HomeMy WebLinkAbout26305-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27070 Date: 05/09/00
THIS CERTIFIES that the building ADDITION
Location of Property: 1140 LONGVIEW LA SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 88 Block 4 Lot 46
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 18, 2000 pursuant to which
Building Permit No. 26305-Z dated JANUARY 27, 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to EDWARD & MILDRED REILLY
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Authorized Si ature
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. 26305 Z Date JANUARY 27 , 2000
Permission is hereby granted to:
EDWARD F REILLY
ROSLYN HEIGHTS NY 11577
for
CONSTRUCTION OF A DECK ADDITION AS APPLIED FOR (MAINTAIN 35 FOOT
REAR YARD SETBACK)
at premises located at 1140 LONGVIEW LA SOUTHOLD
County Tax Map No. 473889 Section 088 Block 0004 Lot No. 046
pursuant to application dated JANUARY 18, 2000 and approved by the
Building Inspector.
Fee $ 75 . 00
Autho ed Signoture
ORIGINAL
Rev. 2/19/98
Form No. 6
Pj
TOWN OF SOUTHOLD
i , BUILDING DEPARTMENT
i
MAY TOWN HALL
._,.•,°y 765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR ink and submitted 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. a
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.
12. 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 Building - $100.00
3. Copy of Certificate of Occupancy - 25 ,
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15��.0yy0 Commercial $15.00
Date . . .y. !. 7. .. x.4 . . . . . . . . . . . . . . . . . . . . . .
New Construction. . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . .
4� /
Location of Property. .?! -.` . . . . . . . . .£.�?7 �!J.0-W. . �.�. . . . . . .U,gm. Y h � . . . . .-
House No. -- StreeL - Hamlet—
Onwer or Owners of Property. ? . GX.�.2 f .d . �. ( �e•� • • • • �J• •l �• • • • • • • • • • • • • • . . .
County Tax Map No 10000, Section. 015 . . . . . . .Block. .9.0 . . . . . . . . .Lot. . . /. . . . . . . . . . . . . . . . . .
Subdivision. . .�y. X a_V.fe.rl . . . . . . . . . . . . . . .Filed Map,�,.5 J. Q. .+ .Lot. . 6S. . . . . . . . . . . . . . .
Permit No .�il. O .ZDate Of Permit4-v .�."".V . .Applicant.tt:2t?!-.5e,. ��:!:? T•
Health Dept. Approval. . . . . . . . . . .. . . . . . . . . . . . .Underwriters Approval. . . . . .... . . . . . . . . . . . . . . .
Planning Board Approval. . . . . � . . . . . . . . . . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . .
Fee Submitted: .. . . . . . . . . . . . . . . .
04&.25*n^B 30 .•. .��'�. '`'�... . . . . . . . . . . . . . . . .
CO 20( 70 ?O APPLICANT
FIILD-INSPECTION-REPORT--_=DATE___==____ __________________COMMENTS
--- ii ro p
II H
tr—
FOUNDATION ( 1ST)
I
FOUNDATION (2ND) 11 it
—_---- ---- ----- -- --___
TW-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ INAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
� Con
DATE ct7 INSPECTOR
3o
765.1802
BUILDING DEPT.
/UNDATION
PEC7`ION
1ST [ ] ROUGH PLBG.
2ND [ ] INSULATION
[ ] FINAL
[ ] FIREPLACE A CHIMNEY
R A KS:
DATE INSPECTOR
gpFF01,tco
Town Hall,53095 Main Road O Fax(516)765-1823
P.O.Box 1179 W Telephone(516)765-1802
Southold,New York 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
April 24, 2000
George Terry
P.O. Box 41
Southold, NY 11971
RE: 1140 Longview Lane, Southold, Edward & Mildred Reilly
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)
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 # 26305-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REM KS: �
DATE INSPECTO
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ �INAL
[ ] FIREPLAC 8 CHIMNEY
REMARKS:
Ily
DATE INSPECTOR
BOARD OF HEALTH . . . . . . . . . . . . . . .
FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . ..
TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . .
TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . .
SOUTHOLD, N.Y. 11971
TEL: 765-1802 NOTIFY:
CALL . . . I . . . . . . . . . . . . . .
Examined :. ., 20.E r� MAIL TO: . . . . . . . . . . . . . . .
!'?.... a°cw> Permit No. oC��JO
Dia/c:. ........................... ............ ....................................
tor) �
JAR ` �G� APPLICATION FOR BUILDING PEIU4IT
Date. .lJ' C. . . . . .. . .. 20.V
INSTRUCTIONS
a. This I be completely filled in by typewriter or in ink and submitted to the Building Inspector wii
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 most be drawn on the diagram which is part of
this application.
c. The work covered by this application may not be cmmnced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue 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, as herein
described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and
regulations, and to admit authorized inspectors on.premises and in building for necessary inspections.
