HomeMy WebLinkAbout21233-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22761
Date DECEMBER 2~ 1993
THIS CERTIFIES that the building
Location of Property 260 MAYFLOWER ROAD
House No.
County Tax Map No. 1000 Section 107
Subdivision
ADDITION
Street
Block 8
Filed Map No.
MATTITUCK ~ N.Y.
Hamlet
Lot 30
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 19~ 1983 pursuant to which
Building Permit No. 21233-Z dated FEBRUARY 22~ 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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to EDWARD FLANAGAN
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-288002 - AUG. 30, 1993
PLUMBERS CERTIFICATION DATED N/A
Rev. 1/81
i~g Inspector
I~ORM NO. ~
TOWN OF $OUT~OLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N°-N?
,o....~',.~...~,.:~~~ ........ ~; ......
..~ ...... ~..~.....~:..:_..~ ...... ~~~ ..................................
at premise~locatJat ......... ~...~...... ~ ,~.....~----~...~..: ....................................
County Tox Map No. 1000 Section ........ ~....~....~..... Block. ........... ~ ..... Lot No...~.....~.. ............
pursuant to application dated .... ~'4'~.~./..~. ...................................... , 19~.., and approved by the
Building Inspectar.
Rev. 6130180
Form No. 6
TOWN OF SOUTHOLD
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 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 i% 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.
Submit Planning Board Approval of completed site plan requirements.
For existing buildings (prior to April 9, 1957) non-~onforming 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 t9 accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
'. Extention I q/30/93
Date .................................... . . ...
New Construction ........... Old Or Pre-existing Building .................
Location of Property .... .~.6.0..M..a.y.f.l.o..w.e.r. Rd. ,Mattituck,N.Y. ,11952
House No. Street Hamlet
0nwer or Owners of Property Mr. Edward Flanagau
107 8 30
County Tax Map No 1000, Section .............. Block ................ Lot ......................
Brower Woods
Subdivision .................................... Filed Map ............ Lot ......................
.2.~.2.~.5..-.Z. 2/22/93 Inland .H.o.m..e.s.I.n..c:
Permit No ........ Date Of Permit ................ Applicant ..................
App . ~ 8/30/93 ~N-288002
Health Dept. roval .......................... Underwriters ~pprovai .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate...~ ......
Fee S bmitt d: $ ./.. ~ ·
I ............ . .............
THE NEW YORK BOARD OF FIRE UNDERWRITERS
17~ 950 § 9 BUREAU OF ELECTRICITY
~-- 85 JOHN STREET, NEW YORK, NEW YORK 10038
THIS CERTIFIES THAT
o~y the electrical equipment ~ ~scdbed be~ a~ int~uc~ by t~ ap~icant ~m~ on the a~e ap~ication number iR the prem~es of
in the followlng locatlon; ~ B~se~ent ~ I~t FI. ~ 2nd FI. () U~.~ S~tlon Bilk Lot
u~s examined on ~ ~ (~ ~ ~ ~ 2 7 ~ ~ 9 9 3 and found to be in compliance with the Na~onal Elect~cal Code.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS
AMT. K.W Oil H.P, GAS H.P ~I,T NO, A.W.G.
SERVIC~ DISCONNECT NO. OF S
OTHER APPARATUS:
RANGES
)ECIAL REC'PT
R
TIME CLOCRS BELL UNIT HEATERS MULTI-OUTLET
SYSTEMS
MT. AMPS TRANS. NO. OE FEET
V I C
NO. %~RCC~c°ND'OF A.cc.W.coNv.O. NO. OF m-t~O
EXHAUST FANS
H P
DIMMERS
AMT. WATTS
E
NO. OF NEUTRALS A. W G
OF NEUTRAL
11944
GENERAL MANAGER
Per
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.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
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
November 22, 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
Mr. Edward Flanagan
260 Mayflower Rd.
Mattltuck, NY 11952
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
xxx An application for Certificate of Occupancy is -~
not on file. (Enclosed)
xXX No Underwriters Certificate on file. j
xxx The check is (~ ....... /not on file.)$25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # BP# 21233Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
0
(1st)
fOUNDATION (2nd)
:OUGH FRAME &
.PLUMBING
INSULATION PER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIONA'L COMMENTS:
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ J FOUNDATION 2ND [ ]~JLATION
]FRAMING [y~FINAL ~~
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION IST [ ] ROUGH PLBG.
FOUNDATION ZND [~]"~SULATION
[]FRAMING []FINAL
REMARKS: ~)~
~.,~,~,~ /~... / '
-. ~. ~ ~, '/,
765-1802
BUILDING DEPT.
INSPECTION
['~FOUNDATION 1ST [ ] ROUGH PLBG.
~.~JDATION ZND [ ] INSULATION
~]/FRAMING [ ~ ] FINAL
· Alt ti0
3. Nature of work (check which applicable): New Building .......... Addition .X~., era n ..........
Repair .............. Removal .............. Demolition .............. Other Work ...............
~ ', ~ ~ (Descriplion)
4. Estimated Cost .... $40 ~0~ .......................... Fee ......................................
~ (to be paid on filing this application)
5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................
If garage, nmnber of c~s ........................................................................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .....................
7. Dimensions of existing structures, if any: Front. ~e~ .sur~y. · Rear .............. Depth ..............
Height ............... Number of Stories ......................................................
