The URL can be used to link to this page

Home My WebLink About30133-ZFOR~¢ NO. 4 TOWN 0F SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30168 Date: 04/30/04 TI{IS CERTIFIES that the ~uilding EMERGENCY FIRE REPAIR Location of Property: 63355 MAIN RD (HOUSE NO. ,STREET) County Tax M~p No. 473889 Section 56 Block 4 Subdivision Filed~4ap No. Lot No. SOUTHOLD Lot 15 (HAMLET) conforms substantially mo the Application for Building Permit heretofore filed in ttu~s office dated MARCH 2, 2004 p~Lrsuant to wl~ich Building Permit No. 30133-Z dated MA~CH 3, 2004 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this cerulficate is issued is FIRE REPAIR TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. T~e certificate is issued to JAMES BEDELL of the aforesaid building. 'OWNER} SUFFOLK COUNT~ DEPAR~RENT OF P~kLT~ APPRO~AL ELEC~ffRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DA'£F~3 Rev. 1/81 N/A 85476C .03/10 j 04 04/24/04 RJM PLUMBING & HEATING // Authori,e Sitature FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES COMPLETION OF THE WORK AUTHORIZED UNTIL FULL PERMIT NO. 30133 Z Date MARCH 3, 2004 Permission is hereby granted jAMES BEDELL 441 FURROWS ROAD HOLBROOK,NI 11741 for : EMERGENCY FIRE REPAIR AS APPLIED FOR. DRAWINGS AND CERTIFICATIONS TO FOLLOW AS REQUIRED. at premises located at 63355 M~IN RD SOUTHOLD County Tax Map No. 473889 Section 056 Block 0£04 Lot No. 015 pursuant to application dated MARCH 2, 2004 and approved by the Building Inspector to Fee $ 150.00 expire on SEPTEMBER 3, 2005. ! Authorized Signature ORIGINAL Rev. 5/8/02 ~D~G A, ~or ~w t. F~ s~ey of~ vfi~ a~te lomfion of ~ ~l~gs, ~ ~cs, s~e~, ~ ~ m~ or 2. F~ Appmv~ 3. A~ovat of ~ ~hfi~ ~vm B~ of Fke~t~. Su~t R For e~g I. amte ~ey ofpr~y sho~g fea~s. 2. A pmp~ty ~1~ a~cafim ~ ~m~t to ~t si~ by ~e a~ii~t. ~ a C~fi~e of Oe~ is C. Fe~ S~mming ~1 $25.~, A~so~ b~I~g $25.~, A~tio~ to a~ b~l~ $25.~, B~s~ $~.~. 2. C~imte of ~up~cy on Pre-e~sfing B~g - $I O0.00 3. Copy of C~fimte of Oe~ - $.25 / 4. Up~t~ ~cate of O~p~ - $50.09 5. T~C~ifi~e ofO~p~cy- Re~idm~ $15.00, Com~i~ $15.¢0 New Construction: Old or Pre-existing Buii~: LocationofProperty: ~,,~_~'- .,'~.,',,l/ Home No. Suffolk County Tax Map No 1000, Secti~ya ~,~ Block Hamlet Request for:. Temporary Cer~d~cate Fee $ubm/tted: Final Cectilicate: ~ fApplicant Signature ~P~ 13 '04 02:45PM SOUTNOLD ~UILDING 631 ?65 9502 Sou~hold, N~ York ] I97].0959 F~x (631) 765-9502 Telephone (631) 765-1802 ~UILDING DEPAI~TM~4T TO~ O~ 8OUT~OLD CERTIFICATION (.Please print) I cedi fy that the solder used in the water supply system contains l~s ~ 2fl 0 of 1% lead. (P~umbers~ignat~e) Sworn to before me this Issue Date Application 3/10/2004 85476C E~ectrical ~nspecfion Service, 375 Dunton Avenue East Patchogue, NewYork 1'~772 (631) 286-6642 ~ssued To: Bedell Street: 63355 Main Road ViS,age: SouthoId Zip: Section: B~ock: Lot: 971 Town: Southold Contractor: S. T. G, Electric Lic,# 4262-E Was examined and found to be in ~mpliance with the National Electrical Code. ~ Commercia~ ~ NVDefects ~ Pool [] lstF~oor~ ~ indoor ~ Basement [] HotTub x~ Resident[a~ ~ Dat. Garage [~ Attic · 2nd F~oor ~ Outdoor [] Addition~r~ Survey Switches Receptacles Fixtures GFI Heaters A/C Fans Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Microwaves Furnace OE Gas Circulators Smoke Detector Bell Transformer Meter Amps Phase UG/OH 1 200 / [] Bldg. Permit: Other Equipment Jacuzzi Television CO Detector ~ire reconnect O0 amp panel with main Hugo S. Surdi Preside~f Rough :[nspedcion: Inspector: Final InsDecUon: 03/09/2004 Tnspec~or: John Mc Mahon This certificate must not be altered in any manner. Inspeczors may be identified by their credentials · ~LD INSPJ~CT~ON P~PO1RT FOUNDATION FOUNDATION ROUGlCf 17RANiING & t'LUNi~ING INSULATION PER. Iq, Y. STATE ENEIR(~'Z CODE DATE COMMENTS ADDITIONAL CO1VEHENTS TOWN OF SOU~EIOLD BUILDI[NG D~EPART~vlENT TOWN HALL SOUTHOLD. ~ 1197~ TEL: (631) 765-18~2 FAX: (631) 765-9502 ~w. ~orthfork.ne~S~utho~d/ i Examined 5 ~% ,20 q Approved ~ [ '~ ,20 ~ Disapproved a/c Expiration ~/% ,20 ~ BUILDING PERMIT APPLICATION CHECKLIST Do yon have or need the following, before applying? Board o£Health 3 sere of Baildkng Plans plarmmg Board approval Survey Check Septic Form N.Y.S.D.E.C. Trastees Contact: USE IS UNLAWFUL Bu/laiug Inspector WITHOUT CERTIFICATE OF OCCUPANCY AP?L~CATION FO~ B~]LD~NG ?~PdYIIT Date~-.~~ LNSTRUCTIONS a. T~his'&pplicatien MUST be completely filled in by rypewxSter or in ~ ~d sub~tted to ~e B~lding ~spector with 3 sets ofpl~s, acc~re plol pl~ to sclc. Fee according ro schedule. b. Plot plan show~ng location of lot ~d of buildings en presses, relatiens~p to adjo~ng praises or public s~eets or areas. ~d ware~ays. c. The work covered by this application may not be co~enced before issu~ce of Buil~ng Pe~t. d. Upon approv~ of this application, the B~lding ~spector will issue a Building Pe~t to the applic~t. Such a p~t shall be kept on the premises available for inspection ~oug~our the work. e. No buil~g shall be occapied or used ~ whole or in pax for ~y p~ose what so ever ~til ~e Building ~sp~ror issues a Ce~ificate of Occup~cy. f. Evew brfil~g pen~t shall expke if the work authorized has sot co~enced witch 12 months a~er the date of [ssu~ce or has nor been completed witl~n 18 momhs ~om such date. If no zoning men~enrs or other re~ladons affecting t~e prope~y have bees e~cted ~ the inmd~ the Building ~spector ~y authohze, in w~ting, the extension of the pen~t for adafion six months· Therea~. a new pe~t sh~I be req~red. ~PLICATION IS ~BY M~E to the Buil~g Dep~e~t for the issu~ce of a Buil~g Pe~l p~su~t to ~e Building Zone Ordinance of the Town of Southold. Sfffolk County, New York· and other applicable Laws, Or&~ces or Relations. for ~e constmctien ofbuiI~gs, additions, or alterations or for removal or demolition as here~ described. The applicant a~ees ro comply with all applicable laws. offices, buil~g code. housing code. ~d relations, ~d to authorized inspectors on presses ~d in bui[dS~g for secessaw ~spectiens. APPROVED AS NOTED ~a~e o~ apphc~t o~ ~e, ifa co~orafion) NOTIFY BUILDING DE~TMENT AT ' (Ma~g ad.ess of applic~t) J~5-~802 8AM TO 4PB ;Oa THE State whe~er app~l~~gent, ~chitect, en~e~, gener~ con.actor, elec~ci~, plmb~ or builder ~ FOUNDATION - ~0 EEQUiNED _ ~~ FO~ P~BED CONG8ETE 2. ROUGH - FRAMING & PLUMBING Nme of owner of2prg¥~sTl~ __oSTd-e~/d- d e2 4. FINAL - CONSTRUCTIC~F MUS-~r' ~As on ~'~e tax roll or latest deed) a co t P ~T~ %'e~'~' ] ed (Name and,~t~o,~/-FeCp~ptkit3~-(~c!