HomeMy WebLinkAbout18855-z
• !
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CBRTIFICATE OF OCCOPANCY
No Z-24455 Date JUNE 21, 1996
THIS CERTIFIES that the building RSNOVATIOA & ADDITION
Location of Property 1220 SIGSBEE ROAD LAIIRSL NY
House No. Street Hamlet
County Tax Map No. 1000 Section 144 Hlock 1 Lot 4
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 9, 1990 pursuant to which
Building Permit No. 16855-Z dated MARCH 9, 1990
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 RSNOVATION AND ADDITION TO AN E%ISTING ONS FAMILY DWSLLING
AS APPLIED FOR.
The certificate is issued to MAOREEN C. COYNE
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N250701 SEPTBMBSR 17, 1992
PLUMBERS CERTIFICATION DATED MARCH 6, 1995 MATTITIICA PLIIPI6ING & HEATIAG
Building Inspector
Rev. 1/B1
roast xo. s
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN BALL
SOUTt1OLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PRFJvtISFS UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
No 18 $ 5 5 Z Dnte ......~'f R.....4 19.Q.~
Permission is hereby grunted to:
* e
to ..~.4V~^lr>?'4~'Ol:~~:::....4?r'~4Q.....4i.:~Sx.....~......~j~
1.~..~,.~.q~.~..Q...~....q~,....4i-'...... ~
1 Q4!-a~.....
r y ~ ~
of premises located at ..f. Z.a.°......1~:S.f~:s.:':4i...,.h.~...~
R.
County Tax Map No. TO00 Section1,...... ~~Ll.~....... Block Lot No...,...~..~f...........
pursuant to npplication dated ......'/..L.04~:~.~1.........~ 14.~.~., and approved by the
Building Inspector,
Fee 5...~~:..~..... /l
~.4 ~
Building Inspector
Rev. b/30/80
r
~ y~~; ~i n n:7 ~,m Form No. 6 ~~8_ Ya 5~5"
TOWN OF SOUTHOLD
h"AR Fj ~9~~ BUILDING DEPARTMENT
TOWN HALL
~ 765-1802
?Ot`:':V OF SOU?HOLD
~~155 ~-~.°lSC- $ 2g'O APPLICATION FOR 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 Deft. 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.
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 Euildin¢ - $100.00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date „February 23, 1995 ,
New Construction........... Old Or Pre-existing Building.... X............
1220 Si sbee.Road Mattituck
Location of Property. $
' House No. Street Hamlet
•Onwer or Owners of Property....,Maureen Coyne ,
County Tax Map No 1000, Section...,144. ,_,,,glock....1...........Lot... 04
Subdivision.,Mattituck Park Properties .Filed Map... 801.....Lot.. 25 & 26
. . . .
Permit No 188552 ,,,,Date Of Permit.3J9/90 „Applicant, Stanley J: Fliss Jr.
F3ealth Dept. Approval ..........................Underwriters Approval.....
Planning Board AE~proval
Request for: Temporary Certificate........... Final Certicate.X:........
F~. ,~.:~T~rte:a: ..25.00
,2a.~~` Si ~9`J . .
r' ;y /
YNall, 53085 Mttin Road . i ~ ; ~ ~ Fax (516) 765-1823
P. 0. Box i 17>~ • .:a , ~,;G ~(y Telephone (516) 765.1802
~mE thold, New York 11971 ~ ~ -y/ ~,ryr",•. _ _
` MAR
; OFFICE OF THE BlJILbING INSPECTOR
R
:Y"" TOWN OF SOUTHOLD `
T4~
C$RTI FICATIOY+t _r__,~_--_-__
;~.=L.
3<
!~a
- . ~~uildirig Permit No./~ ,~R.S,,~Z
f please .print
•jP
CI +~W L f
~ tk~iumher: C. T. (?C~~ ~J7 Cc,~rn~
~4;N"E'.
'~i (please print)
I aertity that the solder used in the wttter supply system
a,.,
~~~britr~fns less than 2/10 0# 1~ lead.
! 9 Lit`
^s /
`±.'J,..
j-1.. e.rl~ ~ '
y
(Flumtyers ign
{
k°•" , sworn to before rae this
day of ~~Cff 1, 19~~
'p
Y~btttry Public, ~Glf~U ou~
' ` Edith F. JACKSON
; Nobly PrbYo, ShN d Now York
k';,
. T
~M ~Y
s
r
t.
