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Home My WebLink About13066-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No Z-27447 Date DECEMBER 4, 2000 THIS CERTIFIES that the building_ Location of Property 1050 PARK WAY House No. County Tax Map No. 1000 Section 70 Subdivision ADDITIONS SOUTHOLD, N.Y. Street Hamlet Block 10 Lot 43 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 12, 1984 pursuant to which Building Permit No, 13066-Z dated APRIL 27, 1984 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 BATHROOM ADDITION & DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR* The certificate is issued to of the aforesaid building. PHYLLIS T. CALLANAN (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-656725 - AUGUST 24, 1984 PLUMBERS CERTIFICATION DATED N/A *THIS UPDATES C0-Z-12817 DATED~PT. 27, 1984. J Authorized~.~ature -- Rev. 1/81 FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING FElt, MIT (THIS PERMIT MUST BE KEPT ON THI: PREMISES UNTIL FULL COA4PLETION OF THE WORK AUTHORIZED) N? '13066 Z Permission ,, .~...,.~,,,,~,= is hereby granted to: ........ :.-/.~.~.,::~,~.......g....: .... ~ ...... ...... ? .,y,~..~....~z/~- .~.~......~...:: ....... ........ ~.,,,'~ c...r ....~ ./.:.~ ...................... ,o...~..~.,=~ ....... ,. .......... ~f:~/,.~ ...... ..,..~.~;~:...../....:ff .................... ....~,.~..~,.?....~,,...~:..: .......... ..~-~...'~.,../~.~....~...,~.~./.Z,~..,~.~ ......................... ,,t prem,ses ,~ed at../.a~..O. .......... ~.'.,~.."~.....~: ......................................... .............................................................................................................................. ~ ~ ............. County Tax Mop No, 1000 Section ..... E./.../,,,,,L~,. ..... Block ........ /..,C.~,, ..... Lot No...,~Z,,':~..,,.-~.,, ...... pursuant to application dated ....................... , 1 and approved by the Building Inspector. Building Insoector Rev. 6/30/80 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...g.1.2.8.1..7 ......... Date S.eRt. 27 19.8.4. THIS CERTIFIES that the building Addition Location of Property .10.5..0 .... Parkway Dr. . ......... HouselVo. ' ........ ~r'e~t' ...... Soqtholc] .... Ham/et County Tax Map No. 1000 Section ...0.7. Q ...... Block . ...1.0. ......... Lot ....0.4~ .......... Subdivision Southwood ............................... Filed Map No. 2.1.4.1....Lot No..6. ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... .$PX ~. $ ..... 1. ~..., 19 ~ ~l. pursuant to which Building Permit No .... 1. 3. .0 .6.6.Z. ........... dated .... ~. [L r.~.1. ..... 2. 7. ........... 19.8..4, 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 Dwelling The certificate is issued to CALLANAN ~ PHYLLIS T. ................ ...................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N 65672 5 Rev. 1/81 Building Inspector 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--wll %~ildtKg~, properly 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 o{ 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. 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 Buildin~ - $100.00 3. Copy of Certificate of Occupancy - ~ .2§~ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ../Z.~.~..~ ............................. New Construction ........... Old Or Pre-existing Building...~. ........... Location of Property ~.~..~..(~. ~P~.~..r~.~. ~.~ .~0~.~i ~.~, House No. Street Ha~et Onwer or O~ers of Property..~Y..~ ......................................... .. County T~ ~p No 1000, Section..~ ........ Bloek...~ .......... Lot..~.J ................. Subdivision .................................... Filed Map ............ Lot ...................... Permit No?~. ~ .......... Date/~/~Of Permit. ~. ~3-./Z.~ ..... mpplicant~~.'~~.'. .......... Health Dept. Approval ........................ Underwriters Approval .... .~5/./.~ ................ Planning Board Approval...~/~ ....... Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ ............................. ..... ............................ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall · ~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, andsubm~tted~c,' ' '~:"**" ...... 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 supply 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. B. 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 features. 2.Sworn statement of owner or previous owne~ 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 / land use --?re-Exis ting C, O, $15, O0 3. Copy of certificate of occupancy $1.00 Vacant land C.O, $ 5,00 New Building ........... Old or Pre-existing Building ............ Vacant Land ............. of Property ........... . ......................... . County Tax Map No. 1000 Section .. ~ 2.~?. ...... Block .... /.,~, ........ Lot,... ,(~,,. ........ Subdivision ................................ Filed Map No.~J.~... Health Dept, Approval ........................ Labor Dept, Approval ........................ Underwr ters Appr0va,/,x}. ,k0.rO,, ...ii ;~,t~,,. · · · · ·.....Planning Board' Approval Request for Temporary Certificate ..................... Final Certificate ........... Fee Subm .............. Construction on above described building eet~s a Rev. 10-10-78 O0 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the e~ctrical equipment ~ ~scrlbed bel~ and introduced by the appllca~t named on the above application number in the premises of in the follow~ng location; ~ Basemen~ ~ 1st FI. ~ 2nd FI. Section Block Lot was examined on and found to be in cotnpllance wi~h ~he require.