HomeMy WebLinkAbout25849-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-26550 Date: 07/07/99
THIS CERTIFIES that the building ADDITIONS
Location of Property: 1250 CAPT KIDD DR MATTITUCK
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 106 Block 2 Lot 45
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 15, 1999 pursuant to which
Building Permit No. 25849-Z dated JULY 7, 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 ADDITIONS TO EXISTING ONE FAMILY DWELLING "AS BUILT" & AS CERTIFIED
BY ENGINEER JOSEPH FISCHETTI.
The certificate is issued to JOYCE M. SMITH
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. H-063282 04/04/99
PLUMBERS CERTIFICATION DATED N/A
- ( I& �'/�; —
Building Insp6ctor
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. 25849 Z Date JULY 7, 1999
Permission is hereby granted to:
JOYCE M. SMITH
BROOKLYN NY 11228
for
CONSTRUCT ADDITIONS TO EXISTING ONE FAMILY DWELLING "AS BUILT"
& CERTIFIED BY ENGINEER JOSEPH FISCHETTI
at premises located at 1250 CAPT KIDD DR MATTITUCK
County Tax Map No. 473889 Section 106 Block 0002 Lot No. 045
pursuant to application dated JUNE 15 1999 and approved by the
Building Inspector.
Fee $ 162 .80
Authorized S ' nature
ORIGINAL
Rev. 2/19/98
TOWN OF SOUTHOLD
r!1 L; Ib 15 IS BUILDING DEPARTMENT
TOWN HALL
JUN 15 1�j u I
i-- 7
APPLICATION FOR CERTIFICATE OF OCCUPANCY
BLDG. DEPT.
LITHO D
s app on must 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 12 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.
B. 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 applican
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 Buildine - $100.00
3. Copy of Certificate of Occupancy - _ .25c.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential/$15.00, Commercial $15.00
Date . . .GI /g19 9. . . . . . . . . . . . . . . . . . . . . . . . .
New Construction. .. . . . . . . . . Old Or Pre-existing
Building. . .
Location of Property. . .12'S.Dowel df T101 14
. . . . . . .. 1Y.. . . . . . ?lt�t�
Gr'1
House No.
T /Street Hamlet
Onwer or Owners of Property.. V..�.� .... ...T • • • • • . . . . . .. • • • •
ll. ..tt. . . ... . . .. .. . .. . . . . . .. . . . .
County Tax Map No 1000, Section. A PP . . . . . ..Block. . . . Z . . . .. . . . .Lot. . .//. .. . . . . . . . . . •
7�5Subdivision. . �AJQ N NC �' FilLot
. . . . . . . . .. . ed Map. . . . . . . . . . . . . . J. /. . . . . . . . . .
Permit No. . . . . . . . . . . . . . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . .
Health Dept. Approval. . . . . . . . . . . . . . . . . .. . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . . . . . . . .. . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . F1,l8,Certicat . . . . . . . . . . .
Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . .. . . . . . . . . . . . . . . . .N. . . . . . . . . . . .
APPLICANT
Q�Pc .SG`�Yo mea ti j;cjWh;
oo-Zags-5fl
PROFESSIONAL ENGINEER
HOBART ROAD/PO Box 616 SOUTHOLD, NEWYORK 11971 516-765-2954
Date: June 14, 1999
Reference: Joyce Smith— 125 0 Capt Kidd Dr.
John Bufus
Southold Building Department
Main Road
Southold,NY
Dear John,
I am enclosing three copies of As-built drawings of the home at 1250 Captain Kidd Drive,
SCTM#106-2-45. The additions to the main house were constructed in 1970 but never received
a CO.
As a result of my inspection of the premises,the additions are sound, with no apparent evidence
of structural problems visible when inspection was conducted. There was neither settlement in
the foundations, nor any movement or sagging of the structure.
The insulation, utilities and piping have been done in accordance with the codes at that time.
gt KE of
s >
m 4 0. 05 25%, e
Jo IPE
THE NEW YORK BOARD OF FIRE UNDERWRITERS PACE 1
8075104 BUREAU OF ELECTRICITY
F 40 FULTON STREET, NEW YORK, NY 10038
Date APRIL 09,1999 Application No. on file 17970199/99 H 063828
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of
JOYCE M SMITH, 1250 CAPT. KIDD DRIVE, ITRTITTUCK, NY
in the following location; ® Basement ® Ist Fl. ❑ 2nd Fl. ATTIC/OUT Section Block Lot
was examined on APRIL 05,1999 and found to be in compliance with the National Electrical Code.
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDE$CENTJ FLUORESCENT OTHER AMT. I K.W. AMT. I K W. AMT I K.W AMT I K.W, AMT H.P.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMi. WAITS
SERVICE DISCONNECT - -NO.-oF - S - _-E R V I C E -- -
METERNO.Of CC GOND. A W.G. A W.G. A W.G
AMT. AMP. TYPE EAUIP. 1 0 2W 1 0 3W 3 0 9W 3 0 4W PFR O OF CC.GOND. rv0 Of HI-LEG OF HI-LEG NO Of NEUTRALS OF NEUTRAL
OTHER APPARATUS:
*NO VISUAL DEFECTS, "An electrical
survey has been made of the exposed
electrical equipment in the
premises indicated. " "No obvious
unsatisfactory condition was found.
