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HomeMy WebLinkAbout21132-z M ~ FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23286 Date OCTOBER 14, 1994 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 855 OLD HARBOR ROAD NEW SUFFOLK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 117 Block 3 Lot 7 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 26, 1992 pursuant to which Building Permit No. 21132-Z dated DECEMBER 9, 1992 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 & ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR, EXCLUDING DECKS. The certificate is issued to CHRISTINE McCABE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-32884 & N-32885 - SEPT. 30, 1994 PLUMBERS CERTIFICATION DATED JULY 1, 1994 - MIKE JACOBI PLUMBING (;4 g&4 Building Inspec r Rev. 1/81 FORM No. a 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) Y 45 N°N° 21132Z Date 19.2 P. Permission is hereby granted to* C aysxfxd?e......~~ r j V5 ~~C f? r~~ cam at premises located at ...2, '.......r,~ f County Tax Map No. 1000 Section ....1 1.7 Block Lot No........ F pursuant to application dated 1..~ 19.. and approved by the Building Inspector, i i Fee lf.K. i~ ! GG~ uilding for Rev. 6/30/80 t © 3d Form No. 6 v V~ 5, TOWN OF SOUTHOLD Jl` Q BUILDING DEPARTMENT OCT `-~1~ TOWN HALL ii 765-1802 BLDG. DEPT. TOWN OF SOUTHOLD N APPLICATION FOR CERTIFICATE OF OCCUPANCY 1. 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-O 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. 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. 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 Building - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residentia~lf $15.00, Commercial $15.00 Date ew Construction..~l'W~y. Old Or Pre-existing- Building.. ocation of Property ...Zt ...1 'V~ :....NJCsW..0019.Ro`k House No.n Street Hamlet nwer or owners of Property 4 % Mr,.C1~ ~/,N c ounty Tax Map No 1000, Section ....Block Lot...7-.............. ubdivision ....................................Filed Map............ Lot................. ermit No ................Date Of Permit............. ,.Applicant............................. 2alth Dept. Approval ..........................Underwriters Approval......................... Tanning Board Approval equest for. Temporary Certificate........... Final Certicate. A ee Submitted: . Q e e, s q~. a $ APPLICANT TEL. 765-1802 TOWN OF SOUTHOLD '1z OFFICE OF BUILDING INSPECTOR P.O.,BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 C E R T I F I C A T I O N Date 11 ~y Building P/Permit No. 211 3d-7-2 Owner ~!1 r~ 5 ~1 ye rj CC,, f, f' (please print) Plumber (please print) / I certify that the solder used in the water supply system contains less than 2/10 of 10 lead. *pIu 's signature) Sworn to before me this day of~ , 19~. /YC l o r 42 Notary Pubiic Notary Public, County HELENE 0. HORNE Notary Public, State of New York 4961364 Oualifi doin Suffolk Counttyy Commission Expires May 22, 19 ~5' lELD iS -7i::: !!-Aa ~ :(i•1 11T • r m W H OUNDATION (1st) OUNDATION (2nd) e: Ole :OUCH FRAME & .PLUMBING • N H 3. n :17SULATI0~7 PER N. Y. I , , H STATE ENERGY CODE -MAI. ADDITIONAL COMMENTS: eX•e•~• e2 ~ m x m d H O - -v H M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL REMARKS: l DATE ~I INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: _ DATE 3 INSPECTORS/ 7-7' M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ I ROUGH PLBG. [ J FOUNDATION 2ND [INSULATION [ ] FRAMING FINAL REMARKS: 4 i P t V DATE y l S -INSPECTOR -fr) 6 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] IN CATION FRAMING [ INAL REMARKS: J~ t DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ I ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE INSPECT / 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL i REMARKS: ~-r 1 DATE / INSPECTO 4 C i THE NEW YORK BOARD OF FIRE UNDERWRITERS WAGE 1 r1.001071 BUREAU OF ELECTRICITY I BS JOHN STREET, NEW YORK, NEW YORK 10036 Date SEPTEMBER 30,1994 Application No. on file 853,74594/94 N 328854 THIS CERTIFIES THAT only the electrical equipment" described below and introduced by the applicant named on the above application number in the premises of CHRISTINE McCABE, OLD HARBOR ~yROAD, (ACROSS FROM MARINA), ISM SUk'EOLK, N.Y. inthefollowinglocation• ? Basement n Ist Fl. 