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HomeMy WebLinkAbout20598-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20897 Date JULY 28, 1992 THIS CERTIFIES that the building ACCESSORY Location of Property 655 SMITH ROAD PECONIC N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 98 Black 4 Lot 7 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 23, 1992 pursuant to which Building Permit No. 20598-Z dated APRIL 30, 1992 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 ACCESSORY GARAGE AS APPLIED FOR. The certificate is issued to FRANK O'BRIEN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-243223 - JULY 20 1992 PLUMBERS CERTIFICATION DATED N/A X. -z Building Inspector Rev. 1/81 F FORM NO. a TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°_N° 20598Z Date 19.m~ Permission is hereby anted to* to of premises located at ...~P. ~Z........ ............CSC':..:r................................................................................. County Tax Map No. 1000 Section Block 7-. Lot No....... 7 pursuant to application doted ell1.3 19~F and approved by the Building Inspector. Fee $ °..`J ' . .k. .......e eor Build I Rev. 6/30/80 4 Q y FormNo. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 f; MAY271 APPLICATION FOR CERTIFICATE OF OCCUPANC TC1,iu A. This application must be filled in by typewriter OF, 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 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 $$115.00, Commercial $15.00 G~iP G` Date ...1'5! eF~ 7/1.19 .11 lew Construction.. Old Or Pre-existing Building House of Property.. ICA House No. Street Hamlet nwer or Owners of Property... IeA ~ G~ q Q~ ounty Tax Map No 1000, Section... ©..(,~....Block.........T Lot ubdivision.. .,'~.GA.1rte<' .....Filed Map...- ,5.1....Lot............/.. ermit No. l.;j.%Z. , , ,Date Of Permit..~Ofze2.... AppIicant.(,., 2alth Dept. Approval ..........................Underwriters Approval......................... fanning Board Approval !quest for; Temporary Certificate........... Final Certicate........... e Submitted: $ ~lR441 C'0~~~8`~7 APPLICANT , ao~~ z THE NEW YORK HOARD OF FIRE UNDERWRITERS PAGN 1001093 BUREAU OF ELECTRICITY F 83 JOHN STREET, NEW YORK. NEW YORK 10038 Date JULY 20,1992 Application No. onfile 77360992192 N 793223 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 ERANI.S P. O'BRTNN, 655 Shim ROAD, POLE NO. 'l, PLCONCC, N.Y. in the following location; ? Basement ? /st Fl. ? 2nd Fl. GAR Section, Black Lot was examined ore JIIGY 113 t 1' 991 andfound to be in compliance with the requirements of this Board. FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS K.W. EXHAUST H.P OUTLETS INCANDESCENL FLUORESCENT OTHER AMT K W AMT. K.w AMT N.W. DISH 9 3 J 3 9 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECTT TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET DIMMERS AMT. K. W. Oll H. P GAS H. P AMT. NO A. W. G AMT. AMP PMT. AMPS TRANS. AMT H P SYSTEMS AMi. WATTS NO. S T FEET SERVICE DISCONNECT NO. OF S E R V I C E AMT. AMP. T(PE METER 1.0 2W 1,93W 303W 3,e AW NO. OF CC COND A. W G NO OF HI LEG A. W G NO. OF NEUTRALS A' W G EDUIP. PER Ar OF CC. COND OF H)AEG OF NEUTRAL OTHER APPARATUS: G. F,C.1;-1. GARY DOROSKI L C,#2941-E 925 HONSELT, tANN CUTCHOGUB, NY, 11935 GENERAL MANAGER If , ; 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 Principal Building Inspector O~pSVFFOl~COG Curtis Horton