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Home My WebLink About15334-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z-16456 Date December 3, 1987 THIS CERTIFIES that the building .C.O?.S.~.R.U.C.~..O.N?..F...,~.~.L?..D?.~.L.L.I. Nfi..~.T.~..~.~.T..A. Cfi.?. ?.~..P~GE Location of Property 575 Sleepy Hollow Lane Southold, New York ~l~$'e ~o: ........................................................ Street Hamlet County Tax Map No. 1000 Section . .0.7.8 ........ Block 01 .Lot 10.11 · .. M/o Sleepy Hollow · 6351 9 Subd~wmon ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Pem~it heretofore filed in this office dated September 2/4, 1986 pursuant to which Building Permit No. 1533/4. z dated . .S.e.p.C.a.m.b.e.r..2.6.,..I.9.8.6 ........... was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which tkis certificate is issued is ......... ONE FAMILY DWELLING WITH ATTACHED GARAGE AS APPLIED FOR, The certificate is issued to ROBERT & RUTH HAMILL ..................... .................... of the aforesaid building. Suffolk County Department of Health Approval 86-S0- 155 UNDERWRITERS CERTIFICATE NO. N8257/47 December 2, 1987 O'CONNOR & SUN PLUMBING PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 FO]B,~ NO, ~ TOWH OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING P ERJ,AIT ('THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby gronted to: ...................................................................................... County Tax Map No. 1000 Section ...... ..Q~....'/...~. ...... Block ...... ..O...l .......... Lot No pursuon, ,o opplicotion doted ..... ~'2.~~...~..~. .......... ond opproved by the Building Inspector. Building Inspector Rev. 6/30/80 THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000~b"~ BUREAU OF ELECTRICITY THI~ ~ERTI~IE~ THAT in the following tocatio~:~ ~Base~¢~t ~ Ist Fl. ~ 2nd Ft. Sect.m Bt~k Lot FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLRTS SWITCHES FtUORE$CENT 42 58 26 42 DRYRRS MOTORS TIME CLOCKS UNIT HEATERS MULTI.OUTLET DIMMERS OTHER APPARATUS: 3*-G. F, C~ I. 2-Smoke De~ec~ors Electric ~ate~c ~ea~ers: 1-4.Skw E ~/o Goodale Electrical Cont Inc. 7355 Hn:l.n Road Mattituck, N.Y. 11952 Ltc~ 783E This certificate must not be altered in any moaner; return to the office of the Board if incorrect. Inspectors may be by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE ~OT BE ALTERED IN ANY MANNER. FIELD INSPECTION FOUNDATION (l~~st) COMMENTS FOUNDATION ~(2nd) 2. ROUGH FRAME PLUMBING INSULATION PER N. STATE ENERGY CODE 4 o FINAL AD ONAL M~TS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. /~3 Owns r /~ jO~ ~ ' (please print) Plumber ~ '~,,.,.,~.-p~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber's signature) Sworn to before me this /~r day of OC~- ,' Notary Public,~ County Notary Public FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTM~:NT TOWN HALL EOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined.. . 19 . Approved . .~.~....~...~.q., 19.ak Permit No..I.~..~.~..~. ~ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERNIIT Received .......... ,19... 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 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 inspjecO'ons. ~, ~,~ . .~ .... (Signature of applicant, or,,name, if a corporat~n) .... /?. . . . . .6. .. ................... (mailing address oF app icant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electric,an, plumber or builder. ,~,'//~.,~.. Name of owner of premises../~.~, .~!' ~.~'... '.~. r~... ~./tl~',e~ .$.'.// .................................... (as on the tax roll or latest deed) If applicant is ~ration, signature of dj~17 authorized~of]~l~er. · (Name and title of corporate officer) Builder's License No .......................... Plumber's License No.. ~..~..~....~}1~?. Electrician's License No..~..~ Other Trade's License No ...................... Location of land on which proposed work will beSdo~n~e...~/~..~.~ ~..~...~..~..~..'~.....~'.~.o.: .~.~. ?..~.... .... .,,.' ................... ........................................... House Number Street Hamlet County Tax Map No. 1000 Secti, on~....~..). ~. ......... Block ../. ........... ;..Lot...~?.../.t. .......... Subdivision../ff~/~..~.~..~.. ~...t~.....~.... Filed Map No .... .~. ~$.../.... Lot ...... ? ........ 2. State existing ase and ~ccupancy ~f premises and intended use and ~ccupancy ~f pr~p~sed c~nstructi~n: a. Existing use and occupancy ..................................................................... b. Intended use and occupancy ............................................................... 3. Nature of work (check which applicable): New Building . ..~. ...... Addition ......... Alteration ......... :. Repair .............. Removal .............. Demolition ............. Other Work ............... ./~./'/. ~ d ~...--'~. · (Description) 4. Estimated Cost ........................ Fee ...................................... (to be 5aid 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 typ of use ...... . ............... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ... Number of Stories ...... ~ . .. Dimensions of same structure with alterations or additions: Front ..................I Rear ....... ........... Depth ...................... Height ......... ..o../ ......... Number o~f iStpries ........... ,. · ~.t ...... 8. Dimensions of enthre new construction: Front ..... .~..~.: ..... Rear ..... .~.~. ...... Depth ...t~ .~.' ........ Height .. ~.: . Nur0ber of Stories .... l..t~.~· ......... i ...... ,. 9. Sxzeoflot Front ]g~ .. Rear ....... ~-.~.,.~..z ..... pepth .~..~.-~,.~..~ ............ 10 Date of Purchase ----" Name of Former Owner .'mw.. 11. Zone or use district in which premises are situated ........................ i ........................... 12. Does proposed construction violate any zoning law, ordinance or regulation' .~..~.' .... 13. Will lot be regraded ....... (~.~..~'. ......... .. .....Will excess fill be removed from premises: Yes ~ 14. Name of Owner of premises . ~a~.~. ~]~ddresl~.~.~ff#~t~/..~¢~:. l .... Phone No. ~ ~,~.~.-./.1,~ ~.' ."'~.. Name of Architect ·., / / ...... Address ...... .~/~,~.~', Phone No ..... Name of Contractor ./~tti~.~$..~.A~/. ~.,~,,~. ~?~. Address ./.~..,~..~.~.~.a...a** .t. . r ehone No..? ~.a..' 15. Is this property located withinL00 feet of a tidal wetland? * ~es ..... No .~.. · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM ., Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate ail 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. STATE OF NEWY RO~, ~ ~ COUNTY OF .~. ~,~ . . ~'~.~' ~A/~i~ .... z2' .............. ~.¢.~.~'d .~'O. ........................ being duly sworn, depqses and says that he is the applicant (Name of indijidual signing contract) above named. ~'/ He is the ............................. ] ............................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the shid work and to make and file this application; that all statements contained in this application are true to the best ofh~ 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 Notary Public, . ................. County .OF' ~.-P-.,T¥ 2OB'ERr C R.UThl t--.IA?i - SINGLE iII~YDWELLIN'~ONLY "'' ~ ~ The sewage dispq ~t and water supply facilities for ~ \ location heve bee~ inspected by this ~pa~ment ~ ~ other a~s~.fo~ m ~d~y, ChM ~ B~ [ruu ~astewa~ Manag~ S.C DEPT. OF HEALTH AItVICE$ C. V'ACAI%IT ) F-~_ZTZT;.~ZZ77ZT_L.T. TZT.'~'-'£TZT,7~ZTE;TZT-L-2~ ....................... APPROVED AS NOTED NOTIFY BUILDING DEPA"TM;NT AT 7S~-1802 S AM TO 4, PM i:OR THE FOLLOWING INSPECTIONS: FOUNDATION TWO REQUIRED FOR POURED CONCRETE 2 ROUGH FRAMING & PLUMBING 3. INSULATION 4, RNAL CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y STATE CONSTRUCTION & ENERGY CODES, NOT REEflONSIBLE FOR r~6SIGN OR CONSTRUCTION ERRORS, oCCUPaNCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY f~ ~ ERTIFICA TION oN LEAU-~-~'~F ocCU?AI'~' cERTJFJCAIC "" soLDER uSED IN wATER SUPPLY SYSTEM cANNOT EXCEED 2/10 of I% LEAD~.