Dimeusions'of satne structure with alterations or additions: Front Rear
Depth ...................... HeiSt ...................... Number of Stories ....................
8. Dimensions of entire new construction: Front...~ee..~g~.. Rear ............... Depth .............
Height ............... Number of Stories ......................................................
9. Size of lot: Front , .'~.O0 ................ Rear ...~O0. ............... Depth . .~.50 ...............
10. Date of Purchase ..... ~g~ A 979. ............. Name of Former Owner . .~ .~g~. ~ ...............
I1 Zoneoruse ......
. dtstnct in which premmes are mtuated .....................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ...~o ...........................
13. Will lot be regraded ........ ~o ................. Will excess fill be removed from premises: Yes
14. Nme of Owner of premises ~ .Pl~g~ ....... Address ................... Phone No.. Z~8969.6 .....
Nmne of Architect ........................... Address ................... Phone No ................
Nmne of Contractor . ~3g ~ .~9~9.q .......... Address ~9~.~99~...~ r ~.'. Phone No. ~9~Z9~ .....
15. Is this property located within 300 feet of a tidal wetland? *Yes ..... .. No .....
· If yes, Southold To~ Trustees Permit maybe required. ~ . u
. · ... ~ , , ~ ~. P~DIAG~
Locate clearly ~d distinctly ~1 bu~dMgs, whethey existing or proposed, and, indicate ~1 set-back d~nensions fr6m
property ~nes. Give street ~d block number or desc~ption accordMg to deed, ~d show street nines and indicate whether
interior or corner lot
. [
O .... ,
LAN G
.......................... being duly sworn, de oses and says that he is the applicant
(Name of individual signing con,ct)
above nanled. '. ' . ~':~ ' ~'
(Contractor, ag(nt, corporate officer, etc.)
of said owner or owners, ~d is duly authorized to perform St' haCe Perfomed the said w~rk and t~ m~e and file this
application; that all statements contained ~ this application are true to the best of his ~owledge and belief; and that the
work w~l be performed in the m~ner set forth ~ the application filed therewith.
Swomtobefore/~methis ' ~' ~k' ' ' ~ ' ' ~" ' '
............ ~...-; .day of...~ .... :~ ...... ,19... "
. . .. ::: [ .... ..........
' ~P~IS,~AN'Y~~f ' . (Sign~,c of applicant)
GuMffied tn Suffolk Cou~ ~ ~
L ' , TOWN HALL
~ , gOUTHOLD, N.Y. 11971
' ~ : TEL.: 765-1803
Approved ... ~ .... ,19 ermit No.
Disapproved a/c ................. ~ ....................
'" .... ' ' ' :J~Build[ngJdsp4ctor) .'
., APPLICATION FOR BUILDING PERMIT
BOARD OF HEALTH
'FORM '
I NO. I SURVEY .........
TOWN OF SOUTHOLD CHECK ..........
BUILDING DEPARTMENT SEPTIC,,,FORM. .............
HOT,FY '
MAIL TO:
Date,, ... ,' 3ebr~ar~-.., . I 'q 9 I ~ ~ '
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to tho Building Inspector, with 3
sets of plans, accurate plot plan tp~qal4. Fee according to schedule.. " . ' ,
b. Plot plan showing locati~n~ ~.f lbt and of buildings on premises, relationship to adjoining premises or public streets
or areas, and giving a detailed d~ipt!on of layout 9f property retest 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 applicatibn, 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 whitever until .a Certificate of Occupancy
shall have been granted by the Building! Ingpector.
APPLICATION IS HEREBY MAD~ to. the Building Department for the issuance of a Building Permit pursuant to the
Budding Zone Or&nance of the Town of Southold, Suffolk ~County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of b;uildings, additions o~lterations, or for removal or demolition, as herein described.
The applicant agrees to comply with ~11 applicable laws, oFdinances, building code, housing code, and regulations, and.to
admit authorized inspectors on prmnisels and in building for necessary inspections.
Inl~md .Homes. Thc. ........ ~ .........
(Signature of applicant, or name, if a corporation)
·/Box..q.97. Matti~aek ........................
(Mailing address of applicant)
State whether applicant is_.owner lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.............................. i .... Gener. al. Ooa~aator. .........................................
Name of owner of premises ...... E~ward, .3'laz~agan ..................................................
, (as on the tax roil or latest deed)
I f applicantjlL~corporation, signatlare ~ f dilly authorized officer.
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED
Builder's License No .... 997~6!.R. I ............
Plumber License No .
Electrician s Li No ~6~5 E
' censo ...... I ........ !
Other Trade's License No i
I. Location of land on which proposed ~ork will be done'. ................................ ~ .............
260 H~flo~ R~! Ma~ituc~ '
IlouseNumber ~ ~'i ~i'"~"Stree~t ~ '..i,... Hamlet
Couuty 'Fax Map No. 1000 Sectio4 . .~ .... '10~ ....... 'Block ................ t... ~0 ...............
I
Subdivision ~Bl:owe~'. Wo9.d:.B · .,... Filed Map No Lot · ·
'
2. State existing use and occupancy of pre~nises and intended use and occupancy of proposed construction:
Existing e and occupancy .~. Famil~r Dwel3.ing ~r.-. v
b Intended use and occupancy '
0'001
0'001