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Home My WebLink About27271-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28103 Date: 12/06/01 THIS CERTIFIES that the building ALTERATION Location of Property: 28545 MAIN RD ORIENT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 18 Block 6 Lot 24.3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 20, 2001 pursuant to which Building Permit No. 27271-Z dated APRIL 26, 2001 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 INSTALLATION OF A GAS HEATING SYSTEM AS APPLIED FOR. The certificate is issued to LIAM M KELLY & LESLEY C LOKE (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 107695 12/05/01 PLUMBERS CERTIFICATION DATED 10/18/01 KEYSPAN Authorized Signative 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. 27271 Z Date APRIL 26, 2001 Permission is hereby granted to : LIAM M KELLY 28545 MAIN ROAD ORIENT,NY 11957 for INSTALLATION OF HEATING SYSTEM AS APPLIED FRO. at premises located at 28545 MAIN RD ORIENT County Tax Map No. 473889 Section 018 Block 0006 Lot No. 024 . 003 pursuant to application dated APRIL 20 , 2001 and approved by the Building Inspector. Fee $ 75 . 00 Authorized Si nature COPY Rev. 2/19/98 Form No.6 M TOWN OF SOUTHOLD Q U BUILDING DEPARTMENT TOWN HALL ` 765-1802 o ' ION FOR CERTIFICATE OF OCCUPANCY g1.DG.�f P ' _ This appl atio a in by typewriter or ink and submitted to the Building Department with the following: A. 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 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 Building- $100.00 3. Photocopy of Certificate of Occupancy-$0.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy- Residential$15.00,Commercial$15.00 Date. 1 — _C) New Construction: Old or Pre-existing Building: � (check one) ( p� Location of Property: 7 �\-�Ul�l I CIAy House No. Street Hamlet Owner or Owners of Property: c1 c A Suffolk County Tax Map No 1000, Section o Bloc (P Lot Z�7/3 Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ c a ?)03 C �� App ' ant Signature O�g�FFOL��oG Town Hall,53095 Main Road y Z Fax(516)765-1823 P. O. Box 1179 • Telephone(516)765-1802 Southold, New York 11971 ifi�Ol �a0! OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE: Building Permit No. 2 1 7*�F Owner: a.,+, Y (please print) Plumber: 60FA4 a-M (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plum)5er Signature) Sworn to before me this / S ` day of Notary Public County JOAN M.BOT110ELU `Mary Pubic,5'tafe of New York Na 01 B0605M QuakW in Nam,County m,SSW EVM APO 23,2003 LONG ISLAND ELECTRICAL INSPECTION SERVICE, INC. 670 Middle Country Road • Saint James, NY 11780 Tel: (631) 265-3075 Date 12/05/01 Application No.on File 10 7 6 9 5 Building permit No. 2 7 2 71 THIS CERTIFIES THAT our local district inspector conducted an inspection of the visible portion of electrical installation described below and introduced by the applicant named on the above application in the premises of LIAM KELLY 28545 MAIN STREET ORIENT° in the following locations; ❑ Basement ❑ 1st Fl. ❑ 2nd Fl. ❑ Outside Section Block Lot was eiammed on 12/0 3/01 found to be in compliance with the current edition of the National Electrical Code. ❑ this certificate may be accepted as a"letter of Approval"that all circuits are in good working condition,not overloaded,and all wiring,fixtures and other electrical equipment