_ ~
?OUIIDATIOIt (1st }
~
~aufIDATIO;I t 2~a } `
- - -
s3
I ~
.',OUGH FRAt~fE ~ ~ ~j° ~ ,
~PLUMBItIQ~ v ~ I
~S ~ o~/
u,
H
3. m
n
IIISULATIOtI PER N. Y. ~ a
STATE EIIERGY
CODE I`
n~~
FI;SAL
• I o'
1 m
ADDITIOPIAL COM~iEttTS:
m
. x
' H
a
s
. H
H
O
• m
y
' r
. - ~ ~
v
• m
-v
c
j Q
f~',~
C1 b l a c fioP /d°a{ ~ ;'vim , . ~ ,'7~ '
O 6eraFe r
~ p ~
! _ J..S~r.~ ~ 1 (VVV ~ O
s ~ LO f S {Panne
Proposed' hocci€ ~ ~
' ~ 1
~4b1 dee{yy:¢r
~')i { g('ep5 S aD * ~ f_,'~~4\hyl FI F.v~.
V :i.o~i .Z.~'r1c.~ W~ /"f~. t ~nc:.,re nly~N:'s ~4
..;;t frtl~ ~N :"C 1' J ~ , ~ sl y. .}in,l .nrr: o 'M's`r trJitaan.
/'.C 41... vl /(i 4..i1 VC1 Fy
ry _ ~4 r;) 'll to I1. LGl~y J Sin y,^.uj
./i1 ~ ~ f n'dJ y' '~4...SUj1
~F!~f 'V
c;
I' F`~~r`~ ` GI.G'"' ~j
f;.'CJ.'"~E,=i T Y ~I` ; ' 7
/ V/r'~ u~C ~ C'~ ~''`I~~ card
SGGL~' f., f-~T L7~= /?7dfl!-!t/JC;'77'
f
C3UARAN7EES AFG~.L?-puc;.~~9~
~ ,G: %1J> 1-: c.' 1' ti ti r~'~,yfr!? }t" •?c^ i' GUAI.'AtdTGED ~tO SUf-FOLIC COUh1TY
/`/G ~ ,.NAi"{4hlAL E~{ih:K~GAMMI~-~IJ~r IE"ALTN
yLt `,%it; , %=`),:...i ,'3'%:1~ 4{' ~
YO~c(!Y~~' 4'f
..:_..L.AhIP '1'ETt-E IN~~Ut7Ji1~1CG C~MPP.t^i~
f1/f':%T;-:~':%~c(Gtc ~%'reC ~YD~?l..YT``C',~' ./r*`r,q, *'!IY'v.'Wc~e~~ l~C~r'. ~C~, ('J^~.~.-~
{i'lc:~~ /rr -itrW „`rry=a'`~'-,;rte Coc~rrr;'+'r~:rrk' ~
o~Yr'r:.. /Y/.:rGl JG'~r/r~~+,:-r~ ,~i'r.?!, ~l~f'tfa;
.c f -
C,acr~ ~~x :i;~ ~ ,:,~c~ , I'.'?'r`r:( ',r'i4t; D//~f~~i~ i~:: 1~.~....-_
f~/`/~f, C4'.T"%AYi ~,/l~1~r~ ~T ~9" ~ ln..r-y Yr-''C I,~~.:i! ir, /~t'H~/ 1'G7riC
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ]ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] lNSU ON
[ ]FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: C
~!p` ~ ~
DATE INSPECTOR
f s~ 765-1802
BUILDING DEPT.
tNSPECTtC~N
[ ]FOUNDATION i5T ( J ROUGH PLBG.
[ ]FOUNDATION 2ND ~ INSULATION
[ ]FRAMING ~ ]FINAL
REMARKS: t.-~~v~~~ ~
1
DATE ~S ~ INSPECTOR
765-1802
BUILDING DEPT.
lN5PECTION
[ ]FOUNDATION i5T [ ] ROUGH PLBG.
[ ] FO NDATION 2ND [ ~ ] INSULATION
Q/ [ FRAMING [ ]FINAL
~G
REMARKS:
DATE S INSPECTOR
/ ~4 ~ T65-1802
G BUILDING DEPT.
1 NSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
[ FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING ~ ]FINAL
REMARKS• G2%~
DATE INSPECTOR
1 ~4 S~~ 765-1802
' BUILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T R UGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[~RAMING [ ]FINAL
REMARKS: ! ~'~G ~itsf~ Gam---
.
o. ~
DATE ~ oZ INSPECTOR
7 765-1802
BUILDING DEPT.
1 NSPECTI4N
(FOUNDATION i5T [ ] ROUGH PLBG.
[FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS:
DATE INSPECTOR
~
o m a i
I ~ z ~ o A ~ ~ ~ < ~ ~ c m ~ m Gi
3 ;'3 'A ~ o 'O ~ ~o N m a n ie (1 O u
K A I-1 f4 ^ b/i N (pl ~'u~ 9 C A ~ 1'1 71
c `~~`4 5wa«a g 4 > ' ~m
A o sus" ao x ~ moo' m ~ ~ w ^I
c ~ r ~ ~ c, a m ~ n F m° 3 D`~y ~
r
° N z
G1 a *~C ~ x a s p p YN W m 1~y c
m s o" ~ ~ ~ > o~ ~ n r. ~ 1
a p x ~ G.., ~
f x q~ ~
< i t - R ~ o S, m
~ ~ _ ~w ut
~ 3 ~c~n £ ~ ~ ~D~ ~Y.
3 ~ rv
3 ~ ~ C c X ~ 'T, O
£ ' ~ ~ _ ti ~ Z
-1 ~ ~ i u~. ry-. N
y c
H ~ y o> T! , b D m W
C
n0 0 £ ~ o a ~.~w ~ ~ m ~
m R
~ 9 el '2.e p Z DTI
A n n a~ y" o ~L ~
p m ymQya~ ~ ~ ~ j
~ mT CG O ~ i~ y Z R ^ b ~ ~ Irf~ O
n O N ~ ~ ~ n n N ~ CS ~ ~
q p C'1 ^s A T y F C H ^ ~ Z T
m- _
= g ~ = ~ Ei~
° ~ ~ ~ g ~ ~ ~ Oj m
z ~ ~ ~ N a D x C
o y Fx a• n ~ O Z
w~ S o p
RI m N F A m m
v ~ ~ a
s
G ~ xf z m a
9 Y ~C v N > C
v_ c }
Z a p ; a z m
a ~ i mN~ F m a ~ u
Z ~ r y r1y1 N 0.
n
c S ~ G:
~ 3 c 3 Q9
n >
y y X41 j N Z T M
N
-i.i~m~w`~ie~~~uVM YiYIJW/YM~~tlfY~~f~~MWf{~u~rNFLq~Ntt~~tNlti
- - -
.n
I
i ~
~
4
O
~ H 3- N
a W ' ~ ~
M
w ~ '4 ~G ~ o o
<l ~ vvQ+~~~i, QQ.
v ~ ~y~;~.•,'~ CrQI
1_ O Q ~ s .1: E• J
RyW ~
I O
V Q
~ ~ Z 9 ~
v ~ o
~ ~ ~ ~ ~ e ~
2 ti U r -s cr o- M ~ °
~ ~ w
v ~ o ~
4 4 ~ ~
t' ~a ti o~ o o ~
~ ~ O ti O p O 0 p ~
Z
~ ~ on M Q
~ ~ h ~ ~ ~ ~ d
4
<t ~ N
a ~ ~
` 1•~
~ ~ Q N ~ ~ ~
U Q M~ 1 n
w
~a ^ ~ ~
W K dP 41
v
`J .-1 M
~ •
U ~ v ~
y
2 t ~ ~ ~ I ~ ~LH Vr/D~~i
~ ~ ~ h d Q ~T c( `9Q~w~a~
4
W `°Q ~ w~~ 4 V 4 H 4 H ~zz~ a
f.
.-f cv rl V' ul LLl
BOAFD OF HEALTH
3 SETS OF PL.1NS
FORMN0.1 SURVEY L/
TOWN OF SOUTHOLD CHECK .r/.
~~tY}~........ .
BUILDING DEPARTMENT SEPTIC FORDf
' TOWN HALL
SOUTIiOLD, N.Y. 11071 NOTIFY
TEL.: 705-1802 CALL
Examined ..~U,Pr!-G-!'~ ~ MAIL T0: S(~j m~`,1~
194
p 4~1.~~~ It9s"
Approved As-!~X!i..~..., 19~P. Permit No. g~S.~. ~ nn ~y
Disapproved a/c Q L'1
(Building Inspector) BLDG. DkP'1:
APPLICATION FOR BUILDING PERMIT TOWN SDt1TH0lII
Date ,February 23 Iy9C
INSTRUCTIONS
a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with
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 stree
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app.
cation.
s 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 perm
-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 for any purpose whatever until a Certificate of Occupant
shall }Lave been granted by the Building Inspector.
APPLICATION IS HEREBY b1ADE to the Building Department for the issuance of a Building Permit pursuant to th
Building Zone Ordinance of the Town of Southold, Suffolk County, New Yotk, and other applicable Laws, Ordinances c_
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe
The applicant aerees to comply with all applicable laws, ordinances, buildine code, housin, code, and regulations, and t
admit authorized inspectors on premises and in building for necessary t pectin s. ~y~~1
(Signatu of 6¢plic"an- t, or nanr~'if'a corporation)
565 Old Main Rd., Mattituck N.Y.
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Contractor
Name of owner of premises ,Maureen Coyne
(as on [he [ax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No. . ,12~ 985-HI
Plumber's License No. ,L12366-P
Electrician's License No.3897-E• , . _ , , • , , , , , . , , ,
Other Trade's License NoMnsoq{_, 6429 -HI•
1. Location of land on which proposed work will be done.
1220 Sigsbee Rd. Mattituck
House Number Street. Hamlet
1
County Tax hlap No. 1000 Section , . , , 144 , , , , _ , , , , , Bluck Lot : .
Subdivision ..Matt. ,Park ,Properties , , . , , • . , , .Filed i`lap No. . , .8~1 25 7 26
Lot
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy Single Family Dwelling
b. Intended use and occupancy ,Single Family Dwelling p _ .`~y,F.,y gli'3M
sa4 k
3. Nature of work (check which applicable): New Quilding Addition Alteration X, ,
Repair ....X , Removal . . Demolition Other 1Vork - .
' ~r (Dcscsiptio~
4. Estimated Cast . $69 } 000.00 Fee . .
Qo be paid on filing this application)
5. If dwelling, number oC dwelling units 1. , , , , , , Number of dwelling units on each floor .
If garage,numbcrofcars
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use , t , , , , ,
7. Dimensions of existing structures, if any: Front , 66f t: . , , Rcar , ,66f t. . , , , , Depth ~ , , , ,
Hei_ht 12,'. • . , • . • . _ , Number of Stories .Rt)@ . .
Dimensions of same structure with alterations or additions: Front . , 66f t., , , , , , , , , Rcar . , ,66: f;t
Depth ~ $~r...:........ Height 1S,' Number of Stories ..Ori?
8. Dimensions of e~rtire new construction: Front 9 Rear ..9 Depth . lJ-.~ 6", , , , ,
Heigl. 12 Number of Stories one. _
9. _$ize ~t:'1=~ro
t~ 100' Rcar ....100 ~ Depth 143
10. Date o_f Purchase ~ulY..$$ ..................Name of Former Owner Mary, A. ,Coyne, .
Residential
11. Zone or,usp„districtin which premises are situated .
12. Does proposed construction violate any zoning law, ordinance or regulation: No , , , , , , , , , , , , , , , , , , , , , , , , • ,
13. Will lot be regraded NQ , , , , , , , , , , , , , , , R`iIl excess fill be removed from premises: Y g X
14. Name of Owner of prcmisesM~Ureen •Coyne . , , , , Addresses Sigsl~e Iki.• Matt.• • Phone No. ,298-445
Name of Architect . ,Address ...................Phone No. .
. .
Name of Contractor ,Stanley J. Fliss Jr. ,Address fin Natt• .Phone No. 298-8~9d
15.Is this property located within X00 feet of a tidal weeland? *YES._..N0.2t..
*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 fn
property lines. Give street and block number or description according to deed, and show street names and indicate when
interior or comer lat.
U
STATE OF \ElV 1'OP.R, S.S
COUNTY' F .
• - • . ~ ~ ~•-'~-{.~-4• t being duly sworn, deposes and says that he is the applica
(A`amc of i n~i ual signing contract}
above named. ~
He is the ~L.~C..iL.4°d.~~:t.,. .
{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 fY
application; that all statements contained in this application are true to the best of his knowledge and belie C; and that tl
work will be perforned in the manner set forth in tltc application ~lcd therewith.
Swom to bciore me this ~ ~ ~
.................day of. ".~.`-c!cx~.-..., 19 ~li'
NotaryPublic, ...........-r;~ County ~ ~ /./~~f....
MoMry~PaWiq,SteMOlNrwttpd[ (Signature of applican
rlo. ~t9819A4
Mir 2Z i#