HomeMy WebLinkAbout14960-zFORM
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hail
Southold, N.Y.
Certificate Of Occupancy
No. Z-16342
Date October 28, 1987
TI4IS CERTIFIES that tile building ADDITION TO EXPAND EXISTING KITCHEN
Location of Property ... ~.5.7...7 .5. ?la. ,i.a..R.o..a.d ........... .O.r.i.e.n..t.,..N..e.w..Y.o.r..k ............
House No. Street Hamlet
County Tax Mall No. 1000 Section . . .0.1.7. ...... Block ...0.4 ........... Lot ....0.0.4. ..........
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
May 27, 1986 14960 Z
..................... pursuant to which Building Permit No ......................
June 9, 1986
dated ............................ was issued, and conforms to all of the requirements
of the applicable provisions of tile law. The occupancy for which this certificate is issued is .........
ADDITION TO EXPAND EXISTING KITCHEN TO EXISTING ONE FAMILY DWELLING
LeROY E. & ANN S. FITTING
The certificate is issued to ..................... ~oWn.o.r,.ley~oX~.~e~.~X ....................
of the aforesaid building.
Suffolk County Department of Health Approval N/A
UNDERWRITERS CERTIFICATE NO. N8 134 I 1
PLUMBEHS CERTIFICATION DATED: January 28, 1987
Building Inspector
Rev, 1/81
FOIII, M NO, II
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PER~IT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Permission is hereby granted to:
..... _/~.-~..~.~..~/.~....~.~Z..,..
.... .~. Sr.. ZZfT...,..~../*:.~'~ ........... Z .......
...O~.,.~..~....~:~. ......... zz.~..-7.
,o ......... -&T.~.~..~..~,a. ........ ~.,'ZE4/~..... .....................................................................................
at premises located at ................... .! ...........
County Tax Map No. 1000 Section ..O~..Z ......... Block ..~....~... ......... Lot No..(~....~... .......
pursuant to c~pp]ication doted ..~.~.....Z..z ....................... , ]~.., and approved by the
Building Inspector.
Building Inspector
Rev, 6130/80
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.
Owner ~
~(please p~int)
(91ease p~int) '
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
(plumber ' s ~ignature)
Sworn to before me this
'~ day of' ~
Notary Public,
~~ County
NOTARY PUBLIC, State o~ NOw york
NO. ~.70787% ~o~k
Tm'm Expires Msrch 30,
Notary Public
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF: ELECTRICITY
85 JOHN STREET, NEW YORK,
NEW
YORK
10038
Dot~ ~ppllc.tion No. on file N
THIS CERTIFIES THAT
only the electrical ~uipment ~ ~sc~ib~ be~w a~d int~duced by t~ applicant ~m~ on the a~ve application number in the premises of
Ler~3 Yi~ting~ Main ~oa~ Orient, ~
~. th~fol~o~.~.~ ~,,~.~o.~ ~ ~.s..,..t ~ ~t r~. ~ ~d FI. s~t~,,. ~t~ Lot
~s examined o~ ~a~ ~ ~9~ ~ and found to be in compliance with the require.~ents ~f this Board.
FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS
fIXTURE SWITCHES INCANDESCENT FLUC~ESCENT
OUTLETS
OTHER APPARATUS:
$ E R I C
,o %~%co.D.t
E
Mai ~ra~o, glac~riciau
W~ggia~ Lame
Greenport, NY 11944
Lic#1049E
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be
11
by their credentials.
COPY FOR,BUILDIHC.., DEPARTI~ENT. THIS COPY OF CERTIF)CATE MUST NOT BE ALTERED IN ANY MANNERi
TOWN OF SOUTIIOLD
OFFICL: OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
$OUTIIOLD, N.Y. 11971
October 22, 1987
TEL. 765-1802
Mr. LeRoy E. Fitting
25775 Main Road
Orient, New York 11957
To Whom This May Concernf
Re: LeRoy & Ann S. Fitting
We are unable to complete your Certificate
of Occupancy because .of the following reasons.
/~/ An application for Certificate of Occupancy
is not on file~
/.h~/ No Underwriters Certificate on file.
~ The check is(o~kx~fnot on file.)
/~/ No I1ealth Dept. Approval on file.
/~/ No final inspection has been made.
$25.00
Please contact our office on this matter.
Thank you for your cooperation.
Building Permit t~ ~_ .~_ ~_ ~_~ .Q~ Z
Building Dept.
No Plumber Solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
~ Occupancy or use is unlawful without a Certificate
of Occupancy. Clear up this matter as soon as possible
so that legal action does not have to be taken.
Thank you for your prompt attention.
76~-18~2
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING
REMARKS:
[~FINAL
765-1882
BUILDING DEPT.
INSPECTION
~NDATION 'iST [ ~ROUGH PLBG.
