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HomeMy WebLinkAbout23004-z h t t ' FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24096 Date DECEMBER 26, 1995 THIS CERTIFIES that the building ADDITION Location of Property 9255 MAIN ROAD MATTITUCK NY House No. Street Hamlet County Tax Map No. 1000 Section 122 Block 6 Lot 19 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 31, 1995 pursuant to which Building Permit No. 23004—Z dated SEPTEMBER 8, 1995 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 AN ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to MURIEL WILSON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N373076 DECEMBER 15, 1995 PLUMBERS CERTIFICATION DATED N/A Pry � 41t. ilding Inspector Rev. 1/81 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 WO4AUTHZED) Date ... ................... ,99 NR 23004 Z Permission is hereby granted to; .... ass /"/ ...:......... ....... ... �. .� .. .. �................. ........`...... .... ..Y......... to ... .�`� - " . ....G ..................... . -............ .. ...... ... . .. ... ..... . ... . ....... ..... ........... .................. .... .. .. ....... ....... ... ..... -177..................................................................... ...................................................................................................................................................I.............. ........................................................................................................I ....... ..... ........................... at premises located at............ �w� ........ G ! . ...................... .......................I.. ...........................C .........lY. - R................................ County Tax Map No. 1000 Section ........ Block.....4................ Loot o. �?.................... pursuant to application dated .................... ...... 19..YJ....... and approved by the Buildinglnspect Fee$. . ............. ....... ... ... . v"�••... Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD z _A BUILDING DEPARTMENT TOWN HALL `!' I 765-1802 DEG 51995 a, APPLICATION FOR.CERTIFICATE OF OCCUPANCY-,-C,,�„";, �..I- A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: t 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) 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 a 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 Buildiniz - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . .��.J�/ . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing Buildin . . .� . . . . . . • . • • • . qq11 /I h Location of Property. . . .I.00:��. . . . . . . . :. . . .�4+�.i.f� . . . .�QG.�. . . . . . . . . . .!' Gr House No./� Street Hamlet Onwer or Owners of Property. . . [�.' .r r.�f. . .�::•�.�S'�•%'• . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. ./ . . . . . .Block. . . .(� . . . . . . . . . .Lot. . . . . .F . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No: 43QQA .z . . .Date Of Permit. �: . . D.x. . . . •Applicant. t �2 t°. Health Dept. Approval. . ./m. . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. ./ 4� . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. .eN�. . . . . Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . ., po,o--W-S U i 3�i� � u 09 LICANT j 1 THE NEW YORK BOARD OF FIRE UNDERWRITERS' .y'` PAGE '"1`. 1000121 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW,:YORK 10038 Date DECEMBER 15,1995 Application No.on file 10808495/95 N 373076 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant mined on the above application number in the premises of LOUISE WILSON, ROUTE 25, MATTITUCK, N.Y. in the following location; ® Basement ®,lRt Fl. ❑ 2nd Ft. Section Block Lot;; isms examined on DECEMBER 16,1995 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT.. A P. 2 7 2 2 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALREC'PTJ TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS OIL H.P. GAS H.P. AMT. NO, A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P.. SYSTEMS AMT. `WATTS SYSTEMS NO. FEET ' SERVICE DISCONNECT NO.OF S E R V I :;,t C` ;,E AMT. AMP, TYPE METER 10 2W 1.0 3W 3 0 3W 3,,,W NO.OF CC.COND. A.W.G. NO.OF HIAEG A.W G. NO.OF NEUTRALS A.W.G. EQUIP. PER O OF CC.COND. OF HIAEG OF NEUTRAL OTHER APPARATUS: PAUL R. BURNS LIC.