The URL can be used to link to this page

Home My WebLink About13939-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ..... g 1993.5 ...... Date .... 9.c-~- °- .b.e?. · q. ~ ................19.8.6 THIS CERTIFIES that the building Construct addltlon & fleck addltion . Locatinn of Property ...~..flp. Longvlew Lan~ $outhold, N.Y. · House No. Street ...................... Hamlet County Tax Map No. 1000 Section . .0.8.6 ....... Block .... 004. ......... Lot .... 0.~.3 .......... M/o Terry Waters 2901 72 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated May 9, 9.8.5 13939 Z ...................... I . pursuant to which Building Permit No ...................... dated May 10, 19.8.5. , 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 ......... Construct addition & deck addition to exis.ting one family dwelling. The certificate is issued to Dominick & Paula Costell9 of the aforesaid building. Suffolk County DepaRment of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N772882· Plumbers Certification dated September 16, 1986 Rev. 1/81 FOW:M* NO. 0 TOWN OP $OUTHOLD SUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y, BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 13939 Z Co..~, To~ ~op ~o. lOO0 ~e,~o. ..... ..O...~.~. ...... m~ ..... 9.~ ......... ~ot Uo.....CZ[..-5 ...... Building inspector. Fee $..~..."'~** .~ .. ,.'~.. ....... 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 we lammm.~mm 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 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 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 o~:cupancy on pre-existing dwelling $1,5.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5.Updated C.O. $15.00 Date ..~..~...~ .I..~.)../~/~Q ....... NewC°ns tz~ucti°n.. ...v~. · Old or Pre-existing Building ............ Vacant Land ............. , .C.o ......... -- County Tax Map No. 1000 Section ... ~.~..~ ....... Block ....O.~. ........ Lot .... O..~.._~ ....... Subdivision.../. ¢~'....~, ,c,~C~'. ............-- , Filed Map No. ~, ~.0..f .... Lot No..,-7, ,~, ........ Permit No../..~.~.~ .~.. Date of Permit..~.~/.0/?~..Applicant. ~ ~.o. ~..~/~.~ Health Dept Approval Labor Dept Approval Underwriters Approval Planning Board Approval -- Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ..... ~, .6¢~ ................... Construction on above described bu ilding,~rmit meets all applicable codes and regulations. ^ppl cant ...................... R~v. 10-10-78 3os31 HENRY J. SMITH & SON, PLUMBING, HEATING & FUEL OIL MAIN ROAD SOUTHOLD, N,Y, 11971 (516) 765--3690 Inc. CERTIFICATION Da te _S_ep~__..~_6_ _1..9. 8 6 Building Owner D. Plumber Permit No._~_3~, Cos~_~_~_E~~J Southold Henrz. 3. Smith &_~B±. Inc. I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this 16thday of ~_p_~__, 19~_C_. ~o~ary ~ublic Notary Public, Suffolk County NO[ARY [:U~LIC, St:~te of New York Residil~g m Sulfoik Cou.ty oO Commission Expires ~rcli 30, 19~ FIXTURE OUTLETS RECEPTACLE~ 16 SWITCHES 8 FIXTURES FLUORESCENT 6 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SERVICE DISCONNECT RANGES SPECIAL REC'PI NO. OFECR~,COND A W, O. 4 OTHER APPARATUS: 6,F.C.I.-1 EXHAUST FANS DIMMERS j A'W' G NO O~NEUTRALS A W O. NO. OF HI.lEGOF HI.L~G OF NEUJ'RAI. 4 O ~ S Electric Box 215 Southold, N.Y., 11971 G~NERAL MANAGER 11 Per "e This certificate must notbe altered in any manner; return to the office of the Board if incprrect. Inspect, ors may be identified by their credentials. COPY FOR LDING DEPARTMENT. THIS COPY OF CER' )CATE MUST IHANY TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 7~$-1802 To Whom This May Concern~ We are unable to complete your Certificate of Occupancy because,of the following reasons. /5/ An application for Certificate of Occupancy is not on file. ~ /_~ No Underwriters Certificate on file. /5/ The check is(outdated~not on file.) /~/ 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. ***/--~/No Plumber Solder Certificate on file, ( all permits involving plumbing being issued after April 1,1984 ) FieLD ~NS~ECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & ?LUMBING INSULATION FER N. STATE ENERGY qOD FINAL COMMENTS ADDITIONAL COMMENTS: 765-18~2 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION [~FRAMING [ ] FINAL REMARKS: ~) /~ DATE 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined... Approved ' '~-0'' '] .O..., 19~.~. Permit No./. .~..~..~.~..~. Disapproved a/c ..................................... ................................ APPLICATION FOR BUILDING PERMIT · ,~.a~, ,, t, .W& ,~ .,,~'*o ~ :~ I'~ F INSTRUCTIONS BLDG. DEPT. TOWN OF $OUTHOLD Received ........... ,19... / a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ~ts 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 ,r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. 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 hall 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 hall 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 luilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or [egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described· ?he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for necessary inspections· .......... l.s.~.J3...c4. ...... (Signature of applicant, or name, if a corporation) · .3. ~/.~7..~/.q 0 / .o_. .... .~.d.,..~..~ .o ./~ ./.~ ~. !... (Mailing address of applicant) ~tate whether applicant is owner, lessee, agent, architect, enCneer, general contractor, electrician, plumber or builder. · ' ..c.q.n.?..a.~.'b. ................... , .................................................. lame of owner of premises .... .,.,~..0../~. )'PO./:~./~.-:...~-' ~././O.. (~.~.,. 7'...~5~,~%./~.~.: ,) .................. (as on the tax roll or latest deed) ocant is'a corporation, signature of duly authorized officer. ? ....... (Name and title of corporate officer) Builder's License No ........ J..~./. .............. Plumber's License No ..... .~].: (.D~... ( ~ ......... Electrician's License No. Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. ....... (~. ?I~.~ ............... o~c/?.<.~...L.~ o.~. ................... ~. House Number ..... /Street Hamlet County Tax Map No. 1000 Section ..... ~.~c~.~. ....... Block .... (~) :'.~"· ......... Lot.. ?.).~.%.'>~ .......... Subdivision f/.~.~'/7..(~.~-.~... ~..~d.<q. (/,~O.,,-~-eZB.. Filed Map No .... ~ .... Lot... 7~ ...... / (Name) ~ ,~_~'0 [ State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ].. ~D~D'~.'I ' [~. . .~.~.~. ."q~.].[.hQ '.51 ............................... b. Intended use and occupancy .... [..~.-(& OD. li li~. . . .~'.~...C.[.[JD.'~. 'o.i~i '.~'~?, . ........... 3..Natt/re of work (check which ~ ?plicable): New Building ..... '~ ....'Addition .......... Alteration Repair .............. Removal .............. Demolition .............. Other Work ............... i~ ,' (D ripti ) 4. Estimated Cost ~ .............. Fee .................. '~ (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 6. If bu~siness, commercial or mi~ed occupancy, specify natur,e and extent of each typic of use ............... ,~ ..... 7. Dimensions of existing structu~res, if any: Front ..... ~.~ ....... Rear .... .2~. ....... Depth .... ~Y,~. ....... Height .... /'.4' ........ Number of Stories ..... ./. ................................................. Dimensions of.sa~e strt!cture with alterations or additions Front .... ;~....4f.~. f~.. Rear .....$7.~c.d:'.-ff. f.. Depth ..... .~z.~...../.,? ff. .... i .... Height ..... .'ff. :.C..w ....... Number of }to,res .... ./. ........ ./.. 8. Dimensions of entire new construction: Front .... /..~...~. ..... Rear .... ~./..~ ..... Depth .... .~'~ .~<~/ .... Height / ~. ' Number of Stories ./. 9. Size of lot: Front ..... IQ.O.'.[ ............ Rear ....... ~. 9.Q .t .......... Depth .... ~ .U-.Q ~ ............. 10 Dare,of Purchase ~ Name of Former Owner 1 1. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction v!olat%ap~( zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ....... i.....~..~ .............. Will excess fill be removed.from_ .premises: Yes ~/No 14. Name of Owner of premises 0~:¢n t.at~q...C~.~¢-I [(~.. Address ~1~0 .~,~ .~.~, ~t11~.....Ol~.~*~ne No ................ Name of Architect ........ ~ ............. ._~... Address .................... Phone No ................ Name of Contractor .%1~ a. ~. .... ~u~! ~.a.e.r.~. 0c,<. Address .C~[0o~a-l. ~..~.~.~.~P~oone No..?a¥:a~ .... ] 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 ~ number or description according to deed, and show street names and indicate whether interior or corner lot. STA'r OF NF V YORK, COUNTY OF ~t_~.\.~ S.S .................... being duly sworn, deposes and says that he is the applicant (Name of individual sighing contract) above named. He is the ! (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 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 man~er set forth in the application filed therewith. Sworn to before me this ' ............... ~..i~.-~ ,~/ ~'~ ~day df... ~..t~.. ............. 19 ~..~ .... ...... NOIAR¥ ptlBLIO,!State oJ Ne¥~ '~'o,~ .... ~,,fCO/(x_y ~ , No 4707878.! Sulidk Cou[It~..~ (Signature of applicant) 7't A?.~ · A5 NOYED NOTIFY D'IPLDING DEPARTMENT AT 765J802 ~ A66 TO 4 PM FOR T]]E ALL C~r,~T[TM ~C~ ~g~l Sk[A[ L MEET :t DATE: