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HomeMy WebLinkAbout20188-z A FORM NO. 4 TOWN OF SOUTHOLD BDILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20725 Date MAY 13, 1992 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 615 JOCKEY CREEK DRIVE SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 70 Block 2 Lot 18 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 27, 1991 pursuant to which Building Permit No. 26188-Z dated OCTOBER 4, 1991 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 & ALTERATION TO EXSSTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to HOWARD M. TERRY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTTFICATE NO. N-234190 - MAY 6 1992 PLUMBERS CERTIFICATION DATED APRIL 3 1992 - PECONIC PLUMS & HEAT. uiB lding Inspector Rev. 1/81 mass xo. 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) 0 N_ 2 0 1 8 8 Z Date ....~C7~~P 19..`.~~ Permission is hereby granted t at premises located at .........................................................~,,,~G~.......................................................... County Tox Map No. 1000 Section .........,T,Q....... Block Lot No. pursuont to application doted ....~yl/...~ 19.~., and approved by the Building Inspector. Fee $...t:1....K Builds I for Rev. 6/30/80 ~J'/ ff ~,\Y!,!_` ~3 ~ ~ Form No. 6 ' D ~ ~ .r }f TOIN OP SOUTIIOLD L~~ ~319~2 '~i BUILDING DEPARTMENT (\L'/J ' 7 J°; G~e ~..,v 's TOWN BALL F~t.f~%i.{~Ct:f t: 765-1802 T01M1tf~fif ;;ti?;; h' si 11Jy t~ r APPLICATION POR 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 £or 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 - Resident~i('al $15.00, Commercial $15.00 rr _ Date ~ ~(Z \ L 3, t ~ F z-- New Constructionl:~~ n~<<~ Old Or Pre-existing Building., Location of Property.~~S.~Q~~CE,/ Gf2-tEl<. D~.,_~~/h ~Jpckr^./ C(~,.JJIZ S~yu l ('IOC.Q House No.' Street Hamlet ~ r ~ Onwer or Owners of Property. f~.~ (2 Q ..M. , , . County Tax Map No 1000, Section....~.o.:.....Block..r`1r............Lot.,~\\/~,,,,,,,,,,,,,, Subdivision....~~^^~~... ........................~./Filgqed Map... X-. ......Lot.../................ Permit No.~~~.7.~.,~!„Date OL Permit.~~~.(~,/, ~...Applicant.t!~~';J~~~,~ 7t(~R'Y P I P ~sspool pr-I?w~~T~&a-2 //J l'f~o~ r~ S.S. Ifealth Dc t. A~ royal. .Underwriters Approval.1./.. Planning board Approval........... ` (tik0.vcs-gip a 4'A'(JFu'~ .....~~.yL Request for: Temporary Certificate........... Final Certicate../.~....,, ~,~uWG'CAR-S CG-~7~f~cp7~ /r.I Y~1~t5 S I'ee Submitted: $,~-;ar,,,,,,,,,,,,,, 6`~a~~a APPLICANT TEL. 7G5-1802 ~aS~FFQC~'~ol~~ TORN OF Sf)U3'~Od.D ~.,:a, ~ OFFICE OFBL'ILDII•IGINSPECTOR o ` h:~ T P.O. BOX 728 ~E; TOWN HALL . % SOUTHOLD, N.Y. 11971 01~ ; C E R T I F I C A T I O N , Date ~`_._~l Building Permit No. ~ d ~c~~ Owner f p(,,I 'jZ ~ ~ G rZ (2 (please print) Plumber~~~y~//lG~ ~~//Vctp~fYL~fj/(/q (please print) / I certify that the solder used in the water supply system contains less than 2/10 of to lead. R~.r~~ ~ _,..G ~,~l..w - (p ber' signature) Sworn to before me this b day of t~~' 7~ 19~, Notary Pu is tlotary Public,St/~i~i~L~ County BARBARA STEPNOWSKI Notary Pubpc, Slme o1New Yak awlAad fn S~Llb~pc~Cawgy ~~arwsar».ao,,~3 THE NEW YORK BOARD OF FIRE UNDERWRITERS l~nr~ 1. 10f~©121 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 70038 Date fl~Y @6719 ~'L APPlication No. on file 7b~~7 ~.l2{9~ ~ THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the obone opp[ication number in the premises of 1fOWAttD 'P1;RRY, 61'3 ,70CBNY Cl2Rti:![t' Uft, t 90[1TNOT,Ur N,~~ in the following location; ? Basement ~ /st FY. ? 2nd 1.1. .Sertion Block Lot uas examined ort ~N~ J'L t ~ 9 oadfound to be in cmnpfiance with the requirements of this Roard. FI%TURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS e ;t OUTLETS INCANDESCENT RVORESCENi OTHER AMi K W. AMT. K W. AMi KW AMi K W AMT. H P „y l ~ ~ 2 I DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALRK'PT TIME HOCKS ggLL UNIT HEATERS MUL7I.OUTLET DIMMERS ti AMT. K. W. OIL H. P. GAS N. P. AMi NO. A. W. G AMT. AMP. AMT. AMPS TRANS. AMT. H. P SYSTEMS pMT. WATLS NO.OF FEET I~ 1 3~i a SERVICE DISCONNECT NO.OF 5 E R V I C E AMT. AMP TYPE METER i ~ ~ i ~ ~ 9 S, ~W J AW NO.Of CC COND. A W G. NO OF HPIEG A. W G NO Of NEUTRALS A. W. G. EQUIP. PERd Of CC. COND. OF M4LEG OF NEUTRAL OTHER APPARATUS: G,I7.C.YL-2 Ptl[J1, R. F3flRN:~ 1~LC,~2&2-~ 275 TOWN WA1iflON LANS~; u'OU~'NOC,Dr N~°, 1.1971 GENERAL MANAGER Perl ~ 1 ` This certificate n ust not be altered in any manners return to the office of the BoaL~d if incorrect. Inspectors may be identified by their credentials. I INSPECTORS t Victor Lessard ~`~~j3~~fl(~- Principal Building Inspector , . ="p Curtis Horton Y y' G~ SCOTT L. HARRIS Supervisor Senior Building Inspectors~a :<''n" = ` " ~ v~ , r',;,~k Southold Town Hall Thomas Fiaher w i ' `t' ~ P.O. Box 1179, 53095 Main Road Building Inspector may- ~"°`~t::'' ',~,''r . Southold, New York 11971 Gary Fish J/~+~` ~e~ Fax (516) 765-1823 Building Inspectrn :a ~ 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 APRIL 1, 1992 HOWARD M. TERRY 615 JOCKEY CREEK DRIVE SOUTHOLD, NY 11971-0477 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. XXX The check is ~X&iA~4t~X~c$~not on file.) $25.00 No Health Department Approval on file. No final inspection has been made. XXX No Plumber Solder Certificate on file. (Al'1 permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 20188-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. - - W 'OUJIDATIO"! (1st) ~ o 'OUNDATIOIJ (2nd) m~ ~ . r i o~ ;OUCH FRAME & PL/U~MBING 1 ~ ~ H 1. / ~ m :1ISULAT20;1 PER N. Y. ~ ~ ~ y STATE E1IERCY CODs ~ ~ * s. ~ '~H ' I ~ ' FIilAL ° ADDITIOIIAL COMMEPITS: ~ x w H 9 9 H , H ^1 O 1t`~ . • 2 M j~ } _ H Z v i~ ~ m H . ~ ! ®t~~ 765-1842 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ROUGH PLBG. [ ]FOUNDATION 2ND [)INSULATION [ ]FRAMING [ ]FINAL REMARKS: - ' DATE ~~~-INSPECTOR 765-1802 BUILDING DEPT. fNSPECTION [ FOUNDATION 1ST [ )ROUGH PLBG. [ J FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~ C ~~P%~ DATE ~ INSPECTOR ~t' _ 6 y65-1802 B6JILDING DEPT, INSPECTION I [ ]FOUNDATION 1ST ROUGH PLBG. [ ]FOUNDATION 2ND [ SULATION [ ]FRAMING [ ]FINAL REMARKS:~~ ~ L ~ i F M DATE ~ INSPECTO ~ n BOARO OF HEALTH . 0 ~ ~ ~ u ~ FORM NO. 1 3 SETS OF PLdrIS . TOWN OF SOUTHOLD SURVEY . . e~ 7. yyy BUILDING DEPARTMENT CiICCf: . . . . . ~1 TOWN HALL SEPTIC FORrI _ . _ . , SOUTHOLD, N. Y. 11971 Town eesepool permit X15$2-~? 8 EPT. TEL.: 765-1802 t70T i FY CALL Examined LI . rtnlL To: APProved ,c~ , 19~~Permit No:°.~./. ~~~i . Disapproved arrc// _ . ~•.z. ..~t'~-~-~ . (Bu~' ing I ector) APPLICATION FOR BUILDING PERMIT Date .......Sept . 1$ 19 9 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ;ets 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 ~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 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 ;hall 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 ;hall 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 3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or 2egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. Clie applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to idmit authorized inspectors on premises and in building for necessary inspe tons. Q . _ _ •~V`........... . (Signature of applicant, or name, if a co poration) 615 Jockey Creek Drive, Southold (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . , , , , , ,Own®r, Builder Vame of owner of premises .Howard M. Term'. (as on the talc roll or latest deed) if applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. Owner, ,former Town LiC. ~ 200) Plumber's License No. , , , , , , ; , , , , , , , ~Q,v,~ya.~'• ..tJ• 119(!L'~Y Electrician's License No. 2$2-E,&. 3897-E (P.Burna) U Other Trade's License No. , owner-builder Location of land on which proposed work will be done. N/9 Jockey Creek Drive Sou$,hohd . , 61,5. ,Jockey, Creek. Drive... , . , , Southold N.Y. 1 1971 i'.O.Box 47? Ilouse Number Street Hamlet County Tax Map No. 1000 Section 7~............ Block .....2............ Lot ..~8 . Subdivision Filed Ma No. Lot . (Name) ~ P State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy , , , oAe family dwelling Be raceeeoOry garage b. Intended use and occupancy , , same with email addition on rear of existing kitehea _.__..rt,.w_... _ ,.~.w,,,...,. 3. Nature of work (check whicRhe1apoplicable): New Building Addition , , Altaratt Repair al . t ' 4 - Demolition 4 other 1Voik , . pni! . . es~ 'on) 4. Estimated Cost ,6 t00C1.Od . ~ Fee~~O'p0.. ~ e~ . , 5. If dwel (to be paid~'~~ 0 pion tin number of dwellin u g+ g 'snits , nn~ • , , , , , , , Number of dwelling unis on ~p , , , , , , , If garage, number of cars 6. If business, commercial or mixed (occupancy, specify natu a and extent of e ch t e of use . 7 He ~htsions of existing stru Numb tf any: Front , , , Rear 28 Depth erofStories...p.~Q.~. Dimensions of same structure with alterations or additions: Front sA.tpe R • ~A111e 6atl]8 p , .Height Nu be f Stories . 8. D'nsensions of ent re new c N s~~ction: F`rdnt . ~ 7, ~ * , , , , ,Depth Rear..,.... Hei ht er of Stories OL"i~1 . r. . 9. Size of lot: Front . 1~,©.?'ti.~~,.......... Rear ......12L1 'Y'1; Depth ~3~ . ~ J~"......~ 101. one or use district in 6 ich prerp ~ ~ ~ ~ ' ' ' ' ' 'uTame o o r caner . QaT~xx,Y..Y+eta'te A res~~en~'~la~. ices are situated . . . . . 1_. Does ro osedconstructtonvio[a p p ~ to any zoning law, ordinance or regulation: 11t? 13. Will lot be regraded .....T30...!..... ..Will excess fill be_removed from premises: No 14. Name of Owner of premises .Hoyla~rd, ~I+, •fi~rry ,Address ~©ck~y• ~7.~eek Dx Phone No..7~~02 • 1 .....fl Name of Architect H©tVard. '~e~'Y'~. , , , , , • , , , ,Address Phone No.. . Name of Contractor 11 ~ a ~ ~ ' • " n •e " " " If es, Southold To " • • Address Phone No............... . propert within 3Q 15. Is this 0 feet of a tidal wetland? eyes,,,,., „ No..?~p..... * Y can Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all Buildings, whether existing or proposed, and, indicate all set-back dhnensions from property lines. Give street and block npmbet or description according to deed, and show street names and indicate whether inferior or corner lot. c l3ee copy ofl,original survey attached ANA plot plan on plan draw~,ngd , i n ~TATEOFNEW~Uo1k S.$ 'OUNTY OF .................I contract} - (Name of individual signingr~ ~ • ~ ' ' ' ' ' ' • • being duly sworn, deposes and says that he is the applicant bove named. fe is the ,I?W13.~x, , ,builder , I' . (Contrac;or, agent, corporate officer, etc.) ~ ~ ~ • • • • • f said owner or owners and is dul a + Y uthorized to perform or have performed the said work and to make and file this ;tplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the ork will be performed in the manner st t forth in the application filed therewith. worn to before me ~t/his~ ~ / ~y ....day of . ~ n!^/1t1:°l~..:, l9l 'otary Public, County / ~ . . F~L ZAB H ANN NEVII.LE • Y ~ • • • ~I.. . Note P Itc,Staf®~ofNewYork (Signatureof~applicant) No. 6~ 6126860, uuffolk Caynty Term Expires October 91,18r,C~.`- ~Y_ ___~~.K{ ~ Terry 5. TT%'S0"E. {20.0 - 5~ aw~~.~:,~._~ . ~ ~ o ~mn~~~~~:~ tl ~oJ.,~~,~d:., . li u. m m 1s lWUna~adF~ano'np l.r.~n~" n ~._'J tlN. co~nl~~nY 9aO lisbd h~ i'~ ~ ro;no ~ :,,~;~~6 a Iotemonelaionmc enx alreute~0uenl owners. ' ~ Y i ~ " MAP OF LAND i ~ = IZ s4'y fr 30' ~ SURVEYED FOt2 house i w ~~„n~~eans+y 3 WOWAi2D M, TERRY I I ~ m ~ SOUTF-{OLD ~ ~ TOWN OF SO UTHOLD , N.Y. iV I } Z N I _'u13.O71 tom N.?T46'S0"W. IZO,O - l~~rJEh,~ ! Main ROad 5~ 9~'~~9t p S' ~ n G I # Q t T 1 JOCKEY CREEK DRIVE °~,~0~~`56~~,~ ~rFO .awn 5~e ; I 6um•anteed to tNe Horne Yitle Division-Chicago! - - _ - - _ _ _ _ .Title Insurance Co, and the Southold Sayings Ban k., as surveyed June 23, f985 SCALE : 30~= I" VAN TUYI E SON 4 = MonUMent - ~~j~r ~~r f o~ Irott pipe t,'Itensed Land Survg710r 1___..__ GreenporF ,New York.