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Home My WebLink About16121-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. ZI6706 Date March 15, 1987 THIS CERTIFIES that the building .0..n .e..f.a.m..i.l.y.. cl..w.e.1.1. .i .n.g.. ........................ 595 Reydon Drive Southold Location of Property ~t~Os~ ~/'o~ ....................... '~'~/e~i ....................... County Tax Map No. lOOOSection .0.7.9 ......... Block . 05 .Lot 14.5 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated June 10, 1987 ptlrsuant to which Building Permit No. 16121z dated . .J.U.n..e..2.3.:..1.9.8. 7. ............ was issued, and conforms to an of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... One family dwelling, attached 2 car garage, covered porch. The certificate is issued to SUSAN LEE PHELAN & M. LEE PHELAN ..................... ?o¥0'o;, ...................... of the aforesaid building. Suffolk County Department of Health Approval 86-S0-207 March 14, 1988 Pending UNDERWRITERS CERTIFICATE NO .................................................. PLUMBERS CERTIFICATION DATED: PECONIC PLUMBING & HEATING 3/15/88 B~ffding Inspector Rev. 1/81 FO~ NO. f~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y, BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) N~- 16121 Z Permission is hereby granted...~to: , ~, C.)~,4~ , .... :i..1~.~.~..~.~ v ...... ...~.~, :....~..:~.:.....u..~.~..~ ........ ~. ~ ,o ~~. ~ ....... ~ ............... at premises I~ated at ....... ~ ..................... .... ~....~.~..~~.~...~...~..~~ ............................................... CounW Tax Map No. 1000 Section ..... ~.~ ........ Bilk ...~.~ ......... Lot No ...... .~..~ .......... pursuant to application dated ......~.~..l[....O..~ ....................... , 19.~o...I..,~-~ and Building Inspector. approved by the 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 Instructions A. This application must be filled in typewriter OR ink, and submitted im~,,,==-, 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 "preYxisting" land uses: 1. Accurate survey of p~operty 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 $25.00 -- BUSINESS $50.00 ACCESSORY $10.00 2. Certificate of occupancy on pre-existing dwelling $ 50 · 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, ~.l.I~.~. ~ ~ .~ ............. New C OhS t r u c t i on ...... Old'or Pre-existing Building ............ Vacant Land ............. Location of Property ~--¢~-- .~.~¥O~'f ~/~,~'~_ Z~.cf..--~.l-~_O I~.[."'Z//' House No. Street Ham/et County Tax Map No. 1000 Section (~ c~ Block ~..,b'~' Lot /Z~. ~- .' . Subdivision ........ ." .Filed Ma o.....-W'7. ..... Lot No ............. Permit No. '//.~.//.~.L .z. Date of Permit-J.~..N.~.~..~.~?.fp']plicant . .b.{.J~p..c...~.t~-.~', . .<~?. ?-. ?.. ......... Health Oept Approval 3.//.z'~./. ~.,~, ~ .............. Labor Dept. Approval ...................... . Underwriters Approval...//~. ¢~..~..~. ........... Planning Board Approval . .--7 .................. Request for Temporary Certificate ..................... Final Certificate . .~... ................ Fee Submitted $.. ~ ~ .¢..d) .................. Construction on above described building and p~rmit meets all applicable codes and regulations. AppJicant~-.~~ .~..: ....................... TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUT}tOLD, N.Y. I t971 TEL. 765-1802 CERTIFICATION Building Permit No. /~/~/ (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of I% lead. Sw:n to befor~ me ?his 19 '~7' Notary Public,~ _County (plumber's signature) Nolary Pubhc, Stato of Now York No, 48~762 Oua~ifi~ in Suffolk County ~ Comm~on E~ms ~ 30, 3 9~/ / h? _ Notary Pubic UNDATION ( 2nd ) UGH FRAME~/~ PLUMBING SULATION PER N. STATE ENERGY CODE FINAL - ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. ~*~ ,,~ INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ F~INAL .,=.A.,~s, ~/~ ~.~,~ ~ ~ DATE ~ INSPECTOR ~ .,, 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ~ROUGN PLBG. FOUNDATION ZND [~INSULATION [ ] FRAMING REMARKS: FINAL ~.1~, 765-~L802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FF~UNDATION 2ND [ ] INSULATION MING [ ] FINAL INSPECTO~~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [~UNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: I NSPECTO~ 765-1802 BUILDING DEPT, INSPECTION [~FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION INSPECTOR~ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 BLDG. DEPT. TOWN OF SOUTHOLD APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in Wpewriter 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''7_ land uses: I. Accurate survey of peoperty 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 / 2. Certificate of occupancy on pre-existing,dwelling/ land 3. Copy of certificate of occupancy $1.00 use--?re-Existing C.O. $15.00 Vacant land C.O. $ 5.00 Date 1,0,/, ,9/8,4. .... New Building Old or Pre-existing Building Vacant Land .x Location of Property ... R~.