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Home My WebLink About14652-z~=ORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z-15634 Date April 13, 1987 THIS CERTIFIES that the build~g ADDITION TO EXISTING ONE FAMILY DWELLING Location of Property . 200 Leslie Road House No. Street County Tax Map No. 1000 Section 097 .Block 09 Cutchogue, New york Hem/et 8 ...... Lot ................. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore f'ded in this office dated March 3, 1986 14652Z ......................... pursuant to which Building Permit No ...................... March 14, 1986 dated ............................. 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 ......... ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to EDWARD L. & JEAN M. FLEMING ..................... ioY.' 'r, :feSit¢?i? ..................... of the aforesaid building. Suffolk County Department of Health Approval N / A N777787 UNDERWRITERS CERTIFICATE NO .................................................. N/A PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 FOB. M~ NO, ~. TOWN OF SOU']HOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 1,1652 Z County Tax Mop No. ]000 Section ..... ,~.,Ot..'] ........ Block .... ,.~..,01. ........... Lot No ...... .'~. ............... pursuont to opplicotion doted ..... ....~.~..-~.-..~. ...................... , 19.~...(~., ond approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, N,Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUP Instructions This application must be filled in typewriter OR ink, and submitted m~ to the Building Inspec- ;~or 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. 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 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 $15.00 Date..Z. NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. House 'No. ' ....... Street .............. /, _J Owner or Owners of Property :.? .......... ........ County Tax Map No. 1000 Section .... ....... Block .... ......... Lot .... ~. .......... Subdivision ,~ I ,~,.,~,',, cj ~ t~ . .Lot No. ......... ,;*. ...................... Filed Map No ...................... /~. Permit No. ].¢l.b.~..z .... Date of Permit/.?..~.fI. ~. ,Applicant . .~].~' ~JO~.., .~..c{.~,o;,C.~' .... Hea~th Dept. Approval ........................ Labor Dept. Approval ........................ (V 7777~ Underwriters Approval ............ 7. ....... Plannin~ 8oard Approval ...................... ~equest for Temporary Certificate ..................... Final Certificate ...................... Fee Submitted $ ............................. Construction on above described building and permit meet;s, all applicable codes and regulations. Rev, 10-10-78 765-1802 BUILDING DEPT, INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING REMARKS: C2 %,. [ ] FINAL DATE ,/~ / .~ INSPECTOR / 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ]FINAL REMARKS: .-.~' ~/~'c~/~,,~-~'~--~ '"2 DATE ~INSPECTOR i'65-1802 BUILDING DEPT, INSPECTION *~FOUNDATION 1ST [ ] ROUGH PLBG. [~FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL REMARKS: DATE INSPECTOR loolo9) THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~.t~ Nove~nber 6,1986 4] 7027/86 ~,,,,,,,~.,,o. No.o.f,,~ . N 777787 THIS CERTIFIES THAT }Irs. Fleming, Leslie '~ Rd#200~ Cutchogue~ N.Y. FIXTURE OUTLETS DRYERS SWITCHES~ iNCAN D~$¢ E NT RECEPTACLE~ 7 FI. [] 2nd FL Section Block and found to be in compliance teith the reqi~ire.tents of this Board, FIXTURES RANGE: FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALREC'P S 1~/2W 1,.~3W 3,8'3W 3~'4W NO Oi~ERC~,COND. COOKING DECKS OVENS DISH WASHERS ~MT. K W AMT K W. MT. K W .as V I C E A W, O t NO' OF HI-[EG A W G, NO OF NEUTRALS OF CC COND OF HI-LEO r Lot EXHAUST FANS DIMMERS OF NEUTRAL Gary Doroski 42S Honsell Lane Cutchogue, N.Y., GENE. IIA~ 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 BUILDING DEPARTMENT. THIS cOPY OF CERTIFICATE ~4UST 'ERED IN ANY TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O, BOX 728 TOWN HALL $OUTHOLD, 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. /Z~/ An application for Certificate of Occupancy is not on file. ~~~ /--/_,/ No Underwriters Certificate on file. /~ The check is(~ced/not on file.)