HomeMy WebLinkAbout25574-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28036 Date: 10/26/01
THIS CERTIFIES that the building ADDITION & ALTERATIONS
Location of Property: 360 STEPHENSONS RD ORIENT
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 17 Block 1 Lot 12
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 8, 1999 pursuant to which
Building Permit No. 25574-Z dated MARCH 2, 1999
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 ALTERATIONS & 2ND FLOOR ADDITION TO EXISTING SINGLE FAMILY DWELLING
AS APPLIED FOR.
The certificate is issued to REGINALD A & SHEILA MINOR
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N-524394 05/16/00
PLUMBERS CERTIFICATION DATED N/A
Authorized Si/ature
Rev. 1/81
FORM NO. 3
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)
PERMIT NO. 25574 Z Date MARCH 2, 1999
Permission is hereby granted to:
REGINALD A MINOR
PO BOX 68
ORIENT,NY 11957
for
CONSTRUCTION OF ADDITIONS AND ALTERATIONS TO EXISTING SINGLE
FAMILY DWELLING AS APPLIED FOR.
at premises located at 360 STEPHENSONS RD ORIENT
County Tax Map No. 473889 Section 017 Block 0001 Lot No. 012
pursuant to application dated FEBRUARY 8 99 and approved by the
Building Inspector.
Fee $ 235.60
Authorized Signature
COPY
Rev. 2/19/98
Form No. 6
' TOWN OF-SOUTHOLD
BUILDING DEPARTMENT _
TOWN HALL
765-1.802
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 ftom 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, industrial building, multiple. residences and similar buildin;
and installations, a certificate of Code Complianne 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 an(
"pre-existing" land uses:
1. Accufate 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 $25.90. Businesses $50.00. _ . .
2. Certificate of Occupancy on Pre-existing Buildini - $100.00
3. Copy of Certificate of Occupancy -
4. Updated Certificate of Occupancy - $50.00 '
5: Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ...�.��Y�a!. . . .. .:... . . ...... . . .
New Construction. . ..... ..*..' Old Or Pre=existi Buil:ding. ..:
� Location of .Property... �.:. .�... ..f�.�. 44:::44.... . . 0,<j�7V7-- . .�....:... . . . . . .. . .
_ 4444. ..
House No�. Street Hamlet
Onwer or. Owners of Property. ?�':�1� . .:r. s. ./.�4. ... /:vel.��. .. . . .. . .. . . . .. . . . . . . . . .. .
County Tait Map No 1000, Section. . 7... . . . .Block. . , l.. . . ... .. . .Lot. .�4�r. . .. . . . . . . . . . .
Subdivision.. .. . ... .. . . . . . . . . . . . . .. . 4 .. . . . . .4 .Filed Map. . . . . . . . . . . .Lot. . . . . .. . . .. . . . . . . . . .
Permit No. I . .. . .Date Of Permit.. .. . . .. . . ...44 •Applicant. .... . .. . . .. 44 .44.. . . . . . . . . .
Health Dept. Approval. .. . . . . . . ... . . . .. .. ... ... .Underwriters Approval. .... . .. . . .. .. . . . . . . . .
Planning Board Approval.. : . . ... . . .. . . . .. .. .. .. . : .
Request for: Temporary Certificate. .. .. . . . . . . Final Certicate. . . . . . . . .. .
iee Submitted: $.... . ... . . . . . . . . . . .. a 4. .4444 . .:
o y s
THE NEW YORK BOARD OF FIRS UNDERWRITERS PAM '
1195099 BUREAU OF ELECTRl0JiY
I 40 FULTON STREET, NEW YORK,NY 10098
Dae MAY 16,2M Application No. on JRe 2W25360(00 N 524394
THIS CERTIFIES THAT
only the electrkel egs*m ext as described below and inbrodnced by the applicant named on tie above appHcadon number is in the premises of
REG MINOR, 360 STEVENSON ROAD, ORIENT, NY
in the following location; ❑ Basement ® 1st FL ® 2nd FL Section Block Lot
;1vas examtixed on MAY 111,2000 and found to be in conepiiance with the National Electrical Code.
FDOMRtEFIXTURES RANGES— cooKme DEcn OVENS DISH WASHERS EXHAUST FANS
OUTLEMs RECEPTACLES SWITCHESWAMXIC"q,UOanow I OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
6 14 7 6
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL EC'".1 TIME CLOCKS �« UNIT HEATERS MU�� DIMMERS
AMG K w. (ill H.P. OAII H.P. AMT. NO. A.W.O. AMT. Amp. AMT." AM►8. TRANS. AMT. H.P. NO.OF FEET AMi. wATTE
SERVICE DISCONNECT NO.OF S E R V I C E
AMT. AM►. ,1Y►E - EQUIP. 1 e iw 1 e bW J e JW J 1 4W m a OF Cc CONE. NO.co 0. III-" OF W.
