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Home My WebLink About21944-zFORM NO. 4 TOWN OF SOUTMOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO Z-23269 Date OCTOBER 7, 1994 THIS CERTIFIES that the buildin~ Location of Property 555 RILEY AVENUE House No. County Tax Map No. 1000 Section 143 Subdivision ADDITION & ALTERATION Street Block 4 Filed Map No. MATTITUCK, NY Hamlet Lot 16 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MA~CH 14, 1994 ~ursuant to which Building Permit No. 21944-Z dated MARCH 15, 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 ALTERATION AND ADDITION TO AN EXISTING OWE FAMILY DWELLING TO INCLUDE THE INSTALLATION OF AM OUTSIDE SHOWER AS APPLIED FOR. The certificate is issued to RICHARD C. POWERS (owner, lessee or tenant) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N320962 N/A JULY 20, 1994 PLUMBERS CERTIFICATION DATED MATTITUCK PLUMB & HEATING OCTOBER 3, 1994 Rev. 1/81 / B~n+ Ins~c~r FORM TOWN OF $OUTHOLD BUtI.D~NG DI~PARTMI:N1 TOWN HAU. $OUTHOLD, N.Y. NO- 21944 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby granted to: .~!.~ .... ~..,'~...~.~.¢. .... ',:q .......... ..~. ~,,~'~' ................................................ . .~..4..,..'z;..~ ....... ~:..~, ...... //.¢..~:~ ......... :.~; to..... ~.. ~-../~ ........ ~. ...... ~(2.~.//¢~....... ~......,~.........~.~.Z~2.Z .~..~......... ~....,~....-~.--.. ....... ..... ~.~,,~ ........ ~ ' . ....... ~ ....... ~.~ ....... ~....~<~<.4~,,~,;~ ..~.~.....~x......~..m....u_.x.~ ........ ~.~,: ........ ,,~ .. ~,d...~¥..x..8, at premises located at ........................................... ~ ...................................... CounlyTax Mop No. 1000 Sectlon,.,../,,/~.. ......... Block ........ ,~,,,/~,,;, ....... LotNo ......... /~. ............ pursuant to application dated .............. ...~.'./~ ......................... 19......~....~...,/ and approved bvthe Building Inspector. /Building Inspector Rev. 6~30~80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must he 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 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 applicanl. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. :. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming p~ol $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existinK Buildin~ - $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 ........... Old Or Pre-existing Building ...... ' gu'gg' 2] ....... Z' .................. Street Hamlg; ........ nwer or Owners of Property...~./.~.~.~.. ~.~ . . ounty Tax Map No 1000,.... 9/ ..... ubdivision ~ .... ............ ~.-r~. .................. ... Filed Map .......... .. Lot ................ .. ... . ~ermit No~.~.Z..~..~-~.....Date Of Permit..~..~.~.~ ~.~.. cant .................. . . Appli ........... aalth Dept. Approval .......................... Underwriters Approval .................. .. . ... . nl g ~oar~ Approva± ..... ~-.~. ............. equest for: Temporary Certificate .......... .~Final Certicate.. ~ ~u~: ~ ............................. ~ , ~ ~-- . P.O. Box252 INSPECTORS Thomas Fisher BgiMing Inspector Gary Fish Building Insp~tor Robert Fisixer Assistan~ Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF $OUTHOLD SCOTT L HARRIS, Supervisor. Southold Town Hall EO. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 7654823 Telephone (516) 765-1800 CER~I~ I CATIOR contains less than 2/10 of iZ lead. that the solder used in the water supply system Sworn to before ae tl,~is Notary Public, _.~-'~f/~5~_~ County Notary Pubilc~'/ ' ~ F. dac~sotq, , m. ~o7~ THE NEW YORK BOARD OF FIRE UNDERWRITERS 1205030 BUREAU OF: ELECTRICITY ~'~ 85 JOHN STREET. NEW YORK, NEW YORK 10038 ~),te JULY 20,1994 ~pplieation ~o. o,~,e e6148894/94 ~ . N 32e962 THIS CE~IFIES THAT o~y t~ e~ tr~ ~ulpmeflt ~ ~scdb~ be~w a~ int~uc~ by t~ applicant ~ on the a~ve ap~at~n numar in t~ p~m~s o~ in the following hwation; ~ ~ement ~ Ist FI. ~ 2,d FI. OU~ .$ecthm Bl~k Lot ~s examined on ~LY ~ ~ ~ ~ ~ and found to be ln compliance with the Na~on~ Elect~cal Code. RXTURE OUTLETS j SWITCHES DRYERS FURNACE FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEE? SERVICE DISCONNECT OTHER APPARATUS: G.F.C.I:-4 S E R V I C A W. O J NO, OF HI-LEG OF CC. COND. OF HI-LEG TWIN FORK ELECTRIC P.O. BOX 48 J~ESPORT, NY, 11947 FOU~DATION (1st FOUNDA TIO~.! 2. f2nd) ROUGH FRAME &~ ,PLUMBING INSULATIO~ PER N. Y. STATE ENERGY CODE FINAL ADDITIO~A'L COM~E~.;TS: 7~5-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] IN~ATION FRAMING [L/yFINAL REMARKS: DEPT. IDATION 1ST [ ] ROUGH PLBG. [ ~FOUNDATION 2ND [ ] INSULATION I' ] FRAMING [ ]FINAL DATE INSPEC'! P.O. Box 252 Mattituck, NY 11952 ,OCCUPANCY OR PLUMBING ALL PLUMBING WASTE & WATER L UNDERWRITERS CERTIFICATE. REQUIRED ...... :.,,, ............. -_-. . .7.:..::_.: .: :: =================================== CERTIFICATE OF SOLDER USED SUPPLY SYSTEM ~ANNOT If copper tubing ia used for water distributing system; piping shall be of types K or L only_ P.O. Box 252 Mattituck, NY 11952 298-4768 q\ Approved ............... ' M~ I~,tlqsM ~ BUILDING DEPARTMENT ....................... TOWN HALL ""' "~*": ' ~OUTHOLD, N.Y. 11971 TOWN OF ~Od&'~2 ;, ,., .................. TEL.: Disapproved a/c ..................................... -. · tBu~g Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH 3 SETS OF PLANS SURVEY ...~ .... SEPTIC FORH .............. MAIL .0,0; ~..~.7. ~.S. ~ ....... INSTRUCTIONS a. Tiffs 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 shall 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 all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary in~~~?__.,) s ~ ' -- ..L"i'~;;J/dgiapplicant~ ~; ~ame, i'''' '~ ~ ~;~r'a~io'~)' '' .,. !? 7 (Mailing address of applicantT ' State whether applicant is owner,.lessee, agent, architect, engineer, ral electrician, plumber or builder. (Name and title of corporate officer) Builder's License No... ~.~)..; ............. ,_D Plumber's'License No... g.5. & ~2 .... t ......... Electrician's License No ..... '.T. L~ ~.) ............. ........................ ~z ..................... , .... ~ ............... '... APPROVED AS-NOTED ....... Name ofownerofpremises. J.~['C.~,~.~d~ C .'~.~.~t..O r~_,,, OA'll~:~n.P.# . ........ ('a; ;,;~' t'h e' t'a'x' r'oii gl' iite;t'k41/C r;m.;" Ifa hcan 1 cor o NOTIFY BUll. DING DEPARTI~ENT AT pp ' t's a p ration, signature of duly authorized officer. 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION . TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMRING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY Other Trade's License No ...................... CODES. NOT RESPONSIBLE FOR DESIGN OR ,CONSTRUCTION ERRORS 1. Locati~)n of ]and'on which proposed work will be done ............................ i'...., ............. ........... ..... .. .................... ...... .L ............... llouse mumser ~ Street Hamlet County TaxMap No. 1000 Section . ./.~.~.. ......... Block ...... '..~/.. ........ Lot ....... X~ ......... Subdivision .......... ~ ................. Filed Map No. '~ Lot (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a Existing use and occupancv t~.~.{~,~ ~,~.'/'O/~t-~/> X~'.' '0(eaJ ~'~ / ' ~. ................. ~/. b. Intended use and occup~mcy .~....~. ~..~._.'.... 3. Nature of work (check which applicable): New Building ......... ~ ......... Alteratio~ Repair .............. Re,oval .............. Demolition .......... ' .... Other Work .... 4. Estimated Cost .... : ............ Fee (to be paid on filing this apl: 5. If dwelling, number of dwelling units ~'~" ~ Number of dwelling units on each floor .... · Ifgarage, numberofcars .. ' .............. If business, commercial or mix'ed occupancy, specify nature and extent of each type of use .. 7. Dimensions of existing structures, if any: Front ......... - ...... Rear ..... . ......... Depth .... Height ............... Number of Stories ......... ; ..... .~. ~. . .~-r. . ............. Dimensions of same structure With alterations or additions: Front ......... Deptl ·.. He ...................... Number of Stories ........... 8. Dimensions of entire new construction: Front ........ ; · . Rear ....... ~',~. ...... Depth .... Height . .' ............. Number of Stories ............ i ...... " 9. Sizeoflot: Front .......... ............ Rear ............ ' .......... De 10. Date of Purchase , pth .......... .. .......... ' .......... ' ......... Name of Former Owner ..... 1 I. Zone or use district in which Premises are situated ............ '.". ....... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... . .~..~/ 13. Will lot be regraded . .e~..O i 14. Name of Owner of premises i~i,i ' ' ' ~ .... ':' ......Will excess fill bo removed from premises: Name of Architect ..r~'~, ~ ~ . ~ N~ ~a2ne~,_o~f Contractor .-.-.-.-.-.-.-.-.-~..~..~.~.o..~.~..'~.' .~..~.~..'I .~:. Address ~.' .~2~:~..~1~ [dhh~ ~N~o. 15. ~ unzs property within ~300 feat of a tidal wetland'~' ~;, ......... >/f=~"~J2. .... "~ If yes, Southold Town Trustees Permit may be required. Q~.d-'~. ..... .... ! PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existi'ng or prolSosed, and. indicate all set-back dim property lines. Give street and block~number or description according to deed, and show . interior or corner lot. )eschption) lication) ~sions from street names and indiiate whether STATE OF NEW YQp, K. cou v OF :.... .rgb....._,..' '(Name of indivi~mi! }i'gning contract) .... above named· . ' ' ' (Contractor agent corporate officer etc ) ............... )f said owner or owners, and is dly authorized to perform or have performed the said work and to make ami file this tpplicatio/~; that all statements contained in this application are true to the best of his knowledge and belief; ami that the .york will be performed in the manner s6t forth in the application filed therewith· ;worn to before me this ............. ...... ...... , ~,%~o'iN.g ~ (Signatur'b of ~ !pplicant)