HomeMy WebLinkAbout25677-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-26371 Date APRIL 12, 1999
THIS CERTIFIES that the building. ADDITION & ALTERATION
Location of Property 3538 CEDAR BEACH RD. SOUTHOLD~ N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 93 Block i Lot 6.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 9, 1999 pursuant to which
Building Permit No. 25677-Z dated APRIL 12, 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 ENCLOSE EXISTING SCREEN PORCH WITH GLASS & SHED ADDITION
TO EXISTING ONE FAMILY DWELLING "AS BUILT" AS APPLIED FOR.
The certificate is issued to EUGENE HEACOCK
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N-063457 ~I'~RCH 11~ 1999
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. 25677 Z Date APRIL 12~ 1999
Permission is hereby granted to:
EUGENE F HEACOCK
SOUTHOLD~NY 11971
for :
ENCLOSE EXISTING SCREEN PORCH WITH GLASS & SHED ADDITION
TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
at premises located at 3538 CEDAR BEACH RD SOUTHOLD
County Tax Map No. 473889 Section 093 Block 0001 Lot No. 006,~
pursuant to application dated APRIL 16 1999 and approved by the
Building Inspector.
Fee $ 75.00
ORIGINAL
Rev. 2/19/98
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN NALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Th£s application must be filled in by typewriter OR ink and submitted to the building
iaspector with the following: for new building or new use:
}. Final survey of property with accurate location of all buildings, property lines,
streets, and unusual natural or topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form)·
3. Approval of electrical instaliation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used ia system contains
less than 2/10 of i% lead·
5. Commercial buildin~g, industrial building, multiple residences and similar bu[ldJngs
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
Fr~r existing buildings (prior to April 9, 1957) non-conforming uses, or buildiags and
"pre-existing" ].and uses:
1. Accurate survey of property showing all property lines, streets, buiiding and
unusual natural or topographic features..
2. A properly completed application and a consent to inspect signed by the applicant.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $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.O0
3. Copy of Certificste of Occupancy - · .25~
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $]5.00, Commercial $15.00
.. ........................
' ,,ocation of Property.] ..... ~~~7~[~...
}louse No. ~ ~ Str~e~ Hamlet
Onwer or Owners of Pro ert- ~~ ~ ~ ~ ~.
................................... Filed Map ............ Lot ......................
S~>division .
Permit No.~.~..~.2%.~.Date Of Permit .............
· ..Applicant .............................
ltealth Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Reqaest for: Temporary Certificate .......
Fee Sobmitted: $.~.,.~ .................
'
, T,HE' NEW YORK BOARD OF FIRE 'UNDERWRITERS
BUREAU OF ELECTRICITY
40 FULTON STREET, NEW YORK, NY 10038 ~ ·
~ ~RCH 11,1999 17gO539~/99 H 063~5~
Date Application No. on file r
THIS CERTIFIES THAT
only the electrical equipment as described below and introdttFed by the applicant na~ed on' the abo¢e applicaHon number is in the premises of
GENE HEACOC[(, 3515 CEDAR BEACH ROAD, EAST HOUSE~i, SOU~HOLD, NY
in the following location; [] Basement [] 1st FI. [] 2nd FI. OUT Section Block Lot
MARCH O5,1999
was examined on and fox,nd to be in compliance with the National Electrical Code.,
FIXTURE RECEPTACLES FIXTURES RANGES OVENS DISH WASHERS
OUTLETS FLUORESCENT OTHER
DRYERS
OTHER APPARATUS:
*NO VISUAL DEFECTS: "An electrical
survey has been~made 'of,.the ~exposed
electrical equipment in the
premises indicated." "No obvious
unsatisfactory condition was found.
SYSTEMS
R C E
JOHN ROt~NELLI ~ L ~c
P. P. BOX 696
SOUTHOLD, NY, 11971 GENERA~ MANAGER
,COPY FOR BUILDING DEPARTMENT, THIS COPY OF CERTIFICATE MUsT ~oT BE ALTE~AD IN ANY 'M~NNER,
q,'..
7o,w~<>/ O F-'
-FORM NO. I
TO~N OF SOUI'HOLD
BUILDZNG DEPARTMENT
TOViNItALL
SOUTHOLD, N.Y. 11971
TKL: 765-1802
INSTRUCTIONS
NOTIFY:
CALL ............... .. .
HAIL TO: ....................
a. ~his at~lieatim ~st be er~.letely iillt4 in ~ ~i~r or in il ~ ~itt~ to ~ ~ildi~ I~tor ~
3 ~ts of pl~, m~ plot p~ w ~le. F~ ~i~ to ~le.
b. ~ot plm ~ l~ti~ of lot ~ of ~ldi~ m [~s, ~lati~ip ~ ~join~ ~s ~ ~lic
s~ts or ~, ~ ~ a ~il~ ~i~im of l~t of ~ ~t ~ ~ ~ ~ diem Ii& is ~n of
~is ~limtim.
c. ~ ~ ~ ~ ~is ~limtim ~ ~t ~ ~ ~ i~ of ~ildi~ ~t.
d. ~ ~,~ of ~is ~li~tlm, ~ ~ildi~ ~tor ~11 i~ a ~ldi~ ~t to ~ ~li~t.
~t ~1 ~.~ m ~ ~s ~il~le ~r i~ti~ ~$t ~
e. ~ ~ildi~ ~1 ~ ~i~ e ~ in ~le ~ in ~ ~r ~ ~ ~t~r mtil a ~nifica~ of
~ ~1 ~ ~ ~,~ ~ ~ Yldi~ ~tor.
~ Ii ~t ~ ~ ~ hildi~ ~t,--t for ~ ism oi a ~ildi~ ~t ~t to t~
~ldi~ ~ ~i~ of ~ ~ of ~ld, ~ffolk ~, ~ Yot, ~ o~r ~li~le ~, ~ims'or
~ati~, M ~ mmtim of Mldi~, ~iti~ ~ dterati~, or ~r ~d ~ ~liti~, ~
~iM. ~ ~llmt ~s to ~ly ~ ~1 ~li~le 1~, ~ims, ~ildi~ ~, ~i~ ~, ~
~ati~, ~ ~ ~it m~ri~ i~t~ m ~i~s ~ in ~ildi~ ~r ms~ im}i~.
State ~r ~li~t is ~r, le~~~i~t, ~i~r,'~ral ~t~tor, el~tricim, pl~r or ~il~
......... .... ........................................................................
~ of ~r of ~s .............................................................................................
(l~n~ and tkle of corporate officer)
Builders License No ..........................
Plm~ers IJ~e Ro ..........................
Electricians License Ro ......................
other ~ra~'s tieense ~o .....................
.~ Iz~'.atico of land ~ ~/~ieh proposed ~ork will he done .... ~ ...... / ..................................................
Oxmry Tax l~ tqo. I000 8eerico ................ mock ................ ~ot ................
2. $~ate.existing use and occupancy of presses and tntend~i use and occtmancv of proposed ccostmetico:
Nature of ~ork (check vhid~ applicnble): N~ lkiildi~ .......... t~ddition .......... ~terati~
..................,, ............ ~;~ ................
Estimt~st ~ '...' ' . .... ,.. ~ .........
~ (to ~ ~td ~ fil[~ this
1[ ~llt~, ~r of ~11~ ~t~ .......... ~r o~ ~lli~ mlt~ m e~ fl~r ................
If ~r~ ~r o[ ~r~ .. ............
.
.
J
.../-~,.q~ ......... .'.,~ o~ ~o~sa' ~~
t~i~t
,~r ........................ ~.,
~i~i~ o~ enCi~ ~ ~i~ ~. ............. . . ~ar ............... ~p~ ............ ..
~i~. . .. .. ~r of ~orie~ . .
~ o~ ~ ~ ..~..~ ...... ~ ..~.X~.~. ....... ~...~ .......
~e o~ ~a~ ................ ; .... ~ of Po~ ~r ........................................
~oe~it~t ; .. . ~sa ............................. ~ ..........
~ of ~tr~tor .............. , ................... ~rsa~ ............................... ~ ~ ...........
I, ~i~ ~ ~in ~ f~t ~ a till mtl~ ~ ~ ..........
~ PLOT
~ate cle~ly ~ disti~l~ ~ ~ildi~, ~r ~sti~ or ~, ~ i~i~e alt ~t-~ d~i~
~t~ether interior or comer lot.
," ~
lie is tile ................. ,,~,.~;~¢,.~ .......................................................................
o[ said miner or o~ers, a~J ~s"i-g~ly a~tberized to ~rfo~ or h~ ~r[~ O~ ~d ~ ~ to ~ ~ f~le this
flint ~ m~ will ~ ~rf~ in tbej m~r ~t forth ~ ~e a~limtim fil~ ~.
~ · G~79605
uual~ ~ ~n S~o~k ~un~ ~
~mi~ ~ ~ir~ ~o. 8, ~
................... beiu~ duly s~om, deposes and says that be is the eppllcanC