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Home My WebLink About12881-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z15378 Date March ]8, 1987 THIS CERTIFIES that the building ....A.d. d..i .t .i.o.n.. 9 .nfl...a .1 .t.e.r..a .t .i.o.n. ................. Location of Property 445 VILLAGE LANE ORIENT House No. Street Hamlet County Tax Map No. 1000 Section . .0.2.5. ....... Block .... 0. 2. .........Lot .. 003 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... F.F~I~,..1.5. ~..1.9.8.4. pursuant to which Building Permit No..1.2 I~ ~.1.~ ............. dated . .F.e..b ....2. 2...I.9.8.4. ............ 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 ......... ..... A(~ ql ~..t.i.q n...a.n.(~. ,a.l.t.e..r .a.t.i.q .n..t.q..e.x.i.s.t..i.n.g. ,d..w.e.l.1. i..n.g.. ..................... The certificate is issued toMr. and Mrs. Thomas Madigan ..................... ?o¥.'o;, ...................... of the aforesaid building. Suffolk County Department of Health Approval ...... .N/A ................................ UNDERWRITERS CERTIFICATE NO. N67 1639 PLUMBERS CERTIFICATION DATED: Oct. 22, 1984 ~,t~ilding tnspector 1/81 FOB~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO 12881 Z Permission is hereby granted to: ~- :~ -- ~ ..... ~.~._~z,~-,..../~,~. ..................... ....... ~.~.cz..~- .............. ~....x- z..~Zl ~...Zz~.Vz~...~~ ....... ~ .......... ~:.~.~~.e '.~ at premises ,~,e/at ..... ~.~..~~:....~/..~ ....... f.....-~ ......... ~ .........................................................................................................................(J~~z .............. County Tox Map No. 1000 Section ...,~.,~..~,~..,... Block .~..~. ......... Lot No, .~..~....~.~.. ....... pursuant to opplication doted .... ~~/~...~.,~...~.,,..../...~..: 195~.....~/, and approved by the Building Inspector. ,/ Building Inspector Rev. 6/30/80 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 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 property showing all property lines, streets, buildings and unusual natural or topographic features. 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 f'(~ 2. Certificate of occupancy on pre-existing dwelling ~.'?' 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 $15.00 Date.. ~..~.... ~ ~'~7''/' '~' '~' ' ' New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ...~.~/~. ................ ' ............................... House No, Street Ham/et Owner or Owners of Property . )~ .C; i.~'. f~.'_~.f.~(... . .O..O~.~...)~O.~ £1- .~. ............. County Tax Map No. 1000 Section ....~..~...~.. ..... Block ...0....~. ....... Lot....0..O. .~. ....... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. ~. ~.(~'./.~.. Date of Permit .~'/~.~/.~¢..Applicant..~.O.~).~. ~Yz~...~.."....~..L;.'~.~.~..~'~..~?. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ~..~..f~./..~..~..~. ......... Planning Board Approval .... : ................. Request for Temporary Certificate ..................... Final Certificate ...................... Fee Submitted $ .~ .~..~..0~.. ..... 4~.~..~ ......... Construction on above described building and p~mit meets all applicable codes and regulations. ............. d. 6.2/53 HENRY J. SMITH & SON, PLUMBING, HEATING & FUEL OiL MAIN ROAD SOUTHOLD, N.Y. 11971 (516) 765--,3690 CERTIFICATION Date October 22, 1984 Building Permit No. /~/ ~' Owner Thnm~ M~H~mn Plumber Henry J. Smith & Son~ Inco I certify that system contains less the solder used in the water supply than 2/10 of ~ ~ad. ~ tl · ~enry P.- Smith Sworn to before me this ~gm~ day of ~c2>g~c~.- , 19 ~ . Notary Public, ~ County Notary Public THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ O1 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~t~ Dec, c~er :LS~ 1~ 27~/84 only t~ elect~cal equipment as described below and introduced by tke applicant named on the above application number in the premises of in tbe followlng location~ ~ Basement ~ 1st FI. X~ 2nd FI. Section Block Lot was examined o~ ~0 ~ ~ and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES OVENS EXHAUST FANS OUTLETS SWITCHES FLUOEESCENT DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS: ~I_~G.F.C. I ~, 2-~$oke Detector ~ox 2lb E R V I C NO Olde RCC~.CON D. Lie 573E AWG OF CC, COND. N0. OF HI-LEG A, W. G. OF HI-LEG NO OF NEUTRALS OF NEUTRAL LDING TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR ILO. BOX 728 TOWN 1tALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 This is to advise you that the job under building permit no. 12881Z issued to Mr. Madigan on 2/22/84 for Addition & AlteratiOnis completed and a final inspection bas ( ) has not ( x ) been done. An Underwriters Certificate is needed In order to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a cheek for $35.00 payable to the Town of Southol~. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange wit}] tbis office for an inspection date 0cenpancy or use is unlawful without a Certificate of Occupancy. Pleat~e help us to clear up thie matter so that legal action does not []ava to be taken. Thank you for your prompt attention. Very truly y~, Victor Lessard Executive Administrator VL:gar encl. FIELD INSPEC"~ION FOUNDATION ( 1 st) COMMENTS FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY %ODE · 4. FINAL ADDITIONAL COMMENTS: FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined. .- ... Z Z 19 Appro, l Pe it o. Disapproved ~1~ ..................................... APPLICATION FOR BUILDING PER~IT INSTRUCTIONS Application No./~.~..?./. ....... Date ................. , 19 a. This application must be completely filled in by typewriter or in ink and submitted 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 issued a Building Permit to the applicant. Such permit shall be kept on the promises 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building 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. (as on ~he 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 .... /~./ .................. Electrician's License No. ~9~/. &M.~... Other Trade's License No ...... 1. Location of land on which proposed work will be done .................................................. House Number ' Street Hamlet County Tax Map No. 1000 Section ..... .O. ?.~ ....... Block .... .0:.7~.. ......... 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 . ....... .. t~&/~ .~.~,~,4 ~ ~ ................................ . t. b. Intended use and occupancy .... ~.A,/~ .... ~ ~.~.'~'~ .... ....................... 3. Nature of work (check which ap!plicable): New Building .......... Addition.. ~ .... Alteration .,,~,t.. ...... Repair .............. Removal ............. Demolition .............. Other Work ............... 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 ..... ~ ................................................................... 6. If business, commercial or mixed occupancy, specify naturetgnd extent of each typ. e of use ............ ./ ....../.. 7. Dtrnenslons of existing structures, ffany. Front ..... ~..&, ....... Rear .. ,~'~eJ.-~. ...... Depth..'4',~..../-~. ~... Height ..... ,~Tr~... :~... Number of Stories ..... ./.~'.~.. ............ 7 ................................ Dimensions of sate structure wlth alterations or additions' Front . ~ .. Rear 2~,~ . . r)epth .... ~. ~. ....40 ..... i.. Height .... ,~......-er. ..... .; ..... Number of Stories.../.~-a-~ .... ~ ........ 8. Dimensions of ent?~ new constrUction: Front ..... ~....~... Rear .... .~...~; ..... Depth . .'~. ..... ;... Height ..... /.~. ...... Number of Stories .... /. ....... / ......... ~, ....... 9. ]ze of lot. Front ..... ~.~...: ........... Rear ....... ~.. .......... Depth ... ~..:~'. ............... 10. Date of Purchase ........... i .................. Name of Former Owner ............................. I I. Zone or use district in which promises are situated ............................................... 12. Does proposed construction vic!ate any zoning law, ordinance or regulation: ..... ~O. ....................... 13~ Will lot be regraded ......... i. · ./~,2~ ............. Will excess fill be removed from premises: Yes ~ No 14. Name of Owner of premises p~.. ~d-~j,~.. Address (//~ff4~ .~... Phone No. :~.~.B..~..8.~.... Name of Architect :. ..... Address Phone No Name of Contractor ~7"~/r~..~-~-"'~ ........... Address .~o/,ao~. ~. ..... Phone No. ~.-'.~.~ff'~... PLOT DIAGRAM Locate clearly and distinctly alll buildings, whether existing or proposed, and, indicate ail set-back dimensions from property lines. Give street and block humber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ...... -.~. ~ .~.~..~ ..... .............. ~/~Sd. j~.~.~.k ................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ..... /~..O~-/~OF/_,~l;r~....~-~. t'~ ........................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is dul~ authorized to perform or have per[creed the said work and to m~e and file ~is application; that all statements contgined ~ this application are true to the best of his knowledge and belief; and that the woFk will be perfomed in the m~ner set forth in the application filed therewith. Sworn to before me this ................. /.~...day o(..~ ............... 19~ Notaw Public, .~~~~,. 8[,1~' .............. / , - ................ {~;8~ ~o1~ ~uW~, (Signature of applicant) ~ T~m /