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Home My WebLink About16361-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17166 Date AUGUST 5~ 1988 THIS CERTIFIES that the building. Location of Property 165 House No. County Tax Map No. 1000 Section Subdivision ADDITION MESROBIAN DRIVE LAUREL Street Hamlet 145 Block 4 Lot 6 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 17~ 1987 pursuant to which Building Permit No. 16361Z dated AUGUST 22, 1987 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 UTILITY ADDITION TO AN EXISTING ONE FAMILY DWELLING. The certificate is issued to GEORGE & KATHRYN JOHNSTON (owner, XXXXXXXXYC4XXXXXX) of the aforesaid building. SHFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N023253 EAST END PLUMBING & HEATING 7/21/88 Building Inspector Rev. 1/81 FORM NO. O TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥o BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N*_ 16361 z Permission is hereby granted to: ~.~.~.~.~.L<.~.....q..~ '.~~L~..,.~,.......~..tto...~ .... . ~..~~:~:~.,.....~...~~.:.~:.~ .............. .~ ....................... ,,t premise* io~ated at ..l.k_~......~..l.~..-X~.~ ........... (N~ .................... pursuant to application dated ..... Building Inspector. and approved by the Fee . Building Inspector Rev. 6/30/80 FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY BLDG. OEPT. , ~rOWN OF $OUTHOLD Instructions A. This application must be filled in typewriter OR ink, and submitted i ~ 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 featu res. 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: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$10.O0 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 5.Updated C.O. $ 50.00 Date ....................... New C OhS truc t ion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ....... /(,5.'~, .... ~.e.~.¥e.~.~.~..../>?~. .......................... ~/~..~..¥e~ . . House No. Street Ham/et Owner or Owners of Property ...... ~.~ .o.1~ ¢ .... .~.~.~.~..~'o..~.....~....K~.7-.~.~./¥~.. ~.~/~ ~.$;'?~-~. County Tax Map No. 1000 Section .... ,/~,/,~: ..... Block ...... .~, ....... Lot ...... ~, ......... Subdivision ................................. Filed Map No ........... Lot No .............. PormitNo. ,/.~3~/ Date of Permit ~/'~?/~'?..Applicant ~¢~.~.~.. ~Z~,'~4.~ Health Dept, Approval ........................ Labor Dept. Approval ................... ..... Underwriters Approval ........................ Planning Board Approval ...... ..~. ............ Request for Temporary Certificage ..................... Final Certificate ....................... Fee Submitted $ Construction on above described building and,p_ermit meets ¢1 appl,ica, ble codes and regulations. ~ ~Z'/7 App cant ..... ~ !/~/../~.... ~'~": .~. EAST END PLUMBING & HEATING POST OFFICE BOX 528 54 RIVERHEAD ROAD WESTHAMPTON BEACH, N.Y. 11978 516-288-3129 LEONARD T. REMPE, I_NC. July 21, 1988 Town of lOouthold Building Dept. Main Road Southold, New York To whom it may concern: This is to certify thst all solder used in the plumbing work at the George Johnston residence on Mesrobian Drive in Mattituck is 95/5. Leonard T. Rempe PresiSent TOWN OF SOUTHOLD OFFICE OF BUILDING INSPEC?OR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because ,of the following reasons. TEL. 765-1802 ?' j An application for Certificate of Occupancy i s ..n.o_t~ _on _file ................................. Underwriters Certificate on fzle_. ,; ~ /~ The che~ck is (outdated/not on file.)~2S~-O~3 / /--/ No Health Dept. Approval on file. /_--/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. ,~uilding Permit # -II ..~__. ~ .__~ __]_ Z Building Dept. ***~No Plumber Solder Certificate on file. ( all permits/involving plumbing being issued after April ,1984 ) .FIELD INSPECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ?DE FINAL COMMENTS ADDITIONAL COMMENTS: ~ ? --4 0 0 765-1802 BUILDING DEPT. . INSPECTION, FOUNDATION 1ST [ ] R/OUGH PLBG' FOUNDATION 2ND [~] INSULATION FRAMING [ ] FINAL THE NEW YORK BOARD OF FIRE UNDERWRITERS ~'~ : ~ ~}f~ ~ I)93BUREAU OF ELECTRICITY ~ ~ 85 JOHN STREET. NEW YORK, NEW YORK 10038 THIS CE~IFIES THAT ~y t~ ~t~M ~u~me~t ~ ~d~ ~ o~ int~ by t~ ~i~t ~M on the a~ ~t~ aum~ in tM p~s of ~s examin~ on J U N ~ ~ ~ ,1~) ~ ~ a~ f~nd to be in compliance with the r~ui~ments of this ~M, ~R~ mK~T ~ ~. M I S E n V I C NO. IT FANS _~C~4~_POII INLDll~ DEPARTMrFIT. THIS COLBY (Nr ClRTIFICAT! IT NOT Il Ak~ I1,1~ ~ Examined ~.