HomeMy WebLinkAbout24303-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25647 Date: 04/15/98
THIS CERTIFIES that the building ADDITION
Location of Property: 845 SMITH RD SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 98 Block 4 Lot 9
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 11, 1997 pursuant to which
Building Permit No. 24303-Z dated AUGUST 13, 1997
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 INSTALL SKYLIGHTS & A DECK ADDITION TO EXISTING ONE FAMILY DWELLING
AS APPLIED FOR.
The certificate is issued to ROBERT A FLANAGAN
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N445425 02/11/98
PLUMBERS CERTIFICATION DATED N/A
QZ1,
a,5�v
///
BuildingI pector
Rev. 1/81
"RX NO. f
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)
9'f
N° 24303 Z Date .............. ...��............................ )9.1...✓
Permission is hereby granted to:
/�✓✓lt�Q�7k'.rill..K1�.7..:1;!�.G..../r✓.:.���1.1��3(��
..l�F✓K...1?a.................................................
.fr�e�..I.e .. ..../l/..?'.&.................
to 0/� yup
7-t✓4T - ..C.r.... ......... .....lQ..,.fT!?...... 46?SG.{XL
s .1e........ ......i . 1� ..... J.....
r.........................................................................................................
......................................................................... ..... ....
Q..../�ti1....
at premises located at........ ..... >gq1 ��.!/7..... ... .s...............Are! !•tG ..,.Yy.................
County Tax Map No. 1000 Section .....,/. ........ Block .....aX...... Lot No. .
pursuant to application dated ..........:s).U.ISI¢........1!•.. t................. 19.1..,1, and approved by the
Building Inspector. J
'-�
Fee5..... . ..s,.........
/ ! ..`.. r . .... ..........................
$u' Ing nspector
Rev. 6/30/80
• TOWN OF SOUTHOLD -
BUILDING DEPARTMENT
✓ TOWN HALL
765-1802
APPLLCATION 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 19. 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.
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.
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.
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 do Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4. Updated'Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential 15 00, Commercial $15.00
Date . . . . . .. .. . . . . . . . . . . . I . . . .. . . . .. . . . . . . .
dew Construction. . . . . . . (�u Old Or Pre-existing Bui difn�g. . . . . . . . . �j
•ocat'ion of Property. . . A .IJ. . . . . . . . . . .Y?ll : '�': . .0-0 . . . . . . . . .. U.-�COI . I V. . . . .. ... . . . .
House No. Street Hamlet
Inwer or Owners of Property. . . ... ... . . . . f . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ... . . . . . . .
ounty Tax Map No . .1000, section. . . . . 1.0 . . . . . .Block. . . . . . .j . . . . . .Lot. . . Y. . . . . . . . . . . . . . .
ubdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . /) . iled Map. . . . . . . . . . . .Lot. . . . . . . . . .. . .. . . .
. .. . .
ermit No. . . ��. . . . . . .Date Of Permit. . . d .t2� .t� . . pp CJ(r
hli�fiNNf .
A can
ealth. Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . ✓ . . . . . . . . . . . .. .
lanning Board Approval.. . . . . . . . . . . . . . . . .. . . . . . /
equest for: Temporary Certificate. . . . . . . . . . . Final Cer„tft te.. . . . . . . . .
ee Submitted: $. .4:y � . . . . . . . . . .. .. . . . . . . . t
APPLICANT
.s Lig �q
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Environment East, Inc
3075 Indian Neck Lane
t P.O. Box 190
Peconic, New York 11958-0190
516-734-7474
cot
84s U �Srrle`�h Rd
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ly
Environment East, Inc.
a 3075 Indian Neck Lane
P.O.Box 190
Peconic,New York 11958-0190 r
� ..- 516-734-7474
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THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
' 1001093 BUREAU OF ELECTRICITY
40 FULTON STREET,NEW YORK,NY 10038
Date FEBRUARY 11,1998 Application No.on file 14927697/97 N 445425 -
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above appllcudox number 4 in the promisee of
MS. FLANAGAN, 845 SMITH ROAD,, PECONIC, NY
entq1
in the following Facade.; 4 Basemt U" lit Fl. ❑lad Ff. ATTIC/OUT Section Block Lot
was trammed on FEBRUARY 06,1998 and found to be in compliance with the National Electrical Code.
FIXTURE FIXTURES I RANGES ICDOKINQDICKSI OVENS I DISHWASH
EXHA A
OUTLETS AECEPfACIEF $W{CHCS IXCANDnCINI fWORf3CFN1 OSNFe AML K,W. AML N.W. AMI. K.W. AMI. N.W, AMI. N.I.
11 18 7 11 1 1.2
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL 0.EC'IT. TIME CLOCKS BELL UNIT HEATERS M SYl-OUTUT DIMMERS
AML N.W. OR Xe. TSA] N.P. AMI. NO. A.W.O, AMT. AML AML I AMP]. TARNS. AMT. H•L NO.OF FEET AMi. WAni
1 F 1
201 1
SERVICE DISCONNECT No,OF $ E R V I C E -
METFR
AML. AMP. TYPE FCU P. I/qW I/]W —L,—-"a OF CC COME. CC.O.CON
HISCAI
OTHER APPARATUS:
SPECIAL RECEPT. AMP.30-1
PADDLE FANS-1
WELL PUMP-1
MOTORS:1-F H.P. ,1-F H.P.
