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Home My WebLink About14351-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z15807 Date June 3, 1987 THIS CERTIFIES that the building one-family dwel ling. Location of Property 755 North Parish Drive Southold h3&'o 'dd ....................... 's't/e~i ............................ Hamlet County Tax Map No. 1000 Section .... 7.1 ...... Block 1 .Lot 8 Subdivision X X X ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated September 18, 1985 pursuant to which Building Permit No. 14351Z dated ..... pc..t .o.b'.e.r...9.,.. 1. 9. .8.5 ..... 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 ......... New one-~amily dwelling w/attached two-car ~ara~e and dedk. Tile certificate isissued to GEORGE & JUNE BUCKLEY ............. fo w-ed~&d~'~t~d'~ ~' ..................... of the aforesaid building. Suffolk County Department of Health Approval .................. .8.5.~S..O7-.9.5' .............. UNDERWRITERS CERTIFICATE NO N 793213 PLUMBERS CERTIFICATION DATED: 3/7/87 Rev. 1/81 Building Inspector 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) NO 14351, Z Permission is hereby granted to: ................ ............. .... ~.~....~..-..,~...***.~***..........."' ~.......'. ............... ........ ~./~ .~:.~... .... ~' ................................ 2:~ ............... 'z"~ ........ ;'";"~ ............. ~ .......................... ': ............ at p,emi,s Io~ated a, ..~.~..~.....~..~..~.~....~..~:......;S~ ........... County Tax Map No. lO00 Section ....... ..O.....--'J..I ...... Block ...... ..C~....) ......... Lot No ......~ ................ pursuon, to application dated ...~~.....~....~...~. ........... , ... and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD 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 m ~ 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 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. F, ees: v~. Certificate of occupancy New Dwelling $25.00, Accessory I$t0.00 Business $50.00 2. Certificate of-occupancy on pre-existing dwelling $ 50. 00 3. Copy of certificate of occupancy $ .5.00, over 5 years $]0.00 4.vaoant Land c.o. 2o.oo 5.Updated C.O. $ 50.00 Date ...~.~ .... ~ ....... NewC°n~uc~i°n ...... Old or Pre-existing Building ............Vacant Land ............. ........ Hou~ ~o. Street Ham/et Counw Tax Map No. 1000 Section ..... D~.[ ..... Block ..... ~ .......... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ....... Date of Permit ........ Applicant ,~, ............... Health Dept. Approval ..... ,~,, ......... Labor Dept, Approval ........................ Underwriters Approval . .~-~ ......... Planning Board Approval ..... .../Zf ............. Request for Temporary Gertificate ..................... Final Certificate ....................... V/ Fee Submitted * .......... .....-k'... Construction on above described building and permit meets all applicable codes and regulations. THE NEW YORK BOARD OF FIRE UNDERWRITERS 1001071 BUREAU OF ELECTRICITY STREET, NEW YORK, NEW YORK 10038 ~T F~brual// 10, ~98~B JOHN 399082/86 THIS CERTIFIES THAT only~, the electrical equipment o~ described below arid irttroduced by the applicant named on the above eppllc~tlo~ ~m~er i~ the prevai~es of George Buckley Jr., l~o. Parish Drive, n/s BoB F~hl Job, Southol~, N.Y. FIXTURE SWITCHES OUTLETS 41 38 FIXTURES NCAHDESCENT FLUORESCENT 41 ~ 2nd FL Section Block Lot a~td found ~o be in compliance u'it h the require.tents Qf this Board. RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS MULTI-OUTLET SYSTEMS NO, OF FEET 1 Smoke Detector E R V I C 2/0 G & $ Electric ~~ Box 215, $o~thol(~, NoYl197i Li¢~578E GEN~AL ~NAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspedors mdy be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THiS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY 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. /2//35/ ~ - (please '-pfi-~)- I Plumber C~-~C3w~ ~ I .c~ ~c~ (please print)I I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. o o ~p~umber' s signature) Sworn to before me this Notary Public, ~/d~'-~-~/('' County Notary Pu~-ic BARBARA STEPNOWSKI Notary Public, Stets of New York No. 4844752 Qualified in Suffolk County CommiSsion Expires March 30, TOWN OF $O/JTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 O -02 .5'-- 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. /ZL.. No Underwriters Certificate on fileo /Z/ The check is(outdated/not on file.) /~'/No Health Dept. Approval on file.~ d'~,~.~ /Z/ 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 ) FIELD INSUECT~,iON 1. FOUNDATION (1st), FOUNDATION 2. (2nd) ROUGH FRAME & ?LUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: ( 1~ tZt'.,t I-~t:"NC t-". ) 765-1802 BUILDING DEPT, INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION []FRAMING .[]FINAL REMARKS: ~, '~O 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .C~.~...0'~....c~.., 19 ~ .~f Approved .~.~..~ .... 19~.k~'. Permit No./..~.~. ....... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT TOWN OF Received ........... ,19... Date .................. , 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 throug~hout 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, an([ regulations, and to admit authorized inspectors on premises and in building for necessary ig"~ections. ~/)/'O /J ff~,,,. ........ · (Signatug6 of applicant,zgr name, ~t a [gorporation) .... .3. (Mailing address of applicant) State wf~her ap~plicaht is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... .................... ...................... Nme of owner of premises. L~ &'. J~X.,. ~ ¢.e~:~.. ~.~ ~-./~ / ...................... 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.' ...................... OlhCr Trade's License No ...................... 1. Location of land on which proposed work will be done...~ ............... f~ ............................. House Nmnber Street Hamlet County Tax Map No. 1000 Section ..... 2l .......... Block .... l ......... ....: .... .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of pr. emises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ ~./~..Cfi. ~'c~..t~.'..~. ..... '~.. ~...../~. ]~. b. Intended use and occupancy ' (%'~ _~-t .'.~¢{.~.*-r¢~ ch ~ppheable): New Building ... ~./ .... Addition §.f ! i~h~]i/~li[~.J~fl~i ...... '' . ......... Alteratiolb,: .... ,./ .... Repaar .......... :kkl, Removal .............. Demohtlon ............ Other Work.. . Est 0l 6dO ..... Fee .......... ~' (to be paid on filing this application) $, If dwelling, number 6f dw~llin~ 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 structu[es, if any: Front .~.,./.~/ ......... Rear .............. Depth ............. Height ............... Number of Stories ...................................................... Dimensions of same structure with alterations or additions: Front ................. Rear ................ Depth .................. ~... Height .......... l ............ Number of Stones .................... "'8. Dimensions of entire new construction: Front . . ~.~. ......... Rear .... ~.7. '. ....... Depth ...~..0./. ....... ~mt, h* N/,tuber of Rt~r~ / 9. Size of lot: Front ..... t. ?.o. j ............ Rear .... /.a. 4 .............. Depth . .~.a. ~..~cTr.~.~..< ........ 10. Date of Purchase .... /..~(.~. ......... ' .......... Name of Former Owner .. & .4. f. ~'~.. :. .............. 1 1. Zone or use district in which premises are situated ..................................................... 12. Does proposed construct~n viblate any zoning law, ordinance or regulation: .... ~../?.. ....................... 13. Will lot be regraded ... o~....I .................... Will excess fill be removed from premises: .~L"~ Yes ~ No 14. Name of Owner of premises~.~?..C..,~../~JT.Y. ......... Address . .~.~ .c.~.~ .p.~_./~?... Phone No.'5..~..~:?.~..~.7. ..... Name of Architect .. ~.'*. ~ .t/7.~. (qt.;. ............. Address ... f.n.~ ...... Phone No ................ Name of Contractor /~.'.0fl..../f.~. ff./7 ............. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions froth property lines. Give street and bloc number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK,, I ~ ~ ~.. (Name of individual sigging%ontract) above named, I being duly sworn, deposes and says that he is the applicant He is the ..................... ] .................................................................... ! (Contractor, agent, corporate officer, etc.) of said owner or owners, and is d~ly 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 his knowledge and belief; and that the work will be performed in the mannler set forth in lhe application filed therewith. ' Sworn to before me this Commission Expires March SO, :Z RODERICK VAN TUYL, P.C, LICENSED LAND SURVEYORS GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL h.S. NO. STATEMENT Of INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE Will CONFORM,/TOj%~IE ST~ND/~RDS~OF THE SUFFOLK C~PTF O~EA~ S~VICES. j APPliCANT ¢ . . SUFFOLK COUNTY DEPT. OF SERVICES -- FOR CONSTRUCTION ONLY ~ ~ ~- DATE: (~ ~ ~ H. S. REF. NO.: SUFFOLK CO. TAX MAP DESIG DIST. SECT BLOCK OWNERS A ~I~ESS :' L 47~& TEST HOLE P. ~98 StaMP PCL. 8 to the ~s~ees SEAL '~ . S~GLE FAMILY DWELLING ONLY HO.Al DATE~ \~ HAy 2g lg8,7 ....... THE SEWAGE ~)ISPOSAL AND WATER SIJPPLY FACILITIES F~)R ~rHl~ LOCATION HA~E BEEN INSPECIED I~Y THIS DEPARTMENT ~ANDI FOUND TO BE ,~ TISFAC-TORY. _ t OWN 0.. Chief' (~f Weste~ater Management Section '~ ._,~_ AL L %0- , E3 ,, ,..!: A-24, RODERICK VAN TUYL, P.C. ,c::: 'v"-"-~ '-' LICENSED LAND SURVEYORS GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. API~ROVAL H.S. NO. ~[O~'~5 STATEMENT OF INTENT THE WATER SUPPLY AN~ SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT OF HEALTH SERVICES. (S) APPLICANT / SUFFOLK COUNTY DEPT OF HEALTH ,|SE.VtCESq ~--J ~ - FOR APPROVAL OF 'F-CON ~,TRUCTION ONLY REF. NO. 85 ,~O'95 IOVED: FFOLK CO TAX MAP DESIGNATION: it. SECT BLOCK PCL. RS ADDRESS: STAMP I t~EED: L. 47F.4 TEST HOLE SEAL SUFFOLK COUNTY HEALTH DEPARTMENT SINGLE FAMILY DWELLING ONLY H.D. REF. NO, , DATE HAY 2 g 198~ . , THE SEWAGE DIS~AL AND WATER SUPPLY FACILITIE'S FOR LOCATION HAVE BEEN INS~CIED ~Y TH S DEPARTMENT F~ND TO BE SATISFACTORY. Chtef of Weste~ater Management Section APPRO 4A~. OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY PLUMBER CERTIFICATION ON LEAD CONTENT BEFORE cERTIFICATE OF OCCUPANCY APPP,.OV~ED AS NOTED ~TIFy 8U LDING DEPARTMENT 5 1802 9 AM TO 4 PM FOR THE ~.LOWING INSPECT?NS: FOUNDATION ~ ~3 ~:~;~UIRED FOR POURED CONC~Ef~ ROUGH FRAnkING ~ ~LU~BING I~SULATi0N ~NAL CONSTEUC?~ON MUST L CONSTRUCTION SHALL MEET .~ ':'~SQUIREMENTS OF SIGN OR CONSTEU. PLAN ~b . t.5~ e 477.0400 ', Main, a Phone 477-0400 Main Road GREENPORT, N.Y. 11944