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Home My WebLink About25643-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z~27120 Date: 06/05/00 THIS CERTIFIES that the building ADDITION Location of Property: 57555 MAIN RD (HOUSE NO.) County Tax Map No. 473889 Section 63 SOUTHOLD (STREET) (HAMLET) Block 3 Lot 22.1 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 25, 1999 pursuant to which Building Permit No. 25643-Z dated MARCH 23, 1999 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 INSTALLATION OF A FURNACE FOR AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to PAUL M & ELAINE R ROSS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 26162 05/13/99 PLUMBERS CERTIFICATION DATED Rev. 1/81 02/11/99 LAWRENCE TMAPASSO Authorized Sig~ur~ FORM NO. 3 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) PERMIT NO. 25643 Z Date MARCH 23~ 1999 Permission is hereby granted to: PAUL M & ELAINE R ROSS PO BOX 1166 SOUTHOLD~NY 11971 for : INSTALLATION OF A NEW FURNACE FOR AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at 5.7555 County Tax Map No. 473889 Section 063 pursuant to application dated FEBRUARY Building Inspector. MAIN RD SOUTHOLD Block 0003 Lot No. 022.001 25 1999 and approved by the Fee $ 75.00 Aut ute ORIGINAL Rev. 2/19/98 TOWN OF SOUTIIOLD BUILD[NC TOUN IIALI. 765-lg02 APPLICATION FOR CERTIFICATE OF OCCUPA?;CY A. This aPl)iication must l)e filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or ne~ nsc: 1. Final survey of property uith accurate ]ocation of all boildings, property lines, 2. Final Approval from Uehlth Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of e.[ectric~J installatio, from Board of Fire Underwriters. 4. Sv~orn statement from 'plumber certifying that the ~ptder used in system contail's less titan 2/10 of l% lead. ' 5. Commercial building, industrial building, multiple residences a~d similar buildings and iostallations,~a certificate of Code Co,plia~ce from ar '- ' responsible for the building, cb~tect or engzneer 6.Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and 1. Accurate survey of property showing ail property lines, streets, building and 2. A properly completed application and a consent to inspect signed by the applicant. Ifa Certificate of Occepancy is denied, the Buildi.g Inspector shall state the reasons therefor in writing to the applicant. C. Fees I. Certificate of Occupancy - New dwelling $25.00, Additions to d~elting $25.00,-- Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildin~ - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary C rtzflcate of Occupancy - Residential $15.00., Col~ercial $15.O0 ~IeU gorlstruc~ion ........... Old O~ Pre-existitlg Building.. ~ House No. Street Hamlet ~op ty ......................................................... .>ubd ~v~s ~on .................................... Fi J ud }lap ............ Lo ~... .............. [lea~th Dept. Approval .......................... UndertCri~ars Approval ......................... ?lanning Board Approval ........................ 2equest for: Tempor;l~y Certiflcate ........... Fioa~ Cert~cate .......... aq =o .............. DATE: 5/13/99 ELECTRIC~ INSPECTION SERVICE INC. 375 D UNTON AVENUE EAST PA TCHOGUE, NEW YORK 11772 (516) 286-6642 26162 APPIJCATION No. ON FJLE VILLAGE: Southold ADDRtrS& 57555 East Main Rd ISSUED TO: Paul R*lles TOWN: Southold LIC No: 2901Re -- ]NTRODUCEO~Y;- - PeSo ............................................ was examined on 5/13/99 and found to be tn compliance wah the Na~onal Electrical Code LOCATION: Base.. ist 2nd 3rd DeL Garage Hot Tub Pool SWITCHES ~CEPTACLES FIXTURES I HEATERS I FANS G.