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Home My WebLink About23979-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32118 Date: 01/08/07 THIS CERTIFIES that the building ALTERATION Location of Property: 555 RILEY AVE MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 143 Block 4 Lot 16 Subdivision Filed Map No. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated pursuant to which Building Permit No. 23979-Z dated 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 ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to RICHARD C POWER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 3018662 12/18/06 PLUMBERS CERTIFICATION DATED N/A Aut orized Si nature Rev. 1/81 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN FALL 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 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 I% 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 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- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial$15.00 Date. a —C) New Construction: Old or Pre-existing Building: (check one) Location of Property: j j s R t Q E!- et House No. 1 Street Hamlet Owner or Owners of Property: t cl vi v l T Oe-v 2!�?, Suffolk County Tax Map No 1000, Section Block Lot Subdivision p Filed Map. Lot: Permit No. 3 3 `j Y —Z Date of Permit. Applicant: / O� Health Dept, Approval: Underwriters Approval: Planning Board Approval: Request for: TenVorary Certificate Final Certificate: (check one) Fee Submitted: $ �c� 00 Applicant Signature co ��x211S1' FORK NO. $ 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) N° 23979 Z Date ...............T(r.Y..4::r1.11t:.�.9 .......... 19.�] :..: Permission is hereby grant to* ......... �yd��.:..<�1�1...... ..r ............................... /../.! ................. ................................ .............. ... . .. . - ..�....- ! ............................................................................ ....................................................... ............. ................................................... ss ......4 .�-r-� .....,�1 . . . ................................... at premises located at................. .... Block .......... .. ...... Lot No. .Z ............. County Tax Map No. 1000 Section ..•..••••• •• -7 �✓ Z`f..........., 1991•, and approved by the application doted . "" pursuant to app ••••"""" Building Inspector. Fee S.. ..... ............... .. .... ..... ..�. .. ........ ................ Building Inspector Rev. 6/30/80 g rJ�cPcPL3rL3r3rL3rJ�r3J 1:11 115:11 111111 I i i l l:Ill:1 rJrJ�rJ�r 13 111 ZZ 1@ �rJrJcPrJ@Pr�rJcPrJ :rJ�rJrJrJr�r�cJ�rJr�cP�PrJ�rJ�r�cPrJ�rJ�cPrJ�rJ�rJrJ� o CSU BY THIS CERTIFICATE OF COMPLIANCE THE 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 TY STREETBUREAU40 FULTTON F C NEW YORK, NY 10038 5 5 Af3, 5 CERTIFIES THAT 5 CSS Upon the application of upon premises owned by 5 Q.C. ELECTRIC, INC. RICHARD POWERS 5 PO BOX 518 555 RILEY AVE. 5 5 LAUREL, NY 11948-0518, MATTITUCK, NY 11952 5 5 Located at 555 RILEY AVE. MATTITUCK, NY 11952 5 rr5 Application Number: 3018662 Certificate Number: 3018662 c� Section: Block: Lot: Building Permit: 3C 90'7d BDC: ns11 ff5 Described as a occupancy, wherein the premises electrical system consisting of 5 electrical devices and wiring, described below, located in/on the premises at: 5 5 First Floor,Outside, 5 CS5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5 U herein, was conducted in accordance with the requirements of the applicable code and/or standard 5 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5 5 authority having jurisdiction, and found to be in compliance therewith on the 18th Day of December,2006. 