HomeMy WebLinkAbout26164-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26941
Date: 02/23/00
THIS CERTIFIES that the building ALTERATION
Location of Property: 330 DAYTON RD SOUTHOLD
(HOUSE NO.) (STREET} (HAMLET)
County Tax Map No. 473889 Section 41 Block 1 Lot 25
Subdivision Filed Map No. -- Lot No. --
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 25, 1999 pursuant to which
Building Permit No. 26164-Z dated NOVEMBER 18, 1999
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 ALTERATION TO EXISTING GARAGE TO LIVING SPACE AS APPLIED FOR.
The certificate is issued to FRANCIS P & BERNICE J. MELLY
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 33525 01/26/00
PLUMBERS CERTIFICATION DATED N/A
/u o z d S gnatu
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. 26164 Z Date NOVEMBER 18~ 1999
Permission is hereby granted to:
FRANCIS P MELLY
PO BOX 617
$OUTHOLDrNY 11971
for :
ALTERATION TO AN EXISTING GARAGE TO LIVING SPACE AS APPLIED FOR.
at premises located at 330 DAYTON RD
County Tax Map No. 473889 Section 071
pursuant to application dated OCTOBER
Building Inspector.
SOUTHOLD
Block 0001 Lot No. 025
25 1999 and approved by the
Fee $ 75.00
Authoff/zed ~ture
Rev. 2/19/98
ORIGINAL
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOB CERTIFICATE OF OCCUPANCY
~.A.. -~%%~7~.~%Q.~l~ust be filled in by typewriter OR ink and submitted to the buildin~
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 buildi~
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.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings a~
"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 appticanl
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 Dccupancy on Pre-existing Buildinm - $100.00
3. Copy of Certificate of Occupancy - , .25~
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15,00, Commercial $15.00
Date 12~?.O. .....
New Construction .......... Old Or'Pre-existing Building ....... ~ .......
Location of Property. [ .... ~.~.~ ............... ~0
.................................
House No. Street Hamlet
Onwer or Owners of Property ..... ~ ..¥.. ¢
County Tax Map No 1000, Section..-~-.~-/%~.o- .Block. ~f-O~ .Lot
Subdivision Filed Map Lot . ..
Permit No...~. g.'r.,.--:~..Date Of Permit ...... /~ppilcan£ .............................
Health Dept. Approval..........,.........-...-.Underwriters Approval..... ............ .. ·
Planning Board Approval....... ............ .. ...
Request for: Temporary Certificate ...... ..... ~tnal Cert~ate ...........
..
Fee Submitted: $ ........ ~ .....
APPLICANT
ELECTRICAL INSPECTION SER VICE INC,
3 75 DUNTONA VENUE
EAST PA TCHOGUE, NEW YORK I! 7~2
(5!6) 286-6642
DATE: 1/26/00
33525
APPLICATION No. ON FILE
VILLAGE: Southold TO~e7~L. Southold
XDDR~SS: ~fl Dayton Road
ISSUED
TO:
Francis
Melly , : , ,
1NTRODUCED BY: EECO Electric Cor?oration LIC No: 2816-E
LOCATION; Base,. 1st ,x 2nd~ 3rd Atti~
Det. Garage Hot Tub : Pool
SWITCHES RECEPTACLES, FIXTURES HEATERS ~ FANS J G.F.L AIR, COND.
5 9 4 1 paddle ·[ 3 ·
DISHWASHER DRYER CLOTHES WASH, GAR. DISP. RANGE OVEN SMOKE DETECTOR
1
FURNACE OIL GAS CIR. MOTORS BELL TRA3L SERVICE DISCONNECT
METER AMPS PHASE
OTHER
EQUIPMENT
OutMde, Rea.
BUILDING PERMIT No.
BLUE ORIGINAL YELLOXty COPY
PiNK coPY OFFICE
Town Hall, 53095 Main Road
P.O. Box 1179
Southokl, New York 11971-0959
Fax (516) 765-1823
Telephone (516) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
January 20, 2000
Mr. & Mrs. Francis Melly
P.O. Box 617
Southold, NY 11971
RE: 330 Dayton Rd., Southold.
