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Home My WebLink About4002-zTown of Southold Annex 1/23/2012 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 35405 Date: 1/23/2012 THIS CERTIFIES that the building RESIDENTIAL NEW CONSTRUCTION Location of Property: 160 Rambler Rd, Southold, SCTM #: 473889 Subdivision: Sec/Block/Lot: 88.-5-35, Filed Map No. conforms substantially to the Application for Building Permit heretofore Lot No. filed in this officed dated 8/23/1968 pursuant to which Building Permit No. 4002 dated 8/23/1968 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: one family dwelling with bathroom in basement. This Certificate of Occupancy updates COZ-3437, dated 4/4/69. The certificate is issued to Rosenfeld, George & Rosen feld, Nancy (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 36920 1/20/12 Form No. 6 TOWN OF $OUTItOLD BUILDING DEPARTMENT TOWN HALL 7654802 APPLICATION FOR CERTIFICATE OF occUPANcy lhi~ application mu~t be filled in by typewriter or ink and submitted to the Building Department w!th_the following: A. For new building or new use: 1. Final mu-vey of property with accumte'lecation o f all buildings, property lines; slreets, and unusual natura} or topographic feature. 2. Final Approval from Health D.ept, of water supply and ~ewcrag~4ispoaal (S-9 lento). 3.. Approval of electrical installation from Board 6f Fire Underwriters. 4. 'aw.om statemem from plumb, er certifying that tho solder used in w~tem contaiva less than 2/I 0 of 1% lead. 5. Commercial building, industrial building, m0hiple residences and similar buildings and installations, a e,e~ficate of Code ComPliatme'from amhitect or engineer responsible gor the building: .6. Submit Planning Board Approval of completed site plan requirement& B. For existing buildings (prior to April 9, 195~/} fion~confo.rming usu, or buildings and "pre-existing" land uses." 1. Accurate survey of property shgw.ing all property lines, streW, buildit~g and unusual naturai or topographic features. 2. A properly c.~mpleted applicatign and consent to inspect signed by the applicant. Ifa 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 $50.00, Additions to dwelling $50.00, Alterations to dwelling $50_00, lqew Cot~tmction: Old or Pre-existirtg Building:' House No. Street 8ttffolk .Co.~ty Tax Map No l000, Sectio. n .~2,2~ ~ - l-t~lh D~t. Appv0val: Planning Bead Approval: Request for Temporary Certificate Foe Submilled: $ _ L-~O, ~ ~ Swimming poql $50.00, Accessory building $50.00; Additions to accessory building $50.00, Businesses $50_00: Cortificate of Occupanc~ on Pre-existing Building - $100.00 Copy of Certificate of Occupancy - $_25 Updated Certificate of Occupancy - $50.00 Temporary Certificate o f Occupancy - Residential $15_00, Commercial $15.00 Oat "/,/,' (check one) Hamlet Biock . ~ Underwritem Approval: Final Certificate: (check one) Town Hall Annex 54375 Main Road P.O. Box 1179 Southold. NY l 1971-0959 Telephone(631) 765-1802 Fax(631) 765-9502 rofler, riched~,town.southold ny us BUILDING DEPARTMENT TOWN OFSOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: N&G Rosenfeld Address: 160 Rambler Rd Ext City: Southold St: NY Zip: 11971 Building Permit Cf: 36920 Section: 88 Block: 35 Lot: 11971 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: as built DBA: Peconic Electric License No: 43457-me SITE DETAILS Office Use Only Residential ~ Indoor ~ Basement ~ Se~ioeOnly ~ Commerical Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage Service I ph Service 3 ph Main Panel Sub Panel Transformer Disconnect Other Equipment: INVENTORY Hot Water GFCl Recpt NC Condenser Single Recpt NC Blower Range Recpt Appliances Dryer Recpt Switches Twist Lock finnish basement, 1-exhaust fan Ceiling Fixtures~~ ~ HID Fixtures Wall Fixtures I I Smoke Detectors Recessed Fixtures CO Detectors Fluorescent Fixtur~ Pumps Emergency Fixture Time Clocks Exit Fixtures I I TVSS Notes: Inspector Signature: Date: Jan 20 2012 81-Cert Electrical Compliance Form FOI~M ~0. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No....34~:/...~, ........... Date ................ AI~i. ............ .4, ........... , 19...~.~.. THIS CERTIFIES that the building located at .... ~,6~i..I~I~].IBX..~,O~:~[ ........................ Street Map No...~rx.¥- ....... Black No ....................... Lot No..l~...,...~lOlZt, J~lJ:J~..~,.~' ........................ wa :ezo conforrr~s substantially to the Application for Building Permit heretofore filed in this office dated .................... A~lg~iNr,....~3.~ .................... , 19...68 pursuant to which Building Permit No..~.0.0~...~. dated ......... Ati~la~B.....:;l~e ................... , 19..~., was issued, and conforms to all of the requirements af the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ....... pz~te..~e..~r~am&~,F..~l~l~:l,ncj ....................................................................................... The certificate is issued to .......~;l~be~,la~d.J~.l~'~_- ........................................................... (owner, lessee or tenant) of the aforesaid building. N 1721818 Health Dept. Approval, March 24, 1969, Robert VXlla Building Inspector ( FOR~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 4002 Z Permission is hereby granted to: ................. ,t ................. Jla$t;Lt~....~l.Z. ........................ to ~.g~l~. ~w...~ne..£~l~...d.welLl~ ................................................................................... at premises located at ..j,Jlt~...J.~.~.....~t~t~...~,.t,l~z'll ........................................................................ ...................................... Jaal~1~..~t ....... Sm~t~o:Mt.Zo~[~ ............................................... pursuant to application dated ............................ A~1~ ....... J~ ............ , 19..~, and approved by the Building Inspector. Fee $.JJ~.(~O ........... S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date Bldg. Permit No. TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structUre located at e/s Rambler Road~ Southold (Give deed location) Terry Waters~ Lot #17 have been inspected by this department and found to be satisfactory. Builder - Timbzrland ~ssoc. Owner - same Distriot Engineer District Engineer TOWN CLERK S OFFICE 3J,~(,;' C,~, ~ ~ ~ - $~THOLD, N.Y. ~ ~ : ~ ' ~omln~ ........... ~.~...., 19........ ~ Application No...~..~.~..~ ....... ..................... .............. , P, rmi N .............................. Disapproved a/c .............................................................................. APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. 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 application. 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 progress of tKe 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 Deportment for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of $outhold, Suffolk County, New York/Ond other applicable Laws, Ordinances or Regulations, for the construction of buildings, additlo~s or alterations, or for/removal or demolition, as herein described, The applicant agrees to comply with all applicable laws, ordinances, buildin'~ code, housing code, and regulations, _~Signature of oppl~nt, ~, name, if a ~;orporation) .... / (Address OT applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................... ~eZ'. .................................................................................................... ~ ............................................................ Name of owner of ~~,-,.~L ~L"~;: ~-"-,~.---, premises .................................................................................................................................................... If ~plicant is a co~orate, signature of duly authoriz~ officer. (Name and title of corporate officer) 1. L~ation of land ~ which proposed work will ~ done. Map No.: ..... ~.~.L~.~.~ ...... Lot No.: ...~.~....~..~.... Stre~ and Number~ ........ 0~..~..~, ~9.~ . ~/ -- ~ ~A~ ~LE~ ~U~T Munici~h~ ..................... 2. State existing use and occupancy of premises and intended use and ~u~ncy of propos~ construction: a. Existing use and ~cupancy ................ ~ .............. ~ ....................... : ........................................................................... ~e~ ~o~ '~ b. Intended use and ~cu~ ..................................... ;.....: ..................................................................................... 3. Nature of work (check which applicable): New Building ..~.e.~ .......... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ..... ]~DOD.,, ...................................... Fee .......................................................................................... (to be paid on filing this'application) 5. If dwelling, number of dwelling units ......... ..O..A..?. ........... Number of d~elling units on each floor ............................ If garage,~ number of cars ~;WO 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 ................................................................................................ ~ ................ Dimensions of same structure with alterations or additions: Front ; Rear Depth ................................ Height ............................ Number of Stories , Dimension--eentiresl(~f new construction: Front 54 ~ ~'~" ~ ....... 34! & 8. .................................... Rear ....... ; .................... Depth ........................ Height ................... ~.w%N~u~nber of Stories ......... 90,t .......................................... 3~'~J',', ...... ~ ........................................... 9. Size of lot: Front ............................ Rear .................................... Depth ..................... ~1~ ~bO 10. Date of Purchase J~e ].968 Name of Former Owner 11. Zone or use district in which premises are situated ....... ~.~.?..~.~..~..~.. .................. 12. Does proposed construction violate any zoning law, orc~ar~e o~ regula~?a ,,~,,~ .............................................. ~p~.e ~4~ ,~*~,~,~.~,u~,~., 928- "" 13. Nome of Owner of premises ..~.~.~..e...~..~.?:'...~......A..8..~..O...~..Address ............................................ Phone No ..................... Nome of Architect ...................... e ................... w ........ Address ............................... ; ............ Phone No ..................... Name of Contractor .................................................... Address ............................................ Phone No ..................... PLOT DIAGRA~ 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. -30-'/ ;fo' sworn, deposes and says that he is the applicant above named. He is the .......... ].....:.,...~ ....... ~"~-d~....~:~...~ ................................................................... ~ ~ // (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to rn~ke and file this application; that all statements contained in this application are true 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. Swam to before me this , ............... .... ...... Nota ~Ct~0:~t~aSr~il°~;~L~ C°untt~'~/~ (Sig6J3tur~ applicant, STATE/OF NEW YORK, * '~S S COUNYY OF ...~ ...... .......... :'i ................ :-~..~:F'~"~: ~~.,... ~e i n g duly (Name at individual si§ ,r)ing t~pplication)