HomeMy WebLinkAbout23945-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26743 Date: 10/13/99
THIS CERTIFIES that the building ADDITION & ALTERATION
Location of Property: 25760 MAIN RD EAST MARION
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 18 Block 6 Lot 12
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 5, 1997 pursuant to which
Building Permit No. 23945-Z dated FEBRUARY 27, 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 REPLACE EXISTING COVERED PORCH, KITCHEN ALTERATION AND ADDITION TO AN
EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to DARLINE B MCGINNESS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. H 058084 12/12/97
PLUMBERS CERTIFICATION DATED 12/09/97 ROBERT VAN ETTEN
B"1-i1 ing Inspector
Rev. 1/81
FORM No. $
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)
N? 23945 Z Date .............
�� l............................,
Permission is hereby grantedd o:
Ci/....... �- -
to .....!Yo:................
� ✓ ....��'�✓ .... halm /�-.. ... .1�-..... .. ......� �... ..�s..!�'1�
at premises located at ....... J�^ lk'.Q....... r' .......I=l .................................
/ .........................................................
............................................................................................................. ..................................r...1...............
County Tax Map No. 1000 Section ...,1 ........... Block ..... K....... Lot No. . d`................
pursuant to application dated ............�� ...... 19.,1.1 , and approved by the
Building Inspector.
Fee 5....,<. ....:. �....
Q in nspector
o
Rev. 6/30/80
a s�nsrs�ssss�n� n�cC 1: '1111:112
5 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5
NEW YORK BOARD OF FIRE UNDERWRITERS 5
5 BUREAU OF ELECTRICITY 5
CS 40 FULTON STREET — NEW YORK, NY 10038 S
CERTIFIES THAT 5
5 Upon the application of upon premises owned by
5 Q.C. ELECTRIC INC. MR. & MRS. McGINNESS �5
5 P.O. BOX 518 25760 MAIN RD.
CCj LAUREL, NY 11948-0518, ORIENT, NY 11957 rj
C� Located at 25760 MAIN RD. ORIENT, NY 11957 5
Application Number: 2078623 Certificate Number: 2078623 c�
SSection: Block: Lot: Building Permit: BDC: ns11
5 Described as a Residential occupancy, wherein the premises electrical system consisting of
5 electrical devices and wiring, described below, located in/on the premises at: 5
5 L5 Outside, 5
5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed Cj
5 herein, was conducted in accordance with the requirements of the applicable code and/or standard 5
5 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5
5 authority having jurisdiction, and found to be in compliance therewith on the Day of 5
7th November,2005. S
SName QTY Rate Racine Circuit Type 5
Miscellaneous
repair storm damage
5
Service
5 1 Phase 3 W Service Rating 100 Amperes 5
5 Service Disconnect: 1 100 cb 5
5 deters: l 5
LJ 5
5 S
5 5
5 5
7c seal �7
1 of 1 5�5
5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5
5 S
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Form No. 6
TOWN OF SOUTHOLD
��1 OCT _ 8 lggg f; I
BUILDING DEPARTMENT
TOWN HALL G',G.DEPT.
TOl'vN OF SOUTHOLD
765-1802
APPLICATION 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 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from architect or engineer
respon,sible 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.
r 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 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 . . . . ./V;,� .�9. .. . . . . . . . . . . . . . . . . . . . . . . . .
New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . . ..✓. . . . . . . . . . .
Location of Property. . . (. . . . . .. . . . .. . . . . . . . . . . . . . . . .
House No. Street Hamlet
Onwer or Owners of Property.. L�f�T: .� C^ !' f. . . ��l �� ✓s� S j . . . . . . . . . . . . . . . . . . . .
y-73rdl
County Tax Map No 1000, Section. U A . . ... ..Block. . D D O�. . . . . .Lot. . . . . . . .... . . . . . . .
Subdivision. . . . . . . . . .. . . . . .. . . . . . . . . . . . . . . . . . . .FGiled Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . .... . . . . . .
Permit No. �3�.Ys ?! Date Of Permit. ��1��./). . . . .Applicant. C(1- NA1e'U. . . . . . . . . . .
Health Dept. Approval. . . . . . . . . . . . . . . .. . . . . . . . . .Underwriters Approval. . . �?:y:���. . . . . . . . . . . .
Planning Board Approval. . . . . . . . . . .. . . . . . . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . .
Fe Submitted: $. . . . . . . . . . . . . . . . .. . . . . . . . . . ..
A . . . . . . . . . . . . . . . . . . . . . . .
APPLIC
Town mall. 53055 Main Roac °164 755-?3<3
?. O. Bax 1 179 � r i c5-LcC�
Soutnolc. New Yorsc 11571 =y� W 111.
