HomeMy WebLinkAbout28887-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29085
Date: 11/18/02
T}IIS CERTIFIES that the building ACCESSORY
Location of Property: 12250 SOUAIDVIEW AVE SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 54 Block 7 Lot 8
Sutxtivision Filed Map No. __ Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 6, 2002 pursuant to which
Building Permit No. 28887-Z dated NOVEMBER 6, 2002
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 TWO CAR GARAGE WITH STORAGE ABOVE AS APPLIED FOR.
The certificate is issued to PATRICK T RYAN
of the aforesaid building.
(OWNER)
SIIFFOLK COUI~i~f DEPART~ENT OF
ELEC-x~ICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DA'r~d3
Rev. 1/81
N/A
021017 02/27/02
N/A
Authorize~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. 28887 Z
Date NOVEMBER 6, 2002
Permission is hereby granted to:
PATRICK T RYAN
460 BOOTH RD
SOUTHOLD,NY 11971
for :
CONSTRUCTION OF AN ACCESSORY STORAGE GARAGE IN THE REAR YARD
AS APPLIED FOR THIS PMT REPLACES BP25130Z
at premises located at
County Tax Map No. 473889 Section 054
pursuant to application dated NOVEMBER
Building Inspector to expire on MAY
12250 SOUNDVIEW AVE SOUTHOLD
Block 0007 Lot No. 008
6, 2002 and approved by the
6, 2004.
Fee $ 263.40
Authorized Signature
Rev. 5/8/02
COPY
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. 25130 Z Date AUGUST 25 98
Permission is hereby granted to:
PATRICK T RYAN
460 BOOTH RD
SOUTHOLD~NY 11971
for :
CONSTRUCT AN ACCESSORY STORAGE GARAGE IN THE REAR YARD OF A SINGLE
FAMILY DWELLING.
at premises located at 12250
County Tax Map No. 473889 Section 054
pursuant to application dated JULY
Building Inspector.
SOUNDVIEW AVE SOUTHOLD
Block 0007 Lot No. 008
6 98 and approved by the
Fee $ 125.60
-, 35. O0
Building Inspectoy
ORIGINAL
Rev. 2/19/98
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't-h-e £ollowin :g+-----.~
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 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) hon-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.
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-exist'rog Building - $100.00
3. Copy of Certificate of Occupancy- $25.00
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: ~(o0 /~0~)X ~O{,
House No. Street
Owner or Owners of Property: ~>~,hr, _ O._xc. Ac.. '"'"~,: '~c-
Suffolk County Tax Map No 1000, Section 0 ~ ~
Subdivision
Permit No. '~ ~D ~ cA.'"} '7_Date of Permit.
Health Dept. Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $
Date. i/' iS'ca
(check one),
Hamlet
Block 07
Filed Map.
Applicant:
Underwriters Approval:
Lot
Lot:
Final Certificate: (check one)
Applicant Signature
Electrical Inspectors, Inc.
308 East Meadow Avenue
East Meadow, NY 11554
OFC: (516)794-0400
FAX: (516) 794-5854
WEBSITE www.electricalinspectors.com
E-MAIL in fo@electricalinspectors.com
Mail To: County Electric
William Oster
P.O. Box 12
Northport
NY 11768
LICit: 1005E
Certificate Number: 021017
Code Southold
Inspector 15
ELECTRICAL APPROVA/~ CERTIFICATE
Richard M. Bivone P~i~p F Goehring, Jr.
President ~tChitf Electrical Inspector
I I
?~,~,.,~ rE.. 2~7/02
Patrick Ryan
~ad
/ /
. AND FOUND TO aEjffi C~MpLIANflE ~'IH THE NATIONAL ELECTRICAL CODE.
This is a visual Su~ey in ~ N~ ~ latest edison Chapter 1, Section 1-1, 1-2
Entire Dwelling.
Basemen~ Bathroom, Famil~m, Uving Room.
1st Flor: Bathr~m, Be~Dini~ R~m, Family Room, Foyer, Kitten, Living R~m.
2nd Flor: Ba~r~m,~om~yer.
1-1/2 Car D~.
lhia ,aflifleata ia not valid
E L E C TRI CA L ,4 PP R 0 VA L CE R TIFI CA TE
TOWN OF SOUTHOLD PROPERTY-RECORD CARD
OWNER STREET / ~,'~-- ~ C) VILLAGE DIST. SUB. LOT
FORMER OWNERI'~ .r~.' T I~,./~, N E ACR. J
I
~ ~. ~k~, ~ R~ ~~3 S W TYPE OF BUILDING
RES. ~ ~ ~ S~S. VL . -?,., FARM CO~. CB. MlCS. Mkt. Valu~
~ND IMP. T L DATE R~RKS
Tilla~l~ ~ FRONTAGE ON WATER
W~lond FRONTAGE ON ROAD / ~ / ~ '
~~ DEPTH
f~
House Plot , BULKH~D
Total
II
Extension .
Extensi(J~b~
Breezeway
Foundation
Basement
Ext, Walls
Fire Place
Type Roof
Recreation Room
Both
Floors
Interior Finish
Heat
Rooms 1st Floor
Rooms 2nd Floor
Driveway
inette
LR.
FI.N. B
Garage
Patio
O. B.
Total
Dormer
CERTIFIED TO:
COMMONWEALTH LAND TITLE
INSURANCE COMPANY
TITLE NO.G 628 487 S
EASTERN FEDERAL SAVINGS
AND LOAN ASSOCIATION
MIGNON T. RYAN
Prepared In c;ccordcmce witll .the minimum
standards for title ~urwye m established by
the L. !. ,i~. L. S. and approved a~d adopleJ
l~r ~uc~ use by T~ New York State Land
Tltl, Alsoclaticm,
SURVEY OF PROPERTY
AT SOUTHOLD
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y
I000 - ,054 - O? - 08
SCALE l" ' 30~
dUNE 6 , 1986
NOV. ? , 1986
765-180:)
BUILDING DEPT.
INSPECTION
[ ~FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] FIREPLACE & CHIMNEY
[ ] INSULATION
[ ] FINAL
REMARKS:
DATE
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[~//~FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS. -
/. ~ ,
DATE
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[. ]~OUNDATION 2ND [ ] INSULATION
[/~]' FRAMING [ I FINAL
[ ] FIREPLACE & CHIMNEY
~MAR~
INSPECT~~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ].~JLATION
[ ] FRAMING [ ~ FINAL
[]FIREPLACE&CHIMNEY
REMARKS: ,~~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ]INS~TION
[ ] FRAMING [/__,,],~INAL
[ ] FIREPLACE & CH. IMNEY~
DATE/.~/~~*~ INSPECTOI
-'i~LD i;;S I:£'C~ .....
:OUNDATION ( 1 st)
?OUNDATION
(2nd)
ROUGH FRAME &
.PLUMBING'
INSULATION PER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
FORH NO. I
TO~/N OF SOUTIIOI,D
BUILD1 NG DE P ARTNF.,NT
TOI~N IIALI.
SOUTIIOI,O, fi.'/. 1197 I
Tgi.: 765-1802
BOARD OF HEALTH ...............
3 SETS OF PLANS ...............
SURVEY ........................
CHECK .........................
SEPTIC FORH ...................
INSTRUCTIONS
NOTIFY:
TO: ....................
a. 'ihis application must be conpletely filled in by typewriter or in ink ar~! mdmfitted to the I~dl.ding Inspector w
3 sets of plans, accurate plot plan to scale. Fee according to aci~kd.e.
b. P].oC plan si~o~tn~ location of lot and of buildings on preRisea, relationsidp to adjoining prenises or ixd~lic
streets or areas, and 8ivtng a detailed description of layont of property ~mt be drmm on tim dtsgra~ d~lch is p~rt of
thls appl icatloo.
c. 'Hm vnark covered by this application My not lm c~J,~nenced before issuance of Px~lldlng Permit.
d. Upon apprt~al of th[s appl. lcatio~, the Building Inspector will~ issue a Ptailding Permit to tl~ applicant.
permit shall be.kept on the pr~dses availabl~ for inspection thrcn~aut tl~ ~ork.
e. No building slmll be oecupled or used in wl~l~ or in part for any purpose ~dmtever until a Certificate of
Occupancy shall Imve been /~rm,ted by rim lhdiding Inspector.
AFPLICATICIq IS IEI~J~Y ~ to tim lt:ilding Department for the issuance of a Building Permit purstmnt to tim
Ikdlding Zone Ordinance of the To~n of Sca~thold, Suffolk County, ~ York, and otl~r applicable Iai, ts, Ordismnees or
Regulations, for the eonstroetion of hdldings, additions or alterations, or for re.oval or demolition, es herein
described. 'ltm applicant a&Tc-~a to coigly with all applicable laus, ordinances, building ec4e, housing code, srd
regulatlons,~m~l to admit authorized inspectors o. pceu,lses and i~aqi..ldlng for necessary inspections.
·. ,'~..D~....c.~.'..~ ,~..xe.~,e...: .....................