~c]on0 .Dr£~z,e. ....................................... .. So.u.t,b,o~l.d. ... House No. Street Hamlet George B.: Akscin a..n.d .O.p..a.1 R. Akscin Owner or Owners of Property .................................................. County Tax Map No. 1000 Section . · · Block ........... Lot ......... Subdivision George and Opal Akscin ................... ~ .............. Filed Map No ........... Lot No .............. Permit No. ..,..,.... Date of Permit . ..... ... . Applicant .............................. . .. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ...,~ ................... Fee Submitted $ .... .0.0 ..................... Construction on above described building and permit meets all a/~licable codes and regulations. Apphcant ........................... Opal~ R. Akscin Rev. 10-10-78 FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL gOUTHOLD, N.Y. 1.1971 TEL.: 765-1802 Examined..~../4-OI&.,P,~.., 19~ .~.. ................................ (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... Date~ U t'l~. ~ 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 MX~E 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 ail applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ..... 1,,I..s..o.. ~.o. ~.s.-T....~.o .~ 0.. .......... (Signature of applicant, or name, if a corporation) ~ ~g.u:?..~.?..t,,.~..~. ~.o. o~..o.~. -3.o ........................ i:' '~t!~ ....... .... (mailing address of app ~.ca State whether applicant is owner, lessee, agent, architect, engineer, generai contractor, electrician, plumber or builder. Name of owner of premises .'~.. ?. ~. '.~..~...~ ~ ~. ~. ~':~.g .{- .~..~..&.. J~J.. 1~..~...~.¥dk~.~.~: ?.4.: ............... (as on the tax roll or latest deed) If applican~t/,s a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ~.~.~.--.-.~.C.o. ?./?..~.o..*y..~..~...--..Sq ~'o ~ Plumber's License No..7.-~.'.~..~. ?.'. ............ , 7- Electrician s License No .................. Other Trade's License No ...................... 1. Location of land on which proposed work will be done. ......................... . ~5 .............. '~.~.~..~.~>x ~ .......... $.q ~ ~ ~ ....~.~ ................. House Number Street Hamlet County Tax Map No. 1000 Section .e.~.q ............ Block . O.~ ............ Lot. ~.~ ........... Subdivision. J ................................... 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 ..................................................................... b. Intended use and occupancy .O..~.t...~. /~::r~-,,t-'~' l)to,~.L£1~,,t~!*-~;~O:~ 3. Nature of work (check which ~pplicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... (Description) ~.~¢ p oi~ Fee 4. Estimated Cost ...................................................................... (to be paid on filing this application) ' .~, N bet of dwelling units on ea h floor ~ 5. If dwelling, number of dwelling units ............. um c .............. If garage, number of cars . ~ ..........................." 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stones ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................. i · · · Height ......... y ............ Number of Stories ..................... 8. Dnnenslons of~t~e~ew cons~ruchon Front . .g~c]~ .......... Rear . .~ ............ Depth .-~./.z. ......... Height Number of Stories .... 9. Sizeoflot: Front ./~,~./...' ....... ... Rear ..../~q.~. ... ............. Depth .............. 10. Date of Purchase . · ./.~.~.,,~..i ................... Name of Former Owner ~ .......................... 1 1. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction vi61ate any zoning law, ordinance or .regulation: ./Y~.~. ........................... 13. Will lot be regraded .. ~...;i...x .. ............... Will excess fill be removed fro[n_premises: -, Yes 14. Name of Owner of premises-~..~.~..F..M__j,~ .L~. }.q. ......Addres~.~..~. ~.o.,.~. ~..~.o.~.-~.~.°.~hone No.~..~'.~.r(.O.,q. ~' ..... Name of Architect ~..~.~.~.!..~?.'.t..~A~.~..~. ...... Address C.~.~.~r~.~??..~.~7 .... Phone No..-v ........... ... Name of Contractor .~! ~o..~.~. ~.~'..~o ~ .R ........ Addressi~,.i~¥.W-~.q..4 . n*tq,. 'hone (... 15. Is this property located withint:00 feet of a tidal wetland? * Yes ..... No~. · If yes, Southold Town T=ustees Permit may be required. PLOT DIAGRA~ Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and bloc~ number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF. . ....... , .... ~_..~ .~r..~..,~..~.~ ~.~..-..kw. }..~.q..4..~. ~ .............. being duly sworn, deposes and says that he is the applicant . (Name of individual signing contract) above named. 'He is the ........ .t:q..o ~ .~.,~.~.-~..~. ............................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is d¢ly authorized to perform or have performed the said work and to make and file this application; that all statements co~tained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manaer set forth in the application filed therewith. Sworn to before me this ....... .~. ,~ ........... day ~f..~z/~,,_ .............. 19 N tary Public~ .. ~ .......... ~ ........ County ~ ~, ~ ,~ _ ~.O.tllty ~tlbllo, 8t81®'o~ ~W ~ _. ~ [~gnature o~ appncanu - no:.48.~256q, SuffOlk County ~erm expires December 31, 19.L~9 ,