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Home My WebLink About16500-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southotd, N.Y. Certificate Of Occupancy No. Z-16662 Date February 22, 1988 THIS CERTIFIES that the building ....A.L,T..E .R.A.T.I..O.N ................................. L ..... 16995 Main Street New Suffolk ocauon o[ rroperry ............................................................... House No. Street Ham/et County Tax Map No. 1000 Section 117 .Block 8 .Lot 8 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Sept. 25, 1987 pursuant to which Btlilding Permit No. 16500 z dated....Oct°.............ber 7, 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 ......... ALTERATION TO SECOND FLOOR BATHROOM AS APPLIED FOR The certificate is issued to JOAN B. ROBBINS ..................... ?oh;.'o'r, £¥goS Ytg; /r ..................... of the aforesaid building. Suffolk County Department of Health Approval N /A UNDERWRITERS CERTIFICATE NO. N00 I 925 PLIJMBERS CERTIFICATION BATED: February 22, 1988 - Mattituck Plumbing & lteat ing Corp. .................... Building Inspector Rev. 1/81 FO~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y, BUILDING PERMIT (THIS PEI~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) . at premises located at ...... ~...~......~.. ............................................ County Tax Map No. 1000 Section ..... l.J'......~.. .... Block ...... ~ ...........Lot No..~ ................. Building Inspector. 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 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~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: Additions $25.00 POOLS $25.00 ALTERATION $25.O0 1. Certificate of occupancy New Dwelling $25.00, Accessory '$I0.00 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 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date . .F..E~..,. (.ti .,.[~..~'. ........ New C one truc t ion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ... I.~. .c~ .~[ .~.., , , .~.~..i.~/,,, .~',~..~.~ .............. ~J~.(~., .~..g...1~...L. J~. Houee No. Street Ham/et Owner or Owners of Property .. j~..O.F~,, .~..,. (~.0. (~.~,( C(..~' ................................. County Tax Map No. 1000 Section ..... ~!g ...... Block ... ~ Lot Subdivision ................................. Filed Map No ........... Lot No .............. Perm it No.J ~..~'.0.0...~.. Date of Permit J.A l~. l~.~ .Applicant.. ~c"'~ .q~.o.t~.. 1~0 ~.~ .[.1~/.~ ........... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval .... J. lQ. I..~..~. ........... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ~ ~.. OO it,,mea~, all ~pp$ic-~le codes and ragu lations Construction on above described building and ~p~-,m// . Applicant . . ~. ~- ~'~. ~.~~~ .............. Rev. lO-lO-7a PA~ 1 ,.,~oTru THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF EI. ECTRICITY ~-- ~, JANUARY 07~19~ JOHN STREET. NEW YORK, ~/~38 N 001925 ~te Application No. on ~ile ~IS CE~IFIES T~T NgWTON ROBBINS, N/S MAIN STREET, NEW SUFFOLK, N.Y. ~ exami~ on andf~nd to be in co,n~iance with the ~ui~ments of th~ ~rd, D~YEES FURNACE MOTORS PJTUI~ &P~UANCl PIIOIRS TIMIC~OCKS MUL~-OUTLIT D~b~RS SYSTIMS NO. O~r NIT SIRVIC~ DISCONNECT S E R V I MOTORS: 1-1 B.P. RUI~ND ELEC/W.B. RULAND BOX 143 MATTITUCK, NY, 11952 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. CO~ FOR BUIUNNG DEPARTMENT. THIS CO~ OF CERTIFICATE IdUST HOT BE ALTERED IN ANY MANNER. TOWN OF $OUT~OLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. Owner ~ 6 ~ (pleDse print) Plumber (please pr int }------~ I certify that the solder used in the water .supply system contains less than 2/10 of 1% lead. (plumber s signatur~9~ Sworn to before me ~his ~__day of . ,' · 19~ . Notary Public Notary Public, County 4QTIFY BUll BING DFPARTMF~'A7 1802 9 AM l[O ~ PM FOR T[~IJ 'Oki r)~'~F,:r: IN?ECTIONS'. FQUh:"MqON- 'llano REQUIRED pqUm,' r-qAMIN~' ~, PLUMBING ...... ' ....q C. O, ¢-" '' "':%'~ $~rAII ' :'*'~'zq r~F 1TI.iF N v If Copper lubi4g is U~ed for water distributing ~ystem; piping shall be of types K or L only ~ tST~ ~,ff~ PrT'Tt C e-9. t) T 1 ~'6 FOUNDATION ( ls t) FOUNDATION (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: BOARD OF HEALTH ..... ..-~ 3 SETS OF PLANS ~.~.~7'...... 'FORM No.~ SURVEY :: .' .W~..'::: '. CHECK 'TOWN OF SOUTHOLD BUILDING DEPARTMENT SE??IC FORM ............. : TOWN HALL NOTIFY $OUTHOLD, N.Y. 11971 TEL.: 765-1802 CALL ................ MAIL TO: Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING P£RMIT Date 5'EP.I'L-W~{~CK ~...., 19g~. INSTRUCTIONS a. Ti'tis 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 ~s 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 inspections. (Signature of applicant, or name, if a corporation) 0..0.,~.0x .~.~t .9..,.~a4 iu-W-~t-m., N .x/.~.t.q s:.~ ....... (S;lailing address of atSplicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................... C p.t~ .nY. & .~-~-r'o. g, ........................................................... Name of owner of premises .. i~O.h I'~ . . .~ : .(~ fl.(~ ~ l 6(,[ .................................................. (as on the tax roil or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of coq~orate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSF~D Builder's License No..I.3.o. g Plumber's License No. g].f'l~'%r'l .~.U.~4. Electric'an s License No. [~f0k, l~. Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ./. ¢. ......... X-r mr. .................... ............ llouse Number Street l[amlet County Tax Map No. 1000 Section ..l./.7 .......... Block ...1~ ............. Lot..O~. ............... Subdivision ..................................... Filed Map No ............... I,ot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . ,~.t~.l."d/J~.~... 0.IV~'-. ~-':t(~,},L-.'"].. 1~ ~[ .b.('iy~.-. ......................... b. Intended use and occupancy .~. & W.fl'T.e'. 7..0..¢,~T... C--rrB th.'1....~ } b~ '. ..... '.. i. '. ..... ~-- 3. Nature of work (check which applicable): New Building .......... Addition ...... Alteration , ·, · ·. Repair ............. : Remo~aI .............. Demolition .............. Other Work ............... : -, ~) '~, ~-~, ~2 (Descrip.tion) Fde . ~ .~. ................................. 4. Estimated Cost . . .~. ~ ~.}. q.o. Cl. ........................ · (to be paid on filing this application) 5. If' dwelling, number of dwelling units.,. I ........... Number of dwelling units on each floor ................ If garage, number of cars ..... : ............................... · ................................. 6. If business, com;nercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front...2 .~.t ......... Rear . .,~t?C [ ........ Depth .. ~ ~.l ......... . ltcigbt . .~ t. ......... Number of Stories . .c~ ......... '. ..................... ; ............ ........ Dimensions of same structure wRh alterations or additions: Front . . ffDKq tY7 ........ Rear ..,q~0.~'.. .......... Depth .... ,,5'(0o~. .......... i. · Iteight ... $t3{q~k'~.. ........... Number of Stories... ~th(B~.-. ........... 8. Dimensions of entire new construction: Front .......... ' ..... Rear ............... Depth ............... }{eight ............... Num;ber of Stories ........................................................ 9. Size of lot: Front ........... j ........... Rear ............... ~ ....... Depth ...................... 10. Date of Purchase ,flqD. L.~. ;,1.~.i, I.~.6 1 ............ Name of Fo.rmer Owner ............................. 1 i. Zom or nsc dtstnct in whmh prmmses are situated. ~1~, t ~)~Tlfl'..L-' ..................................... 12. Docs proposed construction violhte any zoning law, ordinance or regulation: I~/.O ............................. 13. Will lot be regraded ..... ~O..i ................... Wilt excess fill be removed from premises: Yes No 14. Name of Owner of premises irJ~.~'d. 0, .~'012~136.... Address i[/~'(M .6"O.~..~J~.,~ ..... Phone No. r~ 3.ff76 0.~'(7 ..... Name of Architect .......... ~ ................. Address ................... Phone No ................ Nmne of Contractor ......... ! ................. Address .... : .............. Phone No.. '2' ...... ~ ....... 15. Is this property located ~ithin 300 feet of a tidal wetland? *Yes ..... No ~.... · If yes, Southold Town Tru'stees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly 'all buildings, whether existing or proposed, and~indicate all set-back dimensions from property lines. Give street and block humber or description acbording.to deed, and show street names and indicate whether interigr or corner lot. .../ye.g~.~...(.~?7fi,t ........ ~b[. ~.,.' ...... being duly sworn, deposes and says that he is the applica,~t (Name of individual signing contract) abow~ named. He is the ........................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is ddly authorized to perform or have performed the said work and to make and file thi~ application; that all statements con]tained in this application are true to the best of his knowledge and belief; and that th~ work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ~ ~l~,~[~.~~ ~/* (Signature of ap~lican