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Home My WebLink About10558-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP/LRTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34501 Date: 08/16/10 ·HIS CERTIFIES that the building NEW DWELLING Location of Property: 495 DOLPHIN DRIVE SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 57 Block 1 Lot 44 sulx~ivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 5, 1980 pursuant to which Building Permit No. 10558-Z dated FEBRUARY 5, 1980 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 DECK AND CONCRETE PATIO. THIS CERTIFICATE OF OCCUPANCY REPLACES CO #Z-10028 DATED 7/11/80. The certificate is issued to MARYAIFN MAYER FAMILY TRUST ( OWNER ) of the aforesaid building. SUFFOLK COU1T~YDEPART~H~TOFH~ALTHAPPROVAL 10-SO-07 ELECTRICAL CERTIFICATE NO. N 476743 PLUMBERS U~RTIFICATION DA'rKO N/A o7/11/8o oo/so/29 - // A/orize~ Signature Rev. 1/81 TOWN HALL :'~ . ,. ~/ A135 ~~ / 765-1802 , P iCAT,O ]FORCERT ICA E O]F OCC CY '~s app~ation must be filled in by typewriter or ink and submitted to the Building Department with the following: A. ]For new building or new use: 1. Final survey of propexly with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Appwval from Health Dept of water supply and seweragc-thsposal (S-9 form). 3. Approval of electrical iustatlation from Board o f Fire Underwriters. . 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead.. 5. Commewial building, industrial building, multiple residences and Similar buildings and installations, a eel~ificatc of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of Completed site plan reqmrements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and ~'pre-existing" laud uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and cousent to inspect signexi by the applicant. If a Certificate of Occupancy is deniexi, 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 Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00. Commercial $15.00 Date. Old or Pre-existing Building: 495 Dolphin Drive, Southold, NY: 11971 New Construction: Location of Property: (check one) House No. Street Hamlet owner or Owners of Property: Maryanne M_aher and Thomas F. Maher · SuffOlk County Tax Map No 1000, Section 57 Block. 1 Lot 44 Subdivision PermitNo. '~ 0~ ~ DateofPermit. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ 50.00 Filed Map. . Applicant: Underwriters Approval: Final Certificate: (checkone) r'~/~' ~'~" Applicant Signature FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PF(EMISE$ UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10558 Z Permission is hereby granted to ~.,.._~...4. ~..a.. ...... ...r.~ ..... ~~...Z.~..~.. ~.,~ ...... ~.zr~.~..~..~t.... ~../..:. ~o Z~~.c~..~. ~/.~....~.~(~..~ .......................................... ~.~,z.....~.~~,.~..~.c~ ,~..,...~~z.~,a.c.r ..... at premises located a~..~....~~.....~(.CZ~z~ ................................... ..~ ................................................................................................. ~. ..... ~ ............ /... ~z~e~~ .~8~ . ..g~z..~...~ ................................. pursuant to application doted ~ff~~...~ ......... , I , and approved by the Building Inspector. ~ee ~.rZZ...~.~ ..... FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy THIS CERTI~j~2~that the building ................................................ Location of Property ...E./.~..D.o.l?.h..:In..D~..:[y.e..J...~.0.~. .1~1..o.l'.~.h...B.J..~.o.. M.a?.l.i..~. D.P.:[. ¥.e. ..... House No. Street Ham/et County Tax Map No. 1000 Sect,on ...0.~.6. ...... Block ....7 ........... Lot ................. Subdivision .8. O..U.'l;.h.O. 1..d..S.h.o.r.e.~. ............ Filed Map No. ~..~5~....Lot No. ~.~. .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... ~...e.'9:..~. .........., 19 .~.9pursuant to which Building Permit No .... .1.0.~. ~.8.Z. .......... dated .. P.e.b.: . .~ ................... 19 .~.0., 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 ......... ........ .P.r~. y.a~e.. 9.n.e:~. ~.~.~.y..D~..~.~..~.i.n.g ....................................... The certificate is issued to ...gl~..~..e?...~'1...~...L.II.o.~...1~...I~.8..l'.'l;~.]tl~..O.o.:[' ...................... (owner, of the aforesaid building. Suffolk County Department of Health Approval ...1: .O.-.8.Q: .07 .............................. UNDERWRITERS CERTIFICATE NO. Nz~?6?t*3 Rev 4/79 Building Inspector FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supplv and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. Bo For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 / ! 3. Copy of certificate of occupancy $1.00 / / ~ Date .... ~././.I./.~.. .......... New Building opery Pr---'t- ..... ~.. Old or Pre-existing Building ............ Vacant Land ............. ..... .... Location of House No, Street Hamlet Owner orOwnersofProperty fij~,~.~.~,..J--- LL],C~,.,/g./(('~ i/~.~.i~.J~i~..~.C.~,i. .... County Tax Map No. 1000 Section .. O..~.'~.~ ....... Block..~. ............ Lot ................ Subdivision.~.l~r~...~,1~.. (~..~.~,. ,...Filed Map No.~.~.~. .... Lot No..~.~ .......... Permit No. /0.~.~.. Date of Permit.~f .~./.~. ......... Applicant.~..~..~.79... ~.~.~-~..(~.. Health Dept. Approval ..... /.~. ~ .S.O...% .~.7. ....Labor Dept. Approval ........................ Underwriters Approval....~'~..rT.~. ~. ......... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ...~.. .................. Fee Submitted $ ............................. Construction on above described building anl pfr~me~ll ~p~able codes and regulations. Applicant ... ~/. ~ .... ~..