JOYCE M. SMITH Ldw
1444-82 STREET
BROOKLYN, NY, 11228 GENERAL MANAGER
7.1
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 BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT, BE ALTERED IN, ANY MANNER.
IBOARD OF HEALTH ... .... . . . . .. ..
�'"
JUN 1 5 1999 POEM T I 3 SETS .. PLANS
.. .. . .•••. • . • • . •
T . . .•••. • . • • . •OWN OF SOIIUTHOLD • SURVEY
BUILDING DEPARTMENT CHECK
IF TOWN TOWN HALL SEPTIC FORM . . . . . . . . . .. . . . . . . . .
T WNFS UTHOLD SOUTHOLD, N.Y. 11971
TEL: 765-1802 NOTIFY:
q . CALL . . . . . . . . . . . . . . . . . .
Examined.. .. ...... 19. MAIL TO: . . . . . . . . . . . . . . .. . . . .
19..� Permit No.oli.7ll.!•�
Dia/c ............................ .... ..................................
........................................�%...
(Build' g in for
rrg inspector
LIGATION FOR BUILDING PERMIT
Date. 6. . . . . . .. , 199Y.
'INSTRUCTIONS •
a. Tris application must be completely filled in by typewriter or in ink and submitted to the Building Inspector
f 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 premise or public
drawn streets or areas, and giving a detailed description of layout of property mist be on the diagram Which is part of
this application.
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 issue a Building Permit to the applicant. Such
permit shall be,kept on the premises available for inspection throug)xcut 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.
APPLICATICN IS HElsailf MALL to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Soutbold, Suffolk county, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for or demolition, as herein
described. The applicant agrees to comply with all applicable laws, o s buil ing code, housing code, and
regulations, and to admit authorized inspectors on premises and in build or noes inspections.
JOSEPH FTSCHETA, JR. �..-..... .......
PROFESSIONAL WGINfFA (Signa a of a t, or name, if a corporation)
Hcba►t Road n-
Southold, N. Y, 11971 1 /*,X,.7/ ,W
...................................................
(Mailing address of applicant)
State Whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build
............................ . ...�.t-.-...u. .
....... ......................................................................
Name of owner of premises v fid . •: SxL� ......•...•...•.......•••APT D-A'S�NOTED........
as on the tax roll... latest deed) l DAM �B.1 .#
If applicant is a corporation, signature of duly authorized officer,
NOTIFY UILDING AT
(Nam ..d title
corporate
officer)
;. . 1 k n� c� F FOUNDATION 65-1802 9 AM TO 4 FOR THE
(Nene and title of corporate officer) iA `. 7. FOR FOUNDATION
0 ,
TWO REQUIRED
w w e mm CONCRETE
Builders License No. .........................00CUPANCY OR 2. ROUGH - FRAMING & PLUMBING
Plumbers License No. .USE IS UNLAWFUL 4' FINAL ' -ATIOCONSTRUCTION MUST
Electricians License NO. ................WITHOUT CERTIFICATE BECOMPI.ETEFOR CO.
OF OCCUPANCY ALL CONSTRUC'T'ION SNAIL MEET
Other Trade's License No. .................... ' Z UI OF THE N.Y.'
1. Location of laud on which proposed Work will be done..... .C .ali.-&WI iY•
O
BLE FOR
PES
.... ................................................................ ,
House T
Badl t
Street 2 Ste.
County Tax Map No. 1000 Section i.�..t�.6.......'Block ................ I of ..g...........
subaiv. .0, ..Cw'�KC'j.: i51 `5..... Filed Map No. ............... Lot ..M7.......
(Name)
2. State existing use and occupancy of premi,@es and/intended use and occupancy of proposed construction:
a. Existing use and occupancy ..... \t (� .............................. ..............I......
b. Intended use and ocwa4xmcy ......................j......................................................
Repair ............ Removal. .... ..... Demolition ............ Other Work .. .............................. .
(Description)
Estimeuted Cost .......................... fee ..............................................
/ (to be paid on filing this application)
if dwelling, timber of dwelling its ....1....... Dumber of dwelling units on each floor ................
Ifgarage, number of cars ........;..............................
if Dimensions sof tiialor mixed strucdmea��� ' specify nature and extent of each type of use......................
ung :' if awry: Front..3 S?�t...... Fear ....`..8:�.,... Depth . 3'S�9,........
Height ......................... Number of Stories ... ............
Dimensions of sane structure withlalterations or additions: Front ... .?i. .. Fear ..A Z
Dei r .................... timber of Stories ...............
Dimensions of�entire new construction: Front ...t 15.......... Rear /� Depth 14 .........
Height ......................... Iamber of Stories ............•........ �
Size of lot: Front ... 0.....t...... Fear ...L A 0........... Depth ..../ .............
Date of Purchase ................}.... Name of Former Owner ........................................
Zone or use district in which premises are situated ...,...........................................................
Will loproposed
t bei aced ..i fU^ � � ming law, ordinance or regulation: ........................