~.~..ar. g, 19°O,.~. Approved~..~..~-..~'..~.., 19 .~?. Permit No.~ .~..~k[ ~ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ...... 3 SETS OF PLANS ....... 'FORM NO. I SURVEY TOWN OF SOUTHOLD CHECK : -~-~1:::: BUILDING DEPARTMENT §EPTIC FORM ............. : TOWN HALL NOTIFY $OUTHOLD, N.Y. 11971 TEL.: 765-1802 CALL ................ MAIL TO: INSTRUCTIONS Date 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 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 inspectio,,~q,~-~ ~--~ /.. ~_~. -...."r:T~,~,.~..~~.~.. (S~gnature ~__~ica ,~9~,~name, %a co, rporahon) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build'er. Name of owner of premises .................................... .~.~/~¥.~...~ .............................. .~.? . .~..~.0/~ ~_.~ / 1~ ..... .q?..~...~/..~./?? ~.~ .... ~ ........ ....... £ '~' ........... (a~ o'n' the'ia'x' ;o'I1 ;; ilt}}t' 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 .......................... Plumber's License No ......................... Electrician's License No ....................... Ot-he-r Traae s License No... 1. Location of Iand on which proposed work will be donel ..... ~.~ ..... ~ ................ ............. :',' ;-'" ;'" .................. 'r ......................... ........ House Number I (.~ Street Hamlet County Tax Map No. 1000 Section .... ].~.f ........ Block ..... ,t~. ........... Lot .... '~2 ............. 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 .... [.../.~..~-./.~..y . . .~..~ ........ e... b. Intended use and occupancy ................... ~.~...c ?. ~>. (...cfi. 7. t..~/,~,,%~,~, .d..,q. 67 ....... 3. Nature of work (check which ~pplicable): New Building .... ' . Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... . .~.~, +~.~. }' ~ ,~ ~, (Descriplion) 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 ... i ....... / ..................................................... 6. If businessl commercial or mix'ed occupancy, specify nature and extent of each type o'fB~e ..; '. '... :'. ............. ..... t ~ , ! 7. D~mensmns o f ei[snpg structures, if any: Front ..... .~. ~-~ ...... Rear ...~. ~ .~'4~ ..... Depth ... q:~. (o ........ Height ...... ~...t ..... Number of Stories ...... .~. '. [..' ........................ "..',..'.. ~. .......... Dimensions'of same structure with alterations or additions: Front ..... ~ .~ ........ Rear .... ~ 7 ight ~. ~. Depth .... ! .. ~.. He ... Number of Stories Dimensions of entire new construction: Front ...... /.~ ...... Rear ...... /.~. ...... Depth .... f./{, ........ Height ...... ~ .t ..... Number of Stories ....... ..../ ................. 9. Size of lot: Front ........ /..~..O. ? ........ 'Rear .. i...~..~)..t.. . Depth ~.../..~..~../ . 10. Date of Purchase ...... ~..0.7.../.~'. ~.& ........ Nam~of Vor~e'r'~.~w~;~ . .Z/./~. i.~~. .~.-,%.C~ 1 1. Zone or use district in which premises are situated ...... /~'.~ ~ .t .,Q.~ ./.t.q~ ........................ 12. Does proposed construction vi61ate gny zoning law, ordinance or regulation: ...... ~.d) .......... ~ ....... 13. Will lot be regraded ...... ../..,~...o.~ ........ .,,,,q.. Will ex~e. ss filJ. be remcwecl from nremixes: (Yes') No 14. Name of Owner of premises ~.<~../.~.,.~...~.~.~..,S,~ .~Address ~..~...~.~.t-) tfo~...~o~ne/Vl{b. Name of Architect ....... .~.. ~ .............. Address . ..~ ............... Phone No .............. Name ofA2on~a~l( ..... ~7~....~.~ ev'.~.~.,~/.~./'... Address ~7~4 .Ce..~.6t. q~.~.~t/.~h~e No. c~.~. ~. ~. ~.~o..~... 15. Is this property locate~ within 300 feet of a tidal wetland? *Yes ...~.. No ..... *If yes, Southold Town T~ustees Permit maybe required. · i PLOW 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~,, RK/~/,. COUNTY OF ~~'~ ,---, ....... · ~.?.':~~';'..~.~. ....~-7.~..J~..~..].~..4. being duly sworn, deposes and says that he is the applicant (Name ofindividua signing contract) above named. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duiy authorized 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 thi[r ~ ,/Q , ............. 21 .......... Notary Public, ~.~2~{~,~... County . O~l~e t~ ~[m~t ......... ~ ..~. ....... ~ I~lhl~, 8~t~ o~ ~w York r~ '~- (Signature of applicant) ~ ~ir~ O~ember