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Home My WebLink About14429-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. · Certificate Of Occupancy No.. .Z169,07 Date September 24, 86 ............................................... 19... Addition THIS CERTIFIES that the building ................................................ Location of Property 50 Mill Creek & 3~5 Grove Rd. Southold N.Y. /~t~$~ ~O''' ~ 3'~ ....... ~'e~t' .............. ~ ~'.'; ..../~r~/'e; County Tax Map No. 1000 Section ............ Block ............... Lot ................. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore flied in this office dated .0.c.t..o.bg.r..9. ~ ..........198.5.. pursuant to which Building Permit No. ~ 6382 Z October 18, 85 dated ............................ 19 .... 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 ......... A~dition to existing one family dwelling The certificate is issued to . Francis & Marion Dirscherl ............ of the aforesaid building. Suffolk County Department of Health Approval Iq/A UNDERWRITERS CERTIFICATE NO. N 767760 Plumbers Rev. 1/81 Certification dated August 13, 1986 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 14382 Z Permission "'~" '~ is hereby granted to: ................ Co,,n,,,, Ta× Map No. iaaa Sec.an .... .L~.( ....... ~ock ....... .~ .......... ,o, No ..... ."'I..~.:..L ....... pursuant to application dated .... .(~..~...~. ..................... , '~ 19.~..~., and approved by the Building Inspector. Rev. 6/30/80 I~OBI~ NO. 0 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) N~ 14429 Z Permission is hereby granted to: ...~.~ ....... .~...~ ............................... ..J...~.~.......~.......~.~...~ ................. ,.; ...... : .............................................. at premises located at .."~........~...,~....~.~. .......... .~.....L.......~.~.....~.. ,....~...~.....,. ..... County Tax Map No. 1000 Section ..... /.~.~.~. .....Block ....... .~.~. ......... Lot No.....~..-~...~.../. ........ pursuant to application dated ......... .AZ~...~...! ......... , 19..~..:~,, and approved by the Building Inspector. Fee Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- i802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted m ~m~m to the Building Inspec- tor with the following; for new buildings or new use: I. 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 topograph ic 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 $5.00 2. Certificate of occupancy on pre-existing dwelling $ 25.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 F--/~-- 5.Updated C.O. $15.00 Date .......................... NewConstruction ...... Old or Pre-existing Building . ,/~ ........ Vacant Land ............. Location of Property '-~ .~.~.. ,/~.[i.~'../C .... .~5..~.~..~,L(. '/~./V~, Ham/et Owner or Owners of Property . . ./~..~J.~, .~... ~7~., ..... .~. , .F.~.~../~. ,4;.i?...J.,.. County Tax Map No. 1000 Section .../. ~ ¢.'~. ...... Block ...~. .......... Lot..~..~.,. Subdivision ................................. Filed Map No ........... Lot No .............. Permit No../~, .z~, .~, ,Z'Date of Perm t . .App cant. ,F. ,~,~, ,)?.~ .~..6. , ~.. ~l ~¢~ 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 p~,~mit meets_ i'_/~all applicable c~ndTulations. Applicant...~'~64~..~...-.-. ~-.-,.~-~ ................ Rev. 10-10-78 3o3q$ Oo 1001095 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 1 a~ JOHN STREET, NEW YORK, NEW ¥ORX 10038 THIS ~ERTIFIE$ THAT only th~ electrical equipment ~ ~scri~ed be~ a~ introduced by t~ applicant ~med on the a~ve application number in the prem~es of Frances Dirscherl, 575 Hill Creek Dr. in the followlng location; [~ Basement [~ Ist FI. ,*~,s e.~.minea on AUgtl S t 2 8 ~ 1 9 g 6 FIXTURE OUTILET$ ECEPTACLE$ SWITCHES FIXTURES [~ 2nd FI. i Section Block Lot and found to be in compliance with the requirentents qf this Board. EXHAUST FANS 5 6 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SERVICE DISCONNECT I NO. OF I S METER _ 1 100 cb X OTHER APPARATUS: RANGES iPECIAL REC'PT 1. 30 R OVENS I DISH WASHERS · 1 1o2 UNIT HEATERS MULTI-OUTLET DIMMERS OF NEUTRAL 1-G.F.I. 1-Smoke Detector Gary Doroski 425 Honsel]. Lane Cutchogue, N.Y., GENEI~AL MANAGER Per This certificate must not be altered in any manner; return to the office of the Board if incorrect, Inspectors may he identified by their credentio$s. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE ~UST HOT BE ALTERED IN ANY /v~NNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION (please print) Plumber (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plu~r's signature) Sworn to before me this Notary Public, Notary County KAREN W. BOERGESSON Notary Public, State of New York No. 4842180 Qualified in Suffolk County Commission Expires March 30, t9~ TOWN OF SOUTHOLD OFFICE OF BUILDING IN-~PECTOP. P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 To Whom This May Co~cern, We are unable ~o complete your CerLificate of Occupancy because.of the following reasons. /Z/ An application for Certificate of Occupancy is not on file. /Z/~/~o Underwriters Certificate on file. /y The check is(~not on file.) /Z/ No Health Dept. Approval on file. /Z/ 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 1,19~4 ) FORM NO. 6 TOWN OF $OUTHOLD 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 m ~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of ali buildings, property lines, streets, end 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 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 bu ildings. 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 $5.00 2, Certificate of occupancv on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 c.o.