HomeMy WebLinkAbout19682-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26361
Date: 04/09/99
THIS CERTIFIES that the building ACCESSORY
Location of Property: 41780 MAIN RD PECONIC
(HOUSE NO.) (STREET) (EAMLET)
County Tax Map No. 473889 Section 86 Block 1 Lot 7
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 20, 1991 pursuant to which
Building Permit No. 19682-Z dated FEBRUARY 26, 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 ACCESSORY GARAGE AS APPLIED FOR.
The certificate is issued to JAMES C MCBURNIE
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. PENDING 04/01/99
PLUMBERS CERTIFICATION DATED N/A
Rev. 1/81
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N. Y.
BUILDING PERMIT
CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Permission is hereby gront~ .
...............
...... ~.~,...~...~.,~y~....L..~.~/.. ................
....................... /'7 .......... 7.Z_.;.U;.~ ...... ~,'2'2 ......... 7' '~'""2 ..........................................
at premises located at .............. .~.../....../..~., ........ ~,,'..~,/',/,~'/~..ff..~...~,/. ..............................................
County Tax Map No. 1000 Section ..... ~.~,.. ,~..,4 ...... Block ..... ~....../. ....... Lot No ...... ~,,..,~ ....
pursuant to application dated ..... ~~ ....... .~......~.. ............. , ,9...~.../and approved by the
Building Inspector.
.ulldlng° inspector ~'
Rev. 6/30/80
THE NEW YORK BOARD OF FIRE UNDERWRITERS ~AG~, i
ii~i~o eUREAU OF ELECTRICITY
-- 40 FULTON STREET, NEW YORK, NY 10038
Date AP?IL 0~;,1999 Application No. on file 17953399/99 N 485061
THIS CERTIFIES THAT
only the electrical ~ quipment as described below and introduced by the applicant named on the above application number t$ in the pr~ml~es of
JIH HcBURNI.E, 41780 IL%IN ROAD, PECONIC,
in the following ,'ocation; [] Basement [] 1st Fl. [] 2nd FL GAR Section Block
was examined on .~,IL O!, 19-°9 and found to be in compliance with the National Electrical Code.
Lot
FIXTURES RANGES COOKING DECY~ OVENS DISH WASHERS
FIXTURE EECEPTACLES
OUT/ETS R.UORESCEHT OTHER
11 8 3
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS $1~CIALREC'PT. TIME CLOCI~ UNIT HEATERS MULTI-OUTLET
SYSTEMS
NO. OF FEET
DIMMERS
SERVICE DISCONNECT S E R
OTHER APPARATUS:
PANELBOAP/)$, 1-6 CIR.
G.F.C.I, ~'~
I C E
NO. OF HI-LEG
SHK~ON ELECTRIC
62 WAK}I~AN ROAD
~A~?TON BAYS, NY, 11946
GENERAL MANAGER
11 .
Thl. cmflflcate mu.t not b~ GIMrecl in any m~nner, relum lo the ~ of the Board If Incorrect. Impector~ may b~ ~ by Ihelr creclenflab.
COPY FCR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
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 buildin~
inspector with the following: for new building or new use:
1. Final survey of property with accurate location of ail 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, i~dustrial building, multiple residences and s{m{lar buildir
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, o~ 'buildings an
Vpre-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 sig~ed 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 Buildinm - $i00.00
3. Copy of Certificate of Occupancy - , .25g.
4. Updated .Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
......... .................
New Construction . ..~....... Old Or Fre-exis u ng ........
~oeatian of ~roperty... V. ZZg.o. ................ ~../d .................
House No. Street Hamlet
On.er or O ers of Property .... .... ................................
County Tax Map No i000, Section ............. Block ...... .~./. ....... Lot ...... "~ ........
Subdivision .................................... Filed Map ............ Lot ........... ~ .' .......
Health Dept. Approval ....... ,~ .............. Underwriters Approval .......................
Planning Board Approval .... ~ .............
Request for: Temporary Certificate ........... Final Certicate .... ~...~...'.
Fee Submitted:
,"'i-~, ~ ¢ o ~ ~ .... . .~/.7. ¢~Y. · .~4-m. ·'. ...........
APPLICANT
765-1802
BUILDING DEPT.
INSPECTION
[ [ ] ROUGH PLBG.
[ [ ] ~JLATION
[ [ /~ FINAL
[]FIREPLACE&CHIMNEY
] FOUNDATION 1ST
] FOUNDATION 2ND
] FRAMING
DATE
INSPECTOR
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
October 7, 1998
Jim McBurnie
41780 Rte. 25
Peconic, New York
11958
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 (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 # 19682-Z GARAGE
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [ ] INSULATION
[~'~RAMING [ ] FINAL
REMARKS: ~ ~,,~
/
DATE
INSPECTOR
FOUNDATIO:!
~lst~
?OUNDATI0:; ~ f2nd)
ROUGH FRAME &
-PLUMBING
3.
7NSULATION PER N.
STATE ENERGY
CODE
Fi~;AL
ADDITIO~;~L COMMEI;TS:
765-~.802
BUILDING DEPT.
INSPECTION
[~FOUNDATION 1ST [ ] ROUGH PLBG.
[ J FOUNDATION ZND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS:
DATE
INSPECTOR ~~_~
_=.--
~'- l~"~ ~ Lo" ~ GT~-
1115[?
~'~ ROOF DESIGN LOAD
~"%.~,,> 31VOltlla33 ~OHllg
I-
--?
