The URL can be used to link to this page

Home My WebLink About14719-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23489 Date 'FEBRUARY 9, 1995 THIS CERTIFIES that the buildin~ ADDITION Location of Property. 54635 COuNTY ROAD #48 GREENPORT N~ House NO. Street Hamlet County Tax Map No. 1000 Section 52 Block 1 Lot 10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 27, 1986 ~ursuant to which Building Permit No. 14719-Z dated MARCH 31, 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 AN ADDITION TO A ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED BERNARD KIRSCH PENDING N/A Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 1~? 14719 Z Permission is hereby gronted to: .......'~.~...x.....9...~C ................................................ , County Tax Map No. 1000 Section ...... ..(~....~..~..-~.. .... Block ........ ...~....( ...... Lot No. ] ~) BuiJding inspector. Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Vpre-existing" land uses: 1. Accurate surveMof property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspec{or 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 Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date Februarv 8, 1~95 ....... New Construction ........... Old Or Pre-existing Building..~9~............an addition 54985 North Road Greenport Location of Property ............................................... . . .. .-.....~......o....... House No. Street Hamlet Dnwer or Owners of ~ ...... ~, Bernard Kirsch, M.D.P.C. Retirement Trg~t County Tax ~ap No_ '000 Se L. 052.00 ~, - 01.00 Lot 010.000 map or Property o~W.H. ~oung .......................... ~u · ; - and R J. Goodale ~P~ % 9~ ~ ~ bdzvzszon ....... · ................... · .. ....... Filed Map. ..... ...Lot ............. . .. . Permit No. 14719 - Rudol h H Bruer, Attorney .......... Date Of Permit... 03/31/86 ..Applmcant ....... ~ Health Dept. Approval........,........ .... . ....Underwriters Approval ....................... . . Planning Board. Approval ..................... . . . Request for: Temporary Certificate ........... Final Certicate.. XXX 25.00 . .. ..<. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] F~RAMING [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION :)ND ~INSULATiON [ ] FRAMING [ ] FINAL ""MARKS: ~l~,~-~'~/~~'~ DATE ~INSPECTOR ~e¢~P/~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [/~ FRAMING [ ] FINAL DATE /~//~.~/~' BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /" [ ] F_~NAL REMARKS: ~ BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUG~.BG. FOUNDATION ZND [ .],~,ATION FRAMING [/,']"FINAL / ~ '/ ....... CT~ DATE INSPE THE NEW YORK BOARD OF FIRE UNDERWRITERS 1 BUREAU OF ELECTRICITy 85 JOHN STREET, NEW YORK. NEW YORK 10038 FEBRUARY 14,1995 /;pp:ic.,io, No. o, file ~6~4895/95 H ~44392 THIB CE~IFIES THAT DR. BE~ K~S~, ~R~ RO~, S~, N.Y. in the/ol~w~g I~atlon; ~ ~.t ~ I.t FL ~ 2~ FL O~ ,~Non Bilk ~t ~s examin~ on ~RU~Y 09,1995 ~ ~und ~ ~ in complMnce ~h the N~on~ Elec~c~ C~e. eJnNncn ~ncv [.o.o~ [ *~ ~SU~ D~ECTS, "~ electrical su~ey has ~en ~de of the e~osed electrical e~i~ent in the premises indicated." "No obvious unsatisfacto~ condition was fo~d. EDSON & BRUER MAIN ROAD P.O. BOX 1466 SOOTHOLD, NY, 11971 TIME C~OCKS ~ UNIT fllATIIS MULTI-OUT~T V I C E EXHAUST FANS DIMMERS 11 Per ~ This certificote 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~UILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. FIELD ~S£~ECTION FOUNDATION (1st) COMMENTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. CODE ~' FINAL ADDITIONAb COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL gOUTHOLD, N.Y. 11971 TEL.: 765-1803 Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BLDG. DEPT. ,,, TOWN OF SOUTHOLD 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 g Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for thc 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 inspectigns. . (Signature of applicant, or name, if a corporation) o: 5.. ?..s..! (Mailing address of applicant) State whether applicant is owner, lessee, agent, arch!tect, engineer, general contractor, electrician, plumber or builder. ..... ~....