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HomeMy WebLinkAbout25503-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28364 Date: 04/24/02 THIS CERTIFIES that the building ALTERATION Location of Property: OFF EAST END RD FISHERS ISLAND (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section it Block 1 Lot 11 Subdivision Filed Map No. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 22, 1998 pursuant to which Building Permit No. 25503-Z dated JANUARY 28, 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 ADDITION & ALTERATIONS TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN F MCGILLIAN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1040771 03/21/02 PLUMBERS CERTIFICATION DATED 03/01/02 ROBERT E. WALL or'zed Signature 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. 25503 Z Date JANUARY 28, 1999 Permission is hereby granted to: JOHN F MCGILLIAN C/O COOK PO BOX 661 FISHERS ISLAND,NY 06390 for CONSTRUCTION OF AN ADDITION & ALTERATIONS FOR AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at OFF EAST END RD FISHERS ISLAND County Tax Map No. 473889 Section 011 Block 0001 Lot No. 011 pursuant to application dated DECEMBER 22 1998 and approved by the Building Inspector. Fee $ 75 . 00 Authorized Signature ORIGINAL Rev. 2/19/98 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 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 applicant. If a Certificate of Occupancy is denied, the Building Inspectoi:76'hall state the reasons therefor in writing to the applicant. C. Fees APR 8 2W2 1. Certificate of Occupancy - New dwelling $25.00, Additions to awelling_$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 - .25Y1 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . . . .. . . . . . . . . . . .. . . . . . . . . New Construction. . . . ... . . . . Old Or Pre-existing Building. . .... . . . . Location of Property. . . . . . . . .... ... . T. . , ? ... . . . . . .. . . .. J�Wj� . . . . . . House No. Street Hamlet [ Onwer or Owners of Property.. .�:Y. /:�. . . . . .. . . . . . . . . . .. . . . . . . . . .. . . . . . . . . . . . . . . 3� / County Tax Map No 1400, Section. .0]f. . . . . .. . .Block.©� . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . Subdivision. . . .. . . . . .. . . . . .. . .... . . . . . . . .. .�.�....Frilled Map.. . . . . . . . . Lot. . . . . . . . . . . . . . . . . . .. . . Permit No. .a.�.` .L�. .. . .Date Of Permit. �.l`::41.:/. .. . .Applicant). a L�C... .. . . . .. s Health Dept. Approval. . ..... . . .. .... .... .. ... . .Underwriters Approval. .. . . . . . . . . . . . . .. . . . . . . . . Planning Board Approval.... . . ... . .. . . ... .. . . . . . Request for: Temporary Certificate. . . . . . . . . . . Finoertica . . . . . . . . Fee Submitted: $. . . .. ::�i��.:4) . .. . . . . .. . . . . . . . . . . . . . . . .. .. . . . . . . . . . . . . . . . G\ ed_P__ a836 ;503 a ��d 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 BUREAU OF ELECTRICITY 5 40 FULTON STREET - NEW YORK, NY 10038 5 � 5 CERTIFIES THAT 5 5 5 Upon the application of upon premises owned by 5 5 S 5 WALL ROBERT E. JOHN MCGILLIAN 5 11 ALPINE AVENUE ISABELLA ROAD 5 FISHERS ISLAND, NY 06390, SOUTHOLD, NY 11971 5 Located at ISABELLA ROAD SOUTHOLD, NY 11971 5 5 5 Application Number: 1040771 Certificate Number: 1040771 5 5 Section: Block: Lot: Building Permit: BDC: NSI 1 5 5 Described as a Residential occupancy,wherein the premises electrical system consisting of 5 electrical devices and wiring,described below, located in/on the premises at: SFirst Floor,Outside, 5 55 S was inspected in accordance with the National Electrical Code and the detail of the installation,as set forth below,was 5 found to be in compliance therewith on the 21st Day of March,2002. 5 Name OTY Rate Rating Circuit Type 5 5 Wiring and Devices Outlet 16 Fixture L5Cj Receptacle 12 General Purpose 'J Switch 8 General Purpose 5 Fixture 16 Incandescent 5 Receptacle 3 GFCI 5 S 5 S S 5 5 5 5 Seal 5 5 5 5 1 of 1 5 5 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.Ma I 5 5 TEL. 76S-1802 �iO,c�Ffotl� TOWN OF SOMOLD :c OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD,N.Y. 11971 C E R T I F I C A T I O N Date Building Permit No. J Owner, Y) 7, )�rin v� (please print-) Plumber (please print) I certify that the solder used in the water supply system contains less than 2/10 of It lead. (plumber's signature) Sworn to before me this day of- A4dlr- /;/j , --'Z Notar�§ kublic Notary Public, County VERONICA HAMILTON NO` 'RY PUBLIC ST,- 7F NEW YORK NO.01 HAC067785 QUALIFIED IN SUFFOLK COUNTY TERM EXPIRES... �LJ7 .Pat./ y 9, 8 2p � P4rp�FNG so /Ptd pF/ 106.36, 5 74•-zjq 30. W v�� 04/22/2002 09:00 FAI 631 788 7798 FITELEPHONE 1@008 S 1p; doo.0- BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ I INSULATION [ ] FRAMING FA-JV REMARKS: DATES INSPECTOR , o n e BOARD OF HEALTH . . . . . . . . . n� FORM NO. 1 J SETS OF PLANS . . 2 2 0 E . . . . . . . . ffic TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CIIECK . . . . . . _ . _ DEBT. TOWN HALL SEPTIC FORK _ . . . . . . . . . . . . . . • . TOWN ~ . . --,--- SOUTHOLD, N.Y. 11971 TEL.: 765-1802 NDT1 FY ; .r �Z �� CALL . . . . . . . . . . . . • • Examined . . . 19 rin I L TO : . . • . . . Approved . . . . . . . .L�.? . . ., 19 Permit No. . ?_OZJ`3'� . . . . . . . . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . .. . . ... . . . . . . . . . . . _ . . . . . . . . . . . . -�2 . . . . . . . . . (Building Inspector) PLICATION FOR BUILDING PERMIT Date . . .!ay. I$. .:-. . ., 1M 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 giving a detailed description of layout of property, must be drawn on the diagram 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 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 herain described. The applicant agrees to comply with all applicable laws, ordinances, building code, housinMj� s, and to admit authorized inspectors on premises and in building for necessary inspections. coo K, (Signature of applicant, n) PU 80Y, Wok FI-5"Egs x�SLA�J�.kIJ� 0390 (Mailing address of applicant) State whether applicant is owner, lessee, 'agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �.E t AE-R _ C4- T2A C-T0 e, . . . . . . . ... . . . . . . Name of owner of premises . . . : 0 H ISP • .m.e.G �L LI ASN . . . .. . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) 14 Builder's License No. �. . . q 7;- - Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. Other Trade's Licen-e No. . .. . . . . . . . . , , . . 