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HomeMy WebLinkAbout22339-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23477 Date FEBRUARY 2, 1995 THIS CERTIFIES that the building ADDITIONS Location of Property 3265 ELIJAH'S LANE MATTITUCK NY House No. Street Hamlet County Tax Map No. 1000 Section 108 Block 4 Lot 7.19 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 30, 1994 pursuant to which Building Permit No. 22339—Z dated SEPTEMBER 19, 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 FOR A ONE CAR GARAGE, BATHROOM AND MUDROOM ADDITIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to POWER CONSULTANTS INTERNATIONAL INCORPORATED (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N333193 NOVEMBER 10, 1994 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 AUTHORI D) ® Date ....... .... .. ........�. ........................ 19-1... N_ 22339 Z Permission Is hereby granted to; d............................................ ........�. .............. �..........07w..�C� . / �?�I.�- -. .......... ...C...w.!.......�....... ........ yd / .�b 4 ......................................................I.................................................................................................... .................................................................................................................................................................. at premises located at...............3.;�.07... �'� .r... .sf !T '. ......................... ............................................:.......: . �.. L.! .............1 ..... '...................... / Q County Tax Map No. 1000 Section ......(,. ..V....... Block............ ............. Lot No. ...7.®....... ....... pursuant to application dated ................. "..... .a.................. 19...!y..., and approved by the Building Inspect Fee$..... ................... I ..... .............�... . ................... Building Ins ector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD ;�. BUILDING DEPARTMENT TOWN HALL r 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. Y- 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 ' 4 C. 01 , Fees. . 1. Certificate of Occupancy - New dwelling $25.003 Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.G.O. Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50,00 5. Temporary Certificate of Occupancy - Residential $155.00, Commercial $15.00 Date .0.7!l qv . . . . . . . . . . . ... . . . . . . . . . . . . . . . . New Construction. -- ,- - . , ., Old P Or PYe-existing Bc.;_ld.1b �I �t,, Location of Property.°�Vs. . . . . . . . . . . . al.4"', �.��. .�::��]".:e-. . . . . . I� 11�11( t_" . . . . . . . . . . House No. Street -�— Hamlet -- --- —'- Onwer or Owners of Property.RW._i.. GC 11_ZL1 7j1;8 , , , , , „ • , • . . • . • Count Tax Ma No 1000 Section. . ` ��19 Y P � . . . . . . . . . . . .B1ock. . . . .�/. . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . • . . . . . . . . . . . . . . . Subdivision, , '� S��i :Q `is, , , ,Filed Map�-�G: .�. . . . Permit No.�;),33f,„?„Date Of Permit. • q)'Ah, pplicant. ��L+:�47-j 1 6�Y�� +VC• Health Dept. Approval. . . . ..' . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . .:g y . . . . . . . . . . . . . ... Request for: Temporary Certificate. . . . . . . . . . . Certicate. ':'. . . . . Fee Submitted: $, • • ,., • , • • , , , • , , , Rio APPLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS PACE I 10,00121 BUREAU OF ELECTRICITY F_ 85 JOHN STREET. NEW YORK. NEW YORK 100'38 Date N()VEMBER 10,1994 Application No.on file 06616594I74 N 33319:3 THIS CERTIFIES THAT only phe ehlecJtLric#equipment as described below and introduced by the applicant named on the above application number in the premises of EMANUEL CO LLMIS, 3265 ELI�L-HS LMC, , 1 ATTITUCK, N.Y. in thefollowing location; ❑ Basement ❑' Ist Ft. ❑ 2nd Fl. GAR/ATTIC/OUT .Section Block Lot NOW I MER 07 199�x was examined on � and found to be in 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. 8 1 7 8 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 AM. WATTS SERVICE DISCONNECT NO.OF S E R V I C E METER NO.OF CC.COND. A.W.G. A.W.G. A.W.G. AMT. AMP. TYPE EQUIP. l,e'4W 1.03W 3,0'3W 3,0'4W PER Ar OF CC.COND. NO.OF.HIAEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL OTHER APPARATUS: ELEC. R0i'M HEATERS: 1 50 K.W. ,'1-.75 K.W. PAUL R. BURNS LIC.#3897-E P.O.BOX 1061 SOUTH01,D, Imo', 11971-0932 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. 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. j FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ INAL d REMARKS: Jp DATE /� � INSPECTO BUILDING DEPT. INSPECTION [ ] FOUNDATION 15T [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU ION [ ] FRAMING [ NAL REM (8• � DATE IN8PE � 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ OUGH PLBG. ] FOUNDATION 2ND [ ] INSULATION [+/l-'FRAMING [ ] FINAL REMARKS: 17 - DATE I� � INSPECTOR � ,r� T65-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUNDATION 2ND [ ] INS CATION [ ] FRAMING [ - INAL REMARKS: ATE � INSPECTOR . - / 765-1802 suauiNa uEVr. INSPECTION [ ] FOUNDATION 1ST [ ] ROU PLBG. [ ] FOUNDATION 2ND [ SULATION [ ] FRAMING ( ] FINAL REMARK DATE. ` INSPECTOR � 765-1802 BUILDING DEFT. INSPECTION [ ] touNDATlO 1ST [ ] ROUGH PIBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: � DATE v INSPecro�'y�L��� JUDATIOV '( 1st) tIJDATIOI1 (2nd ) ti c3l FRAI to H 7 cm ULATION PER N. Y. II STATE ENERGY II CODE I FINAL ADDITIONAL I - ADDITIONAL COMMENTS : ./ I ' x � o ' r •..rCS'_r-•-.