NO.OF MMRM OF(null"
OTHER APPARATUS:
PADDLE FANS-2
SMOKE DETECTORi-1
TRACK LIGHTIWo-16
JtM WE ELEC. INC. LIC.#3633- L
PO BOX 38•
GREENPORT, NY, 11944-0038 GENERAL MANAGER
Per
This aetWon!ofowit not be aHered In any manner,return to the afto of MTe Fowd It incorrect::U rCmn may be Iden by fhw*:Ondenflals.
a0PY FOR BUILDING N THIS • CERTIFICATE MUST NOT IN ANY MANNER.
o��g�fFO(�-co
Town Hall,53095 Main Roadp : Fax(516)765-1823
P.O. Box 1179 COD
Telephone(516)765-1802
Southold,New York 11971-0959 O5
dol
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
March 2, 2000
Reginald A. Minor
P.O. Box 68
Orient, NY 11957
RE: , 360 Stephensons Rd. , Orient.
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
XX An application for Certificate of Occupancy is
not on file. (Enclosed)
XX No Underwriters Certificate on file.
XX 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 # 25574-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
BUILDING PERMIT REVIEW CHECK LIST
Application Name: NA � &aIL4
Architect/Engineer: Date Submitted:
SCTM#: District: 1.000 Section: / Block: 1 Lot: Z-
Project2? q Subdivision
Location: J0 I r IUATe ROP�p I 16 Name:
Req. p Req.
Zoning District: [Lot size: Actual: o95D +9CRe 1 [Lot coverage Proposed:
[Front Yard MA P-ropbsb1:�� 4SideYIr -CI �f"kP o sed: 6_Ta [�_S Proposed:
Project Description: Rfn2�vdf±!�, l OP-227-1d)G5
AGENCY PERMITS Permit
REQUIRED FOR REVIEW N1 A. NO YES Number
Suffolk County Health Dept.
New York State D. E. C.
Town Trustees
Town Zoning Board approval:
Town Planning Board approval:
Flood Plane Elevation???
Flood Zone:
Notes:
:FP,G7,- AID trl.%RL- &0 0
cScrc�o F q92- Sr 60
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
I 1 FRAMING [ ] FINAL
[ ] FIREPLACE 8 HIMNEY
REMARKS:
DATE INSPECTO
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[tom] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
w
DATE INSPECTOR
M.180Z
BUILDING DEPT.
INSPECTION
[ ] FOU ATION IST [ ] ROUGH PLBG.
[ OUNDATION 2ND [ ] INSULATION
[ J FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
S•
Z2
DATE � INSPECTO
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] F UNDATION 2ND [ ] INSULATION
[ FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: I'
DATE e -INSPECTOR_�G�'��
� s � 7
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] RO PLBG.
[ ] FOUNDATION 2ND [ NSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLCE CFIIMNEY
REMARKS
mC
DATE S� � IN8PECT0
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ UNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:(//hU�dJ7 iA/lD/tlD32 /k�
ilZ2 WWI
DATE IN8PECT0
BUILDING DEPT.
INSPECTIO
[ ] FOUNDATION IST [ ] UGH PLBG.
[ ] FOUNDATION 2ND [ INSULATION
[ J FRAMING [ ] FINAL
[ ] FIREPLAC CHIMNEY ��
REMARKS: (Ole
DATE INSPECTOR
suauINc DE".
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] 1 TION
[ j FRAMING ] FINAL
[ J FIREPLACE & CHIMNEY
REMARKS:
4/000)
DATE � 111:20INSPECT
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BOARD Olt UWU,a u •
V 3 SILTS Of PI-ANS ..........
n LS •PORN NO. 1 SURLY ........,0000 .. : 0000 . . . .
U TOWN OF .SOUTNOIX
FEB 8 BUILDING DUI&RTNL�NT C11acR 0 0 0 0...•.•••• . . .
TOWN iIALL 81LYTYC°F0RH .•••••••• :• . • . ....
SOUTUOLD, N.Y. 11971 NOTIFYI
13LDG�DEPT. Tac.: 765-1802 6 ••((
WN OF.:0 11 0DCALL .298.S59Rowj-`�°s )
q NAIi. Tot .ti4.+• Q:X• 743. . . .
..2:2�........, 10.. Mattituck, .NY11952 ,0
ixanined. �,c� .�.