ELEC. WATER HEATERS:31-4.5 K.W. bs'
G.F.C.II-3
'SMOKE DETECTOR:-3 — -
'Nt�.-L�, >
<<< Continued on Page 2 >>>
GENERAL MANAGER
Per
This cemfleale must not be altered In any manner;return to the omce of The board It Inoorrecf.Inspwfon may be Identified by Meir Credentials.
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 2•'
1001093 BUREAU OF ELECTRICITY
F 40 FULTON STREET,NEW YORK,NY 10038
Date FEBRUARY 11,1998 Application No.on fie 14927697/97 N 445425
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number 4 in the prem6n of
MS. FLANAGAN, 845 SMITH ROAD,, PECONIC, NY -
in the following Location; M Btatnum Lia lit Ff. ❑2nd FL ATTICIOUT Section Block En[
was rrami.,d an FEBRUARY 06,1998 and found to be,in compliance with the National Electrical Code.
FIXTURE gFCEPikctls SWITCHES FIXTURES I RANGES I COOKING DECKS I OVENS I DISHWASHERS EXHAUST FANS
OUTLETS INCANWS FWORF]CEM O1NFR AMI. KW. AMI. N.W. AMI. K.W. AMi. K.W. AMi. N.P.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'FT. TIME CLOCX5 SELL UNI}HEATERS Mrs Ts OMg Ei DIMMERS
AMi, K.W. OIL N.P. (PAS Hf. AMI. NO. A.W.G. AML AML AMT. AMPS, TRANS. AML N.P. NO,OF FEET AML WAITS
SERVICE DISCONNECTNO.OFFg S E R V I C E > ' -•+=`£.
MEi
AMi. AMP. MF ECUIP, i02W I MI 3a 3W 40 eWModC.OND. O A KO.OF XIAO HO OF NENRAM
'M HiMALL
OTHER APPARATUS:
DOROSKI EIEC. INC. LIC.#2941
425 MONSELL LANE -
CUTCHOGUE, NY, 11935 GENERAL MANAGER
Ili 11
Per
This redltiecfe must nal be rM.md In env manner:reium to Ilse afflo of the Scrod if Inconerl.I...otcr mew be IdenNfled by mels rred.nxnl.
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ISI 1
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN ION
( ] FRAMING [ FINAL
[ ] FIREPLACE CHI
/M"E
REMARKS:
DATE INSPECT
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDA ON IST [ ] R"Wo-LOG
[ ]Z
DATION 2ND [ iNSULATION
ING [ ] FINAL
[ ] FIREPLACE SSC/HIMNEY
REMARK - ✓'/� _
G� *
ol<f _
DATE 1Z INSPECT
765-1802
iLDING DEPT.
SPECTION
/IF:
NDATION1ST [ ] ROUGH PLBG.
NDATION 2ND [ ] INSULATION
[ FRAMING [ ] FINAL
[ ] FIREPLACE A CHIMNEY
REMARKS: 2�e�
DATE INSPECTOR
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ INSULATION
[ ) FRAMING [ j FINAL
( ] FIRfEPLACE A CHIMNEY
REMARKS:
Z -
DATE �/ INSPECTOR r
IL J t�rA TYPE
6KIST, FAFTa?S
@ 5K-<LkG+-47 rf-AMING- -
S:rn s t DE<s
'-TECD TSI � , ,�
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LoY 2d
o ro H P""o c Guo/anTead fo Sw 0/c G�ur 7y
N.�1'iGnat/ f�c,/7fC ond /y f r -G=o�nf�
rt/c Guararrq G Gpy+/04Hu
QS SCJrVcgre � (f4/y
' of/o w teary ruyi � so,�
HNotc : %ot /+awi/ rc fcr rD fr tz, /
a �t /ycliaH /Vc'c.k F�ark," fi/cd iy fH
S�.rr=o/k CaiHf7' �/crk '„ offr"cc as Liccasc� Lo demur-yeyors
NJap No SS/ Gre:,--nPol 7 Ne K• 1/ar-k
3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . .Y . . . . . . Alteration . . . . .
Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . . . . . .
G (Description)
4. Estimated Cost . . . i. .j. . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(to be paid on filing this application)
5. If dwelling,number of dwelling units . . . 1: : : : . . . . . . Number of dwelling units on each floor . .l4. ... . . . . . . .
AA"" �
if garage, number of cars . . . . . . . . KA—.' , , , • . .
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . . . .N�.'. . .
7. DunensionsQ r e�xistin structures, if any: Front . . . , �-� . . . . Rear . . .�.:0:1: . . . Depth . . , 36;0,";
Height . . ;`J -D . . . . . . Number of Stories . . . .I` 7.. . . . . . . . . . . ... �. . . . . . . . . . . . . . . . . . .
. . . .t. . . . . . . .
Dimensions of sametstrugture with alterations or agditiQims: Front . . . Rear . . >m . .:4. . . . . . . . . .
