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HomeMy WebLinkAbout14562-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z-15264 Date February 10, 1987 THlS CERTlFlES that the building ... One family dwelling 50 Indian Neck La. & 40300 Main Rd. Peconic, N.Y. Location of Property ~tJs~ ~/oi .......................................... ..... 's'tle;i .... Ham/et County Tax Map No. 1000 Section 086 . .Block 04 .Lot I. 3 Subdivision M/o Peconic Bay Cove .Filed Map No. 7159 .Lot No. ' I conforms substantially to the Application for Building Permit heretofore filed in this office dated January I0, 1986 pursuant to which Building Permit No. 14562 z dated.....................February 24, 1986 .... ... ~,wasissued, and conforms to all of the requirements of the applicable provisions of the [aw. The occupancy for which this certificate is issued is ......... ONE FAMILY DWELLING The certificate is issucd to GEORGE & MARGARET TINTLE ..................... ?oYn'e'r, x x .................. of the aforesaid building. Suffolk County Department of Health Approval ....... 85 - S O- 216 UNDERWRITERS CERTIFICATE NO. N 766903 PLUMBERS CERIIFICATION DATED: Rev. 1/81 May 15, 1986 ~ing~Inspecto~ ............. 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) 19..~......~o Date Coun,~, To× Map ~o. ,000 Se~,o. ...... .O.~..q. ....... B,o~k ..... ..0..~ .......... Lot ~o ..... L:..~ ............ pursuant to application dated .....~...~....'....~. ............. , 19..~...~,---- and approved by the Building Inspector. Building Inspector FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall $outhold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. 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 featu res. 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 p~operty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.'00, over 5 years $I0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... ~NewC~ns t~uc t ~9~P~.. .. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ............ ' ~ ' > · House No, Street Hamlet Owner or Owners of Property . .~.~.~;.J.~.~..~. /.~.~'.~.<~.-~..~'. "~" ' ' ............. ~/./. ~. '.2~. ~. ....... County Tax Map No. 1000 Section ...~].~ ......... Block .... ~. ......... Lot. Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. ~.~.~. Date of Permit ~-P'~-~ Annlin~nt(~£-~dZ"z~ .~..~.~'_z~,~'~ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval../~. ~..~..~.f.~.~....--.~.: .~.. ~' .~,~lanning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $..~..5.....~.. .... ~.~..~. ......... Construction on above described building and permit meets all app cab e c~.~es and ragu at ons App cant Rev, 10-10-78 Co~- ~.~ TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-I 802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because,of the following reasons. ~'/ ~o~at~o~of Occupancy i~le. ~L3~C/~y¢ J) /Z~.~ No Underwriters Certificate on file. /Z/ The check ls(~a~c~/not on file. 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. ***/~/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) COMMENTS FOUNDATION (ls~,,)~ FOUNDATION 2. (2nd) ROUGH FRAME & FLUMBING J INSULATION FERN. Y. STATE ENERGY CODE FINAL / / ADDITIONAL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY · ~ ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 ,at~ ~'m~"~' 2, m~ ,',,,,,~.,,o. No.o.~,,e 3~4Z20/Se N 765903 THI~ CERTIFIE~ THAT ~ a. 'rlnt].e, ~o/w~t ~r~r Indi~ N~k I~, Off 5~n .- ~ad, Pe~nic, in thefollowinglocatlon; ~ Basement 5 ,st Fl. ~ 2nd Fl. Section Bl~k Lot ~sexaminedon g~t ~ and found to be in cotttpliance u'ith the require.tents qf this Board METEIEQUiP ~'~w l~'3w 3~3w 3~w "O.O[E.CC~.~ SERVICE DISCONNECT A,~T, A~p, Type - 1 150 CB OTHER APPARATUS: RANGES ;PECIAL RECPT 1-G. F. C.I. t-;~noke Detector Track Ig_ghting 8' 4 I-bmi~ NO, OF HI-LEG OVENS I DISH WASHERS ' ' 1 1.2 UNIT HEATEE~ MULTI-OUTLET  SYSTEMS NO, OF FEET C E A,W, G NO OF NEUTRAi OF HI-LEG EXHAUST FANS DIMMERS AWG. OF NEUI'RAL C~orge A. Tintle Box. 142 Driftwood Ogve, Gree~ Port, N.Y. 11944 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. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 802 CERTIFICATION Date Building Permit No. Owner C~0~ (please print) Plumber ~N~ (please print) 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 I~q~day of Notary Public, Notary Public County 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [~FRAMING [ ] FINAL REMARKS. DATE 765-1802 BUILDING DEPT, INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ] FINAL DATE 765-X802 BUILDING DEPT. INSPECTION [ ] FRAMING , REMARKS: [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] IHSULATION [ ] FRAMING [ ] FINAL DATE, ~///~~ INSPECTOR BUILDING DEPT. INSPECTION FOUNDATION1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION 76S-1802 BUILDING DEPT. · INSPECTION [ ] FOUNDATION tST [ ] ROUGH PLBG. N FOUNDATION 2ND [ ] INSULATION [ ] FRAMING *[ ] FINAL DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ~-~ROUGH PLBG. / [ ] FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL DATE INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS-' ~'~/"y DATE ?