Dcea construction violet
regraded N.M. r....... Will excess fill be removed from premises: YES ND
Psi 5Noi1't! /4;p9.4-'82Nd 1 �L 2/B -2022
Names of Owner of sea .fib 9.................. Address •• p�CCrC fr // '�'.. Phone No. ..............
Name of Architect ............. ................... Address .............................. flare NO. ..............
Name of Contractor ..............;..................... Address ...............................Phone NO. ........... ..
Is this property
MMD 30D feet of a, tidal wetland? * YES .......... NO ..........
TRi xs PF. a NAY W imam,
PLOT DIAGRAM
Locate clearly and distinctly alll buildings, whether existing or proposed, and indicate all set-back dimensions
oro property lines. Give street and block ember or description according to deed, and slaw street nares and indicate
ether interior or corner lot.
•:1.x,6"�.-ifik. .l�iirii�'.�.11'�Ii:�fy
' �t(.{
AIE Or NSW WOY ,
uNry or
SS I
.. ..... r::R ,13$ "duly sworn, de Y Ow time applicant
ame of individual-signing.contract) '.;,
OiIU� +i
+igen , 4porat" . „
is the .. , 4 '4 .......................................
,...........,...,...........
(Cogtraetor t col esofbider etc$} r'� .....
.jr d;k' P A°' f
said owineV,Pr. rs,, and is duly authorized �dklfi3��a AMperformed the said work and to make and file this
.,...
Rlice ion; tE?at,P-ll,itatenepts contained in this application are true to the best of his knowledge and belief; and
atthq; g�u yiil bq performed in the manner mel lnrtfi in the application filed therewith.
+oto°Co//�``fdce�me'tFiis
...day of ��r!✓�?r.. ....19..��..
Notary Public .. 1 K :. .. Qd. ....... ... :.......:.
( i tyre Applicant)
LINDA J.COOPER
Notary Publle,State of NewYork i
No.4822563,Suffolk Cou0010
Term Expires December 31,7
SURV Er OF LOT # 151
SURVEYED 04-12-qq
I SUFFOLKCOUNTY TAX #
"MPTP OF GAPTR I N KI DD E5TATE5" 1000 - 106 - 2 - 45
FILED JAN. I g, I g 4q A5 FILE # 16-72
51TUATE: MATTITUGK CERTIFIED TO:
TOWN OF 5OUTHOLD .JOYCE SMITH
5UFFOLK GOUNTY, NY
N
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7 '30"E 10®.0®'
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u�
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b.o' 2a.r o ioo C7
off , v t
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' / asphalt drive
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860 0'30"Wgay
100.0 '
-----------
Captain Kidd Drive
NOTES:
iilnea 511¢.1[.1"o"eeeatmn to a
!Y�6,f map,,tAlnb9 a ticenseo 09. surveylr's s2.1
) V] ]5[1111 18¢[[,011)209, Sub-d,vlslpn 2. 0
IN MONUMENT FOUND 1,
s NN Pere stab.eep°ltl mulm...
0 PIPE FOUND ® see ea, aff oe f°:ea`t1 ae r
e sno 11111 o°v a-1 nra,`,1.s�rvoy:e:�
�a by the . stale As.ocfatlon of Proles
Cl:7;;Cr'I:J':) HED6E _ ta,a sw rrylrs""safn a reflfeaeflre anau r
AREA = 12,000 5F OR 0.28 AGRES77
taa ag."er 5m mae.oe mammefln nates nlreo_
m 8118 a.,e"a.a o me f.mma,"t wua" eer.
em".er "ot o-aoa lrawa e"ae'emonm mete�—
JOHN C. EHLERS LAND SURVEY
6RAPHIG 5GALE:I '= 50' 6 EAST MAIN STREET N.Y.S.LTC.NO.
C— --_�-- RIVERHEAD,N.Y. 11901
t--� 369-8288 Fax 369-8287 REF.E:UOES199—�
I
M-1802
BUILDING D .
CTI®N
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS
la
DATE 2 INSPECTOR
ADD 'PChI l m,-rlOki r— N�4
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APPROVED M' VOTED
� I
•UNDERWRITER$CERRFICATE OCCUPANCY OR
REQUIRED USE IS UNLAWFUL
_
THOUT
' - - WI OF OCCEPANCYATE
UANCY VI
JUN 151999
_—J
I -- - Roc Herr. I
I ---- —
" T WN FSOJTHOLO
APP E AS NOTED
TE B.P.W
FY BU
� . I r65-17802 SLAM TO 44 PM FOR 'HE
INSPECTIONS:
FOLLOWING INSPE
I -FOUNDATION
TWO REQUIRED
7 FOR POURED CONCRETE J
2ROUGH - FRAMING m PLUMBING
3 INSULATION 4Ftg OF Nlly Y
. _. -_ _ lay _ _. __ - -_ .__ __ �l�L.6 `IL )U __. ___ +--/"-3rl�• T 4. FINAL - CONSTRUCTION MUST vlsCh �A BE COMPLETE FOR.C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y. ?D _
STATE CONSTRUCTION al ENERGY m
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS o �O� 050,0 ro`r 0
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