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Home My WebLink About35123-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPA=RTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34117 Date: 12/07/09 THIS CERTIFIES that the buildin§ CHIMNEY Location of Property: 495 BENNETTS POND LA (HOUSE NO.) County Tax ~ap No. 473889 Section 113 Subdivision MATTITUCK (STREET) (HAMLET) Block 13 Lot 13 Filed Map NO. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 2, 2009 pursuant to which Building Permit No. 35123-Z dated NOVEMBER 2, 2009 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 CHIMNEY FOR AM EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JAMES H & LEILJ% M MCKAY ( OWNER ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAI, RLRC-fKI CAL C~ITI FICATH PL~I~ERS CERTIFICATION DATSD N/A ~/A N/A /AhOrlzed Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPA 2 4 2009/L. BLDG. DEP[ [C¥ TOWR OF SOUTHOtD This application must be tided 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 preperty with accurate location of ail 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: t. 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 Occupaney 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 New Construction: ~)( Old or Pre-existing Building: Location of Property: /7~ f_5~ ~./~', 0 37L~//~: ?J. //', House No. Street Owner or Owners ofPropeny: ~c*~lS' *{ ~-~//~. Suffolk CountyTax Map No 1000, Section //,/ ~ Subdivision Permit No. '~ ff / ~ ~ Date of Permit. Health Dept. Approval: (check one) / Hamlet Lot: Filed Map. //'- Z - (2 ppli nt: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ A(-' d) E) Final Certificate: (check one) ?x~// Applicant Signature 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. 35123 Z Date NOVEMBER 2, 2009 Permission is hereby granted to: JAMES & LEILA MCKAY 495 BENNETTS POND LA MATTITUCK,NY 11952 for : CONSTRUCT MASONRY EXTERIOR CHIMNEY ON EXISTING DWELLING. REPLACES EXPIRED BP # 10502 at premises located at County Tax Map No. 473889 Section 113 pursuant to application dated NOVEMBER Building Inspector to expire on MAY 495 BENNETTS POND LA MATTITUCK Block 0013 Lot No. 013 2, 2009 and approved by the 2, 2011. Fee $ 200.00 Authorized Signature ORIGINAL Rev. 5/8/02 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. 35123 Z Date NOVEMBER 2, 2009 Permission is hereby granted to: JAMES & LEILA MCKAY 495 BENNETTS POND LA MATTITUCK,NY 11952 for : CONSTRUCT MASONRY EXTERIOR CHIMNEY ON EXISTING DWELLING. REPLACES EXPIRED BP # 10502 at premises located at County Tax Map No. 473889 Section 113 pursuant to application dated NOVEMBER Building Inspector to expire on MAY 495 BENNETTS POND LA MATTITUCK Block 0013 Lot No. 013 2, 2009 and approved by the 2, 2011. Fee $ 200.00 Authorized Signature ORIGINAL Rev. 5/8/02 /0m~e NO. ~ TOWN OF SOUTHOLD~, BUILDING DEPARTMENT TOWN (:LERK'S OFFICE SOUTHOLD, N~. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 10502 Z Permission is hereby granted to: .... ~..~ ....'.~ .~........~ ..... ..~......~....~..o...~'" ' - '"" ............... . ,o..~~..°..~..r.....~~...~,...~.~.o.~...~..~.~ ........ · .~....~....~~4~.....'. .......... ._._...~ ........... ~ .................. ..' ........... '. .......... at premises 'oca/ted a~...~.~.....~...~....~.....~"~/...~...~..~.....i~..~.~...~..~-v~m~!...~:~ ......... ........... , ....... ~ ................................ ~~~.~ · ~~/~...~.~...~ ............ ~ ........... ~ .......................... Building Inspector. Building Inspector ' 35-13-3 ?~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: ROUGH PLBG. INSULATION FINAL FIRE SAFETY INSPECTION FIELD INSPECT~0N 1. FOUNDATION (Jst) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PR N.Y. STATE ENERGY cope FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 Disapproved a/c ..... ~..~_. ..... ~ (Bfiilding inspector) APPLICATION FOR BUILDING PERMIT Application No..f'~..J.~.