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HomeMy WebLinkAbout24676-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26804 Date: 11/29/99 THIS CERTIFIES that the building ADDITION Location of Property: 555 SMITH RD PECONIC (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 98 Block 4 Lot 6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 20, 1998 pursuant to which Building Permit No. 24676-Z dated FEBRUARY 13, 1998 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 SCREEN PORCH & DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to FRANCIS E & JOAN RAIA (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N-465126 09/15/98 PLUMBERS CERTIFICATION DATED N/A Bui ding Inspector Rev. 1/81 i,'o j: ll iJ c. V TOWN OF SOU'THOLD { 'BUILDING DEPARTMENT `'' ` �i Q l t . TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF. 000UPANCY A This application must be:•filled in by' typewriter-OR .ink and 'submitted ;ao:,the'building r inspecto.r, 'with ahe following: for new building or riew` use: .1. Final survey of. property with accurate location of all 'buildings,``p`roperty lines, streets,, and unusual natural or topographic features. 2, Final Approval from.Health Dept. of water supply and sewerage7disposal(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 applican•t.. . 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 Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. . Updated Certificate of .Occupancy --$50.00 5. Temporary Certificate of Occupancy - Residential $1-5.00, Commercial $15.00 Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New'Construction. . . . . . . . . . Old Or Pre-exist' Building. . : . . Location of Property. . . S .. . . . . . . . . . . . . . . . . . . .: �. .� . . . . . . . . . . . . .L�l�v 1C-" . . . . . . . . . House No. - Street Hamlet Onwer or Owners of Property, . .rZ . . .. . . .. , , a. , ,. .. .. . . . .�.. !. . . . . . . . . . . • . • . . • ,/. . . . . . County Tax .Map No 1000, Section. . . 1. . . . . . . .Block. . . . . . . . .1. . . . . . .Lot. . . . . . . . . . r� , J I ry Subdivision. . . • . . .2GL:. .. . .ZaL-. . . . .Filed �. . . .Lot. . . . . . .�.1�. . . . . . . . . i Permit No. . . .. . . `(). .. . . . .Date Of Permit. . . . .. ) :/ . ,Applicant. U� nit';; ..�;�7 . 'FLY- c3 u� vJ Health Dept. Approval, . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . Request for: Temporary Certificate. . . . . . . . . ��in erticate./ Fee Submitted: $, �� , , , , , , , , , , , , , , , , , , , , . . . . .. . 7�� I APPLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1001093 BUREAU OF ELECTRICITY F 40 FULTON STREET, NEW YORK, NY 10038 Date SEPTE11BER 15,1998 Application No. on file 15975198/98 N 465126 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of DR. & MRS RATS, 555 SMITH ROAD, PECONTE, NY in the following location• ❑ Basement © Ist Fl. ❑ 2nd Fl. OUT Section Block Lot was examined on Sf TEMBER 10,1998 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT1 FLUORESCENT OTHER AMT. K.W. AMT. I K.W. AMT. K.W. AMT. K.W. AMT. H.P. 1 2 1 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 I C E METER NO.OF CC CO ND. A.W.G. A.W.G. A.W.G. AMT. AMP. TYPE EQUIP. 1 0 2W 1 0 3W 3 0 3W 3 0 4W PER 0 OF CC.COND. NO.OF HI-LEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL OTHER APPARATUS: SCREEN PORCH-1 PADDLE FAN-1 G.F.C.I:-1 DOROSKI ELEC. INC. LIC.#2991--E - ( L L 425 MONSELL LANE CUTCHOGUE, NY, 11935 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. ,;747o' 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 7ST [ ] ROUGH PLBG. [ ] FgUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: Z- �L DATE ` 1-2-zlfe INSPECTOR ��� Y�q 7 70-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION 1 FRAMING [ INAL [ ] FIREPLACE & CHIMNEY REMARKS: _ `� r,1q DATE INSPECTOR ,U l� ::TEED I;:S1'ECiI0i: JJllkTn COMMENTS - H FOUNDATION ( 1st ) FOUNDATION ( 2nd ) 2 . d� U� ROUGH FRAME & U -PLUMBING L%y��'`• c y 3 . � Ii1SULATI0A7 PER N . Y. STATE ENERGY CODE 4 . FINAL z ADDITIONAL COMMENTS : x - a x H H S - O z t� • r y CJ . IV H -PGW fAl� (ata6 utaO t 4e e — Yli qq l 11 (/ny . 6 ' p;. Environment East, Inc. 2885 Indian Neck Lane P.O.Box 190 Peconic,New York 11958-0190 516-734-7474 Fax:516-734-5812 7 \VV/ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT f EI�I TOWN HALL JAN Z SOUTHOLD, N.Y. 11971 TEL.: 765.1802GL; : � w=� Examined . . . . . . 