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Home My WebLink About21489-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. No Z-22699 CERTIFICATE OF OCCUPAN~C~/ Date NOVEMBER 4~ 1993 THIS CERTIFIES that the building ADDITIONS Location of Property 505 MIRIAM ROAD MATTITUCKe N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 99 Block 1 Lot 35.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this'office dated JUNE 9, 1993 pursuant to which Building Permit No. 21489-Z dated JUNE 1Se ~993 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 ADDITION & GARAGE ADDITION ATTACHED TO EXISTING ONE FAMILY DWELLING WITH OPEN BREEZEWAY AS APPLIED FOR. The certificate is issued to ELIZABETH TWOMEY (owner} of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-291072 - SEPTEMBER 30~ 1993 PLUMBERS CERTIFICATION DATED ~OCTOBER 21~ 1993-MATTITUCK PLUMB & HEAT. Rev. 1/81 FORM NO.$ TOWN OF SOUTHOLD BUILDING DEPARTMEN~ TOWN HALL $OUTFIOLD, N.Y. No_ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Oate ...~//.../.~ .......................................... 21489 Z Coun~yTax Map No. 1000 Section ........ ~,,,.2 ........ Block .......... Z ............ Lot No ...... ,,-~-,.,..~-~.,.,'~.~...~... ..... pursuant to application dated .........~'/~../..~ ................................... 19..~7.....~... .... Bulldlng Inspector. Fee Rev. 6~30~80 and approved by the 'Form ~o. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN HALL 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: 1. Final survey of property with accurate location of all buildings, property lin&s, s~reets, 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 archiuect or engineer r~sponsible for the builCing. 6. Submi~ 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. 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, Addifions to accessory building $25.00. Businesses $50.00. Certificate of Occupancy on Pre-existing Building - $100.00 Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 Updated Certificate~of Occupancy - $50.00 Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 t 3. 4. 5. ew Construction ........... Old Or Pre-existing Building ................. ocation of Property ................. ../~. / ~House No. Street Hamlet ewer or Owners of Pro art ~'-Z'~ ~--~'~ ~...L~ .~..~.~ P y....~v.~.~ .... ~ ............. ~ ............ ~unty Tak Map No 1000, Section ......... Block· .Lot .... ' ................. Filed Map.. .'.~-~...Lot ...................... ~rmit No.~.~.~..~..~....~. ~ . ~//~/~ · ..oate Of Permit .... Applicant .......................... ~alth Dept. Approval .......................... Underwriters Approval ......................... arming Board Approval .... ,quest for: Temporary Certificate ........... Final Certicate ........... , ....... CO ~-- ~9 ~ APPLICANT ' NOTE: · -'MONUMENT SUI~DIVI$10N MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON JAN. i9~I949 AS MAP NO. 1672. SURVEY FOR THOMAS TWOMEY LOTS 25,26, ~ ~7 CAPTAIN KIDD ESTATES MATTITUCK TOWN OF SOUTHOLD SUFE 'CO. N,Y. SCALE: 1"=40' PR OFES S I0~'~ ~E N Gl N E,~R AND LANO SURVE~R,N.Y, 9':~IC. NO. 12845 RIVERHEAD, N.Y. INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD October 19, 1993 SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 Hr. Thomas T~oomey P.O. Box 55 Peconlc, N.Y. 11958 To Whom This May Concern: We are unable to complete your Certificate of Occupancy beeause of the following reasons: 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). BUILDING PEP~MIT ~ BP# 21489Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. FOUNDATION l~t) FOUNDATION 2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE Ye FINAL ADDITIONAL MMENTS: INSPECTORS Thomas Fisher Building Inspector Oa, ry Fish Building Inspector ScCrri' L. HARRIS, Supervisor, Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765~1823 Tel~hone (516) 765-t800 Robert Fisher Assistant Fire Inspector Telephone (516) 765-180Z OFFICE OF BUILDING INSPEC~COR TOWN OF 8OUTHOLD CERTIF I CATI, O~ contains less than 2/10 of l~{ lead- I cere{fy that the solder used in the wate~ supply system "V Sworn to before me th, is 7GS-X802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INS~ULATION [ ] FRAMING [~FINAL !' ,-// /.,,~/ DATE INSPECTOR 765-'~802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ~ZND [~INSU~TION [ ] FRAMING REMARKS: [ ] FINAL DATE 765-1802 BUILDING DEPT. INSPECTION [,/J F/OUNDATION 1ST [ ] ROUGH PLBG. / FOUNDATION 2ND [ ] INsuLATION FRAMING [ ] FINAL ]'65-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: FINAL INSPECTOR ~ BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~ DATE THE NEW YORK BOARD FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~-- BS JOHN STREET. NEW YORK, NEW YORK 10038 Jppllcation No. on file THIS CE~IFIES THAT o~y t~ el~trical equipment ~ ~scrlbed be~w a~ int~uc~ by t~ applicant ~m~ on the a~ve ap~ication nu tuber in the prem~es of ~ B~. .~ ~ I~FI. ~ 2nd FL GAR/OHT S.ct~on Bt~k Lot in the followlng location' . . SgV~ggR 2~1,99o and found to be in compl~nce with the N~onal Elect~al Code. FIXTURE FIXTURES RANGES :OOKINGDECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT OTHER 22 DRYERS 26 24 ~,2'~" FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I C )THER APPARATUS: B(~OK[~ D}~TgC~'OR ~ ~ l NO.O~ERCC~COND, A W O. NO.O~= HI-LEG A.W O. NO, OF NEUTRAJS A.W,O. OF CC, COND, OF HI-I-EG OF NEUTRAL 11971 LI:C.