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HomeMy WebLinkAbout19952-z j FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20340 Date NOVEMBER 12, 1991 THIS CERTIFIES that the building ADDITION Location of Property 200 PRIVATE ROAD #5 PECONIC N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 68 Block 1 Lot 5.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 17, 1991 pursuant to which i Building Permit No. 19952-Z dated JUNE 17, 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 TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to FRANCIS P. & BERNICE J. MELLY (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-211329 - NOVEMBER 4 1991 PLUMBERS CERTIFICATION DATED N/A ~L~ Building Inspector Rev. 1/81 roast xo ~ 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° 19 9 5 2 Z gate ......~:,f~ 7 I9~/... Permission is hereby gmnted L s l / ~~..~.-~.....y~..........~~~~y.:...............~~. of premises located ot .....,~"~~~1...1.-`1-.-~.j..~~~~G....~..1......~~~..~ ......................................................T.. ~.:C.2............................................................................ . " County Tox Map No. 1000 Section .....Cn..~.......... Block Lot No....~ pursuant to application dated .............~i...,! ~ 19.~~, and opproved by the ' Building Inspector. / a-a ' Fee s.~~...~], ~ ~.:~~L.r Build I to - Rev. 6/30/80 i i Form No. ~r ~ TOWN OF SOllTIfOLD ~'~~~-~-~L~?~~~~~w~' '1~ r g~ ; . ~ Et1 ~i BUILDING DGPARTCiCN' f' ~ `i ~ TOWN HALL [t r~ ~ { fa { u `i r ~ ~ ,~f7 . APPLICATION FOR CGRTIFTCATE or 'O CCU P,1 CY r ti,yrJt `~dJifft)lC.~~t~ 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. Z• Final Approval from }{ealth Dept. of water supply and sewerage-disposal (S-O 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 1l lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code C~,rnpliance from archi':ect or engineer responsible for the buildins• 6• Subm9.t Planni.^,g Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming "pre-existin d uses, or buildings and g" 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 L'uilding Inspector shall state the reasons therefor in writing to the applicant. 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 Luilding - $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, Co(mlmercial $15.00 Date 1.~3a' ~1.. Construction.. Old Or Pre-existing Building..,X,,, ocation of Property„~QO,Private Road #5 off Soundview, Peconic.,, New York 13ousc No ....................Street..................................... Hamlet twcr or Owners of Property...., F,R~INCIS P: & BERNICE J. MELLY ,unty Tax hfap No 1000, Scction.,068 .........B1uck...1............Lot.. 5.~.1. bdivision...A~,re~,of• Diam onds ~ i 1128 .......................Piled ,1tt.. .Lot....? rmit No19,~,52Z. ~ ~ ••••....Datc Of Pcrmi.t...~~1,~~91,,,,,Applic:tnt,NORTHSIDE CONSTRUCTION a/c alth Dept, Approval..:., IV h" FRANCIS P.~~P1ELLY •&•wife " " • • • • • • • • • • • ....Underwriters Approval, , ,~~,~~l;Lpta/ ~nning Board Approval...........