~ents of ~his Board. FIXTURE OUTLETS DRYERS IECEPTACLES SWITCHES FIXTURES RANGES OVENS EXHAUST FANS NCANDESCENT FLUORESCENT SYSTEMS NO. OF FEET OTHER APPARATUS~ S E NO, AW.G, OF CC COND, NO OF HI-LEq OF HI-LEG NO, OF NEUTRALS I OF NEUTRAL Tow~ Hmi'bor Lmie Oou~ho].d., N.Y. ilgV1 GENERAL MANAGER This certificate most not be altered in on? manner; retorn to the office o( *he Board i( retorted. Inspectors mo? be idenfi}ied b? *belt credg~tk~l~. COPY FOR BUILDING DEPARTMENT. THIS COPY OF C;.~rf r, CATE ~U~ST NOT BE ,~LTERED IN ANY MANNER FIELD INSPECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ~ODE FINAL ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. Owner?~ -~, ~--~L[, (please p~nt) (pleXs~rint) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this %~-~ day of ~o_7~2~ , Notary Public, ~'~O~/~County Notary Public t. INDA lC DAWSON Notary Publk~ State of N~ Yo~ No. 4694688 Qualified In Suffolk County Term Expires March 30, 19 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL.: 765-1802 Examined .. ¢//..5.< ~. ...... ,19~.~.~ Approved..~./'.~.'~. ....... ,1~. 7Permit No..~ .,~..~.~2 Disapproved a/c ........... L-v.. 55'. ........ 'k/~/'(17 ........ APPLICATION FOR BUILDING PERMIT Date .../.~. · .~ .~. ....... , 19~ Application No .................. 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, accnrate 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 Occupahcy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MAD~ 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. - . (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... ................................................................................. Name of owner of premises.. P.~.Y~/.~ .... ~.:...~4~.g~:..~. .................................. (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...~//'~.~t. ~ D.-~?. ~-~.. Plumber's License No.. ~.~..~.~..~..E.~.~.~. ...... Electrician's License No...~.~.~.[ .?~.°e~S ....... · ' Other Trade's License No .... ~.,/~eh .~..g.~'.~..~y House Number · C~)iinty Tax·Map 'No. 1000 Section Location of land on which proposed work will be done... ~.d~...~--.(~... ~.~..~. ~..u~..~.y.. ~..~-....B.c~.. ~. /.~ ..... ................................. .................. Street Hamlet · .~..~.O... Block .... ~..~..; ........ Lot .... .~.~. ........... Subdivision ..................................... Files Map No...~ .~. I ...... Lot..~ ........... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisfing use and occupancy .... /~.OO.~.Q,...,...~.~..~.O~.~ ..................................... b. Intended use and occupancy .... &.~ k ~.,{JO.l~i~ ................................................ ppli ) ~. 3. Nature of work (check which a cable: New Building .......... Addition ....... Alteration .......... Repair .............. RemoVal ............ Demolition .............. Other .... Work ............... ~,~ ~,~ ~.._?.~___ ' (Desc~ption) 4 Estimated Cost i~~'~ ........... (to be paid on filing this application) 5. If dwelling, number of dwelling ~nits ............... Number of dwelling units on each floor ............... If garage, number of cars ' 6. If business, commercial or mixed occupancy, specff~ure and extent of each ~e,of use .................... 7. Dimensions of existing stmcture~, if any: Front...~ .......... Rear ... ~ ........ Depth .~.~ ...... , . . . ~ ~a~ht Z~.~.*~m:~ o~ Sto~ ................... , ............... ~] [. [ ..... D~ensions of same structure with alterations or additions: Front ... ~ ~. ......... Rear ....... Dep~ ............. ~.. He ................... Number of Stories ............. Dimensions of entire new const~ction Frbnt ~' ~f. Rear . ~ ......... Depth . .. ~.~ ...... a. ~ht .../~( ....... ~m~o~Sto~... ~.. ................ bi;ii. ~ ~8;_[~i ~2[ ~2 .... 9. Size of lot: Front .. Z'~.~O.~ ......... Rear .... /~ ............... ~0. D~ ofe~h~s,. ~.. ~a"' m. 7.S ........ ~am~ o~Fo~Own~ .~.t~¢. ~, .~?~¢ ...... 11. Zone or use district in which pr~misos are situated...~D~.~.~ .................................. 12. Does proposed construction viohte any zoning law, ordinance or regulation: . ~ ........................... 13. Will lot be regraded ... ~...~ .................... Will excess fill be removed from premises: ~s ~ 14.Nme of Owner of premises .~l~.. ~A~. Address .Z~ .~... Phone No..7~ ~T. ~. Nme of Architect ........................ ~ or co~o~. ~. ~.f~ ........ ~da~da~**~ ~ .................. ~,~ ~ ~hon~°n~ so.N° ................ .~ aY :. er~ ~.. PLOT DIAGRAM Locate clearly and distinctly alll buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block Inumber or description according to deed, and show street names and indicate whether interior or corner lot. LoT ~ STATE OF NEW YORK, COUNTY OF ................ S.S (Name of individual sigging contract) above named. : I~T~,e.~ orc being duly sworn, deposes and says that he is the applicant He is the (Contractor, agent, corporate officer, etc.) of said owner or owners,.and is dhly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are tree to ~he 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 {.¢.. .... ...... ....... day of. ~/'~.' ~ .... ,~_ ~/ Notary Public, .. ~. ~.~'~:. ~&. ~. NOTARY PU[JUC, S~ate of N~w YotN No 47078~8, ~u[foJk Term Exp~r~s March 30, ~,~~ ~_. ~~Si~nature of applicant) t~