Depth . . . . . . . Z. .1?. . . . . . . . . Height . . .ZL ."O. . :(:. . . . . . . . . Number of Stories . . . .t.y . . . . . . . . . . . . . .
8. Dimensions of entire new construction: Front . ,79Y.0-. Da�QRear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . .
Height . . . . . . . . . . . . . . . Number ofStories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9. Size of lot: Front . . . . . . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . .
10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Forme Owne
11. Zone or use district in which premises are situated . . . . . :T�.-AQ. . . . ?,Si
12. Does proposed construction violate any zoning law, ordinance or regulation: . . . .t.j. S?. . . . . . . . . . . . . . . . . . . . .
13. Will lot be regraded . . . . . . M.( ) . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: es
14. Name of Owner of premises�! .F�?�N!kE'(�. . . . . Address '( S, ZWk(it-t. ('`p. . .Phone No. .7
Architect . . . . . . . . . . . . Address . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . .
of Contractor �JV.•.G: 'C. . . . . . . . . . . . . Address . 1� .r2 n is Phone
PLQT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and in(licate whether
interior or corner lot.
� r
STATE OF NEW Y. . s.S
COUXTY OF . .
r. . . . . . . . . . being duly sworn, deposes and says that he is the applicant
. .. . .
(Name of individual signing contr ct)
above named.
Ileis tile . . . . . . . . . . . . . . . . . . . . . . . . . o . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . !. . . . . . . . . . .
(Contractor ent, corporate officer, etc.)
:)f 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 the manner set forth in the application filed therewith.
Sworn to before me this p
. . . . . . . . . . . . ay f . �� UL`�. . . . . . . . .. 1974
Notary Public, County
-� // i . . . . . . . . .
"YQtWeEff. tR. 1 (Si gn u pplicant)
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
I I L;97 TOWN HALL
SOUTHOLD, N.Y. 11971
x-- TEL.: 765-1802
&13
Examined . . . . . _ '.'.'. 1 �� q Received . . . . . . . . . . . , 1 9 .
Approved . . . . .I3 . . . . . . .. 19 /Permit No. W?Kloei
Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . /
( ill ng spector)
APPLICATION FO BUILDING PERMIT
Date .d.Vt:—�l. . '.2—. . . ., 19�
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with
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 stye=
or areas, and giving a detailed description of layout of property must be drawn on the diagram which Is part of this app
cation. I
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 issued a Building Permit to the applicant. Such pent
shall be kept on the premises available for inspection throughout the work.
e. No building slrall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan,
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 t
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws,Ordinances
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and
admit authorized inspectors on premises and in building for necessary inspections.
r:;*v i !�N.4 T. . . .�t Its C
(Signature of applicant,or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde
(Z. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Name of owner of premises . . . . :dy( . . . . L ?'C c�t� A. . . . . . . . . . . . . . . . . . . . . .'. . . . . . . . . . .
(as on the tax roll or latest deed)
I
f appy,'an 'syc� poi. ion '*nature of duly authorized officer.
j: . . . . . . . . . . . . . . . . . . . . . . .
amc and title of corporate officer)
Builder's License No. . . . . . . . . .
['lumber's License No. . . . . . . . . . . . . . . . . . . . . . . . .
Electrician's License No. . . . . . . . . . . . . . . . . . . . . . .
Other Trade's License No. . . . . . . . . . . . . . . . . . . . . .
1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . .
. . . . . . . . . . . .
[louse Number ppStreet Hamlet
County Tax Map No. 1000 Section . . . . . . .t.�. . . . . . . . Block . . . . . . . . . . . . . . . . Lot . . : .'. . . . . . . . . . .
Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . .
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy . . .�5. �P . . . . .S Q !� t.t. � i\ . . . . . . . . . . . . . . . . . . . . . . .
b. Intended use and occupancynl �. . . .
. . . . 1 .(. .�. . . . . .C�lh'1!-S
Illfo� wad=tttirr-, arfd it+a}gW. .
R�7�`^
8";V108,
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✓ OCCUPANCY OR fi" 6'..
USE IS UNLAWFUL t
1 ..lo, ,� �- 35hcte .tANE.L--
WITHOUT CERTIFICATE,
OF OCCUPANCY
APPROMAtN01l� 24" ShsE v / CRAwEF 2" D1tAweK PASEe
DATE: 37 I.PS 'L�
FEE: , i R ..
NOTIFY MUMS 00111INIMMAW .
1' 785-1902 0 AM 10*-M M 10
.. FOLLOINMY' � A,c>�i 3�EY'ri
1 FOUMIXI M --TM
FO pro Ana K T GAS$. DE,wL S
2 ROII41 lbw
3,,INSULMM
Bocomftmfmca FLA
ALL CONSTNUCIION MMLL Mr•E r Avr oy _ , onr,wR eW J
THE REQUIREMENTS OF in wt � * PtG,
! STATE CONSTRUCTION•& �P 6'1"o,
' CODES. NOT REBF30domA MRDATE , +; J ARY16gG
DESIGN OR CONSTRNPIION lMOM ` ,ylp,
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OPAWING
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