HomeMy WebLinkAbout23097-zFORM NO.$
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD~ N.Y.
BUILDING PERMIT
ITHJS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
23097 Z Date .............. ,.~/,~,~ ,~., ...............................
Permission Is hereby granted to:
~.~,~L,...~.~~.~,,.,~....~./..~. ~)/,,~ l,d~
, ~? .~:~....,~.: .......................
. .~. ~. ~j. a .~,,~ ....... ~ ~ ,. . . z /. . ~ ~ . .~. . . . ...............
to . . . . . . ,C~. ~.~,~ .~.~. . . . .:. . .~ ......... '. ~ ~. ~. . . . . ..~~ ~. . . ..~'. .. . . . .~. . . .~. . .,,' ~' ~
~.,../....~*,t .......... .x..~ .............. ~ ......... ~~..~.~ .......... ~....~ /
at premises located at...../.4~-..~..~...........~....~¢'~...c~7..~. ¢.~ ........ ~ ..............................................
CounlyTaxMapNo. 1OOO Sectlon./.~...~.. ............ Block ........ 4~.....~.........~.otNo ...... ,.~,..~.... ............
pursuant to application dated ...........~.....~'~ ...... .~..~.,. .................... 19...,~...~.~..:.., and approved by the
Building Inspector.
Fee $.....~...~...~..¢
/~,/ ~ullding Inspector
Rev. 6130180
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
$outhold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24485 Date JULY 10, 1996
THIS CERTIFIES that the building ACCESSORY
Location of Property 1555 FLEETWOOD RD. uuTCHOGUE, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 137 Block 4 Lot 34
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 18, 1995 pursuant to which
Building Permit No. 23097-Z dated NOVEMBER 1, 1995
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 NON-HABITABLE ACCESSORY STRUCTu~ IN FRONT YARD AS APPLIED FOR
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
WILLIAM & JANET WALSH
N/A
N-388566 - JUNE 13, 1996
JIILY 1, 1996 - MIKE JACOBI
Rev. 1/81
¢~1 0¢ /' BUILDING D EP ~TM~'~NT
~CATION FOR CERTIFICATE OF OCCUP.~YCY
This application must be filled in by typewriter OR ink and submitted co the building
inspector with the following: for new building or new usa:
Final su~zey of property with accurate ioca:ion of all buildings, property lines,
streets, and unusual uatural or topographic features.
2. Final Approval from ~ealck Dept. of water supply and sewerage-disposa!(S-9 fo~).
3. Approval of electrical installation from Board of Fire Unde~iCars.
4. Sworn statement from plumber certifying chat the solder used ~ system connains
less than 2/10 of Z% lead.
5. Co:ercial building, ~duscriat building, multiple residences and .s~i!ar buildings
and installations, a certificate of Code Comp'liance from architect or engineer
responsible for the building.
6. Submi: Planning Board Approval of compleced site plan requirements.
For ex-isting 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,
.&iterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions co accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existin~ Buildin_~ - $i00 O0
3. Copy of Certificate of Occupancy - ~ -25¢.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $i5.00, Commercial $15.00
New Construction. ~/ Old Or Pre-existing Building .................
Eouse No. S ~reet
County T~ ~p No i000, Section .............. Block ................ Lot ......................
Subdivision ......................... ~ ......... Filed Map ............ Loc ......................
Eeal:h Oep:. Approval .......................... Under, ri:ers .~_ -
Planning Board gpprovai ........................
i
Request for: Temporary Certificate ........... Final Certicate...
~ ~PLIC~NT
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
$OUTHOLD, N.Y. 11971
C E RTI F I CAT I O M
TEL. 765-1802
Building Permit No. 2 ~ O ? ~-~,~..
Owner_ ~./;/l,o.,/v'( ~/~ 1,~' ~
(please priht)~
Plumber ~(~(~ ~ CO~I
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
SWorn to before me t~s
1~ . "?" "
(plumb~s ~ignaturel
CLAIRE L. GLEW
Notary Publio, State of New York
No. 4879505 ~ /
Qualifiad in Suffolk County 7/,,
Commission Expires December 8, 19~.~'
F
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE
85 JOHN STREET, NEW YORK, NY 10038
Date JUNM 13,1996 ~pplJcatlonNo, onfile 11836596/96 N 3~566
THIS CERTIFIES THAT "
o~y the electrical ~uipme~t ~ ~scrib~ be~w a~ ing~uc~ by t~ appl~ant ~med on the a~ue applicagion number ~n the prem~s
WILLI~[ W~SH, 1555 FLEETWOOD ROA~'3, CUTCHOGUE, N.Y.
i~ thefollowlng locution~ ~ Basemen~ ~ Ist FI. ~ 2~d Fl. Section Bilk Lot
~ examined on JUNE 07,1996 and found w be in compl~nce with the NaMJn~ Elect~cal Code.
23 6
DRYERS
OTHER APPARATUS:
PADDLE FANS- 2
HOTORS:I-F H.P.,1-2 H.P.,2-F
P~/~ELBOARDS:i-14 CIR. 100,1-1 C~L 60
ELEC. WATER HEATERS: :1-4.5 K.W.
G.F.C.I:-2
SHOKE DETECTOR; -3
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
July 1, 1996
Samuels & Steelmen
25235 Main Road
Cutchogue, NY 11935
Re: William Walsh - SCTM#1000-137-4-34
Prem: 1555 Fleetwood Road, Cutchogue
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. $25.00
No Health Department Approval on file.
No final inspection has been made.
xx No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 23097-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
F 1 I'IAI,
AI)I.~ I.T tONAl, COHHEI,TT$:
THE NEW YORK BOARD OF FIRE UNDERWRITERS PA~s 1
1~ ~uRE^U o~ E-ECTmCITY
85 JOHN STREET, NEW YORK, NY 10038
D, te JUNK 13,1996 AppllcatlonNo. onflle 1~836396/96 N 388566
o~y ~he electrical ~uipment ~ ~.crlb~ be~w a~ int~uc~ by t~ .p~ant ~d on ~he a~ appl~.~ number in the prem~s of
WILLI~ WALSH, 1555 FLEETWOOD ROAD~ CGTCHO~UE, N.Y.
i.,hefoll.,~.~l.c.,~o.; [] ~.,,.,...t [] ~ ri. ~ 2.~
wos exatnlned on ~ ~ ~1~ and found to b~ in comptitmce ~ith the N~O'on~l Electtical Cod~.
FIXTURES RANGES COOKINO DECKS OVENS DISH WASHERS EXHAUST FANS
27 4
OTH6R
MULTI.OUTLET
SYSTEMS
NO. OF ~ET
OTHER APPARATUS:
C
INa. OF NEUTRALS
OF NEUTRAL
PADDL~ FANS-2
MOTORS: 1-F H.P. ,1-2 H.P. ,2-F
PANELBOARDS, t-14 CIR. I~,1-1 CIR. 60
ELEC. WATER HEATERS: ~1-4.5
SMOKE DP. TECTOR ~ -3
RICHARD K~INFELDT LIC, 9665E
~14 C/~%LTO~ AVE
ISLIP TERR., NY, 11752-2904 ~
This certificate must not be altered in any manner; return to the office of the Board if incorrect, inspectors may be ' ntified by~ their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST~NO~:BE ALTERED IN ANY HAMMER.
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] ROUGH PLBG,
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] INS/ULATION
[ ~/]'~INAL
[ ] FIREPLACE & CHIMNEY
DATE
INSPECTOR
D!
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ] I~LATION
[ ] FRAMING ~ FINAL
[ ] FIREPLACE & CHIMNEY
REMAR~
DATE ~//~/~ INSPECTO~
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [~ULATION
DATE INSPECTO
765-t802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ]/~OUNDATION 2ND
[//] FRAMING
[ ] ROUGH PLBG.
[ ] INSULATION
[ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: /~~~
DATE
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOU/NDATION 1ST [ ] ROUGH PLBG,
[ ~"FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE
INSPECTOR ~/~~ ~/~
765-1802
BUILDING DEPT.
/ ISPECTION
[L,,]"FOUNDATION 1ST [ ] ROUGH PLBG,
FRAMING
FOUNDATION 2ND [ ] INSULATION
[ ] FINAL
INSPECTOR
DATE //~
FORM NO, 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT:
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL,: 765-1802
Disapproved a/c .....................................
. (Btflldfng Inspector)
APPLICATION FOR BUILDING PERMIT
B~RD OF HEALTH .........
3 SE~S OF PLANS .........
SURVEY ................ ..
CIIECK ........... ; .......
SEPTIC FORH .............
NOTIFY;
CALL
FLAIL TO:
INSTRUCTIONS
a. This apl~lieation 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 sti-eets
or areas, and giving a detailed description of layout of property mu~t be drawn on the diagram which is part of this appli-
cation.
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 i~sued a Building Permit to the applicant. Such permit
shall be kept on the premises available for inspection througtmut 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 HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of South01d, 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, housin~ and regulations, and to
admit authorized inspectors on premises and in building for necessa~~ ~i . . o
.. ,'~'~.X.~e)~v v.~. v r'.~r, , , : ........
-- .~'(Si~natur~ of applicant,"or-ffame, if a corporation!
f a hcant' //'F'~5'
(Mailing address o pp ' )
State whether applicant is owner, lessee, 'agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of pwner of premises ...~. · ./4..<~..,~...~.....'~.' .... ' ...................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No ~
Plumber's License No ....... ..................
Electrician's License No ................ . .......
Other Trade's License No ......................
OCT 18 1995
Location of land on which proposed work will be done ..................................................
.... .... ' .......... ......... ·
House Number Street Hamlet
Cou'nty Tax Map No. lOOOSection ...:..i(.c3...~.. .... Block ..... ..~.... '.. Lot..c~.~. ...........
Subdivislon.. ~ ..... . ............................ Filed Map No ............... Lot ............... (Name)
State existing use and occuponcy of premises and intended use and o~cupancy of proposed construction:
a. Existing use and occupancy ~.~...~..'.~.~..~.-~. ·
........................__ ~,;.'v ~-,~l,f ,, ag,-~ :a~,,~q'~;,% ' .' .....
b. Intended use and occupancy . . ~r=~.;. ~...;,..:., 2,;~'~?
'3. Nature of work (check which applicable): New Building . .~ .......... Alteration .... ;.. i.
Repair .............. Remo al ............. emol,tmn ................ Other Work ...............
4. Estimated Cost ........................ Fee
~ (to be paid on filing this application)
5. If dwelling, number of dwelling uhits .... 77 Number Of dwelling units on each floor.
· If garage number of cars ~ -~- . ..... .........
If business, commercial or mi.xed ioccupancy, specify natnre and extent of.each type of use ~
7. Dimensions of existin~ structures if any'Front ' Rear ...~...~..~..~7 Dept i.~..~..~..'.27'.
Dimensions of same structure with alterations or additions: Front ................. Rear ...............
L~imens~ons o~ emire new construction Front .... /.fig? t~.F.. ~ / ~:~ ~ ,, ., ' ' ' '
~. · .................. ~um~ oi rormer uwner ~
11. ~one or use district in which prem'ses are situated... ~(. - ..:,~...~ ................ ~: .......
12. Does proposed construction violate any zoning law ordinance or regulation: ~.~. ...............
13.?.ill 16t ~be~regraded ....... ~ :.' ' :: win excess nil he removed from premises: Yes No
Name of Contractor .......... i ............... Address ................... Phone No ................
15. I.s t:h±s property wit:hin 300 feet: of a t:idai wet:land? ~Yes .... ~ No ......... ~llf yes, SouL:hold ToQn Trust:ecs Permit may be required.
' ! PLOT DIAGRAM
Locate clearly and distinctly all b[lildings, Whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and block nulmber or description according to deed, and show street names and indicate whether
interior or corner lot.
;TATE OF NEW YORK,
;OUNTY OF .... ~%/.~.~.~.-.~... 'S.S!
......... '~9../~.~../~..~..~....~o~'/~. ~.~Tz.k~...' ......... being duly sworn, deposes and says that tie is the applicant'
(Name of individual signing 9ontract)
bore named.
'
[e is the '
~ (Contractor, agent, corporate officer, etc.)
f said owner or owners, and is duly aulthorized to perform or have performed the said work and to make and file this
~plicat on; that a I statements containec~ in this'application are /rue to the best of his knowledge and belief; and that the
ork will be performed in the retainer setlforth m the application fi ed therewith.
worn to before me this
..... day of ......... ,
' (Signature of applicant).