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Home My WebLink About16415-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17519 Date NOVEMBER 16, 1988 THIS CERTIFIES that the building. RENOVATION & ADDITION Location of Property 50 WILLOW POINT ROAD 8OUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 56 Block 5 Lot 25 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 31, 1987 pursuant to which Building Permit No. 16415-Z dated SEPTFa~BER 1, 1987 was issued, and conforms to all of the requirements of the applicable prouisions of the law, The occupancy for which this certificate is issued isRENOVATION & ADD. TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to RICHARD NASS (owner, X~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HF2%LTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PENDING - NOVEMBER 7, 1988 PLUMBERS CERTIFICATION DATED JULY 1~ 1988 - HENRY J. SMITH & SON, INC. Building Inspector Rev. 1/81 ~'OB,~ 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) N9 16415 z Permission is hereby granted to: · " 'C~'I '" ~~....~..q.,...J../..~.~J. ......... ~.~. ~..~'~ '~ '.~~ to ..... ~.~.~ ...... .).......C~ ...... at premises located ot ...~..~,...,.,,..~,.,,~~.....,.r~.,.,~,,.;.,.,,~;~. .............................. County Tax Map No. 1000 Sectio~...O..J~. ........ Block ...... ..C~..~... ....... Lot No.....-~,~.. ............ pursuant to application dated ...~...,~. ,.~,,,,.,..~,,,~ ............ , 19.~.~.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 .Y. 11971 ., ~'~~r~tions .... A. This application must be filled in typewriter OR ink, and submi~ed ~ to the Building In~ec- tot with the following; for new buildings or new use: 1. Final su~ey of propertv with accurate location of all buildings, prope~y lines, streets, and unu~al natural or topographic fea~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 Unde~riters. 4. Commemia{ buildings, Industrial buildings, Multiple Residences and similar buildings and in~alla- 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 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling,S25.00, Accessory ~$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 ?..~... 5.Updated C.O. $ 50.00 /Date ..~.U~f.L~/.L,../. .... New C OhS t r u c t i on ....... Old or Pre-ex isting Building ............ Vacant Land ............. Location of Property . ~'-~.... House No. ~.[~f~_.~ ..~....~ Street Hamlet Owner or Owners of Property .................................................. County Tax Map No. 1000 Section .... ~ ........ Block .... .~C ........ Lot....c~.4 ......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. (.~..c(./.~.'.-~... Date of Permit ...Applicant..',~].Qb.O.. C 7 ....... i ...... ~ Health Dept. ApprovaJ ........................ Labor Dept. Approval ........................ Unde~riters Approval ........................ Planning Board Approval ....... ~.. .............. ~equost for Tom~orarg Certificate ..................... F~nal Certificate ....................... Construction on above described building and perm!t meets all appJ, icable codes and regulations. Apphcant .~?'~'(~, ~,,..~..~,..4~./?..~..) .... ; ~ .............. Rev. 10-10-7a TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD~ N.Y. 11971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. /5/ An application for Certificate of Occupancy //is not on file. _ No Underwriters Certificate on file. /5/ The check is(outdated/not on file.) /5/ No Health Dept. Approval on filo. /5/ Nu final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Bui] ding Permit Building Dept. ***/5/ No Plumber solder Certificate on file. ( all permits involving plumbing being issued after April 1,198~ ) HENRY J. SMITH & SON, PLUMBING, HEATING & FUEL OIL MAIN ROAD SOUTHOLD, N,Y. 11971 (516) 765--3690 CERTIFICATION Building Permit No.__~l_5~ ....... 0wner_]Ltch~y_d_[~_~o_u~h~o!~L_NY__ ..... Plumber Henrz_~±_~&~_~_~2Bm. Inc. I certify that the splder used in the system contains less than 2/10 of 12 lead. water supply -- -~ FV-Smr~-=: --- Sworn to before me this 1st .day of ~y_ ....... , 19 88 - #484489~--~ t a~y~uu~ 11 c Notary Public, Suffolk County ~OTARY PUBLIC. S!~t~ of ~W Y~ FIELD INSPECTION 1. COMMEN'iS FOUNDATION (1 FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ?DE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. [] INSPECTION FOUNDATION 1ST [/ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION* FRAMING [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING REMARKS: ROUGH PLBG. [/~INSULATION FINAL INSPECTOR ~/ BUILDING DEPT. FOUNDATION IST [~]' ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING FINAL REMARKS: / / DATE '[(~ INSPECTOR BUILDING DEPT. INSPECTION ~FOuNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL DATE c~/<~//~/~ INSPECTOR THE NEW'YORK BOARD OF FiRE UNDERWRITERS 10C)1071 BUREAU oF ELECTRICITY S5 JOHN STREET, NEW YORK, c,Y~ ~)3E ~te Ap~i~ti~ No. on flle w exami~ ~ a~found to be in ~mpllan~ with the requi~meats of thh ~. DI~YERS RJRNACE MOTORS FUTUII! AI~L&~CI NINIS TIMI ~S UNiT HIATE~S MUtTi. OUT~T MMMIIIS SIRVICE DISCC~4N~W S E R V ! C This certificate must no~ b~ altered in any manner; return to the office of ~,e Board i~ incorrect. Inspectors may be identified by their ~ls. ~, ~ BUI~ DEP&RTMEHT. THIS COPY O~ CER_TIF_C(~ T?