FOUNDATION 2ND [ ~ INSULATION
[~I~MING [ ] FINAL
REMARKS: ~:'~
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
To Whom This May Concern,
We are unable to complete your Certificate
of Occupancy because,of the following reasons.
/--/ fn application for Cer,tificate o~ Occupancy
-- xs not on file./~pp/,
/~/ No Health Dept. Approval on file.
/~/ No final inspection has been made.
Please contact our office on this matter.
Thank you for your cooperation.
-Building Permit # :/ ~ ~.~ ~__ Z
Building Dept.
***/5/ No Plumber Solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
FIELD INSPECTION DATE COMMENTS
FOUNDATION (1st)
FOUNDATION (2nd) , ....... ,, , _____~
~ouG~ FRAME ~ ~-,0 F~¢~'~ r' PZO~ ._
o~
PLUMBING O' ~ ~O
INSULATION PER N. Y.
STATE ENERGY
C~ODE
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
~OUTHOLD, N.Y. 11971
TEL.: 765-1802
Received.~..~'~.
Disapproved a/c ............................. a .......
................................ ....
(Btfilding Inspector)
APPLICATION FOR BUILDING PERMIT
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 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 Tow~n 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 i~ .~,~/d~.
(Signature of applicant, cCr..aamd, if a corporation)
· rl'~n¢ N)/
~5.?.. 2,¢. H&,n.B.d, .0. .... ~ .... ~. .... ~.~ ¢ ....
(mailing address or applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Nameofownerofpremises .k~J¢.O.C]..~....4~...trier3. 5. J~-I' .~..~.r)....(-r-~. ...............
(as on the tax roi1 or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer) /
Build.er's License No ........ ~. j. ~. : ............ [ eob~.(aI-[L), So~'~ }q._~D~}'~/--
Plm;ber's License No .........................
Electrician's License No ' --
Other Trade s License No' ......................
1. Location of land on which proposed work will be done ..................................................
. v. ........... o,:a.. B.o.o& ..................... Oe. i¢.a .... ..............
House Num bet Street Hamlet
County Tax Map No. 1000 Section .[ :7 .............. Block.. ~. ............ Lot .... .'~ ....... ". ....
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
2. State existing use and occupancy of premises and intended u~e and occupancy of proposed construction:
~ ~...~. -
~. ~xi~tin~ usC ooc.~nov ...... .... .~~ .............................
b ~ntended .~¢ ~*d occupanoy ~¢d
3. Nature of work (check which ~pplicable): New Building .......... Addition v/' Alteration ........
Repair .............. Renloval .............. Demolition .............. Other Work ................
.~.14 ~..~., .~. (Description)
4. Estimated Cost ........................ Fee ......................................
(to be paid on filing this application)
5. If dwelling, number of dwellin units ............... Number of dwelling units on each floor ................
If garage, number of cars ....... J. ~[ ..............................................................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .....................
7. Dimensions of existing structu{es, 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 cons[ruction: Front ............... Rear ............... Depth ...............
Height .......... Number of Stones ... J ...................................................
9. Size of lot: Front ...... .t. · · ............ Rear ...................... l~epth .... ,. .................
10. Date Of Purchase .... [."/r/l~lq{~ .................. Name of Former Owner ~.q~]it~...(: ~.1.1')O'. .............
11. Zone or use district in which p~emises are situated .....................................................
12. Does proposed construct!on v~late any zoning law, ordinance or regulation: . ~.Q ...........................
13. Will lot be regraded ... ID. ~..r~- ·. n .... ~-,--_u~.~. · · Will excess, fill be remove, d from premises: Yes No_
14. Name of Owner of premises ~t~t .~/1.. ~.l~/f) ~AddressF~,J~,. O/~[~. Phone No. ~']~. ,~,~,~q~'
Name of Architect . "~ . ....... Address .................. ,..~ Phone No ............. ~...
Name of Contractor .~. ' '~ ~.~ ~.' ........ Address~¢}~t}f d. $~ t~t~. Phone No.~'~./~.-~7,,?-fx%~Pw..
15. Is this property located within 1;00 feet of a tidal wetland*. * Yes ..... No ~t' ....
· If yes, Southold Town Trustees Permitmay be required.
,PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and bloc number or description according to deed, and show street names and indicate whether
interior orl corner lot.
STATE OF NEW YORK, S.S
COUNTY OF .................
................................................. being duly sworn, deposes and says that he is the applicant
(Name of individual si~ning contract)
above named.
He is the
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is daly authorized to perform or have performed the said work and to make and file this
application; that all statements co~tained in this application are true to the best of his knowledge and belief; and tkht the
work will be performed in the manner set forth in the application filed therewith.
Sworn .,t/:~aefore me/&is
.... .....
Norm, /.,) r"'"'
// / JOSEPH LAWRENCE 'I'OWNSEItI~'
// / a-6mf Umc V0a .
elks. No. 52-9366~50
My Commission Expiros, J.i~;.:h ~--,, 19