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Home My WebLink About14807-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town HaH Southold, N.Y. Certificate Of Occupancy No ..... .Z.I.6.9.5.8 ....... Date June 6, 1988 THIS CERTIFIES that the building .... a.l.t.e.r.a, tfi. o.n. .................................. Location of Property 2950 Ca~p Mineola Road Mattituck County Tax Map No. 1000 Section ...... 1.2.3 .... Block ....... 5. ....... Lot ....... 5. ......... Subdivision .......... .X .................... Filed Map No....X. .... Lot No ..... .X. ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ·.. Ap.r.~.l..2.2.,..1.9.8.6 .... pursuant to which Building Permit No ...... 1.4.8.0.7.Z. .......... dated ...... Ap.r. il~ .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 this certificate is issued is ......... ...... Al~er.~io.n .t.o..e~ia~ir~g .o.~-.f.a~ily..~lw.e. lling ................................ The certificate is issued to .............. JAt4~S .& .EILEEIq .KP, E.I{ .......................... Cow.er, ~Z~ of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N779366 Matt±tuck Plurab±ng & tteat±ng 3/30/87 PLUMBERS CERTIFICATION DATED: Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 1 $07 Z Permission is hereby granted to: County Tax Mop No. 1000 Section .... .J....'~....:~. ....... Block ..... ..~....~,. ........ Lot No ....... .C~..'~ ........... pursuant to application dated .... ~......,.~...~ ................. , 19.'~...~.., and approved 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 typewriter OR ink, and submitted I~ 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: 1. 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. ,~'A~-t-~s-'-~]-~ POOLS $25.00 ALTERATION $25.00 C. Fees: -- 1. Certificate of occupancy Ne~ ~5~00, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5,00, over 5 years $10.00~-- 4.Vacant Land C.O. $ 20.00 _~/~'~.Z 5.updated C.O. $ 50.00 Date ........ ~_ ~..~.. New Cons tpuc 1; ion ...... Old or Pre-existing Building.~., ......... Vacant Land ............. ocat,on of Property .... House No, Street I-lam/et Owner or Owners of Property ...~.i ~.~ .~ ~l~....~. ~/~/.'{'. ~.... //.P. ~-~.~. ..................... County Tax Map No. 1000 Section ............... Block ........... ... . Lot ........... ... .. Subdivision .......................... ~ .... z .Filed Map No ........... Lot No .............. Permit No./LT~¢~'~..~.~ Date of Permit ~A~pplicant ..... ~..~...~' ........... Health Dept. Approval ........ ~ ............. Labor Dept. Approval ....... . ."~...- . ........ Underwriters Approval ~ Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $. ~.~, Construction on above described building and permit meets all applicable qodes aEd regulations. ~. ,1~-~.~'~F~O~:~ \ ~(~ ~ ~ Applicant.. .. ~ ~ .......................... /~.~.~. Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~L2'0~0~0 BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 ,.t. ~ov~e= i?. ~a~ ~,,,~.,o.~o.o.~,~ ~3~a~/~ N 779366 THIS CERTIFIES THAT only t~ electrical equioment ~ ~scrlbed be~w a~ntroduced b~ t~ ap~Jlca~t ~ed ~n the e~ve application number in the premises of in the.following location; ~3 Basement November 6,1986 ~ 2nd FI. Section Block Lot and found to be in compliance with the reqt iretnents qf this Board. RXTURES RANGES COOKING DECKS OVENS DiSH WASHERS EXHAUST FANS SWITCHES 11 16 DRYERS SYSTEMS E R V I C OF CC, COND NO, OF HJ-tEG AW.G, OF HI-JEG NO OF NEUTRAt5 A, WG OF NEUTRAL Twit Pork ~lect. P. O. BOX 48 Jamesport~ N.Y. 11947 Lic~3488E GEN~RAt, MANAGER 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 B~ILDING DEPARTMENT. THIS COPY OF CERT FICATE ~UST, NOT' BE ALTERED iN ANY N~NHER. 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 L;~C) Owner ~f~v~3.~ /L~)L~ 0 (Please print) ' (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this 19 F~_. Notary Public, (plumber's si~ure) NOTARY PUBLIC, Slctll of Now York No. 4732613 Qualified in Suffolk County ~',ommission Expires ..MAn'eh 3~}, '191S'6~' COMMENTS FOUNDATION 1st) FOUNDATION (2nd) ROUGH FRAME & FLUMBING INSULATION PER N. STATE ENERGY CODE FINAL Ye ADDITION[L COMMENTS: 76S-'t 802 BUILDING DEPT. IHSPE 'rlON-, [~FOUNDATION 1ST [ ] ROUGH PLBG. [---]--FOUNDATION 2ND [ ] INsULATIoN [] '="AM,~G [] DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [/~FINAL DATE, g/////;/ INSPECTOR ~'~.