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HomeMy WebLinkAbout20651-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF O~CUPANCY No Z--23060 Date JUNE 23, 1994 THIS CERTIFIES that the buildin~ ALTERATION Location of Propert~ 3430 WICKHAM AXrENUE MATTITUCK, NY House No. Street Hamlet County Tax Map No. 1000 Section 107 Block 9 Lot 16.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 13, 1992 ~ursuant to which Building Permit No. 20651-Z dated MAY 26, 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 ALTER EXISTING ATTACHED GARAGE INTO A BEDROOM & BATHROOM AS APPLIED FOR. The certificate is issued to (owner, lessee or tenant) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. H041357 PLUMBERS CERTIFICATION DATED JUNE 20, 1994 JAMES D. BARNEY SEPTEMBER 2, 1993 Rev. 1/81 ~~uilding Inspector TO%VN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BF_. KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~N? ~0651Z Permission is hereby granted to: ~ pursuant to application doted .... ~.~ ........ ----/.,..~. ........... , Jg...~.~?h- and approved by the Building Inspector. Building Insl;ector Rev. 6/30/80 ~. Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 365-1802 BLDG. DEPT, TOWN OF SOU~HO!m 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 now 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: I. 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 - $i00.00 . 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 Date . .~..~.~.~.~..~..~.//~...~. ............. New Construction ........... Old Or Pre-existing Building ................. Location of Property ......................................................... House No. Street Hamlet Onwer or Owners of Property...~.~--~. .... ~.~... ~,~. ~../?.~..' ............................... County Tax Map No 1000, Section .............. Block ................ Lot ...................... Subdivision .................................... Filed Map ............ Lot ................... · · Permit No.~.~.~.-'~..~ .... Date Of Permit ............ Applicant ........................... Health Dept. Approval .......... Underwriters Approval ........... Planning Board Approval/ ....................... Request for: Temporary Certificate ........... Final Certicate..'.~. ....... Fee Submitted: $..~.~.~.~L- ~ 7 ~ 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 September 14~ 1993 James & Pamela Barney 3430 Wi~kham Avenue Mattituck, N.Y. 11952 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 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) No Underwriters Certificate on file. 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 # 20651Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. TOWN OF SOUTLIOLD ' OFFICE OF BL~ILDING INSPEC,~FOi~: P.O. BOX 728 TOWN HALL SOUTI{OLD, N.Y. 11971 TEL. 765-1802 C E R T ~ F I-,C A,T~ O____~N Building Permit No._~2~7 ~ (please p ~ i~'t ) ~-~--'~z-c~' ~/ P e prmnt) I certify that the solder used in contains less than 2/10 of 1% lead. the water supply system Sworn to before me this 4ff~O/t//..) day of ~f~/*/~'~' NOtary Public,_ Nota ~J3~lic -- County ~F.~ 'THE NEW YORK BOARD oF'FIRE UNDERWRITERS 8038801 BUREAU OF ELEci~RIcITY ~'-- 85 JOHN STREET, NEW YORK, NEW YORK 1003B Da,. ~ 20,1994 Applicution No.o,/,e 8e125e93/93 H 041357 THIS CERTIFIES THAT ~ . ~ . o~y t~ eJ~trlcal ~uipme~t ~ ~scdb~ be~w a~ int~uc~ by t~ applicant ~m~ on the a~ apphcat~ numar in the J~S D. ~, 343~ WIC~ A~, ~I~CK~ N;Y. exa,,i,ea O, JUNE 13,1994 FIXTURE OUTLETS DRYERS SERVICE DISCONNECT and found to be in compliance with the National Electrical Code. RANGES ~'ECIAL REC'PT E R FIXTURES S TIME CLOCKS SRLL ~T. ASPS. TRANI V I C 1~'2W 1~'3W 3~I'3W 3.~4W NO, OFCC. COND~ A.W.G. pER ~' OF CC. COND ~THER APPARATUS: RLEC. ROOM HEATERS,i-i.O K.W. MOTORS: 1-F H. P · G.F.C.I.'-3 SMOKE DETECTOR, -1 NO. OF HI-LEG UNiT HEATERS MULTI-OUT/ET SYSTEMS NO. OF FEET EXHAUST FANS H P DIMMERS ~ A, W, G NO OF NEUTRALS OF HI-LEG 3430 WICKHAM AVENUE ~ · GENERAL MANAGER : m~P lhis certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectorsy y their credentials. INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieezorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD 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 September 14, 1993 James & Pamela Barney 3430 WickhamAvenue Mattltuck, N.Y. 11952 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) axx No Underwriters Certificate on file. The check is (outdated/not on file.~$25.00 No Health Department Approval on filer No final inspection has been made. No Plumber Solder Certificate on file. (Ail permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT ~ 20651Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOW/~ BUILDING DEPT. THE NEW YORK BOARD OF FIRE UNDERWRITERS 8~388(~[ BUREAU OF ELECTRICITY ~-- 85 .JOHN STREET, NEW YORK. NEW YORK 10038 Oate J~l~ 20,1994 ~pplicationNo. onfile 8~125093/93 H 041357 THIS CERTIFIES THAT o~y the el~trl~al equipment ~ ~scrlb~ be~w a~ int~uc~ by t~ ap~icant ~med on ~he a~e application number in the premises of J~S D. B~EY, 3430 WIC~ AV~, ~UCK, u~s examined on 13,1994 and found to be in compliance ;vith the NaMonal Elect~cal Code. FIXTURE OUTLETS RANGES SERVICE DISCONNECT [ NO. OF I S E R V I ¢ ~ AMT. j AMP. tYPE ~I~J~'PR. I~e'2W I.'e'3W 3~'3W $-~4W NO'O~ECRC#COND' OF~C~O~D NO'OF HI'LEG ~ ~.L~6 , ELF~C. ROOM HEATERS ~ 1-1. O K.W. MOTORS: 1 -F H.P. SMOKE DETECTOR JAMES D. BARELY 343~ WICI~{AM AVENUE HATTITUCK, NY, 11952 MULTI-OUTLET SYSTEMS NO. OF FEET EXHAUST FANS F DIMMERS E NO OF NEUTRALS A, W G. OF NEUTRAL GENRALMANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identiJ~J by their credentials. COPY FOR BUILDING DEPART~,,~ENT. TH~$ COPY OF CERT~FICATE MUST NOT BE ALTERED IN A~Y MANNER. Town H&I[, 53095 Main Road P. O. Box 1179 Southo~d, New Yor~ 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD February 18, 1994 2nd NOTIFICATION James & Pamela Barney 3430 Wickham Avenue Mattituck, N.Y. 11952 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: XX An application for Certificate of Occupancy is not on file. (Enclosed) XXNo Underwriters Certificate on file. 