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Home My WebLink About23021-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24387 Date MAY 29, 1996 THIS CERTIFIES that the building ALTERATION Location of Property 4605 WICKHAM AVENUE MATTITUCK NY House No. Street Hamlet County Tax Map No. 1000 Section 107 Block 4 Lot 9.7 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 11, 1995 pursuant to which Building Permit No. 23021—Z dated SEPTEMBER 22, 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 ALTER AND CONVERT AN EXISTING GARAGE TO A MASSAGE THERAPY ROOM (HOME OCCUPATION). The certificate is issued to DANETTE & CHRISTOPHER KELLY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N385293 MAY 7, 1996 PLUMBERS CERTIFICATION DATED N/A d' g 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 WORK AUTHORIZED) NP230211 Date................... . ........................ Permission Is hereby grante to; N�.. ........... ../ .........;....................... ........... ..me?. .......��,�s................. A41fiiJ.?-tom...... � � / �.... to ....61'47a-A........... i�...........W 1�-- ............. ....... /- > ....... ...( ��......... .........A........... l Assam c �..... !� .........� .. ..:-.... [� ...A...Y..:...Y.�T.........�....(Z-t .T..ti ..� .0............................................................................................ .................................................................................................................................................................. ............................................................................ at premises located at......... �. .............�� 1 ....�✓ rsi ................................................................ ......................;..................................... County Tax Map No. 1000 Section ./Q.;?............ Block... ............. Lot No. ........./.....7...... � 1J Q 12.'4 � pursuant to application dated ....... ..'......// , 19....,(�.J...., and approved by the Building Inspector. �f r� Fee $......................... ................... .. .. ....rui ............................ ing Inspector Rev. 6/30/80 -orm No. b * TON 0= SOUTHOLD BUILDING DE?ARTIIENT TOWN HALL 7b5-1802 :LaPLIC�zTION FOR CERTIFICATE OF OCCUPANC ' A. This ai)ulication must be filled in by cVpeWrlter, OR ink and sL'bmit,ed to t`e building inspector with the following: =or new building Or new use: 1 . Final survey Of property with accurate location of all build-nay, property lines, Streets, and unusual natural Or topographic features. ' _. Final ADDrovai from Health^. Dent:. of Water supply and sewerage-disDosal(S-c form) . j. Approval Of electrical installation from Board of Fire underwriters. 4. Swot. statement from plumber certii inj that the Solder used in system contains less than 2/11-0 of ly; lead. 5. Commercial building, industrial 'building, multiple residences and similar buildings and installations, a Certificate of Code Compliance from architect. Or engineer I responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. 8. ^or existina buildings (Dr'or to April 9, 1957) non-conform,ina uses, Or buildings and t'Dre-existin2tt land uses: 1 . Accurate surveyof property showing all property lines, Streets, building and unusual natural or copographic -eatures. 2. A properly completed application and a consent to inspect signed by the aDD licant. -f a Certificate of Occupancy is denied, the Buildina inSDeC70r SLiall Stale the reasons therefor in w-ritinz to the applicant. .. Hoes 1 . Certificate of Occupancy - New dwelling S25.00, Additions to dwelling $20 .00 , ,iterations to dwelling $25.00, Swimming pool S25.00, Accessory building 525.00, Additions to accessory building S. 25.00. Businesses W50.00. =. Certif icate 0f Occupancy On Pre-e_Yisting Buiidin-_ - S1OO.00 S. CoDv o_ Certificate of Occupancy - _25c. A updated Certificate of Occupancy - $50.00 J. Temporary Certificate of Occupancy - Residential S10.00, (Commercial S15.00 - I 311( Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .sew Construction. . . . . . . . . Old Or Pre-existing Building. .. . . _ . . .ocation Or Propertv. . .4(` . . . ��". :: v . .:".VOA .. . . . . . t.'J �y dA�l�/:. . . . . . . . . . . . . . ?louse No. Street Hamlet )nwer or Owners of Property. . .` ...� '.. . .°. . . . .d . . �{ 1kY�1V . . . . .l l�� ,ounty Tax Map No . 1000, Section. . . P� . . . . .Block. . . .�' . . . . . . . . .Lot. . . . .1r. . . . . . . . . . . . . . . . �ubdiv'si0n. . . . . . . . . . . . . . . . . . . . . . . . .I. . . . . . . fled Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . ?ermit NO.��3Q \. .Date O- Permit. App"j 4 C anz. . . . -tealtn Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Under"writers Approval. -;W4 . . . . . . . . . . . Tannins Board ADprova.. . . . . . . . . . . . . . . . . . . . . . . . ;ad t ueS for: Teirm orary Cart'=icata. . . . . . . . . . . -'real Certicate. . . . . . . . . . . �.�-ee Submitted: S . . . . � `00�-..,�. . . . . . PAC J13�L0 . . . . . . . . . . . . . . cc �a�-�� pDT lC �: Form No. 6 TOWN OF SOUTHOLD BUILDING DCPARTMLNT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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: 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. �. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1.7 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 stall 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 Buildine — $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 -t15.00 Date . . . . . . . . . .�. .+� . . . . . . . . . . . . . . . . . . New Construction. . . . . . .. . . . Old Or Pre—existing Building. . .'I:/ Location of Property• . -14 kcQ.15. . . . .u.D.Lc"KVICk;M. . . . . . .ftA.'. House No. Street hamlet Onwer or Owners of Property . . . - •)• • ounty Tax Map No 1000, Section . . . . 1. . . . . . BI(.)CIf . . . . , . . . . . . . .Lot. . . .99 .(. 5ubdivisi.on. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FjI.cd Mop . . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . .. . ;Permit No. . . . . . . . . . . . . . . .Date Of Permit . . . . . . . . . . . . . . . .App.lic:tnt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1\,ilealLh DepL. Approval . . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval . . . . . . . . . . . . . . . . . . . . . . . . . �) '1anning Board Apnrovnl. . . . . . . . . . . . . . . . . . . . . . . .. request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . ,��. . . b0 -ee Submitted : $ . ... .5... . . . . . . . . . . . . . . . . . . . . OEM "THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1195204 BUREAU OF ELECTRICITY F 85 JOHN STREET, NEW YORK, NY 10038 Date MAY 07,1996 Application No.on file 11621496/96 N 385293 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of MR.& MRS. IMLg Y, 4 605 6dIMIAM AVENUE, MATTITUCK, N.Y. in the following location; ❑ Basement ® Ist Ft. ❑ 2nd Fl. OUT Section Block Lot was examined on MAY 02,1996 and found to be in compliance with the-N, tonal Electrical Code. ;c FIXTURE FIXTURES RANGES COOKINGI)ECKS OVENS IDISHWASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENT1 FLUORESCENT OTHER AMT. K.W. AMT,`' K.W. AMT. K.W. AMT. K.W. AMT. H.P. 3 6 4 3 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. :AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. N SYSTEMS O.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP. TYPE METER 1.0 TW 1.03W 3.0 3W 30 IW NO.OF CC.COND. A.W.G. NO.OF HIAEG A.W G. NO.OF NEUTRALS A. EQUIP. PER Ar OF CC.COND. OF HIAEG OF NEUTRAL OTHER APPARATUS: Ij ITH F. scHUHnNrd, 1I . LIc. 301-I+J LL PO BOX 422 CUTCHOGUE, NY, 11935 GENERAL MANAGER Per This certificate must note be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. ii COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT 'BE'.AL'TERED IN ANY MANNER. o��g�FFO(,�cOG y Z Town Hall,53095 Main Road p • Fax (516)765-1823 P. O. Box 1179 A Telephone(516) 765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD May 8, , 1996 Ms . Dannette Kelly 4605 Wickham Avenue Mattituck, NY 11952 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 # 23021-Z Please contact our office on this matter. Thank you. for cooperation. SOUTHOLD TOWN BUILDING DEPT. 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ j INSULATION [ �RAMING [ ] FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS: %` C2G DATE � � � INSPECTOR 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] RQI�GH PLBG. [ ] FOUNDATION 2ND INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS:, DATE � / ! � INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS N FOUNDATTOM ( IS-T) FOUNDATION (ZND) ROUGH FRAMP, b -----.11 -- - Z PLUMBING I . INSULATION PER N. T. STATE ENERGY cony; II II- I II I II FINAL II - ADUITIONAL COMIENTS: O a BOARD OF WEALTH . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . _ . _ . . . . . . . . TOWN HALL SEPTIC FORN _ . _ . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 NOT 1 FY 1� CALL . . . _ . . . . . . . . . . . . Examined . . . . . . l d- . . . 19 ./. � tIA I L T 0 . Approved . . . . . . . :(/� . . ., 19 ( ermit No a✓��r ,r! . . . . . . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . W. ,•� . . .� . . . . : . . �. . . . . . L5_ l9 1'1 R ! ilding Inspector). . . . . . . I U APPLICATION FOR BUILDING PERMIT SEP ,,J' % 9 - 10 Date . . . . . . . . . . . . ., 19 BLOG.DEPT. !� TOWN OF SOUTHOL.D INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and 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 street 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 Occupanc} 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 othier'applicable, Laws, Ordinances o; '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 inspect' (Signature of applicant, or name, i corporation) L five— (Mailing address of applicant) State whether applicant is owner, lessee, 'agent, architect, engineer, general contractor, electrician, plumber or builder. O C fir' "lIY7. . . . . . . . . . . . . . . . . . . . . . . ... . . Name of owner of premisesQc��:VzL . . .- (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. Plumber's License No. . . . . . ... . . . . . . . . . . . . ... . . . Electrician's License No. Other Trade's License No. . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . . . .L' J , , , , � � ' t. ►'J�! �r . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . .. . . . . . . . House Number Street Hamlet 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 . V . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... b. Intended use and occupancy -3. Nature of work (check which applicable): New Building . .. . . ... . . . .. Addition . . . . . . . . . . Alteration V Repair . . . . . . . . . . . . . . Removal . . . • Demolition • • . , , , , . . • Other Work . . . . . . . . . . . . . . . (Description) 4. Estimated Cost . . . . . . . . . . .... . . . . . . . . . . . . . . . . . Fee . . .'}d .��• �. . : . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) S. If dwelling, number of dwelling units . • . • . . . . . Number of dwelling units on each floor . . If garage, number of cars . . . . . . . I 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 . . . . . . . . . . . . . . . Number of Stories . . . . . . .1 Dimensions of same structure with alterations or additions: Front Rear Depth . . . . . . Height . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . Rear Depth Height . . . Number of Stories . • " " „ " " 9. Size of lot: Front . . . . y Rear. . . . . . . . . . .. . . . . . . , . .bg ' ' :.e' ,� . 10. Date of Purchase . . . . . i.'.g�. . . . . . . . . . . . . . . ... . . . . . . . Depth' ' . . Name of Former Owner . (Z4lQr1l;_ 71t_c)tW1�1, 11. Zone or use district in which premises are situated , .12. Does proposed.construction violate any zoning law, ordinance or regulation: `' 13. Will 1 regraded . . . . .�• . . . . . . . . . . . . ... . . . . . . . . .!: . . of be . . . . . . . . . . . . . . . . . . . Will excess fill be removed from remises-' - .,- � a; 14. Name of Owner of premises . . . . . . . . . . . . . . . p ,,,,V .,�:+;i:Yes No Address . . . . . . Phone NiI.%-''s,� ri}, ;!:4�,' Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . Phone N Name of Contractor . Address . Phone Noo.. 15. Is this property within 300 feet of a tidal wetland? * ' • " " " " " *If yes, - Southold Town Trustees Permit ma be required. . No. . . . . . . . . PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing Ior 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. APPROVED AS NOTEED��, , � DATE: �L B.P.# FEI � '✓ BY: NOTIFY BUILDING DEPARTMENT AT ` 765-1802 9 AM TO 4 PM-FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS' OF THE N.Y. STATE CONSTRUCTION & :ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION. ERRORS 'TATE OF NEW YORK, :OUNTY OF . . . . . . . . .\ S.S ' � 1 ��• • . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) .hove named. le is the . . . . . . . . . . . . . . . . . . VJ1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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 pplication; that all statements contained in this application are true to the best of his knowledge and belief;and that the ,ork will be performed in the manner set forth in the application filed therewith. worn to before me this . . . . . . . l/. lc. . . . . . . . . .day of. � 'l -e . ., 19 . 'otary Public, . . . . . . . . • , , • • . . • County �4 g - • • • • • . . . • • • . LINDA J.COOPER . . . . . . Notary Public,State of New York ignat re of applicant) No.4822563;Suffolk County Term Expires December 31,1 ice•'. . _ ',!. - ', -..��... � r, -G.�r.•`:l'.-�-•-�•%�"��_---�^.:--:�ti-�.='�°�M t� i-�.i-.:.e"RwweF!+�!a!t-�..",�tr-..ri:-...M--.:ti:a.-.:..r,Ual'.e^..•:�'.�:":.i:,4v�+,-.rr: � �. _ .. ' h�l IN . V'`.> I • I 5 - $ i toaj .si . t - t ,.. r .. ' 'c 1. f _ :i. ) dry.,, .. . 'f _ J .1 ; i_. - 1 .1 ) r LS r i _. 'Sk t $ ` Y _ - % . f _ • ) i .. if •, i ' F s�+I - . .-�.. �I,;. , . . , , � � ,� . I 1, �. � ..,,., I/ � I.- ,I,, . ..,,,, ", : : 7 m,.�-.�:-I . .s. '»o � ::'-\�.I�-�I E�a�S,n�4: Q,F�m ., k 0 A.9 q; a��77 r f 1 �"��.-�I`..:.",I�I,�.�:�.�,.�-,�,I,.:;".,,-.—,:I.!,-�.-`�,�,�,1,.,I�...,�I_,.I.,...".:--.,.,-,,.; I. y w /a .-,y cc �4y '3 r°�'` �: ,. . .. . grow ' .+. ,:. ,' "." .. 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