are in standard condition. FIXTURES RANGES COOKING DECKS OVENS DRYERS F!HP FANS SWRCHES RECEPTACLES GFI DIMMER INCANDESCENT FLUORESCENT H.I.D. AMT, SIZE MET. SIZE AMT I SIZE AMT. SIZE EXHAUST PADDLE 1 DAN LAUNDRY HEATING EQUIP.MOTOR EXIT EMERG. SUB FEED TIMER TRANSFORMERS AIC EQUIP MOTORS GENERATORS AMT. SIZE AMT- SIZE AMT. H.P. SIGNS LIGHT AMR. SIZE AMT SIZE AMT AMP TYPE AMT. H.P. AMT, SIZE 2 FHP " POOLS MICRO IWATERHEATER I SMOKE TRACK ELECT. SERVICE INFO ABV ❑ HOTDETECT LTG HEAT SINGLE MULTI CONDUCTOR NO.OF TUB AMT. SIZE AMT. SIZE -ORS a FT. TYPE AMPACrTY PHASE PHASE VOLTS SIZE•TYPE METERS WHIRL ON I UG z Bl0 POOL 9 z OTHER APPARATUS: domestic boiler wiring This certificate is not intended as an approval or guarantee of electrical w efficiency am covers only the electrical equipment and installation as of date. a Upon the Itmoduction of additional equipment or alternations,application W shall be promptly made for inspection. W APPLICArR: m TOM TE 125 SCHMIDT BLVD � W FARMINGDALE, NY 117256 LIC#4451 -E GENE / ER W 0 0 WHITE-ORIGINAL COPY • YELLOW-MUNICIPAL COPY • PINK-ANENT COPY • GOLD-OFFICE COPY T6S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROU PLBG. [ ] FOUNDATION 2ND [/FI ULATION FRAMING [ NAL [ ] FIREPLACE CHIMNEY REMARKJS 7- DATE IN8PECT0 FIELD INSPE_C_TION REPORT DATE � COMMENTS aaa-_�- -_ __-- _ __- _ II_----¢s=s=xssaxs==xxaaxaaasaasscs=sxxssaaaa=axassaaaxaa v II H FOUNDATION ( IST) II jj I I if FOUNDATION (2ND)----------------- - 1 II II -II II >r II O r ROUGH FRAME & ��---_----�N PLUMBING If II I II ij II -II - --------------- ---- --- fit' 1� Eq INSULATION PER N. Y. �i H STATE ENERGY -il CODE 1 if I �t if ssxmmxxxxxxxxxaxxxxaxxammax�aaaxxx_I xa�a== xmaaaxaaaxxxxmmxaaasxxaxaxxxxaxaaaaxx axaxxxx O i H II II II II r 1 FINAL 11 If if xaxxxxxxaaassxxxxxxaaaxx_—xxaaaaa�mms-_xs-- as s _ _x xxxaxa_ aaaaasasasxx=s=s 0' l ADDITIONAL COMMENTS: xxmmxxxxaa=axxxxxxaxaxasxaxaxmmaaaxaxaxx===x=axaaxaaaxxaaa=�axaaaaaaxaasaaaaaxxaxxax_-=sxssx Q H 0 x N � I as -IV wt-4 yr 0V LJ I nvLL - ttO1LI)INU PhKNll l APPIA(.A'fION C;hEC;KLIS' BUILDING DEPARTMENT Do you have or need the following,before applying TOWN HALL Board of Health SOUTHOLD, NY 11971 3 sets of Building Plans TEL: 765-1802 Survey PERMIT NO. - Q222-7/ Z-- Check Septic Form N.Y.S.D.E.C. Trustees Examined_ ,20 Contact:. Approved �—� 200 Mail to: Disapproved a/c Phone: , i �. Buildi4 Inspector APPLICATION FOR BUILDING P RMIT Date "f 20 0 1 INSTRUCTIONS a. This 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 waterways. 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 issue a Building Permit to the applicant. Such a 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 what-so-ever until a Certificate of Occupan is issued 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 and in building for necessary inspections. Signature of applicant or nallne, if a corporation) 125- S"c 4 , Jf s"T mar ► (c (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder - UP31114 11f7- 6, n Name of owner of premises Gc e LL v, "nAlorn art (as on the tax roll or latest dee . ell B.P.