HomeMy WebLinkAbout12628-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hale
Southold, N.Y.
Certificate Of Occupancy
No. z. 148.~1 Date A..ugust .2.9 19 .86.
THIS CERTIFIES that the building One family dwelling. .
Location of Prop ty 6.9.5 V..I.L.L.3:.G..E .L.~.~.E ' ORIENT
· 't~ouse glo. Street ..... Ham/em
.2.o.
County Tax Map No. 1000 Section . 0.2 5 ..... Block 2 .... Lot
Subdivision --- Filed Map No ~-.~'~ Lot No ---
conforms substantially to the Application for Building Permit heretofore filed in this office dated
.... .A.u.g :. ........ 16 .... , 19 .83. pursuant to which Building Permit No .................... 1.26,2.87.
dated .....S?.P.L.....................' 22 19 .83.. , 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 .........
One family dwelling.
The certificate is issued to CAROL .& .W. ILLI..AM GILLOOLY
(ownery-Jt~}JX
of the aforesaid building.
Suffolk County Department of Health Approval ... 13-SO-127 Au . . ....
.................... ,. A9.8..q
~endiAq ACgr ~l 1986
UNDERWRITERS CERTIFICATE NO ......................................
UNDERWRITERS CERTIFICATE NO. Service only N633459
Building Inspector
Rev. !/81
lrO~ NO. ~
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N. Y.
BUILDING PERMIT
(THIS pERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
12628 Z
Date ....... ~.. ...................................... , ...
Permission is hereby granted to:
.... .~.~ ............. ~~..~. ..................
.~~,.....~..:~., ........ 1.)..~..~.~ .........
,o ..~.....~.....~.~.....~.¢.~~.~~.~_~__ .........
~ ....... ~ ~w~...¢-.~ ...... :.~,.....~.....:.~ ..... ~ ...... ~.~.~ ..............
at promi*~ ~m~t,a ot ...~.....~ ......... ~~ ......... ~.~ ..........~~.~ ................
County Tax Map No. 1000 Section ....... ..~...~..., Black ........,.'~. ......... Lot No ........... ~.!~.~....~...0, ! ~
pursuant to application dated ..................... .~. .............. , 19.~....0.-.~, and approved by the
Building Inspector.
Building Inspector
Rev. 6/30/80
__ TOWa~..~ ~,~,~
APPLICATION FOR CERTIFICATE OF OCCUPANCY
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
~=uthoid, N.Y. 11971
Instructions
in duplicate ~,
A. This application must be filled in typewriter OR ink, and submitted <, ,V,,. :l:o' zhe Budding Inspec-
tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal--(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercia~ buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of p~operty showing all property lines, streets, buildings and unusuat natural or
topographic featu res.
2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees:
1. Certificate of occupancy $5.00
2, Certificate of occupancy on pre-existing dwelling
3. Copy of certificate of occupancy $1.00
4oVacant Land C.O. $5.00
$15.oo /5
Date ../.,../..... ..............
New Building · i.~ ~' Old or Pre-existing Building Vacant Land
Location of Property .~.~...~. ·
House No. Street Ham/et
Owner or Owners of Property . .~'.../~-~.../"?, .~.f.~.. ,f~,.,.. ,~. · ,/'~- · ?, -~,~- ..........................
County Tax Map No. 1000 Section 0~-~'~ Block ~ Lot ~'./.K .......
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No./.~.~..~. ,~.. Date of Permit c~/.~.~/, .ff~...Applicant .~.t'.o.I..~.. ~..i\/.~.0~/~. g~l iiX;il.X/ ....
Health Dept. Approval...1.~..~..~ff2 .--..~.~...'~..,. Labor Dept. Approval ........................
-
Underwriters Approval .................. Planning Board Approval .................
Request for Temporary Certificate ..................... Final Certificate .~.' ..................
Construction on above described building a/~!
Applicant .%c~..
~r, ' d nd regulations.
1000708 THE NEW YORK BOARD OF FIRE UNDERWRITERS
DS BUREAU OF ELECTRICITY
~- 85 JOHN STREET, NEW YORK, NEW YORK 10038
Bill Giltooly, 600 Village La., Orient,
in the/ollowing Iocatiod; ~ Basement ~ 1st FA ~ 2nd FI. Section Block Lot
was exatr~ined on ' ~ eb ruar y 6, ~ 98~ artd found to be in cotnpliance with the require.,ents of tkis Board.
FIXTURE
OUTLETS
RECEPTACLES
FIXTURES RANGES COOKING DECKS OVENS EXHAUST FANS
DRYERS
FURNACE MOTORS
FUTURE APPLIANCE FEEDERS
TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
NO. OF FEET
SERVICE DISCONNECT
OTHER APPARATUS:
S E
R
AWG,
OF CC COND
210
V I C
NO OF HI-LEG
AWG,
OF HI-LEG
NO, OF NEUTRAU
OF NEUTRAL
2/o
Servic9 Only,,
Sal Prato ' Electrician
Wiggins Lane
Greenport~ N.Y., 11944
LIC.#1049
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified
~ DEPARTMEI MANNER.
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECrOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
August 20, 1986
Mr. William Gillooly
605 Village Lane
Orient, N.Y. 11957
Dear Bill:
RE: 'Certificate of Occupancy
This is to confirm our conversation of Aug.
18, 1986 regarding the issuance of a Certificate
of"Occupancy for B.P. #12628Z.
Upon receipt of ~the Underwriters Certificate
for this dwelling we will issue the C.O. This
certificate is necessary for our office to com-
plete your application. Thank you.
Yours truly,
Secretary
cc. Francis J. Murphy
FIELD INSPECTION
1.
FOUNDATION (~st)
FOUNDATION (2nd)
2.
COMMENTS
ROUGH FRAME &
PLUMBING
INSULATION PER
STATE ENERGY
C~ODE
FINAL
ADDITIONAL COMMENTS:
'i
FORM NO. 3
TOWN O?SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
File No ................................
To ~.m~ .~....~..~../~/.2~ .......
..~.~..~..Z~? ......................
...~..~e.~.7,..6/..~..././. ~.~.'z...
PLEASE TAKE NOTICE that your application dated .... ~.~.~;~...../.~. .... , 19~..~..
for p=it to const~ct .... O~.e...~..~.~,~ W~...~;~ 7 ............... ~..~
LocationofProperty &~ ~[/~e' ~ . - ~/C/~
Hou~o. '7' ......... }~/e;[ .................... k;~/e~
County Tax Map No. 10o0 section .~5.- ...... Block .... ~ ~ ..... Lot~: ~( .....
Subdivision ................. Filed Map No ................. Lot No. ~ -
is returned herewith and disapproved on the following grounds . ~,~77.. ~.~.... ¢? .~:. '.
. ...... r. . . .w ...... . . :. . .2 ...........
Building Inspector
RV 1/80
P D
HENRY E. RAYNOR, Jr., Chairman
JAMES WALL
BENNETT ORLOWSK[, Jr,
GEORGE R1TCHIE LATHAM, Jr.
WILLIAM F. MULLEN, Jr.
Southold, N.Y. 11971
September 16, 1983
TELEPHONE
765- 1938
Mr. William Schriever
Main Road
Orient, New York 11957
Dear Mr. Schriever:
The following action was taken by the Southold Town
Planning Board, Friday, September 9, 1983.
RESOLVED that the Southold Town Planning Board approve
a set-off (106-13) as designated on the map of William and
Richard Gillooly, dated September 1, 1983, located at Orient,
with a condition that covenants and restrictions be filed
stating no further subdivision will be made on the one-acre
business property in the future.
Please forward two (2) copies of the above mentioned
map and a copy of the covenants and restrictions to our
office. Thank you.
Very truly yours,
HENRY E. RAYNOR, JR., CHAIRMAN
SOUTHOLD TOWN PLANNING BOARD
cc: William Gillooly~
By Susan E. Long, Secretary
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[~"~UNDATION :)ND [ ] INSULATION
[ ] FRAMING
REMARKS:
FINAL
765-1802
BUILDING DEPT.
INSPECTION,
[ ] FOUNDATION 1ST [ ] R~OuGH pLBG.
/
[ ] FOUNDATION ZND [z'j/INsULATioN
[ ] FRAMING
FINAL
DATE ,~ ~2Y , INSPECTOR
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P,O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
November 7, 1985
To Whom This May Concern,
We are unable to complete your Certificate
of Occupancy because ,of the following reasons.
