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HomeMy WebLinkAbout24884-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26088 Date: 11/09/98 THIS CERTIFIES that the building ADD & ALTER Location of Property: 1975 YOUNGS AVE SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 60 Block 1 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 15, 1998 pursuant to which Building Permit No. 24884-Z dated MAY 15, 1998 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 & ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MARY ELLEN KELLY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N-463625 08/31/98 PLUMBERS CERTIFICATION DATED 08/21/98 PECONIC PLUMBING & HEAT. Bu' ing Ineptocor 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. 24884 Z Date MAY 15, 1998 Permission is hereby granted to: MARY ELLEN KELLY 1975 YOUNGS AVE SOUTHOLD,NY 11971 for CONSTRUCTION OF AN ADDITION AND ALTERATION TO A SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at 1975 YOUNGS AVE SOUTHOLD County Tax Map No. 473889 Section 060 Block 0001 Lot No. 001 pursuant to application dated APRIL 15 1998 and approved by the Building Inspector. Fee $ 75 .00 llzeee Buildin nspectof ORIGINAL Rev. 2/19/98 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY X. 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. 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. 3. 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. ,. 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 $15.00, Commercial $15.00 Date .. . . . . . . . . . . . . . . . . . . . . . . . . few Construction. . . . . . . . . .. Old Or Pre-existing vBuilding. . .'--. . . . . . . . . . . . ,ocation of Property. . . .�.`� 7S. . . . . . . . . . . . . . . . . . YJ ::�� e: . . . . . . . . . . .ScIt tr ,{;`. . . . . . . . . . . House No. Street Hamlet )nwer or Owners of Property. . . 1IA `:'�. . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ;ounty Tax Map No 1000, Section. . . . .. . . . . . . ..Block. . . . . . . . . . . . . . .Lot. . 1. . . . . . . . . . . . . . . . . . . ,ubdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . zy8a y �s . . . gwt s 'ermit No. . . . . . . .Date Of Permit. . a /. ..9 . . . . .Applicant. . . lealth Dept. Approval. . . . . A. . . . . . . . . . . . . . . . .Underwriters Approval. . . . 5 Z 'lanning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Lequest for: Temporary Certificate. . . . . . . . . . . Final Corticate. . . . . . . . . . . O leeSubmitted: $. . . . . . . . . . . . . . . . . . I . . . . . . . . 6 .- C a0 g !! APPLICANT. . . . . . . . . . . . . . . . . . . . . . . . %o�°SUS}�o Town Hall, 53095 Main Road . y Fax (516) 765-1823 P. 0. Box 1179 'v W Telephone (516) 765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E 12 T I F I C A T I 0 N ry DATE: f? �' Building Permit No . Owner: /Vtc�n 6(y+1- I�J'k (please print) / Plumber: ('t^l/7/�✓l/ C�/27�J//t/�< V��� /� (please print) �— I certify that the solder used in the water supply system contains less than 2/10 of. l% lead. Plu d- s Signature) Staorn to before me this day of 19th Notary Public, County Wary Pa-'i-, �yetit�g�i�,C;"_'.c 9rNlais;;iComo or)t:s;,,to:Sept.30,1� I THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1001071 BUREAU OF ELECTRICITY r 40 FULTON STREET, NEW YORK, NY 10038 Date AUGUST 31,1998 Ae Lication No. on file 16446398/98 i4 463625 THIS CERTIFIES THAT �ERMTT N0. 