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HomeMy WebLinkAbout22115-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. No g-23157 Date AUGUST 11, 1994 THIS CERTIFIES that the building Location of Property 72~ CENTRAL D~IVE House No. County Tax Map No. 1000 Section 106 Subdivision ADDITIONS MATTITUCK, NY Street Hamlet Block 2 Filed Map No. Lot 24 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated ~uilding Permit No. 22115-Z MAY 20, 1994 pursuant to which dated ~ 8, 1994 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 AN ADDITION AND DECK ADDITION TO A SINGLE FAMILY DW~.T~IN~ ~ APPLIED FOR. The certificate is issued to MA~Y & PHILLIP O'REILLY (owner, lessee or tenant) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N320963 UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 J~LY 20, 1994 N/A Building I n~ect or FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENf TOWN HAL). $OUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ................. ................................ 22~.15:7 ................................................................... z2.,,./~.//~ .......................................................................... ~ · at premises located at .................. .~..~ ........... ~/~...~.. .......2../-~. '.~.. ............................................ ................................................................. ~,,~.~ .................................................................. Counfy Tax Map No. 1000 Section ........ /~'~?~ ....... BIock.....~..,,~.. ............. Lot No...,,'~,, ,,~,,.. ............... pursuant to application dated .......... ~//~.?./ .........~ .................. ~ 9.... ,,?...~...., and approved by the Building Inspector. E~e ~...,,.Z..~..'..~ ...... Rev. 6/30/80 FOrm TOI~ OF SOUTHOLD BUILDING DEPARTMENT TOI~] t~LL 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: 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 2710 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. 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 i. 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-existin~ Buildine - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial ~15.00 Date ................... ~ew Construction.....k~.. .... O~fl Or Pre-e×istin~Bui~ding ......... Location of Property ..... ~. .................. ~:~.~ ..~ ....... House No. Street Hamlet Onwev or Owners of Property .......................................... .. · · · . . County Tax Map No 1000, Section .... ~.~).~. ..... Block ....... ~ ...... Lot ....... ~ ........... Subdivision ............ Filed Map ............ Lot ........... Permit No...~..~-..%]~. .... Date Of Pe~Tait.,,~,q.~..~?.~.'..Applicant ................. .U~ .... Health Dep~ Approval Underwriters Approval ..... Planning Board Approval ...................... .. Request for: Temporary Certificate ........... Final Certicate .... .~..... / 1st) FOU14D ATIOI-I ROUGH FRAME &. "~LUMBING .... Co~£~s INSULATIOn! FERN. STATE ENERGY .. CODE FI~AL ~DDITIO~;A'L CO:4~EI'ITS: THE NEW YORK BOARD OF FIRE UNDERWRITERS [ ] q%9"v~ BUREAU OF ELECTRICITY r- 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date ,~[]I,¥ 2C~, 1~'~4 /~ppllcation ,~o. ofl file THiS CE~IFIES THAT PHILLIP O'RBILLY, 725 CENTRAL DRIVE, POLE#5, MATTI~3CK, N.Y. in the followlng location; [] Basement [] I.t FI. [] 2nd FI. ©~]' .Section Block u~s examined on JULY ~. 5, ! 994 and found to be in compliance with the Notional Electrical Code. Lot RANGES ECtAL REC'PT I SERVKm mSCONmCT I HO. OF I S 1 1(~ CB 7 X TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET V I ¢ OF CC. COND 4 NO O~ HI-LEG EXHAUST FANS E G.F,C.I*-! ~RT, Ir/', 11944 L~C. &3635-11l This certificate most ~ot be cdtored in any manner; return to ~,e office of the Board if incorrect. Inspectors may be iclentHied by their credentials. COPY FOR BUILDING DEPARTMENT, THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. 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 18, 1994 R & R Home Improvements And Building, P.O. Box 676 Greenport, NY 11944 Re: Mary & Phillip O'Reilly Inc. 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. The check is (outdated/not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (Ail permits involving plumbing being issued after April 1, 1984). 22115-Z BUILDING PERMIT # Please contact our office on this matter. cooperation. Thank you for $OUTHOLD TOWN BUILDING DEPT. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION zST [ ] ROUGH PI. BG. FOUNDATION 2ND [ ] INSULATION FRAMING ~NAL _ DATE ~' '/ . ,NSPECTO~,~ 7LS-xs0~ BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROU/GH PLBG. FOUNDATION ZND [ I/iNSULATION ..~/ - FRAMING ~ ] FINAL REM,~KS,, ~ DATE INSPECTOR BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [~SULATION FRAMING [ ] FINAL REMARKS DATE 765-1802 BUILDING DEPT. /INSPECTION FRAMING [ ] FINAL REMARKS: DATE . INSPE ~- BUILDING DEPT. PECTION INDATION XST [ ] ROUGH PLBG. F~DATION 2ND [ ] INSULATION FRAMING [ ] FINAL DATE INSP FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .... ~/.~. ....... 19 Approved ..... ~/~. ...... 19 .~.~. Permit No. ~. ~.././,~'.