5 5 Name OTY Rate Ratine Circuit Type 5 5 Miscellaneous 5 5 as built 1990- 5 5 bathroom renovation 5 5 Wiring and Devices 5 5 Outlet 3 0 Fixture 5 5 Fixture 3 0 Incandescent 5 5 Outlet 7 0 General Purpose 5 5 Receptacle 2 0 General Purpose 5 Switch 5 0 General Purpose 5 5 Power Pole 2 0 GFCI 5 SAn as built inspection,of the delineated electrical installation,determined that an obvious hazard is not present and the installation is believed to 5 Sbe in comformance with the applicable reference standard for the estimated period of construction of the premises wiring system. 5 5 5 5 sea/ I of I 5 c� This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 110 l7 u�r�rJ�rScncnrJcnrJ�rJarrrJ�crcrcncnr�rrrJrfrJrJrJrJ�rJ�rJr1rJ�l�cnrJcPrJ�rJ�rJL3pLLrL3r3pLr3pLrlcnct@nrrcnrrr.Pct�ncnrJrJ�rJrJrJr O��gUFfO(,�co GO Z Town Hall,53095 Main Road O Fax(631)765-9502 P.O..Box 1179 y�ol �aO� Telephone(631)765-1802 Southold,New York 11971-0959 B`IJILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Date: '10 e Building Permit No. Owner: m I / (Please print) Plumber: ///c (�,7 ��1� �(lam.i".'9 1Tot; (Please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. bers ignature) Sworn to before me this 3 e 0 day of 20 9 1p DENISE KING Notary Public,State of New York Registration #01KI6041757 Qualified in Suffolk County My Commission Expires Me 15,211L, Notary Public County M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: 621 z:,-: o' DATE 4� 13 129 7 INSPECTOR �� 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] "UGH PLBG. [ ] FOUNDATION 2ND [ t�J/INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: � Olc DATE !�' INSPECTOR 23?7l M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] UNDATION 2ND [ ] INSULATION ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: 2 O� DATE z b INSPECTOR I` Ilil.❑ Ill;il'I;l:lIUII Il)!I'UIIT IIAIV Q\ runnnn'Iorr rMINIM'1'1UH (2r11)) ' I'I.Ilflll I fl(; ------------------------- ----- - .aw wrtee,. _---- — ,^Q 111!i IILA'1'IUfI 1'ICII H. Y . !i'1'A"I'I! P.IIIC II(lY COI)IC -, _, rt _ ----............__.._......,...rt..__.. ..,__..,.-- µr p I IIA I. _ \.\• -.-------------.-........__.,.....,.. ................ .....,-___..,.....wrt__......____rt..____rt---------------------- -----------m------------- __rt_-...._..........,........,._....-........-_ rtrt___rt_rt-rt_rt_-_ ----------------------------------------------------- rt__rt_.,..,,.,,,rtrt.._.._rt_ AUUI'I'IUIIAI. CUHHia r'I'B 1 /3 97 s-I V o � T __ Ff n G �d —� 1 BOARD OF HEALTH . . . . . . . . . . . . . . . POIIN NO. I 3 SILTS OF PIANS v . . . . . . . . . . . . TOWN OF Sg1I.I;,1,IQl Il _._-SIlRVRYr- ItIIILDINC DI?i1A111'M�1'1'� 'It . .✓. ._• ! ( . • • . • • . . TOWN 11A1 .PTI.0 PORN . . . . . . . . . . . . . . . . . . . SO1 THOLD, N.Y. 11971 TRI: 7Gs-1RoFB 2 d O ' iiuray: pipp CAI.I. .LU^b.l.l'j. . BLDG.DEPT. TOWN 01. TO: . . . . . . . . . . . . . . . . . . . . Disapproved arc ...................... ............ ... ................................ .............................................. ... ... ..... ......... . 1 ildine lnspecfor) APPIACAT1oN FOR IIIIILDING I'Rmur 9 INS"rittlur I ONS a_ 'Thin application uuat lie cugiletety filled in by l:ylxsariter or in ink mil skdndtted to the Building inspector with 3 sets of plans, occ rate plot plan to scale. Fee according to Rd"mitde. b. plot plan slxruing location of 101: arxt of Inildings on prenises, relationship to adjoining prenises or jxblic �nl:rests or arens, mil giving a detailed descripLion of. Ieuymut of property mist lie draan on the diagram wltic3u in part of this application. r.. 1lie work roverei by This opplicaLion eny out: Ire camco:ed before iscaao:e of IAillding Pennit. d. Upon approval of thin 11110cationn, the lloilding losirclor will jostle a poilding Permit to the uplAlcanl:, Dich permit sliall he kept on like prenises available for inspection tiomn lout the work. e. fk) Wilding shalt be Occopiel or used in whole or in part for any purpose wikal-"er until a Certificate of Occ tt n cy slkall have Igen granted by llne Building Inspector. APPLICACKItl IS IIiW HY MfJW to Lone Building Deparinent for the issuance of a Bdlding Permit pursuant to the Building Zane Ordinance of the Town of Southold, Suffolk County, New York, nal other applicable lsuws, Onlinancen or Regulations, for llle o:mnstrucLion of Imildiugs, mklitiona or alterations, or for ruouva] or oknoliLion, as herein nkscribel. '[1x: applicant: agrees 1.0 cu-JAY With fill applicable laws, ordinances, Inilding axle, Inaksing cole, not uegulaliana, six] to andnit authorized inspectora on prenises soil in Inildinit for necessary in pections. .. ....................... goature of aggfli aoC, or neve, if n corizuraul.ion) l� ................................................... (Mailing mkiress of. applicant) Stale wltettrr applicant is owner, lessee, ngent, an]nilect, engineer, eneraI contracLor electrician, pluduer or Wilder. ...............................\............../................................................................ .............. Nene of Owner of. prenis:s iR 11uc'2A.: :'.y1 QW.L�.)\.............................................. (as an Line tax roll or Intent: deed) if alnplicant is u corluration, signature of duly mrtixnrized officer. ......................................................... Mane nix] title of corluraLe officer) Builders License No. .. �/..3O.l..t..l�... Pludrrs License fun. ..,.:.................... } �- Llectricians license No. ............... ...... ."CA KEW vr'\ Other '1'role's license Non. ....Ta,--.. 1. location of: lnrxl on nAnidi proposed rank will he dory......... ............................................... ...555...................11.1?�... .c......................._....V.�W 11ucl° ................... House amber Street ��,,// lk��e� (county lax Map tun. HIED Section ...�..l..�... Rlo:k .......�..... lot ................ SoNlivision ...................................... Filed Nall No. ............... Int: ............... (Name) 2. State existing use and occupancy of premisen aoi iinl:eoled use aol occupancy of proposed ronnLnuclimn: a. RxisLiug tare nkxl o:cupnncy ..