HomeMy WebLinkAbout15313-zFORM NO. 4
TOWN OF $OUTEOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-25108 Date JULY 1, 1997
THIS CERTIFIES that the building ADDITION
Location of Propert~ 1427 LIGHTHOUSE RD. SOUTHOLD, N.Y.
House NO. Street Hamlet
County Tax Map No. 1000 Section 50 Block 5 Lot 4
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 15, 1986 pursuant to which
Building Permit No. 15313--Z dated SEPTE~4BER 24, 1986
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 NEW PORCH, KITCHEN & DECK ADDITION TO EXISTING ONE FAMILY
DWELLING AS APPLIED FOR.
The certificate is issued to pEARL VAUGHN
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-422178 -- JIPNE 10, 1997
PLUMBERS CERTIFICATION DATED
JUNE 26, 1997--H.SMITH PLUM~ING & HEATING
Rev. 1/81
I~OB3~ NO. ~
TOWH OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PER'AlT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N9 15313
Z
Permission is hereby gronted to:
........
.....~....~...~.....~..:~.,.....L~.~.../ ...........
,o ~..~...~.~..~.../C.~.~L~.;....~&~.....~ ....
at premises located at ...J...~..~.'7...,...~:..°.....~..,.~t~,~.~.,,~.....~.~.
'/..¢......J..,~..~ ...... ..~ .............................................................................................
County Tax Map No. 1000 Section ..... .0..~.'~.,. ....... Block ....... .(~...~. ..... Lot No ...... ..~. ...............
pursuant to application dated ...~..~..~ ....... ~ ........... , 19.~..g.., and approved by the
Building inspector.
Fee $....~. ................
Building Inspector
Rev. 6/30/80
Form No. 6
TOWN OF SOUTNOLD
BUILDING DEPARTMENT
TOWN HALL
765-I802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
6. Submit Planning Board Approval ~f completed site plan requirements.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
Upre-existing" land uses:
i. Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
~. A properly completed application and a consent to inspect signed by the applicant.
· If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildin~ - $100.00
3. Copy of Certificate of Occupancy - ~ .2~¢
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
New Construction ........... Old Or Pre-existing B~ilding...~. ..........
Location of Property. I~_,~O ~, ~.~c~c~____ ~..~.
House No. ~ Street Hamlet
Onwer or Owners of Property .......................................................
County Tax Map No 1000, Section...~O. ...... Block ..... ~ ......... Lot..~ .................
Subdivision Filed Map Lot
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... . ,' / ~//~Fin'al Centre_re
Fee Submitted: $ ......................... · · · .~/~ ~
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
CERTIFICATION
DATE: June ~, 1997
Building Permit No. 15313Z
Owner: Pearl Yaughn 1400 Lighthouse Road,
(please print)
Plumber: H. Smith Plumbin9 & Heating, Inc.
(please print)
$outhold, NY
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead in the work done by H. Smith
Plumbing and Heating, Inc. ~~~~~)
Sworn to before me this
c~--day of June , 1997
I'lotary public, State ol New York
--- quallhed m Albany Coul?~y ..
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, NewYork 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
August 18, 1995
Ms. Pearl Hulse
Route 6, Randall Road
Wading River, NY 11792
***** THIRD NOTICE *****
Re: Building Permit #15313-Z
Premises: 1400 Light House Road,
Suff. Co. Tax Map #1000-50-5-3
Southold NY
During a review of our
building permit has expired,
never been issued.
files it was noted that the above
and a Certificate of Occupancy has
According to the Code of the Town of Southold, Article
XXVIII 100-284, it is unlawful to occupy or use a structure
until a Certificate of Occupancy has been issued.
Please contact this office as soon as possible so that we
may clear up this matter.
Thank you for your cooperation in this matter.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
'FEBRUARY 2, 1990
2ND & FINAL NOTICE
PERMIT EXPIREC NO C.O.
TO Whom This May Concern,
Rgi PEARL VAUGHN
We are unable to complete your Certificate
of Occupancy because,of the following reasons.
~_--~ An application for Certificate of Occupancy
is not on file. ENCLOSED
~_--ff "No Underwriters Certificate on file.
/5/ The check is~not on file.) $25.00
/~/ No Bealth Dept. Approval on file.
/5/ No final inspection has been made.
Please contact our office on this matter.
Thank you for your cooperation.
Building Permit tt I 5 3 I 3 Z
Building Dept.
*~*/~ No Plumber Solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
TO~rl~i OF $OUTtIOLD
OFFICE OF BUILDING IN£?ECTOR
ILO. BOX 1179
TOWN IIALL
$OUTIIOLD, N,Y. 11971
March 21, 1989
TEL. 765-1802
Mark Finne
1370 Lighthouse Rd.
Southold, N.Y. 11971
RE:- PEARL VAUGHN
To Whom This May Concern,
We are unable to complete your Certificate
of Occupancy because .of the following reasons.
~/ An application for Certificate of Occupancy
is ,lot on file. (ENCLOSED)
~_--/ bio Underwriters Certificate on file.
/~/ The check i:~(Yo~ixt-~/not on file.)
/~/ No Health Dept. Approval on file.
/-'/ No final inspection has been made.
$25.00
Please contact our office on this matter.
Thank you for your cooperation.
lh~ildir:~f PermLt # 1 5 3 I 3 Z
Building Dept.
**~/ rlr~ Plumber Solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
]65-1802
BUILDING DEPT.
INSPECTION
[] FOUNDATION 1ST [] ROUGH PLBG.
/ --
[ ] FOUNDATION ZND [/~] INsuLATIoN
/
76S.'1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[] FO/UNDATION 2ND [] INSULATION
[~F~MING-/' [ ]FINAL
FIELD I~[~EC~T ION
(1st)
COMMENTS
FOUNDATION
2.
(2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
,I
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
~OUTHOLD, N.Y. 11971
TEL.: 765-1802
Approved . .~. ~ .~..., Permit No.
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
BLDG.
TOWN OF SOUTHOLD
Received ........... ,19...
Date...~..-7'./'../. ......... 19.?~.
INSTRUCTIONS
a. Tins application must be completely tilled 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 tins 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 cod¢¢ ankh,regulations, and to
admit authorized inspectors on premises and in building for necessary insptectio~,,,s;,.~ / ,-~ ~'
(Signature of applicant, or name, if a corporation)
State whetller~ applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises' i i~ . .~~ ......................................
,~--,,~ (askO'n the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's LicenseNo ..........................
Plumber's LicenseNo .........................
Electrician's License No .......................
'. Other Trade's License No ......................
House Number Street Hamlet
County Tax Map No. 1000 Section .... ~.i~ ......... Block . .' ................ Lot ...................
Subdivision ' Filed Map No ............... Lot ...............
(Name)
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 ...~.... ~..~.....'~'..//-..~.~ ......................
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