HomeMy WebLinkAbout16866-Z Town of Southold Annex 9/5/2013
~ P.O. Box 1179
54375 Main Road
p Southold, New York 11971
f
A~
CERTIFICATE OF OCCUPANCY
No: 36488 Date: 9/5/2013
THIS CERTIFIES that the building ADDITION/ALTERATION
Location of Property: 1055 Stanley Rd, Mattituck,
SCTM 473889 Sec/Block/Lot: 106.-8-54.4
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this ofliced dated
3/28/1988 pursuant to which Building Permit No. 16866 dated 3/30/1988
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:
Qaraee addition to an existine one family dwelline as applied for.
The certificate is issued to Phillips, Peter
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 16866 8/27/88
PLUMBERS CERTIFICATION DATED
- - - -
Autho Si ature
POEM NO. f
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)
NO 16 tJ U lJ Z Date ...~~C:l~!...~?:`.~' 19~. b
Permission is hereby granted to: ,
at premises located at . `..5.....~.!?::~.4~CT.~'~r..~~~...5/~-
County Tax Map No. 1000 Section .....~.0.~ Block ......Q~......... Lot No..~~.~:.~~
pursuant to application doted ....~~~..a.g...•...~......, 19g.g., and approved by the
Building~~I
jn~~spector.
F/e~e~ 5...+r?!1...'...
~TM.i~. 3~3~~44
w,i?, 3uaLa. ~
Building Inspector
Rev. 6/30/80
Form No. 6
TOWN 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 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 Apri19, 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. [f 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 $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00,
Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, 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.
New Construction: Old or Pre-existing Building: (check one)
Location of Property: ~ ~ S S~ ~ j ~ N L r`. p , ~ A 7 7 / 'rliG t%
House No. Street /,fin/ ~p Hamlet`
Owner or Owners of Property: ~ U /1 ~ L L / 1 -S,
Suffolk Count Tax Ma No 1000, Section ~ ~ t/'
Y P /~(p Block ~~Lot
Subdivision Filed Map. Lot:
Permit No. 1Q ~j _ Date of Permit. ~ Z3 /3 Applicant:_ Gr7 ~ r( H / L c, I ~-f
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: ? (check o e)
Fee Submitted: $
Ap 'c t Signat
~pF SOpjy .
~o~ ono
Town HaII Annex Telephone (631) 765-1802
54375 Main Road ~ ~ Fax (631) 765-9502
P.o. eox u~9 e rogecrichert(a)town.southold.nY.us
Southold, NY 11971-0959 ~
~1y00UNT'1 N~
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Peter Phillips
Address: 165 Dogwood Ln City: Mattituck St: NY Zip: 11952
Building Permit 16866 Section: 1 ~6 Block: 8 Lot: 54.4
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
contractor: DBA: All Voltage Electric License No: 4626-me
SITE DETAILS
Otfice Use Only
Residential X Indoor X Basement Service Only
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage X
INVENTORY
Service 1 ph Heat Duplec Recpt 7 Ceiling Fixtures 1 HID Fixtures
Service 3 ph Hot Water GFCI Recpt 4 Wall Fixtures 2 Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel 1-60 A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks
Disconnect Switches 3 Twist Lock Exit Fixtures TVSS
other Equipment: garage addition
Noles:
Inspector Signature: Date: Aug 27 2013
81-Cert Electrical Compliance Form.xls
_
~~-laos /o-ir
BUILDINQ DEPT.
INSPECTION
[ ]FOUNDATION is?' [ ] IIOUAN P'L~i. `
[ ]FOUNDATION 2Np [ ] IN:ULATNMI
[ ] FwAMINO [L]'f'~ML
REMMIK:s
DATE l ~ l3 a INfP'EC't~OR
,...4,
o~~,OF SUUTy~
t~~
l
TOWN OF SOUTNOLD BUILDING DEPT.
765.1802
1 NSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING /STRAPPING [ ]FINAL
[ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION
[ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION
[ ]ELECTRICAL (ROUGH) ~J-fLECTRICAL (FINAL)
REMARKS:
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DATE z7 ~ 3 INSPECTOR
c'lc:!_D ;i'~C;iU:I ~~Ui,:c ~ ~CMMENT°
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FOUNDATIOIJ (2nd) _ m~~
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STATE ENERGY
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'I '.1?'PS f1F PLAN:; .
