Loading...
HomeMy WebLinkAbout16572-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17792 Date FEBRUARY 23~ 1989 THIS CERTIFIES that the buildinq. Location of Property 100 PARK AVENUE House No. County Tax Map No. 1000 Section 123 subdivision ADDITION MATTITUCK, NEW YORK Street Hamlet Block 07 Lot 5.3 Filed Map No. Lot No. conforms subst~ntimlly to %he Application for Building Permit heretofore filed in this office dated OCTOBER 26, 1987 pursuant to which Building Permit No. 16572-Z dated OCTOBER 27~ 1987 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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to THOMAS & PATRICIA CAREY (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-025686-AUGUST 3~ 1988 PLUMBERS CERTIFICATION DATED NOV. 23, 1988-JA~ES H. MORAN Rev. 1/81 Building Inspector FOBM~ NO. Il TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CTHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Perr~ission is hereby granted to:/-) · I at premises located at .../.....r~..o.. ........... ~,....L~:~..: ........ .~.?...),..~.~ ............................... County Tax Mop No, 1000 Section ..... l...~...~ ....... Block ....,,~..,~ .......... Lot No....,.~..!...~ .......... pursuant to application dated .... ~...~.,.~.....,~...,,~, .............. , 19.~....~/.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y, 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m~ to the Building 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. Commercial 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 unusual natural or topographic featu res. 2.Sworn statement of owner or previous owner as to us~, 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: Additions $25.00 POOLS $25,00 ALTERATION $25.00 1. Cer~ificate of occupancy ~lling $25.00, Accessory ~$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0 3. Copy of certificate of occupancy $ 5.00, over 5 years $I0.00 4.Vacant Land C.O. $ 20.00 5.updated C.O. $ 50.00 Date .......................... New C OhS truc t i on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property Ownero, OwnersofProperty .......... County Tax Map No. 1000 Section /~'~ ~ Block ~ 2 Lot . .~'~"~. . . Subdivision ................................. Filed Map No ........... Lot No .............. Permit No.I .~. ~ 7 .~..;~. Date of Permit ./.~ .~. ~b~pplicant....~./~../.¥/~..~..~.~'~.?.~.~. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. ~ Applicant ..... '7~ f.~.-C. Z2q'%o../.-.~ ....................... Rev. 10-10-7B VICTOR LEggARD PRINCIPAL BUILDING INSPECTOR (516) 765-1802 FAX (516) 765-1823 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD January 27, 1989 Mr. Thomas Carey 100 Park Avenue Mattituck, New York 11952 Re: Building Permit ~16572-Z Tax Map ~1000-123-07-5.3 Dear Mr. Carey: During a review of our files, it was noted that the above building permit does not have a Certificate of Occupancy. According to the Code of the Town of Southold Article XIV, 100-141 and 100-144 a building permit is needed for construction of an addition to an existing dwelling. It is unlawful to occupy a dwelling until a Certificate of Occupancy has been issued. Your final inspection has been made and we have your application and check for the Certificate of Occupancy. Please have your plumber fill out the enclosed certification and submit it to this office. As soon as we receive it, we will issue your Certificate of Occupancy. In order to avoid any legal action you must correct this violation immediately. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. VRW:gar Vincent R. Wieczorek Ordinance Inspector TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permi% Owner (please/prin~) Plumber~ ~, ~/~/ (please p~int) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this ~,~ day of ~O~ Notary Public, (plumber' s signature) THOMAS J. CONTEGNU Nota~ Public, State of New York Ho. 4891871 Qualified in Suffolk County Ceramist;on Expires May 4, 1989 ) sS.: COt;;{T¥ OF SDF?OLK ) and say that I am licensed as a ~L~STER PLk?IBER in accordance with ~he Occupational. _ // : That the material and w~rk installed in conjunction with Building. Permit Number ./~1" issued by the T,~-n of -~rzzk*.naren Building Department for th'e structure 3. o~ated full compliance , State ®f New Y®rk, is in T~at this affidavit is made pursuant to the requirements of the Town'of Brookhaven ' Building Department In connect, ion with the issuance of a Certificate of Occupancy/ Compliance for this structure. Sworn to before me this day ' ,~e ~.'1'~ ~,C~- 19 ~.~. Print Name (Signature} THOMAS :l. CONTEGNr' ~0taW Public, State of New Yo~k ' No. 48~I~7! ~)ualified in Suffolk County [,~ommisaion Expires May 4, 198~1 THE NEW YORK BOARD OF FIRE UNDERWRITERS [000~,~ BUREAU OF ELECTRICITY ~ '~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date AUGUST 03,}988 ~4pplicaflon~/o. onfite 55373388/88 2~ 0255~6 THIS CERTIFIES THAT o~y the electrical equipment ~ ~scrlbed be~w a~ iflt~uced by t~ applic~t ~med on the a~ve application number in the prem~es of ?HO~AS CA~,~Y, END PARK AVE. ~ATTITUC~, N.Y, ~. ~.fo~o,~.~ h,~.t~o.: ~ ~.~..~ ~ ~.~t rL ~ ~d FL 3FL S~,~,,. ~ Lot t~s examlned ofl JULY 11,1988 attd found to be ln complionce u.lth the r~tulremcnlz qf thlz Board. . . ~(~UJp. - p~R.~ O~ CC. tOhD -O ~-O OF HI-[~ O.O NELl L$ OF NEUTRAl OTHER APPARATUS: G.F.C.I:-3 SMOKE DETECTOR:-! GLENN R. BRADLEY P.O. BOX 602 - LAUREL, NY, 1194~ GENEI~AL MANAGER LICENSE NO. 1227 Per_ C~ £/ This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by lheir credentials. t 765-180Z BUILDING DEPT. NSPECTION ! ! FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] IN.~.ATION FRAMING [,'~FINAL INSPECTOR TOWN OF SOUTHOLD OI:I'qCE OF BUILDING INSPECTOR P.O. BOX 728 T©WN HALL SOUTHOLD, N.Y. 11971 TEL. 765-I 802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of the foll~owing reasons. /--//An_ application for Certificate of Occupancy /is not on~ file. /--~/~/--~/N° Underwriters Certific~3~c~ on ~ /~/ No Health Dept. Approval on file. /--/ Nv final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Dui]ding Permit t, [ ~ ~ ~ ~ Z Building Dept. ***/~/No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] I.~,ATION FRAMING [,~INAL DATE ~?~/~/~/F INSPECTOR ?'iELD ±,,S.-.~.±OJ i~DATE COM~£NTS FOUNDATION ( 1 s t) FOUNDATION 2. ROUGH FRAME/ ,FLUMBING f2nd) INSULATION ?ER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: t'~4~P OF' L ~JD ' "/'OWN ~F ~oLr'r~'OLO . (~,'~ Z,,.55. t 765-1802 BUILDING DEl:ri., INSPECTION FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL INSPECTOR 765-1802 BUILDING DEPT. INSPECTION ] FOUNDATION 1ST [ ] ROUGH 'PLBG. ] FOUNDATION 2ND [,//]~SULATION [ ] FRAMING [ ] FINAL REMARKS: ~ DATE INSPECTOR 76S-1.802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 15T [ ]~ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [~FRAMING [ ] FINAL REMARKS: DATE -~--/~ S--///p~ INSpEcTOR THOMAS F. CAREY 646 PARKS1DE DRIVE JERICHO, NEW YORK 11753 TELEPHONE (516) 4,.'.'.'~-7596 BOARD OF HEALTH ...~. 3 SETS OF/~PLANS ....... oRM No. SORVE TOWN OF SOUTHOLD CHECK ~1 BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL TEL: 765-1802 CALL ........ MAlL TO: (Building Inspector) APPLICATION FOR BUILDING PER~IT Date ... ............... , INSTRUCTIONS a. This application must be completely filled in by Wpewriter 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 Buitding 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 re,~val or pe'~plition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building 96,j~e] housi, fig 9j~de, and regulations, and to admit authorized inspectors on premises and in building for necessary inspec,tio~.f/ ........ . . . . . . , :. :. : .' :.c . (Signafure of app. l~n~, .03 n~,~laS~_if a corporation) ....... z. . .h,. /. ................ (Mailing address/of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises '7~/~'~'~"'~T ~: /g~'"~*'5~'./.'r~ ~'~'~ ..................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) . ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. ...... / ................ House Nnmber Street Hamlet County Tax Map No. 1000 Section ... [~75 &~?'7c'/' Z Block ...Q 7/. ............ Lot...~.,..3 ............ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy...~..~./~.~..a~Z~..'......~...'~---~..~....~...cT'~...'...' ............................. b. Intended use and occupancy . .~..~/.//~..~.~... ~.~. · .~. · · .~. · . . . .~..~..~.~..~O.1 ...... 3. Nature of work (check which abplicable): New Building ..... ' ..... Addition ...'~. ...... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4.. Estimated Cost ........................ Fee ..................................... (to be paid on filing this application) 5. If dwelling, number of dwelling.i units ............... Number of dwelling units on each floor ................ If garage, number of cars .... i ..................................... . ............................. 6. If business, commercial or mixe, d occupancy, specify nature and extent of each type of'use .' .... ' .... ~ ......... 7. Dimensions of existing structures, if any: Front .... ¢...~..' ...... Rear ... ~.~..: ...... Depth...~..~. .......... Height .... lg..¢-f ....... Number' of Stories .... '.~'..: .....i .......... ~ '. ......'. 2 ......... / ............. Dimensions'of.sa~ne. stll~ctrrrR-Tith aRe, rations or additions: Front ....~..~. .. Rear .~.~. ....... ~-8. Dimensions of entire new const~ucti0n: Front .. ~.~/ .. Rear ~.qt .... Depth ./.~. ......... lteight 2. t e ..... ,If tn~b~r of Stories '~ ........... t ..... 9. Size of lot: Front .../.~...7'...(~.d ........ '. Rear .... /..~ff../... (.~,J ....... Depth /..~.~. ff.~ 10. Date of Purchase .......... I ................... Name of Former Owner ............................. 11. Zone or use district in which pr~mises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation' . ..... 13. Will lot be regraded . .~..<:~... ' ................... Wilt excess fill be removed from premises: Yes fp 14. Name of Owner o remises ..; ................. Address ................... Phone No ................ Name of Architect ......... ~ ................. Address ................... Phone No ................ Name of Contractor · · ' . Address .... : .............. Phone No. 15. Is this property locatediwithin 300 feet of a tidal wetland? *Yes ..... No ..... · If yes, Southold Town Trustees Permit maybe required. ~ PLOT DIAGRAM Locate 'clearly and distinctly all buildings, whether existing or proposed, and. indicate all sbt-back dimensions from property lines. Give street and blockl number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK - S ...7.~.d~. ~¢~¢T....¢:..~.~..~. '~/' .~../.'~..~'¢. · .'~. · · .~. ........ being duly sworn, deposes and says that he is the applicant (Name of individual sigOipg contract) above named. He is the..: ......................................................... (Contractor, agent, corporate officer etc.) of said owner or owners, and is dub, autlibrized to perform or have performed the said work and to make and file this application; that all statements contlained in this application are true to the best of his knowledge and belief; and that the work w/ll be performed in the manner set forth in the application filed therewith. Sworn to before me this Notary Public ........ ~. ~.,-'...~..~dd~..... County , ~_~ NOTARY PUBLIC, ~ate e New York , ' ' .7' ....... . .... ' _ No. 4707878, :~uffolt~ Count~ ~- r ~ ' / (Signature of apphcant) k, t-, lerm Expires M,rch E N ERGY CODE CALCOL/?i- ON5 ) PLEATING EQUIPMENT TO MEET 7813.23 - 75% EFF. .'-~EATiN,7 CONTROLS TO ME~ 7813.13 RANGE 45 TO 75 DEGREES FAHRENP~IT. ) WATER HEATING PER 7813.31 THRU .38. ) PIPE INSULATION 7813.19 0.17 0.58 o'zlo 0.03 O. oS ) WINDOWS - DOONL8 GLASS. )~CONSTRUCTION TO MEET N.Y.S. ~ERGY CODS. //~_ ~;~ I .............. fill' II1~I~' dl~lributlng , y --' .~r~,~-'- , 0 DER NOT USE IS UN~WFUL WITHOUT CERTIFICATE~ ' NOTIFY I~OILDING ~,EPARTMENT AT 78~-1~2 9. A~ TO ~ ~4 ~ THE II C