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HomeMy WebLinkAbout31523-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31405 Date: 01/23/06 T~IS CERTIFIES that the building ACCESSORY Location of ~roperty: 45200 MAIN RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map NO. 473889 Section 75 Block 6 Lot 9.3 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 11, 2005 pursuant to which Building Permit No. 31523-Z dated OCTOBER 11, 2005 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 ACCESSORY GARAGE IN THE REQUIRED REAR YARD AS APPLIED FOR. The certificate is issued to ALVIN H & CAROL TERRY ( OWNER ) of the aforesaid building. SUFFOLK COUNTY DEPARTME/qT OF HEALT~ APPROVAL N/A ELECTRICAL CERTIFICATE NO. 2081325 pLUMBERS CERTIFICATION DA'£~a3 N/A 11/30/05 ~~ut/h~~ature Rev. 1/81 Form No. 6 TOV~N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For 1. new building or new use: Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topograptdc 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 consent to inspect silk, ed by the applicant. If a Certificate of Occupancy is denied, the Building h~spector 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 dxvelling $25.00, Swimming pool $25.00, Accesspry building $25.00, Additions to accessory buildhlg $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildiug - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Llp&ated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. / O '-/c:,~ -t9 _-~. New Construction: Old or Pre-existing Building: Location of Property: L~ House No. Street Owner or Owners of Property: ~L~/~1¥ ~t CIt3 .~_O~: 'T [~1~--~-~ Suffolk County Tax Map No 1000, Section 0~ ~ :~ ~ ~> q '~<-.- ~t~ 't3~ock _ Subdivision Filed Map. Permit No. 3 ! ¢ ,~ ~ 2~- __ Date of Permit. ] 0 [ It / 0 ~__ Applicant: Health Dept. Approval: Underwriters Approval: (check one) Itamlet Lot Planmng Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~ ~, tr0 Final Certificate: (check one) Applicant Signature NEW BY THIS CERTIFICATE OF COMPLIANCE THE YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET ~ NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by THOMAS REGAN 46520 RT 48 SOUTHOLD, NY 11971 ALVIN TERRY 45200 RT 25 PECONIC, NY 11958 Located at 45200 RT 25 PECONIC, NY 11958 Application Number: 2081325 Section: Block: Lot: Certificate Number: 2081325 Building Permit: BDC: ns11 Described as a Residential 0-599 square t~. occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: garage only, Detached Garage, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard prornulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the Day of 30th November, 2005. Name QTY Rate Rating .Circuit Type Miscellaneous as built- 1981 Panels 60 3 Wiring and Devices Outlet 7 0 Fixture Fixture 7 0 Incandescent Outlet 8 0 General Purpose Receptacle 6 0 General Purpose Switch 4 0 General Purpose An as built inspectiom of the delineated electrical installation, determined that an obvious hazard is not present and the installation is believed to be in comformance with the applicable reference standard for the estimated period of construction of the promises wiring system. seal 1 of 1 Thisce~ificatemay not be altered in any way and is validated only bythe presence of a raisedsealatthe location indicated. T~ECTiON DATE ! COMMENTS (1st) FOUNDATION 2. ROUGH FRAME & PLUMBING (2nd) o INSULATION PER N. STATE ENERGY ~.ODE FINAL ADDITIONAL COMMENTS: TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSULATION [ ]FRAMING / STRAPPING FINAL [ ]FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 31523 Z Date OCTOBER 11, 2005 Permission is hereby granted to: ALVIN H & CAROL TERRY PO BOX 35 PECONIC,NY 11958 for : CONSTRUCT ACCESSORY GARAGE IN THE REQUIRED REAR YARD AS APPLIED FOR. (THIS REPLACES BP #11420-Z) at premises located at 45200 MAIN RD SOUTH/PEC County Tax Map No. 473889 Section 075 Block 0006 Lot No. 009.003 pursuant to application dated OCTOBER 11, 2005 and approved by the Building Inspector to expire on APRIL 11, 2007. Fee $ 75.00 ~~or~?~ e~gnat ute ORIGINAL Rev. 5/8/02 FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 11120 Z Permission is hereby granted to: ..~,..c ............... z....;~.., f. ~,..~. _ .,'tL.z .................. ...~,:b~'.....~.~.,~,..~........~:~::~ ....... ......... ~..~zz ./.~/~ ..................... ..~... ............... to ...... ..q ..c.:.:~..c:.: :~:?.LzC'.~.c..~.. ........ .v.~.(L.~:.~.c.:~.z~..~.~.7...`z~cr~:~(.~:~.z:~.~.~..~.~ .... ...~.~..~ ........ ~...//~ ....... '..~..~c~ ......................................................................... ./...... at premises located at .~*~..-.~..~..(~.. .................. ~..../...~..~/C!~'..¥.~.....~..