HomeMy WebLinkAbout14939-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z17419 Date OCTOBER 17~ 1988
THIS CERTIFIES that the building ONE FAMILY DWELLING.
Location of Propert~ 1370 R.O.W. LIGHTHOUSE ROAD SOUTHOLD
House No. Street Hamlet
County Tax Map No. 1000 Section 050 Block 05 Lot 05
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 20, 1986 pursuant to which
Building Permit No. 14939Z dated JUNE 5, 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 ONE FAMILY DWELLING, ATTACHED GARAGE, AMENDED TO INCLUDE DECK.
The certificate is issued to MARK & PATTY FINNE (owner,
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 86-SO-74 10/13/88
UNDERWRITERS CERTIFICATE NO. N785446 12/23/86
PLUMBERS CERTIFICATION DATED HENRY SMITH
Building Inspector
Rev. 1/81
FORM' ~0. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, bi. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Permission ~s hereby granted to: ~ /~
~..~d,.,,....~.;..y..;././..?.2.../. ......... ....~ ..~...~
· .
at premises located at .......... , ...... · ...... .* ..................
County Tax Map No, 1000 Section ..... .(~.,~.'"~.,. ..... Block ..... .(~.~.. ....... Lot No ...... ~:~'~. ..............
Building Inspector·
Building InSPector
Rev. 6/30/80
FORM NO. 6
TOWN OF $OUTHOLD
Building Department
Town Hall
Southold, N,Y. 11971
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitted ~ ~ 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 features.
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:
I. Accurate survey of property 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 BOOLS $25.00AL?ERATTON $25.00
I. Certificate of occupancy New Dwelling. $25. O0, Accessory ,~ ]0.00 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
5.Updated C.O. $ 50.00 Date ..........................
NewConstruction ...... Old or Pre-existing Building ............ Vacant Land .............
Location of Property .. )~?~ ~, ~0. G'~.~j../~./~..~.. ~
House No. Street Ham/et
Owner or Owners of Property , .~..0-~. L ~...2 .~..-,.~. ~ ...............................
County Tax Map No. 1000 Section ...¥~..~) ......... Block ...~.-~. ......... Lot...~.~.~ ..........
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No. J~.~. ...... Date of Permit .......... Applicant ..................................
Health Dept. Approval ........................ Labor Dept. Approval ....................... '.
Underwriters Approval ........................ Planning Board Approval ..................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $ .............................
Construction on above described building aad~rmit meets ali applicable, codes and regulations. AP plicant · .~/~c,~. ~..~..~L/~ .........................
Rev, 10-10-78
~oo~o7~ THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NEW YORK 10038
o.t~ ~c~mb~¥ 2~,~9~6 ~pp,ca,o. No.o./,fe~O~6?/~6 N 785446
THIS CERTIFIES THAT
only the electrical equipment ~ ~scribed below and int~duced by the ap~icant ~med on the above application number in the premises of
Mark F~nne, 1~70 L-~.ghthouse Rd., Southold, N.Y.
~s examined on ~ 0 C oI~b (~ ~* 1 1 ~ 1 9 ~ ~ and found to be in cotnpllonce u'ith the requiretnettls qfl this Board,
FIXTURE
OUTLETS
3Q
~ECEPTACLES
55
SWITCHES
45 30
DRYERS FURNACE MOTORS
FIXTURES
FLUORESCENT
SERVICE DISCONNECT
)THER APPARATUS:
G,F.C.Z,~I, Smoke l)etectors-$
Track Ligh/ing-6~'O'' $ lites
RANGES
L 17,.7
APPLIANCE FEEDERS ~PECIAL EEC'PT
S R
TIME CLOCI('S~ E, ELL UNIT HEATERS ~ULTI-OUTLET
H~ SYSTEMS
V I C
NO OF HI-LEG
AWG
OF HI LEG
NO OF NEUTRALS
Lot
EXHAUST FANS
DIMMERS
A, WG
OF NEUTRAL
41o
Ofi S Electric
Box 215
Southold~
11971
~RNm:EAL ~ANA~EE
11
Per L ....
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.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIF CATE MUST~NOT, , ~ BE,ALTERED IN ANY MANNER.
BL.DG. DEPT.
