HomeMy WebLinkAbout25044-zFORM 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. 25044 Z Date JULY 16, 1998
Permission is hereby granted to:
RITA J GILLEY
3 WELLINGTON COURT
NORTH MERRICK~NY 11566
for :
ENCLOSE A CARPORT ADDITION "AS BUILT" FOR A SINGLE FAMILY DWELLING
TO CODE.
at premises located at 3245 BEEBE DR
County Tax Map No. 473889 Section 103
pursuant to application dated JUNE
Building Inspector.
CUTCHOGUE
Block 0009 Lot No. 004
5 1998 and approved by the
Fee $ 75.00
Building' Insp~tor
ORIGINAL
Rev. 2/19/98
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25872 Date: 08/04/98
THIS CERTIFIES that the building ALTERATION
Location of Property: 3248 BEEBE DR CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 103 Block 9 Lot 4
Subdivision Filed Map NO. -- Lot NO. --
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 5, 1998 pursuant to which
Building Permit No. 25044-Z dated JULY 16, 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 CONVERSION OF A CARPORT TO A GARAGE ADDITION "AS BUILT" ON A SINGLE
FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to RITA J GILLEY
of the aforesaid building.
(OWNER)
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
N/A
N/A
Bu~ld~ Inspect~
Rev. 1/81
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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. F%nal 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, muitiple 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.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
Upre-existlng" 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.
3.
4.
5.
Certificate of Occupancy - New dwelling $25.00, Additions to dwellin~$25.0Q~
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory buildi~'$~.O0,
Additions to accessory building $25.00. Businesses $50.00.
Certificate of Occupancy on Pre-existing Buildinm - $i00.00
Copy of Certificate of Occupancy - , .25~.
Updated Certificate of Occupancy - $50.00
Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . /W~ ~9~ .....
House No. Street Hamlet
Onwer or Owners of Property .... . .~!../-~...~...~. ~%~.~..V.6] ~ ~..W~...$....~..,~ ~ y ............
County Tax Map No 1000, Section .... ~P:~ ...... Block ...... ? ......... Lot.-..&/ ..................
Subdivision ..... ~ ............................. Filed Map .... .~- ....... Lot...r ..................
Permit No .... ~.~.P>l~ .... Date Of Permit ................ Applicant .............................
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ....
Request for: Temporary Certificate ........... Final Certicate ...........
. -- ' . ...... ,.. i ....
~OUNDATION (1st)
~OUNDATION (2nd
~OUGH
FRAME &
-PLUMBING
INSULATION FERN. Y.
STATE ENERGY
CODE
FINAL
June 1, 1998
Town of Southold
Building Department
Town Hall
Southold, N.Y. 11971
Dear Building Department,
Enclosed please find the following enclomu~es~for
3245 Beebe Dr. Cutchogue.
1. Permit for garage (notarized)
2. Form No. 6 for Certificate of Occupancy
3. Three sets of plans
4. Three copies of survey of property
5. Envelope containing 2 checks~ one for permit and
one for CO Occupancy
We need an appointment for the building inspector to
inspect the garage.
you.
Rita Gilley, owner
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] FIREPLACE & CHIMNEY
REMARKS:
[ ] ROUGH PLBG.
[ ].~,ULATION
[ ~ FINAL
DATE
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST
FOUNDATION 2ND
FRAMING
[ ] ROUGH PLBG.
[. ]~I~ATION
[ ~] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: .
DATE
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] INSU~.LA~iON
[/..--3"~N AL
[ ] FIREPLACE & CHIMNEY
DATE
INSPECTOR
UNDERWRITERS CERTIRCATE
REQUIRED
PROVIDE % HR. FIRE
RATED SEPARATION TO
PART. 71.7.3 (f) (1) Of
I.¥. STATE BUILDING CODE.
OCCU J NC' OR
USE ispNL~WI:UL
Oi: O1CUPA'NC'Y
DATE:~
N OTII~" BUILDING
765-1802 9 AM T(
FOLLOWING ~NSPE¢
1, FOUNDATION -
FOR POURED COl
2, ROUGH . FRAMI
'"~ '~3~:~ LATION
tS NOTED
4 PM FOR THE
rlONS:
TWO REQUIRED
ICRbl E
IG & PLUM[lING
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
WILSON
%,
A~DIOR £~0.~! DAIWA OIII'AII~F.I) l'~Ot, l O~I~EI~S
M^R, I~1976
-YOUIqO ,~ .YOUHO
400 O.~TRAt,IOER ^VF.i'~UE, RIVCRJ ~AP, FlEW YoRK
SURVEY FOR:
ALEX J. DANOWSK~ ~ RERTHA Ii. DAt{OWSKI
TO~,L ,', ,.~F SOUTHOLD
FORH NO.
TOWN OF $OUTIIOLD
IIUI LDI I'IG I)EPARTHEHT
TONN IIALL
SOIITIIOLD, N.¥.
TEl.: 765-1802
IIOARD OF IIEALTtl ...............
~ SETS OF PLANS ...............
SURVEY ........................
CI1ECK . - -
SEPTIC FOP, H ...................