'n 2nd F1. Section Block Lot was examined on SEPTEMBER 26,1994 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS ECEPUCLES SWITCHES INCANDESCENT FIVOF ;:I I T OTHER AMT. K W AMT K. W. AMT. K W. AML K. W AMT. H P. 8 22, 4 8 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET DIMMERS AMT K. W. OIL H. P GA3 M P. AMi NO. A. W. G. AMT. AMP. AMT. AMPS. TRANS. AMT. H P SYSTEMS NO. OF FEET AMT. WATTS 2 600 SERVICE DISCONNECT NO. OF S E R V I C E MIT. AMP. TYPE METER 1-02W 103W 303W 3A' /W NO. OF C. COND A. W G. NO. OF H1 LEG A W G. NO OF NEUTRALS A. W O EQUIP. PERd Of CC. COND OF HIAEG Of NEVT AL 1? OTHER APPARATUS: MOTORSt1-F H.P. G.F.C.II-1 SMOKE DETECTOR:-1 TRACK LIGHTINGt-10 C & S CONTRACTOR LIC4578-E aryl BOX 215 SOUTHOW, NY, 11.971 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. r i r i 1 (l\ if I / l \1 ,y 1 / I I r FEFEIIEP FROM 02. 10.1953 18133 Fv.-...1 1 t i I } ~ ( r y(61 K c~Ky I r z` - i i _t IF 9-- H7 a 6 III 1 . I I W I II'I~i ~ u II.~-~n g ~I~I1I'IIIIII.II BOARD OF HEALTH FORM NO.1 3 SETS OF PLANS TOWN OFSOUTHOLD SURVEY BUILDING DEPARTMENT CHECK TOWN HALL SEPTIC FORM SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ttoTl FY ;ry ~ Examined CALL T 19.?i MAIL TO: Approved .......10/q Permit No..0`32 Disapproved a/c _ . ins spector) APPLICATION FOR BUILDING PERMIT q Date pv.•1Ht~t'~~4., 199 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 set,$ 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 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. 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 i ectio ~S ?i!!....... . (Signature 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. ©V-) nt°f .............................\\....c............................................................... -Name of owner of premises ...~11 ll(. C ft e? ..7 (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. D'.t 1. . , , , , , , , Plumber's License No..(~,3.~ , ,1. , , , , , , , Electrician's License No.b Q , , , Other Trade's License No. . X Q. v-ut 1. Location of land on which proposed work will be done . f. ~ . Q Ip'1 . ~...........Q' ~rY:...:. U:... (k House Number Street Hamlet County Tax Map No. 1000 Section ...1.1.7 Block ~ Lot . Subdivision Filed Map No. Lot............... (Name) ~ State existing use and occuPahcY of premises ~ and mten d ~ use ` a d occupancy of proposed construction: n . S' a. Existing use and occup_aficy t `,~'SPa°~ e Fx is 'Fa d3? b. Intended use and occupancy . tl Yg~=a a 34 . r , 3. Nature of work (check which applicable): New Building Addition . , Alteration V Repair ....4/........ Removal , Demolition • • • • • • • • • • . Other Work (Description) 4. Estimated Cost ~6~ ~,b m 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 ' • • • • • • • • • • 6. If business, commercial or mixed occupan y, specify nature find extent of each type of use ...C).. . i senstons of e~jfisting struens, if any: ront , ,V, • , , , Rear . ,t)`~,4". , • , • , , , , Depth Height a.,7 Number of St ries I . , . . Dimensions of same structure with alterations or additions: Front . , , Rear ....Q-,A l;rM Depth ...S41-kthZ . r . Height ......?A'/r , , , , , , , . Number of Stories . 8. Dimensions of entire new construction: Front , • . , , • , , Rear Depth . Height Number of Stories , . . 9. Size of lot: Front Rear . Depth • • • • • • „ • • . • • • • • 10. Date of Purchase l n. • , , • • • , , , • Name of Former Owner .~1, . , , t 11. Zone or use district in which premises are ituated. , A~."°.,+o*:h°6'4a~ , , , , • , , , 12. Does proposed construction violate any zo ing law, ordinance or regulation: ,~,t~.. . 13. Will lot be regraded "y'v ' Q r • • • • • • • • • . • Will ex ess fill be removed f o premises: Yes No 14. Name of Owner of p emiseS q1~~1 rflCc ddress Vt) .'~Y.1J~1 ~one No. Name of Architect rbl . y+}Q~ t7~l•; y, Address Koo's R . , P e... Phone NOVA) ?,OR/ AI.Z y Name of Contractor l? n)~?4,4!°lO t -Address 15. Is this property 9421~/,p, (C~,tiTG L115hone No. 7 a,:~Sti!~a * within 3 s y 00 feetof a tidal wetland? yes,,,,, No NP If es, Southold Town Tru tees Permit maybe 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. ay 1 ~e4 I I • I I i i I i i I! ~ r I I ;TATE OF NEW YORK,. / ~S.S 'OU Y . F being duly sworn, deposes and says that lie is the applicant • s. . (Name of individual I contract) bove named. 'eis 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 )placation; 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 ..1..., ; 19 ~ otary Public, ...;I ,County .r0YC8 M„ of 62 f%$ aafftw%* SuffdkCou~~y~!r (Signature of applicant) mlree une 12,1a ~s TI, , >.~.o....-,.,, ~~nwwmww«wwwr +.,,.:*mwrm~.Hwun~ ewera..~~:w~amK,m+,w{n~~~ 1 p J . ~J I. s z