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Home My WebLink About8417-zFORM NO. 4 TOWN OF SOUl=HOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19406 Date OCTOBER 1, 1990 THIS CERTIFIES that the building. ADDITION Location of Property 1455 CEDAR BEACH ROAD EAST House No. Street County Tax Map No. 1000 Section 92 Block Subdivision Filed Map No. SOUTHOLD ¢ N.Y. Hamlet Lot 4 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 11, 1976 pursuant to which Building Permit No. 8417-Z dated MARCH 11~ 1976 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 ADDITION TO EXISTING ONE FAMILY DW~.LLING The certificate is issued to V. OLGA LEE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N-018134 - SEPTEMBER 18r 1990 ' J~/~i l~din~ ~spector FOI~TI NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT '(:rills PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8417 Z Permission is hereby granted'to: located at ..,JJ~.t.,~.:...JJ~tl~...~l(..j~ .......... ~ ............. ,:: ...................................... , apphcation dqt~ ~-....~ .................. , I .: ~ - ' .................... ,and ~PPF~ bT the ~ ~-' I~pector. -~' ' 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 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. 4. Sworn state,eat from plumber certifying that the solder used in system cont~-s less than 2/10 of 1% lead. t 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· 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 o£ Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimmmng pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50·00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5·00 over 5 years - $I0.00 ' Updated Certificate of Occupancy $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 / Date ..................... New Construction ....... Old Or Pre-existing Bu%lding ........... Location of Prope~;;i../.~.~.~. ........ ~/~..~...~i~.i...ii;..~ .... House No. Street Hamlet Onwer or Owners of Property'..¢.~.~... ~.~..~. ............................................. County Tax Hap No 1000, Section....~.~.. .... Block.. .I .......... Lot ...~. ....... Subdi~ision .................................... Filed Map ............ Lot ...................... ,ermit No ........ ate Of ~,~/7. . ~'-. . ... . . Appli ............... . .. [lealth Dept Approval Underwriters Approval " Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate...~. ...... Fee Submitted: $ ..... ~..-;' ................... ..,. .................. THE NEW YORK BOARD OF FIRE UNDERWRITERS pA(=z s01 sT nuaEAu E-ECTR,C,TV ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 D~te EEP?EHSZR 18,19~0 ~pplicationNo. onfile 70335290/90 H 018134 THIS CE~IFIES THAT o~y t~ e~t~d ~u~ment ~ ~cd~ ~ a~ int~ by t~ ~nt M~ ~ t~ a~ ~t~ num~r in t~ pM~s of g. Oh(~A hgg, 1455 CgDAR PT. RI)., SODTHOhD~ N.Y. in the followln~ location; [] ~ examined on $~PTE~BEa Og, 1990 and found to be in compliance with the requlre~neats of thD ~rd. Lot I RXTURES OTHER DRYERS FURNACE MOTORS PUTUBE AFFUAHCE F~R~RS AMT. K.W, ~L H.P. GAS H.P. AMT. NO. A.W.G. RANGES SFL~CIAL REC'P1 COOKING DECKS OVENS DISH WASHERS TIME CLOCKS BELLlUNITHEATIISUNIT HEATIIS MULTI-OUTLET .,. ~S. TRANS. .~ SNo,~ST~II~Ni~T OTHER APPARATUS: R v i C *NO VISUAL DEFECTS: "An electrical snrve¥ has been aade o[ the exposed electrical equipment in the EXHAUST FANS premJ, ses indicated." "No obviol~s unsatisfactory condition ~as found. MRS V. OhgA bEE BOX 1273 SOIJTItObD, NY, llq5'1 1t This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IFI ANY MANNER. TOWN OF SOUTItOLD OFFICE OF BUILDING IN~?ECTOR P.O. BOX 728 TOWN HALL SOUTItOLD, N.Y. 11971 August 2, 1990 TEL. 765-1802 Ms. Olga Lee 17 Homewood Lane Weston, Ct. 06883 To ?~om This May Concern, We are unable to complete your Certificate of Occupancy because of the following reasons. /--//An application for Certificate of Occupancy /~ ;he check is(*xa~z~aT~m_~.~t on file.) 025.00 /Z/ No llea~th Dept. Approval on file. /Z/ No final inspection has been made. Ploase contact our office on this matter. Thank you for your cooperation. Building Permit {I 8 4 I 7 Z Buildinq Dept. ***/Z/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) ..... ......... b. ~lot plan ~h~in~ I~tion of lot ond o{ buildinO~ ~ premise~, ml~tlonship to ~d~oinin~ pr~mi~ or public ~r~ or~, ~nd oivino a d~t~il~ d~rlpti~ o{ I~ o{pr~ mu~t ~ dm~n on th~ die, mm which i~ ~ o{ thi~ c. lh~ ~ork ~r~ b~ thi~ o~lic~ti~ m~y n~ ~ eomm~nc~ besom i~uOnc, of 8uildin~ ~rmit. d. H~n ~pp~l o{ thi~ opplicati~ ~eBuildin~ Ink,tot will i*~u~ ~ 8uil~in~ ~rmit to th~ ~pplic~n~. Such ~11 be k~pt on th~ pmmise~ ~ailobl~ {or imp~tlon ~hr~h~t t~ ~rk. No building shall ~ ~cupi~ or u~d in whole or in Pa~ for any pu~se ~ever until a Ce~ificate of ~cu~ncy e. shall have been granted by the Building Insp~tor. APPLICATION IS HEREBY ~DE to the Building Depa~ment for the i~uance of a Buildi~ Pe~it pumuant Building Z~e Ordinance of the Town of ~uthold, Suffolk County, New York, and ~her applicable ~s, O~i~nc~ Regulations, for the constru~ion of buildings, additions or alterati~s, or for mm~al or demoliti~, as heroin ~ri~d. The applicant agrees to comply with all applicable la~, ordinances, building c~e, h~si~ c~e, a~ ~ulati~s, admit authoriz~ in~tom on premiss and in bulldin~ ~r n~ i~ti~s. '4~,'~~ ~- ~ ..... ~ ............... .~ ...... ~,~, ..,....~, ................... (Signature of applicant, or ~me,~'lf o co~i~) .......... ........................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~bL Q~- I~_~ . Nome of owner of premises .......... 'T .................................................................................................................................... applicant is a corporate, signature of duly authorized officer. .......... ....................... (Name and title of corporate officer) Builder's License No .......... .~..6..~2~.~......~.°~ Plumber's License No ................................................. Electrician's License No ............................................. ~- /- 4 Other Trade's License No ................................................ ,~ ,, ,, ! ,,~, 1. Location of land on which,j3~osec~work will bp~depe. Map No.~.~.~...~..~,...~...~..~....~.,.. Lot No~.~...~..(-, .......... Street and Number ....... ~..~.,.~.....~,.,,,,~.....~-~'......~,...~ .................... ~.~... Munlclpall~ 2. State existing use ana~ occupancy of premises and intended use and occupancy of proposed construction: O. Exisiting use and occupancy ....... ~ .... /.I .~./~ b. Intended use ondoccupancy ......... ~..,~,,/..,,~..~..,~.- ................................................................................................. 3. Natu~re of work (check which applicable): New Building....: .............. Addition ..... ~ ..........Alteration ................ Repair .................. Removal .................. Dernoli;don .................... Other Work ..................................................... (Description) 4. Estimated Cost ..?....~l.~.1...'~.. ................................ Fee I ~'-~'~-~ . '~: (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 .................................................................................................................................... If business, commercial or mixed occupancy, specify nature and extent of each b/pe of use ............................ Dimensions of existing structures, if any: Front ....~, .................... Rear ..... ~,...~..~ ................. Depth .~,~...~..~ .......... Height ....... L.O..'. .......... Number of Stories .............. .J .................................................................................................. Dimensions of same structure with alterations or additions: Front' "~-O~ Rear 2 ~ ~ Depth ..... ..~.~.~ ................... Height ..... !...O. .................. Number of Stories ........ ,/. ...................... 8. Dimensions of entire new construction: Front .~..~..[ .......................... Rear ...~.~ ............... Depth ..... .J.,~.. ............. Height ....J...~..~. .......... Number of Stories ......... ~/. .......................................................................................................... 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10.' Date of Purchase .............. i ......................................... Name of Former Owner ........................................................ 11. Zone or use district in which premises ore situated .................................................. Ii' ............................................... 12. Does proposed construct on v o ate any zoning law, ord nonce or regulation: .... J~....~. ............................................. 13. Will lot be regroded ....~..¢~ ................ Will excess fill be removed from premises: ( ) Yes ('~-) No 14. Name of Owner of premises ..~..J~.~........~.~... ...................... Address ................................Phone No ....................... Nome of Architect ....................... x ..................................... Address ..D....~/......~ ......... Phone No ....................... Name of Contractor ..~C)....(~.~.~ ............................... Address .~.~[~...le.~..!..~.. ......... Phone No..~..~.~..?.~..~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fram 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 ~,.! ........................... )' '~'-' ............ ~...k~.......~..>.......k~..~ .......... : ............... being duly sworn, deposes and says that he is the applicon, (Name of individual signing contracf) above named. He is the .............................~.....'~.. ....... ~.1~...[~....1...~....~....~.. ................ ,.~..~,,~...~...'..........~......~..f6,.?...t'....~..) ....... [~,ontrector, agent, corporate officer, etcj of said owner or owners, and is duly authorized to per~orm 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 work will be performed in the rganner set forth in the application filed therewith. Swam to before me this /~/J /// / ......... I,..k ........... day of ...... Notary Public,. ................................................... County ...... ~..~..~.........(~. ;......~).... ~ ................................ (Signature of applicant)