~1,~••,•..... ~:ucst For: Temporary Certif'icatc...... ` Final CC C1Ca CC, -Submitted: 25.00 © ~C) APPLICANT 4' • f PAC,l~I tono~{4~~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ ~uREAU of E~ECTKtcmr g5 JOHN STREET. NEW YORK. NEYY/? O RK~ 0038 i") j:{ 1 NnVN,MMF;R 04,:1997. X14444 ~1 pore ApplMation No. onfile THIS GERTIFIE3 THAT Doty the dectrlca! aquipwtewt a Jetcrihed 6ebw rmd tnteoJutxd hY the a}pl7ant hawked on the shoos app/ieatton nuwtber to the preaniwa of ~ FRANK MELLY, SpUNDVIFid AV>'~NIJ>'7, FttfVA9"F ROAD Nl5{yoi,r':1kln), YP;60N[i", N. Y. in thefdbrcinR leeaft~'o9~ ~YT ~a~. ~ Itt Fl. ? Pwd pl, sertian tlbck Lot uns examituNf on and found to 6e in compliancruith the reyuiremente of thin !bard. N%Ttl~ AqK f1WTt]IB TIlM6 NCIIf O AUST fA?K Ct1T1O'S INCANOFSCEM ~ NIIOtFECENT OTHER AMT. K. W. AMT. K. W: AMT. k.W. MIL K. W. AMi. H. r. J ; ~ 7 yj ORYlM4 C~ MOTORS IUt11M AMUMICf IiYf tlC7t TItA1.ClCGIS N6l IINN NU/1K ~ NAT. K. W. dl H. r. 6AE H. r. AMT. NO. A, W.O. AMi. AAM. AMT. MME: TRANS. AMT. H. t ~ AMi. WARS x R~oNNecT tto. of s R R v t c R NAi. AMP. 1MIE p~j~. 1/tw 1/7vY SITU 9/AW NO.Ore~ .COND. ~ NO.Or HFlEO ~'H'Ip ND.Or NEVtRAa a'NWEU7G1Al OTtKR Al?ARilTak r f: - ~~f - ~ / C,OODAI~f; 'F;i,S:CTRIC LIt7.N783-IS o~~ 7355 MAIN ROAD 8/~AI MANAORR MA'TT'!'PUCR, AV, 1.i9S'I. i Psr o- ~ 7Tak eltt111ea)a aMNt not M alhrad in a makrnr,_ratum to Nn ofRn d Nka Mato if:'ineorred. IntpaeMrt ~ M idEplifi~/ b~e,(hair ersdantiak. i _ . _ _ _ _ IwF' MAtlIER. z /CR ~11LpIgP DEI~. TiMS 6i0r'IP IbF ~lRTMl~1rR M~rT'l!0''f b!E Ad. _.e _4~~.__...__ .v_ - - i~ 5~~~k~` TEI,. 7G5-1802 ~~O r OGy TOWN OIL SOUTIIOLD =c2, ui. ~4'c OI'[~ICG Or DUfLDING fNSPECTOR ° ;J`.~ "'~^5' rn P.O. I3OX 728 cn ~i.~7'..•.. v' ' ~ TONN f[ALL ~ryol ~,ap`~ SOUTIiOLp, N.Y. 1 f971 SEPTEMBER 20, 1991 NORTHSIDE CONSTRUCTION 2105 CAMP MINEOLA ROAD MATTITUCR, NYL 11952 RE: FRANCIS P.. MELLY S WIFR _ To 47hom This May Concern, We arc unable to complete your Certificate oL /Occupancy because of the following reasons. An application for Certificate of Occupancy is not on file. (ENCLOSED) No [Inderwriters Certificate on file. /,t/I~ T1rc check is (/not on file.) $25.00 No Ilcalth Dept. l~.pproval on file. No final i.nspccCion has been made. Ploase contact our office on this matter. Thank you for your cooperation. 13uildinq Permit If 1 9 9 'S 2 Z [Suildi.n<1 Dept. No Plumber So.l.cler Certificate on file. ( all permits involving plumbing being .i.^,sucd after elpril 1 , 19II4 ) CC: FRANCIS P. MELLY :1cLD y;~~S:;:C:iUi~ ~~~n:i. .;vt~(MLNI~ \ -e ~ 1. ~ ~ FOUNDATION (1st) H~~y ~ ' FOUNDATION (2nd) _ _ _ z 0 P,OUGH FRAME & 0 PLUMBING H 3. ~ , ca I1dSULATIOfI PER N. Y. • • y STATE ENERGY ~ CODE x~ r c~ 4. y~~ FIidAL ADDITIOPIAL COMMENTS: ~ x . b H 31 • H H\ z N x m • A • r H - ~ v m ^o H rss-isoz ILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSU ION [ ]FRAMING [ FINAL REMARKS: r ~ v~'` DATE INSPECTOR ~~~~v 765-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUN ATION 2ND [ ]INSULATION [ FRAMING [)FINAL REMARKS: DATE y~ ~ INSPECTOR 1~~~~~- 765-1802 BUILDING DEPT. INSPECTION [ FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FINAL REMARKS: ~ ,g,1 DATE ~ ~Z INSPECTOR ' B0,1FD OF RE LTii FORM NO. 1 3 SETS OF L \YS ~ , , TOWN OFSOUTHOLD SURVEY BUILDING DEPARTMENT cllecl: _ , TOWN HALL SEPTIC FoRrl SOUTHOLD, N.Y. 11971 TEL: 765-1802 r:oTIFY; CALL .~9. J. d . Examined Id f 19 of rtn i L To Approved ...(o.,/. ~ 197r.~. Permit No. ~%.g S ; . Disapproved aJc _ . ~-lQH1t10S,~011a (B i spec or) APPLICATION FOR BUILDING PERMIT yy ~~6~ ~ ~ ~ ..~~p` ~l~i Date . 