�1tJ!Jt+:'.. .:1�. .................................................... rl,TM3?.1 TR7(1C11 b. Inlexlect use anal occupancy .......... 'f . .-'..........dnY.WaY.tastvAIi4Ay1fm11........... poltu2 nt bokblouQ Q902S1'�J210.oN _..._._._..tt YeM evu(4 3 mwT 7. 4 of lxnk (clxeck wldch uigdicuhle): Iku IkllldiugAllernl.ion .. Ikryxlir X.... .. Italmval Dalml Mon . ...... . . ... Other Iblk ...... ......... ............ ....... (I)L (:r ipL i(xl) it. IisLixvlte(I (:1811: ..?orb......... ....... fee . ... .....'. ... .............. ......... .... . ... .. .T ..p- 7 (Io Ix! paid on riling (Ills nllpl icnc loll) 5. If (kxel Iing, Ixnrier of Asetl lull will l A.).8rynl)er of (krill ini; unils (tit encu floor ..... .C:.. If garage, Ixaller of cars ......... ......... . ...... . G. If Ixmhx!ss, cosercial or nixed oc"71intle t!i fy nalur-e mxl extent of each type of tine......... . .. .. .. . ..... 7. Il ill Litt,iris'a of exislAng stroctures, if sly: Froot. ......f :tear .. .... ...... Ileplh ................. Ik!ig11C ... ..VN............... lkoller of Stories .. . ...�ti ., ... . .. ... . . Dineuaioos of sidle sf.nlcfure with alteratials or rxklil:[ons: FrouL ....IQ... ..... Rear d,. ..... . Depth .......01-P........ Ikll)IC ... ../n!�T�'.�cL��_�Nnlx.r of Slorlen .. ..go.'�•��,... it. Dilwonl os of coLhc heli (xxrstnxcl:inn: Frool .. CCIk:plh 777777-:- Ile i0tr ..... .-:............. Pk nlx!r of :ilorien ......... . .. . 9. Size of Lrt: IhalC .... �..gg..GG.. .... hearG�.... ....... 10. Iklle of Hlrcham. ....��-Gl�.V.R... Nile of Fouler Nuer .. .. lC`t. .. ... ... ............ .... 11. 2txle or use district in rAddi premises ate uituafed .... . ..S1!1.' ^' .'C—... ... ..... .... ............... ... . ....... 12. Does prnlx/Sed C(xlaLrrx:tlmo violate tiny t Iing IIM,.(IrdillaoCe or regulat,lal: .. ....... .... ...... ..... 17. Will lot he regrsleil ...A�� .......... Will excess fill lie ralmve(i Fran litanises: YI?,S N) I 14. lialles of (kxler of praalsee .......r. A(klreaa ...........rr`-----:......... Nxxle Ikl. .............. Moe of Architect: .......... ..J. �. . Alkiress ......!. ........A,A.... Hx)ne Nn. �'.p. ..... ./. .,. Wale of CAlistractor Y(/?'t <?<=(Sf .rl•`... A?•S'!^.. Mklrese/` ?r, p2s_?.. .Uo!1 .......111a(le lk>�/P.�.d��u..... 15. Is (ills properLy within 700 feet of a tldat wetla(x1Y * YES ND . ...... .. *IF YES, S(AIIII(MI) 701,111 •I11417110S g1111•11.1- FAY IV? Ruplium. PLOT DIAGRAM locale clearly nlxl distinctly all Ixllldh%li, rdlelher exislAag or proposed, nlxl iivlicnCe all sel:-lux:k diuensiona frao prolieily lines. Give street tall black nniter or Ikeacr[ptim accottling to deed, nlxl slim street nanen nlxl hxlicale ldleUx!r inferior or cornu lot. 41 - r,w �•rT�r, ?PiERWRITERS CERTIFICATE ` � i" X3979 REQUIRED Clr PRR K«=H FIT TO 4 PM '0,7 THE F, .. ".BFECTIONS: 1. r-(A)AADATION - TWO PFOUIRED �I n!J -,<<,5 FOR POURED CONCRETE . J PAWN 0? ; (3r R) 2. ROUGH - FRAMING & PLUMBING I UNI "1,1lcUL 3. INSULATION _ J .s'tSt 4. FINAL - CONSTRUCTION MUST BE FOR l ROUT CERTIFICATE ALL CO STRUCTONCSHALL MEET THE RQUIREMENTS OFOCCUPANCY STATEECONSTRUC ION &THE ENERGY CODES. NOT RESPONSIBLE FOR SI'AIIS (V IrII Y(XW DESIGN OR CONSTRUCTION ERRORS Exxit'lly (A � SS � �•� �A*-L, ............ ....... ..Ix!i(llg duly fm)ln, delxlsea ulxl nays lint he In the npu plicnl. (Dau! of ilxlividlull. it 11,11i og cont ra(k) t nlx)ve Oiled, .�-_ Ili! in Ila! .... ....................pxxkw..S ............ ..... . .... . .. . ............ ............................ (0)"Irlictor, ngeolt, corlxlrute officer, etc.) of 11aid Ixax!r or (INIx!nl, 1110 in (kAy uothorized 110 Ixtrlinm or luwe Ix!rfollwd [Ile mild work 111x1 10 MIN! 1111411 Ille Ihis mpplicalLiolli 11181E 1111 ntnlalellan conlaiesl 111 thin al)plicatioll me (IIx! to [lie Ileal: of [1111 k(xxlledg(! 1110 Imiliefg Illxl Illnl. the mills will lie lierfolned hl the lmanx!r net foilh [ti the upplicsil.ion filed Iherewglh. !")Io to IKII'Me ar! (his .. ... .....6.. ......(illy of lkllary Ihlblic ....... .. .. .. ... .. .. . .. ... ._. ....... .... Sigonlm a of Applicant,) NN SS=. GO Now MI SYMOMI N0.01 SC4 8 c T"Eapins Mir 31, 5 _ ,TOWN OF, SOUTHOLD PROPERTY RECORD CARD _ C OWNER STREET � VILLAGE DISTRICT SUB. LOTfi S h 'f - / 0 FORMER OWNER N E , ACRE GE . 13 Pcb4Wck C. e0werA 0'" • S W TYPE OF BUILDING / •/ :.) �� ___ RES. 7-/0 SEAS. VL. FARM COMM. IND. I CB. MISC. Est. Mkt. Value LAND IMP. TOTAL DATE REMARKS �- U U q O D / DDD I0rqc3L - Ic 3C7 8S Pi lc�Pl ftRA9"jc v0 '- 3 0a / o / o Y } y a h - L I Ilk - W r A io . 40 f�u)e�- 5 cc-D, 3 oe o2 3o6 .2 60 ✓ 9/27/"' AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FRONTAGE ON WATER Farm Acre Value Per Acre Value FRONTAGE ON ROAD S C 1 O A ,/ Tillable 1 BULKHEAD Tillable 2 DOCK Tillable 3 Woodland Swampland Brushland House Plot l W. .� .7 a j I A Bldg. Foundation C�irr w✓ Bath lox .301 / 00 i .. .� i 3 — --- t Basement �. j Floors xtension Ext. Walls C�� j� Interior Finish - - ---- _ lroor4 i AS xtension Fire Place Heat F rwK.a Porch flJQ Roof Type Porch Rooms Ist Floor 3reezeway Patio /0 Rooms 2nd Floor iaroge Driveway Dormer B. 6d6 S/-QED �J ' h3 Jim Brockbank Construction P.O. Box 252 Mattituck, NY 11952 298-4768 ��Q-,se .vole � Lr�✓c �� G ��/�t� � r�/ / e1�i�su��e's /HC eve c.� A-�oC, le- fo /51c ftiv+iA� �j oU 3/L. TH jIevo( 7tiyeee 7 �46 5,.g�t �=«!r. T�.'J yw6Ie w /// Ge S� oae7 ,c /`t c Gv�s f ex7/c2.o,vL //u�,a// p�cG11e Q� Gv! ti do w Gu r%/b e /,V .tC/ 7✓t/�//c 4t/ 5 e/g /c �/Gao� CvinJcLac�..). //!e <s Lf,'d>0-/e-(-/ 67 Awa axe �vde,� wll� c / /UC-� /y 44-16C0. Ste!¢/ ✓d lcll to l c 6-le-I//d w; p2X(> Gt7Wo (BSc¢/ / aw( //� c S!//• li-Ne1v-sc /r,�ofe S/q-�- Jim Brockbank Construction FEB 2 4 1997 LIc Ao.3o9 vi i 9 P.O. Box 252 YiLUU. LiErl.� Mattituck, NY 11952 / 298-4768 (22-0 �Cllpll Xq Clrb S _ u a 1 39 d/ E,4.� � a j r ( 7�'rc�-•�las�.f-_ o J— Jim Brockbank Construction P.O. Box 252 \ Coa7iuu + N Neu> Mattituck, NY 11952 E--- __ 298-4768 �� c,C � � �c�cr I w�►�ti,��o A Ne.w I n �os�• m ,a �x�S�+S1 � _ 1 ►4+�cRs�wRrrwBobt� � � - ---__ ._.__._ G�710 „ �RXIJ e?t 1 t iu uv 1 Utlby i ) n i New --- - -- - MEW r�� j►'�tts�yy.'r _�I �� j W Ittiti{ ` �" L. �'�',. ."..�. •• �.�. ANT � �-. .. '�( +....�.,. 'r"a�t� .1.;IN n. ti - I s C�X, 1SAIk�� ! �0w1\� ! �- 1 1� � � j j en11►s-11�^�`'rJtciclr, � I 1 - v $FT-1 , i l t Jim Brockbank Construction P.O. Box 252 Mattituck, NY 11952 298-4768 JA (/_1 `1 �� U L " 2x6FIK7cc>. /I- �H C e � lW e w *-cel /I- , l�U�s � r ve I To J(b oalkhe 1 Jim Brockbank Construction P.O. Box 252 Mattituck, NY 11952 298-4768 f�9tt� �e t2 S xsstf��, 11rA . 13 V top �JoR'�� E'_feUl��1oN