24884Z only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of MARY ELLEN KELLY, 1975 YOUNGS AVENUE, SOUTHOLD, NY in the following location; ❑ Basement © Ist Fl. ® 2nd Fl. Section Block Lot was examined on AUGUST 24,1998 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS SWITCHES OUTLETS INCANDFSCENT FLUORESCENT I OTHER AMT. I K.W. I AMT. I K.W. I AMT. I K.W. I AMT. I K.W. AMT. H.P. 3 6 1 6 1 3 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC-PT. TIME CLOCKS I BELL I UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K.W. OIL H.P. I GAS I H.P. AMT, NO. A.W.G. I AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E - R - V- - 1 C - E - - -- ---METER NO.OF CC GOND. A.W.G. A W.G. A W G. AMT. AMP. TYPE EQUIP. 1 0 RW 1 0 3W 3 0 3W 3 A 4W PER 0 OF CC.COND. NO.OF HI-LEG OF HI-LEG NO.Of NFUTRAl3 OF NEUTRAL OTHER APPARATUS: G.F.C.IL-1 SMOKE DETECTOR:-2 G & S CONTRACTOR LIC.#578 ELK ri BOX 215 ANN SOUTHOLD, NY, 11971 GENERAL MANAGER 11 EPer 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. o�OgUFF04�oG y` Town Hall,53095 Main Road W Fax(516)765-1823 P.O.Box 1179 • O�� Telephone(516)765-1802 Southold,New York 11971 BUILDING DEPARTMENT TOWN OF SOUTHOLD September 11, 1998 Mary Ellen Kelly 1975 Youngs Ave. Southold, New York 11971 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. XX No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 24884-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. 1 • 1 r • I-I M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 LATION ( ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE �179 INSPECTOR � 2� M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST j ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: l ( ' DATE 2S INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [,-INSULATION [ l FRAMING `J [ ] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: DATE G r INSPECTOR �c.� I M-1802 BUILDING DEPT. INSPECTION tl,,l FOUNDATION IST [ ] ROUGH PLBG. [ 7FNDATION 2ND [ ] INSULATION MING [ ] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: ell i DATE 17no INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: DATE 621-)-Iel� INSPECTOR i 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [14-.'ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: _ Zd,4 C DATE INSPECTO 0,2 M-1802 BUILDING DEPT. INSPECTION [ XFOUN ATION 1ST [ ] ROUGH PLBG. ATION 2ND [ ] INSULATION G [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS:� l1 DATE INSPECTOR BOARD OF HEALTH . . . . . . . .. . . . . . . D FORM 140. 1 3 SETS OF PLANS . . . . . . ... .i . . . . TOWN OF SOUTHOLD SURVEY . .. :: . ... :. .. . .. . . . . . . . L:APR I BUILDING DEPARTMENT CHECK . .. . . . . .. .. . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . .. SOUTHOLD, N.Y. 11971 BtfaG,OEPT. TEL: 765-1802 NOTIFY: F ITN LD /�S 'o�P ,, q CALL : : .. . y . .. . Examined. MAIL TO: .. . . . . . . . . .. . . . . . . . . Approved.. [.` 1929 Permit No. ................ .................................... Disapproved / (Building .nspect ) APPLICATION FOR BUILDING PERMIT ,..Date.. . . . . . . .. . . . . . .. 19. . . . INSTRUCTIONS a. This application must be completely filled in by typewriter 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 mist be drawn 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 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 BERM MALL to the Building Department for the issuance of a Building Permit pursuant to the Building Zane 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. He n%,4y 'J a ¢rf /1,0-- (Signature 71C ................ .... .................. ..:......... (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, phnber or builder. ...G...::............................................................................................................. E (( � Name of owner of premises ...4S_r.'