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Home My WebLink About15201-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z15958 Date July 17, 1987 THIS CERTIFIES that the building .. qn.e..~.am.x, ly..dw.e, ll kng. ..................... Locatmn of Property 3825 North Bayview Road Southold County Tax Map No. 1000 Section q7.9.. .Block 02 .I.~t 3.4 Subd~v~mon .............. Fried Map No ....... Lot No .............. conforms substantmlly to the Apphcahon for Buridmg Permit heretofore filed m flus office dated .... 4u.g ~ .7. ~ 1.9.8.6. ..... pursuant to wtuch Braiding Permit No. 1520 lz dated . . .Aug, .%8 ~. !98.6. ...... was ~ssued, and conforms to all of the reqmrements of the apphcable prowmons of the law The occupancy for wluch ttus certfficate m ~ssued m ...... O.n.e f.am..~l.y dw. el. li.ng~..2 c.ar .gar. age. a. nd.su.n, deck. The certificate ~s ~ssued to GISELA S. DURHAN of the aforesaid bufldzng. Suffolk County Department of Health Approval . 86-S0- 156 July 1, 1987 UNDERWRITERS CERTIFICATE NO. N802755 April 9, 1987 PLUMBERS CERTIFICATION DATED: May 20, 1987 Rev 1/81 TOWN 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) 15 2 01 Z Date., .~..~......~........~...,?. ........... , Permlsston is hereby granted to' ~ ................ ..... ' ~ , at ................................... premi.e, '~ated at ...~[~.~]~]] ~ "~'. ~' ~/~[~~~ ~ '.. . . ~~.~ Bilk ..... ~..~ .......Lot No .....~:.i ~un~ Tax Map No 1000 Sech ........ pursuant to application dot~ ~ ~ .... , 1~ ~ 9. and opprov~ by the 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 This application must be filled in typewmter OR ink, and submitted m ~ to the Building Inspec- tor with the following; for new buildmgs or new use: 1. Fmal survey of property w~th accurate location of all buddmgs, property lines, streets, and unusual natural or topograph ~c featu res. 2. Fmal approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electmcal mstallatlon from Board of Fire Underwmters. 4. Commermal buildings, Industrial bufldmgs, Multiple Residences and similar buildings and installa- tions, a certificate of Code complmnce from the Amh~tect or Engineer responmble for the budding. 5. Submit Planmng Board approval of completed rote plan requirements where applicable. B. For ex~sting buddings (pmor to April 1957), Non-conforming uses, or buddings and "pre-ex~sting" land uses' 1 Accurate survey of p~operty showing all property lines, streets, buddmgs and unusual natural or topographm features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buddings. 3. Date of any houmng code or safety ~nspect~on of buddmgs or premises, or other pertment mforma- lion required to prepare a certtfmate. C. Fees' Additions $25.00 1. Certlf~cateofoccupancy New Dwellzng $25 Q0, Accessory ,$~0.00 Business $50.00 2. Certificate of occupancy on pre-ex~st~ng dwe[bng $ 50.00 3 Copy of certlflcate of occupancy $ 5.00, over 5 years $]0.00 4. Vacant Land C.O. $ 20.00 .-~/~/;.~. 5.Updated C.O. $ 50.00 Date ........... NewConst]~uctlOn ..... Old or Pre-existing Bulld,ng ....... . Vac~qt Land ............ ocat,onofProper ..... .................. ....... House No. ~t Street Earn/et Owner or Owners of Property . County Tax Ma~o. 1000 Sect~ . .O...~..~ ...... Block .... .O. ~ ..... Lot...~.!.L~. ....... Subd[v,s,on . ....~..~)., ..l)~,v~..~?.. . .Filed Map No.."~.$~..~..Lot No....~... ~... Perm,t No../.~..'~ .~. Date of Permit...~ ~J.~l,cant...~/~.~..~.. ,~./~.. ~.? ~....~. Health Dept Approval .................. Labor Dept. Approval ........................ Underwrtters Approval .................. Plannmg Board Approval ...................... Request for Temporary Certificate ............ Final Certificate ...................... Fee Subm,tted $ ................. ~.~ / Construct,on on above descr,bed budd,ng and/c~erm~.~?~ all/l~l~.~'/code~ and regulat,ons. Apphcant~/' _ ..~_ ...~..~."../~..~ .... 