FoIiM NU.t SURVEY
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FORM
TOWN HALL NOTTPY
;OUTHOLD, N.Y. 11971 CALL
fit/, TEL.: 765-1802 MAIL T0:
EXalllllled ••~.I•w`•"-"• •`3'~~• 19~~
~ ~r-i L~ 1 llrl 1 r
Cltic Qn..c~°.., 19 ~~e Permit No. ~ ~ (O ~ ``'',s--=-
Approved .
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Disapproved a/c • • Ib~`\ ~ M~ 2 8
~~~JJJ
~ ``U` BLDG.DEPT•
n TOWN OF SOl1TF1oLD
~?•a, .
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date 19 .
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 pazt for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Depaztment 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 building for necessary inspections.
(Si nature of
appl~ , ' a•corporation)
/ (Mailing address of applicant)
~SdoitiA~ /\/.f~ ///06
State whether applicant is owner, lessee, agent, azchitect, engineer, general contrace`tor, electrician, plumber or builder.
Name of owner of premises .E~~"lL .l! ~/~'l .
(as on the~tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED
Builder's License No . .
Plumber's License No . .
Electrician's License No . .
Other Trade's License No . .
l . Location of land on which proposed /wlork will be done . .
House Number ~ Street Hamlet
County 'l'ax Map No. 1000 Section Block a8 Lot,f . //f1~~dS .
n /
Subdivision . !14'4<<-f.... tG~.Z-..... Filed Map No . Lots ,31a!q^+'D~7.... .
(Name)
2. Slate existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy
Intgeded use and occupancy ...l.°?~ `S'tCDn/~ Ai2A E Dfl~~~v,?, l~ ;E.~~Jd~it/~.0~~
, • !~'I , , ,
3. Nature of work (check which applicable): New Building Addition Alteration .
Repair Removal , Demolition ..............Other 1Vork .
(Description)
4. Estimated Cost ~Si'i'DO Fee .
(to be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on each floor .
If garage, number of cars CA?
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .
7. Dimensions of existing structures, if any: Front ~`r~~ Rear . !r9~~ Depth .cam v!~? .
Height /.S?4'2 . Number of Stories .
Dimensions o ame structure with alterations or additions: Front . l`G. 8 Rear . J.~~........... .
Depth ..029.??:~............ Height .f9~?7- Number of Stories .
8. Dimensions of entire new construction: Front Rear ~ Depth L z.'
Height /S~a..t Number o Stories / ~ .
9. Size of lot: Frorft ./A«.E Rear .~~~~!~ad! f~~........ Depth . z°rl - .
] 0. Date of Purchase ~ Z .....................Name of Forner Owner .
11. Zone or use district in which premises aresi[uated...~~'"~.'g~~'•r.•••••••••~~••••••~•••••••••••••••••••
12. Does proposed construction violate any zoning law, ordinance or regulation: . !Y0 .
13. Will lot be regraded . PNy !N!~..~Q of Ea'C 1Vi11 excess till be removed from premises: Yes C to
L~i~ ../~i
lli Address 3G -!`9 7~~ L ~ .rL~
14. Name of Owner of premises . Phone No..... 93....T
Name of Architect . ~?Eit'!'~}~~!~''".!SF?! ~ Address ..~~0.!y!~:.~ ....Phone No .
Name of Contractor ..........................Address ....:..............Phone No............... .
15. Is this property located within 300 feet of a tigidal wetland? *Yes No ,X...
*If yes, Southold Town Trustees PermitPLO~DIAGKAMed.
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.
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STATE OF NEW /YORK, S.S
?~E~F?~~ ~~~~~~~`l.? being duly sworn, deposes and says that he is the applicant
~ (Name MI indivi ual signing contract)
IbOVL' nam0d. ~
ie is the ~/?~iINL rr2~Os./~yfili .
(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
application; that all statements contained in this application are true to the best of his knowledge and belief; and that the
.vork will be performed in the manner set forth in the application filed therewith.
iworn to before/me this '
~'Y ...day of . P 19d'.~
,,l
~ G/~i!..... County ,
Jotary Pu ~
EUGENIO COLAdTO .