~.'4~t;~...: ................................... ................................................................................................................. L~'/~z..~.~.z,z.,...~ ~.. C-. County Tax Map No. 1000 Section .; ...... .~...:d. ........ Block ..... :~.¢...(~ ....... Lot No....4,z/~..~... ...... pursuant to application dated .... ~.~..~.'.~.~.../.~?.q~./,~,. ....... ../...D. ......... , 19..~...~.., and approved by the Building Inspector. Fee $. ,....,,Z... ............... " ~ -l]uilding Inspector Rev. 6/30/80 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1803 (Builctin~, Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No..~,/..~..~..C)...~5.... a. This application must be completely filled'in by typewriter or in ink and submitted in triplicate to the Buildi 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 stre~ or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this apl: 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 iss~ue a Building Permit to the applicant. Such pern 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 Occupan 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 t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or .for removal or demolition, as herein describt The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in buildiugs for necessary inspections. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build, Name of owner of premises...~. ,~_.l',/:) &... ~'}~'ff~a.i on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .... ~.Lf ................... Plumber's License No ......................... Electrician's License No.-/~.../-.~.~. Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................................ .. ...................... ..StZo o. ././.&4. .......... ......... zr/. '7 .............. House Number Street ftamlet County Tax Map No. 1000 Section .... '~'7 '~''~' ....... Block .... ~..~. ......... Lot...~.~ ~ ....... Subdivision .................................... '. Filed Map No ............... Lot .............. (Name) 2. 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 ... 5. Nature of work (check which applicable): New ~'d~g .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... (Description) I-.Estimated Cost ........ .c,3 ........................... Fee . f.(~Y. ~ (to be paid on filing this application) L If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars ..... ."~', .)~.. ............................................................. 5. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensious 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 ...................... 3. Dimensions of.entire new construction: Front .. ;?.,~! ......... Rear .. ,5',g2 ......... Depth . .g..~* .......... Height .. ,/~/[ .......... Number of Stories ......... ~ .............................................. · '.Size of lot: Front ...................... Rear ...................... Depth ...................... 3. Date of Purchase ............................. Nalnc cf Fcnn. er ©whet ........................... i. Zone or use district in which premises are situated .................................................... ~..Does proposed construction violate any zoning law, ordinance or regnlation: . ..//'.T:. ......................... I. Will lot be regraded ....... X'¢.5 .................. Will excess fill be removed from premises: Yes No I. Name of Owner of premises ,<f~.~2fkv.. T'~..2¢~..~.... Address ,,f,'~t././.¢ .ff.~. ~.~?.7./.~<~.. Phone No. Nmne of Architect ........................... Address ................... Phone No ............... Nmnc of Contractor,,Cf, d~.r. ,~'.2TF/?t'.~7./( I ......... Address dC. ,-'~r&¢'2 ~.~/..j'4.-¢-~,hg. Phone No. [~.¢:~ ?.qt .~. ..... PLOT DIAGRAM Locate clearly and distinctly ail buildings, whether existing or proposed, and indicate alt set-back dimensions fi'om :operty lines. Give street and block number or description according to deed, and show street names and indicate whether :terior or corner lot. *fATE OF NEW YORK, OUNTY OF. .Z./.( .... S.S ..--/~Z ~- ~.At ./Y ~ t:~~¢--~e~a being duly sworn, deposes and (Name of individual si~ning contract) ~ove named. says that he is the applicant e is the ......................................................................................... (Contractor, agent, corporate officer, etc.) f said owner or owners, and is duly authorized to perform or have performed the staid work and to make and file this pplication; that ail statements contained in this application are true to thb best of his kdmwledge and belief; and that the 'ork w~l be performed in the manner set forth in the application filed therewith. worn to before me ti)is .......... /? .......... dayof ...... ~..~.,..t.~. ?. ..... 19 .~. / rotary Public, (~2/..t2~..~. ~"~(~..~...~.~. ........ C.gunty .... ' ' "~;~ (Signature of applicant)