1. Location of land on which proposed work will bedone. . . . . , , • , . , , , , , , , House Number . . . . . . . . . . . . . . . . . . . . . Street . . . . . . . . . Hamlet . . . . . . . ... . . . . . . . . . . . . . - County Tax Map No. 1000 Section j . Block . . . . . , , , ; , , , Lot . . . .,-A . . . . . . ... . . . . Subdivision . . . . . . . . . . . . . Filed Map No. amLot . . . . . . : . . . . . . . . (Ne) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . .. . . . . . . . . . . . . . . . . S fl.X(`( (n F-9. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . . . . . . . . . . . . . . . . . . . .S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -3. Nature of work (check which applicable): ' Pp icable): New Building Addition . Alt �� ��� • Repair . . . . . . . . . . . . . . Removal Demolition • • • • • • • ' Other Work . 4. Estimated Cost . . . . . . . 3��o®�• . . . . . . . . .) . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . C_10!=,31 / (to be paid on filing this application) S. If dwelling,number of dwelling units . .. . . . . fid, Number of dwelling units on each floor, • If garage,number of cars . . . . . � • • • • • • • • • • . 6. If business, commercial or mixed occupancy, specify nature•and extent of•each t e. • . • • • • • * * • • • • • � • • 7. Dimensions of existing structures,if an • Front . YP of use . . . . . . . . . . , �. . . . . . . Y• .':7� Rear. -07P De 0. . . . . ... Height . . , r.�.7 Number of Stories . . .v�.L, ' ' ' ' ' ' ' • • • Depth . . . . , Dimensions of same structure with alterations or additions: Front �O • • • • • • Depth . . . . : . . . . 34 . . . . . . Height . . . . . . . ; '7 ` . . . . . . . . . . Rear . . .�� . . . . . . . . . . . 8. Dimensions of entire new construction: Front . Number of Stories . . . . . . .�, Height . . . . . . . . . f�/OAIE. . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . Number Stories 9. Size of lot: Fr6at / 94 . . . . . . . . . . . .. . .$rte' • . . . . . . . . . . . . . : . . . Rear. . . . . . . . . . . . Purchase 10. Date of Pu . . . . . •Depth . . . . . . . . . . . .�... . . , , , , Name of Former Owner . . 11. Zone or use district in which premises are situated , • • 12. Does proposed construction violate any zoning law, ordinance or regulation: • • • • • • • ' 13. Will lot be regraded . . Will excess fill be removed from premises: • • •Yes . • . . • • • 14. Name of Owner of premises .Of{IJ m it-c.f RN l �• s No • • • . Address � � ,3►.Ti N ►1.ti toc�aphone No.Via'a�sem_c5�o Name of Architect CQI;!qJ (Z COQE • • ,Address4! �Nr 4W 41to!'1eow ata jai- Name of Contractor . Naf'ZOte�il° • , , , , , • • Phone No. �. . , , . Address Po%o)t•(g6 l _FX 0 Phone No. (510?1%;5550 15. Is this property within 300 feet of a tidal wetland? Yes. . •. . . . No. . . . . :. . . *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 from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. =-- SEE P�"r'T'►Act�E;D — . STATE OF NEW YORK, �OUNTY OF . . . S.S 1aRe� COOK ' ' ' • • • • • • • being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) .__•. lamed. leis the . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . .. (Contractor, agent, corporate officer, etc.)