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Home My WebLink About16257-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Date November 17, 1987 THIS CERTIFIES that the building .A.l.t.e.r..a.n.d..a.d.d ................................... Location of Property ...I.4.2.5..N.o.r.t.h Sea Drive Orient House No. Street Hem/et County Tax Map No. 1000 Section . .0.].5 ........ Block 05 ..... Lot 27 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... J.u.l.y..7.,..1.9.8.7 ...... pursuant to which Building Permit No. 16257Z dated . .J. ql.y..2.2.,.. 1.9.8.7. .............. 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.l.t.e.r..e.x.i.s.t.i.n.g attached garage and add a two car garage to an existing one family dweffffi~: ....................................................... The certificate is issued to RUSS AND MARION WOOD of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO .... N838688 10/20/87 PLUMBERS CERTIFICATION DATED: John E. Walters 10/16/87 James P. Anderson Building Inspector Rev. 1/81 TOWN OF SOU33'iOLD 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_ 16257 Permission is hereby granted to: ....... ..~.~....~....~.,.~.......u..~ ~ prem~ ises located at ..(..~..~..~....~......./l~..'~ ........................ Mop No. 3000 Sectso, .....~..I..~ ......... mo~k ...... .o.,~ ...... Lot No ...... .~..~ ........... pursuant to application dated .......... ...~.~.~.. ...................... ,19.~..~.., Building Inspector. Fee $..~....:. .............. and approved by the ~~ '~ ~ildlng Insl~.~tor ........................ ~. ....... .~ ............ Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 8LD~. DEPT. TOWN OF ~OUltlOl, D APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m ~ 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 p:Coperty 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: Additions $25,00 ?OOLS $25.00 I. Certificate of occupancy New Dwelling $25.00, Accessory ,$10.00 Business $50.00 2. Certificate of occupancv on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 o.oo 5.Updated C.O.' $ 50.00 Date ..... 1.( ............ New C on s t r u c t i on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .., ./,~.~.,5~. ....................... J~J. p(~..T.H...~..E-.A., .~,. ........ 0,~.{.~.~../.'~.. House No. Street Hamlet Owner or Owners of Property ... County Tax Map No. 1000 Section .... ~ l.'5~ ....... Block .... .O..S*. ....... Lot.. ?.7. ........ · . Subdivision ...... · .~. [. Tt~5/..T.., .~.¥.T.H~,. ,~, .~/~ .... Filed Map No. ~..SL~L.¢.....Lot No.. ?, .~-. ......... Permit No. J.~.g..5. 7... Date of Permit .,,//;/?./.8.7..Applicant... ~ b~..~.. '....~.~.R. ,~. ............. Health Dept Approval ' Labor Dept Approval Underwriters Approval...~.~. F. 0.~. ~. ............ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ...... .U~,., ............. Fee Submitted $. ~ ,S'0 043 Construction on above described building and permit meets all applicable eedes and regulations. Applicant . ~N...,?--......~ ........... d.6. THE NEW YORK BOARD OF FIRE UNDERWRITERS ~.~"~ BUREAU OF ELECTRICITY 8S JOHN STREET, NEW YORK, NEW YORK 10038 ~.t, '~t~,u~,,v ~, m~7 ~pp,lc.,~o.~o.o,,;,le '~OmS/S7 N 793746 THIS CERTIFIES THAT only the electrical equipment as d~scrlbed below and introduced by the applicant named on the above application nu tuber in the premises of Rusling WoO~, 14Z5 North Sea Drive, Orient, N.Y. in the fotlowing lacation; ~ Basement [] Ist Ft. [] 2nd FI. Section Block Lot u~s examlned on ~¢~b~Lt~ ~ ~-~/' and found to be itt compliance u, it h the requlren~ents of this Board. FIXTURES RANGES OVENS EXHAUST FANS DRYERS SYSTEMS OTHER APPARATUS: S E R OF CC. COND, C OF HI-LEG 275 Town Ho~or Lane So~thold, N,Y. 11971 GENERAL MANAGER 1~ L':;~ 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 IN ANY MANNER, i~}b[~ THE NEW YORK BOARD OF FIRE UNDERWRITERS - ' BUREAU OF ELECTRICITY ,~ '~ 85 JOHN STREET, NEW YORK NEW YORK 10038 ~ PD o~t:o~ 20 ,1987 510506/8? ~.~ ~-, ~,~'~"""" ~' ~"~'~ N 838588 THIS CERTIFIES T~T in the following location; ~ Basement ~ Ist ri. ~ 2nd FL ~fl~e Section u~sexarninedon OC~20~~ ~ 1~ andfoundtobeinconplarcewlththereq~irements~¥thisBoard. FIXTURE FIXTURES OUTLETS SWITCHES FLUORESCENT DRYERS RANGES OVENS DISH WASHERS EXHAUST FANS SYSTEMS NO. OF FEET OTHER AP. PAR A~TUS: E E V I Paul Bztrns 275 To~rn l~a~;bor Lane Southold l~ew York 11971 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be credentials. COPY FOR[BUILDING DEPARTMENT. THIS COPY OF CERT FICA~E MU~T HOT BP-ALTERED N ANY MANNER, TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. ]~ ~ Owner ~0~U)g (please print) Plumber~O~q ~, ~ ~ (please print~ 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 /~, b~ Notary Public, · (plumbe,r' s signature) "----'~ / Nota~f~ Publ~c~ Notary Public, State of New Yor UNDATION (1~/) UNDATION (2nd) UGH FRAME & PLUMBi~//~ SULATION PER STATE ENERGY CODE · ADDITIONA'L COMMENTS: 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [. j FOUNDATION ZND [ ] I~ULATION / [ ] FRAMING [ ~ FINAL REMARKS: DATE: /'1/(~/~'~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ]FRAMING [~iNAL ~ RE.MARKS: ~~~.. ~ --# / / / - / /' DATE /? INSPECTOR ~ ~'*~ 76S-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [//] ~OUGH PLBG. / FOUNDATION 2ND [ ~' INSULATION [ ] FRAMING FINAL DATE INSPECTOR~~~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. / ]/I~OUNDATION 2ND [ ]INSULATION FRAMING [ ]FINAL DATE. ~/~h7 INSPECTOR 765-1802 BUILDING DEPT. INSPECTION ~FOUNDATION 1ST [ ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING [ ] FINAL REMARKS: DATE INSPECTOR BOARD OF HEALTH 3 SETS OF PLANS 'FORM NO. I SURVEY ..... TOWN OF SOUTHOLD CNECK - -I-~'~ .... BUILDING DEPARTMENT SEPTIC FORM ............. TOWN HALL NOTIFY SOUTHOLD, N.Y. 11971 .