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Home My WebLink About14527-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Halt Southold, N.Y. Certificate Of Occupancy May 27, 1987 Date ................................ THIS CERTIFIES that the building ..... 9.r~e..-.f.a,m.i..ly..d.w..e.]_.l.i.n.g.. ................... 290 gena Road Location of Property., .... 14.45 .............. ¢~p.t.a.i..n..I{i.d..d..D.r.i..v.e ........ M..a.t.t.i.t..u.c.k. t~ouse No. Stroh! Hamlet County Tax Map No. 1000 Section ...... [ 0.6...Block ......... .5 ..... Lot . [ 5 Subdivision Captain Kidd Estates . .Filed Map No. 1672 .Lot No. 1gl conforms substantially to the Application for Building Pem~it heretofore filed in this office dated December 9, 1985 pursuant to which Building Permit No. 14527Z dated ...... .F.e.b.r..u.a.r.y.. 6. !..1.9. .8 .6... 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-family dwelling w/one-car garage and attached wood deck. Th~ certificate is issued to PETER SOULLAS ................... ?o;;.,'o;. ...................... of the aforesaid building. Suffolk County Department of Health Approval 8 5- SO- 19 6 UNDERWRITERS ~CERTIFICATE NO ................. iq8 0 2 3 5 5 5/6/87 PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 ~0~ NO. ~ TO~N OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereb/gronted to: .... ...................... ...... ~..~. ........ ~.~...~...~.~ ................... ...... ..~.~....~.~..,...~:...~ ...... .l/.~ol , ,o ......... .G~. ~.~.T.~.~...~c.......o. ~.~...... ~/~. z.~..~......F;~.~..~**r-~ ............... o, p,em,s~s ,~.o,ed o, ..... ~.~.~.~'.=..O...~.~Z:..,....~.~.~......O..~.....C........Z..~..~. ..... Co~ To× Mop ~o. ~000 See,on .../0.~ ......... ~o~k ...0...~-~.. ........ Lot No. 0..~..~--.. ........... pursuont to ~pplic~tion doted ~ ....... ~ ............................. , 19.~....I~, ond opproved by the Building Inspector. Building Inspector Rev. 6/30/80 .DG, DEl 'f. TOWN OF SOUTHOLD APPLICATION FOR CERTIFICATE OF OCCUPANCY FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 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: I. Accurate survey of pZoperty 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: 1, Certificate of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $I0.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O.,.~. / $ 20.00 5.Updated C.C. / $ 50.00 Date .......................... / NewConstruc tion ...... Old or Pre-existing Building ............ Vacant Land ............. House No. Street Ham/et Owner or Owners of Property ... ,~., ,~..~,, ..... , ,~.--~. ?..~..I .................................... ~, County Tax Map No. 1000 Section .... /',~ .~. 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 ..................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $.. Construction on ebove described building and permit rn/eegi~ll ap/caJ~/codes and regulations. '"/"' '7 ............... .................... Rev. 10-10-78 765-1~02 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: [ ] FINAL ,DATE,. ~/~/~ INSPECTOR lo~)o62 THE NEW YORK BOARD OF FIRE UNDERWRITERS BURI~AU OF ELECTRICITY ~.,~ ~.,,~.,,o.~o.o.~.~ N 802355 THIS CERTIFIES THAT only the electrical equipment ~ ~scrlbed below a~ introduced by t~ applicant ~med o. the a~ve application nu tuber in the premises of ~ter ~u~, ~p~in ~d or ~ Z~na ~d S/E ~rn~ ~ntral DriVe & ~th ~.d, ~.ttituck, N.~ ~sexa,ninedo,~ M~I 26, 1987 11 20 1~ 1~ 1 10.3 2 F 3 F 2 ? 100 ~ 2 X I 1 1 1 227 ~t ~a~ater ~ ~ttituck, N.Y. 11~2 ~c. 152~ G'N~IL B THIS COPY OF CERTF CATEMUST NOT BEALTERED N ANY MANNER. ]'65-1802 BUILDING DEPT. INSPECTION [~UNDATION 1ST [ ] ROUGH PLBG. [ ] FRAMING REMARKS: FOUNDATION AND [ ] INSULATION [ ] FINAL BUILDING DEPT. INSPECTION FOUNDATION ~ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ,.,.-- [ ] FINAL REMARKS. ~ TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. ~(please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this ~ day of ~ , · d Notary Public ,~County signature) Notary Public 76.5-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ]FINAL REMARKS: '//~,l',~'0 ~/~{ 0 J~LD ~NS?ECTION DATE -- COMMENTS )UNDATION ( 1 st) )UNDATION Y q- STATE ENERGY FIB 1 FO FO ADDITIONAL COMMENTS: / ~ ~'. _ ¥ 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapproveda/c ........... ..... ~' (Building ~.~or) ~, BLDG. DEPT. APPLICATION FOR BUILDING PER~IT "TOWN OF SOUT~LD Date ........ ~NSTRUCTIONS a. Tkis 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 wl~91e 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~uffolk 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 cod% and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. /~ (Signature of applic~afit, 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 ....~...~7..-7~...~.a~. .... ~.O. ?..//L../~.. ......................................... (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 ..... ~..t~.../~.~ ....... Electrician's License No .... ~..~...../~..~..d~.~... Other Trade's License No ...................... ./F. Location of land on which proposed work will be d~.~e...~, eq: .7'7./7./...7~....~.4 .... -7....~...~../Jr/.....W'~.. ........ .... d/tW. .... .... .... .................... House Number Street Hamlet County Tax Map No. 1000 Section .... /..g?..~. ....... Block .....O~.. ........... Lot..'.../....O~... ....... Subdivision .... ?.'.~? .T.,, .(57.U..~.,, .~.'5..T.&.?.~. ...... Filed Map No. 1~"7 ~ Lot ~ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ?~O/c'~t~ ' b. Intended use and occupancy ..... .~...'~..~'. .... .~..~ :.(.c/ ...... /.~...e.~..~..~.r~../..~.j .................. 13. Nature of work (check which applicable): NewBuilding .......... Addition...~ ....... Alteration ........ Repair Removal · Demolition Other Work 4. Estimated Cost ..... ~g..Wi.O.b.e., ..................... Fee ...~.'..~.~.Z.~.. .................- - (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... .~..~...~.. Number of dwelling unit~ on each floor : If garage, number of cars ............. ~'~'.~. . . 6. If business, commercial or mixed occupancy~ specify nature and extent of each ty 'of use .... 7. Dimensions of existing structures, if any: Front ............... Rear ........ i ...... Depth ............... Height Number of Stories Dimensions of same structure with alterations or additions: Front ., Rear : Depth ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear .... .... 1 ...... Depth . ........... ... Height ............... Number.or_Stories ................ 9. Size of lot: Front ............. ~.'} ...... Rear .u{'~t. ' ............ , .......... -5 ~ 't~.]~' 'q ......... .................... Depth :....~..1.,. ............. 10. Date of Purchase ...... .~//o~. ................. Name of Former Owner . .'.. ,~.a~. t~..,~..~. (.~. ............ 11. Zone or use distric~4n_.w..hich premises are situated ........ ~...097.?. ?.~..u .~../~., .t_...".~.~7~.~..~..~a2T. t.~..~.; ........ 12. Do~s proposed constructiob'l~-violate any zonin~ law. ordinance or regulation: .... .~..O. ....... ........... 13. Will lot be regraded .... .... ~ ....... 7,..: .... Will excess'fill be removedl from :r;mises: 14. Name of Owner of premLs.e,s .... ~ .7~. ~.. ~.5'~?.///~. Address at.~.~..~Y..o.~,tafO, a~..~,. Phone No.. Name of Architect~..~?..~. .F~..~.~.. ~. &l?~..... Address . t~.'(.a.~'.. Ae,,Ar/.~m~... Phone No.. ~q~.n.: .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 show: street names and indicate whe_ther interior or corner lot. ~y ~ TOW t- STATE OF NEW YORK, o ~ '~"'"---~ ~"~ cou v ........ ...... "' ..... .~..~.?..~....8.~..U~ ......... being d'~l~u ~n, depo!es and says that he is the applicant (Name of individual signing contract) above named. He is the .......................... ..., ........... (Contractor, agent, corporate officer, etb.) of said owner or ownem, ~d is duly authored to perform or have perfo~ed the said work and to m~e and file ~is application; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the work will be performed in the m~ner set forth in the application filed therewith. Sworn to before me this ............... ~ ...~. ..... day of ......... Notary Public,... ,~d~....~.,... ~.~-.j ./~".,. No. 4707878; Suffalk C, eunt~ ~ l'erm £xptm March .......... , 19~..~ (Signature of applicant) CAP T'A IIV KIDD S. ~00~$0#~. 94. I DRIVE SUFFOLK COUNTY HEALTH Df SfNGLE FAMILY DWELLING ONLY IEF. NO. THE HAVE BEEN ,ment Section MAP OF CERTIFIED TO: DIME SAVINGS BANK F/RGT AMERICAN TITLE INSURANCE COMPANY FOR: JDS PLUMBER CERTIFTCATIO1V ON LEAD CONTENT BEFORE CERTIFICATE OF oCCUPANC? · SOLDER' USED IN WATER ~UPPLY SYSTEM CANNOT ~,XCEED g/lO o/ !% LEAD, 1[ Copper tubin~ i~ u~ea for wot=r distributing Sys em; piping shaft be of types K or I~ only ;Ap~R~WD AS .NOTED .~_..., .~ r-4OT-~--FY BUILD1 765-1802 9 AM TO 4 PM FOP- TH~ FOLLOWING iNSPECTIONS: 1. FouNDATiON ' TWO REQUIRED FOR pOURED CONCRETE 2. RouGH - FRAMING & pLUMBiNG B. INEULAT%ON 4. FINAL - CONSTRUCTION MUST BE COh^pLETE FOR C, O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y, STATE coNSTRUCTIQN & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR coNSTRUCTION ERRORS. - iI