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Home My WebLink About26662-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27390 Date: 11/02/00 THIS CERTIFIES that the building ADDITION Location of Property: 915 PRIVATE RD #31 SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 77 Block 3 Lot 16 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 7, 2000 pursuant to which Building Permit No. 26662-Z dated JULY 21, 2000 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 ALICE J HUSSIE (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N-540153 10/20/00 PLUMBERS CERTIFICATION DATED N/A u or' ed Si nature 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) PERMIT NO. 26662 Z Date JULY 21, 2000 Permission As hereby granted to: ALICE J HUSSIE PO BOX 1491 SOUTHOLD,NY 11971 for CONSTRUCT ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. at premises located at 915 PRIVATE RD #31 SOUTHOLD County Tax Map No. 473889 Section 077 Block 0003 Lot No. 016 pursuant to application dated JULY 7, 2000 and approved by the Building Inspector. Fee $ 75.00 Author z Signature ORIGINAL Rev. 2/19/98 { Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL r-— -- -- r n F" 765-1802 a ` APPLICATION FOR.CERTIFICATE OF OCCUPANCY 1 A. This application must be filled in by typewriter OR ink and subm�ittM 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-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. 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 Buildiniz - $100.00 3. Copy of Certificate of Occupancy - .2_5*,n 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . `f/3 U. . .: . . . . . . . . . . . . . . . . . . . . r New Construction. . . . . . . . . . . Old Or Pre-exist g Buil i.ng. . Location of Property. . . . . . . . . . . . . . . . . . . . . . . .� . . . . . . . . . . . . . . . 4 . . . . . House No. Street Hamlet Onwer or Owners of Property. . . . . . . . .. j. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . ./. .� . . . . . .Block. . . . . 3. . . . . . . .Lot. . . . . .1.,(?. . . . . . . . . . . . . Subdivision. . . ..,... . . . . . . . . . . . . . . . . . . . . . . . .. .. . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. �:� .r�.'. . . .Date Of Permit. . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: 1 $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . co APP CANT THE NEW YORK BOARD OF FIRE UNDERWRITERS. PAGE 1 1001071 BUREAU OF ELECTRICITY F 40 FULTON STREET, NEW YORK, NY 10038 Date OCTOBER 20,2000 Ap,�lication No. on file 11027100100 N 540153 THIS CERTIFIES THAT . PERMIT NO. 26662 only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of ALICE HUSSIE, GOOSE GREEK LANE, SOUTHOLD, NY in the following location; ❑ Basement ® ist FL ❑ 2nd Fl. OUT Section Block915 Lot was examined on OCTOBER 16,20W and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS MCANMCEN4 FUIORESCENT I OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 2 6 2 2 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECPT. TIME CLOCKS SELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K.W. OIL N.P. GAS M.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS SERVICE DISCONNECT NO. S E R V I C E AMT. AMP. TYPE EQUIP. 1 0 2W 10 3W 3 0 3W 3 0 4W �'�PERR 0 Of CC.ECOND. A. . G.COND. NO.OF NI•lEG OFF NI G.AEG OF NNO.OF NEUTRALS A.W.G. EUTRAL OTHER APPARATUS: G.F.C.I:-2 G & S CONTRACTOR LIC.#578E L L BOX 215 ANN SOUTHOLD, NY, 11971 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-8UtCDTN- DEPARTMENT. 7HIS COPY OF CERTIFICATE MUST NOT 6E ALTERED IN ANY MANNER. Oro, �� yam► Town Hall,53095 Main Roadp 1 Fax(516)765-1823 P.O. Box 1179 y Z Telephone(516)765-1802 Southold,New York 11971-0959 %31-- BUILDING DEPARTMENT TOWN OF SOUTHOLD October 24, 2000 Alice J. Hussie P.O. Box 1491 Southold, NY 11971 RE : 915 Private Rd. #31, Southold. NOTE : Letter required regarding change of ridge. To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons : XX An application for Certificate of Occupancy is not on file . (Enclosed) XX No Underwriters Certificate on file. XX The check is (not on file . ) $25. 