�.►.+.. .r .. .............
(Signature of applicant, or name, i corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee
/' agent, architect, engineer, general contractor, electrician, plumber or builder
!.1....e .............................................................................
y I /�
Name of owner of premises O&V i.! d 4 -M- h 1 A4 a '�..:1�:.k/
I.............................................
n the tax roll or latest deed)
(as o
If applicant is a corporation, signature of duly,authorized officer.
................1........................................
(Name and title of corporate officer) T
Builders License No. .�..�.g. ( .+ ......
Plumbers License No. .........................
Electricians License No. .....................
Other Trade's License No. ....................
1. Location,of,;land on
which proposed work will be done................:.............................................
.:y.Q.............S ....................... V ......................
House Number Street Hamlet
c�
County Tax Map No. 1000 Section ...�.`4�....... Block ...Q., ........ Lot ....z... -r ......'
Subdivision ............... Filed Map No. I ....... Lot .. !4: :W.
(Name) C
2. State existing use and occupancy of premise's and intended use and occupancy of proposed c stnuc.tion :
a. Existing use and occupancy .A t 15 1.f!r.n: .1:A1...... �..T,.Ct(n,1:
b. 1.
Intended use and occupancy ..!).? J. 17. 1.2.4................ ..�r,( l l!.Fon.......
n
j, rause u, WUEK hUWCK W101 qphtllcable): New Building .......... Acklition ,�.... Alteration...........
Repair ............ Removal ...I,......... Demolition ............ Other Work ..................................
(Description)
4. Estimated Cost .... ...... fee .......... ..... ..... ....
(to be paid on filing this application)
5. If dwelling, number of dwelling banns ... ........ Ikulher of dwelling units on each floor
................
If garage, numher of cars ....
6. If business, ccu ercial or mixed occupancy, specify nature and extent of each type of use.....................
' i n
7. Dimensionsexistingstructures, if any: Pront. ,-, .,:3...... Rear '-h�..�s.�..�...... Depth�.� i ./.
.. .........
..... ....,.,... Nhnber of Stories .....�........... .�., „ �•'•�
Dimer / �h alterations or additions: Front,T8 3 �• Rear�.:1,41..,,3 .
to �� ....... L .�.;1............... Nuhiher of Stories ...(...........
re
.. Ilei , „ / '
a. Diuensions of entire tnew�construction: Front ��,.4. ........ Ream u,.6...... Depth �1.�...�?....
7 i
11eig1ht ..L.................. Nudger of Stories ..................... �
9. Size of lot: Front ,8..� I',�.... r �.S�Q..4�...... Depth ..................
/v oa o
10. Date of Purchase ...............,...... Name of Former Owner .........It. Zone or use 1 +
district • which
hp 'emises are situated � �'.. /. en.!.1,a.�x.....................................
12. Does proposed cconstructiAonviolate any zoning law, ordinance or regulation: :..............
13.14. Will
lot regraded Owner of •... Will excess fill be removed from premises: YES O
.. .
Name
y^)1) yt,� ,
prem m./. !:�X .)\A Address .............................. Flone No. ..............
Nana of Architect ..... ..:... .......I Address ....I....11.1. Phone No. .
Nam of Contractor .`- .QJ-6;r .';n1,.J,¢.C.0 .. Address P)..d'ix.vy.119
15. Is this property within 300 feetl of a tidal wetland? * YES .......... NO X........
*IF YES, s00in" TOWN TRDSiFl.S PERMrr MAY BE RIjILRLJ).
I PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate set-back imen ions
from property linea. Give street and lblock ember or description according to deed, and Creet nems i icate
whether interior or corner lot. i 00
:37) a ahs<ocAJ P
w--7t N_41
,
opoae.L
New s��clC
4 h
,y Y.
Noy.56 CGne9Gc' BiA
a <1
0 dt Ilya t (Sunwte)
cove. s .y �jL2 � ISO. .
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he 'yAh�2]r
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SfA'lE OF NEW Y(AiIC, I ni T�R 1 p O
O(MlY OC I �'�, o .� T
SS I
I. onlGVILPrNe
........g .. . .............being duly sworn, deposes and says that he is the applicant
(Name of individual sr ni w contracC)
above named,
Ile is the . G.- w?,a n C!, 2
L. .......................................................
..............
(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 tlhe manner set forth in the application filed therewith.
Sworn to befQreje this
Li� .. 0
Notary Public ..�� ........, .