}•••��;�a�,.r.:..,:ar-.ws;.-,...r r�:.3�"�. ...•, . . .. ,. ... .. .. T -. .-. .. ... .. 80,X RO OF HEALTH . . . . ... . . . I`9? FORM NO. 1 3 SETS OF PL.XNS . . + TOWN OF SOUTHOLD SURVEY . . . . . _ _ . . . . . . : . . . . P� 301994 . . . . . - - - - - - . . . : : . . . . BUILDING DEPARTMENT CIIECI; TOWN HALL SEPTIC FOR, _ _ _ . . . . . . . . . . . BLDG.DEPT. SOUTHOLD, N.Y. 11971_ wry of so rs7oLD 9 TE L.: 765 1802 r:o I F•t .. /� CALL _I 1 Examined . . - , • - , . . . . . . ., 19 . . !•SAIL T0 : Approved . . . 19 9ermit No. � . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ _ . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Building Inspe or) . A LICATION FOR BUILDING PERMIT Date A .C" 30.� . ., 19q 4 INSTRUCTIONS a. This application must be completely filled in b PP p y y typewriter or in ink and submitted to the Building Inspector,with 3 se,s of plans,accurate plot plan to scale. Fee according to schedule. 1• b. Plot plan showing location of lot and of buildings on premises, relationship 'to adjoining premises or public streets 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. z 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 inspections. _ . .. . . ; .ti1M. . .1.. . . . . .. . . . . . . . . . . . (Signature of applicant, or name, if a corporation) .0. :�C�C l �� `fit. coo 31G: N`r: �la5g (Mailing address of applicant) .State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . ... .tic,` `©P. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . . vM�� U.F,� . . . &OL-•C,M;(S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If ppli - s ilo It' signature of duly authorized officer. (Name an title of corporat�oer -. - -._-_ Builder's License No. . .��. J.J.�. . . . . . . . - _ - Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . .CL i�, i-�S. .. LAtv�. . . . . . . . . .�. �.. C ram. . . . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section . . . .f.ca. . . . . . . . . Block . . . . . . . . . . . . . . . Lot . . 741. . . . . . . . . . Subdivision-. .l- `,1!�:�.S LAND �f�-Ce5 Filed Map No. 5l=,G�, ,�. . Lot . . . . i . . . . . . . (Name) . . . . . . . . . . . 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: - a. Existing use and occupancy . . . . . . , , .. .. .. tk •U � 1 b. Intended use and occupancy . . . � . .e,. . . 3. Nature of work (check which applicable): New Buildinga / • • • • • - • • • • Addition Y. . . Alteration Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . . . . . . 4. Estimated Cost . . . 7.4'G. _ (Description) �? . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) S. If dwelling,number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . Ifgarage, number of cars . . . . . . . . .Q , • • , • • " " " " " " 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use • • . . . ' 7. Dimensions of xisting structures,if any:'Front . Rear (7 Height . .I. �It •. . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of saome structure with alterations or additions: Front "f'. ,j,�-�.°. �7,0�X �. . Rear � 13'�Ce�.(-aDepth .2$ . i S,- . . . `:� • • • • • • • • • . . Height . . . . . . Numbeories . j `�► 8. Dimensions of entire new construction: Front . 13i�`� .� -p�� ' . Rear . . . j�.:Q Depth Height . . . . . . . . Number of Stories . (�• ' • ' ' • ' ' 9. Size of lot: Front . . . . . . . . . . . . . . . . . . . . Rear . . . . `. . , . . . . . . . . . . . . .De th . . . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase • " ' • ' • • " p " " " " " ' • • • • • • • - • • . . . . Name of Former Owner 11. Zone or use district in which premises are situated . . . . . ' • ' • • • ' ' 12. Does proposed construction vhiQ1 a any zoning law, ordinance or regulation: 13. Will lot be regraded ? , • . . • , . . Will excess fill be removed from premises: ' Yes No 14. Name of Owner of premises �: !�'®LaML , • , , , • • Address �akvF Lr:! phone No. Name of Architect .Address . Phone No. ' Name of Contractor JV •E�kSC • It�1C•- AddressPQ: tr . . .f , c,t�;E •ph • • ' 15. Is this property within 300•feet of a tidal wetland? *Yes• • . • • • • F. one No. *If yes, Southold Town Trustees Permit may be required. No. .t . . . . 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. STATE OF NEW YO . COUNTY OF . . . . . : ,. . . . S.S ��'' �• • • •�•v• •s• • • • - • • • . . . . being duly,'sworn, deposes and says that he is the applicant (Name of individual signing contract) -above named. i-Ieisthe . . . . . . . . . . . . . . . . . . . . . . . . .:3"'. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .(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 1pplication; that all statements contained in this application are true to the best of his knowledge and belief;and that the -vork will be performed in the manner set forth in the application filed therewith. ;worn to before me this . . . . . . . . . .. . . .. . . . . ay . . .V_�i . . . . . . ., 19 Jotary Public, . . . , , • • . . f . . County' ROBERT I.SCOTT,JR. NOTARY PUBLIC,State of N.Y. . . . .. . . . . . . . . . . . . ... 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