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HomeMy WebLinkAbout23379-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24398 Date JUNE 5, 1996 THIS CERTIFIES that the building ALTERATION & ADDITION TO ACCESSORY Location of Property 2175 PINE NECK ROAD SOUTHOLD NY House No. Street Hamlet County Tax Map No. 1000 Section 70 Block 5 Lot 48 . Subdivision Filed Map No-. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 11, 1996 pursuant to which Building Permit No. 23379-Z dated APRIL 22, 1996 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 ALTER AN EXISTING ACCESSORY GARAGE TO A "NON-HABITABLE STUDIO & STORAGE SPACE TO INCLUDE A BATHROOM AND ATTACHED HEATER ROOM WITH AN ATTACHED DECK AS APPLIED FOR. The certificate is issued to LOIS L. DUNNE (owner, lessee or tenant) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. H049589 APRIL 16, 1996 PLUMBERS CERTIFICATION DATED MAY 30, 1996 LOIS L. DUNNE /'� 71 t ilding 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) R23379 Z Date ............ .................................... Permission Is hereby granted to; ...................�.'��°"�1r ......'................................... �. . ..�� ................ .................. e........................................................... ,ter . Cuff to . �r .......... . ............./` ...........''��................................... ....... ........ ... .... . Q fl...........j/:- . ....... .......,....................... . ................................... �✓ i� - .........� 5..........� .....� �....... .... �................ ...... .......... ........ �� ........ ... ........I........ .................. .................................................. at premises located at................... ... .�1!'� ......•!,!!'!�G! ......AV.............................. ................................................................................................................................................................ County Tax Map No. 1000 Section ....... ......... Block......�............ Lot No. .......��........ pursuant to application dated ...... ......../.(............ . 19.. . t., and approved by the Building Inspector. Fee$....1.. ........ ............... ...... ... ....................... Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD D i ; BUILDING DEPARTMENT ' !} 1� ,1 APR I 1 1996 NJ 1 �:� ✓�. TOWN HALL �1� ;=4 p'LL2 765-1802 a E BLDG.DEPT. K' APPLICATION FOR CERTIFICATE OF OCCUPANCY T0WN,0PS0JJTHO.LD jtt ,�,, A. This application must be filled in by typewriter OR ink and submitted ilding 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. 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. 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�$15.00, Commercial $15.00 Date . . . . .I f.�:3.�5( _. _. . . . . . Vew Construction. . . . . .. ... . . Old � 4-8 Or re_-e.x.istin.gBu:i.l.d g. . . . . . . . . . . . . . . ocation of Property. . . . .a �i.:1C Voa.8. . . . . . . . . . . . . . . _ ,��,.. . . House No.1* Street Hamlet Dower or Owners of Property.. . .�i:s . . .� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . bounty Tax Map No 1000, Section. . . . . . . . . .Block. . .,�. . . . ... . . . . . .Lot. . . (F. ... . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot... . . . . . . . .. . . . . . . . . . . . "ermit No. . . . . . . . . . . . . . . .Date Of Permit. . .. . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3ealth Dept. Approval. . . . . . . . . .. . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . Manning Board Approval. .. . . . . . . . . . . . . . . . . . . . . . _equest for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . ;ee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . �a�c3-1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . APPLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 8@59609 BUREAU OF ELECTRICITY F 85 JOHN STREET. NEW YORK. NEW YORK 10038 Date APRIL 16,1996 ,application No.on file 11471896 f 96 H 049589 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 LOIS L. DUNNE, 2175 PINE NECK ROAD, SOUTHOLD, N.Y. in the following location; ❑ Basement ❑ lst FL 1i❑ 2nd Fl. CAR/OUT Section Block Lot was examined on APRIL 11,1996 and found to be in compliance 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. I K.W. AMT. I K.W. AMT. K.W. AMT. 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 T. WATTS SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP. TYPE METER 1,,2W 1,9 3W 3 0 3W 3.0'4W NO.OF CC.COND. A.W.G. NO.OF HIAEG A.W.G. NO.OF NEUTRALS A.W.G. EQUIP. PER 0 OF CC.COND. OF HI-LEG OF NEUTRAL OTHER APPARATUS: SMOKE DETECTOR-4 *NO VISUAL DEFECTS: "An electrical survey has been made of the exposed electrical etjuipmentr in the premises indicated. " "No obvious unsatisfactory condition was found. LOIS L. DUNNE 2175 PINE NECK ROAD GENERAL MANAGER SOUTHOLD, NY, 11971 Per 't This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by the credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. V G A Town Hall, 53095 Main Road x 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. �� C Owner: �.O (S , X)TA hh(2-" (please print) Plumber: (pleas 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 day of ��NP 19q Notary Public, l C,ounty � c v" ELIZABETH ANN NEVILLE Notary Public,State of Rvvvv York No, 52-8125850,Suffolk CoUlItY Terni Expires October 311119 . o�oSUFFot,�coG o� yc ca = Town Hall, 53095 Main Road p • 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 May 14 , 1996 Ms . Lois Dunne 2175 Pine Neck Road Southold, NY 11971 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. ' (Enclosed) No Underwriters Certificate on file. 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 # 23379-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. ' ot I It I:ro It.1 D I'I'.' ut III I."I I UN io N� FMIIIIIAT I Oil ........... ----- ---------- ---------------------------- --------------------- & P1.1111111lic .......... ------------------------- -- ------ -------- ----------------- .......... I WHILAT I Off III-'It y STATH, FlIfUtoy C 0 1)1 .......... F I IIAL - ------------------------ - ----------- ------------------------ ADD I T I OIIAI, ---------- ------------------------------------ ----------------- ............... \N�0 ............ L f ,%..��,� BOARD OF HEALTH . . . . . . . . . . . . . . . ' I'URti N0. I 3 SI?'i'S OF PLANS . . . . . . . . . . . . . . . TOWN OF SOUTHOLD S11RVIiy . . . . . . . . . . . . . . . . . . . . . . . . _ BUILDING 0RI'AR'1't11?N7' ClIFICR . . . . .•. . I. . . . . . . . . . . . . . . . . . r!%'•/}.� r' g`� I IIALL SfiP'1'LC FORM . . . . . . . . . . . . . . . . . . . SOUT1101.0, N.Y. 11971 Trl.: 765— 11102 NOTIFY: CALL. . . . . . . . . . . . . . . . . . . rvc.n;neol....._- y., 19.� J2 MAIL TO: . . . . . . . . • . . . . . . . . Approved....... L y 19. .� i'erllnil: No. J ............................ Disapproved a/c .................................. ....z Cl' . .............. .. ....... . ?.......... (lkni. •r rns,vecLnr) APPLiCAT1.0N FOR 111111-DING PERMIT BLDG.DEPT. Date. . �. . . . . . , 19!�. . G TOWN OF SOUTHOLD I-� INSTRUCTIONS n. 'Ibis oppi icatim must be culgifet:ely filled in by tylxaariter or in ink aml suIxid.tted to the Wilding Inspector with 7 sets of plans, acc:uraLe plot plan to scale. Fee according to schecklle. b. Plot plan slowing location of lot: and of Inildings on premises, relationship to adjoining premises or lxlblic streets or areas, acxi giving a detailed description of layout of property nest be drawn on the diagram which is lxnrt of this application. c. 