~T HOT BE .~LT_ER~I#~_.,~y_. ,_~.- ...... BOARD OF HEALTH ...../~. 3 SETS OF PLANS ......~'o- 'FORM NO. I SURVEY . TOWN OF SOUTHOLD CHECR BUILDIN(3 DEPARTMENT ~EPTIC FORM ............. : TOWN HALL SOUTHOLD, N.Y. 11971 NO~;~ TEL.: 765-180Z CALL -'~-' -'- ..... ~ MAZL TO: Disapproved a/c , . . ................................... .................................. ........ ..D- . .......... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS 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. e. 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 inspections. · ...... (Signature of applicant, or name, if a corporation) . . . .q.-12. . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · .................................................................................. Name of owner of premises .... .~. ,~.'....~: t..~.~..,9.~/.r). .... ~..~.~. ~: ...................................... (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 .... ./~71. ~.~;~..././~. ...... Plumber's License No .... Electrician's License No. Other Trade's License No...&5/.~...,~. ~.. 1. Location of land on which proposed work will be done .................................................. House Number County Tax Map No. 1000 Section Street Hamlet .~.--~. ........... Block ~-- Lot. ~5 5- '-' Subdivision ..................................... F!led Map No ............... Lot ................ (Name) State existing nsc and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......... ~.~.~. ..... · ...... b. Intended use ahd occupancy ............................................ : ....... ................. 3. Nature of work (check which applicable): New Building .. ' ... Addition ...... ~ Alteration ..... Repair .............. Remgval .............. Demolition .............. Other Work ............... /~..d.~./. ~.,L (Description) 4. Estimated Cost ............................ Fee ...................................... · (to be paid on filing this application) 5. If dwelling, number o f dwelling! units ...... /. ........ Number of dwelling units on each floor ................ If garage, number of cars .... i ................................................................... 6. If business, commercial or mixeld occupancy, specify nature and extent of each type of use ................... 7. Dimensions of exisgng structures, if any: Front ..... ?t~ ....... Rear ...'1.7. ........ Depth... ~.~. .......... Height ..... gx.~..~. .....Number of Stories . ('f. YT.. ...................... J.. 2 .......... Dimensions'of same structure with alterations or additions: Front 77 ....... Rear ... ~ 7. ...... Depth ... ~.q..~. l~j. Height ....... ~. ............. Number of Stones .../~.~ ................ -- 8. Dimensions of entire new construction: Front ..... , ......... Rear ...... /.~ f ...... Depth .. ~.~.' ......... Height ..... /~.: ...... Numb?r of Stories .. ?..~/..~. ........ .. .......................... 9. Size of lot: Front ./'t'o. ...... Rear ..... ... ~: .~... 7 ........ Depth ....~.l~.,;:~ ............. 10. Date of Purchase .... /. ~*.. i ................... Name of Former Owner .~-t','~. ,~t4~$. · · .<~. ,,. · 1 1. Zone or use district in which pr~mises are situated ..... ~-g... ~. ...................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ....,~..~. ......................... 13. Will lot be regraded ...... ~-'/9 ................... Will excess fill be removed from premises: _Yes 2~' No Name of Architect /?/..~...~, i .,<(~.~d' ....... Address ~. ~.~,~('~,~d~.o~Phone No. i~.'(.~t.~-.~.' 15. .Is th~.s property locatedlwithin 300 feet of a t±dal wet~.~es .,~.. No ..... · If yes, Southold Town TrUstees Permit maybe required. i PLOT DIAGRAM Locate clearly and distinctly alI buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block: number or descriptio~ according to deed, and show street names and indicate whether interior or corner lot. /~ ~-~ ~ ~ y-/~2 g.~ ~J STATE OF NEW YOR~,, ~ . COUNTY OF ....... ~.~...~..~.~.. S.S ................. -.-~/~//-~ .~..~..~'"?~./. ............. being duty sworn, deposes and says that he is the applicant (Name of individual sigh'ting contract) above named. He is 'the...~O../~.)f~'~... ~. ~--/.f_~ .~. ................... . ................................... (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 Cont!ained in this application are true to the best of his knowledge and belief; and that the work will b~ performed in the manner set forth in the application filed therewith. Sworn to before me this ................. l ....... day o~ .............. 1 Notary Public ................ :..~..O. ~. '.F, .O/.>1~.. Couniy . ~t£~ [. DE V0E ........... "' .......... ..NOTARY PUSLIC. iState ~f Now ¥0~lt [/ "' (Signature of applicant) . No, 470~78,1Suffolk County.~, o per tubing IS ~sed ~t c 0 ~.st~ibutin9 soLDE~_ ,'m=M cANNOT CEBTJFICAI~ ~'- I~V ~ILDh4G DE NOT 0 ~ PM ~ i[ I~eL~(A1~D ,6, m, 0 0 ,I _4J / x EY, I~T D~- TO ~ei~KUO Lid J OP~ H TO_ TYP/~L: 5F_.C~HI2 FL~OR PLA-It FRQN[ ELEYAIIOH IZ R t~H"I G, Ib~.- ELEVATI~/"/ ~,XlsT. /r R.AD E i !,,I,,i / / -j