~57. c..dS.. ~ ~..~w/.. er. ~..¢</.... ~e..-7~:..w..e..4-. ~...0.:.44. 7,~¢- .7.0. Name of owner of premises .. ~)O.~.~.0...e.~....-~.~. ~..NJ~ .~....~1'~...~..c,.{.4. ......................... (as on the tax roll or latest deed) If applicant is 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 ............ ~,<~. t~.... ~/~,4Z7~ Other Trade's License No ...................... ~ 3~ Location of land on which proposed work will be done .............................................. ..... ........ House Number Str~t Hamlet County Tax Map No. 1000 Section .~. 7/~< e.. Block .................. Lot ................... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy.../...~..~.../.., i .~.,~ ~..{ .~./..~...~..~. './././. ............. b. Intended use and occupancy .................................................................... 10. 11. 12. 13. Nature of work (check which applicable): New Building ..... ' ..... Addition . . Alteration . .i ....... Repair Removal · Demolition i Other Work .~._. (Description) Estknated Cost ........ (to be :paid on filing this application) If dwelling, number of dwelling units ..... If garage, number of cars ..... ~t~/. ~? A~..~W....O/1~./~.O. t/~ ~g7..-~ .... ~.~... ~.~:7:t~. ~..-~)..~.~. ~7 ~'' If business, ommerc,al or mixed occupancy, specify nature and extent of each tyP. e of use ..................... Dimensions.of existing structures if any Front...--~.. ,-~.../. ...... Rear .~.~. ff ..... Depth 40. r Height . ./. ~:~..( Number of Stories /. ............... Dmaenslons of same structure with alterations or a.ddmons Front ... ~ ~..'..... ..... Rear . u~ .~. .... Depth e~..q~. ........ Height .... /....: ..... Number of Stories. ~.-.-~..~7~, ~ .... Dimensions of entire new construction: Front...//../.~. ...... Rear..//. '-.~? ....... Depth ~ ......... Height .../.'-.F~,../ ...... Number of Stories ..... O/~....~'"~7.. ......... Size of lot: Front .. ~.~-'.¢ ?..z- ............ Rear .../.~..~. ~..~. ........... iDepth ,.~.~..~. .............. Date of Purchase ............................. Name of Former Own Zone or use district in which premises are situated ..................... Does proposed construction violate any zoning law, ordinance or regulation: Will lot be regraded ............................ ..W. ill excess fill be ret toyed from premises: Yes No 14. Name of Owner of premises~/gq/~)f:'ff./~a"~(./~'~../P~lress~, f~..~.~., ~.ff../q..~lPhone $o~..~: ~ Nme of Architect . :~: :: ............. ~.. ,... Address ............. i · Phone No ............... Nme of Contractor~a'.~O~7~m.. Address ~,~. 7~, ~/~tO~. Phone No..q~..~,~. IIq , : PLOT DIAGRAM ] Locate cle~ly ~d distinctlg ~1 bufld~gs, whether existing or proposed, . i~dicate ~1 set-back d~ensions from prope~y Bnes. Give street and block number or description according to deed, ~r show street names and indicate whether interior or corner lot. ~~ oi STATE OF NEW YORK, COUNTY OF ................. · , ................................................ being duly sworn, 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 ~aid work and to make and file this application; that all statements contained in this application are true to the best ofhi~ 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 .............. ~. ...... day of ..................... 19 .. Notary Public, ..~~/' - ~. ~)-~ .~/...~'~ County . , ~. ,...~ a ~~U~!~ _~!o_ .~W~~ ~' ~ ~ ~ ' ' (Signature of applicant) Term Expires M~,~. o,.,. ,~.-,,.--, / ' ./ NOTIFY BUILOtNB OEPARTMENT' AT 76~54B02 ~ ~M rO ~ PM ~R THE FO[ } 0~ ~=~ ~ ~-~pECTIONS: -I~ ~,,~EN OF 1'HE