00 No Health Department Approval on file . No final inspection has been made . No Plumber Solder Certificate on file . (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 26662-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. M.lSOZ BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN ATION [ ] FRAMING FINAL [ ] FIREPLACE & CHIMNEY REMARKS: Ole ,DATE INSPECTO BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] F UNDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: 9,t-h lvlfllo fo%wig Q DATE I INSPECTO BuauiN6 DE". INSPECTION [ ] FOUN ATION IST [ ] RO PLBG. [ ] F NDATION 2ND [ SU ION RAMING [ ] FINAL " [ ] FIREPLA CHIMNEY REMAR A� O J ,DATE � INSPECTO X65-1802 BUILDING DEPT. INSPECTION [ j FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPL CHIMNEYR KS: m � DATE / INSPECTOR Nj M-1802 UILDING DEPT. NSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ J INSULATION I 1 FRAMING [ 1 FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS: rrc _tet G _tel �11� PAW&C 4r- 6100 r-6OYJ INSPECTOR FOUNDATION ( IST) 11 I1 i -- - ------------ u u i Tr--------II � FOUNDATION (2ND) u u ------------------_______ ITu u II II 11 II ------��--- ------ - --- ZO ROUGH FRAME & PLUMBING II II II it it 1!I It110, H INSULATION PER N. Y11 _ STATE ENERGY �--- CODE -- it a ,I FINAL ------------ ADDITIONAL ----------ADDITIONAL COMMENTS: ra J m H hj H O z a t !,ltGY CUUS CALCULATIONS (For Note-Electric heat) Design Criteria 6, 000 Degree'-Days O.A. 100 I .A. 70OF Zy 7`7 FOR: C� U.SS/ PER: /0e/,i/7 llA'1'EU: ,3 a � AREA DESIGN THEI MEL REMARKS SUBSYSTEM "U" RATING :xLeri.oi: Walls (Opaque) Z 7 3 D 7-7 + 2, 1 r__-- -- -- Glazing 2 u % 73 .3 2, - 13 Doors / 0 L10 Ceil.iuy/ltoof (Upaque) 2-1L V S SkyligliL-s _ t 1aor 2 Z U S 17oundaL-ion Walls Slab Insulation TOTAL Notes: Buildl.ny Envelope Systems Lo meet requirements of 7015. 2 11VAC Equipement to meet requirements of 7015 . 11 11VAC Systems to meet requirements of 7015 . x2 Duct SysLems to meet- requirements of 781.5. 1.3 VentiiaLions Systems to meeL requirements of 7015 . 19 Insulation of Pipiny Systems to meet requirements of 7U15. 15 Service Water Heating Systems & Equipment to meet requiremenL•s of '1015 . 7.1 l,lectri.cal & Lighting Systems & Equipment- to meet requirements of 7U1.5 . 31 To the best of my knowledge, OF nEw p belief, & professional y�a�NCE rGT9�. judyemenL- , these plans are in * y. compliance with the code . r w � t v� O 032254-1 � A9�FESS IO%k 0 V /D STATE OF NEW YORK ) ss: COUNTY OF SUFFOLK ) a" c.t PI ` ` �l being duly sworn, deposes and says: That derponent is over the age /of 18 years and resides at !2� x—f-/ i(Che- (srfeAporb. o That on the day of d'/`1 , 2000 deponent architect/engineer, licensed by the State of New York, hereby states that s/he accepts full responsibility for the accompanying plans compliance with the New York State Fire Prevention and Building Code (9 NYCRR); said plans pertain to property located at SCTM# 1000- '77 - 3- 14 t street address Architect/Engineer At of naw Sworn to before me this Gay of t" , 2000. '' r r EILEEN S.SANTORA NOTARY PUSUC,Stet*of Ntnv Yqy A 'j No.304916018 M`/(� � 03 1-1 Q**liii*d in Nw"co" �i��%(/// C*nnniri** tp � p Notaryu ilii/ Z cc: Applicant BOARD OF HEALTH . . . . . . f � 3 SETS OF PLANS . .` FORM NO. 1 SURVEY u'�+ 7 TOWN OF SOUTHOLD CHECK aft:• �4 { BUILDING DEPARTMENT SEPTIC FORM . . . . . . . . . . . . . L—�--- --J TOWN HALL 0!-DG. DE''T. SOUTHOLD N.Y. 11971 NOTIFY '�= T^ '% 3. Nature of work (check which applicable): New Building . . . . ... . . . . Addition . . .X. . . . . . Alteration . . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . . . . . . (Description) 4. Estimated Cost . . $12 ,9!0 0 .0 0. . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 5. If dwelling,number of dwelling units . . 1. . . . . . . . . . . . Number of dwelling units on each floor . . . . .1 . . . . . . . . . . If garage,number of cars . . . . . . . . . .N/A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . . . . . . . . . . 7. Dimensions of existing structures, if any: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number ofStories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . $. Dimensions of entire new construction: Front . . . .?0... . . . . . . . Rear . . ?P... . . . . . . . . . Depth . . •11.' Height . . . . . . . . . . . . . Number of Stories . . . .1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of lot: Front . . . . . . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase . . . . . . . .NIA. . . . . . . . . . . . . . . . . . Name of Former Owner . . . N/A. • . . . • • • • . . • . • • • • . • • • 11. Zone or use district in which premises are situated . . . Re s i d en t i a 1 12. Does proposed construction violate any zoning law, ordinance or regulation: . • •NO 13. Will lot be regraded . . . . . . . . . . . . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes No 14. Name of Owner of premises Alice Hussie . . • • Address . . . . . . . . . . . . . . . . . . .Phone No. .7Q5–. .3,544 Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . .. . . . . . . . . . . . . . .Phone No. . . . . . . . . . . . . 15. Is this property located within 300 feet of a tidal wetland? *Yes . . . . . No X. . *If yes, Southold Town Trustees Permit maybe required. PLOT AM Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensio&b from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. SEE SURVEY STATE OF NEW YOnv COUNTY OF . . . . . . S.S . . . . . . . . . . C L�. . :f .�.`�S It . . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. , ' Heisthe . . . . . . . . . . . . . . . . . Q?w w?!✓. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly 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 th er set forth in the application filed therewith. Sworn to before me this . . . . . . . . . . . l . .d f. ��G� . . . . .' Notary Public, . . . . . . . . . . . . . . . . County ROBERT 1.SCOTT C Notary Public,State N •York Qualified in Suffo (Signature of ap t) No.Ot SC472 Term Expires May 31, ?— _ --- • - J �rAr}.t ri.t Y,i .'b A q'��'!Yf�'.j•l�a J �•• �`v - .` rr. d _ r '� L • r nom• ,r`�+ r ! �l l ',v' r � "� - ': '� •,�_.�.! • �i:. ~ rt r•'! ,�. a• .� M_t e .� �\ {� • ' ,'r ° <: Afic J. Hussie P.O. Box-1491 9.35 Goose Creek.Lane . ..i. .1. y ..f.. ct•. Souihofd, NY 119.71: — see' dieefari l•� �.r•. .J '.. . r:...,, �' . . ��: .:_ — � --_,_ 1 N . -1Q 5 7Z'Z5'30~.e. "'�1 !$O.0 •wet/ r .' wood deck , . .••l�ENNEDY �' V�- '3. o�• W •--• , - - • - �r'r.. ,t=�-�__-__. --�f' -- -�'�----- p rc.a.w. 14-. 4CKJGQ. On tv -- - - _ �,. N.'7z•z5'3o~w. - 150.0 I' 1 u.o.w Mc DAvlO � r Davis (V«ca.fl-) --30 , BUILDING PERMIT REVIEW CHECK LIS"- --Applicant/ Date n Owners Name: �( .p,�.c.e1 Reviewed: " l �- Architect/ Date Engineer: \,16,V,rNnnc e._ f r Submitted: 7 d SCTM #: 6 District: 1,000 Section: Z Block: 3 Lot: Projectn Subdivision Location: QI S Mne _ ��Q 1 YL I/d L _ Name: z— Single & separate Requir certification: (Yes No Req Rey. Zoning District: ILot size. Actual: J ILot coverage Proposed: I Req Req. Req. [Front Yard Proposed: ] [Side Yard Proposed: J [Rear Yard Proposed: J Project Description: AGENCY PERMITS Permit REQUIRED FOR REVIEW N.A. NO YES Number Suffolk County Health Dept. y New York State D. E. C. Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation ??? Flood Zone: to • �3• s-� fc.,:�:E'n"t",•sN:m'x^ry �r^ _ MI -w e,^^. „ i...m ,'.?,p. ]� t^ �T" •mem^ �t"�?'T T.. ri. +m.'Ri..,'1!'.^-®h'?tzi!v::?hi :mo ^vaTrn^ 1-1..-.=• 'n+^cr.., = 1'e4,T:Tti"?°" -..ro�..v , '?AG.,iT, „M,� ,., """ ,,.p} "M ,. - 9✓'G .y, . .i"`R'�'"d" ., �rl., a " :3,, vi '1,: i Z ,' v,�y! _ u' �-m,J' 4s, ,F^ ,Ln . _.: �`•:, vs, -_: - 1 t . t ; / �{"; ,. . ' . ,'' t ,f:e .9 ��y,J'.;'- •* r* '- �-+'+ I ''.1 fir,.... v vl;{ ; � "�' .`d, t '_ ;. . ; .: :>1 -::: ,.� - -::,.-� _ +. It s r : DO NOT:PROCEED WITH APP as xoiEo PRRMING INTI6SURVEY ' ��mhDE . Ilk FIR bAYE: %Tea. BA OF'F.QUNDRTION LOCATION .RATED SEP TO a Pee — -- HAS BEEN APPROVED. PART _ ,--,`NOTIFY BUILDING '. PARTM N aOF TE'BUI'LDIxG I = " 765-1002-8' AM TO 4 PM FOR THE - - ?"FOLLOWING INSPECTIONS: - 3N '0 .t.. OUIRED _ _ - . TWO RE ' - T v . TION U NDA 83U FOR POURED CONCRETE' 31tl91311U3U$N3118M +t ROUGH -'FRAMING & PLUMBING'. (+(+1'1 p' p'^ '(+,. p - - - ; ty 4. IFINALATIO CATION M_ UST _ . OV1�11'FFiI�V I ' OIC .. , . _ x .'+ ? - BE COMPLETE FOR C.O. [ c WF ALL CONSTRUCTION SHALL. MEET USE IJ UNLAWFUL n' T�7 1 'T C ., . , THE REQUIREMENTS OF THE N.Y, .1�11TL1oUT CERTIFICATE - - STATE CONSTRUCTION & ENERGY 11V I(f�7 pn COEDS,SIGN OR ONSTRUONSIBILE CTIONERRORS. ' OF OCCOf11NCY °9 ry T r J ty 4 Yze r .,It i� q F4 r / r O1rr ,,kh o-e� o .. . � u :r7 44X3 x s, 1 4 t } F t l I a•- v� y:;t L(_� 7' / t 'r }" Ij k. l' r -, _ . 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