'ihe work covered by this applicatia bury Ixvt be cumerxmed before issckmvice of iklilding Permit. d. lllxxn approval. of this application, live Wilding inspector will issue a Ikiilding Permit to the applicant. Such permit Mull be kept oar Clue premises available for inspection thr(xnghout the work. e. No Wilding Mall be occcapied or used in whole or in part for any lxnrlxise whatever until. a Certificate of. Occupancy shall. have been granted by the Ikuilding Inspector. API'Li(', im i5 trim311Y mx-'. to the Iknilding Department for the issumice of a iknildlng, Permit pursuant to the Wilding lave Ordinance of Live '1'ocar of: Southold, Suffolk Wint:y, New York, and other applicable laws, Ordirkances or Regulations, for the constniction of Imildings, additions or alterations, or for reimal or demolition, as Iverein described. 'Ibe applicant agree's to emply with all. npplicabl.e laws, ordinances, Wilding code, housing code, acxi rev; •'v " o admit autlorizecl inspectors on prouises and in Wilding for necessary inspections. (Signature.of. appli ant, or name, if a corlxn-ation) APRt „� ................................................... (Mailing address of. applicant) BLDG.DEPT. _ Tows of soUTHO 0 State wlnetiver alvp roan r, lessee, agent, ar(Iiit:ect, engineer, general contractor, electrician, plumber or Ixuilder. .................. o's .....:"_....b C.V)V►_ ......................................................... Nzine of saner of premises ... .. (as on the tax roll or latest deed) If ayvpl icant is a corporation, signature of duly aullorized officer.. ......................................................... (Nine alxl title of corporate officer) 1luilders License No. ......................... I'Imbers License tlo. ......................... I:lectric'tans license No. ..................... Other 'rrmle's License No. .................... 1. Location of: land cm which proposed work will be done. ....... ..:.................. &A .. .... ...................aI�S I j,ne �c�4.. o.Cc_4................... .�?.......................... ..... Raise Artier Street C llmilet Ccxmty Tax Map No. lO()O Section ....'!�......... Block ........J'..... Lot .....4( ....... 90Idivisioxn ...................................... Filed Map No. ............... Lot- ............... 2. Slate existing use and occulIancy of remises aril intendedg1s...e ariloccupancy of proposed constnnction: a. Existing use andoccupancy ..... 41.f_. 4VLA. `:.` '!. ........................................ UU lu. Intended nse nix] occupancy ..... ................................................................ 1. N•11ure of ►x)11t Ulleck t,Alldl apl►licuhle): Nutj Iklildinl; ..... .... . AMit'ion ...Y..... Alteration ...!!.. MI ............ Itaiuval ............. Daml itIoil ............ Other 1hPcl( ....................... ........ ... du (Description) 4. I:sl:i11w1ted Cost .../Q(�u`t>�Cl........... fee ....... .......................... ... .......... (to he paid on filing tl►ia application) 5. If AmI l inl;, otsiber of &,ell inl; units ............ 11n1Per of chael I ing units cx1 enci► floor ......1 ......... IfEnrol;e, otsiber of cars ......... ............................ . 6. If boahlesn, canllercial. or mixed oc:culxu►cy, specify nature alxl extent of, each type of use....................... 7. I)imennicr►s of existing alr►lctrrres, if any: Front................ hear Depth .. ............... Ikliglll' Umber of Stories ......... ...... ....... Uin►ensions of sine slnreture with idt-eradoos or .►(klil'ions: Front' ............... Itear ......... ...... Ik!plh . Ileiglll' ............... ..... Usiber of Sforien L.....,_ . Il. I)hPPenr•,ions of entire oew misLnx:ticxl: Fr(x►C Near Depth o� 1 :' ifs Ik!iI)w ...... Mnlx!r of Stories ....I..5.ko'fy....... pp : 9. Size of lot: IgonL .... ........... hear .. 10.0..... .... De1)11► ` Io O......._• , ! 10. Ib►fe of Purchase ....1.1 ........ M-xlr! of Former (h4per ...lti�WlC....`:.. �4i 1/e �- .. I. Y.(x►e or use district io r.A1icl1 premises are nituat'ed ..... . ........... 12. I)oea prolxwed coostro:Lion violate noy zrx►mng Im,.ordinaiwe or rel;ulilLion: ..a...