,TOWN OF SOUTHOLD
HENRY J. SMITH & SON,
PLUMBING, HEATING & FUEL OIL
MAIN ROAD
SOUTHOLD. N.Y. 11971
(516) 765-3690
inc.
CERTIFICATION
Date 0 c t o b e_r_ 17_~__1_Q_8 8___
Building Permit No. 1~939Z
Owner Mark &.~I~dno**~_ ..........
Plumber__~A~Z_~_~!~_~_~RB±_~=
I certify
system contains less
that the splder used in the water supply
than 2/10 of 1E lead.
Sworn to before me this
~k_day of October
1988
Notary Public, Suffolk County
BERNADETTE L. TAPUN
NOTARY PUBLIC NB'I459B
State ef New York
Residing in Suffolk Coullty
Commissior) Expires SepL 30,
FIELD INSI~ECTION
FOUNDATION
FOUNDATION
(2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N. Yo
STATE ENERGY
CODE
COM~4ENTS
FINAL
ADDITIONAL COMMENTS:
-'.-~...," ~_,M~ ,A~ ~r/~ ~ / ~ -- .
765-t802
BUILDING-DEPT, - -~ ~
/INSPECTION
[L/] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION ZND [ ] INSULATION
[ ] FRAMING
[ ] FINAL
REMARKS: ~"(~ ,/~ ,
765.,1802
BUILDING DEPT,
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION AND [ ] INSULATION
[ ] FRAMING [ ] ~'iNAL
REMARKS: ~ ~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 3LST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING [,/J/FINAL
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS: '--'-- /'/ "~' ~
V
765-1802
BUILDING DEPT.
INSPECTION
[,] ~IJNDATION~ 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING
[ ] FINAL
DATE
INSPECTOR
'FORM NO. I
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N,Y. 11971
TEL.: 765-1803
proved...~.~..~7~. ·., 19 .~¢. Permit No..}. ¢.~. .~. ~. .~
approved a/c ................ i .....................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date .................. 1
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 descrilStion of layout of property must be drawn on the diagram which is part of this appli-
cation, i '
c. The Work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this applicaiion, the Building Inspector will issued a Building Permit to the applicant. Such permit
shall be kept on the premises availabl~ for inspection throughout the work.
e. No building shall be occupier[ or used in whole or in part for any purpose whatever until g 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, ancklegulations, and to
admit authorized inspectors on premises and in building for necessary inspections. _ ' ~-~' .
(Mailing address of applicant)
State whe~er applicant is owner, .~ssee, agent, architect, engineer, general contractor, electrician, plumber or builder.
_
N f f p is
ameo ownero rem es ....... . ...................................................................
(as on the tax roll or latest deed)
If applicantds a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No ......... : .................
Plumber's License No .........................
Electrician s License No ......................
Other Trade's License No .....
1. Location of land on which proposed ~work will be done ..................
House Number i Street Hamlet
CountylTax Map No. 1000 SectiOn ......... .~..~..O. .... Block .... -~. ........... Lot .... ~ ...........
Subdivision ................ ~ ................ 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 ..... .~..~. ~. · .~. · ....................................
use and occupancy ....... . .G~...~~~..~ ................
b.
Intended
3. Nature of work (check which applicable): New Building .......... ~" Addition .......... Alteration ..........
Repair .............. Removal .............. Demolition .............. Other Work ...............
~rf2~, GOO (Description)
4. Estimated Cost ........... ~.~d ...... : ................ Fee
~ (to be paid on filing this application)
/
5. If dwelling, number of dwelling units ~.~ ..... /. ...... Number of dwelling units on each floor.. [. ............
If garage, number of cars ......... ~. ~ ............................................................
6. If business, commercial or mixed occupancy, specify nature and extent of each type 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 ................. Rear ..................
Depth ...................... Height .......... ,~ ........ Number of Stories ........... ~, .........
8. Dimensions of entire new construction: Front . .~. ~.. '¢ ' ' ' ' F6~"
.......... Rear ...~ ........... Depth ...~ ...........
Hoight }~ ( ...... N:~rnber of Stories . . ~ ...........................
9. Size of lot: Front ...................... Rear ...................... Depth ......................
10. Date of Purchase ............................. Name of Former Owner .............................
11. Zone or use district in which premises are situated ............................. -. .......................
12. Does proposed construction violate any zoning law, ordinance or regulation: ................................
13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No
14. Name of Owner of premises .................... Address ................... Phone No ................
Name of Architect ........................... Address ................... Phone No ................