~ ,~ 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined ~..~'..~. .... , 19~..~. Approved~...3.. ¢ ..... 19~.[. Permit No..I. ~ .~. ?.-I...~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BLDG. DEPT. TOWN OF $OUTHOLD Received ........... ,19... / Date... ,~/,/~, ~, ...... , 19 4~.~/ // a. This application must be completely filled in by B, pewriter 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 tkis 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 hereht 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 insp?~ons. -// /~ ....... . . ................. (Si~ture of applicant, or name, if a corporation) ..... (Mailing address of applicant) ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises...' .~.~ ?.-~'..~.. ~i;~i. l~'.~ ~..../~.E .~..~. ................................. (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 ....... ~ ..~../f.£ ............ Plumber's License No ........ .t./ ............... Electrician's License No. / / Other Trade's License No ...... t! ............... 1. Location of land on which proposed work will be done...~---~.,M $.~.~ ?t/¢.. ~, ~.A~r~.~.~. ...................... · ........ .... ............. - ......... House Number Street Hamlet County Tax Map No.1000 Section . ./~.~ ........... Block. ~. .............. Lot...~. .............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of prexnises and intended use and occupancy of proposed construction: b. Intended use and occupancy .... ~.Z~./l*'l...~ ......... ~ .... :: . . i .................................... 3. Nature of work (check which applicable): New Building ..... ' ..... Addition ........... Alteration . Repair .............. Removal .............. Demolition ........ ~... Other Work ............... i (Description) 4 Estimated Cost ~ (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 ....... i ....... Depth ............... Height Number of Stories Dimensions of same structure with alterations or additions: Front ............ i ..... Rear .................. Depth ...................... Height ...................... Number o£ Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ........ i ....... Depth ............... Height Number of Stories 9 Si of lot Font Rear ~iDepth 10 Dte of P chase Name ofForme Owne 11 Z dititi wh'chp ' 'tated ' · one or use s r c n 1 remlses are si u ......................... : ............................ 12. Does proposed construction violate any zoning law, ordinance or regulation: . ' .................... 13. Will lot be regraded .............. Will e cess fill be removed from premmes: Yes No fp ' 14. Nmne of Owner o remises .................... Address ............... r ....Phone No ................ Name of Architect ........................... Address ............... i ....Phone No ................ Name of Contractor .......................... Address ............... ~ ....Phone No ................ 15. Is this property located withinl.00 feet of a tidal wetland? * Yes ..... No ..... · If yes, Southold Town Trustees Permit may 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 block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ....... S.S ................................................. being duly sworn, depqses and says that he is th& 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 work and to make and file this application; that all statements contained in this application are true to the best of hi:. 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 SOLDER USED IN WATER SUPPLY SYSTEM CANNOT EXCEED 2/10 of I% LEAD. PLUMBER CERTIFICATION ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY APPROVED AS NOTEO ,'~OTIFY ~uILDING DEPARTMENT AT 765 1802 9 A~ TO 4 PM FOR THE FOLLOWING ~PECTIONS: 2 ROUGH F~AMING & PLUMBING 3, INSULA r~ON 4, RNAL C¢~J~TRUCTION Must ALL ~0~ ET~U~TION SHALL ME~ THE R~OU~EMENTS OFrTHE N.Y STATE CONSTRUCTION &ENERGY CODES EOTRESPONSIBLE ~R ~ESIGN OR CONSTRUCTION ~RRORS. PI2..OPOSED K.[TCF~_N~ bAT!.U.. o AONYdflOOO JO 31VOIJI.I.B3O lflOHll~ lflJMV'INfl Si ]sn ~IO'AONVdflO30 .¸1