V-1 SCOTT L. HARRIS, Supervism Senior Building Inspector Go Z Southold Town Hall Thomas Fisher P.O. Box 1179, 53095 Main Road Building Inspector • Southold, New York 11971 Gary Fish Building Inspector Fax (516) 765-1823 Telephone (516) 765-1800 Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD May 29, 1992 Charles Salvaggio Construction 23 Meadowood Court Huntington, New York 11743 RE: FRANCIS & VERONICA O'BRIEN To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) XX 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. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 20598-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. -OUNDATION (1st) ~I c 'OUNDATION (2nd) z o ~ ;OUCH FRAME & vi -PLUMBING cn H 3. V V INSULATION PER N. Y. STATE ENERGY CODE I _ y ~ b v r r H FINAL ADDITIONAL COMMENTS: M H 9 y 0 .a ° `~J\ x - m ' r y o ~ m H rt C' cD :C. * " o w v v. 0 a ' c~ La rn m:v 00 !t o 00 z El 71 ~ ~'y ay -at ^i Q ~j cry a r5 0 ~zy2 s~ lc1 0 L C8 ~ 'Cj G.e art ni .r .s..J c« w^y k xaFnmm r0 rry C', d 03 rr. MZM v tin awn <'o cm )ell 14 y: i , 10 e• t. \tl a a r'.;. W ~ ~Q ^W 'v 4 r n Y 7t n ~ ~a 1' 1.._..... _ _ _ _ ~ ~ a ~ ~ L ~ N , X d ~ ~ r 'I 1 R ~ i I.;, I i i i 7 to . - _ ~ - ._,~...------~-,-----y~ ~ o ; x 1 ' ___.___-_._i_.___.~ v_._..______._.__..__._. n i v } ! ~ ''i ~ ~ ~ r,, v ~ n { 1' --Y.-,..i . - f ...--~i__.r__, , i f i i ~ i~~, ~ ~ , i i i "~J I, I ~ ~ ~ i i ~ / l~ i I S ; l i lam/ (f' i r------_.._.__..~ _.m_~...~.m_.~....~.,~..... 1 i ~ ~ I i 4 i 4 S Y 765-1802 BUILDING DEPT. INSPECTION [ FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE `5 INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU N [ ] FRAMING [ FINAL REMARKS: DATE INSPECTO r FORM NO.1 30SETTSOOFHPLA.NS TOWN OFSOUTHOLD SURVEY 'i APR 2 3 1992 BUILDING DEPARTMENT CHECK TOWN HALL SEPTIC FORK . • fi~ _ SOUTHOLD, N.Y. 11971 TEL.: 765-1802 C~ t:aTIFY;?/ TCVu~~:,~ / T ALL Examined . , . 19!.~ A / MAIL TO Approved / . 19/. Permit No..4~0 _ . Disapproved a/c . . (Build' g Insor) APPLICATION FOR BUILDING PERMIT Date /s 3........, 191&Z 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 owthe 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 c 90e, housing c de and regulations, and to admit authorized inspectors on premises and in building for necessary inspec io - (Signature of applicant, or nam corporation) (Mailing address of applicant) /T/Y//?sZS ;2 713 7 7 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, e ectrician, plumber or builder. . Name of owner of premises ! Nc (1 G', f U E/1 u6 ~~if GJ /~s K! G' ^ (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 . Plumber's License No. Electrician's License No . Other Trade's License No.... 1. Location of land on which proposed work will be done . . s... 5'M,........ L......~y.... %ps9 . House Number Street Hamlet County Tax Map No. 1000 Section 9 Block 7.'// Lot ....7 . Subdivision 4-IrC 1".14 Filed Map No. S.-~;7/........ Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy l~ Cf~EG b. Intended use and occupancy /~e~/. , , , I Repair (check . which applicable): New Building Addition , Alteration 3. Repaie of work check which Removal Demolition . Other Work , . 2 0 UI (Description) 4. Estimated Cost..... Fee...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling nits 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 . . . . . . • • . , Hem en of , existing . . structures, if any: Front Rear , Depth 7. Height . Number of Stories . . . Dimensions of same structure with alterations or additions: Front . Rear Depth Height Number of Stories , . g construction: Front 6 ........Rear Depth S~: $ Height Dimensions ew NumberofStories 9. Size of lot: Front Rear Depth . . . 10. Date of Purchase l Name of Former Owner . 11. Zone or use district in which premises are situated . . . . . . . . 1 13. Will 2. Does proposed construction violate any zoning law, ordinance or regulation: !(!Q . . 14. Nameot b Owner o regraded .IVR , • , ' ' ' ' • , • • Will excess fill be removed from premises: Yes No premises . , Address Phone No.......... Name of Architect 15. Is this within 3 Address ...................Phone No................ Nam e of Contractor t~dFi.~LES . , S.~./i/i~G~1D. , Address,?.Jyr9.u~.9B.dl„GU,D, .4 Phone No.~ ,7/, J property 00 feet of a tidal wetland? *Yes........ No.. r *If yes, Southold Down 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. ~p 1 ll~ dU~ ~I /Ail •~~ad~. 'off' ,^`I 9 AK r /004) .tc cP- oq STATE OF NEW YORK, S S COUNTY OF . . I `AI .4 individual signing • • • ' • • • , • • • being duly sworn, deposes and says that he is the applicant (Name ng contract) above named. T He is the • o•~~~ (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 rrc day of ° , 19 Q v Notary Public 0" .r'.CA(County PAUL ; SOEHAACIIf . NOTARYPU State, of New York e nature of applicant) 6uoll ledln &Wotkk County Ca yowtonBoresJura4,1992 SUFFOLK CO. HEALTH DEPT, APPROVAL. H.S. NO. t r fl ' (491N0l2 SUt3t?rL"'1~if:~Pd - - - k3H r oa l•?~ ~f ,d-~.~~~m.~...~.~_~. r ~ ~ ~ srx:vr=-~: Fri r=ear: STATEMENT OF INTENT D / fnrrrierll/ CE'ldN7 _ _ THE WATER SUPPLY AND SEWAGE DISPOSAL i SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE ' lndmn Mec~ JI ~~..'-.y < p ,~1, 2 ~(=C ~t_JCdK: SUFFOLK CO. DEPT. OF HEALTH SERVICES. Q' l r'c c ide~;eE+~ x 7c)wr i or- :you z uor _t; , f'J.Y. {s1 APPLICANT o i SUFFOLK COUNTY DEPT. OF HEALTH p_ 1~ ~ i pr dafe rr;) N'om' SERVICES FOR APPROVAL OF CONSTRUCTION ONLY DATE 1 R r8 m '.~hAi N79'3YE. - 124.56 F H S. REF. NO. 2" APPROVED. rF~ ~ it `vT": "v~; ~ tiJ;,. IAra `I k~m ~ yrowfr=nce' p 0. 'I II `f 'I I/VAII r \ ' SUFFOLK CO. TAX MAP DESIGNATION: i ~ Ij ; I 3 ? n ~ , r~ a ~c; r g n¢ ,Y t e I Vi DIST, SECT. BLOCK PCL. 1000 098 4 7 ~ ~ to r' 'Y , o xn OWNERS ADDRESS: -1 61 p. yt L ~`tl Y IBC I R NuNTfr.~TOrv a-tx:.,fJ.ti;l1744,` iron It - ~1 30, icalt.• : 30'- DEED' L. 5790 P. 572 C&'c.f:) C or LOC~sTY` MAP; BOp a 1 0 C TEST HOLE STAMP 'i'.' u U well u, - rl =MOnUfttCYif' 5uf7or0 co . QsQie n bE 0 s v = rnanurncr taJ,. so;r a. , C)k i+ 1000, 'i ~ r l^ni7 f~aCr \ J iNei•Fher (oi+44 be fLr77iirr au6e7V+de+, - l 29x~Ia9C.1 r I bar 5.79°37"W. - 129. h Amo, Shown f5Med':Q,- 7P_ ZgI 1 v,,Mi*r di 10)44,& -ft "fee4 Sc do.4trOEt.CJgl+'M 161 ts~ ~leK~rortsr~er ~o tt7ean sect l~v~+.'. - ~re~iderrre~ , SEAL - . f '-.L Snr. N~ -tr a. TofaS ; Aroa= 0,4, g!O sq. j%F,. 7rarr-!~'~"i-i -m fNe wvlcr~ nhl{/ ~ , ;r`. ' _ hlole: Lot rrunrb~ra ar:rown rimer , F'n-:rF Firnsr race :,-l- F~r'ti4r r' cR1-1 i"~-(~ Ir(DCJYLYI iGa C.o., ° ~K" I ; _ 10 7s J"ur ed -"mc~ % hrcfiara Nack Fbrr~," ieM n Rpp~R.IC,K V - ~•5t filed rtt fhe Suffrolt•: Lc~SO. Gerke J~-~~ ~V RFR,R,K VAI~jLiYL, P. 1 ab vf~ p :JO.J':~1. 1-0 - 11- LICENSED U LICENSED LAND SUR EYORS ?.j t9? I wff>rL: Go.Tax Mdr GREENPORT GREENPORT NEW YORK ~i~+rooa,sec+.a3a, (F .-4,~.t-r.