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Home My WebLink About25425-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26292 Date: 02/22/99 THIS CERTIFIES that the building ADDITION Location of Property: 650 RAMBLER RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 88 Block 5 Lot 21 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 29, 1998 pursuant to which Building Permit No. 25425-Z dated DECEMBER 17, 1998 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 NEW HOT WATER HEATER AS APPLIED FOR. The certificate is issued to PAUL M & ELAINE R ROSS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 09/30/98 / N/A 01/06/99 LAWRENCE TRAPASSO 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. 25425 Z Date DECEMBER 17, 1998 Permission is hereby granted to: PAUL M & ELAINE R ROSS PO BOX 1166 SOUTHOLD~NY 11971 for : INSTALLATION OF A NEW HOT WATER HEATER AS APPLIED FOR. at premises located at 650 County Tax Map No. 473889 Section 088 pursuant to application dated OCTOBER Building Inspector. RAMBLER RD SOUTHOLD Block 0005 Lot No. 021 29 1998 and approved by the Fee $ 75.00 Authorized Signature Rev. 2/19/98 ORIGINAL TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. Submit Planning Board Approval of completed~sita plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '!pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building 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. Co Fees i. 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 Buildinm - $100.00 3. Copy of Certificate of Occupancy - ~ .25~. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction ......... Old Or Pre-exi~inM P~uildin~ .. . O ~ . P Y ................................ .~...~ ...... ~./. ............... House No. Street Hamlet Onwer or O~ers of Property... J./~.~.~.~,~ ..... ~.~'. Co ty T= Map No O00, Sec ion. . loc . .. ot Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ....... i ................. Planning Board Approval ........................ 1 Request for: Temporary Certificate ........... Final/~erticate./-c~ ........ c.55% Y .................................. Town Hall, 53095 Main Road P.O. 8ox t179 Soulhold, New York 11971 Fax (5 ! 6) 765-18?_3 Telephone (5~6) 765-~802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD CERTIFICATION DATE: Building Pg~-mit No. Owner: ~M.-/ (please print) Plumber: ~/~ ~/~/~./~/~ ~ ~ O (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead./~ . ' v( Plumbers Sworn to before me this ~ O day of ~~"-~, 19~~'~ No t a 1-f Public , ~~*~ounty KENNETH A. MIONE N0~'ARY PUBLIC, State of New York No, 01MI5040174, Suffolk County 'l'erm Expires March 6, 19-~-~ ELD i~:SI:EC · '-ON )UNDATION (1st) 3UNDATION (2nd) OUGH FRAME & .PLUMBING lliSULATION PER N. ¥. STATE ENERGY CODE 'FINAL ADDITIONAL COMMENTS: .I.;OgH Jla. I TOBIt OF 8OUTilOM) 'ro~bl IIALL 8DUI'IIOI,D ,, 'Il .'i. I 197 l TEL; 765-J802 ApprovLv..I ................ , ..... ' ' ' ' Disapproved a/c ................... : ............... BOABD OF BBALTIi ....... : ....... 3 8BT8 OF~ PLA~8'. ....... ' ........ SURVBY .............. ~ .......... SEYTIC ~OP, H ................... HOTI~Y: CALL .................. HAIl, TO: .................... ' Date ................ ,19 IH$'rRuc'rIoHs ..... ...... ............................... . APPROVED AS NOTED I~ aM)ticm~t i8 a co.ratio, si~re of duly ~tl~ri~l officer, N~ BUILDING DEPARTMENT AT 76k1~ 9 AM TO 4 PM F~ WITHOUT CERTIFI(AT~ ~' ~'~ ~ Pl~s Lice~ ~, ~ ~ 4. FINAL - ¢ONStWUCTION MUST ~E WEOUIWEMENTS OF THE N,Y, Od~ ~'~ Ltce~ ~ ..................... ~A~ .CONSTRUCTION & ENERGY 15, PLOT D~AORAH ~ locate clearly e~d distinctly all butldlr~s, ~d~r ~lerfng or pro~, ~ t~icata aTT ~t-I~ dl~nnionn p~rcy ll~a. GI~ nt~t ~ bl~ ~{~r ~r t~scrlptl~ acco~lng to ~, a~ ~ strut re, ms n~{ ,( (81(Vmttlro o~ Appl. i~) ' .,., · .." KENNETH A. MiONE. / ' NOTARY PUBLIC, Slate of New YoTk No. 01MI5040~74. SLiJfolk CO~ ' Term Expires March 6, 19~