(2................. 1:1. Wi l 1. lot he rel;rocled .....ho........... Will excess fill he re111nved Iran prEaa�iisses: YIaS U) Ill Mims of ()vier of prenlses ���1.5..�. ... Arklrens �7 q�CiV?G6...�. N►one tkrne of Architect ......1.7t1el.e...... ............. Acklress ... ...... ..................... 11►orx! No. .............. Nt.11e of Contractor .....9-4Q r2 G..................... Acklress ...............................I1►cP(►e No. .............., 15. is this properly within 300 feel' of a Lldal ►aet:laml? * YNS .......... 1X) ...kl/... *1F YIiS, S(llJllttxA 7C7Id[J 'llp)SI1 S Lti12lDI'1' 1fAY 111? ItC()I1I.ItIJ). PLOT DIAGIIAH Nwate clearly nlxl distinctly all hiliclini-,s, t,A►ether existing or proix►sed, mxl I ulient:e all set-back dls►ensions f-Mill property 1 roes. Give street rlrxl block raviber or descripLi(x► according to deed, tuxl Aims street nnnen n(xl irxlicofe ►A1elher inferior or corner lot. 4'1 4 UUNIli (N' t114 Y(MK, �1 f (XIINIY IF ... Sl%'L�� ..... •.•••• • 5 ..... ... . ....... ..beinl'. duly sw)rn, delxu;en E11x1 nays t.hal' he in the nppl ical►t (Mmu of imlivi(I(k11. signing cont:rueL) nlxlve n(rrcsl, Ik! ir: Ilu. ........................t L.. .................... ......................................... ((knlLraclor, ngeoL, corlxmiLe officer., el:(:.) of: unid (Aawr or ow1Klra, 111XI in duly authorized to Ix!rfonu or have IK!rfurllr!d 1.1►e bald wod( cnxl to ncdu! olxl bile Ihin npplicotiou; lhlrl: sill. nLatioPento confaimd in thin nppliral'ian are tale to (lie bent: of hin knowledge nlxl b6lief; r11K1 IIuU. die w(P11( will IPe perfornu!d to the sivaow!r set' forl.h iu [lie ❑pplicnt:icln l'ile(I Iherewilll. !)w(Prn to Ix!f Pa:; ..........i.l. .... . 19..`.2 U)tary ..... CLAIREL.GLEW . .. . .................................. Notary Public,State of NowYOrk� (Signature of Appl is aoO No.4879505 CIualifietid in Suffolk County Commission Expires December S,19 4 !{.. ,.I,.� t ,a. .. ,�.�j .li�' +r`L• ;.,'1; .F.:•z � ., ! � h Lam., ,).[/+,�� (�7L}' )1 +'� •V. ••,^�""-`�-r"^T-••".; •i t� ��1 :�-'�+�,G -____1 � � 'r+ ,�'f�4f•-�'C_y.t. -•:•'yr. 1'., W�.�;:- '�G.• �: dy,}. �•'. "-JWAUTHORIZ[D ALTERATION[OR ADDS r:•Rr .; •,!y '_j''••;,1Cy'.'i:{,•• ,`f:; •,;,i s, :.1s :�J+ 'r-'t •e`';, t' 1��,c'1':F:a i�:;l., 'r - +�(•�. Sr :[O TNIS SURVEY IS A VIOLATION Of' ' "-i't£• i�i:.r :i: 'i;, .t _ t . ':�•] 4 ,•1l'` t 1 '"i•- `•�� F."{t Y .:.,Q r>•u •1` .'', •ki' ,,;n ttr •� .r'. s.r ,:`'a,j•..J�• k'� •SlCTION 7109-OF THE NE ORK;STATiE• •A�a,fi] r 'i'i !C.r + i - r 'a i'� �r.•;1,L3 -f..�: •' Fn -S']1- s..{ .L'. ".,.� t•: >-+�r:.•; ;t."�.• •r .:,' .�(- e: ,r•, •r '��' .';, .r•; r'!K` "y, t,''?3. - ',�S]. , .�'* 1 ic-Q,' }r•;•; ''i ; rl. .M r ��. •.r: •Si d i:' .9 .1 'rp.�: 't'�✓<. H.'6r 1 1t .EDUCATION LAW... i' e)', 1f :tip :`5(5 ,� �• ,tt •t• :.1..:.1.5. ,, l'',. .a •r>.•r.:.IAA �, .Py "f ,1,;• •s, , ,;Rr _.Ls,•• .�'' COP.IES:OF THIS SURVEt,"' P`NOT'tsEwar•!Ir;';, +,�• rl�,`' '.{ - . j :yy,. l'i! -{J1.�' 'y1 - P, l':e`'9: "r-:'` ', t,S• {-• G� _ :r' 'l '`S'..'t;.�.}% ]. .t .; ;}y, •(`_ xt• •.r'. t THE LAND SURVEYO :S I ED SEA'C+OR':]a 'y a. '� ^�Ify',' • - Is' �`��-2• °r :4' _ ;r..}� �• s_" 't� +t' �.'ri.' EMBOSS D SFALi S LL�4Q�i• CON�IDEI{E3` a �, `a!- :4i`4.4- .'I•r $ 4e• '..' .:.G =�., _� € hn � ! _ �, 1'. ,h.. N•... • %4^ �r9.'. ,1t:'', •; a•I u (. - ,u..� •7� _ T 4� BE A VALUE?�4O R ID:T PYr( :Y'" ;a'';>,t ,�. 1{'r' .��; !.'yT�..i?•'•:Y:.i�r`.�� r` t 1.,�-�c.�,,:".L`�,:y�.r''- 'ry� , ..�•y 'C,• „' .r , Si��"r' •��1-f ,L t.,• - .. ti' 1` •'''�:,•;i. 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NOT RESPONSIBLE FOR C RTIFICTE OF OCCUPANCY DESIGN OR CONSTRUCTION ERROR _I f USED ,N WATER r Y5 T E1117 CANNOT EX �- /30 of 1% LEAD. .�: . � � �Gi ��'`Nve ��W� �� � �1z`— 6�` - --� —v----- � 'C N r. -� � �a f ... �_ . . _.. � .= . : . ; ... - _� . . � , . y� -�S _ ,� �. 1 f{. 1� �`� �`�'` �e 4'r- � —��,�, s.: ��D � r ,.