HomeMy WebLinkAbout21768-z
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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23175 Date AUGUST 23, 1994
THIS CERTIFIES that the building NEW DWELLING
Location of Property 155 HARVEST LA. & 600 FARMVEU RD. MATTITUCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 121 Block 7 Lot 13
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 26, 1993 pursuant to which
Building Permit No. 21768-Z dated NOVEMBER 9, 1993
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 ONE FAMILY DWELLING WITH ATTACHED GARAGE, DECK & SCREENED
& OPEN PORCH AS APPLIED FOR
The certificate is issued to MICHAEL & LESLIE FINNICAN
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 93-SO-80-AUG. 11, 1994
UNDERWRITERS CERTIFICATE NO. N-313684 - MAY 12, 1994
PLUMBERS CERTIFICATION DATED AUG. 16, 1994 - MICHAEL FINNICAN
ilding Inspector
Rev. 1/81
" Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL F,-- 0 c> V__ s
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 17 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.
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.
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 - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential 15.000, Commercial $15.00
d Date ~(O .~4K
New Construction.......... Old Or Pre-existing` Building
Location of Property.. l~5 ...................!lwzve3T... Z,4nd It -t. c,~
House No.., Street Hamlet
'AA
R"C~ -Z LfCSGt~ ~e?71-,¢s../ jj
Onwer or Owners of Property...
County Tax Map No 1000, Section .............Block... ...........Lot.......1
Subdivision....... (/f~1.o ...................Filed Map, Lot....................
Permit No. aJ.~ G..it:...Date Of Permit ................Applicant.............................
Health Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval
Request for: Temporary Certificate........... Final Certicate.....
Fee Submitted: $
G~e , /483x8" ~-t.-::--
Co -~Z ~121)~ APnT TrANTm
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INSPECTORS azzz?r
UFFO(ye®
1 SCOTT L. HARRIS, Supervisor
W Southold Town Hall
f z
Thomas Fisher
Building Inspector P.O. Box 1179, 53095 Main Road
r'c sJ's Southold, New York 11971
Gary Fish Fax (516) 765-1823
Building Inspector Telephone (516) 765-1800
Robert Fisher
Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR
Telephone (516) 765-1802 TOWN OF SOUTHOLD
C E R T I F I C A T I O N
DATE:
Building Permit No.~~ 2
Owner: IV(e
j4& /n// sic 9~0
(please print)
Plumber: e-
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1Z lead.
C r~°
~ s
(Plumb s ignature)
Sworn to before me this
& _ day of 19 .
Notary Public, County
JEFFREY SCOTT SMITH
"Public,Stotts ofNorYale o y Public
Suffdk Cowry • No.3131950
Commlaft E*= March 30,199,x`
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1000382 BUREAU OF ELECTRICITY
F 85 JOHN STREET. NEW YORK. NEW YORK 10038
Date MAY 12 ,1994 Applieation No. on file 83027793/93 N 313684 ,
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
MICHAEL E. FINNIGAN, 1-f5 HARVEST LANE, MATTITUCK, N.Y.
in thefollowing location; <S Basemen[ r 1.Ft b'!. i.J LE 2nd F-l. GAR/ATTIC/OUT Section Block Lot 39
was examined on MAY 09 11994 and found to be in compliance with the National Electrical Code.
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS' OVENS 'DISH WASHERSI EXHAUST FANS'
OUTLETS INCANDESCENT FLUORESCENT OTHER MAT K I AMT. K. W. AMT. K.W AMT K.W AMT. H P
82 1 74 79 3 1 1.4 2 F
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECTT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
AMT. K. W. OIL H. P. GAS HP AMT NO. A W. G AMT AMP AMT. AMPS. TRANS. AMT, H P SYSTEMS
AMT WATTS
NO. OFEET
1 F 2 - - 3 - 1 2 600
SERVICE DISCONNECT NO-OF S E R V 1 C E
METER w G
AMT AMP TYPE EQUIP I,e' 1W I $ 3W 3 $ 0`.v 3 $ 4W NO. OF PER CC. $ COND OF A CC. W G COND NO OF HI LEG CFA H1 LEG NO OF NEUTRALS A y, W , GT~,
1 200 CB 1 X 1 4/0
OTHER APPARATUS:
15 AMP.CONTACTOR SWITCH-1
24 VOLT TRANSFORMERS-2
MOTORS:5-F H.P.
G.F.C.I:-7
SMOKE DETECTOR:-2
WESLEY T. HARRIS LIC.#377-E
40 SOUTH DRIVE
¢ENERAL MANAGER
RIVERHEAD, NY, 11901
Per 11
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.
J
COUNTY OF SUFFOLK
ROruwi J. GAPTTAT
fIMFOLI( COUNT/ FJ=U"V[
~S am" E iMfra01n MJk. M.P.M.
COMMON=
NOTICE
PRIVATE WELL
The albch.d per" has been issued by the County" Department of lisMih
Sandow for ft prembas shown wff fire utlbatlon of a pdvab Mal for drW" Metier
supply. N has been delm ith a fl.ough a oomprehenel" wow wwtiw andrW the
kmbddon of keaf rm dw*n OW the water gift of the well was wNhin nrkrlnasrr
New York Side drki* waft Ili etude and/or pukbl nor at " am of apprwat.
Hott=er. phase nob the *ftwinp facia and moormnrerrdagons adh 9" WA:
1. The WATER QUAtHY of a prfvab wall Is sub)ad to dranpe.
2. APPROVAL by the DEPARTMENT does dQj p mmnbs OW the wabr WAW will
alwatrs mast drNrkkrp waft 11 dads.
3. The DEPARTMENT *m* mwm nwxk the the omm have a pNftft
comprehenslva Waft an** Performed to m Nit waft *w* 10 pmvwd the
unknowkp oonaranpbn of oaifninded waft.
4. Should waft gwly detwtorstbn ooour. N may be n@me my firer PtM water
nwh be exlerded. W ft*nW devim be kwtm%d for the waft qwy b be
Iftim .
Undw Provisions of the Suffolk County SaNlary Code. N is the responat tit of the
ow,Wgvkwo to provide a copy of this Notice and PMM ID the Bayer of the plan
Ness
prior to sale or resale. .
WWM-05 P4v.2)
COUNTY C [RYI.QI....M..L Ou.ur.
COUNT CCNT[R
RIYERM[90 MY IIe01.J191
e!I"C 100
1c L INS: EC:10N D TT : UMMENTS _
FOUNDATION (1st)
-
FOUNDATION (2nd)
2.
~ ss o
ROUGH FRAME &
PLUMBING -
3. R -I ze ~a ~ceS ° ?cv y
INSULATION PER N. Y. r a S y!
STATE ENERGY
CODE
a
4. e~ r` fr ~Jii/i m
y~
e !e - G- ~2du,,//s fee
FINAL /JirtNJln/
o
ADDITIONAL COMMENTS: x
s32 c /mot r~ 3 l1
ra
ro
H ^
xl \
9
H sn
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MAW2
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROU PLBG.
FOUNDATION 2ND NSULATION
[ ] FRAMING l [ ) FINAL J
REMARKS: l9
l
Z~e
i
DATE ~ INSPECTOR
765-1802
BUILDING DEPT,
INSPECTIO
[ ] FOUNDATION 1ST [ ROUGH PLBG,
[ ] FOU ATION 2ND [ ] INSULATION
[ FRAMING [ ] FINAL
REMARKS:
L
{
E
DATE INSPECT
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOU TION 1ST ] ROUGH PLBG.
[ FOUNDATION 2ND INSULATION
[ ] FRAMING [ ] FINAL
REMARKS:
I
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E
f'
DATE INSPECTOR, .
I
M-1802
BUILDING DEPT.
INSPECTION
[ FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND,[ ] INSULATION
I
[ ] FRAMING [ ] FINAL
REMARKS: r
I
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1
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I DATE INSPECTOR
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BOARD OF HEALTH
FORM NO.1 3 SETS OF PLANS
F` f SURVEY
TOWN OFSOUTHOLD
sr' BUILDING DEPARTMENT CHECK
2 6 TOWN HALL SEPTIC FORM .
SOUTHOLD, N.Y. 11971
TEL.: 765-1802 Y.Oi I F~
CALL LL
19 Y~ PIA I L TO
Approved lfi_~ Permit No. ` .
_ .
Disapproved a/c
(Buil mg Ins tor)
APPLICATION FOR BUILDING PERMIT
Date 19
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
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;-'biiii' g code, housi ode, and regulations, and to
admit authorized inspectors on premises and in building for necessary"-i29f .
(p 'ant, or name, if a corporation)
14 . 4 le
(Mailirfg address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
DCu.....
Name of owner of premises / !{FlEL , 9~,~Sr> C L , / /r/
(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. PlUYS .
Plumber's License No.}~n1
Electrician's License No. _3 7.e .
Other Trade's License No . .
1. Location of land on which proposed work will be done . .
Q ................~f.1eUPSr....~
House Number
Street Hamlet t
County Tax Map No. 1000 Section h . 2,( Block ....7.:... Lot . `
LT
Subdivision .....mvw. a4 ( Filed Map No. Lot .
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ~~f
b. Intended use and occupancy .
3. Nature of work (check which applicable): New Building ! , , . Addition Alteration
Repair E1 oval , , , , , , , , , , Demolition Other Work .
(Description)
4. Estimated Cost 00 0 , v b
i .
. . . . . . . . . . Fee .
(to be paid on filing this application)
S. If dwelling, number of dwellinsunits . • Number of dwelling units on each floor
'
If garage, number of cars .