~..."~T.. ................... ,a-,o-,e THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ l~In BUREAU OF ELECTRIC~ITY 8E JOHN STREET, NEW YORK, NEW Y~ORK 10038 o. te May 2~ 1,~0 AppiicmtlonNo. onfil. 063604 only the electrical equipment ~ described belo~ and introduced by the applicant anted on the above application number in the remises A~drew ~ar~ikucci~ e/s Dolphin Dr. 151' n/o Blue ~rlin Dr.~ P of Arshamo~ique, L ~ I. in tbe following location; ~ Basement ~.lst FI. ~ 2nd FI. Section Block Lot FIXTURE OUTLETS IECEPTACtES SWITCHES FIXTURES FLUORESCENT and found to be in compliance with the requirements of this Board. DISH WASHERS EXHAUST FANS DRYERS OTHER APPARATUS~ 1-Smoke De,actor 1-4.5[Q.~ Hot Water Heater E R I OF CC COND NO OF HI LEG C A W O NO OFNEUTRAL$ OF HI-LEG · L Z/O AWG OF NEUTRAL John T. Eapana=o inc. 102 Oak Ave. Shirley, N.Y~ ii967 Lic. 334 E GENERAL MANAGER 1 t ',,~ ~rT~,~,~.m~/~rT~t~/~.~e?ye,~/,¥.~7~, , ~~~ d ~ , cot e~t Inspector~ may ~e denhfled~by their credenhals ~ COPY FOR BUILDING DjnaDrm~mv Tam r~v ~.~ z_ =~=~ ..~. ~~~ .;~ ~ ----'?--.,?---. , .... ~vr~. vr ~f~l~l~J~0J 6~ ALzE~E0 IN ANY MANNER. ~ FIELD IN~PECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY COpE FINAL FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ,~.:'2~, ,r~.. Approved ~./.D.e-.. Disapproved a/c .......... ............. (Buildin~ Inspector) Application No. ZO Date ........... , 19 .~. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 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 streets 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 issue a Building Permit to the applicant. Such permit 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 or 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, buil,ding code, hr6~using code, and regulations, and to admit auth°rized inspect°rs °n premises and in buildings f°r necessary ins~lc,t~x~'l~/ ~ (Signatkv(e of a~~&corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber ........................ Name of owner of premises ..................................... .C~.('.-~./. ................... (as on the tax roll or latest deed) If appl/cajn~LE co/~atig}n, signature of duly authorized officer. ..... .... ....... 5 ...... Builder's License No .......................... Plumber's License No. C% Electrician's License No..~.~. Other Trade's License No ...................... 1. Location of land on which proposed work will be done.. ?.~-~/,5.....~..L,p~.lr[.. ~ ~1.1/~,~.../.~..o.. t. ~',~¢....B. ~. ~...~ r, e-. ~..~....~ .,:& ~ .............. ~.e.~ .t/-s~... o.~a..o,. ~. ~. .............. I House Number Street Hamlet County Tax Map No. 1000 Section . .~/...~-.~ .......... Block . .'./ .............. Lot ................... Subdivision ~.0. t/~-. {4:0..b'.,-~....~..~...~...~ ............... Filed Map No. ~..~>..~.~. ....... Lot . .~'.3. .......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............................................................. b. Intended use and occupancy .... I.. g .T'~.. g~ ..... ~._~../~..~'......~..~... ( .~. ~,-~. ~41 .~( ./3L- ............... 3. Nature of work (check which applicable): New Building ....... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... .o.o.? dX (Description) 4. Estimated Cost ) ..; ........................ Fee ..................................... , (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 .... -.; .'. · D( .°..IYI.~.~. ..-' ..................................................... 6. If business, commercial or mixedl 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 .................... i' ' Height ...... . ~,,. ~ ............ l~lpm~er of Stories ....... ./~ ........ 8. Dimensions, pfentirenewconstmction: Front.· .t't'ol~. ......... Rear/~.i~ ............ Depth ~ itl . Height I .L~. '. ........... ~umber of Stones . . .[. ....... ~ I ......... '' .............. '~ :-~'~ ........... ~ 9. Size of lot: Fror~t ...1.~..' ;i .......... Rear· .[~.'9 ................. Depth ./.r./.~.. 10. DateofPurchase ............ ~. ................ Name of Former Owner ..-:- .......................... 11. Zone or use district m which premises are s~t ated ..... .- ................................. 12. Does proposed constructmn wolate any zomng law, ordinance or regulatmn: . .hi.0. ............. i ' fill' removed from ' Yes 13. Will lot be regraded . 't ...................... Will excess be premises 14. Name of Owner of premises .~ ~..,.g.U. gu.~. 7 ..... Address ................... Phone No Name of Architect ........... 2-/df-, Address No. ~/,r,r~5",-~...~.... Name of Contractor 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 Y~OR~ ,, , ,~, ,~.. COUNty ........ .~. t. [0 ..... .1~. [~ .~.[ .~.~. P,,-"2,~ ................ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named· He is the ...................... !'......ff'"~.~.. i i...~.'~ ................................ : ................. ! ~(Contractor_~fgent, corporate officer, etc.) of said owner or owners, and is dul9 authoBzea to perform 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 manner set forth in the application filed therewith. Sworn to before me this , · ..,. ,,9 .....~.~ .......... day of,...7~ .... , 19 .4~. Ilo. 52'451~41~i ....... · ' ~'~ ~ew YO~ . . . C~rnrnlsslon £xp~res ~arch 30, 1980 ~FFOLK COUI~Ty [{EALTH DEr, gj:::T~,W_.ahi~, Chlo~ o~ ~ - .% ROD£RICK VAN TUYL, p. C. / STATEMENT OP' INT'I'NT IT' H. $. REF. NO.: APPLICANT -1 /~? 7'oX~'-':,t_. Eh. T. L). ~. Tc::~-~.A. C ~. i7, d. iA, ~ o'O -'t?_ 2¥, ]4- II t ,/ / % RE. N "~ ' ./ FI