1r0. . . 1 l.� LTOWN OFSc i';TIOLD Received . . . . . . . . . . . ..19 . . . Approved G�!. . ., 19 . . . Permit No. . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .)4oG / uil ing Inspector) APPLICATIO FOR BUILDING PERMIT ,! Date v.' 3. .�.`. . . . . . . .. 19 . t p�!> r INSTRUCTIONS a. 'This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plalia, 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 dfawn 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 sliall 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 IIEREBY 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 constriction of builduigs, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, ]rousing code, and regulations, and to admit authorized inspectors on preniises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) �.C) - Bo-..-- 1'1O PECoN� N�. . . .. . . . . . . . . . . . . . . . . , (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of pre►nises . . . �UClS . . . �bl�I� . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . .. (as on the tax roll or latest deed) I applica is c po do i attire of duly authorized officer. _ . . . . . . . . . . . . . acne and title of corporate officer) Builder's License No. `. .5 .. . . . . . . . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . :l Electrician's License No. t f. Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . . . . . . . . . . : . .{. . �_ . . . . . . . . . . . . . . . ti �: ... ._.. . .•.� . . ..._.�. .� . _ .. . . . . . . .. . . . . . . . . . . . .. Ilouse Number Street Hamlet '�l. . ,. on . . . . . ,r� �. . . . . . . . Block . . . . . . . . . . . . Lot . , , , , • .County Tax Map No. 1000 Secti Subdivision . . . . . n ZRk A. . .N tE�CK—. . . K-t—' . Filed Map No. 5.5.�. . . . . . . . Lot . . �' r. . . . 2. State existing use and occupancy of premises and intended use and occupancy/of proposed construction: a. Existing use and occupancy . . . .L��. . . Jt1 ( :; f . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . . 1. ��Y�l ((J,2�s,1•.t .&•.^ , : . :`�. f�Qi'l; �O ;v , Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . . . . . . . . . Alteration . . . c . Repair . . . . . . . . . . . . . . Removal . . . . . , . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . E .�. SCP , (Description) P Estimated Cost . . . . . .�. __ . . . . . . . . •//. �. . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) If dwelling, number of dwelling units . . . . . . . . . . . Number of dwelling units on each floor . . . .j. . . . . . . . . . . . Ifgarage, number of cars . . . . ... . . . . . . . M.k . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... If business, commercial or mixed occupancy, specify natu>e and extent of each ty a of use . . . . . . . '. . . . . . . Dimensions oqf existing structures, if any: Front . .7 . . . . . . . hear . . �.��?.'. . . . . . Depth . . �e . . . . . . . . I-ieiglit ��(2l.�:���!. . Number of Stories . . .� ?,l. . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . $APn . . . . . . . . Rear . . . . . . . . . . . . . . ... Depth . . . . . . .SAME. . . . . . . . . IIeiglit . . . .�-5Ekfnt' . . . . . . . . . . . Number of Stories . . . .s5�'�C -.i. . . Dimensions of entire new construction: Front . . ..�� . . . . . . . Rear . . . `L�. . . . . . Depth . . .�. .. . .. . . . height ._ . ... . .i �:��. . . . Number of Stories . . .:. - _ j. S c21,G-P.l E ra ,Po�GC-� : . . . . . . . . , . . . Size of lot: Front . .Lt�o oo�t„ . . . . . . . . . . . . Rear . . . . . ....% . : Jt?O,.t* *` . . Depth ... .. . . . . . . . . . . . . . . . . . Dateof Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Zone or use district in which premises are situated . . . . .5::4Q : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Does proposed construction violate any zoning law, ordinance or regulation: . . . . . �.. . . . . . . . . . . . . . . . . . . . . . . . Will lot be regraded . . . . . . . . . . )\Jx?. . . . . . . . . . . . . . Will excess fill be removed from premises: Yes dame of Owner of premises i2 rs 49 . . t�` . . . . . Address ,5,55�m�Ttfi ft0; , , Phone No. /.] A-mlhitect Address . . . .Phone No. .