- . KI( ...... (as on the tax roll oratest deed) If appliccaantt its/a�cor,.pporation, signature of duly authorized officer. ....k.: �..!.................... ................... (Name and title of corporate officer) Builders License No. ..� U�3...t�z...... Plumbers License No. ......................... Electricians License No. ..................... Other Tra&'s License No. ..................... I. Location of land on which proposed work will be done............................................................... ,........,(�� ...............•:•JU-h G�5.. .�..,.,.......................... .................................. House Number Street Hamlet Canty Tax Nap No. 1000 Section .... ........ Block .... ........... Let ..�............. Subdivision ...................................... Filed Map No. ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use god occupancy of proposed construction: a. Existing use and occupancy ....S�v .° . .. ..... `�— ...................................:.......: b. Intended use and occupancy ............................................................................. �., 1 •+�•.+wewrwweraR+rn. �� 3. Nature of work (check which applicable): New Building ....t�... Addition ..`..i;fl?, Alteration, .. Repair .....,..,.,. Removal ............. 1laxrxlition ............ Other Work ..1�,.�.... ....... <<� ( �SLo ...... ..... ......(1lescription) .... 4. Estimated Cost .... .............. fee . . (to be paid on filing this application) 5. If dwelling, number of dwelling emits ....L...... Nrrber of dwelling units on each floor ...t............ If garage, number of care ...................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use......-.......I...... 7. Dimensions of existing structures, if any: Front....�3........ Rear ... ........ Depth . ;.7............ Hleiglmt ......4................ Nuttier of Stories .... lz.......... � Dimensians of ease structure with alterations or additions: Front .� .......... Rear ..z.3........ Depth ............. Height .....(49............ Nuttier of Stories /{...... r 8. Dimensions of entire new construction: Front ...` .r 6..,G...... Rear ...., h....... Ilepth .9...6.:...... r ieight ......(x................ Riaber of Stories .....(............... 9. Size of lot: Front ..,3s............. Rear .....�9 .......... tle tth 13.3 yy�� p ..............:..... 10. hate of Purchase ..✓,fell............ Name of Former Owner ...:................................... 11. Zone or use district in which premises are situated n............................................................. 12, Toes proposed construction violate any zoning law, ordinance or regulation: ........................ 13. Will lot be regraded ...4$ ............. Will excess fill be removed from preadses; YES 14. Names of Owner of premises ./yly�£/,Iw,/4/(J......... Address l9.>.S.(4s :�r.flt?., Phone No. '2 5 s6 9 Name of Architect ..... .............. Address ........I..................... Phone No. .............. Nave of Contractor .12s I���o3 Itis Address 3gw,llfi Sore (,(N Phone No.7�1;Z67S .... ....... 15. ,Is this property within 300 feet of a tidal wetland? * YES .......... NO .lY....... *IF YES, S01m"D mm lim mldli3 PEWff NAY BE RI+IPIRED. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-hack dimensions frau property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or cor-^- IV- N 73000 40 E� 133.29' �r #AAA 9 x 9 r Ui r Q N s �;� � �r` ,� � I ,�� I.< ..� � z .Fromm 'l•6 � `° „r5 750 54 30" W r q,, 133, 12r a� STATE OF NEW YORK, yS!.it COUNTY OF . . . . . . . . . . . . . . . . . ••••••••.R X G�R C/ f .......!: o P'.F.(�being duly sworn, deposes and says that he is the applicant (Name of individual pigning coitr€tl) above named, lie is the ..................... .......... ... ............................................. (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 time manner set forth in the application filed therewith. Sworn to before me this ...........` ..... , day of .......... 19, //�� Notary Public, F {Iplirrtxnty 12 N Qualilio in ,ui �>;C Y k Cornm'a;aaoncE,,q)irosr0ay 0 ..Lore i ai. i.......................... P�Fieayll, i9_._ �1���•(SipnaLYere of applicant) dY 7^F _+� V •_.,r Y 1 +} . .i 7 s 242724 . 0 reputed land now or formerly , }u� , george r, jennings gJ§ est ��e 11ryuC . 11 jc N (3000' 40 E 133.29 * N . along � li vC „` fr,` ° x co lit P " ✓,! 1 c yy 'e a �', it 41 'L? : lxQ La — C7 16 /�y� •/IV17X 11j (r P 75° 54' 30,1 W Q I L.` ' .r t 'a bt{ S * ; reputed land now or formerly cz 'j M � . 3f + . , dovid owen 81 patricla onn averetle 411 tD �� 1ri1RYEY`' d0 0WSOLELY FOR THE PUK SOS Q tltE CONVEYANCE OF TITL&,'OF Sirs' S4gW,;4 i 01 TO BE USCID FOR T'1 A! �,Y#tEMOYA►�,'FJR LAYC':T OF FENOES, HE C--v'- �SA�IIS OVe�NY ern��t`11IRFt {'k��>x '„ AVIHOAIZ D $I(;" rh ,p •PI ERT t kw,p �a t C,, • AS $ygWNaf , r •.1"��' fr� " 4C4110N c�.UTMOI,_b,SUfFOLK COUNTY,N!`W YORK "' LAND SURVEYQ !C,UAR^NfK 'ONLY TOSECURITY TITLE a ,GU RAMP Co. GARDEN CITY PAR ` N Y. t:uut Ty �?ERAL SAVINGS , a LOAq ASSN, . aR{ s- •'��� N. Y. S. LIC NO,, 4 .17 -�-. NOf AFSPONSIlLE FOR FAfEMFNfS AND SU! SURFACE CONDIG0M, O;I LA )HAH s O�e•v fNrFD�.CO t'4.�0� ��1�0� -..��_..___.�_.._ _�...__.__� ...�...—r..._-. _._.. . a,PP�a, `� �� 1 i. 1 457 P UN0011 ITERS CERTIFICATE APPROVED AS NOTED 't 514- $ y8g�l0 C,SGVJ ) s ) = E' PROVIDE '/iHR, FIRE < DATEB.eaai0)�s 9bi � , ,� � �RATED SEPARATION TO FES; er, 3%' . �y p �z, sr � PART,W.3 (f).(1) OF „NOTIF`t 00LOING CEPA E AT �,,, y p B ,U ^' sae 18ol's,AM To 4 PM,FGR THE' g `g. ` y (1 4 !s I'+ N Y,STATE BUILDING CODE - FOI.LOiMNG MISPECTNN75;' pjf�'�9 �'� �,�T 4 RI l3`•1C7 ! ^r FOUNDATION + TWOFOR RQUIREO " L '�. OUp6yy (NAMING PLUMBING 49bz 4`; 01+3� 9F Will C? ' 9 INSULATIO a p <<4. FINAL •.CUSYFIUCTIQN MUST SE COMPLETE FOIR C.O. ' t ' C M '_ i r w . . � ALL CONSTRUCTION SEAL MEET '=SHE REQUIREMENT$ OF.'THE NY a ^ PROVIDESoklw �CTINGai STATE CONSTRUCTION.& ENERGY ` ' - + - Y r , • " CODES ' tfOT RESPONSIBLE FOR % t .. ALARNDIM♦IM ?^` ....; t 41 DESIGN OR'.CONSTA00T N ERRORS ' t �W S ir) '� c A$ TO PARL-f2E I N.YS BUIIDIhG CODE t Q x Pi i �p 1 , ) f d �i �� ! ) 1 } I � za � t > f s t > .�ff copper TObing IS used fo at9Fdisi ibufflio" 9tDt piping STiaD b�3 p � GftypeSKo_r_Lonly, I UNDERWRITER$fERT1Flr,^,iE " a I E nsf � 5 , P REQUIRED - �6,. t, r},ua. r PROV)OEANTI•SCALDAND/OR THERA00'CKPREVENTING � < PLUNIRER C£�iTIF,lCAT10N DEVICES AS TO PART. 9025(R) lI/LEdl1CQN7ENT f7EFOR ,`' M Y STATE BC<ILOING CODE #i¢ so/a7Ffa' ij,Ci lel N' YT z7 5l%9'f#!Y YgIrI7 `F""' t °S ` PROVIDE OPENINGS FOR „ `= a t :IME 660 ESCAPE ASnPPR weoer gx+tansy , ^� REQUIRED BY PART. 7.14 Of N V STATE BUILDING pCODE PLUMBING < Ai 1,PLURLING WASTE - &WATATER LINES NEE4., < =TESTING BEFORE COVERING i t; vxAwmc nvMeS• '..� a. u t Nr , c +�r 1f kh Al ,:� r •. 'S r tri P. S r [ �•� h .'`� '� r �Yi �irtA�J { r ,c 1 tab", F +C 3 A 26319 TEJ W-1 ids aFr>1 { } i X RJRe. .. 1 h 17i p 1 r E C .SA.fS, �s it Y UICt ,71 APPROVED CS 3 p AW ' 4 4c s+� sr ilia 4 t X M DR�Wi1J0 nUMm pit stillr 01