~I. ~ COND. D[SHWAgftER I DRYER CLOTHES WASH. GAR. DISP. RANGE OVEN $7ffOKE DETECTOR FURNACE OIL GAS CIR. MOTORS BELL TR,/L¥. gERVICEDISCONNECT F OTHER EQUIPMENT Section - 63 Block - 3 Lot - 22.1 HUGO $. SURDI pRESIDF~VT BUILDING PERf4IT No. Tms eeoilica~ must not be a~te~l h~ any manner BLUE OR1GINAL YELLOW COPY PINK COPY OFFICE UNDA~ION (ISLE) UNDA'~ION ( 2~NI~__ ) ...... STA~ E~R~ CODE Town Hall, 53095 Main Ro~ld P. O. Box 1179 Southold, NewYolk 11975 Fax (516) 765-1823 ]'elephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD CERTIFICATION Building Permit No. ~--~'~ Owner: ~C~%3 ~ ~o~ (please print) Plumber: (please print) I certify that the solder used contains ]_ess than 2/10 of in the wa~er supply system 1% lead.~ nature) Sworn to before me this Notary Pu~~ KENNETH ^, NO?^R¥ PUBLIC, St~t~ of b~ew Yorl( No. 0]MI5040174, S~,ffo~i~ Cc nty Term Expires Marc~] 6, , BLDG. DEPT. TOWN OF SOUTHOLD FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examiued ................ , 19 Approved ......... , ermit No Disapproved a/c .............. i / / (Building Inspector) o,.o t ole- tace- oF-- a. Tiffs apPlicati¢ ~ts of plans, accurate b. Plot plan sho~ areas, and giving a ation. c. ' The work eovl d. Upon approv~ mil be kept on the p e. No building sl mil have been grante APPLICATION I: DING PERMIT NS 21 SETS OF PLA~IS' · ...... SURVEY ~ C~1~¢}~ ............. ~ ..... FO F,,I S g P~,xIC ........ ~ · . . C ~ r L .~ HAIL TO'~ ' . ....X% ......... Date >r in ink and submitted to the Building Inspector, with lises, relationship to adjoining premises or public st?ce' .ust be drawn on the diagram which is part of this appl ~~75 (? a.."~;d her°re issuance °f Building Permit' ill i~sued a Building Permit to the applicant. Such penni t,Od3 ~er~ e work. . ~r any purpose whatever until a Ccrtificate of Occup~c mt for the issuance of a Building Permit pursuant to th uilding Zone Ordinance of the Towh ol ~outnom, ~uuom ~uu,,ty, New York, =d other app~cable Laws, OrdM~ces o egulations, for the construction of bufldMgs, additions or alterations, or for removal or demolition a ' ' ' he appBcant agrees to comply with] all applicable laws, ordinances, buildMg code, housing code, an~ Imit authorized Mspecto~ on premis'es and M buildMg for necessa~ inspections. . (Signatur9 of applicant, or name, if a corporation) (Mailing address of applicant) :ate whether applicant is owner, lessee,~ 'agent, architect, engineer, generai contractor, electrician, plumber or builder. ~me of own~ of premises' .X~~ ~% / I ', .... ''' ............ ~ ........... / ; (as on the tax rol ilt};t'fi dd') ......................... applic.~corpor~;n:sig~~yau~ri~d~-/:~J-"/~ officer.' . ,,,~,,~,~, . . ; (Name and title of ~.oratb~fncer) '~' , ~: Sql& ~ ' CC.UP&NOY ~u~Mefs ~ns~ ~o .......... , ...... 765-1802 9 AM ~ 4 PM ~ .' , ~}. IC~l/nUo/bgKll[IUgl[ FO" mUREDCON~E Electrmmn s l.ice-se No ...... -- ~ '~1 IDfi M~V ~. ROUGH - F~MING & . u~ uu~urflllbl . 3. INSU~ON Off, er Trade's License No... .... ~ ............... * 4. FINAL - CONSTRUCTION MUST = BE COMPL~E FOR C.G. Location of land on which propose~ work will bc done ................ ~L[ ~O~ST~CTION SHALL MEET ............ ; ....... ,..~) ... ..,....%~ ' ~%~S*R'UCTION * ENERGY , .................... [-louse Num bet ~ Street ~SFO~SIBEE ' FOR .... ' D~OR CONSTRUCTION ERRORS Con ax a o. Section l ....' ......... Block ............. '... Lo ............... Subdivision . ........ . ........... : .................. Filed Map No Lot (Nalne) .............................. Stat6 existing use and occupancy of]prenffses and intended use and occupancy of proposed construction: u.a' IntendedEXisting USeuscandandOCcupanCYoccupancy .... .... ::' .......................................... ~,'~' g/ ~¢¢' ~OfU~ C~:' ' ~~R .3. Nature of work (check which apPlicable): New Building .......... Addition ..... Alteratior ....... Repair .............. Removal ............. Demolition .............. Other Work ......... ; .... 4. Estimated Cost ' ' .. ,(Description) 5. If dwelI . (to be paid on filing this application) ing. number of dwelling nnits ............... Number of dweli ng u its on each floor .. · If garage, number of cars ....................... ' .............. n... . .......... 6. If business, Cmnmercial or mixed occupancy, specify nature and eXtent of.each type of use ................... 7. Dimensions fl'existing struc~res, if any: Front ............... Rear .............. Depth ............. Height ............... Numbei' of Stories ........ . ............................... Di~ m mid is of shine structt re with alterations or additions Front ........... Depth .. ' ........ Height . ' ................ Rear ....... 8. ' ...... ' ..................... Number of Stories ........... ' ......... Dimensions of entire new construction: Front .............. : Rear ..... Depth .... Iteight ............... Number of Stories .............................. . ... 9. Size of lot: Front .................. Rear ...... ' De .... ' ......... 10. Date of Purchase ' ,, ................ pth . ......................... marne of Former Owner .... ' ......... 11. Zone or use district in which premises are situated .............. 12. Does proposed construction vitiate any zoning law, ordinance or regulation: ................ 13. Will lot be regraded ....... .._. ................... Will ex, c, ess fill be removed from remises' ' ........ 14. NameofOwnerofpremises ~.~.9,ok._ ¢oS~ Address '\4'/ ~-¥ \, ~....i,.{~.m~p · ,,,_, Y~s N .................. ' ....... p,,~. ,. v-v ?. l'hone No. ;1¥77 Nme of Architect Name of Contractor ~ · . · Address ................... Phone No. ......... AddresS. ?.x.S>. ?.c:',-~... ?.~..~..k,,,!~hone No. i~.~.' ;Z%~;d'''' 5. Is th±~i~roperty within 300 feet of a tidal wetland? *Yes ........ No ..... ' .......... yes, Soul:ho,Id To~n Trustees Permit may be required. '''' ... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions fron- ~roperty lines. Give street and block number or description according to deed, and show street nmnes and indicate whethe~ nterior or corner lot. ~TEOFNEWYO'RK, '~ ,-'," , . ' )", ~. UNTycoI~!~dD,.~:i..) ' ~'l("!r,t'':.S-S'; ,~ .../ ~ ~ (Name of individual si~i~con,tract) ,., . , . , poses ann says that he is the apphcant ye named. /,'v,",, ,,, , - ~ x I , ~d pwn'e'r or o~ners, ~d is duly autlm~perform or have nerfo~,~,~ t lc0tlon; that all statements contained ~ this a lic ' n are ........... ~am wor~ aha to make and file this pp atto true to the best of Ins knowledge and belief; and that the ( will be perfomed in the manner set forth in the application flied therewith. m to before me this ....... ..... *' ' '. -t ........................ / ' (Signature of,~pphc~t) T~~6,~/ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I~ULATION [ ] FRAMING [//] FINAL [ ] FIREPLACE & CHIMNEY 765-1802 BUILDING DEPT. INSPECTION REMARKS~ DATE. ~'~//~/~' iNSPECTO~ ~ .~~~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROUGH PLBG. [, ]~ULATION [" ] FINAL [ ] FIREPLACE & CHIMNEY DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] INSULATION [ ]Z~FINAL