6. If business, commercial or mixed occupancy, specify nature and extent of -each type of use
. .
7. Dimensions of existing structures, if any: Front Rear, Depth
Height Number of Stories .
. . . . .
Dimensions
w
Depth , of same structure ith alterations or additions: Front Rear . • , ,
Height , • . Number of Stories
8. Dimensions of entire new construction: Front ...~~.'11 , Rear 7/,'. G , Depth
.Height Nu•~t}ber of Stories .
9. Size of lot: Front 3 3,'....... Rear Depth ..../0.Q./ .
10. Date of Purchase Name of Former Owner
11. Zone or use district in which pr (ale ises are situated .
12. Does
proposed any zoning law,
.ordnance or Will exce sregulation:
13. W11 lot be regraded p ruction vio premises: Yes
fill be remove
14. Name of Owner of d from '
remises Address Phone No........... .
Name of Architect Address Phone No. .
Name of Contractor . Address . Phone No. ,
15. Is this property within '00 feet of a tidal wetland? *Yes, No..f-~....
*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 tot.
i
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STATE OF NEW RK
COUNTY F .....'S
• • • • • • • Al being duly sworn, deposes and says that he is the applicant
Name of individual signing contract)
above named.
He is the..... ...............I.C (~u
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly' authorized to perform or have performed the said work and to make and file this
application; that all statements contained in this application are true to the best of his knowledge and belief; and that the
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
rJ !.day of I'I . . . 19
Notary Pub.. County
C_11~
EIN z
CLAIRE t. at, It
Notary Public. State of N~w Yor G~Cl~-~'
No.48796 06
olk CouMY (Signature of applicant) -
Qualified in Suff
Comralsslon Expires December 8,19 ,1
OFFICE OF THE TOIVN CLERK
Town of Southold `Oi
Judith T. Terry, Town Clerk 'j?y~
Application No.
Town Hall, 53095 Main Road
P. O. BOX 1179 Construction
IfAe n
Southold, New York 11971 0 _1c Alteration
Telephone 1 x 0
bq4ec4C Residential
(516) 765-1301 ir,Clio
Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee
r
DATE
APPLICANT NAME:
APPLICANT ADDRESS:
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY:
OWNER MAILING ADDRESS:
OVINER, PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT.-PERSON:
TAX MAP NO.: Section Block
Lot
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:..
Signature of
Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
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SUFFOLK CO. HEALTH DEPT. APPROVAL
i I
1 • N. S. NO. 93 80
f i .
f
VAC.)
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I 7 STATEMENT OF INTENT
Coto" THE WATER SUPPLY AND SEWAGE DISPOSAL
+ r ti Y Y SYSTEMS FOR THIS RESMUCE WILL
50 ~ HA!ZVEST LAP !E CONFORM TO THE STAMOARflS OF THE
° ' ,C Fl a° RM, 3 5 f/ 910 SUFFOLK CO. DEPT. OF HEALTH SERVICES.
N~ icy 3C~ E. ~ (s), .
The ~ ~ S io icANT
SEPTIC SfSTEM ~
IW AQIII SUFFOLK COUNTY DEPT. OF HEALTH
0 SERVICES - FOR APPROVAL P'OR
4 CONSTRUCTION ONLY
A. P.EeOMM DATE:
Gm OMOEafYr~NrEpd H. S. REF. NO.. w-56 - 56
APPROVED:
I*STORYFit.44C. i-
UNG@TLQOk15T4'' ° SUFFOLK CO. TAX MAP DESIGNATION:
SCAL~'SO°I DIST. SECT. BLOCK PCL.
VAC.)
!I y ~a ? off etc
ILI AREA'~I i46 S.F 1000 121 7 13
S OWNERS ADDRESS:
,i ? 5=s • ,~v / SOX 10%
IJA: WELL tt
I 2 t L'~' _
N
DEED: L. NIA P.
1 ` TEST HOLE S.
! Unauthorized altarCa: cr additlon
j ! to this wrveY is a cP;!-7_c of
1 Section 7208 of Li- xaw Yolk State
! (VAG.1 Education Law.
Copies of this smay map not.c3dng
4
i { 31 the lend embossed sew shall sc.a cr
valid alhsll ll not not be mi~:.;arad
to
to be aveW true copy.
+ ! only to the person or whc.. r:'n
Q ~40f ~ is Prepared d 'n h'a .
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c lending i .d
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LKEN9tD LAND SURVEYORS
GR[ENPORT NEW YORK
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REVISIONS BY
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VJhJd.aZwc I PLUMBER CERTIFICA R CERTIFICATION
CONTENT BEFORE
CERTIFICATE OF OCCU TE OF OCCUPANCY
1 USED IN WATER
o 0 SOLDER USED IN W SYSTEM CANNOT
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