~00~ $~[~b&s, ~
[SHEET
2384 [TOTAL ,,5,
0
Z
0
m C
'--I
-<
Z
Disapproved ale .................................... . ..
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
· ~OUTHQLID.. tq..'~. Lt571.
TEL.: 7G5. 1802
BOARD OF H£ALTH .........
3 SETS OF PLANS ..........
SURVEY ....
S~'PTIC F 0 R,"I ..............
NOT I FY
CAE:
HAIL
(Building [n:pcctor)
APPLICATION FOR BUILDING PERMIT
· INSTRUCTIONS
a. T16s application must be completely filled in by typewriter or in ink ~nd submitted to th;' Buildin-_. La:pe~t.~r, wit/
sets of pIn,~% ~'-,,rata plot plan to scale. [::to ;~ccor~ing to schedule.
la. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premix= or public stre:
or areas, and giv/n; a deta/lgd description of layout of property must be drawn on th,. diagram which ix pa~ of this ap/.
cat, on.
C. Th-' work covered by this application may not bc commenced before issuance of Ruilding Permit
'd. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such perrr
shall be kept on thc premises available for inspection throughout the work.
e. No building shall be occupied or used in xvhole or in part for any purpose whatever until a Certificate of Occup~n:
shall have been granted by the Building Inspector. '
APPLICATION IS HEREBY MADE to th,. Building Department for the issuance of a B,,;lding Pe..-x..it e=."~.:ant to t.~
[luilding Zon= Ordinanc~ of' tb.e Town of Southold. Suffolk County, New
~,c:ulations, for the construction of bui.ldiq~s, additions or atterat OhS. or for removal or demolitionS, ca hereto describe:
Th& .applicant ag[ecs to comply xvith all applicable laws. ordinances, building code, housin= codez/z/n
,dm,, speeto on prem s and
·
~Mailing address or' applicant)
State wl~ether applicantcD ~ i'J~'~'i~ owner, lesse,., agent, azchitect, engineer, general contractor, electrician, plumber or build-':
........ ........ · ..............................................................
Nam,. of owner of premises ~C'. ~-~ ~rl
(as on thc tax roll or latext deed)
'fapplicant is a corporation, signature of duly authorized officer.
plumber's License No /"~-
Electrician's Liccn:e No .................. ~
O[hcr T¢~dc's Liccn:c No ......................
L ti o~l~a.nil o.,o~ h p pos ill .be d '
DCa on wh/c ro cd work w one:
ou~c Number Street. Hmnlct
County Tax Mu o. Section , ~ ~' O0
................. Block ........ Lot
5ubdivh~on .................................. -. . Eilcd Map No. · .............
{Name)
~tzlc esi~tin= u[c and occupancy of prcm~sc[ and h~lcndcd use and occupancy of proposed construction=
A. ~xtSt~ng uae and occupancy .....................
B. 'Intended uae and Qccu~ancy.; .........................
· Nature of work (check which applicable): Ne~v Building ....... Addition ..... /alteration
.: ............ .............. D moli,on ..............
enn~s court ' '~ ..... Accessory guilding ..........Fence ~ ' '
f., z2... ' .......
(L~ he paid on filing this application)
Ir dwelling, number of dwelling units .... [ · - · Number of dwelling unit~ on each flo ..... I.. .
........ .......
I£ garage, number of cars ..... 'a:~,
· If busincgs, commercial or mixed occupancy, specify natnrc and extent of each type of use ....................
· Dimensions of existing structurc~ if any: Front Depth
, ............... Rear . .. ..........................
Hci:ht ...... Number of Stories
Dimensions of same structure with alterations or additiong: Front................. Rear .................
Depth ...................... Height ....... ~ ............. Numb~.r 9f Stories . - 'l .......
Hmght .. ~..~.~ ......... Number of Stories .... l ................ '...
Size of lot: Front .............. -....... Rear ............ Depth ................
Date of Purchase ........................ --- -- Name of Former Owner ............................
Zone or use district in which premises are situated. · ...................
Does proposed Construction violate any zoning law, ordinance or regulation: .....................---.......
Will lot be regraded
...... o .......... Will excess fill be removed from prerni~: , ·
Name of Owner of prernixe~
............... Addrem.. ...... .......... . Phone No...-. ..... .--..
Name of Architect
........ . . Address . Phone No
Name of ContraCtor ' '
· . ...... Addresg ..... Phone No ...............
i.l.m t-kim property located within'afl8 feet of a tidal wetland? 'mYES .... NO ....
~If yes, $outhold Town Trustees Permit may be required.
PLOT DIAG RAM
Locate cle:trly and distinctly all buildings, whether'existing or proposed, and. indicate all set-back dLmen:!on: :':
operty Hnes. Give street and block number or description according to deed, and show street names and indicate
for/or or corner lot.
FATE OF' NEW YORK, S.S
DUNTY OF . . ·
................................................ being duly sworn, deposes and says that he is the applie::
(Name of individual signing contract)
: is the ·
(Contractor, agent, corporate officer, etc.)
· said owner or owners. ~d is duly authorized to perform or have pcrfo~etl the said work nnd to m~e and file th
'plicatioa: that all statements contained in this application are truc to thc best of his knowledge and belief; and that
mk will be pcrt'om~cd in thc m~ncr set forth in the application Qlcd therewith.
yom to before mc this
atary Public ...... ~2-~- · ; .- . ... County
· 'HELEN K. ~ V~D~ENew York
(SignJture of applic~'