• • • • • • • • • • ' • ' ' f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ulication; that all statements contained in this application are true to the best of his knowledge and belief;and that the 'ork will be performed in the manner set f rth in the application filed therewith. worn to befoZe this . . . �?. . . . .day o . . . . . t'L 19w otary lic, . � . . . . . . . . . . . . . . . . . . . . . . . . . . County TH®MAia V.bew9 RTY JR. Notary Public State of Now York . . Nc'asaessa N(Signatu applicant) �iU9ilf{�q in$uitglk Cou��++ty Term Expires 12/31/4W I - _ _ :.a.'. - rY".. : � ; .�arr.• rraab' r':u+u,.xa,+ .>':w A:,cx p •1�; ' IT' " Y� ',"I , n ( ! •_ _ ,. Y Y m;,td ,r ,Mm N: r '�•�1' dN k1 fi� tra 1 1N Ix Y, S # k tx If 41/ Y r wF n as yya, ' I I � ' Fi r '✓I^ Y a y ! � '. J r iv f' 'ITS " 1 'N a kM `'. v: T /G/ IT If T, �5 q. vIr .'.axaiu Ig _ ❑ � ld Y V' d .d 4 >e r f, x ��h, '+ 'M M + a � a eywe { yYt q d"1 WI nr I "5 f Fi _ Ll A Ae r ��i6q Si.W'f' ,�•.�rr�r .f'' , d� ,, 1 ��; J �"Fd , .� Jur Nr .d �»�vr ^ r �1� §' _G QG01!C Awp e 2 y va xl !JN aprIf', IT I n�e ' dITv4 d . 1 - aP a H ITt i IT IT, REYTSI011x1'11 4T if oIT ri : �aFLnIl LLI[�I /a�t\1y1�}II D I 1 dY y,N� � 4oik 1 y dakIi III NW 'i I df4 ITT J tr (Jf�L!>nY F'I-1 I10v V v'� d14, r.AAlr a , PRONDEANTI•SCALDAND/ON THERMAL SHOCK PREVENTING r =s O ft DEVICES AS TO PART,902.j(K) �r tV hp4' I 6te.m fi¢. aui er .�' , .I' I N.Y. STATE BUILDING CODE FTTI I IBJ I i 1 � �� � ( , � �n�i� `�A1' � ,' � r If copper tubing is used for Waterdistribu np 0 NDS Q p['�r i P system:Piping shall be ItWHGbr NAd'fti Of types K Or L Of1IY111 1 @ T,z 0i auris gL lOA¢PILf V(fi Ir y p� b,n P LUM81 NG Yt 0 4Y4G ' h} FI rI�Y'Ps�ua�, Fa 12 a N y N I r - ® O CO lJ iO ® r;. _ LSI I ALL PLUMBING NEED , ¢ a � O� 'pd� � LI'f '�' � � —"— �aC� 'fO�:Ta F''„ - ”` 'C1N 'LK� BWATER LINES NEEDi� :I I' I - I *0hl6'f �Ti4iL � .. TESTING BEFORE COYERIILQ V y ' . .QUA Jd V• 1„ e a q ` Nro'd�lEi'n'''+'W r°�t` r O � �1' 1 *+ .� \ // 2•i0 ,l .�.,-.�..�.--.,— - h"C" ` rIT , u'uciLN ,�4`.Ix'*. 4 ' � � • I v O _ a _ _ _ ,: .. i _ _. , l !{ 5rN v. �IG, KI4" MI y +: ' .. . .. Y tl k PLUMBER CERTIFICATION M . pA2 + N ON LEAD CON7`ENT BEFOR r "�. ► � � CE RTIFICATCOFOCCUI (yir4aBRA&nrl., �F v 1 3vk ' i1*A5� 6 rr � ,�� � SOLDER USED _ - SUPPLY SYSTEM CAryND EXCEED V) DF 1%LSA 051 l - , ell PROVIDE % NR. FIRE4i : � '(z RATED SEPARATION TOJI PROVIDE"0 1111141 T ROVIO eo OPENIN E CS FO R PART. 7.17.3 (f)1Z10F EMERGENCY ESCAPE AS AEARY DEVICE. �a N.Y. STATE BUILDING CODE. ! REQUIRED RY PART.'714 OF AS TO MRL 72LE , N.Y3SURDINOCODE. r ri aN ,.L STATE RUILDING'CO L if iru ltiv J*y�s'.1 x Y"Ko T V ea ASF _— — ,� : ev SIF E . _ UNDERWRITERS CER IGi REQUIRED folwo ' ti�D It, M �u ' ', " a Iti APPROVED AS NOTED CY DATE:' IAAA mo. P N F u :1 1' 1 ; II E' a., I k a r G? 4 ;dCa �i AY. - NOTIFY,BUILDING' DE ME T ,P 786.1802 9A � " v 9.� LOWING IN __ �— I. FOUNDATION ECTIONS:REQUIR E x M F Ic r Na, x _ TWO' e Fr v I I {OCCUPANCY ti ' FOR POURED CONCRETE DIN �, w FRAMING A PLUM S, INSULATION : k n '�: t � �t'D 2. ROUGH - » � �4, FINAL - CO 4 ud71"�{ a O �+ 1O� 4 CONSTRUCTION MU + I USE IS UNLAWFUL: BE COMPLETEFQR C.O. IH h'f a Lay T 10 N 'ALL 'CONSTRUCTION SHALL ME . fie D20{OQ• d �» xI d WITHOUT CERTIFICATE THE REQUIREMENTS OF THEN Op VEl 7i ty y STATE CONSTRUCTION 8 ENERG / OF OCCUPANCY CODES. 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