~282-B GENERAL MANAGER Per rhis 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 B~ ALTER~DI" ANY MANNER: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD,.N.Y. 11971 BOARD OF HEALTH 3 SETS OF FLA~S SURVEY ..... EIIECK ................... SEPTIC FORH ' TEL.: 76'5-1802 xa,n,ried./3 .f ...... ,19~ -. Disapproved a/c ..................................... · (B~ding Irtf_poC~or) APPLICATION FOR BUILDING PERMIT Date · 19 INSTRUCTIONS' -~l a.' Tiffs apjlication 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 muir 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 inspect/on 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 ]~uilding for necessary,i'5'~ns. ~ .. . -- ' . (Si°nature of applicant, or name, if a corporation) ..~ o. 6L~.: ~.~.. C+~../../~. ~ . (Mailing address ~f applicant) S~ate whether applicant is owr~t, lessee, 'agent, architectj engineer, general contractor, electrician, plumber or builder. ...... Name of owner of premises .... ~... . ................................... . (as on the tax ~) or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) · ?/,ff/, 14/ Builder's License No ...... '." ................ Plumber's License No. ' .... . .......... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ............................ i .... } ................ · ..... .... , .......... ..... . ................ [-louse Number Street . 'Hamlet Con'nty Tax Map No. , 000 Scction ':~..:.~.~. Block ' ..). ' Lot .... Suhd,v,s,on . :O. . . . .r X. . . ' "ea Map No. .... Lo, (Name) · ' ............... 2: State existiug use and occupancy of preraJscs and intended use and occupancy of proposed construction: a. Existing use'and occupancy .... . . .... . -3. Nature of work (check which applicable): New Building . ~ ...... ~ .................. ~.~- Repair ............ .'1- Removal .............. Demolitionk.~.~r~x%/.... ....... Other Work .............. · .~ille ...... (Description) ' . F 4. Estimated Cost ....... f ............................ ee ......... (to be paid on filing this application) $. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ · If garage, number of cars ......... ~. ............................................................. 6, If business, commercial or mixed occupancy, specify hr/tufa and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front .... fir~. ........ Rear ... ~.~.' ....... Depth . .-~..~.'~, f.. i ..... Hei-ht Number of Stories ~ .................... . ............... Dimensions of same structure wtth alterations or add t OhS Front .... ~.~ .......... Rear .. ~. ..... Depth . .~. t. ............ Height ... ,~'~'~'~% ........ .. Number of Stories ....-~:~. .... '.:..: ........ 8. Dimensions of entire new construction: Front ..... ~ .6: f ..... Rear . ..~..6:..' ........ Depth . ."~,:~.~. ........ Height . -~r. ffgTY..~. .... Number of Stories . . ~_~..,,~:r..~' ........... , ............... ' ........... 9. Size of lot: Fro'bt .... ~.,~.. f. ........ ~ .. Rear ..../..&-...C: f. ........... Depth ....~..~. f. ............ 10. Date of Purchase .................... ' ......... Name of Former Owner ..................... : ....... I 1. Zone or use district in which premises are situated ....... . .............................................. 12. Docs proposed construction violate any zoning law, ordinance or regulation: .....a~..O. ..................... 13. Will lot be regraded ....... .~/.~ ................. Will excess fill be removed from premises: 14. Name of Owner of premises ." ./~'~...c., ff....~r~...~-~.r(... Address . -.~4q,O~/~ ...... Phone No.. ~.~.: .~s..~: .~,7... Name of Architect ....... ~..~. ..... ~....~ ..... Address...a..~-:.-:a.-.,~-' wt- :.' Phone No..,.;; .~..:-.v~,~'~ ~. Name or Contractor ~'.~'~.~Ce~-'. ~"t~/."f~/~C~,i~ddress ./.~7....,~.,0.. ~"Y~.~,h~ne No. ,<~O.../.../.7,,. 15.' Is this property within 300 feet of a tidgl wetland? *Yes ....... ~N~.fl ....... i *If yes, Southold Town Trustees Permit may be required. PLOT 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 indicate whether interior or corner lot. ;TATE OF NEW YOR$, r.-- - - s.s _ . . J 0 U NTY~,O.,F W~t~ .~- ~ ~~ being duly sworn, deposes =d says that he is the applicant (Name of individual signing con tract) bore named. (Contractor, agent, corporate officer, etc.) f said owner or owners, ~d is duly authorized to perfom or have parroted the said work and to m~e and file this ~plication: that all statements contained M this application are true to tim best of his knowledge and belief; and that the ork w~l be perfo~cd in the manner set forth in the application filed therewith. .yom to before me this /'~ ......... .... iTM t FOLLOWING INSPECTIONS: 1. f::OUNDATION - '1'~O REQUIRED FOR POURED CONCRETE 2 ROUGH . FRA~/~ING & 4 FIN~M. CO~J~TRUCTION ~IjST 8E CD~PLET~ FOR ALL CONSTRUCTION SHALL M~ET THE REQUIREMENTS OF THE STATE CONSTRUCTION ~ ENERGY COOES NOY RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS .I