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Home My WebLink About13725-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z15422 Date March 25, 1987 THIS CERTIFIES that the building .... O..n.c.. f..a .m.i.l.y...d.w.e.~. 1: .i.n,g. ..................... Location of Property ...1.5,5.5.5...S.M.!T..H' .D.R.I..V.E..N.'.O: ........ S. O. .U .T .H . 0. L. .D ................... House No. Street Hamlet County Tax Map No. 1000Section 076 ·Block 2 .......... Lot 4 SubdivisionMA1· or GOOSE NECK .Filed Map No. [6..6.3 .... LotNo. 31 & 32 conforms substantially to the Application for Building Permit heretofore fled in this office dated . .F .e.b. .. . .1.9. ,. . 1985 pursuant to which Building Permit No. 1372.5Z dated M..a .r.c.h...6 ~.. 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 ......... · One. fam. i. ly dwelli, ng. ,?it.h..a. tt.a.c.h..e.d..o.n..e..c.a..r..g.a.r..a.g.e.. ................... The certificate is issued to MARY N. CODE ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval .... ! .47.8.0. 7.1 .0.6. ........................... UNDERWRITERS CERTIFICATE NO N 759912 PLUMBERS CERTIFICATION DATED: March 3, 1987 Rev. 1/81 ~OB~ NO. B 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) N9 13725 Z ..(~...'.'] ~ Block ~..'~.. Lot No County Tax Map No. 1000 Section ................................................... pursuant to application doted ....~.'~~.....1..~ ............. ,19~.~.,-- and approved by the Building Inspector. ~~ ~..~...~.......:L..~. .......... Building Inspectpr Rev. 6/30/80 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y. 11971 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 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 New Dwelling $25.00, Accessory ,~10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwe{ling $ ,50.00 3. Copy of certiflcate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewC°nstructi°n· .~t-, · · Old or Pre-existing Building ............ Vacant Land ............. House No, Street Hamlet or Owners of Property . ~/L/'f~/~2'~.. '~'' I ' ~ ~ .................................. Owner County Tax Map No. 1000 Section ...~.7.~ ........ Block, .~. ............ Lot../-~. ........... Subdivision./~AI./~.. ?..~....~.~. Q.~...~.../~..c~.~ ..... Filed Map No. /.~. ~. ~. .... Lot No. B. ,/~'. ~.~,... Permit No..~.~ 7'Z ~, ~' Date of Permit . ~.'.~..-~'..Applicant. A/J/(~'/?.. j~.....CZ~).7~..;~.. ....... Health Dept. Approval ........................ Labor Dept. Approval ....................... Underwriters Approval ........................ Planning Board Approval ..................... Request for Temporary Certificate ..................... Final Certificate ...................... Fee Submitted $ .~. ~'~/~T~ ...................... Construction on above described building and permit meets ~11 applicable codes and regulations. Applicant... j~.d~./~.....~ .......................... Rev, 10-10-7a THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 100S~ THIS CERTIFIES THAT only the electrical equipment as d~scrlbed below and introduced by the applicant named on the above application nu tuber in the premises of Mary N. Cod'e, 1555 Smith Drive North, Southold, N.Y ~sin thefollowlng, xa,nined locatlon~j~y 14,~Basement1986 [] Ist Fl. [] 2nd Ft. Section l~lock Lot on and found to be in co.~pllance ~*it& ~he ~eq,~ireme~ts of this Board. FIXTURE FIXTURES RANGES OVENS DISH OUTLETS ~ECEPTACLES SWITCHES 23 4~ 24 23 DRYERS FURNACE FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT 2-SmOke Deteotor S E R V I C E NO. OF PER ~' NO, OF HI-LEG 4 4 ~ry Code 1475 Smith Drive North So~thold,~.X. This certificate must not be altered in any manner; return to the office of the Board if incorrect. FOE GENERAL MANAGER Inspectors may be identified by their credentials. ILDING THIS COPY OF ERTIFICATE TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. t 1971 TEL. 765-1802 CERTIFICATION Building Permit No. /.~7~ Z~ Owner .~,,~. ~ ~ ~, CO~ · ' ' ~(please prin~t) (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. ~/~ , % Notary publio, 0o=nt= Nota~ pu, blio, State of New York No, 4844752 Qualifl~ in Suffolk County Commission Expires Ma;ch Notary P~bl i~c Memorandum from . · · · BUILDING INSPECTOR'S OFFICE TOWN OF SOUTHOLD Town HALL, SOUTHOLD, N. Y. 11971 765 - 1802 March 2, 1987 Dear Ms. Code: I tried to call you today but no one home. was I have all the papers in your file for your C.O. but we still need a plumbers certificate. I am enclosing the form please have whoever did the plumbting' sign it and have it notarized. Once I have this paper I can do the C.O. Thank you, FIELD INS[:ECTION FOUNDATION (1st) COMMENTS FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY FINAL ADDITIONAL TS: NT~W YOr~ STAT~ DEPART~NT OF E):~P~.~ CONSgRVATXON ~g~ato~ Aff~ir~ Unit .... Bldg. 40, S~-~om Stony ~,.- .............. t516) 751 7900 RE: A review has been made of your proposal New York State Department of Environmental Conservation has found the ____parcel ._~.'~proJect to be: __ Greater than 300" from inventoried tidal wetlands. Landward of a substantial man-made structure greater than 100' in length constructed prior to September 20, 19~7. ..)~X Landward of 10' contour elevation above mean sea level on a gradual~ nat-- '' ural slope. ~ Landward of topographical crest of bluff, cliff or dune in excess of 10 feet in elevation above mean sea level. Therefore, no permit under Article 25 (Tidal Wetlands of the Environmental Conservation Law) is required at this tim~ since ~he current proposal is beyond Stat~ mandated JUrisdiction pursuant to this act. However, any additional work or modifications to the proJec~ may require a permit, IC is your responsibility to notify this office, in writing, if ~uch additional work of modifications are contemplated. Very truly yours~ Daniel ~. Larkin Regional Supervisor of Regulatory Alfa/rs Approved · · . 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 ., 19-~..~.. Peri'nit No. J..~..~. ~. ~ BLDG. DEPT. TOWN OF $OUTHQLD Rece±vo ........... ,]9... Disapproved a/c ..................................... .................................... APPLICATION FOR BUILDING PERMIT Date · .~.~..~.../.ff~. .........19 ~...d- INSTRUCTIONS a. Tttis application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspect°r, 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 insplc~ons. D ("~)Jf-t0 ~) / ....... .... ............. ;dl .... (Signature o~Japplicant, or name, if a corporat' ) ..... .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. d Name of owner of premises . (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.. ~../~/../~..~..C. ............. Plumber's License No ................. Electrician's.License No..././//.~. ................ Other Trade's License No.. ¥(~. ............... I. Location of land on which proposed work will be done ........... t · .................................... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...................................................... b. Intended use ~d occupancy ..... ..... .... ............ .... ,.. · ..., ............................. sa%/-'~t(.,~..c..~ "r , o*, . Fee (Description) 4. Estimated Co .~..(Q.C~9, ............................................... ~ ~' (to be paid on filing thi~ application) 5~~ If dwelling; n~mber of dwelling[units.. ~ ~ ........ Number o f dwelling units on each floor ................ Ifgarage, number of e~s .... ~ ............................................... . . . .. .. . . ... .. . 6. If business, commercial or mixe~ occupancy, specify nature ~d extent of each type of use .......... c .......... 7 Dimensions of ' 'rig stmctu ~s ifa y: Front Rear Depth Height ............... Number of Stories ....................................................... I)~ensions of same structure ~ith alterations or additions: Front ................. Rear ................. I)ep~[ ........... ........ r - · He~t ...................... Number of Stories ..................... ~ime~sions of,entire new const~ction: Front .............. Rear ..... , .......... Depth .............. I~e ght .............. ~Num~r o, ator~ ...... ~ ........... ,, . . ~..~ ........... Size o[lot: Front .. ~:...; ........... Rear..Z~5 ............... .Depth '..[.~.~ ............. Date of P,rchase ...... ~ ~ ~ .... Name of Fo~r Owner Zone or use district in which premises are situated - . ............................................... Does proposed construction violate any zoning law, ordinance or repletion: ................................ Will lot be regraded ........ ~ ................... Will excess fill be removed from premises: ~ No N~e of Owner of premises .~. ~. ~o d e .... Address ~/lg~.~.~. ~ ~7Y/~. Phone No. ~$. Name of Architect ..................... Address ................... Phone No. ~~. N~e of Contractor ........ ~... Address Phone No PLOT DIAG~ clemly ~d dist~ctly fl~ bufldhgs, whether existing or proposed, ~d. indicate fll set-back d~en~ions from Locate propegy fines. Give street ~d block: number or description accord~g to deed; ~d show street nines and i tdicate whether interior or corner lot. ~~ 10. 11~ 12, 13. · ) .x:.. ,' Nature o 1%.¥vphcable: New Building ........Addition ...... Alteration .......... Repair .............. vel ......... Demolition ............. Other Work ........ above named. ...... being duly sworn, deposes and says thatshe is the applicant -..~tte is the ..................... ......... (Contractor, agent, corporate officer, etc,) of said owher 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 m the manngr set forth in the application filed therewith. Sworn to before me this ....... :. :.'.. :... ? ~ M/71~r' ' ..~ ~. ~..~,v...,,...r./: /k/~f~, [J :/Itl. '~," · (Signature'ofapplteant) STA1E OF NEW YOR/K. COUNTY OF .... ........ ! ..... (Name o iudiX -iX,:.ng oontract) ,T, M/ RODERICK VAN TUYL,,.~.C. ~. V.---- LICENS~'D LAND SURYfYORS GREENPORT , NEW YORK SUFFOLK CO. HEALTH DEPT. AP~ROV,~L H.S. NO. Apply, ed .t~ .c~or&.n~ ~ith ~9".~ ~ Review STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE~ .S~AN,~DARDS~A~,~Z..,A~,~?~.~]~T~OF THE SUFFOLK CO. DE PT {S) .~OHr~ ~ ~ 4 PTO!~ .q.m?., yOp APPLICANT o'~ SUFFOLK COUNTY DEPT. OF HEALTH SERVICES - FOR APPROVAL. OF CONSTRUCTION ONLy/ DATE H. S. REF. NO. . SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL. OWNERS ADDRESS: DEED: L. P, TEST HOLE STAMP SEAL ~e sew~ disp~al '~d wa~e~ supply ~aeilities for ~this location hame been [nspec[ed~by this department ~d2fo~ Servioes . ,' ~/ . ..... ' ......... ~ -:0~. RODER~CK VAN TUYL, LtCE~D LAND SURVEYORS' GR EEN~T N~ YORK SUFFOLK CO. HEALTH DEPT. AJ~ROYAL STATEMENT OF INTENT ' THE WATER SUPPLY AND SEWAGE DI~OSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE $TANDAE~S OF THE (s)~ SUFFOLK COUNTY DEPT. OF HEALTH S'ERV~CES -- FOR APPROVAL OF THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK 5o,: RV,CES. SUFFOLK COUNTY DEPT. OF HEALTH S'ERV~CES -- FOR APPROVAL OF CONSTRUCTIO~ ONLY DA TE: H2S. REF. ~.: I~ - ~O - /~ A~ROVED: SUFF~K CO~ TAX MAP DE~{NAT~N: DmT. ~CT. B~K , ~,. OWNERS ADDRE~: DEED: L. P. T~ST MOLE STAMP