To Whom This May Concern:
We are unable to complete your Cert'ificate of Occupancy
because of the following reasons:
XX... An application for Certificate of Occupancy is
not on file. (Enclosed)
XX
XX
No Underwriters Certificate on file.
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 # 26164-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION I ST
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] RO~I~PLBG.
[ ~IJLATION
[~J FINAL
[ ] FIREPLACE & CHIMNEY
.
DATE //q/~ INSPECTOR ~~~~
.D llqSPE~TION RE_PORT DATE .= COHI'IENTS
==~ .... ~- .............
~AT ION (IST)
~AT[ON ( 2~
~TION PER N. Y.
STA~ E~R~ , II
CODE ~.
,,
765-t802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [~ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [~~sULATION
[~MING [ I FINAL
[ ] FIREPLAC~CHIMNEY
PROVIDE ~ HR. FIRE
RATED SEPARATION TO
PART. ;17.3 (f) (1) OF
; BUILDING CODE.
PROVIDE OPENINGS FOR
EMERGENCY ESCAPE AS
REQUIRED BY PART. 714 OF
N.Y. STATE BUILDING CODE.
APl'ROVED AS NOTED
NOTIFY BUILDING DEI)A~t'MENT'AT
F~ ~8:
1 F~NDA~ - ~ ~E~I~ED
~. ~O~ - ~~BIN~
4. ~iNAL - CON~T~C~ON MUS~
~LL CONST"UCT'~ SHALL ME~
~.~= ..~ OF THE N. ·
~~:~S~ION & ENERGY
~'~D;S. N~ESPONSIBLE FOR
DES ~N OR~UCT~ON ERRO;S
UNDERWRITERS CERTIFICATE
CERTIFICATE
PROVIDE SMOKE*DETECTING
ALARM DEVICES
AS TO PART, 721.1
N.Y.S BUILDING CODE.
FORM NO. J
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. ] 197
TEL: 765-1802
Dis~pprovad a/c .............................. ....
BOARD OF BEALTN ...............
3 SETS OF PLANS ...............
SURVEY ........................
CHECK .........................
SEPTIC FORM ...................
NOTIFY:
CALL fTt
......
...... .............
(Building ~fnspector) $'
~PPLICATION FOR BUILDING PE~IT
INSTRUCTIONS
Date ...................
a. 'mis application unst be canpletely filled in by typewriter or in ink and submitted to the Building Inspector wil
3 sets of plaas, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing .location of lot and of buildings ee premises,, relatibnship to adjoining pramises or public
streets or areas, and giving a detailed description of layout of property mast be drama on the diagram dnich is part of
this application.
c. The work covered by this application my mot be ccrauenced before issuance of Building Pemit.
d. Upam approval of this application, the Building Inspector will issue a Building Pemit to the applicant. Such
permit shall be kept on the premises available for inspection thronghout the work.
e. No b~ilding shall be occupied or used in deele or in part for any purpose r&atever until a Certificate of
Occupanc~ shall have been granted by the Building Inspector.
APPLICATICI~ IS ~ MAIE to the Building Department for the issuance of a Building Pemit pursuant to the
Building Zone ordirmnee of the Town of Sc~thold, Suffolk County, New York, and other applicable Laws, Ordinances or
R~gulations, for tim cormtreetion of buildings, additions or alterations, or for removal or demolition, as herein
described. ~ applicant agrees to comply with all applicable laws, ordinances, b~ding code, housing code, and
regulatians, mn to admit anthorized inspectors on premises and in building for rl~ceSsary inspections.
................ f_~ ................. .~ ....... ~ ....
(Signature of applicant~or name, if a corporation)
(elq 00x4 c0 11¢71
(Mailing address of applicant)
State ~etber applicant is ~uer, lessee, agent, architect, engineer, general contractor, electrician, plmber or builder
...................... .........................................................
Na~e of o~ner of pr~ses ........... .~. · .P%~. · ~{.-~------~--'- .-~- ¢- -L-1~'-7-"- ..................................................
(as on [he tax roll or latest deed)
If applicant is a corporation, signature of duly aut[mrized officer.
(Nana and title of corporate officer)
Builders License No .............................
Plumbers License NO . .
Electricians License NO ....
Other Trade's License No .....................
]. Location of land an which proposed work will be dome ..............................................................
[t0~se NAmer Street Hamlet
Camty Tax Map NO. ]000 Section....--.~.ql'O¢........... BIoek ......OI -~..Q ...... Lot ....... ------ -- ~..~..(.,.~ 0 0
Filed Map No Lot
Subdivision.... ............................................... ...... ,..
(~)
2. State existing use and occupancy of premises and intended__ use and occupancy of proposed constmctlon:
-,,,.,':".'-' v '
a. Existing use and accupaney .............................................................................
b. ~tanded use and occupancy ......................................................... ...... , . ... ,.... ....
N.~Lure o[ work (dmek ~ddd~ aPPhicable) ~ lkfilding .......... &klltion .......... Alteration .. tiff
Repair ............ Remaval ............. Demolition ............ Other Work ..... . .............................
I .(Description)
(to be paid on filing this application)
tf ax~enlng, ,u,~r of ~nang ,pits ....~..a/..~.... ta,~r of aX~lhng onits on each floor ....... ~.~.~ ....
If garage, nosher of cars ....... ~.t~..O ..........................
If Business, e0rarereial or mlaed ]occupancy, specify nature and extent of each type of use ......................
Dimensions of existing s[ructure~, if say: Front .... ?.~..' ........ Rear .~.P..~ ......... Depth .... ~..0..~ ........
Delght ....... ~.~.' ............. li~ber of Stories ....... ~. ~ .......
Dimensions of sam structure wit! alterations or nddit~ona: Front ...... 7.q/.,...~ar .... ~.qL¢. ......
Depth .......... ~.~.~ ...... lteighl ...... .~.~. ! ........ l~l~er of Stories .... ~ N.~. .....
Dimensions of entire new constrt~ :tion: Front ................ llear ............... Depth ..............
lleigq~t ......................... l~aber of Stories ...........~ ......... .
si~ of lot: n~t /~tC ~a~ ...... ./..'(5 ......... Depm /Y~ ~
Zone or use district in ~hich premises are situated .............................................................. /~/
Does proposed constructio~ vlolaqe any zoning la**, ordlnm~ce or regulation: ..... 0
Will lot be regraded ....... .~..0.
Nares of Owner of premises
Nme of Arddtect .... /¢~ .......
of Contr tor
Is this property within 300 feet
It~cate clearly and distinctly all
hem pro[mrty lines. Give street ami
Amtber interior or corner lot.
........ Will excess fill be removed frem premises: YES NO
...................... Address .............................. ltmoe No ..............
.................. ....., ...................
of a ti~l ~tl~? ~ .......... ~ ..........
PLOT DIAGRAM
Buildings, ~hether existing or proposed, and indicate all eet-bock dimensions
lock nmt~r or description according to deed, and shcx* street hemes and indicate
...
above naned, ]
...belng duly sw~m, deposes arxl says that he is tim applicant
(Cont q fl'sac mcr, etc.)
tot, agent, c rporate o
of eaid c~er or c~me. rs, and is duly ~thorl~ to ~rfom or h~e l~rfo~ O~ ~id ~ and to ~ a~ file this
a~licat[~; ~mt all statmnts c~ta~ in ~is a~l.[catlm~ are t~ to ~e best of l}ia k~l~e and tml ief~
that tim turk will ~ ~rfo~ m the immer ~t forth in the a~licatim fil~ tbe~x~h.,
~m to ~fore m O~is I
Notary lhablic ... ; ...........
UNDA d. COOPER
Note~_ Public. State o~
No. ~122563, Su~t'ol_~,Cou~Y
Term Expires December
(Signature of Applicant)