HELENS D.HORNS (Signature of Applicant)
Notary Public,State of New York
No.4951364
Qualified in Suffolk Count
,z
Commission Expires May�26c --
I r ,
SURVEY OF
LOT 65
MAP OF
TERRY WATERS _
FILE No. 2901 FILED DECEMBER 29, 1958
SITUATED AT
BAYVIEW
10 TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
L4 S.C. TAX No. 1000-88-04-46
SCALE 1" =20'
SEPTEMBER 8,1998
�N
NN
AREA = 15,000.00 sq. ft.
0.344 oc.
— — — _ i_
CERTIFIED TO:
FIDELITY NATIONAL TITLE INSURANCE COMPANY OF NEW YORK
NORTH FORK BANK
EDWARD F. REILLY
MILDRED A. REILLY
I
i
I
UNATHORRED ALTERATION OR ADDITION
TO THIS SURVEY IS A VIOLATION OF
SECTION 7209 OF THE NEW YORK STATE
EDUCATION LAW. j
COPIES OF THIS SURVEY MMP NOT BEARING
THE LAND SURVEYOR'S INKED SEAL OR
EMBOSSED SEAL SHALL NOT BE CONSIDERED
TO BE A VALID TRUE COPY.
CERTIFICATIONS INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY
IS PREPARED, AND ON HIS BEHALF TO THE
TITLE COMPANY, GOVERNMENTAL AGENCY AND
LENDING INSTITUTION LISTED HEREON, AND
TO THE ASSIGNEES OF THE LENDING INSTI-
TUTION. CERTIFICATIONS ARE NOT 71RANSFERABLE.
� I
THE EXISTENCE OF RIGHTS OF WAY
AND/OR EASEMENTS OF RECORD, IF
ANY, NOT SHOWN ARE NOT GUARANTEED.
i
PREPARED IN ACCORDANCE WITH THE MINIMUM
FOR TITLE SURVEYS AS ESTABLISHED
BYTHEL.SI.ALS. AND APPROVED AND ADOPTED Joseph A. Ingegno
FOR SUCH USE BY THE NEW YORK STATE LAND
TITLE ASsocuTl°". Land Surveyor
y�pH G G9L Title Surveys — Subdivisions — Site Plans — Construction Loyout
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PHONE (516)727-2090 Fox (518)722-5093 j
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^888PANOY OR
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WITHOUT CERTIFICA E
APPROVED AS NOTED OF OCCUPANCY
1a7-ofi 13.p.x .
t7EfK LE DG✓iN • IEAMS DATE:
NAIL. eZ4I50L7-e„ !:) -rO - FEE: By.
Fl.Craf2.TJ/5l' P:} :'sJe LF ."i n; NOTIFY BUILDING DEW
765-1802 9 AM TO 4 ERT E
FOR
FOLLOWING INSPECTIONS:
1 FOUNDATION - TWO REQUIRED
c K 5 PS 's L7 �' FOR POURED CONCRETE
-r'6 -
2 ROUGH - FRAMING • NUMBING
c' -T f"N F K J tvr LA-N'ZJAl G 3. INSULATION
( SJd e+ WA., IN &J-a rar) RE.LO CA•re" -1;) 4. FINAL - CONSTRUCTION MUST
--"`- -A ` 712 +�-[ 'T p Fr, Y [r-T 9E COMPLETE FOR C.O.
j��G J S 4 R, ! +j S ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STQQQATE CONSTRUCTION Q ENERGY
t k4 I WI _ _ DES RESPOSIBLE FOR
IGN OROCONS RUCTION ERRORS
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ERM
BUILD T� N__ � 7 l
Applicant/ 1 �, Date
Owners Name: k11 - �rJtt, rC� Ids C1 Reviewed: - - 4v
Architect/ Date
Engineer: Submitted: b�
SCTM #:
District: 1.000 Section: - 131ock Lot:
Project l p C Subdivision
�,�D
L,4) J Name
Location _ V 1�1 b ti. - -- -
-- vvv
Single& separate Required
certification: (Yes/No -- ------ — -- –
/� Rcq
Rcq. Qp
Zoning District v [Lot siu 000 Actual b w.-opul It of coverage 0'roposcd
R f / Reg f Req , /
e9 7
(Front Yard /Proposed: Y [Side Yard -0 Proposed O) tRcar Yard Proposed J
�/ n
Project Description:
AGENCY PERMITS Permit
REQUIRED FOR REVIEW N.A./ NO YES Number
Suffolk County Health Dept.
New York State D. E. C.
Town Trustees
Town Zoning Board approval:
Town Planning Board approval:
Flood Plane Elevation ???
Flood Zone:
Notes: