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Home My WebLink About14345-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17811 Date FJiRCH 3, 1989 THIS CERTIFIES that the buildin~ Location of Property 705 SMITH DR. SO. House No. Stree% County Tax Map No. 1000 Section 076 Block 02 ONE FAMILY DWELLING SOUTHOLD Hamlet Lot 028 121, 122, LOT No. & 123 subdivision MAP OF GOOSE NECK Filed Map No. 1663 conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPT. 16, 1985 pursuant to which Building Permit No. 14345Z dated OCT. 9r 1985 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 ONE FAMILY DWELLING, ATTACHED ONE CAR GARAGE & REAR DECK. The certificate is issued to DONALD H. INSULL (owner, ~L~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 88-SO-142 1/27/89 UNDERWRITERS CERTIFICATE NO. N746731 APRIL 28, 1986 PLUMBERS CERTIFICATION DATED STEPHEN O'CONNOR 3/5/87 Building Inspector Rev. l/S1 YOR,M[ 'HO. B TO~N O~ SOUT~OLD 8~ILDJNG D£PARTM~NT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N_° 14345' Z Permission is hereby gronted to: ....... ../..~..z~..~..~....: .............................. .... ~.~.~9.. ~-.:~ ........ ~:.~....z'. ~'.z...~./../ ro ..... C(2.~..~.~.~..~..c,/. ....... .Q?....~...~,...~.~.~..~....../~Z~.~.. ......... L.....~ .................... at premises located at .......:l.~....~,.'~... ....... ~,//~.S.7./://....-/-~.........~. ..................................... pursuont to appllcotion doted ....... ~i ........ //...~a ............. , 19~...~.~Fand 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 A. This application must be filled in typewriter OR ink, and submitted u ~ 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-iS-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 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. C, Fees: Additions $25.00 1, Certificate of occupancy New Dwe[[ing,$25.Q0, Accessory ,$]0.00 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 /~..~/¢~.7'/~.'--" 5.Updated C.O. $ 50.00 Date .................. NewCons truction ...... Old or Pr~-existing Building ............ Vacant Land ............. Location of Property .... .~..~. ).~...~ . . .~.....~. ?. ................................... House No, Street Ham/et Owner or Owners of Property . .~...~-~,./¢.~ ............................................ County Tax Map No. 1000 Section ..... ~..~. ...... Block .... ~. ~. ....... Lot...~...~..~. ....... ....... F,,edMap No ........... Lot No ...... ~ t~.' u. ~/. Permit No../..~. ~.'' .N/.~..~LDato of Permit.../~/~/..~Applicant. ,~. 4,~...~/~.. ~;...~. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. pp ca t~- .................................................. Rev. 10-10-7$ ~-c~ ~3/ THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000771 BUREAU OF ELECTRICITY ~'[ 8B JOHN STREET, NEW YORK, NEW YORK 10036 .a,e AVriZ ZS,Z~ App.c.tio. No.o./.~ ~69S00/SS N746731 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicartt named on the above application number in the premises of Donald Insull, w/s Smith's Dr.,S. 900' n/o Bay View Rd.~ Southold~ NoY~ in the following location; [] Basement ~] 1st Fl. [] 2nd FI. Section Block Lot was examined on AV T ~ ~ ~ ~ ~ .~ ~ ~ $ and found to be in compliance with the requirements of this Board. FIXTURE OUTLETS ].8 ~RCEPTACLES SWITCHES $5 17 FIXTURES RANGES OVENS DISH WASHERS FLUORESCENT VAPOR 18 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDEi~S TIME CLOCKS UNIT HEATERS DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I C OTHER APPARATUS: Motors-].-/ [J.P. Smoke Detector-I N Oi~E~C~COND. OF~ZC COND. ~/0 NO OF HI-LEG OF HI-LEG NO OF NEUTRALS OF NEUTRAL Ruland Electrzc Co. P, O. Box ],43 Mattituck~ N.Y., 11952 lic.#242E GENEI~AL MANAGER · Per! r~ L~ This certificate must not'he'altered in an), manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOr '. THI: N A_Ny~MANNER ~~. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N,Y. 11971 TEL. 765-1802 CERTIFICATION Building~Permit No. ~/~/~ Owner (please print) Plumber (p~ease print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. q]' (p~umber ' s signature) Sworn to before me this .~,~-~j day of 77Qs~/~2 , 19~7 Notary Public,~~_~County Notary Public UNDA J. COOPER Notary Publlo, $~e o~ NeW ~ ~plres D~r ~], 19 .'iELD INS[~ECTION ~ ~um,l~o ?OUNDATZO~ .Ii s_t_) 'OUNDATION 2. 40UGH FRAME & PLUMBING 3. INSULATION PER N. STATE ENERGY CODE (2nd) FINAL ADDITIONAL COMMENTS: 76S-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND ~ INSULATION FRAMING REMARKS FINAL DATE INSPE~I'OR J ' FORh/I NO, TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined. (~-~....~. ..... , 19 .~.fi'-'' Approved.( i*7.... . ..... ,19 ¥e, nit Disapproved a/c (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ........ INSTRUCTIONS a. This application must be completely filled in by Wpewriter or in ini~ 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 j. nspect~ions. ~ ~.~,., __ (Signature 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 .... . .~. ~ · ·..~..' .... · .'~. ~ $ 9.