�: . . .'unie of Contractor �IIiRQN�rt rV7 „F1(Sf;. �NG, Address f P ./.`c?. lP��o!��?�: -.Piioiie 1;;U.-.734-:�` PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from.., )erty lines. Give street and block number or description according to deed, and show street names and indicate whether rior or corner lot. ; r • ii. TE OF NEW Ye % S.S iNT OF . . . . . ( M'� . . . . . . . . . being duly sworn, deposes and says that lie is the applicant i (Name of individual signing contract) e named. Mlle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .+. . . . . . . . . .; (Contractor, ag nt, corporate officer, etc.) dd owner or owners, and is duly authorize - o per onn or have performed the said work and to make and fde'this 'cation; that all statements contained in this application are true to the best of his knowledge and belief;and that the ' will be performed in'the many r et forth in the application filed therewith. m to before me this y / . . . . . . . . . . . y of. <?°'aj . . . . . 19 ;ry Public, .��=?u':'. . : . . . . . . . . - . . . . County ROBERT 1.SCOTT)JR. Notary Public,State of Now York ' ' ' ' . ' ' ' ' ' ' Qualified in Suffolk County Ig re,of applicant) No.01 SC472 Teeth EM"s May 31y_ • 1 1 ' P 1 Z0'd IK01 TITLE NO. 72 S'^ 02361 & S lNQI. : NECK RUA _...__.-- ... �Q LOT 10 120.051 sir N S i3'QQ' 1r rof M!/A kd* o �1 _ r1 !sty. "N aEu�.. - m r 1 F,: Nam. P cc r— X. �1�. ;FoI;�cN 6 orlFti'( Cb .r.•txy ' ►� t �rt•C't o b I I} C • L.Q'r 14 ':`1Jtloulhor(Zed altdration or addil, to'ehIs survey is a vblolion of .:"p�Lic►kili�7"209 of fF►ra Now York,Store Educotiar, taw ! `�DlOs of this survey mop hot bparirg the land survbyo,'s inked or embossed•seat slxtll not be considered s4 be "lid copy. Gvarontees or cerri:iwtiom Odieated hproon sholl run on Il : p°ro0A m the curvafJ to 1Y to the Premed,and on his bahalf to 11,e flth cortrpony.sovemmentol e9ency and lending Instirurion listed 4n,oriel to 16 aulo"":01.-Ihi 164ding institution, Gus;csr4!.eedilic�atiom aro not. ►maifiac�vblrr onal n ;►o oddi►i tsl ons or r n, I titlbsaqujgf pWneiluryna SURVEY FOR '` • �• --, ` REFERENCE: FRANCIS a JOAN:,: �?A!1'� . 1NDIAN NECK PARK— MAP NO. 531, FILED MAY 27, 1913 AT PECONIC TOWN OF SOUTHOL D 6!lARANTEED TOs SUFFOLK COUNTY, N.Y. ! ��'; �.�''>• 'CHICAGO TITLE MSURANCE COMPANY SAVINGS & LOAN ASSOCIATION OF RICHMOND HILL SCALE r I"� 30' =°i ' ` . �`' F'RANCIS & JOAN RAIA ti. �:; r. JUKE 2, 1972 _ , JUKE 13,19 7'2 - " � _• :- & > LAND SURVEYOR ft1%1P"j?f=A►1 ru V Tat Inn WU MAY ad 4e Environment East, Inc. 2885 Indian Neck Lane T P.O.Box 190 Peconic,New York 11958-0190 516-734-7474 - - Fax:516-734-5812 00 P,44L- t 7 f , y . , Pfw yb T`(�F , • b — _ . t SC tip wr f \ i � VwT, ,,rJs" e 4 ,1 i� �1uN' .i. ` . 5 t tq Ov A vim} c K Dy} r y'�LLTe a\ h _. ' - - V �1♦ '' "-wr�.w+r. 5'.Lz 3+�. �:5." y..,,i +�._4,:...! z;Z:E a iMIMY�JwJJ•wlr u1n1•.-' + - • 4MIM w•1' _ Moowiw J J i. y.� �,�* F ��\'�l` V fs'(A'�"'�.i � 4-^�.�n��^"".i� F 4'�^r, 1b•�1'T^1 Tw�'f„ 41 . .� Its t2 . 097 APP RA • SCALE: BY: -. 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' v , �. �.,. ti.,.r_.,.�..._u.._ -,s . :., ,. „_.._-.._. x,xlwar,.,.,,..,..e..-.tet_�.:. ," y.. ,'�'_ „.. -:.,. ,,.,, ..,�. _,_. „ ,. kms``' ^a:.',N_,,...�'�.•_N,,,..,_.._,�.x.•_., < . , a „�_..�v, _.,k,.,,-.7 _ sa: __fir:- .,.,-._ ...,.,-�--'....._ �.,.,,___-...��_...,,,_��.�_.,.�w._.,,w�r..'4..u`�,_..3.+�"..�......ur,,.ry„rs_„��,..s.. :..,:_,c._l�,$.�.,.. __...,,e-,�#' vm�,_,'tr-�5 rw: .�,ri�. F a r• _ r ex2,8 i�lD6E T exi�'�', �. � © ' `+� ► .._., hit C N C:E 5 -- # "1't F Nrl r _ *t i2 , CLIfS Ty?, Ar 4 _ . . . .x0400C>eN 6r- W Su��T-tN 1514. R —141 t � C � �` '' ice'L.1NC� a l__4 • •Sw['i' . f !, --.—+ ,a.�-r ^ .....u.... «..,..-t+ '''j} ...f... -..iw,+Mni.rfe'} { 1 i fl_.k 4.e \ 1 G's t"+ e 7 CCA Ns COA "f .. t w 4 I I ► il " s:.+-t ' 6 A' t i t r �° F'C "! UNDERWRITERS CERTIFICATE REQUIRED OCCUPANCY OR USE IS UNLAWFUL r. WITHOUT CERTIFICATE, - OF OCCUPANCY N AM 1M i !M !M M.. , FOUVAUS PON 2. Mow 3. INSUL,�ON 4 _BE COMMfTE FOR C�O� MUiT �► : ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. r STATE CONSTRUCTION t ENERGY CODES. NOT RESPONSIBLE FOR I S DESIGN OR _ON ERRORS rol ,...rte. -•�= , t� C-TUfke Res<mLv 1 P c,r�.•.t t ."': _150 AMP RA $CAL.-g: �� 't t� r �tr �,�� tflliK�IP� Af TA } I At40A - - _