TOWN Ci'SGu�;ar. �w
OFF3CE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C E R T I F I C A T I O N
DATE:
��
Build-inc Perm`_ No .
Owner:
(please print)
I // g�
plumber: RDpU'1 yaA/ L�"ti�rt/
(please print)
7 cert'fV that the Solder used in the water supply system
contains less than 2/10 of 1% lead.
(Plumbers Signature )
Sworn to before me tris
4- day of _i)ecem ber 19
Nota=,, Public, lk. County
-Dw MEUWIEDORO510
NOTARY PUBLIC,State u}New York
�-tY 46:4870-Suffolk C�unn
ommission Expires q I-6q%?
r r-.r r2
o�OgUFFO(,�co,
IM
Town Hall, 53095 Main Road y = Fax(516)765-1823
P. O. Box 1179 v. n� Telephone(516) 765-1802
Southold, New York 11971 O
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
December 10, 1997
Robert McGuinness
114 Washington Ave.
Greenport, N.Y. 11944
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 ixll�
not on file. (Enclosed)
XX 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 # 23945-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
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765-1802
BUILDING DEPT.
INSPECTI®
[ ] FOUNDATION IST [ ROUGH PLBG.�G� �-��
[ ] FOUNDATION 2ND [ SULATION 2
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REM KS:'. 12 � ��. ¢
c
DATE--7
ATE F INSPECTOR �/�
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
.-�
DATE � INSPECTOR ,�,lj
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ FINAL
[ ] FIREIPLACE & CHIMNEY
REMARKS: �� �• �-
DATE <a-- Z INSPECTOR G/
/ �
2
M-1802
BUILDING DEPT.
NSPECTION
[ FOUNfDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACES CHIMNEY
REMARKS: ✓��1
DATE 11314yy INSPECTOR
765-1802
BUILDING DEPT„
INSPECTION
[F DATION 1ST [ ) ROUGH PLBG.
[ FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING ( ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: �C
0ll ,;e- .
DATE �y �7 INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[
/] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
f �DATE 3//-3/9 7 INSPECTOR ���
THE NEW YORK BOARD OF FIRE UNDERWRITERS
r'f" "7i`3" BUREAU OF ELECTRICITY
F— 85 JOHN STREET, NEW YORK, NY 10038
Date [If;(II"�Citjj); j„ ,f`_3""i Application No.on file I-� ':•:': I "'-' H �r?.i��ill
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
POPENT F!'i +NNN ?", 2c`"760 UATN R10-ILD, OPI£NT, NF
in the following location; ❑ Basement Q Ist FL ❑ 2nd Fl. •Section Block Lot
was examined on 0M.1ll I14M FI`, 1997 and found to be in compliance with the National Electrical Code.
FIXTURE FIXTURES RANGES _ _COOXINGDECXSI OVENS IDISH WASHERS I EXHAUST FANS
KEPTACFES SNATCHES _ I. L__.V AMT
OUTLETS INCANDEXENL FLUORESCENT OTHER AMT N W. AMI. N W kVkT N W AMT N W. AMT. H.P.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BEII UNI7 HEATERS MULTI.OUTIEi DIMMERS
SY LOUT
AMT, N,W. OIL H.P. GAS HIP AMT. NO. A W.0 AMI. AMP, Mfr. AMPS TRANS. AMi H P NO.OF FEET NAT. WATTS
__T_ - —
1 — L
SERVICE DISCONNECT NO.OF S E R V I C E
MITER NOW CC COND A W G. A w.G A.W G.
AML AMI 1nE EQUIP. I N RY 1 R 3W13/2W13/IW PER H Of CC.COND, NO Of HI-LEG Of HI-LEG Of NEURALS] OF NEURAL
OTHER APPARATUS.
FITCHEN lmP$l—VATI—N 1
r:�r:ee+T Il,rzrNr,s:
113t,
IdLv..._._-. L L
liT:1N i?t,Ari
R,IF;NI', NY, I1'Lr7 GENERAL MANAGER
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.
+ BOARD OF HEALTH . . . . . . . . . . . . . . .
FORM NO. 1 7 SETS OF PLANS . . . . . . . . . . . . . . .
TOWN OF SOUTIKILD SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
p BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . .
TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . .
SOUTUOLD, N.Y. 11971
TEL: 765-- 1602 NOTIFY:
L/
CALL
,// ..... 19 MAI 1, TO: . . . . . . . . . . . . . . . . . . . .
Approved.-, ,1......., 19,?7 1'e nniC mi. -Y.7�ri ............................. ......
Oigripprtwed arc .................................. .................. .................
