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Home My WebLink About15861-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date OCTOBER 26, 1988 THIS CERTIFIES that the building~ Location of Property 135 GROVE ROAD House No. County Tax Map No. 1000 Section 80 SubdivisionM/o Reydon Shores ADDITION Street Block 4 Filed Map No. 631 SOUTHOLD, NEW YORK Hamlet Lot 12.1 Lot No. 17~18,&19 conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 31~ 1987 pursuant to which Building Permit No. 15861-Z dated APRIL 4, 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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to BARBARA WEBER (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. H 005456-SEPTEMBER 29, 1988 PLUMBERS CERTIFICATION DATED 10/1/88-J.E.D. PLUMBING & HEATING Building Inspector Rev. 1/81 FOB~ NO. ~ TOWN O~: $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT COMPLETION OF THE WORK AUTHORIZED) N~ 15861 Z Permission is hereby granted to: ........................ at premises~ Ug,--~located at ../..~.~....]..~...~....~..~=.,.....~~ .................................. County Tax Map No. 1000 Section C)~ O Block ........... .~. ........ Lot No .....)....~'..:...~. ........ .~ ,~...~.. . , approved by the pursuant to application dated ..... ......~ ............................ 19..~..~.., and Building Inspector. Fee $ ........................ Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Buildlng Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCU ~' WN OF SOUTH()[ 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 p~opertv showing all property lines, streets, buildings and unusual natural or topographic featu res. 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 occupency New Dwelling $25.00, Accessory '$I0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $100.00 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 NewC°nstruc%ion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ........ ~;... :~,~,, ..... ¢~)~ .......... ~,.,,,, ,~. ,~,~, ,~,~',~, ,~., , .~,,/... House No. Street Ham/et Owner or Owners of Property ...................................................... County Tax Map No. 1000 Section ............... Block ............. Lot.,, ; ....... Subdivision ........... P..,'Y .... q.~. .~.~ ....... Filed Map No ........... Lot No ..... ' .... ' .... PermitNo./..'~.?.~./..~.. Date of Pormit '~I .... Applicant. .~...~. ~,~. ...... ~..4~..~ ....... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval .... ~ ............. Request for Temporary Certificate ..................... Final Certificate ....................... Fee Subm tted $. .~.. ...................... Construction on above described building ~rmit meets all~.plicable codes and regulations. Applicant ..... ~ .... .....~.~ ..~. ..................... Rev. 10-10-7a 3 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ~]~NAL DATE INSPECTOR TOWN OF SOUTHOLD ' OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. '~65-1802 CERTIFICATION Date Building Permit No. '(please print) Plu er. . . 3. (pi'~ase print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. ~/ ~ipl'umber's signature) Sworn to before me this Notary Public Notary Publ~ic, ~,'~ "~nt y ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS 8007005 BUREAU OF ELECTRICITY [-- 85 JOHN STREET. NEW YORK, NEW YORK 10038 SKPTF, liBI*;lt :29.19~8 ~0~2~87/87 ~ 0C)5~5~ Date ~4pplication No. on file THIS CERTIFIES THAT o~ly the ~l~ctrtcal miu~oment as a~scri~d b~ow and lntroduc~i by th~ ~pl~mt n~sm~d on th~ abo~ applic~glo~ nm mb~r ~ t~ p~ o] in t~ f~lowing h~,t'~ · . e t ~ ~d .~tlon Bilk ~ examin~ on Ond~nd to be ~n co~hpllonce with the ~qui~ments of this RXTURE EXTUII~S RANGIS OVENS iXHAUST FANS 3 ~, 8 K/IINA4ZE MOTOI~S ~ DISCONNIO' S E R ¢ BARBARA {{EBER ~}J"~5 ¢;ROV~.: DR. SOiITHOL}), NY, 11971 This certificate must not be altered in, any manner; return to the office of tfN Board if incorrect, be identified , their credenl~als. COPY FO~: BUILDfl, IG DEPARTMEHT. THIS COPY OF CERTIFICATE MUST NOT BE ALTEPJ~ IN AHY MAHI4ER. TO~%tN OF SOUTIIOLD OFf'ICI{ OF BUILDING U~SPECTOR iLO, BOX ?28 TOWN HALL SOU I'IIOLD, N.Y. 11971 TEL. 765.1802 To Whom This May Concern, I';e are unable to complete your Certificate of Occupancy because .of the following reasons. /L//An application for Certificate of Occupancy zs eot on file. '/~_~,/ .L9 .]nderwrlter= Certificate on file. /_.// The chock -[s(o':~tc~7~not 0'4 file.) ~c3~,6~ /-_/ N~o Health Dept. Approval on file. /.~/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperationS' Buildinq I'e=m±t t~ ], ~ ~ ,~ .~ Z Buildinq Dept. *""/~ Ho Plumber solder Certificate on file. ( all permits involving plumbing bein] issued after April 1,1984 ) OU~DATION (1st) OUNDATION (2nd) OUGH FRAME ~ ?LUMBiN~.--''~ NSULATION PER N. Y. STATE ENERGY CODE FINAL . ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION ]FRAMING [~FINAL INSPEL~I'OR ~ ./~ [ ] FRAMING REMARKS-' 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [~ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FINAL DATE I NSPECTOR~"~/~ ~ 765.1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [~NSULATION FRAMING REMARKS: FINAL /x 765-1802 BUILDING DEPT. INSPECTION DATE /~/'~P/~ INSPECTOR~ 765-180Z BUILDING DEPT. INSPECTION FOUNDATION 1ST [ R~OUGH PLBG. FOUNDATION ZND [ ] INSULATION INSPECTOR 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1803 Examined ....~..~, ...... 19~. ?. . .~''..4 ...... 19~..]. Permit No. ]-.&.'-.~..G.I..~.. Approved Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERIV BOARD OF HEALTH ..~... 3 SETS OF.VLANS .~.-~.~.-,~-~'~ SURVEY ..~. ..... CHECK SEPTIC FORM · NOTIFY CALL ................ ~AIL ~t~ 3 tl98T ,,,,'row~ OF Date ..... .o. ~.q,. ~ .... '.., 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. 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 ~ 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 Pemnit 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. ., ~ .~g..~.. ~..~.... ?.'{ ~'~...~5.. ............... (Signature of applicant, or name, if a corporation) .... ....... (Mailing address of applicant) State whether ap~icant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 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 .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on which proposed work wilI be done .................................................. .... ...... ...... .... .......... House Number Sffeet Hamlet .~.. l.~: ( '~''' County Tax Map No. 1000 Section ...... ~.0. ........ Block ............... Lot ............... ~.~.d.~. ~q.a.~O...~.~. ..... : .... Filed Map No. (o'~ ~ Lot Subdivision ....... ( 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............ ¢ .. ........ , ................ ......... ii" 'v :, ...... . b. Intended use and occupancy ;' : 3. ' '! ' b/: Alteration .......... .Nature of work (check which apph.cable): New Building .... i ..... Addition .......... Repair .............. Removal .............. Demolition ..... ' ......... Other Woi'k'. ese n -- (D riptio ) 4. Estimated Cost ................ , ............. ' ....... Fee ...................................... i ' (to be paid on filing this application) ' I 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars ....... 1 ................................................................. 6 If business, commercial or mixed olccupancy, specify nature and extent of each type of use ' 7. Dimensions of existing structures, ~f any: Front~ ...... ~,~t ...... Rear .... c~f. .................. Height, ..... / g. ....... Numbe,r of Stories...~- ......... '4 ................................ Dimensions'of same structure with!alterations or additions: Front .... ~. ........ Rear .... ~.~'i .......... Depth ........ ~fz~ ........... i Height ........ L.z'.r. ........... Number %f Stories .............. 't ....... -8. Dimensions of entire new construction: ~ront ..... j.t[.t.. .....Rear .... /~. ........ Depth ., .a}.~. ........ Height .... ;. J.2,I .......N,~mbe'r of Stories ..... ! .............. , ..................... t ..... 9. Size of lot: Front ~,,. ,~..'ff..,~ i. Rear. ' .gO .. Denth . ~.o¢ ..... 10. Date otPurchase .......' ' q/.:~2,i' ..... , ............ Name of Former Owner . C~J~Ij~:/.'[.6.7.. . 11. Zone or uso distract in which prem~ses~afe, situated ..... ~tX 1 ~ g.~. . . ./~[ ....... , ......................... 12. Does propdsed c~nstruetion:;~]ol~t~l~l~zbning law, ordinance or regulation: .... ~. '] .O ........~... ............. 13. Will lot be regraded ..... '.'~'.~/)~. ~.~1/~. ............Will excess fill be removed.from premises: Yes 14. Name of Owner of premises ~/).: .I ~).. ~..~.~ff.. ...... Address . [.](~.°.//~. ~..~... Phone No..7~_~. r& t .5(.~... Name of Architect ..... ,...ff~/..vy9~'..,/°,~zA~<...... Address...~.~..'.D..~..~.~.'... Phone No ....... 2 ........ Name of Contractor '.. ~, .~/'l~.~.~.~ff. .......... Address ...~',~. g~. ~. ......... Phone m~g'..~ ~.(..~..ff.~.4... 15. Is this property located wi!thin/ 300 feet of a tidal wetland? *Yes ..... ~ .... *If yes, Southold Town Trustiees Permit may_ be reouired. i , PLO'T~DIAGRAM property lines. Give street and block n< tuber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW Y~RY~ y_ t7/..-, ..... (Name of individual signin contract) above named. ........ being duly sworn, deposes and says that he is the applicant (Contractor, agent, corporate officer, etc.) >f said owner or owners, and is duly tuthorized to perform or have performed the said work and to make and file this spplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the ~ork will be performed in the manner slet forth in the application filed therewith. ~worn to before me this .... .~)..g....~_.. ........ day o..[.~~...~.. ...... ,19..~ r,o. ,~/~sl, suffo k ~un~.~ (Signature of applicant) PLUMBER CEI~ICA TION ON LEA~T EEFORE CERTIFICATE OF OCCUPANCY ! '~.: I' '~;.;. SOLDER USED IN WA TER ~' ~'~d ~'~ ~ '- SUPPLY SYSTEM CANNOT 6?? ,~ ~/VCy 01~ ~xc~o ~/,o o, ,~ ~o. system; piping shall be Of types K~orL on,l~. ri iL' Phone 477-0 Main Road GREENPORT, N.Y. 11944 II II '" I ~ - 2198~ · row~-OC'sou~q OEO