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Home My WebLink About15306-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z15916 Date July 6, 1987 THIS CERTIFIES that the building kitchen and deck additions Location of Property .. 4.4~5.0 ............ P. ¢.c.o.n.i..c..B.a.y .B. lvd Laurel House No. Street .......................... Hamlet County Tax Map No. 1000 Section . .. ~ 2.8. ..... Block ....0 .4 .......... Lot .2. 2. ...1..a...2.2...2.... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... Fl..ay..2.1. t..1.9. 8..6... pnrsuant to which Building Permit No. 15306 Z dated . .S.e.p.~.e..m.b.e.r...2 .2.,.. 1..9 .8.6 ...... 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 . .~P. ..... construct a kitchen addition ,and a deck addition to an existing · g)/d' fkiJi ' bi/' 6 ' 6f Ef ............................... The certificate is issued to ................ Rasnnond. &. RQaTr~/a. G.o. 9.d.w.J:.n' ............. (owner, lessee or tenant/ of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO ...... N.7. fi 4.49.4 PLUMBERS CERTIFICATION DATED: May 26, 1987 Budding Inspector Rev. 1/81 FORM' NO. O TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDinG PERA~iT (THIS PERMIT /vtUST BE KEPT ON THE PREMISES UNTIL FULl_ COMPLETION OF THE WORK AUTHORIZED) No. 153(16 Z Permission is hereby granted to: .... I..~.~ ........ ~.~..~....~ ............... ~....~..~...~.2~~~....~..~..~.a.~.~.. .................................... .............. ............. County Tax Map No. 1000 Section ...... [...~....~. ........ Block ...... .,~.....~. ....... Lot No ......................... pursuant to application doted ...... .,.,.,~..,~.,..~,! ................ . 19.~.[o.., and approved by the BuiJdlng 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 ~ This apphcation must be tilled in ~pewriter OR ink, a~d submi~ad ~ ~ ta t~:~il~ I~aa- tor w~th the following, for new buildings or new use. 1. Final su~ey of property with accurate location of all buildings, property lines, ~reets, and'~nu~al 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. Bo 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 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: 1. Certificate of occupancy New Dwelling $25.00, Accessory.,~10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.'00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00.0,/..~, /, 5.Updated C.O. $ 50.00 Date ......................... NewConstruction. ..~... Old or Pre-existing Building ............ Vacant Land ............. .. .LxP Location of Property .................... House No. Street Ham/et Owner or Owners of Property . .~..~..~.v'3. ~?.~..' .'~.'...~..07...~.~. ~..~.....'~.....~..0..~.~. County Tax Map No. 1000Section . .L. x~) ., Block ~ ~ Lot .~ ~'.."~'.'~' Subdivision ................................. Filed Map No ........... Lot No .............. Permit No/.~?.°.~..'.~.. Date of Permit ~/a;.'~'~.~.~....Applicant...~.~/.~.~?. ~ . . .'~, .'. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ., .V~.. ............ Fee Submitted $ ........... ~ ............. Construction on above described building andj;zP-~,mit meets all applicable codes and regulations. App cant ,, , ~ ....................... Rev. 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 C E RTI F I CAT I 0 TEL. 765-1802 Date Building Permit No. ~Q ~O~ ~_ Owner ~ ~ooJ~3',~ ~please print) Plumber.~~ ~L(pleas~ print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber' s sig~ Sworn to before me this Notary Public, ~ County Notar, y Public He. 4732613 Qualified i~ Suffolk County THE NEW YORK BOARD OF FIRE-UNDERWRITERS 10u0~44 ~i~ BUREAU OF ELECTRICITY g ES JOHN STREET. NEW YORK, NEW YORK 10038 o,,t~ Augus~c 18. 1986 Appli,,atlo.