NOT'/DY :~ ~-
............... ~.~ .~o~.. ...........
INSTRUC'rlONS
a. 'Ibis spplfeattou roast be conpletely filled in by t~'l~vriter or tn i~ aed mtl~itt~ to ~le ~filding lnslector
3 ~ts of pla~, acetate plot plan to ~ale. F~ ~cor~i~ to
b. Plot plan ~t~ l~tt~ of lot ~ of ~ildh~s ~ ~i~a, relation~dp to ~jotnlng prints, or ~bllc
,tr~ts or areas, n~ 8ivt~ a ~tall~ ~m:rlpt{o~ of lay~,t o~ pro~rty mint be dr~ ~ tl~ dla~ ~*lch la I>urt of
rids a~fl icati~*.
c. Ibc ~ c~r~ I~ this a~licati~ my ~mt be cm~ before is~,~ o~ ~ildt~ Pemit.
d. U~ a~al of ~ds a~lieaci~m, tim lkdldi~ lna~ctor wil~ ia~ a ~ildlng Pemit to the applicant.
~mlt Imll ~.kept ~ ~m ~s ~ail~le for hm~ci~ tl,m~a~r the *turk.
e. ~ ~ilai~ atoll ~ ~ied or ~ tn ~le or in ~rt [or a~ ~ ~mt~er mtil a C~rtifieate of
~y ~mlt hwe I~n ~ant~ by d~ ~Ddh~
~a~'rl~ IS t~ }~ to tbs Ik~ild{~ ~rt~et for tbs issue of a ~ildlng Pemit ~ramnt to the
I~ildi~ ~ ~i~l~ of tbs 1~ of ~tlmld, ~ffolk ~n~, ~ York, ~ otber a~llcabl~ l~s, ~i]~e. or
~lati~a, ~or tie ~st=ti~ of hdldi~s, ~iti~s or altarati~s, or for ~1 or ~llti~, ~s
(~seril~. ~m ~ppll~t ~u to c~ly wi~ all a~licabla l~s, ordi~mes, ~{ldlng c~, {~ing ~,
regaflati~s, ta~ to &it m~ri~ in--tots ~ ~{~s aM in ~ildi~for ~es~
(S~g~t~e o~a~lk~t, or ~, tf ~ co.ration/
.......
(~ilhg ~mss of a~lleantl ~
State ~mOmr a~llcsnt is ~er, les~, agent, archlt~t, engtt~r,'ge~ral c~tr~tor, electrician, plt~imr or latlhle
0 ~ ~ .~ .............. ~ ..............................
~ of ~r o~ pr~l~ .................................................................
(aa ~ tl~ tax mil or later d~) ,
If a~fiicant is a t~retJm, si~re of duly ~tloriz~l officer.
(llama a~xl title of corporate officer)
l~fildera l,leense No. ."TT ....
Ph~oera License NO ..........................
~lectrleimm l,lee~ ~ ......................
1. l~ati~ of la~ ~ ~id~ p~l ~rk .ill N ~ ............ ~ ................. ' ..................
.... ........ ........ .....................................
~.t~ T.~ m, NO. ~ ~i~, ..... ~.P.~ ...... .~ ...... ? ......... ~t .... ~ ..........
~ Film }~p
~ivisi~.... . · .......... * ....................
2. State existi~ u~ a~ ~y of i~i~s a~ iote~kM ~ ~ ~ of p~ e~stnmtla~=
a. F~is~i~ ~ a~ ~y.. ................. ...- -. ' .........................................
b. ~nte~ u~ a~ ~ .................................................................
3.
Il).
II.
14.
15,
*,,d~ther interior or cor?__r_~]ol:, ~
P;~ture of ~o~k (d~:k ~hidl al! ~licahle); 1~ lhlhling .......... ~kliti~x .......... Alteration., ~ .....
I (to ~ fid I~a filtn~ this al~licatl~)
...... 2~
~ ............. ~, ..... ~. ........ ~... ~. ....... ~ ...............
'
I PLOT I)IAOIIAH ,
I~ate clearly al~ dlati~tly al~l ~[]dl~g~ ~mtlmr ~lating or pro~, m~ h~licaCe all ~t-I~ dJmnaiona
or (hacripc{~ according to t~, a~ ~ ~tre~ ~'~a ami i~llei~Ce
.%xm~ Lo Ix~fore m th|a
Hot~ Public, ~tete of NeW Y~k
No, Ol~AS024D~ 8
Quelffied in Nassau Co~nW
Commission Expires Mardh21, ~
(C~q~tractor~ agent,*cot rate officer, etc.)
o[: $aid (~mer or ~mra, taxi lo duly m]tl~oclM ~o I~rfonn or have lerforn[~] Ihe ~ji] ~ck alxJ tO n~ke taxi file thia
al)pi ication; 'that all statamnt8 c(mCai~l in tht8 nlqdtcatim) ore tn~ to the Imsc of his kixml~ge a[~ I~l ief~ alxl
that th~ ~}rk ~il[ I~ ~rfon~l in the a~amr ~t forth in the appl. icntit~) fii~l tl~r~iUt.