# If applicant incorporation, signature of duly authorized officer FEE: BY. P NOTIFY BUILDING DEPARTMENT AT (Name d title of corporate officer) `765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1, FOUNDATION - TWO REQUIRED Builders License No. FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING Plumbers License No. s` 9 " /� 3. INSULATION 4. FINAL - CONSTRUCTION MUST Electricians License No. BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET Other Trade's License No. THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY 1. Location of land on which proposed work will be done: CODES. NOT RESPONSIBLE FOR DESIGN OR �NSTRUCTION ERRORS 2855/.- 1!14,14 �d, c�� r� �� s� � �,� W House Number Street Hamlet County Tax Map No. 1000 Section Blockr Lot Subdivision Filed Map No. Lot (Name) . UNDERWRITERS CERTIFICATE REQUIRED Z. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy__ l�>rs;do•��-� 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work a r L To 4,,s (Description)wT r,►r i. Estimated Cost `7 SO D Fee (to be paid on filing this application) If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars . If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories Dimensions of entire new construction: Front Rear Depth Height Number of Stories Size of lot: Front Rear Depth 0. Date of Purchase Name of Former Owner 1. Zone or use district in which premises are situated 2. Does proposed construction violate any zoning law, ordinance or regulation: 3. Will lot be re-graded Will excess fill be removed from premises: YES NO 4. Names of Owner of premises Address Phone No. Name of Architect Address Phone No Name of Contractor Address Phone No. 5. Is this property within 100 feet of a'tidal wetland? *YES NO • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 6. Provide survey, to scale, with accurate foundation plan and distances to property lines. 7. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. TATE OF NEW YORK). SS: :OUNTY OF ) i�t�w�tis i�d., r �Flt (1Vasigrii g contract)above namedbeing duly sworn, deposes and says that(s)he is the applicant me ofindividual , S)He is the _ f'Lvu, Ire- s Co Hfyla e'r-a� (contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is;dilly authorized to perform or have performed the said work and to make and file this application; iat allstatements contained in this application are true to the best of his knowledge and belief; and that the work will be m -rfored in the manner set forth in the application filed therewith. worn to fore me this U day of 200/ 40 Notary Public S ture of Applicant HELENE D.HORNE Notary Public,State of New York No.4951364 Qualified in Suffolk County Commission Expires May 22, Loel Keyspan Plumbing&Heating Services. Tom Paquette—Master Plumber Lie. # 3549-P Project Name: Kelly—28545 Main Rd. Orient Pt. 10' Gas Pipe, Gas Boiler, Gas Water Heater. Front of House { } 1 \�25'•—R. o w_ N. 780 34' 40"E. 1 LIL4 Ipump ' 132 a 371.56 a (� HEw IL/L• I �o � � � __ 1329 { I `o 5.6 I I NEW Re+nov/a. WELL of '0 slave I i a.7 m I I II IOW / m1u I o �t ° m 1 "bLL I WOOD 8Ar A5//• ,� I,L,a,' reps W/NDOw WOQO STla./ PS r�CM/M 54'i'� STORY FRAME 1�7• '/ ¢ I cP �4 r�.+c-7 HOUSE ' / 3 N/O/F GEORGE L .YOUNG I 3 i NEW LIL +O 1 m .N 113ei� 1 83. 76 ' I � m 0 132 A 1 -.0. I I I f ,..z rw"� ,•^'.�=:S:t,. ... v�.'•w,...+�.r...wWM+�IaMm,�......�—.a..ww-, � I I i I 1 1 I V PLOT: -A I R` AREA = "1,79 acres e 1 ' s Y 0' N 1 I I � I I ) I O I i I O I LI I s19n. I 1 sfk. MonS. 79�28'40 "W. NEW L* S,78 CL 4d•E. zlo LILA 227 81 ' 56. 05' 210 MAIN R O AD ( NYS ROUTE 251 SURVEY OF PROPERTY AT ORIENT TOWN OF SOUTHOL D