~o.o,,/il~ 415026/86 THIS CERTIFIES THAT N 754494 o~ly the electrical equipment as described below and introduced by the applicant named on the above application nu tuber in the premises of ~aymond Goodwin, Peconic ~ay Blvd. (Delmar Dr, - Birch Dr)Laurel, NY August 11, 1986 and found to be itt contpl~ance with the req.lretnents ctf tbls Board OUTLETSFIXTURE SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME ~LOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: S E R V NO, 01~E ONO OF CC, COND C A W G NO. OF NEUTRALS A W.G. NO OF HI-LEG OF HI-LEG OF NEUTRAI. K~chard Relyea P,O. ~o~ 372 ~aurel, ~Y 1194~ Lic#l148E GENERAL MANAGER 11 Per This certificate must not be altered in any manner; return to the office of the [~oard if incorrect. Inspectors may be identified by their 76S-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION FRAMING REMARKS: 2ND [ ] INSULATION £ ~FINAL DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND t I I~SIJLATION FRAMING [ ~]/FINAL /? INSPECTOR FIELD INS[~ECTION FOUNDATION [ (1st) COMMENTS FOUNDATION 2. ROUGH FRAME & PLUMBING (2nd) TION PER N. STATE CODE FINAL ADDITIONAL 'COMMENTS: 7GS.'1802 BUILDING DEPT, INSPECTION []FOUNDATION 1ST []FOUNDATION AND []FRAMING REMARKS; [ ] ROUGH PLBG. ] INSULATION ] FINAL DATE //////~ ,¥?/~ INSPECTOR 765-1802 BUILDING DEPT. FRAMING [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION XST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ]FRAMING [ ]FINAL INSPECTOR RAYMOND T, BODDWlN June 1, 1987 Town of Southold Building Department Town Hall Southold, NY 11971 Re: Buildin8 Permit No. 15306 Z Gentlemen~ I am enclosing the following; Cheek #1634 payable to Town of Southold in the amount of $25.00. Completed Form No. 6, Application for Certificate of Occupancy. Building Permit #15306 Z. Town of Southold Certification Form completed by Mattituck Plumbing & Heating Corp. It is my understanding that a copy of the Fire Underwriters Certificate has been sent to you directly by the inspector. The above enclosures should complete the requirements for issuance of the Certificate of Occupancy. Kindly send the Certificate of Occupancy to me at the above address. If you have any questions, I can be reached during the day at 212-513-6232. Sincerely, FORM NO, 3 TOWN OFSOUTHOLD BUILDING DEPARTMENT TOWN CLER~SOFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL PLE~'~E TAKE NOTICE that your application dated.....~.../~.... ,~.../ ........... ,19~.. for permit to ...................... at Location of Property . ~(~ -. ......... House No. ~treat Hamlet Co,,ty ~ u~ ~o. ~000 s,=t~o, .z.~ ....... ~o~ ~....: ...... ~t~z,....../~.. ¢~. ~ FQed Map No ~ Lot No Subdivision .......................... ..~. ~.. ~.~..~.~:.~/..~.~.~..'~ ~ ~.. ,,, Building Inspector RV 1/80 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined .~~ .~l..., 19~ Ap proved~"~/'~4~.~..-~w, 19 ~.~. Permit No..~.~'~.~ .O..~...~ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ~19... Date...~..~..t' .... , 19 .~.. INSTRUCTIONS a. Tins 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 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 ~emovai 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... ~ctions.~~. '~'~' ".~~ ,~/ _ , .......... i~icant, or name, if a, corporation) ...... ..... ..... p. ........ (m, ail±ng address~'~ app~(i~anl:5 ..... State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. Name of owner of premises . .~. h~PgP..'.-~.....Q?.o.~.~..m../?. .... m ..~.?0.~.~'/~. ...... ~..~.~ .,~...~. ,:.T.~.~. )... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No..~.q Plumber's License No....~...~..(o..~..'.-..~. ........ Electrician's License No...~/.~. ?...~..~.~. ....... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ..... .................. ................... House Number Hamlet County Tax Map No. 1000 Section ...] ............. Block ....~..~. ........... Lot..~..~/.~.. ?-..~. ! .'.'~... / 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 . .(~.'.~ % I .~. ~'FM c ~-- b. Intended use and occupancy .. ~% I .D ~.M..c. ~ ~ ............... 3. Nature of work (check which applicable): New Building .......... Addition ........ Alteration .......... Repair .............. Removal .............. Demolition .......... i.. Other Work ............... .-~ ~ (Description) 4. Estimated Cost ..... o o o Fee ......... ~ ....................... (to be ~aid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling unit! on each floor ................ If garage, number of cars ............................................ ~ ........................... 6. If business, commercial or mixed occupancy, specify nature and extent of each typic of use ............ ' 7. Dimensions of existing structures, if any: FroNt ............... Rear ....... i ...... Depth ....... ' ........ Height Number of Stories Dimensions of same structure with alterations or additions: Front .......... I.. Rear Depth ...................... Height ..... i: ?iH" .......... Number of Stories .............. . ....... 8. Dimensions of entire new construction: Front.. Height ...I ?'f.! .... ..... Number of Stories ... I../.~ .............................................. 9. Sizeoflot: Front ..................... Rear ...................... Dep[h~ ...................... . 10. Date of Purchase ...... ]i~17.~.. ................. Name of Former Owner . !.. ~(-../-,.I¢.l.'l~. ............... 11. Zone or use district in which premises are situated .......................... 12. Does proposed constructaon vlolate any zonmg law, ordinance or regulation: ..~. ....................... 13. Will lot be regraded .~.t'xr~.l?.l~l~L.~ .............. Will excess fill be removed from premises' Yes (~rNo') Name of Contractor . ~....#A--4) .................. Address c.~,v¢~,.c,D ~;0~ ~ ~.~Tz-. Phone No.47.~:'?.~.?:-.~ ff. ~..~. 15. Is this property located withinl.00 feet of a tidal wetland. * ~es ..... No . .k-~.. · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. im .icate all set-back dimensions from property lines. Give street and block number or description according to deed, and. sho~, street names and indicate whether interior or corner lot. ·,"-O--} ~p~ .~..o..,f.9... ".~.~..~..o...ec-_J>, t,,~. t .*0 ............... being duly sworn, depo,ses and says that heis the applicant (Name of individual signing contract) above ualned. He is the ............. (Contractor,. agent, corporate officer, etc.),~ , mad is duly 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 ofhlJ knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ~ ~ ~ "M,~ No. 81-4610~18 ~ (Signature of applicant) O. uallfied tn New York County Commis3ion Expires March 30, 1987 l p~co~c ~OUO~V~8,° ~ p6.00 ~EVI~IOt~$ YOUNG & YOUNG APRIL6~1978 ADO OSTRANDER AVENUE, RIV[SHEAD, H£W YORK MAY 15~ 1986 AL~EN W, YOUNG HOWARD W. YOUNG SURVEY FOR: ~AYMOND ~ GOODWlN b NO.MA ~ sc~ 1.= ~o~ I ~D7,-;978 ~ ' SOLDER IISED IN WATER SUPPLY ~TEM CANNOT EXCEED 2/I0 of I% LEAEL If eeppor tubing is ua,ad for wat~ distributing lystem; piping Ihall be of typel K or L only, ON/.EAD CONTENT BEFORE NO. DATE REVISION CERTIFICATE OF OCCUPANCY OCCUPANCY.OR USE IS UNLAWFUL" WITHOUT CERTIFICATE OF OCCUPANCY ~ T " SCALE' ~-- j ~l DATE: ~,~. ~ JOB NO: SAL PASSALACQUA INTERI~K ~ESiGNER · 5PACE PLANNER, 15~ GKEEN S~RE~*VA[LEY 5TKEA~, NEW YORX l~SBO PlHfiq~ ! -r INO. DATE J REVISION DATE: G,~.~. ~(~, ~. BY: '"~=[:="' JOB NO: SAL PASSALACQUA INTERIOR DESIGNER · SPACE PLANNER 156 GREEN STREET,VALLEY STREAM, NEW YORK 11580