~..2,.~. TEL.: 765-1803 CALL - MAIL TO: INSTRUCTIONS 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 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 Soutlmld, 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 apphcable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspec,tions~ /O c~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................... ~. ~....,. ,.~ ~, ~_., · · ;1~ · · ·/2.c., ... ,..: ;.. · · ~.,.. ............ : ............................ Name of owner of premises ................................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) . ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No... ~ .09. '.~.z-fi... ~ ........... Plumber's License No...~.0.~....l~.m/Tq~.~~ .......... Electrician's License No...~.r~.q . .~.a ~.~._? .... ' ...... Other Trade's License No ...................... 1. Location of land on which proposed work will be done~ ................................................. .. 1.q.25 .. ......... ......... ® .... ...... House Number Street Hamlet County Tax Map No. 1000 Section ...'~. · .... I. 5... Block .... :~ ..... ~. .... Lot.. ~ .... .~?. ..... Subdivision ~91'~I'~T- ./2o5./' T~,~r- ~'~:],~. Filed Map No. [b.~¢.¢. .....Lot ~ ........ ................ ........................ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................................................................... b. lntended use and occupancy ADD 2..C..~c~... d~.&5. C.. /~.~I~D.L,~.E.~, .~.!g.7?,'~~" ~ 3. Nature of work (check which appli'cable): New Building ...: .' ..... Addition... Alteration .......... Repair .............. Removall .............. Demolition .............. Other Work ............... g'?.c~.op ~ . ' ¥:.' (De ip.tion) 4. Estimated Cost P~. 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 olccupancy, specif× nature and extent of each type of use ' . .............. ...,. .... ' ~ ~' ' ' ,~o¢/L g)', 7. D~mensmns of ex~stmg structures, If any: Front... ~.~' .O. Rear .. ~ . .. Depth .. Height ............... Numbe.r of Stories ..... o..,?.t'%. ............... ~? .................... ;~ ......... Dimensions'of same structure withlalterations or additions: Front ...... ~7 .......... Rear ...'..7:7,-4 ......... Depth .... ~.?...t .............. i Height ..... o?.f, .~-?.~fi~ ........ Number of Stories ...................... 8. Dimensions of entire new construchon: Front . .. ~.~..~....~ .... Rear ............... Depth .. ~ ~./. ........ Height ............... Numbe!r of Stories .. Oto.~7. .... ~.. ............................................. 9. Size of lot: Front ....... t. ' 'i ......... Reai ...... ! ........ : .... Depth . ,7.~..6f ................ I0 Date of Purchase N eofF truer. Ow .............. i ................ am o ncr ............................. 1 1. Zone or use district in which prem!ses are situated ..................................................... I2. Does proposed construction violat~ any zoning law, ordinance or regulahon: .... ~.17 ....................... 13. Will lot be regraded ....... ~" ..... -'" ~'~'~'-~' ~ .......... ~o~ ' '' Will exces~fill~ ~, be. removed from. premises'. Yes 3 ~ [4. Name of Owner of premises .'~j'~,~.o~.. ~/, .~. Address ~.~.~-~ .~.e-.~..D.RO .0.g[qo'/Phone No..3. .2:.3. .q .~.'.~..~ Name of Architect ....~_ ....... · .., ............ Address ................... Phone No ................ Name of Contractor . .2,1P~-'M.. ¢ 'i' .D.b.~ d ......... Address "/~ . ~(~r~ .~.~71:.. D~'~or~,.e.~r.Phone No.. ~?..~ .: .~..~ ~'.. [5. Is this property located wiithin 300 feet of a tidal wetland? *Yes ..... No ...~.. *If yes, Southold Town Trust Locate clearly and distinctly all b )roperty lines. Give street and block nr nterior or corner lot. ees Permit maybe required. PLOW DIAGRAM fildings, whether existing or proposed, and. indicate all set-back dimensions from tuber or description according to deed, and show street names and indicate whether iTATE OF NEW ~OI~K/ Z S.$ :ou ¥ ~' being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) tbove named. te is the ...................... .°~..~. · .r/~....V~7~.. ....................................................... (Contractor, agent, corporate officer, etc.) .)f said owner or owners, and is duly guthorized to perform or have performed the said work and to make and file this ~pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the york will be performed in the manner s~t forth in the application filed therewith. ;worn to before me this ....... ~' ..............9 ~fday°f"J/':~ ......... 19.~. IJ~J. ¢OOPE ..... ..--f (Signature of applicant) Not~ry Publ ~, State of New ~ # No. 4822563, Suffolk Coun~ (..)~ Term Expires December 31, 19---