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. /~'~l ~ Owner ~ % (please print) (please print) L~ 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 ~5 day of 19 Notary Public, County Notary Publzc .' 1ELD FOUNDATION FOUNDATION (2nd) ROUGH FRAME & PLUMBING STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: '.. , ,-~' ~. : ,'. IT ~[ DEPARTMENT ' DAT~~ ~ . · --~... ~.,n WATER SUPPLY FACtLITIF S F~I ~T~ ~S ~~?, BEEN NSPECTED BY. THIS DEPAR',~ME~ of~ate~ ~anagement Se~lon system for this residence w~ll con- ~quate samtary dlstance t " supply and sewage 95oooy .............. vSo 765-~.802 BUILDING DEPT. INSPECTION []FOUNDATION 1ST [ ] []FOUNDATION 2ND [ ] []FRAMING REMARKS: ROUGH PLBG. INSULATION [ ] FINAL DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL DATE // ~/<~C?~/ INSPECTOR 7GS-X80~ BUILDING DEPT. INSPECTION FOUNDATION 1ST []ROUGH PLBG. FOUNDATION 2ND []INSULATION []FINAL [ ] FRAMING REMARKS: DATE iNSPE~I'OR ~C'C~r~b / yko £ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ]~NSULATION / FRAMING [~ FINAL REMARKS: 765-1802 BUILDING DEPT. INSPECTION []FOUNDATION 1ST []ROUGH PLBG. I* '] FOUNDATION ZND []INSULATION []FRAMING []FINAL REMARKS: ~j~i~_~ DATE INSPECTOR '~~ THE NEW YORK BOARD OF FIRE UNDERWRITERS id00771 BUREAU OF ELECTRICITY ~m~ ' 431993/86 A~r3.~. 09~, ~9~1~ 85 JOHN STREET NEW YORK. NEW YORK 1QO38 o.,~ ,,,,.,c.,,o.,,,o o./,,e N 802755 THIS CERTIFIES THAT G£se. la Durhan, N/S ~. Bayview Road, I0O'E/O Ships Dr(East End)$ou~hold, t4¥ tn the followmg locatmn. ~ Basement ~ I~t Fl teas exammed on i'~rch .~O, 1967 ~ 2nd ,~7 ~ect.)n BIm-k Lot and found to be .~ compltance ttdh the req~tretnent~ of tht~ Board FIXTURES [ RANGE~~ OVENS ]DIS~WASHERSJ EXHAUST FANS FLU~ESCENT ~:~Y ~T ' K W } ~T r ~ w [ ~T i K W ~T K W SERVICE DISCONNECT ~-bmol~e Lt ~ r~.cl~o~ I--.~.~.C.L L . X R V t C E iluland ~leccrlc Co. P.O. ~ox 143 Pm~icuck, t~ 11962 Lic~242R ?E~AL MANAGER r~ Per' ,~ ~ This certificate must not be c~ltered ,n any manner, return to the off~ce of the Board If tncorrect Inspectors may be ,denhf[ed by their credenhals COPY FOR BUILDING DEPARTMENT THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER Exam~ne/~.l,~-'. ~-~ Approvekt~.4~. '~' &'~ D~sapproved a/c FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT .I ~:; ..~. TOWN HALL .~~O uTHOLID SOUTHOLD, N,Y. 11971 TEL ' 765-1802 ,19~ Recezved ........... ,19. , iv~{' Pem~,t No 1 ~' .a_.o I e- (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a This apphcat~on must be completely filled in by typewriter or ~n ink and submitted to the Budding Inspector, with sets of plans, accurate plot plan to scale Fee according to schedule b. Plot plan showing location of lot and of buddings on premises, relationship to adjoining premises or pubhc stre~ or areas, and glvmg a detmled description of layout of property must be drawn on the d~agram which is part of this apl: cataon. c. The work covered by flus apphcahon may not be commenced before ~ssuance of Budding Permit d. Upon approval of this application, the Bmlding Inspector will issued a Bufldmg Permit to the apphcant. Such peru shall be kept on the prenuses available for mspechon throughout the work. e. No budding shall be occupied or used in whole or m part for any purpose whatever until a Certificate of Occupan shall have been granted by the Bmldlng Inspector APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Bmldlng Permit pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances Regulations, for the construction of buddings, additions or alterations, or for removal or demolition, as hereto describe The applicant agrees to comply w~th all applicable laws, ordinances, budding code, housing code, and regulations, and admit authorized inspectors on premises and in budding for necessary i~p~ct~ons / ~ ,~ (S~gnature oz appI~t~tht, or name, ~k~ corporation) ..... .............. ........ .... ~,ma:t.t:kng addres~ or appJ_:tcant) State whether apphcant ~fi,~owner, lessee, agent, architect, en~neer, general contractor, electncmn, plumber or bmldc · ................... Name of owner of premises ''/ .............. (as on the tax roi1 or latest deed) If appllcan~2~tk~r~porabon, sign?ure~ffduly authonzed~cjfflcer (Name and t~tle of corporate officer) Builder's License No Plumber's License No Electrician's License No Other Trade's License No Location of land on Much proposed work will be done House Number Street County Tax Map No t000 Section ~ >~ Subdivision ~,,t ~. ~4/~x (Name) Hamlet Block ..~ ? . Lot. '~. Filed Map No '~ ~/) Lot 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 3 Natureofwork(checkwhlchapphcable) NewBufldmg ~'. Addition ...... Alteration Repatr . . Removal ....... Demolition ........... Other Work ..... (Description) 4. EstnnatedCost. 1},0, O..0~..~ ." 5. Ifdwelhng, numberofdwelhngumts , If garage, number of cars ...... .2, · · . 9 10 11. 12. 13. 14 ....... Fee ......... (to be paid on filing this application) 0/~ .1~.... Number of dwelling units on each floor .......... If business, commercial or mixed occupancy, specify nature and extent of each type of use ............ Dunenslons of existing structures, if any Front .... Rear ..... Depth Height ..... Number of Stones .. Danenslons of same structure with alterations or addtttons. Front ............ Rear .............. Depth ....... Height Dmaenslons of entire new construction Front Height . . I~ ....... Number of Stones Slzeoflot Front . ,/-~,~ · ..... Date of Purchase .... t~.,}" .. ............. Number of Stones. · / .... : .. Kear . .)m.~ ......... __ .... qS~Jg' ........................... ~ ..... Rear . . >.)-&... la ~'. . Depth ...~ ~'.~ · .6~* ..... .... Name of Former Owner .................. 15. Is this property located withinl00 feet of a tidal wetland? * If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Zone or use district in which premises are situated .............................. Does proposed construction violate any zomng law, ordinance or regulation . ~.~ ............... ~ Wall lot be regraded . . ~.~. ....... Wlll excess fill be removed from premises' Yes ~ NameofOwnerofpremlses . ~t.lMn DdttJ4#~J Address.2).~O~I.~' PhoneNo .~'¥'".~'q.~ .. Name ofArchxtect . ,, ....... , .,.. Address .... ?eaT..1~. ?i?~.1~. Phone No .... , ....... Name of Contractor .~.IO~..l.~) .~..~..;1~$~-~ .~. Address/.0)~4 ~l.~!}...,~0:,..~. Phone No. 7.~.a. .'l~3.aC%.. . * Yes ..... No t.~.... Locate clearly and distinctly all bmldmgs, whether existing or proposed, and. indicate all set-back dn'nensmns from property hnes. G~ve street and block number or description according to deed, and show street names and indicate whether xntenor or comer lot. STATE OF NEW Y~K, ~ "S COUNTY OF ~ ~' ........ '.,~ ~'~-4~ C~, [&)~t~. & [( ...... being duly sworn, deposes ~d says that he rathe apphcant (Name of mdtwdual st~mg contract) above n~ed.~ (Contractor, agent, co,orate officer, etc ) of said owner or ownem, ~d m duly authomed to perfom or have perfo~ed the said work ~d to m~e and file t~s apphcat~on, that all statements contmed m ~is apphcatmn ~e true to the best of h~s ~owledge and behef; and that the work will be perfo~ed m the m~ner set forth ~ the apphcatton filed therewith. Sworn to before me th~s Term ;~" ~ ~1,1~ SOLDER USED IN WATER SUPPLY SYSTEM CANNOT EXCEED 2/10 of 19~ LEAD. PLUMBER CERTIFICATION ON LEAD CONTENT SEFORE ' cERTIFICATE OF OCCUPANCY OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE' OF OCCUPANCY If,~opper tubing le used for water distributing Sy~tmn~ piping ~hall b~ of ~_K_. or L only NOTIFY BUILDING DEPARTM~T AT 7~5-1802-9 A~ TO A PM ~R'~E, ' F~LL.OWI~G IN~PEC~ONS: FOU'NDA~ION '~O ~EQUIRED FOR P(]U~ED ~:ONCRE'~ ~ ROUG~ FRAIVilNG b P~:~MBING ~, R~AL CO~ST~UCTh3¢~ MUST BE CO M PLE'rE THF REQUIREMENTS ~ THE N.f ~ATE CONSTRU~ON & ENERGY , CODES. NO~ mESIGN O~1 C(-flSTRU~ON ~RORS, : -4' P,c, 11' ~ PL. 2,¸