Notary Public, Stste of Naw Yak ature of applicant) •
No. X7.4708030
Guelffied in Oiwene my
Canmiesicn Expires J 3//P~
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OF SOUTHOtD PROPERTY RECORD CARD
-cow-a-s-
31NNER STREET y Jrj VILLAGE DIST.' $UB. LOT?. ~_3~'~~~d,%l
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RMfRI' dNY~~(' IP[ { F N E AGR.~ I . Z {
S W TYPE OF BUILDING
n ~ C'a Y
~ SEAS. VL !FARM COMM.. CB. MICS. h1kt. Value
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LAND lMP. TOTAL DATE REMARKS
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t ' ~ . .~r ~ C ` ~O - ~ '-tbn QCfc~; o ~C ~S d~ v
1 7 00 Op 8 DQ ' /3 2. c~z - ~ e . { `q `4\
~ I z-LfZ~fZ tt5-~hit~i 5 to i~~ sic,
~~(f ,z-!_)Z71Z P(I~-Phll,~s~ f~~}i;tir~s NJc.1
able ~ FRONTAGE ON WATER ~ ! { 2 ~ ~ Z'7) Z ~ iY-Phl ~ t ! dls ~ I I~ ~1 QS ~ J~-'
adlarwd FRONTAGE ON ROAD
odawlend DEPTH
+u Plot 1 acve +6~ i6o BULKHEAD
ov i of
~I ~ cos ~1i~
3/22/88
Dear Mr. Lessard:
Enclosed find building permit for second garage at my home on
165 Dogwood La. in Mattituck. Tax map number 1000-106-08-lland25
I am waiting for George Fisher from Penny Lumber to complete the
drawings for me. He will bring them in the first part of next
week. I would like to start the foundation as soon as possible
as well as the construction.
Thank you,
Peter H. Phillips
INSPECCORS pFFO(
(516) 765-1802 ~Q$ ~C
VICTORLESSARD,Principal h~~ 4Gy SCOTCL.HARRIS,Supervieor
CURTIS NORTON, Senior = J2 Southold Town Hall
VINCENT R. WIECZOREK, Ordinance y P.O. Box 1179, 53095 Main Road
ROBERT FISHER, Aasistant Fire v, Southold, New York 11971
Building Inspectors G • Fax (516) 765-1823
THOMAS FISHER y~If01 ~ ~a0`' Telephone (516) 765-1800
GARY FISH
OFFICE OF BUILDING RVSFECTOR
TOWN OF SOUTEIOLD
November 1, 1990
Peter & Hella Phillips
A. Star Realty
36-19 Broadway
Astoria, N.Y. 11106
Re: BP16866Z addition to dwelling (2nd garage)
date: 3/30/88
Dear Mr. & Mrs. Phillips:
I am writing to you regarding the above permit which has
expired. You have never called for any inspections and you
have not gotten a Certificate of Occupancy.
Please contact our office to resolve this matter. If you
have not completed the work a new permit will be necessary.
Yours truly,
i / /
~~~x, /J~ 0-~-
Secretary
~~~pF SOpjyolo
Town Hall Annex Telephone (631) 765-1802
54375 Main Road ~ ~ Fax (631) 765-9502
P.O. Box 1179 ~
Southold, NY 1 1 97 1-0959 ~
~~'Y~OUNTI
BU1LD[NG DEPARTMENT
TOWN OF SOUTHOLD
May 24, 2013
Peter Phillips
6 North Dr
Malba, NY 11357
RE: 10ss Stanley Rd, Mattituck
TO WHOM IT MAY CONCERN:
The Fo/ll~owing Items (if Checked) Are Needed To Complete Your Certificate of Occupancy:
v Application for Certificate of Occupancy. (Enclosed)
lectrical Underwriters Certificate. (Contact your electrician)
A fee of $50.00.
Final Health Department Approval.
Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84)
Trustees Certificate of Compliance. (rows trustees # ass-lssz)
Final Planning Board Approval. (Planning # ~s5-~s3s)
Final Fire Inspection from Fire Marshall.
Final Landmark Preservation approval.
Final inspection by Building Dept
BUILDING PERMIT: 16866 -Garage Addition
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APPkIGATlO F ELECTRIC L INS
- REQUESTED BY: ~QM
4
Company Name: I v~ SAC. ~ ~ ' . ~
Name:
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License No.: a ~
dress: ~ t.4-
' Phone No.: I
JOBSITE ENFORIVIATION: (*Indicates required information)
*Name: QN ~1,1 ~S
"Address: V-1`iTl IZ.t ~ ~i'S ~
*Cross Street; L~ b .~.y~ _
`Phone No.: _ ~ ~ -a
Permit No.: ~
Tax-Map District: 1000 ction: Block; t,pt;
*BRIEF DESCRIPTION OF WORK (Please F~rint pearly)
~ f3UlL~ I~Y~~"G'h~N FD2 ~SA(Z~S ~SVO ~a~
n
(Please Circle All That Apply)
*Is job ready for inspection: ®Np - Rough In Fina~
*Do you need a Temp Certificate: YES / ND~ -
Temp Information (If needed)
*Service Size: 1 Phase 3Phsse 100 150 200 300 350 400 Other
*NeW Service: Re-connecF Ur~#arground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
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(!4611)- DENOTES FILED MAP LOT NUMBERS.
DURVCY NOTlt:
1. VNAUTNORMlO ALTlMTM1N glA00RMN TOTMl IURVlY h A VWLATION OP tlCTNN TN/ q TH! N!W TORK /TAT!lOVCATION IAW. CWMD OF
THI! aURVlT MI1P NOT NU1RaMi TM! fURVlYdI'a NNlp OR lMtMaW NAL lINLL NOT t! COWNMJ<W TO a! A VALMf TRU! COW. ClRTFIGTKNt
INOICATEO N!RlON WALL RVN dLY TOTN! F11V10WPl111pNt PM WHOM TM /VI1VlY I! PIIlFAKO, ANOON NItMlRRNNR t[NALF TOTN! TRLE
COMPANY, OOVlWMlNTAL A0lNCY, ANO LWNNO N/1DUTIW WTlD N!RlON. ClRTMgATgNa AR! NOT TMNaFlMML! M ADORNINAL
IN]TFNTION! OR aU!!!W WT OWNIIU.
3. TNIt tURVIY N 1D0.1[DT TO MY MtIMIM OF RlCg1O AtW OINIR VIRTINIM FACTa WMICX AM MaTMCT OF TDL! MN1M NtDLOIG
I.OFFtlT/ WOWN N!RlON AR! FMA tP[CMN: NIROI! MO aNO11L0 MOT 0! UllD Al A MMl FOR COXITIIVCTIOH OF FEXC[! OR OTN[R
1TRUCTURlt.
4. sualuRrACe sTRIwTUlet AxwaR uTRmn, M ANY. Nor aNOVN.
0. N[OOE AND FWC! OIgR! 1NOWN M! TO ClNf[RLN! UNLltt OlNlRWIIF NOTlO.
I ClRTIW TIUT TNM M11F RlPRl1lNTt M ACCUMT! MO TRU! ACCWM OR A tURVlY, PlRFOIIM[D M TN! FIELD UNOW MY lUPlRVMNN ON
NM01], R TX! LMDTNtRlM PARTKULMLY 0!lgMm.
TN! RlCORD O[tCRMTpN p TII! /WlCT PRMlRTYPpIMt A MATNdATNUUlY tt01lD F1OVR6. TXM DURVEY WAt FRWARlD M ACCOROANC!
wrtx TNCdIIMWTCOOl OF PRACDCe FQII LAND WRVCYORa ADOPTeD SY TNe xewraRK STATe AtaocMTwx oP PRO[elIIDNAL UNO SUFFOLK COUNTYDIST. 1000
BURVlYORI.
T. EASON LAND SUKVEYOK SEC. 106 BLK 8 LOT 54.004
• SSOS NESCONSET HIGHWAY, SUTCE 236, MT SINAI, NEW YORK 11766 DATE: 4 30 13 SCALE: 1"=40'
.Artr•~~.
' : ~ Plmae (631)474-2200 /Fax (631) 899-9085 email TEASONLS@OPTONLINE.NET PRO E EA13-135
. BOUNDARYSURVEY ~ ~ y
SUBVEYFOR• PETER PHILLIPS ~
,~~~~~N[ A ~4''~~~~A,~
MAP OF.• SUNSET KNOLLS, SEC110N 2
j' Fib' S
LOCATION.• MATTITUCK, TOWN OF SOUTHOLD, NY f _ . ,r ~
CEKTIFIED T0: PETER PHILLIPS °
N° 0
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