner of premises=�Atr''1 •�(l=lZ'- • w1l3Address 4f-51,?4►l ,(?;1) • No
Name of Architect . . . Address • • • • -Phone No--,'�•; 4•y�b
Name of Contractor . . . �•1\1C\�. -�'1%ac�\l• • • s ' C,�?O;(Sv�o1e • • Phone No. . . . . . . . . . •_•
15. Is this propert within • • • •Address . . ,t,��,•��O�� Phon�'No. . . . . . . -
Y 300 feet of a tidal wetland. * �/ • • • • •• • • -
- � � Yes. . . . . . .
*If yes, • Southold Town Trustees Permit may required. No. , . , , , - „
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whet' _. existing or proposed, and•indicate all set-back dimensions from
property lines. Give street and block number or :, :� i according to deed; and show street names and indicate whether
interior or corner lot.
ftpp
UNDERWRITERS CERTIFICATE DAT ° _�N. F�131
p,-�`
REQUIRED FEE-
'BY. -- _
IYOTIFY: FUILDINI(3 OEF'
755-I802 ' Ail . �1 f�T AT
FOLLOWING INSPE&I FOR THE
_ �. •p.Ot1�10,�i•10�s - T►/'�a • 1~
FOR POURED CONCRETE C28!li?l is
. v ' GG-#
FINAL
x+ r,
.:j oft"
'ti
ON iii�j r°
r� �. ' t.. d +E.. rud 1 F
rp NOT rd=ter%d["�r➢�s�� FOR
;TATE OF NEW Y�1�,
;OUNTY OF . . . . . S.S
• . . . . . . .`.�.. . . . . .. . . N C eJ-
0j_,._• . . ... . . . . . . . . being duly sworn, deposes and says that he is the applicant
hove named.
(Name of individual signing contract)
�
e is the . .. b t�
(ContraC.tor, at, 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 belief; and that the
irk will be perfor,_1, zn the manner set forth in 'tlic application filed therewith.vorn to before m this
. . . . . . . . q. . . . ay of Tu.
'tary Public . . . . . Sul
County_ 1
ROBERT I. ,,JR.
NOTARY PUB tat-of N.Y. - ' . . . . . . . . . . . . . . . . . . . . . . .
No.4725089,Suffolk Coin (Signature of applicant)
Term Expires•May 31,19
D�c1Gi�GC r-GES AIL1
- - - ------ w C•47i o J
APPROVED AS NOTED CV
NCI ���C.L..lCJ•
�s
sr � r _ —
N(WIFY 8WLDlHN4G 0 EPP,r'PNqfl'E
FOLLOWING INSPECTIONS:
-OUNDATION - TWO REQUIRED
MIA
liNMERINRITERS CERTIFIC"GIs.
REQlJl EED
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