$5.00 5.Updated C.O. $15.00 Date. ~6~_ ,/. ~.. New C on s t ~R c t i o n ...... OJd or Pre-existi~g Building~ .......... Vacant Land ............. Locat.on' of Pro er .~u~No~ . . ~.O.. ' ~ ' ~O~tre;;~ ~:~ ~ ~' Ham/et o00 ... ....... ..... & ........ ......... Subdivision ................................. Filed ~ap ~o ........... kot No .............. ~ermit ~o ......................... . . Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate . ~ ................... Fee Submitted $., ~.,.,, ,~Z).,,/..~ .~. ,'~ ........ Construction on above described building and permit meets all applicable codes and regulations. Applicant ..... Rev. 1o-le.Te 765-18~2 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. I' ] FOUNDATION 2ND [ ] INSULATION [ ] FINAL [~FRAMING REMARKS: DATE ~//~/(~--/~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [] INSULATION [] FINAL DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION ~ST [ ] ROUGH PLBG. FOUNDATION 2ND ~_JNSUI..ATION [ ] FRAMING [ ] FINAL REMARKS: DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [~ ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION ~/~ FRAMING [ ] FINAL BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ~/FOUNDATION AND £ ] INSULATION [ ] FRAMING [ ] FINAL DATE~ INSPECTOR FIELD INS[~ECTI()N FOUNDATION ~ st) COMMENTS FOUNDATION 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE Ye FINAL o/ COMMENTS: ,2. 'FORM NO. 1 ..... _ ,/t TOWN OF ~IOI~THOLD BUILDING DEPARTMENT ToWN HALL EOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved..O.~ .).~., 19 .{4/Permit No/.4.~..~..~..~.. Received ........... ,19... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT 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. e. 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 apphcant. 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 Zc. ne 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, ordinartces, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessa .~pectio~. · bc . ....... (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 o 'owner of premises ...... . CqC, ficrl ....... (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. Plmnber's License No ..... ]/..~,..7~... ..... Electrician's License No .............. ' ......... 1. Location of land on which proposed work will be done ................. llouse Num bet Street Hamlet / '~ .. Lot ........... County Tax Map No. 1000 Section .... ].~ .......... Block ................ .L/.~... ]... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existiug use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... /.. .! ..... .C~.'.~ . .t ...... ;.. ~., ~ ,,e ..................... b. Intended use and occupancy ..... ~ .~(, ~-.) ................ 3. Nature of work (check which applicable): New Building.. .... ' ..... Addition ....... Alteration ......... Repair .............. Removal .......... :. ~.. D6molition ............ OtherWork .............. (Description) 4 · . · Fee ; ~' (to be paid on filing this application) 5. If dwelling, number of dweiling units ............... Number of dweiling units on each floor .............. If garage, number of cars ... ~ ................................................................... · ' ' ~d ify h typ ' 6. If business, commercial or mix occupancy, spec nature and extent of eac e of use ...~. ................ 7. Di~. ensions of exi~ting structures if any: Front .... .~') . ....... Rear .... De ......... H.eight ...... ! ~./. .....Number of Stories ...... './. ............................................... Dtmensions of same, structure alterations or additions: Front ............. Rear ............. Depth ...... ~- ......... i... Height ....... ./~.! ........... Number of Stories ...... /. .............. .8. Dimensions of entire new consiruction: Front ............... Rear ............... Depth .............. Height ............... Number of Stories ................ ; ....................... :.., 9. Size of lot: Front ...... ~ ............ Rear ................. De ................. I0. Date of Purchase ......... ~ ............ : ...... Name of Former Owner ............................ 1 1. Zone or use district in which p~emises are situated ...... '. .................. : .......................... 12. Does proposed construction vi01ate_ any zoning law, ordinance or regulation: ... O.0 ......................... 13. Will lot be regraded ....... q~ ................. Will excess fill .be removed from premises: Yes 14. Name of Owner of premises .~i.; ;'ofi'd~ e~! ......... i.. Address . 9"0~4-Y/'~ !d~. ....... Phone No.: ......... - Name of Architect . . ./. ~ O!-{~ .~%J'~ ~..r.Z ....... Address ................... Phone No ............... Name of Contractor ~'~., (~qc. ~ ~.{.~.l .~¢.r-.'~-Oc,... Address ............ Phone No ............. PLOT DIAGRAM Locate cl~arly and distinctly all buildings, whether' existing or proposed, and. indicate all set-back dimensions fro~ property lines. Give street and bloc number or description according to deed, and show street names and indicate wheth~ interior or corner lot. STATE OF NEW,YORK, . COUNTY OF..,{ ~C'~.[.(~ .... ...... ~'~/. ~3.(J ~./~¢C~'~ ~'~tl 'i ................ being duly sworn, deposes and says that he is the applican, (Name of individual signing contract) above named· (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 thi~' application; that all statements con~ained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manqer set forth in the application filed therewith. Sworn to before me this .... day Notary Public ........ .,.~.-. ........ County ~ · ~ ~ ~a ~,'f~-' t (Signature of applicant) ,., ~ ~. * PLUMBER' T~ON r ' r ' r '~ :: , ~ ' ~' ' ~ ' :ON '~ ' ' ~ :'' ' i /' · ' CERTIFICATE OF OCCUPANCy ' 4 PM ~R THE , i ,