/Z/ An application for Certificate of Occupancy
is no% on file.
/.--/ No Underwriters Certificate on file.
~--_~ The check is(outdated~not on file o)
/Ky/ No Health Depto Approval on file.
/--/ No final inspection has been made.
Please con~act our office on this matter°
Thank you for your cooperation°
Building Permit #L~67~ Z
Sept. 22, ~953 (expired)
Building Dept.
***/~/ No Plumber Solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined .... '.~. ~"~..~. ?-.., 19
Approved .... ~...~..~.., 19~.~.. Permit No./.~.Q .~.~...~.
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
sets 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, ~s herein described.
The applicant agrees to comply with all applicable laws, ordinances, building codj~o~sin~g codff,/9~regulations, and to
admit authorized inspectors on premises and in building for necessary inspections~/~/~--
(Signature of apse, if a~poration)
.....
(Mailing address of a~0plicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name or owner o f premises . .O/..~..//f?gl..../~../~../~'C[ .f//~O~.. .... ¢.< ¢.m~.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 ..........................
Plumber's License No .........................
Electrician's License No ...................
Other Trade's License No ......................
I. Location of land on which proposed work will be done ................................................ I '
o ..................... ................ . '
l~;~e' ~q~;~ ~ir ........................ ~ir;;~ ' Hamlet
County Tax Map No. 1000 Section t~.~ '. Block ~ ~ J
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ........ : ...................... : ....................................
b. Intended use and occupancy ...g .~;./.D..~./.' .C~.. .... .O..~. .......................................
3. Nature of work (check which applicabl,e): New Building . ..~. ...... Addition .......... Alteration ..........
Repair .............. Removal .............. Demolition .............. Other Work ...............
(Description)
4. Estimated Cost ..................................... Fee ......................................
(to be paid on filing this application)
5. If dwelling, number of dwelling units .../ ........... Number of dwelling units on each floor.//e~s ...........
If garage, number of cars ...........................................................
6. If business, commercial or mixed occfipancy, ;pecify n;t~re and' extent of eac~ type'oi~se iii ~.' .' ./f.' .ff~.'
7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ...............
Height ............... Number of Stories ...... ' ..................................................
Dimensions of same structure with alterations or additions: Front ................. Rear ..................
Depth ...................... Height ...................... Number of Stories ......................
8. Dimensions of entire new construction: Front ...~.9 ..... , ..... Rear . .~O .......... Depth ...~.. .........
Height .. ~.~.~. ~ ........ Number of Stories .77'..aa.Q ..................................................
9. Size of lot: Front '~'~:~'fi~ 7~.' .... Rear ...................... Depth ......................
10. Date of Purchase .~.'~) ......................... Name of Former Owner .b-~.~d...~..c./.~t.r4/~L~,~ ..........
I 1. Zone or use district in which premises are situated.. ~P~lr?tgt,~......... ...................................... .
12. Does proposed constructio, n~v~olate any zoning law, ordinance or regulation: .... ~.O.
13. Will lot be regraded ........ ~ ' .................... Will exc~ess fill be removed from premises: Yes
14. Name of Owner ofpremises~.(.6.Q..t4'2Ct...~..~.(.t~..v~.. Address {:~ff.t.,?~..~.t, ff,.~.~.. Phone No~. ~73.{..-e~..
Name of Architect .~,/~...~. _7~..o..r~. ~ Address /.~j .'~t~ .... phnna NM ........
Name ofContractor~.0.'/3/ S.'.~.~ ........ Address" .. ~.'.ff(' 't~,z~,~e'~ 'p['~,~2 ~,'~':.,~Z;~" '
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 YQRK.., 'o ~
COUNTY OF .-~v..~/~i~'..,~. ....... '~1~
(Name of indivlda~l signing contract)/
above named. (
duly sworn, deposes and says that he is the applicant
He is the ................... ¢~. ,~c~ .-':r.,-Cdr~, .........................................................
(Contractor, agent, corporate officer; etc.)
of said owner or owners, and is duiy authorized to perform or have performed the said work and to make and file this
application; that all statements contained in this application are true to the best of his knowledge and belief; and that the
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this i
'
......... ../..~f~..7~...day of .... · ./~.~':, 19..~3 .