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 ~ 20651-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. 765-~802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] I~ULATION FRAMING [//]' FINAL INSPECTOR.,//~~~ FOUNDATIO|,! (2nd) ROUGH FRAME & -PLUMBING I~;SULATION PER N. STATE ENERGY CODE FI;IAL ADDITIONAL COMMENTS: FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ....... 19 .\pproved~;~ ~,` .~,.. '.., 19~'~Permi, No...~. ~. ,~, Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTI1 ......... ....-~'1 SETS OF PLANS .......... z~'~SUKVEY ................... CIIECK CALL . . · . · INSTRUCTIONS 'a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 3ts 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 pubI/c streets r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. c. The work covered by this application may not be cbmmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit mil 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 mil 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 uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to /mit author/zed inspectors on premises and in building for necessary inspections. ~ /,t41gnature of applicant, or name, if a cor~ration) (Mailing address of applicant) tare whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ameofownerofpremises ..... '~ ,~/4,'w~"C// ~ .~/it4/V~-~'.... ................. : .... (as on the tL~x roll or latest deed) applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ......................... Plumber's License No .............. Electric/a,n,;s License No ................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................. ~. .. ouse Number Street ............... Hamlet .......................... Lot .... ~ ........... SubdMsion ..................................... Filed Map No. (Name) .............. Lot ............... State eMsting Use and occupancy of prcmisgs and intended use and occupancy of proposed construction: · . . '""'" '"'.?;' ........ "'" ; ' ' ; .......... nolition ..... ,,, ........ Other %~,ork ....... 4. Estimated Cost ..?.~..CO.O, .a.~u..I ' ' ' ~/~4o,,,.~, ,.~ ,,~ (Description) ....... · ....................... Fee .~...~.t e/- ~.. . . .. (to I id fill j thi ppli ti ) · v ,,gum .... ii'"i ..... m ero we ngunitsoneac our ................ 6. Ifbusiness corem ...... '--" ',. ........... .' "; ................................ q Y fY d tel h t~pc of use · · · ~: · . .',,',i .... 7 D , *..-.,,- ut mlXeu o CUpanc , spcQl ne.tuft an exten cac · ' pfc ' ' i~a y:F ' ' · lmenslons XlStlng structures, n rent ........... ~H.e'gh.t Nub t, CSt its ..... " ' ' D pth ........ '. ·; .... Rear ........ c I ............... IU e o or ............... sip f ith hit .............................................. ~atmen ns o samestmcture w erations or additions: Front Depth Heit,'bt Rear 8 .......................................... Number of Stories ~ · Dimensions of entire new construction: Front ' ' ' ..................... · Rear Depth He it ............... Number of Stories .' ............. ..': ..... ~ R~ "" ' ......... 9. Size of lot: Front .............. ! ar ....... ' ........................ 10. Date of'Purchase ... ~ ............... Depth .................... ........... ! ............... Name of Fenner Owner 1 I. Zone or use district in which premis:es are situated ............................. 12. Does proposed construction violate ny zoning law, ordinance or regulation: ........... 13. Will lot be regraded ...................... ;... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ...... "· · ress ................... Name of Architect ...... I .......... Add Phone No ........... ....... i .............. Address ................... Phone No ............... : Name of Contractor ...... '.. ~ · , ' 'i ............. Address . . ~5. Is this property within o ............... Phone No ..... O0 ifeet of a tidal wetiand~ *v~= ' .......... · If yes, Southold Tow~ Trustees Permit may be required. ~ ... ,' , PLOT DIAGRAM Locate clearly and distinctly all buiidings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or descriptio~ according to deed, and show street names and indicate whether :nterior or comer lot. TE OF N~V'W~nK.~.._ rtl ,('Name of individual signi~ ~;;,'}/a~ .......... being duly sworn, deposes a)ld says that lie is the applicant ~ve nameu. ~(Contractor agent corporate officer ) ........... said owner or owners, and is duly anthdrized to perform or have performed the said work and to make and file this lication; that all statements contained inl this application are true to the best of bis knowleflge and belief; and that the 'k will be perfumed in the manner set forth in the applicatiou filed therewith. ~m to before me this a~ Public, ~(. County NO. 4879506 O ' oalifled in Suffolk Cou~ "' Commission Expires De~mb~8, ~9~~ "