#3897-E` P.O.BOX 1061 .>f SOUTHOLD, 'NY, 11971-0932 lu:iwwAt3ul i P This certificate must not be altered in any manner] return to the :office of the Board if'incorrect: ,Inspectors may be identified b t it.credentials: ;',• L5 l'7 l5 9 V L5 DEC 2 1 1995 BLDG.DEPT. TOWN OF SOL)Ti-i07-n SFFOJ/rco cOG CA Z Town Hall,53095 Main Road p • Fax (516)765-1823 P. 0. Box 1179 y �� Telephone (516)765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD November 24, 1995 Stanley Fliss Jr. 565 Old Main Road Mattituc,k, NY 11952 , Re: Muriel Wilson - SCTM#1000-122-6-9 Prem: 9255 Main Road, Mattituck NY To Whom This May Concern: We are unable to complete. your Certificate of Occupancy because of the following reasons : xx An application for Certificate of Occupancy is not on file. (Enclosed) xx No Underwriters Certificate on file. xx The check is not on file. $25.00 No Health Department Approval on file. No final inspection has -been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 23004-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. 0-6 M-isox BUILDING DEFT. INSPECTION [ ] FOUNDATION 15T [ I ROUGH PLBG. ( ] FOUNDATION 2ND [ INSULATION [ ] FRAMING ( ] FINAL REMARK8• JCv�� DATE /Dl� INSPECTOR � J 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION (vl"-FRAMING [ ] FINAL REMARKS: r��-m—�e_ r�,G• D/GTE���¢ p� INSPECTOR -3 coy 70-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOyNDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE 8 CHIMNEY REMAF�KS: DATE �� �-' INSPECTO 765.1802 BUILDING DEFT. INSPECTION [UJ OUNDATION 1ST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS:���� DATE � INSPECTOR rIET.ir`^-;'.NSN.CTION REPORT DATE COMMENTS FOUNDATTON ( IST) II itG' FOUNDATION OND)______II -- ------------------ ------------ ROUGH _ _____=ROUcH FRAME s if _ n / — PLUMBINGif I11 All eq I --II1< j4 n li- TNSIII.ATTON PER N_ Y. I if STATE ENERGY CODEif FINAL lII II ----ADDITIONAL COMMENTS: SINtj. t� r r� ro w r _ BOARD ' OF HEALTH . . . . . . . . . FORM NO. 1 3 SETS OF PLAZIS TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . �3 . AUG . . . . . . . . . . . . J 11995 �• �E-���u�lrl�9-y,�a�.�• SEPTIC • . . . . :+'0[Z SOUTHOLD, N.Y. 11971 TEL.: 765-1802 �7�'� CALL ` . . . . . . . . Exaniined �,. . . . , 1 MAIL TO - Approved . . . . . . . . , 1�/ J Permit No Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . �G'• ���fit� l� 6Ui� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . :. . . . . %%�`� — (Building It AP //C FOR BUILDING PERMIT Date . . .�,Y/� . . . . .. 19 . . . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink arid.submitted to the Building Inspector, with 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 stieet, 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 permi 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 of 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 tc admit authorized inspectors on premises and in building for necessary ins ections. � . �,� . . . . . . . . . . . . . . . (Signature of Oicant, or nal;n if a corporation) . Odd . . (Mailing address of applicant) State whether applicant is/ owner, lessee, *agent, architect, engineer; general contractor, electrician, plumber or builder. Name of owner of premises . �GS-�1�� .ls�!.�1�P12. . .W?a . . 0T.Ae.r. .... . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . (as 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. �. .79� j . . . ./.7. ./. . . Plumber's License No. . . 4.12.3.4 - , . . . . . . Electrician's License No. Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . I. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . .9a, s. . . . . . . . . . . . . . �1�,h , . ¢m.. . . . . . :. . . . . . . . . . . . . . . . . . . . . . . .. House Number Street Hamlet I County Tax Map No. 1000 Section . . . . . . . 