........ ... ........................................ .
(Ihai ld' last ctLor)
APPLICATION FOR UUILUTNG PERMIT
Date. . . . . . . . . . . . . . . . . 19- „ -
t NSTRIICTI oN.9
a. 'ibis alnplication mist be cdnililelely filled in by tyliewyker or in ink nixi scdrnitted to Ura Ihrilding Inspector w
7 sets of plans, accurate plot: plan to scale- Fee according to scheihde.
b- Plot plan showirng locaticer of lot arnd of boi ldiogs on pronises, relat ionnship to adjoining pr Fraise,^. or pndrl is
,sl;reefs or areas, and giving, n,del:ailed denc_ription or layout, of properly nest be drrnaa on the dingran which is part of
Unis applicaLio n.
c. 'flue work covered Iry this applicaticnu arty oot be crnneo:ed before issontwe of Ihrilding Permit.
d. Upxm apinuval of this alq>l icalirnr, the lhuilding Inspector will issrme a AdIding Permit to the arjA ir,anL. Sovlr
permit. shall be kept rnn [he prollises available for inspection Iluorglxnat the work.
e. No boildin g shall be occupied or used in whole or it paa for airy purpose whatever rotil a Certificate or
Ocogmo:y slrnll have been granted by the Ihrilding Inspector,
APPL1CIVrIOl IS HEREBY Mf'JJR to the Building Deparluwnt: for the issuarwe of a Ihrilding Permit prrmnant to the
Boitdirng 7,dnae OrdinnaoCs of tile 'Iixar of Soothold, Suffolk (cooly, New York, and other applicable laws, Ordionnees or
RegulaLious, for the constrarcGon or ioildings, additions or alterations, or for removal or demolition, as berein
described. 'Ibe applicmrL agrees to rmply with all applicable laws, ordinances, Innkding rale, horsing code, and
retndations, and to aciuiL mattnorized inspectors on premises and in building for
ffo�r �necessary iinspect_iolns.
-"!'r.,i6lN.N!'!.v!15;...................
(Signmture of applicant, or none, if n corporation)
-.--.(t-Bailing address or applicnot)
State whetter applicant is Owner, lessee, age t, architect, engirneer, general contractor, electrician, plrnier or hoilde
or'01 .cce"...�C.ay. R.4���a-R . ........................................................................
Nine of corer of premises .....oAc ,wfl -AJJJ... � res!
(as as lbe Lax mll or latest deed)
if alipticnot: is n corporation, sigrolure of duly malmorized officer.
............. ............................................
(Nane nrd title of corpxrraLe officer)
Ihrildcrs Licen:;e No-
Planners License No. ........................
Electricians License No. ...- -..............
OLher 'Trade's Liceose- No. ..... ............
t. Location of land on w1dr.h proposed work will lie donne-.- ....PRO....1:T... n
... .. ....... .....................................
Iknnse la+riner Street / 110010
QAulty 'rax Map No. 1000 Section ......J!...... Block .....t7.....---. lot .-.��.........
.,uldivision .......... ............................ Filed Kip No. ............... lot ...............
(Name)
2. State existing use and MA-VIN3rncy or pronmses and intended us�etp amid rn,apancy of proposed constructicio:
a. RxisLing use acxl occupancy -..........U--``N dGG.' .11�-tG'f-4.............................................
b. intended use anocc pxaxy ........TA-g2Kr....-r14 orn...........................................
kli ,:'l1', i� .
1' A W , y,
S. tlit lieu of krill( (elleck %Alidi al Ill icahle ; fka4 Ikeildinl, .......... Mklilion ,..). .... Alleraliau ... .......
kelxlir . .... ....... ItalervaI . ......... ... I)eylul it ion .. .......... Older tont .. ................... .. . ... .. .....
�� 0��yy (0erx:r i pt:ion)
4 . EM indeed Glsl' . .. ..'..TY......... ..... fee ... ...... . ...
... ... . . ..... ........ ....... ......
(it) Ix: paid til I Ifill, this spill icul.icxl)
`i. If ehn:lI iull, exolier of chelI hqj olds . ... . . .. . .. tkeiix:r of eh,el Ihig uulls kilt each flexor . ... ........ . ...
If garage, linker of care ....... ... ......... ... ..
6. If tokilllesa, ctilli rctal or alixeil kx:colulex:y, sllec.tfy mature mel exleol of each type cif use... ... ....... . .. ......
I IlilWolliexw lie` ext Hlisg alnu:turvea, it; soy: Ike cid . . . . ..... . ...... (tear ... . ... ... .... . DGIA 11 . .. ....... .. .....
Ito igit: ... ..................... . Culler of Sl or iLa . . .... . ... . .. ... .. . .. .
tine;nslous of aiue: sttlu:ture with alleraLicxls lir .ukliLionH: Fresh . . . .. .......... Itear . .. . .. ... .. .. ..
Ih:plll . .. ... .. ............ lkeigJlL . . . ... .. .. . .. .. ..... ti..d l:r of Stol iea . .. ... .........
fl. Oiaeus ions of enl ire liew coast rlua.iexu Fetid . . ../�L... ... .. He:ur .eF X�s��,:� Sana, Ikplh ...{�.`... ...-
i
I le it)lI .. ... .R.................. M.lixer of :ilorien . . . .. .(.- ... . ... . .. ..
i �r +qp
9. Hila (it IoL: Flcxd . ..ass. ... ... .... Itear . . ay7'.3.�... .. . .. ,k:pth . . .3 At.. a... ... . .
10. Nat! of Vulchnse jN.............. ..... Nam! of Fourer 041wr .. .\.V.�?N. . ...P.pe l t ........ ...
I1. yAite or use dial riot to wilirllpresrlises arc sito:devl . .. .. ...... .. ... ....... .... . .. .. .. .. . ... ...... .. ..... .... .....
11. lkxeti lotoli li(M con411twi lon Vlolille ilily E Mllllg IiM, Or(lloiloCe elk 1'Oglllill.10o: . .. . . .NQ........ ... ....
13. Will lot Ite legrrxleel . .NW l.... .......rr.7�....A�... Will excess fill lie ieljk,,W d '�Frddan ilk+eillisee: YES A
14, thatics of (oder of ptenlses D9 k.90T.PA J.4%+NMeS3 A<klress .wi,.�Y.7tw'r.:� 4-Y..'I'ta. Itxxue Ito. 177�Py1'
Kite of Alchitcct ............... ... .......... .... .... Arklress I1ione R.). .. . .. .. . .
Ione: of (exo raclor ..... ............. ................. Ackltess .. . ... .. .. ... ..................Noone lb.
Li. is this prolierty within 3(Y) beetof it lielat IeLlalxl'f * YES ... . . . .... Ni) .. .!�.. ..
*IF YG9, 1XIIIII(MI) 'llllhl 'IIiIIS117?S tiel1flT HAY ISI? W?(1IM,]).
11101 I)JAGI AM
Irx:ale clearly aeui distinctly all Ixiilditg,s, (((elder existing lir prolxised, soil ilxlicate all set-hack dimensions
flan propLity lines. Give street akin httx:k lather or descriptioo acconliog fo eleedf aeul rillcna street vales alai ileli Cnte
%Alelher interim or confer lot.
SM11-1, (W WA4 Y(Av'
0AIIIIY (AP . . .?lJ?!/!.�Io,,.r k�.j.. ......
... .. .{� ..T!i!�. .-(/. !.'/../.�e%:"'-.. ... ... ... ... ... ... . .. ...lxsiul,.duly mAll", delxlse: aril says that. he i:r the applivsut
(Mviee of iiilividual signlul, coull'ocL)
_r11xiVe I14M1e'd,
lke it; We .... ,..CU`"`,2e9G\'U iz
..... ....... ... .. .............. ......... ... ... .... ... .......... ... ... ......... ...
((buts actor, agetlL, corlwrllte officLI , etc.)
of Haid (stunk of rnnxv n, 111x( is duty mlthorized to ILn form lir tmvu Ix:rfonn:d the acid wollt mil Lo nzliee 111x1 file Thin
opplicilLloll, thio. :ill stiltolInllfl cootailltd lel Ilkin ilpp[ki1110o ;oL title to the liest. of [kill klKMlellge aeil lx?Buff ilex(
That. the work will Ix perfoun:d in the ucunier set. Rath ill the application filed therewith.
!kxrrel to liefole lir thin
... ... �..... ..clrly of .6'ie1119Kv. . ... 199e..1 ... .
lonely .......
/ .. ...... ^^..I. ... ...........
DEBORAH A.MORTON (Sigoatofe of Appli(!ant)
Notary Public,Stell of Nllwle Yolk
No.401'17180
Qualified In Suffolk Count((
Commission Expires Noveiwm lgv
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NOTIFY 'BUILDING DEPA
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r 'T-FOUNIIic�ivt9—'T�'�w fSEOUFR
Ot�fiCER ___ FOR POURED CONCRETE d° a
--
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- -- - - - -- ---- — . - ------ — - - ------ of LIV�+$J[�1��
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d. FINAL CONSTRUCTION MUST rt \
ALL CONSTRUCTION SHALL MEET
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