~'-.. Disapproved a/c ..................................... BOARD HEALTH " OF ......... 3 SETS OF PLANS .......... SURVEY ................... CIIECK .................... SEPTIC FORH .............. MAIL TO: (Bu~din~nspector) APPLICATION FOR BUILDING PERMIT Date.. [~.6~..I.'7. ....... 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 must 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 issued a Building Permit to the applicant. Such permit ~hall 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 HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone 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 ail applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. . .... -- (Signature of applicant, or name, if a corporation) .. ?-.9.: .~.~. ~..~.? ¢. ........................... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. '; ~ .C.,.'.'~k~.L ................................................ Name of owner of premises .... ~"k ~'' '~" ~as on the tax roll or latest deed) If app~t is a cors~tic~nt s~nature of.duly authorized officer. ... x,4 ...... ......... · , (~ame and title of corporate officer) Builder's License No ....... [.3.'~.C)...l. ~..-[. ....... ! PI b ' L' N ~2~ um er s lcense o. t Electrician's License No.-~! ?5..~.~.~a.. ~.k. e?.4'))¥... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ..... .7.,2~.. · ...(;~,:~.! :'~.~.. & ~ .~?.~ ........ .~3.~ t.17i, i~ .~, ::.¢. ................... llouse Number Street Hamlet County Tax Map No. 1000 Section ..... ! .(?.(.e .........Block ........ % ........ Lot .... '~.q ........... ' ' "Op~..6(.~. g;~.. ~..'~.0~.e. 5.. Filed Map No...l.¢~-1'.'/. ...... Lot ............... Subdivision . l~'.l.:4, t?.. ~.i .:.-: - (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existin~ use and occupancy ........ , ...... ~-/~. . b. Intended use and occupancy ........... ~' [ '7' ~ ~ S ~;'~s,~. 3. Nature of work (check which applicable): New Building .......... Addition .. ~·'~ ..... Alteration ...... Repair .............. Removal Demolition Other Work ~'~. ~ " (Description) 4. Estimated Cost O c ( ~ ~: · "" 't .......................... Fee ...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... ~ ......... Number of dwelling units on each floor ..... I ........... . If garage, number of cars ...-. ................................................. 6. If business, commercial or mixed occupancy , specity nature and extent of each type of use . . "t~.'./~) ............. 7. Dimensions of.e,xisting structures, if any: Front ..... 3 ~L..' ...... Rear · · ~.l ' · . Depth . ~; ? ........... Height .... ......... Number of Stories ..... t ............. 'ii'. ..... Dimensions of sa.me structure with alterations or adcl, itions Front ,~ ~=~ Rear Depth L~.~ Hei t ~~l~/ "' ~- i~ ~L~ '.:. 'i ............. ........... gh ...................... N,,,o~ ~,~ otms=~ ...................... 8. Dimensions of entire new construction: Front .... ,Zc...: ...... Rear ..... .~/~/ Depth . .'.3.~ Height ... ~ .'/. ' Num bet of Stories ~ .......................... 9. ?,i e of lot: Front ... ,.~.c~z~_. ~.~,~,.~,~. Rear ...................... Depth ...................... I0. ~ate of Purchase .................. /.. ........ Name of Forme~-Dwner ............................ ! 1. Zone or use district in which premises are situated .... ~. ~a ~ .~.~.j.Caf. ................................... 12. Does proposed constructinn violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ...'t;~ ............. · ......... Will excess fill be removed from premis~: e~ No 14. Name of Owner of premises ~'.~ .~y.~...Of.~.~..,.~.3~/... Address .(..~:,'.~. :'~ .c....~r~ ;¢, Phone No ................ Name of Architect ............. ~ ............. Address .................. Name of Contractor _~.~ ~.-..~.,~ ,~x: .o. f~ ......... Address P ~ ~(5. C~t ~-1 (~a 6~-~,' Phone N~ ................ · Phone Nc.a/.~. ~. :'.l. ~.'~'~7. 15. Is this property within 300 feet of a tidal wetla~'d~ ' *Y'~s..:'.~.'.. No....~..... · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly ail buildings, whether existing or proposed, and. indicate ail set-ba~k dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether ' interior or coruer lot, STATE OF N~'-YOR_~, ~:'~ ~ / i ~ ~ coumv..OF L i I ...... ~.~ ~ ~ .~.V.~ V(. ............ being duly sworn, deposes and says that he is the applic~t (Name of i~ividual signing contract) above named. gent, corporate officer, etc.) of said owner or owners, ~d is duly authohzed to perfom or have perfo~ed the said work and to m~e and file this ~pplication; that ail statements contained ~ this application are true to the best of his ~owledge and belief; and that the work will be perfomed in the m~ner set forth ~ the application filed therewith· 'worn to before me this , ~ ] / ........ ~mission c~itee o , ~ / P, UNDERWRITERS CERTIFICATE R£<JUIR£D OCCUPANCY OR USE IS UNLAWFUL WITHOUT ~~, OF O~ APPROVED AS NOTED NOTIFY BUILDING DEPARTI~IENT AT 765.1~2 9 AM TO 4 PM FOR THE 1. FOUNDATION . ~0 REQUIRED 2. ROUGH * FRAMING & PLUMBING 4. FINAL - CONSTRUCTION MU~ BE COMPLETE FOR C.O. r. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF ~E N.Y. STATE CONSTRUCTION t ENERGY DESIGN OR CONSTRU~ION ERRO~ *