· ~ ..... Date ~/~6L J~' .~..., 19 .'7~. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 issue 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 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 buildings for necessary, inspections. //_ _. //~ z--~. . ...... .... f'J (Signature of applicant, or nail(e, if a corporat'o ) ~,~.~..~.~ ~-r.~... ~ ~.~, ..~..~ .~-.~..~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .. .r~...~...~ ................ ax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..... ~../YT:~. ........... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No... ?...'~. · . . . .5..~.q.*).. i. Location of land on which proposed work will be done .................................................. ~q~' ~.~.~.~..e.. ~. ~.../7.~.. ~ ~:...~ .~....-/~..,..-(..,..~...~ ~ ...... : ' '~;,'l~i ........................ House Number Street County Tax Map No. 1000 Section .... l.l. 3.. ......... Block .... ./.7 ........... Lot .... /.~.. ........... Subdivision..-'~~.~. · .~. ............ Filed Map No .............. Lot....~. .......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of prop°sed c°nstructi°n: a. Existing use and occupancy ..... 6.~..~.....~..°5..~..t.l.F..,...~..°-)..?.[(.'.~..J'.---- ............................. b. Intended use and occupancy ..... ~ m .~. . . .~1/ --. .,~.. . . . .~../~'l't~. .~. . .~. .~.. ~,~._ . ............. 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .. ~ .... Repair .............. Removal .............. Demolition .............. Other Work ............... / /~ 15) ~ (Description) 4. Estimated Cost ..... ff. ............................... Fee ..... ./..~-'. ......................... (to be paid on ffling this application) 5. If dwelling, number of dwelling units ............... 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 type of use ..................... 7. Dimensions of existing structures, if any: Front .... .~..-~. ....... Rear ....~..-~.. ...... Depth...~'....-~. ........ Height .....':[-..J~.. ...... Number of Stories ........ .7_.. ............................................. Dimensions of same structure with alterations or additions: Front ... ~,ff.ar..m...~- ..... Rear ..... .?'.'% ..~ .~. ..... Depth ...... ff..°vt?l .~-~- ....... Height ..... ,.,~..~.t.~ .-~ ....... Number of Stories .... .J-..,t..~...~. ......... 8. Dimensions of entire new construction: Front .ad/...5'.,~.q'! .q__.. Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front ..... /'.?...-~. ..... Rear / .~:.._,4~'. ........ Depth .... ..~..~. 10. Date of Purchase .... '~/7../...~/?ff..PPY, ......... Name or Former Owner .... 1 1. Zone or use district in which premfses are situated ........................... , ......................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .... /[/~. ........................ 13. Will lot be regraded .......... . .-77-... ............. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .~.~.~..e.~..~.'-../~..c~.~)~... Address ~4~.~.e. 22..~.~./t~....~.o(.. Phone No..~.~. ~.~:4~'.~./~.... Name of Architect ............................. / Name of Contractor -~..7~21/.~/. (~q .t,.J.~.y..~.' ....... AddressAddress 4Q?.c.,. .................../'~' ,~.d~ .z'~.,t~' PhonePh°ne No.N° ................ .~..P'.'g.~. ......... 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 ..... STATE OF NE.W ~,R,~ IL . COUNTY OF.. · · .~..o.1~7... S.S ........... .~.~.O'L~ ...... .~. .... . . .(r~...~. ~c being duly sworn, deposes (Name of individual signing contract) Y above named. and says that he is the applicant He is the .............. ~.~, ~ .~..(. ................................................................. (Contractor, agent, corporate officer, etc.) of said owner 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 in this application are trne to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this NOTARY PUBLIC, State 0' New Yorg .o. su.o, Term Ex~ires March 30,