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 ./.1Si�J►E'�ll t�.:�. . . . . . . . . , , , , , b. Intended use and occupancy . . . . .5�� �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Nature of work (check which applicable): New Building . .. . . . . . . . . Addition . f�- , . . Alteration Repair . . . . . .: . . . . Removal Demolition , • , , , , , , , , , . Other Work . . :. . . . . . . . . . . . (Description) 4. Estimated Coy- . Fee . . . . . . . . . (to be paid on filing-this application) 5. If dwelling,number of dwelling units . .. ..d ��.':�• • .�., Number of dwelling units on each floor . If garage,.number of cars . . . . 6. If business, commercial or mixed occupancy, specify naturf'and extent of-each ypejof use• ' • • • . . • • ructany: 7. Dimensions of existing stures,if an . Fr m o . ''t/ . . . . . . . . . . • �, , , , , Height . . .13.6. . . . . . . . Number of Stories ... ... . �.ef'/�. . :Rear . . .;1.�.. . . . . . Depth . . . .'t7�� . . . . . .'. Dimensions of same structure with ' ' ' ' ' ' ' . .V ¢ I)eptli'. , , G,` alterations- additions: Front . . . . .yQ. . . . , , , , . Rear . . 7Q • . Height .��. , . . . . . . . : Number of Stories . . .CAE , & Dimensions of entire hew construction: Front . . //. /d' . ' ' ' ' • . .Height :/S. `. . . . Rear . . 11 .��;'. . . . . Depth . . .7 . . . . . . . . . . . . . . Number of Stories 9. Size of lot:•Front . < 109.P . . . Rear, , Via '; . . . . . . . . . . . . . . . . . . , . . . . . . . . . . 10. Date of Purchase . . . . . • • • • • • • • • • • Depth . • • • • • • • • • • • • • • • • • • . . . . . Nameof Former Owner 1y1eS. , ..�DSC. .G�11. Zone or use district in which premises are situated .12.. Does proposed construction violatg�any zoning law, ordinance or regulation:• . • . . ,/�®, . ' . . • . ' � . ' 13. Will lot be regraded „(!!,O . Will exce s fill a remov rom premises: ' 'Yes 14. Name of Owner of premises Y`% No p (A J. Gc��l�v i Address .q ��: i�.�. / 4►P . .Phone No. .GZ.�Name of Architect .'. . . . . . . . . .Address _ Name of Contractor Z-5760f /i�.S . •t • Phone No. G • • . . . Address�4Z7, AtPhone No. ;� 2' 15. Is this property within 00 feet of a tidal wetland? *YeS. . . . . . . . No. .X. . . . . . *If yes,- Southold Town Trustees Permit may. -be required. 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-NEW YORK COUNTY OF . . . . ,. S.S • • � �`�•i�• J` �� �• '••• • . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) PP above named. He is the . ... . .cw,IAC C./0 r . . . . . . ... : . (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,.-. `file this and ipplication; 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. ;worn to before me this . . . . . . . . . �~'. . . .day of. . . . r .. ., 191��, lotary Public, . . . . . . !� . , . - ounty HELENE D.HORNS • • .., f:' . . . . . . . . . . . . . . . . . Notary Publio,State of New York . gna (Siture of applicant) No.4961364 PP ) Qualified in Suffolk Coup - Commission Expires May 22,1 2 U d j g d 5 15 tv� � MoN pp'�6p o v � r J r t L � If f AUG 3 scu�,��D y . MAP OF LAND lJ O O F r JAMES 0- 1_OUISE W 1 LSON A-r 4 NIATTITUCK Qf SUFVOLK CouwrT c,N.Y. 0 1 Scale : S0'- I" W L . 60 l3 ti . L N N GuaYghteed to tote Inter-CouH4y Ul Ti+1e Guotrah+q d- Movtgaoje J CorttpmtttuS Ckvtd to tl,e O%me N nl ' Savit,ga 6arlk of B'Cootchl" z �h.toYu J as surveyed Math 17,%9S0 fraw�.hose /t ` '_ - �_kiw, 36 L1ce.rtsed Sy e q ov Gree.tiport , New York NO loo.o PI e Ave. MoH' W. '�---SS6.25 to Facioru� 3T' M � � N � OPA � UNDERWRITERS CERTIFICATE REQUIRED CAL,l'vUVANUV OR AD R. 'NOTED rl U i 11 FUL Up" 1—n 8.*P.- 1 4. FEE:,` NaR FY BUILDING DEP AT UT ERTIFICATE 765-180�_ 9 ANI TO 4, 'FOR-THE • 'If% F 6"C C U 6P A g",4 y FOLLOWING INSPECTIONS: I- FOUNJDATI'OiN - _PVV0 REQUIRED FOR POURED C0flJCR.ETE 2. ROUGH - FRAN UNIG & PLUMBING U. INSULAATION 4- F-I,'IjAL. - CONSTRUCTION MUST' SE COMPLETE FOR C.O. ALL CONSTRUCTION ZHALL .MEET go Al THE REQUIREMENTS OF 'THE XYrr STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR-CONSTRUCTIONP'ERRORS ............... ;zxa Nvs 40 Rm t_6 Y,116 r . \A V Kra s;de n I To Anch rTaco Owl Grade i�F J .2 Rol 71 Ex fsf;n Loom fan k off' shelves Ex i s�'i►'�q Clo 1::7d©oo r /flow C/o. I 0 r ,y ,� �.oc�•se W,`Ismh w AUG PROVIDE OPENINGS FOR EMERGENCY ESCAPE AS REQUIRED BY PART. 714 OF o N.Y. STATE BUILDING COD . i ? X 'yZ I I