~/~F~J i NSPECTOR ~.~~ 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765'1803 Disapproved a/c ................................ ii~.~ (Building Inspector) APPLICATION FOR BUILDING PERMIT ..... TOWN OF '80UT~OLQ Received ........... ,19... Date . ~..~.~..x~... ........... 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 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 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 inspecti~. (Signature of ap"plicant, 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 ~..~....~.ff4~,...~.-..~.r ..,~...a~?.,4~....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 ......... : ...... ~., ........ Plumber's License No.. ~...~.. ~..~..(.~.~<~ Electrician's License No. ~C..[.~. .............. Other Trade's License No ...................... b~(3 '~b ~3 I. Location of land on which proposed work will be done .... ~?.~7/ff,..4.c/.q.-~..,fi7' .~.q.,~./?..~.~....~.~.~..~.~..~.~/~..~: .~?.z,. · ....................................... ..... House Nnmber Street Hamlet County Tax Map No. 1000 Section ..... .~.'.~..' ........Block ....~. ............. Lot.../.,.~ ............. Subdivision ..................................... Filed Map No ............... Lot ............... (Nmne) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ~},q.' f.~:z. 7./...~.a.~ .~.../). .................... ~.: ...................... b. Intended r~se and occupancy '....~.~.ey(~.../4. i .~?.~?. ~. .~). . . .2'7.~. . . .'.'~..".~. ~. ,-./.~?.....(~.~.(~---.:. I"q~. .~t. y.~.. .~. . . '.... ~3. Nature of work (check which applicable): New Building ......... dditio ...~ ....... Alte~ration ........... Repair .......... . .... Removal .............. Demolition ............ i-. Other Work ............... 4. Estimated Cost...... . ..,. ................ .. .. . Fee .. ~ ' ~ (to be p~aid on filing this application) 5. If dwelling, number of dwelling units ..... ~. ........ . Number of dwelling units on each floor If garage number of cars /. ' 6. II. business, commercial or mixed occupancy, specify nature and extent of each typ~ of use .................... 7.' Dnnansions of existing structures, if any: Front .... .-7:. ....... Rear ... ': ........ .... Depth....--77~ ....... Dimensions of same structure with alterations or additions: Front ' Rear Depth .... y..-.;..: .......... Height ..... ; -:..7,.-:'.v:: ...... Number of , tories ............ · .......... 8. Dimensions of entire new construction: Front...~{.,~ .......... Rear ................ Depth ...o~. ........... Height . .". ............ '. Number of Stories ...... ~ ...... ~ .............. ............. , ...... ~ ....... 10. Date of Purchase . :o¢.'.~,,~ .,,~. .... yf./(~.. ........... Name of Former Owner ~q(.,~.o...~] .'. i .... 11. Zone or use district in which premisbs are situated .............. ' ............ ~ ............... 12. Does proposeS construction violate any zoning law, ordinance or regulation: ...... .' .ff~.' ............ Name of Contractor ....~..~. :?ff.//t-~...~..~7 ........ Address ...... ~?z~.~.....'... Phone No ................ 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 .......... ~t?.~? .g'.~....,~.,.. ~. ~ .............. being duly sworn, depo~es and says that l~e is the applicant (Name of individual signing contract) above named. He is the : (Contractor, agent, corporate officer, etc.) i of said owner or owners, and is duly authorized to perform or have performed the saiid work and to make and file this ~pplication; that all statements contained in this application are true to the best of his ,knowledge and belief; and that the ~ork will be performed in the manner set forth in the application filed therewith. 3worn to before me this : 5,66 Z SUFFOLK CO. HEALTH DEPT~ APPRovAL CONFORM TO THE STANDARDS OF THE ' '[ ' ~' ' THE WATERSTATEMENTOFsuPPLY AND SEWAGE INTENT ............. SYSTEMS FOR THiS R~SIOENCE WILL SUFFOLK CO. TAX MAP DESIGNATION: OlST, SECT. BLOCK ~L, LICENSED LAND SUR~ORS I ~-f - .... SUFFOLK CO HEALTH DEPT. AI~I~tOVAL ~_',_,,~ r h* ~ ~ , I U ' ; ~ CONFORM TO THE STANDARDS OF THE I ~ , ~] ~ ,~ m / OWNERS ADDRESS: ~?~ 6~o~',~ ~ i /: ~ox' ~ .. U'.{~F'rW~;~[; dOVE --~,.--~x ~,~' ~; ' ' ' ,,.' - ................... '.-,)~ ~L~'~ : ~ ~i ; ~ ~ ": !I' , ~ .... TEST HOLE STAMP / : ,~? ;~FFOL~UNTY HEALTH DEPART ENT , IX, ',".' '" THS sEWAas Om. POSA~bd' ~ER, SUPPLY ~AO,'~mS F~ ~ 'eY~ --- - ... ~ r- LOCATION HAVE BEE~I~PEOTED', BY THIS, DEF ~RT~E~ FOUND TO BE SAT~SFA~ORY: , ..... ' . ., JAN. ~,~T LICENSED LAND SURV~ORS ~ GREEN~RT NEW YORK SOLDER USED IN WATER suPPLY sYSTEM CANNOT ExcEED 2/10 of 1% LEAD. APPROVED AS NOTED EE" , ..... '~ By: NO~I~ BUILDING DEPAN~ENT AT 765-1802 9 AM TO 4 PM ~R THE FOLLOWING INSPEC~ONS: 1 FOUNDATION ~0 REQUIRED FOR POURED CONCRETE 2 ROUGH FRA~R)NG & PLUMBING 3. INSULATION ~ FINAL CO~STRUCTtON MUST BE COMP[6T6 FOR CO ALL CONS'I ~[~CT)~N SH~LL ME~ I HE REQuIr',~)~., F~crS OF ~E N.Y STATE COltSl'~ K)ON & ENERGY ~ODES. NOT RESPONSIBLE FOR "~ES)GN OR CONSTRUCTION ERRORS, .%, Or..