HomeMy WebLinkAbout18611-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19319 Date AUGUST 24, 1990
THIS CERTIFIES that the building ALTERATION
Location of Property 760 PECONIC BAY BLVD. LAUREL, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 145 Block 2 Lot 7
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 24, 1989 pursuant to which
Building Permit No. 18611-Z dated OCTOBER 30, 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 ALTER REMOVE & REPLACE PORCH ADDITION TO EXISTING ONE
FAMILY DWELLING.
The certificate is issued to_ JOSEPH FARRELL
(owner}
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N-126022 - APRIL 26, 1940
PLUMBERS CERTIFICATION DATED N/A
Building Inspector
Rev. 1/81
r
roses xo. s
TOWN OP SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMP^LETION OF THE WORK AUTHORIZED)
NO lOV~~ Z Date /b~~~ pp
19.A..~
Permission 's hereby granted to•
X3"9 ,,....7,d.~ ../1...9.
S 2--
J
at premises located at ....~~.~.......~./Syrr~~3.2.G.GG~....................
~G2
County Tox Map No. 1000 Section ...../,,l.~m~... Block ..........Q.Q...Zc^Lot No..........G...,r.......
pursuant to application dated j:.~..-..~~~ 19.9.,.1..:, and approved by the
Building Inspector.
O~
Fee $...~O.L~..r.:S~
t
~L
Buil mg I o
Rev. 6/30/80
+ .,/o Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMEN'S
TOWN HALL
765-1802
APPLICATION FOR.CERTIFZCATE OF OCCUPANCY '
.1. 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 19. 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.
3. 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 o£ Occupancy is denied, the Building 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 Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4. Up,7ated Certificate of Occupancy - $50.00 ,
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date $~a3,9o
:;cv Construction........... Old Or Pre-existing Building....
.-t ,
:.cation aE Property.. d ~R~..... ~Cbn/C I;r~~! ..ka~.u~r l,A,f,t.,fe.~............
House No. 11 SCreet Hamlet
')over or Owners of Property,.~~'?-nh.~:.~~~~:):`.
County Tax Map No 1000,nSection.....~:+~,,~.....B1ock..v~~.......,.Lot.., a0:~
Subdivision...~'1,:~•d;~'?•y„r~:~ ................Filed Map...~~.}°~ ..Lot 3 -
yy~~
l'PC.Or~ic. e~aloPmen~F CTO~p ~~C
Permit No.~g~o1~Z-, Date Of Permit.'..~d14~:~~$Q....Applicant. .'~4fre,1}~,y~QS~~71z,_._.•••„
ficalth Dept. Approval ..........................Underwriters Approval........................
?lanning Board Approval.
Request for• Temporary Certificate. Final Certicate.. `f•';~44
?ee Submitted: oo,,,,, 5 _ Qy
! 63W1 :`a-s•..,.e.s'. Jali{.C$Yt7'.. M
APPLICANT .
~cl ~1931~ _ .
THE NEW YORK BOARD OF FIRE UNDERWRITERS "'rLI i
1 13 ~ 1 tl / 6UREAU OF ELECTRICITY
BS JOHN STREET. NEW YORK, NEW YORK 10038
APR1I. b,349f7 ApplicotianNo.onfile f'G680i89/h9 N ]Yf+U:?:
THIS CERTIFIES THAT
only she electrleal equipment as described below and introduced 6y the applicant nomad on the obooe appficatlon number in the premises 4/ -
PAlll. ANLEN, t't:r,ONtr, ItAY l;l_Vli., 95 A, IAUkttf., N. Y. _
in thefallowinq lDCOCIOn> ? Basement Q Ist Fl. ? Ynd Fl. DUt 3er[ion Bfock Lot
was examined un MA R I: li 29 , 4 3'10 and found to 6e in compliance with the reyuirementx of this Board.
FIXTIN! RXTIMK RANtiES COOKN[O DECKS OVENS W EXNAUST FANS
OUTIRS ACLES SYFITC116f INUNDtSCtNT nUDRESClNT OTHEn AMT. K. W. AMT. K. W. AMi. K.W. AMT. K. W. AMT. N. P.
'11 ib f,
DRYERS FURNACE MOTORS NTUR! AFNIANC! Rl0ER5 SMCIAL REC'?T TMIE CLOCKS pLL UNIT NEATMf MUIT
~ETLtt gMMlRS
AMT. K. W. Oll M. P. GAS N. P. AMT. NO. A. W. G. NAT. AMP. AMT. AMPS. TERNS. AMT. N. r. ND. a ~T AMt. WATTS
E,II(I ~
SERVN3 DISCONNECT NO.OP 5 E R V 1 C E
AMT. AMP. 1YPF ~ 1 X r`M 1 / SM' S X SW J X AW GIER 1CON0. OF CC
CG~ D. NO. OF HblE6 a ~ N0.0P NEUTRALS ~ 'NEVIGMAI
i
R
OTMR AMARATUS:
WiNLNO FOk ADUII IUN R) I1UU',L 1)[dl Y-t_
f.. i'.f:. 1'.-3
SMOKE OF lli l'tURa-L
¦
s
-~°lER-~
JAM`i MUKItAY L1C.ASb53-E
P. O. POX :CI',
LAUREL, NY, 41.'a~+f OENIRAIMANA~
t1
Psr
This certificaN must not bs aRerod in any manner; rNUrn fo 1M offin of NLS Esard if incorrect: may 6e. idan}ifisd by tMir cndsntiok.
COPY FOR BWLDINC DEPARTMlNT. THIS COPY O~ ClRTIFICI?TIE IN ANY MAIMER. -
TEL. 7G5-i 802
Qp~~FE~[K~OGy TOWN.OI' SOUTIIOLD
` `',!ti~! OI'PICE OP BUILDING INSPECTOR
~ :'j a P.O. BOX 728
~ '~~~')5 ~ TONN HALL
O~O~ ~ ~a~ SOUTIiOLp, N.Y. 11971
August 14, 1990
Peconic Development Corp.
P.O. Box 594
Mattituck, N.Y. 11952
RE. JOSEPH E. FAERELL
To 4lhom This'.May Concern,
We are unable to complete your Certificate
oL' Occupancy bacause of the following reasons.
J_t/j An application for Certificate of Occupancy
k5 not on file. CENCLOSED)
o Underwriters Certificate on file.
/~Tlie check is (/not on file. ) $25.00 '
No ltcalth Dept. rpproval on file.
No final ins.pcction has been made.
hlcasc contact our office on this matter.
Thank you for your cooperation'.
Sluilcling Permit II 1 8 6 I i Z
Uuildinc7 Dcpt, '
No Plumber Solder Certificate on file.
. ( all permits involving plumbing being
.iasucd after npril 1,19IIA )
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IIISULATIOPI PER N. Y.
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~I`~ 765-1802
BUILDING DEPT.
f NSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ FINAL
REMARKS: ~V~-o-~f'
DATE S ~ O INSPECTOR
l Ft b ~ t ~ ass-isoz
BUILDING DEPT.
iNS~ECTiON
[ FOUNDATION 1ST [ ) ROUGH PLBG.
[ FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ )FINAL
REMARKS: „l`~. ~
DATE I~~INSPECTOR
6
JO , 016 NEADTNOIUZlD ALiuAtFOIE oR AERNno.
Y~V IO TXLB SIRIVlY IS A VIOLATION Oi
O/ LICLFON 721N O/ 1ME NEW YORK STATE
V IgICATN)N LAW.
CpplES Oi THIS BUkVEY MAR fWf BEAAFN(
O ` INF LAND SURVEYOR'S INKkD SEAL OR
Y~ ~~J EMBOSSED SEAL SNALL NOT BE CONSIDEREL
\ ~~y0• ro eE A v,ttw muL cow.
\ JVARANTlES INDI,`,w~E~,,'~ HEREON SHAH RUN
'~~w,^y~~~ `L • I 3NlT TO INE RERBOW^IOR WHOM iNl SLIAV+
~ , IS PREPARED, AND ON HI6 BEHAti 10 (nl
, fITLL COMPANY, GOVERNMENT At ni. v.<I ANi
J R~ , N '.lNDING INSTIiVOfiN US1::U Mk: Cr•. AND
h ` ~ [O THE ASSIGNEES Oi IHl :ENLnNG INSTb
~1E .t® ~ O fUTION GUARANTEES ARE NOi IAANSEERABIt
5 ~I •0 AUVdIONAL INBLiIITIUMS OR SIIBBEpLNN;
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S~lK:r±Fy,n~!y~ ?:1.4F Fn sD !4!'Fi?E OFFICE ~n ~ 0~3 .o•, .A
OF THE CLERK OF SUFFOLK COUNFY VL ~ree.o T', ~
oN sEar. ir, laze .as NIpP No. z(2. ~ ~ e
- 3UFFOLh: CO.TAX NEAP ~4 ~ `
DIST, Iy.Qq Sf,CT.~eL.QQgGOT. , ~ moo.
1 ~ ~ ,
,
~JJRVEY FpR B•
.li7SEPM E. FARRELL h~;'`
,il3pllULEY PARK" y~`j
~.wAU R~(.. ~ ~,~~'~~~fw yQ°Rk. ~ hu~~h~V 4T. ~ /~,~1~'~
`(:C?WN OF' SOUTMULD QUAR ~',t.'It
SUFF. GO., N.Y. MEaooweRO ° ~ 1 ~s"
pP%'
HOME FIFLE 310 O
St;ALE ~ I it = ~Ql TITLE IN9 ~ .E ~ a3 R~sl ~ /
FE9. 21 1JS~ a o'> t~
, PROFESSp s gr+ ,;.r
j~qR. ~k (~?$~J LANG SURVEYOR, y~,, xa9i~c , ~~a 'C
RIVERHEAp, N.Y.
.,o...,.,._,.,
~W~. k7~7-1212 ~ -
BOARD OF HEALTH
3 SETS OF PLANS
,FORM NO. t SURVEY
TOW V OF SOUTHOLD CHECK • • • • • .
BUILDING DEPARTMENT SEPTIC FORM
TOWN HALL NOTIFY
SOUTHOLD,N.Y.11971 CALL
• TEL.: 7G5~1802
MAIL T0: ~
Examined ..~~~~G....., 19 P, , 'IJ~ ~r
Approved ~ /'3~ ~~6
19 . .Permit No.........../ Y~a~"C
Disapproved a/c f
~ r,
. ~ ; ocr 2 4 ~9p
(Buildi g Inspector)
t~t~DS. DEa'r.
APPLICATIO OR BUILDING PERMIT 7QWNUF50UTFIOLO
-m•--..a
. Date 19
INSTRUCTIONS
a. T}us 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 diagtam 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 for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY IviADE 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
Re_utations, 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 in/}spp~jectpors on premises and in building for necessary in ections
''p `
~ ri t; „ ..w... • , (Signatttre of applicant, or name, if a corporation)
;...wr;P,;~W:r; ,`;',;~ry3~:,r~ , . po. ,(3q~' N~ •it9Sa...
a;dJ' ~~;,f:'r =s r•r• (Mailing address of applicant)
State whethe~rF,y~~.pljcaag ~s owner,,,l~ssee,, agent, architect, engineer, general contractor, electrician, plumber or builder.
VVV . ,
Name of osvncr.of p•;:R?~;ises ...JDS+e~.~ Farr l l .
(as on the tax roll or latest deed)
If applicant i`s a corpoca~tion,'signafure of duly authorized officer.
: h, It.~t :,z.., ~ i
(Na"me~a'nd^`tifle of'corporate officer)
ALL COtITRA~CTOR"S MU T E SUFFOLK COUNTY LICENSED
builder's License No. ~ P~ : ; I-f~, • • , , , , ,
Plumber's License No . .
Electrician's License No . .
Otltcr Trade's License No . .
I. Location of land on which proposed work will be done . • .
fiousc Number Street Hamlet
County Tax Afap No. 1000 Section ~~S Block ~~°Z.......... Lot . , d0'7
Subdivision ~ t•lFi~~2~. f (,t.'.r ~ . Filed \1ap No. I o'L....... Lot ..:3 .
• •(Namc)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ....S.th~~d'..'~^.""`~~ • r~$i~;C,r?-G;•~; , • • • • • • , • • ,
b. intended use and , ~ ` ~g
occupancy $
_ t~r`~T~
g, Nature of work (check which applicable): New IIuilding Addition • • . • • • • Alteration .
Repair Removal , Demolition Other 15'ork .
f (Dcscriplion)
4. Estimated Cost !dlN~4... . Fee , .
(to be paid on Cling this application)
5. If dtvcllin~, number of dwelling units ~ Number of dwelling units on each floor .
If garace, number of cars . . .
6. If business, commercial or mixed, occupancy, specify nature end extent of each type of use ,
7. Dimensions of ext fisting struchtreS, if any: Front . Rear Z.~?.. Depth . T~`~.:":S....... ,
Height Via.. , Number of Stories 1.~.~?r...... .
Dimensions of same structure with alterations or additions: Front . $t~?,Y1~, , , , , , , , , , Rear .
Depth ' .Height ......................Number of Stories .
8. Dimensions of entire new construction: Front Rear ...............Depth , .
Height rc;; . Numb r of Stories . .
9. Sizi of lot: n( ...:..~r~ p~ Rear . S~~.g~ . . Depth .595... , .
0. Dace of Purchase ................Name of Former Owner ,
1. Zotic or use district in which premises are situated . .
2. Does proposed construction violate any zoning law, ordinance or regulation :
o
hill lot be rc~raded ...!V Will excess fill be removed from premises: Yes
o
4. Name oC Owner of,premisesJAbe,P}l ~`~rC C-l I ......Address . ...............Phone No............... .
Name of Architect I,~ , , , , , .Address ...................Phone No............... .
Name of Cp ntp ctoyp~CO/Jl~/.w'ti.}~pf~m~ri'~.ni4C~P.. Address ....:..............Phone No..~J.-,~!.~?se2 o
5. Is this ro ert located within 300 feet of a tidal wetland? *Yes No
*If yes, Southold Town Trustees Permit may be reyqu~ired.
PLOT D1AGItAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from
roperty tines. Give street and block number or description according to deed, and show street names and indicate whether
tterior or corner lat.
~ xl s n?~ ~j . ,
t ~ I
Z X Z Q APP O D AS NDTED
DATE: ~ B.P.B I
N01'IFY BUI NG QEPA
766-1802 8 AM TO 4 PM F SHE
FOLLOWING INSPECTIONS:
1. FOUNDATION TWO REQUIRED
FOR POURED CONCRETE
2, ROUGH • FRAMING m PLUMBING
I 3. INSULATION
A. FINAL - CONSTRUCTION MUST
HE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CC)DES. N(ST RESpONSlt3l`'E FOR
f?ESIGN OR CONSTRUCTION ERRORS
~A7E OF NEW YORK, S.S
I_ ,Gt,J~
, . , . , , , .~L.t<U being duly sworn, deposes and says that he is the applicant
(tiamc of individual signing; contract)
avc named.
is the.... SE@Ce......
(Contractor, agent, corporate officer, tae.)
said owner or owners, and is duly aUthorizcd to perform or have performed the said work and to make and file this
~lication: that all statements contain$d in this application are true to the best of his knowledge and belief; and that the
r}; will be performed in the manner scat forth in the application filed therewith.
am to before me this
............~y, .day of..~~`:~......,19.~y
:ary Public, ; . County
AmtE>~M.NuN1 (Signature of applicant)