~kSlBLE FOR BESIGN OR CONSTRUCTION ERRORS. Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. · Location of land on which proposed work will be done: House Number Street '-'- Ha~-nlet / County Tax Map No. 1000 Section ~-~' Block (/ Subdivision Filed MatfN o. (Name) Lot /-~ Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed constructi6n: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work (check which applicableS: New Building Repair ~ Removal Demolition 4. Estimated Cost ~dr, ~ 5. If dwelling, number ofdwelling units [f garage, number ~f~cars Addition Alteration Other Work Fee (Description) (To be paid on tiling this application] Number of dwelling un/ts on each floor 7kTD~ertslon. s, of e>xistmg stmctur~§, if any: Front ~,~ Rear /¢?,?,5- Height.~,r'. ' Number of Stories ~ Dimensions of same structure with alterations or bdditions; Front ..~'4~-¢(7 Depth Height Number of Stories Ifbusin~ commercial or mixed occupancy, specify nature and extent of each type of use. Depth Dimensions of entire new construction: Front Height Number of Stories Size of lot: Front ~---~?'DqT, ~-,~/ Rear /~,5~ ~ Name of Former Owner 10. Date of Purchase ,,¢/¢fi'~ Rear __ Depth 11. Zone or use district in which premises are situated Rear 12. Does proposed construction violate any zoning law. ordinance or regulation? YES NO ~ 13. Will lot be re-graded? YES NO ¢/-W¢ill excess fill be removed from premises? Y-ES NO L,-/' Address p~'4,'~,-"~*~%/'~,q/,Phone No~ 14. Names of Owner of premises ~'~,,'~e',-q ~C~'L(' '- ~ ~ Name of Arcbkect Address ' ,4~.¢ ~-/<'/"~Y'~Phone No ' ' Name of Comractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES__ * FF YES, SOUTHOLD TOWN TRUSTEES & D.~-,,C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland?'-'~-¥ES NO * I17 YES. D.E.C. PERMITS MAY BE REQUIRED. NO Y 16. Provide survey, to scale, with accurate foundation plan and distances to property lines: 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) r-', ~ SS: COUNTY OF ~u,~-~-,gt~ ---7~'¢wr'vx~'t-4 ~ ~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named. 6g3He is the ~;2 tx., ,~ ~ ~(2ontractor. Agent, Corporate Officer. etc.) of said ownm' or owners, and is duly authorized to perform or have performed the said work and to make and file this application: that all statements contained L~ this application are tree to the best of his knowledge and belief: and that the work wil[ be performed in the manner set forth in the application filed therewith. Sworn to before me this ~ day of,,'~,x¢?~/ 20 ~ '7/ - Notary Public ' Si~ture of Applicam John Kramer PUaUC, 8~ts of New York KR~ - Suffolk C0unt,¢