(Signature of applicant, or na~e, if s corlx~ratlou)
(Hailing address of applicant)
State ~lmtJmr applicant is ~.n~.r, lessee, agent, architect, engineer, general contractor, electrician, ph~nber or I~dhl
~.,~ of o~er of ~ises .'..--~.....~m-'-.X.... .... .....:---- ..~....~.~m ..........................................................
(aa on tim tax roll or latest deed)
If applicsnt is a corporation, signature of duly surly)tirol officer.
and title of corporate officer)
l~filders l,icense No ..........................
Plumbers Licenae 1% ..........................
Electricians License No ..... ~. ...............
Otl~r Trade'a License No .....................
I. location of land on ddd~ proposed ~ork will be. ,t-~;~, ~ L
.....................................
Ilause l~ber Street limtlet
County Tax ~p ~. I~ Mtim . ~.~ ......... Bl.~k
~ivisi~ ...................................... Fil.~ ~p ~ ......... ~, ..... l~t ...............
(~)
2. State existi~ u~ ~ ~ of ~i~s ~ inte~
<~) ~ ~: ~ I ........
a. FMsti~ t~ aM ~y ........ ~..;... ~ .................................
~ ~ ~ , : ......................
b. lnte~ u~ ~ <~ ............................... ;... ...................
~',t,,'e o~ ~ork (d~eck diich applied_hie)'- I~ Building .... '.{~.... Addition .;.~
licpair ............ lksuoval ............. Ik~,~lirlon .. ........... Ori~er gork
Esti,,~,ted Cost ~.~~.~....~.. ...... fee .......................
(to be paid o~l filing
If ~kaellil~, ixmi~r of d~elllng traits............/ li,d~er of. (Lelling Lairs (x~
If garsL~e, tired)er of cars ...... ~.~'~ .............................
if. Ixmioess, o~mmrcial or mixed'occupancy, specify ~Cure m~ ~Cent of ead~ type of u~ ......................
I~i~,c ..... <~ .............. ~,,i~r of Stories ......................
I)inenai~m of ~m aCne,re ~lth alterations or amities: Fr~C ~..~ ~ ...... ~ar . :~.'. ~-~ ....
I~pth .................... l~{~lc .................... Kml~r o~ Stories ...............
.~/..7~...
..... I~ar .. ~;-. ....
fi. I)iuenal~ of enti~5, ~ ~t~tt~: ~ont ...........
' ' ~ of Stories*. ....................
,k,~,c ......... ~.~ .......... Rider
,o. .... D ........
,~.~,,~ ,,e n,,~,,~ .. X~.$.~ .......... ~, oe ~,o,,,,~ ~ ~%~:...~,k~.n. ~ .......
I I. ~ or u~ di8trict In ~{tdl pr~l~n ~ ,t~t~ . :~ ES. ~.~.~~ ..... ~:.~.~. ...................
12. ~n pro~{ ~mt~ti~ violate nny ~ing i~, ordi~me or regularly: ..... ~. ..............
I]{. Ui{l lot Im r~r~ .................... ~ill ~eaa fill Im r~
· ,~e of C~tr~tor ................................... ~ren$ ............................... I~ ~ ...............
15. ls this p~rty uithin ~ f~t. ofa riehl ztl~{ ~ ~ .......... [~ ..~ .......
PI.OT DIAGRAH-
l~cate clearly and distinctly all buildings, ~lmtlmr existing or proootmd, and indicate aTT act-back dir~ensions
property lines. Give street ami blnck md)er or description according to al:cd, an~l.sl~ ~atreet rimes arxl indicate
~dmtlmr interior or corner lot ............ ¢, /LP~/, O
S'I'^'Iir, 01: M'.'~
(XIJNIX (X: .......................
(N,',~e of. i,~lividtml signing ecmtract)
~rn, depo~,e~ taxi ~y, tlmt lie i~ the 8ppl. icJ,~t
Ue is tile ...................................................................................................
(Cxmtractor, ngent; corporate officer, etc.)
(il: said (~nx~r or ~rs, nfzl is ~ly mLl~rJ~ to i~rfonn or ht~e perforn~ the ~tcl ~rk m~ to nnke ami file thi~
nlq)l icati(nG that all 8Catemnta ~tal~ in this nlq)licatlon are t~ to U~e l~8t of his h~l~e and tmliefi t. xl
thnL tl~e ~rk ~ill I~ ~rfon~l in tim u~mner ~C forth in the appl. icati~ fil~ tler~tfll.
~ to,fore ~ Uda
~ ~,, 7//11~/~ , (Siipmt:m'e of Al~dicsnt)
/ /~