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Home My WebLink About13727-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z. }8. ~. .99 ........... Date. AUGUST 16, 1989 THIS CERTIFIES that the building ONE FAI~IIL¥ DWELLINO Location of Property 200 WILSON RD. CUTCItOOIIE County Tax Map No. 1000 Section . . . !9.3 ...... Block 04 .Lot 43 NAP OF Subdivision...S.U. I~I.N.Y..~..l:10.1~l!.S' .............. Filed Map No..3.2.3. !...Lot No. 2.0. ........... conforms subfitantially to the Application for Building Permit heretofore filed in this office dated · ...F.g.B.....2.5.,..I .9.8.5... pursuant to which Building Permit No..1.3. 7. .27.Z' ............. dated.....March ...... 6',. .... 1985.. ........ .. 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 FAMIL'~ DWELLING WITH DECKS. The certificate is issued to ARLEEN OLIVER ..................... bY, L.;. .................... of the aforesaid building· Suffolk County Department of Health Approval 85-80-13 AIIG. II, 1989 UNDERWRITERS CERTIFICATE NO....~.7. !.4.1.3.3.. 9.eX....2.%. 1985 WILPRED KRUSE APRIL 15, 1985 PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 FOl~f NO. ~ TOWN OF Sou'rHOLD 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 13727 Z County Tax Mop No. 1000 Section ........... ..~ ....... Block .... ..(~... .............. pursuant to application dated ............. ..~-.~ I .~. ........... , 19.~..~.., and approved by the Building Inspector. Rev. 6/30/80 APPLICATION FOR CERTIFICATE OF OCCL FORM NO, 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N,Y. 11971 765- 1802 Instructions NewConstruction. 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 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- Lions, 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-existi~g" 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- Lion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 I. Certificate of_occupancy New Dwelling $25.00, Accessory ,$ ]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O./ $ 50.00 Date ..A,u.~:. 1.4, 1989 ..... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .... .2.QQ. ~,~.~.~9~-. mci ........................ Cu;c~Rogue ............. House No. Street Narc/et Ar.. 1 een Oliver Owner or Owners of Property ........................................................... County Tax Map No. 1000 Section 103 Block ....4 ...... Lot. 43 Subdiwsion Sunny Shores 20 ................................. Filed Map No. 3231 .Lot No, PermitNo. 13727 Z DateofPermit^pplicant AXle. n. ..... Health Dept Approval 85=80-13 ' Labor Dept Approval Underwriters Approval N ?14133 Planning Board Approval Request for Temporary Certificate .................... Final Certificate , X Fee Submitted $ .... 2..5: .0.9 .................... Construction on above described building and permit meets all applicable codes and regulations. Applicant ........................ Rev. 10-10-78 CO THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 THiS CERTIFIES THAT only the elect~cal equipment as described below artd int~duced by the applicant named on the able application number in the premises of in the follo~iag Iocatlonl ~ Basement ~ 1st Fl. ~[~ 2~d FL Section Block Lot ~as examined on ~)~ }'~ ~'~ and found to be ln complia~tce wi~h the requirements of this Board, FIXTURE FIXTURES RANGES OVENS OUTLETS EXHAUST FANS OTHER APPARATUS: S E R SYSTEMS NO, OF FEET I C E A.W,G NO OF HI-LEG A W.O. NO OFNEUTRALS EEgO ]~ectric ~)r~ (Cq~tff Cornel],) 325 Will~ Point Ros, d ~ilolithold, N.~Z~ 11971 Lie,. 2818E ' GBNEI~AL MANAGEE ', i r~ This certificate must not be altered in any manner; return to the office of the Board if ipcorrect Inspectors may be identified by their credentials. ,, CO Y FO BUILDING DEPARTMENT TH $ COPY OF:C RTIF CA~E UST NOT BEALTERE0 IN ANY MANNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. 1372 Owner ~ f/~ ~/ ~/~ (.please print) / P 1 nmb e r ~,~. ~w/~.~J~' . ,,~.~ (~l~ase prin~) ' I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. //~(plum~e~' s signature) Sworn to before me this 19. ~ · Notary Public, Notary P~blic/~ County NOTARY PUBLIC, State of New Yerk N~. 52-~5~'2513 Qualifie~.m Suilat~ Ce~mty ~omm/ssion Expires March 30, FIEL~ INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY FINAL ADDITIONAL, COMMENTS: Memorandum from... BUILDING INSPECTORS OFFICE TOWN OF SOUTHOLD TOWN }J~ALL, BOX 728. $OUTH©LD, N.Y. [ 1971 765-I802 765-t802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION ,/ FRAMING [?1~] FINAL REMARKS: DATE /~ ,~ ,/ INSPECTOR ' FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~°OUTHOLD, N.Y. 11971 TEL.: 765-1803 BLDG, DEPT. TOWN,OF, ~pU"rHogo Examined ................ ,19 ... Approved ................ ,19... Permit No ............ Disapproved a/c ..................................... .Received ........... ,1 9 · , · (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by Wpewriter 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 appW 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 admit authorized inspectors on premises and in building for necessary inspector. ~/ ff ~t(';)~,~, v ........ .... (Signature of applicant, or name, if a corporation) · ' ' (Mailing ~[~e~'~kof applicant) · ~7~ .(?. ¥./..7~...'-. . //??:5 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...... ................................................. Name of owner of premises ........ - .~:q..~. ...................................... (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 ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done. ~//~/Z~ ... ................. z ................. House Number Street Hamlet County Tax Map No. 1000 Section ...... /f.~.~.. ...... Block .....'~. ............ Lot.. ,'~,....~. ~ ...... ~,,,,v,v'./. ~/)ozz~' ' ............... Subdivision ......... - ............................Filed Map No. 3.~..3. ! ...... Lot (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 and occupancy .... :-~'. (..~.(.f ..... . .. ! .......................... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Rep, air · Rem'oval Demolition Other Work ~ (Description) 4. Estimated Cost .......... ......................... ee ...................................... I ,: *" (to be paid on filing this application) 5. If dwelling, number of dwellinglunits .... .~ ~ .E.. ..... Number of dwelling units on each flo0r ................ ~f garage, number of cars .... ~ . . ?lf~.~.. ...................................... 6. ~ business, commercial or mixe.d occupancy, specify nature and extent of each type of use iii ' '.~/~.~..' 7. uimen'sions of existing structur6s, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth I Height Number of Stories 8.' Dimen§ions of entire new construction: Front ...,?,.O.." ........ Rear . .3?.' Depth .~f.... Height . , .' ..... u r o .............................................. 9 Sizeoflot Front I00~ Rear 100' n~,,,h ,~,'~O 10, Date of Purchase ...... ............ .Name of Form.e,r Owner .. ~?.4~/.~... 'J-~rO~.~..d.~/~./.. 1. Zone or use district in which pr6mises are situated . .~-~g(~.~.~: ,~...~.~.~. . , I---~:. -Boc~ proposed eonstructmn vmlate any zoning law, ordanance or regulation: .../~.~ ...................... ?,. ,W, ill lot ~b~regrad? . .,~.O. '.A;~',~ ';.t.p -:~.;o. ~, .....Will ex,c~s.s~fill be removed from premises: . Yes (NO Name of Architect . ~ . Address ................... Phone No ................ Name of Contractor ~)~,~ ' ~>~/?.~..' iii. Address .~.(~t..~-...~A~. i(..~-:... Phone Lo'ate dearly and distinctly ail property lines. Give street and block interior or corner lot. .,..~STATE OF NEWJORK. S.S COUNTY OF..OD.~. ~.O L.&.~ .... I .. ~ t~.&OCf, h..-~&... C).AL tr~;7.~.. PLOT DIAGRAM buildings, whether existing or proposed, and, indicate all set-back dimensions from umber or description according to deed, and show street names and indicate whether Notary Public, ,... i ............. County NO'rARY PUBLIC, State of New York # /! ............ , No. 52-4522513 r ~/ I ~ qua~itied In ~uflol~ County ~, Cam'mission Expires March 30, 19.~tG (Signature of applicant) ................ being duly sworn, deposes and says that he is the applicant (Name of individual signingi contract above nmned. He is the ........... ?. ~ ./~..W?..~. 9.~.O..~.~... of said owner Or owners, and is duly authorized to perform or have performed the said work and to make and file this applica, tion; thor all statements contained in this application are true to the best of his knowledge and belief; and that the work willibe performed in the manner sci forth in the application filed therewith. Sworn to .before me this 2760 LITTLE NECK RD. CUTCI*:0GU£, NY 11935 ~-- TUYL. P.C. ]£1CEI~ISED LAND SURVEYORS GR.E£NPORT 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 TO THE STANDARDS OF THE SUFFOLK'~.. ~EPT;~3F HE~LT~I'? SERVICES. APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY __ _ ~_- DATE. ;SINGLE FAM~ Ly SUFFOLK CO. TAX MAP DESIGNATION: DIST, ~CT. BL~K PCL STAMP SEAL M..O A, L5 L RODER)C-K VAN TUYL,P.(~. ,5. v ~ ~-~---T.~ LICENSED LAND SURVEYORS GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APP~OV S,L' H. S, NO. STATEMENT Of INTENT THE WATER SUPPLY AND SEWAGE DISPOS/~,L SYSTEMS FOR THIS RESIDENCE CONFORM TO THE STANDARDS OF T~E SUFFOL~ D.~PT. ~Of {si .... APPLICANT SUFFOL,I~ . COUNTY SERVICES -- FOR CONSTRUCTION ONLY DATE: DEPT. OF HEALFH APPROVAL OF H. S. REF, NO.: APPROVED· __ i" SUFFOLK CO. TAX MAP DESIC-NAT~ON: : DIST. ' SECT. BLOCK PCb Io~,Q:- l ";"-, iO~:- :; '" '-. ' ? DWNERS ADDRESS!' ,~-- DEED: L'~ N~,-~ 'rEST HOLE SEAL SSFF~K COUNTY [;~PN~MFJCf OF H,r~d~TH SB~VICES SINGLE FAMILY D~FILING ONLY The sewage disposal and w~ supply facdi~ies for this ocat on have ~en nsp~teCby th s other 3genc~ and f~ Chief of Bmeau of g ~tewa~r ~anagement RODERtCK 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 TO ThE STANDARDS Of ThE SUFFOLK CO. DEPT. Of hEALTH SERVICES. APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL Of ,CONSTRUCTION ONLY DATE: H. S, REF. NO.. APPROVED: SUFFOLK CO, TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL. ooo ,o_ 4 OWNERS ADDRESS: 2763 ........ "- '""'"' ~'~ ~' DEED: L. ~/¢~, P. TEST HOLE STAMP