• L ................
0000...,. 19. ['enol t Tb.
Al-4)roved...... 0000
...............
Disapproved-a/c ..................... ..........:
......................................... 0000 0000.
... 0000. ..
ik,ilding Inspector)
PLICATION FOR uuILDINQ PaRNrt' Febrp ary, �i, , ,,19.9 •
-Date... ...
INSTRUCTIONS
titer or in ink and submitted to the Tk�iiding Inspector wi
a. 'psis application oust be c¢to sc ly filled accordin8 ad�achdle. rgaisea Or pt�l�tic
3 sets of plans,,accurate plot plan to and of scale. relatioaehip to adjoining p rt ttF
b. Plot plan aping location ofoeacriptia oEdl �ings CnOf property not be dram on tlw disgraa%slid' is parr.
streets or areas, aril Giving a detailed
tris application. not be ammenced before issuance of Building pto tt.
c. .ne work covered by this application rgy penatt to d>e applicant-
c.
�+d�
(1, upon approval of this application. the Iuilding Inspector wilttsthe work. ing it a Certificate of
permit shall lx-kept on
the premises available for inspection Chri for
anb► purpose ohatever unt
e. No building shall be occupied or used in Whorls or in pa
Dccupency shall have been panted by dle Wilding Inspector. Pursuant to the
Department for dtis .issuance of a iiuildicg Pern►it
APPLICKn ai IS IBM= Nle' to the Building York, acid other applicable 1AW8, Orli rein ces r
building zone Ordinance of the Toon of Swthold, Suffolk
lna County,
nty, rW York
or for rsW&I or demolition, 95
Regulations, for dle
construction of buildings, houstug Code, add
described. Tibe applicant agrees to Camp1Y with all applicable laws, Orditadx;s�, ding Inspections.
admit authorized inspectors ah premises and in lxi ng
regulationa.iacid to �" ......................
regi o1•d•�tino►r•••••••6•' ration)
(S gesture of applicant, or nsmg, if a corps
(see above for mailings) ........
.......0...06000.60.6. ..........
(Hailing address of applicant)
Slate Wl►etller applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plufier or lxiildi
•
..........................• 00..0...6.............................
.........O ♦'•�r
................: ...0.....0000...0 0 ........
Re.qinald. &. Sheila•Minor............................................
N= of owner of premises ..... ..
..
(83.0
� on the tax roll or latest deed)
If applicant is a corporation, siWature of duly authorized officer.
............. ............. ..........
me
(Na •and•titte�of•corpocate ofifcer)
Builders License No. .t/b/f,,,,,,,,,,,,,,,•,
Plubers License No. .........................
Electricians lAcense No. 0000.................
War Trade's License No. k1�1 ..OXi�1�t+ •••..
I. iocation-of land on uAlc h proposed work will be done.
0000. 0000.
Stephenson Road
Orient ..........................
360
...•lbww tkuber Street
....1........... Tot ...,i,2..........
CountyTax Map No. 1000 Section .......17...... Block I,R
Ma of "The Cedars" Filed Hap No. ..42.1..:...... 1�C 0000...........
Subdivision ......P...0..0..........0............
(Name) intended use and oCCYpsjhcy of prow ru
constction:
and
2. State existing use and occupancy of premises
..Ams- amity.xPA14VAps..................•...........................
a. F�cisting use and ocdupaihcy .
b. Intended use and occupeMy ..Rn1l^: 3 3,Y.JCg.4td@A9A.With.altoratd.on.zenavatJon s.•aind
addition.
V
3. Rjuira of work (do*%Aiidt applicable)& liew Wilding .......... Aoklition AX.....at Alterationx.........
tlepair ............ Ilamonat ............. Demolition ............ Other Work Renovat6ioa6•••••••
(Descrlption)
4. Lstlnrtted cost .............:............ fee ..............................................
Q f (to be paid.cxn filing this application
S. if duelling, rnnlfer of dwelling units �l� ily. aniier of dwelling units on eaci, noon ................
no chane .
if garage, number of ears ............. ..................
6. If Rosiness, commercial or mixes occupancy, specify nature and extent of earl+ type of use—VA..............
1. Dimmnalons of existing structures, if any[ Pront................. hear ............... Deptlf .................
Ilulght ... ................... ftsiber of Stories ............ ,
Olnensiofa ofson structure with alterations or'aiditionat Zront ....6.......... near ...............