~9~.d~ /5/ No Health Dept. Approval on file. /5/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit # / ~ ~ ~ Z Building Dept. ***/Z/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 FOUNDATION (1st) FOUNDATION (2nd) ~ FLUMBING COMMENTS N. Y. STATE ENERGY CODE ADDITIONAL COMMENTS: 765-'"802 BUILDING DEPT. INSPECTION FOUNDATION tST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: [ ] FINAL DATE ~'~~,/~ INSPECTO~ 'FORM NO, 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 ., ., 19~. Permit No. !9.~..~..~. .~. Disapproved a/c ..................................... .................. (Building Inspector) APPLICATION FOR BUILDING PERIVilT BLDG. DEF TOWN OF., 0. ~ ,~,~ · Received ........... ,~9.. · Date ............... , · ·. INSTRUCTIONS a. This application must be completely ill[ed 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 for necessary inspections. admit authorized inspectors on premises and in building .... ....~--~°;~.t,.~,,.../:r{.//~....c-x...L'/Q~""'~"i~.~.-~...r_.~ (~n~ature of applicant, or name, if a cor~o~at'on) ..... ...... ...... ~, (Mailing address of appli%nt)/ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....................... tT. .r2. ........................................................... Name of owner of premises ...... . .~.~d/v-~. O. (2. d...l-...A .%-'/6°. · -~. ()... ~ ...... ./~../'~ }q(/. '//'):_'~' ..... (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 .... .1~..o} .~T...~y....c?.,~. % .~.... Plumber's License No ................ .......... Electrician's License No....~.~..~..L5~. ..... ~.g..O.'~.. ~0~ Other Trade's License N~)7 . .................... 1. Location of land on which proposed workwill be done ....... .~. ~../ .... ?..~.0.../...~e. ~*1~}~..~d ....... · ...... ...... £¥ ........ ...... ./9. House Num her Street 'l'gamlet County Tax Map No. 1000 Section ~q Block q Lot t~ . Subdivision ..................................... Filed Map No. $"1 2.3 · Lot ~ ~ (Name) 2. State existing use and occupancy of premises and in~ended use and occnpancy of proposed construction: a. Existing use and occupancy ......... .~..~..[0...~ ................................................... - b. lhtended use and occ~upancy ...... ~..) ~)/' e. ' . ...... '3. Nature ofworg (check which applicable): New Building ' .... Addition ... i2( ~ Ali6ration ...... [... Repair . .: .... Removal ....... Demolition ...... -.. , Other Work-.. ~4~/O ~ (Description) 4. Estimated Cost , oo.o.. Fee i (to be Paid on filing this application) 5; If dwelling, number of dwelling units .... ~ .......... Number'~)f dwelling unit~ on each floor'....t'f.~. ......... If garage number of cars ' qlI~ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ... ~ ................ 7. D~raenslons of existing structures, if any: Front .... / ........... Rear .. ..... i'. ......Depth .../.6! .......... Height Number of Stories I ~ 1 Dimensions of same structure with alterations or additions: Front ~ . Rear Depth Height Number of iStories Dimensions of entire new construction: Front ............... Rear ........ i. ...... Depth ............... Height / z ' Number of Stories I $ Size of lot: Front .... t.~..$...: ......... ... Rear... 1.3.~.,.7 ............ )epth .~ z'/~ . 10, Date of Purchase .,/{ .P,~....t.q. 3.q ................ Name of Former Owner 5T.~.~. . .~. q¥.~? ............... I I, Zone or use district in which premises are situated Ze>t,,¢ .~... 12, Does proposed construction violate any zoning law, ordinance or regulation: ................................. 13. Will lot be regraded ........ /??..; ............... Will excess fill be remove from premises: Yes 14. Name of Owner of premises . ~..[.. ~.?,9.m. ~?.'[ ...... Address ~e..~l,,te ~ ~.O?f-,h.%~. Phana NIc~ ,r/,.~- $¢27 Name of Architect ..... ~'.., ~,,L~.I~.e.~. ............ Address ~.~.~7.~.?~. ?.trg. j.0?gff.~tbrPhone No, y.V.?:qy, o.o ., Name of Contractor Address i 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 sho~ street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF .......... ....... S,S ................................................. being duly sworn, dep (Name of individual signing contract) above named. )scs and says that he is the applicant 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 of his 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 ~. 470~78, ~k ~ ~ 7 FO IN THE OPFIC£ :OLK ¢OUNTYON NO. 1i¸