~ ..................................... (as on the tax roll or latest deed) If applic~ is a corporation, signature of duly authoo)~ed officer. :,. y: (Name and title of corporate officer) Builder's License No .......................... Plumber's License No...(~0I~.~ .~.,~..~- ........ Electrician's Licen se No... f~, ~....~./~2~ Other Trade's License No .................. ~.~ 1. Location of land on which proposed work will be done.....~..~& .~....%.o~..,...~..u..~...~....~..~..~.o.~.. ..... House Number Street Hamlet County Tax Map No. 1000 Section .... *..(~)..~.~ ....... Block .....r~.. ........... Lot....~.. · .~.~. .......... Subdivision...~. Q.~.~..~..~...C~.[~, .................. Filed Map No...~.~..(Q..~ ..... Lot./.~. !/.1.~.. ~.,. [.~..~_~ (Name) 2. Stat? existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............................................. b. Intended use and occupancy ................... ' ' 3. Nature of work (check which tpplicable): New Building ....I/. ..... 'Addition .......... Alteration .......... Repair .............. Rel royal'. ............. Demolition .............. Other Work ............... 1~ o ..... Fee .......................... 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 ... ' ........... .o.~.~_.~ ..................................................... 6.If business, commercial or mi~ed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... N~mber of Stories ........................................................ Dimensions of same structure with alterations or additions: Front Rear Depth .................. i .... Height .......... ,. · · ,, ........ Number.of Sto~ies ........... ~..., ...... 8. Dimensions of_et}tire new construction: Front .... ¢.t{.-. ¥ ...... Rear ....~..q.'7 .Ill .....Depth ...~.~.-.t? ....... Height .... [. ~' ......... Nutnber of Stories .......... .~..~{~ ....................... .~, ...... 9. Size of lot: Front .... /~.[~.. i.'~. ........... Rear ..... /. · .~..'"'. ...........Depth ...,(.~.. ............... ~. ' N fF · Dat ; amc o ormerOwner ................. 10 eof Purchase . .., ................................ 11. Zone or use district in which premises are situated ............................. . ........................ 12. Does proposed construction v~olate any zoning law, ordinance or regulation.. '~.O . .. 13. Will lot be regraded ....... ~/'~:,1 i ............... Will excess fill J~e [emove~ from premises: Yes 14. Name of Owner of premises ./~1~t~...~2.~.,1.1,[... Address ~.~.~..~..~!~t.~.. Phone No ................ Name of Architect .... 'v~ ' ' ................. Address .................... Phone No ..... -'' 't'¥ · '.xz. · Name of Contractor. ~ .... ! ..~.~ .~.'~ddres~ .*'~.*. ~.(.~vx~.) ..gqo~.. Phone No..~ ~.~.'~...~.5 .... PLOT DIAGRAM Locate clearly and distinctly 11 buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and bloc k number or description according to deed, and show street names and indicate whether interior or corner lot. STATE~.__ c / ,~/-_ //,~OFNE~9~OR~-' ~, ~ { SS " COUNT~ ' . ...... · ~' ~'~ ~.: b~/..~-~~eing duly sworn, deposes and says that he is the applicant (Name of individual signin~g contract) above named. He is the ..................... ; ......... ~ .................................................. i ~ntractor,~gent, corporate officer, etc.) of said owner or owners, and is d~tly authohz~rform or have p~rformed the said 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 w~ll be performed in the manlier set forth in the application filed ther6with. Sworn to before me this .......... .~ ~ .day °~... ~19 . .~ . ' iNOll~t~?l~'~?£, ~ ¥~,k (Signature of applicant) ~NE~.~ · SUFP. ¢,O. Nt~ALTN DEPT. ,APPRovAL DO/qAL ¢ EL la' INSULL, ~ED: ~ T~ ware] mlpoly and sewage disposal f~ to ~e ;t~nd~rd of the Sq~E ~,1 :. . . . '~, C¢ "~ ' ' 'soo '~ -'-- ~1~ ~Y~ .................. 2. ....................................................... ~ ~ ~ ~' ~ (,ii.~' ~ ~ ~0~ ~,~, ~ ~ ~'~It ~' ~ . tlt~ co~ny, gov~n~ntal age~ a~ MAP OF' LOT'5 ~A_U~.~_ ~-3 ~u,~,-r~¢~ .-,-o ~-- , ROD~tCK VAN TUYL. P. C. tOWN OF ~UTHOLD /~, ' .... ' ....... ...... TA I[MZNT'OF I'NT~NT ~IUFF. CO. DEPT. OF H~,ALTH IIBERVIOE~ I S T SINGLE FAMi~Y DWELLING ONLY FOR APPROVAL OF CONITRU~ION ONLY THEWA~ SUPPLY AND ~EWAGE DENCE WILL C~FORM ~ THE OF H~LTH. SERVIOES. OWNER: DEED: I SUFF. CO. HEALTH DEPT, APPROVAL ~ H SUFFOLK COUNTY DEPARtMFmT OF HEALTH SERVICES .......... . .,h,,, .,, for SCALE: bJ ~,rqON~J ~E- ZSLJF FC L~ CO. l-/q× l'flA f~ .... '~ TE~T HOLE SUFF. CO. DEPT. OF HEALTH 5ERVIC;i~ sTATEMENT INTENT u~': :,o~. Z' THE WATER SUPPLY AND ~AGE - 6 ' DENCE WILL CONF~M ~ THE ~Ef,{ ~'~-[~ STAND.DS OF SUFFOLK CO. DEPT. T ]f copper tubing is used for waler distributing sys em; piping shall be of types K or L onl~y, "~ MBE~ CEi~TIFICATIOIq' · pLU' --.~,:,~rT BEFORE ON LEAD U°~ CERTIFICATE OF OCCUP~CY ~OLDE~ USED IN WATER BUPPLY SYSTEM CANNOT EXCEED ~/10 of 1% LEAD. AP~O~'~D AS NOTED FEE:~/,~~' BY: NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION : TWO REQUIP. ED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. [NSULATION 4. FINAL - CON'BTRUCTIDN MUST BE COMPLETE FOR C O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE.CONSTRUCTION & ENERGY CODES· NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ) il,