Name of Contractor .......................... Address ................... Phone No..~.~..~7.~ .TY~. ....
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 number or description according to deed, and show street names and indicate whether
interior or comer lot. ~
a
/~'
STATE OF NEW YORK, S.S
COUNTY OF .................
................................................. being duly swam, deposes and says that he is the applicant
(Name of individual 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 said war{ and to make and file this
application; that all statements contained in this application are true to the best of his knowledgexand belief; and that the
work will be performed in the manner set forth in the application filed therewith.
Swam to before me this
.............. ~..0 ....... dayof ....... .~2~ . .~23~;~ 9 ~.~. ~ ·
Notarymublic, ...~..Z..~..&..~..~.. ....... ....;.;..;..~f.!~ .~..,~~,.
~i~1~ ' (Signature ~[ ;~li~a~'ti
0
TEST HOLE
51.6
e
N. 48054'40"E. ~
320.00'/~_ t
5' util
S. 48' 34' 40"W.
AT SOUTHOLD
/?~/~s/ TOWN OF SOUTHOLD
~" " SUFFOLK COUNTY, N.
~>' / I000 50 05 -
0
, ~ SCALE I"= 30~
'"° ~ ~'~' ; FEB. 25, 1986
~ APR. 4, 1986
/'/~ S~ ~ AUG, 4~ 19 8 7
CERT FlED TO :
COMMONV/EALTH LAND TITLE
INSURANCE COMPANY
TITLE NO. 6624 - 328 - S
MARK FINNE
PATTI FINNE
WIDE
utility easement
138. 00'
V/ACS
NI O/F
( VACANT )
AREA 25,465~ff
ELEVATIONS ARE
TO ASSUMED DATUM
TEST HOLE
(ELEV. 51.6
REFERENCED
Prepared in accordance with the
s¢andards for title surveys as estabH~L
the L. LA. LS. and approved and ad~,tAe,
for such use by The New York State Len~
Title Association.
I.Y.S. LIC. NO. 49668
PECO~ ~RS B ENGINEERS~ P.C.
(516) 7( 20
P. O. ~OX 909
MAIN ROAD
SOUTHOLD~ N,Y. 11971
t~
0
0
SOUND VIEWAVE.
50.9
N.48:$4'40''E.
( V~"'C~N T )
N/o/F L, NO
~-5' utility easement
N. 48 c'$4'40''E . ~
$20.00'
AREA =
TEST HOLE
51.6
s!q: FT.
utility easement I 50.5
R 0 w ~k
30' WIDE
S.48°
__ ~. utility easement __
N' O/F WAC $
( VACANT )
ELEVATIONS ARE REFERENCED
TO ASSUMED DATUM
The water supply and sewage disposal
system for this residence will con-
form to the standard of the Suffolk
County Department of Health Service,
?4',,.~f~, , .~- ~~4,~ -
~ SURVEY FOR
~ FINNE S PATTI FINNE
0 0
AT SOUTHOLD
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.
I000 - 50 05 - 05
SCALE I"= 50~
FEB. 25, 1986
APR. 4, ~986
TEST HOLE
(ELEV. 5t.S
4 reel, s
COMF~ONWE ALTH LAND TITLE
INSURANCE COMPANY
TITLE NO. 6624 -
MARK FINNE
PATTI F/NNE '"'"
_~ ~ - HEALTH ~RVICES
~S ~EF
:: N.Y.$ · LIC. NO. 49668
PECONiC SURVEYORS & ENGINEERS, P.C.
'( 516)~765 - 50~0
P. O. BOX 909
MAIN ROAD
SOUTHOLD~ N. Y. 11971
'FOLLOWtNG ~NSPECTION$~,,
'~ FOO~4OA'qON4 TWO "~UmED
,, , FOR POUREO C:(~NCRE~E ~:
2 ROUG, ;RAMING r& ~UMBING
' 3r NSULA~O~ ~'
· RNAC CQN~UC~ON MUST
ALL CON~TRUC~ON SHALL ME~
THE REQUIREMEN~ O; THE
~DES, NOT ~NS~E ~
~IGN OR ~N~RU~ON ~ORS,
, : ;,USE IS ~" ': ~ ~: '~' ~' ~"~