19 . t ~'E:{3~~~R~`IM;,~I~~;>~,w,'~~.:~~ INSTRUCTIONS a. ~jThis 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 far 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 code, housing code, and regulations, and to admit authorized inspectors on premises atld in building for necessary inspections. (Signature of applicant, or name, if a corporation) . ~io5~. ~~~./~~~~olti.,~f,,MR~I~~~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~y.~. L.~ . j~ i Name of owner of premises ....~!~~~C:I:S...'..te~l~....'~..W.~F.~.......... (a on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of copprpo~/rate officer) Builder's License No. ...0.~, 1.~. r~.~ . r Plumber's License No. !U.4.yC , . . Electrician's License No . . Other Trade's License No . . I. Location of land on which proposed work will be done....P~~~' 4.L' . ~ o o........... PRwa~..-: ~ ~~n~v~.~ House Number Street Hamlet County Tax Map No. ] 000 Section .n....~. ~.~~.Block ..........lR Lot ~ ~ ! . Subdivision ..~l:fl,~''.'~oV1~S... f1G2:t1.~ Filed Map No. ..~/.1~, , . , , , Lot ...Z:......... . (Name) State existing use and occupancy of premises and i~/nJ~tended/use and occupancy of proposed construction: a. Existing use and occupancy , n a:'Gt.W.i! `,y.. fZ f :5 r~~i;/,~ ~ . . . . . . . . . . . . . . . . b. Intended use and occu anc ~:~G.< <:~.i~ . ~ t p. ~ . ~ ~ „«,b.1: 3. Repaiz of work (check whiRemovla~ able): New Building , Addition ! Alteration . • • • • • • Demolition , .........Other Work , , X02 (Description) 4. Estimated Cost .Fee . y..... (to be paid on filing this application) 5. If dwellin number of dwellin un' g> g its Number of dwelling units on each floor . . If garage, number of cars . 6. Tf business, commercial or mixed oCCUpancy, specify nature and extent of each type of use . imensions of existing structures, if any: Front . . Rear Depth , . Height Numbe of Stories . p ;alterations or additions: Front . . Rear . Death sions of same structure with) Height Number of Stories . 8. Dimensrons of entire new construction: Front Rear , , .Depth . Height Nu)nbei• of Stories , , . 9. Size of lot: Front . i..... , Rear S',$, : gl............ Depth ~~~~$j . 10. Date of Purchase .................Name of Former Owner . 1 1. Zone or use district in which rem p jses are situated _ 12. Does proposed construction violate any zoning law, ordinance or regulation: - ~ i lot be re raded . 14. Name of Owner of remises : ; ~ • ' ' ' ' ' ' ' • • • Will excess fill be removed from premises: Yes No P ~ ...............Address , .......Phone No....... . Name of Architect Addross ...................Phone No............... . erne of Contractor , , 15. Is thi* property within 30 " " " '••Address ...................Phone No. ' 0 feet of a tidal wetland? eyes,,,,,,,, No......... 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 narnes and indicate whether interior or corner lot. II I I i it STATE OF NEW YORK, S.S COUNTY OF . (Name of individual si ni • • • • ' ' ' ' ' ' • • • being duly sworn, deposes and says that he is the applicant g r?g contract) above named. ~ He is the (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 ................~~........day of J ~ ~ 19 9~. Votary Public, ...~d~s.~~3. _ ' _ - County . Np.EN It DE YOE C~'~Z:t~~!~v,?-.. ¢~~~,Gc~L~L ;t~.~~, . NOIARYPUBLIC,SWeottbwyelft i / (Signature of applicant) lam Ek~r~7A arch 80 1~I - ~ ~ ~Q U0~'- v--_. _ _ i _ _ 1 '_p~1Yg7-~ _ _ _ ' ~ ~ / ~ % sec ~ 1 ~~'tr 4.. ,L'. ' - . 7 n' ~ C ~,7,-~~-, r ~ Q, _ i . r + ~t H- I [ - ( ~ j /j ~ ' ~ yam; Sv, f'7 "z x M _-N.57`g7 50°E u, Tt~WN '~74F d t ~ / i tll W --,s~rv~ ~.:;"°d,r. `~...r._ tom. _ 35