Im ........... lleigpnt .. Nunber of Stories ..2.—.1/.2.
ftR ......... 0000. ... ........ 0000
S. Dimensions of entire new construction: rront ................ [tear .....,.......... Depth ..............
1kij�ft ......................... timber of Stories ...............$)3gVn on attached arch. plans
9. Sime of lot[ Pront ...3L5A:........... hear ...4.49L.26........ naptlf ...1.301+...........
10. Hare of Purdtase ..................... Now of Donner (lunar ........................................
1I. Zone or use district in.sfiich premises are situated .residential...........................................
12.- Does proposed eanatniction violate arty zoning law, ordinance or regulationt ...No..................
13. Will lot be regraded ,..NO ...6.66...... Will excess fill be removed from premises: X=X N3
14. lianas of Owner of premises ...R:..+..$:.. t?� ... Address .Qi:'. PAPA r.Aff............. 1'lfone ib. ...........
Wits of Ardnitect ...Ut..1UJUAUAiJQR ..Lur. .. Address .OLrient%,..D1X............. Phone N0.323.........
Wnma of Contractor .A0X 119XV..P e..Y q J�........... Mdress ...... .......................Phone No. ...........
15. Is this property within 300 fest,of a tidal wetland.? * YES .......... DO ...XX....
*1F YIDS, SQfi m MM 74111S1(±if8 MMIC MAY DIQ IZLWIMU).
PLOT DIAGRAM 6
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all. set-bark dimensions
fmproperty linea. Give street and block nuttier or description according to deed, and show street nares aril indicate
%Awther interior or corner lot.
Please see attached architectural drawings and survey with t
proposed addition to dwelling. Renovations and alteration
also shown on architectural drawings in detail .
SrAlli Olt KU Y(XtK,
fo '
tlllMlY (it 0000 Su f....l?t...........
..Reginald..Minor. .................................lit- ill Deily swunf, delmses mxl says Ural• lie is the a0pliumfl
.
(Wort of hxiividual signing contract)
above twined,
owner
Ifs is Life ......• ..
....0.......646.............. ....... ................................................
(Contractor, a gent,•corporate officer, etc.) ,
of ttnld tamfar or owners, wd is duty authorized to perform or have perrbrn+ed the said work mil to make anti elle this
0114AIcaticnt; Llfnt all statements contained in this application are true to rine best of his luxvledge mil belief; mxl
tlfat tlfe wurk will 1xt perfonmed.in Line mnnner set forth in the application filed therewith.
:lwcfrn to befure era this .
........6 1?......day of F.e7]ruary....199%....
Notary Publi
----- _,. .(Slgnmturs of Applicant) Reginald Mirior
UNDA F.KOIMALM
NOWY PuMIA,Stabs of NewYtltk
- No.524524771
Cont��EVIr�t ov.30rnty &
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Proposed Renovations - Minor Residence
FOR MR. & MRS. REGINALD MINOR - P.O.BOX 68 - ORIENT, N.Y., 11957 ,
Design by Art Directions, Inc. - P.O.Box 310 - Orient,N.Y., 11957
UNDERWRITERS CERTIFICATE
REQUIRED
PROVIDE '/ HR. FIRE
RATED SEPARATION TO OCCUPANCY OR
PART. 717.3 (f) (1) OF USE IS UNLAWFUL
N.Y. STATE BUILDING CODE. WITHOUT CERTIFICATE
OF OCCUPANCY
PROVIDE SMOKE-DETECTING
ALARM DEVICES
AS TO PARE 711.1 APPROVED AS NOTED
N-YS BUILDING COUL DATE 3-t-59 B.R a7 / a
FEE: - `� BY: . RcW'-
NOTIFY BUILDING DEPARTMENT AT
796-1802 9 AM TO 4 PM FOR THE
PROVIDE OPENINGS FOR FOLLOWING INSPECTIONS:
EMERGENCY ESCAPE AS F1. OIRPOUREDCONCRETE
EQUIRED
REQUIRED BY PART. 714 OF 2 ROUGH - FRAMING & PLUMBING
N.Y. STATE BUILDING CODE, S.
FINAL -CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE NY.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
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Proposed Renovations All
Minor Residence - Orient, N.Y. Exterior Elevations
Date: Prepared for: Prepared by: Drawn Folio #
� F�M l U 13DI A I Scale: 1/4"=1-0' Mr. &Mrs,Reginald Minor ArtDirections,lnc. by: , Al '
—_— —_ _ P.O. Box 68 P.O.Box 310
-- Approval: Orient N.Y. 11957 7 Orieennt N.Y. 11957
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Minor Residence - Orient, N.Y. Plan & Construct. Details
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Scale:Various Mr. &Mrs,Reginald Minor O B U s,Inc. b,;
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