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Home My WebLink About24061-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25059 Date JUNE 2, 1997 THIS CERTIFIES that the building Location of Property 100 OAK ST. House No. County Tax Map No. 1000 Section 141 Subdivision OIL BURNER ~TTITUCK, N.Y. Street Hamlet Block 1 Lot 11 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 8, 1997 ~ursuant to which Building Permit No. 24061-Z dated APRIL 22, 1997 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 NEW OIL FIRED BOILER The certificate is issued to DOROTHY VICTORIA (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A 15074 -- DATED MARCH 5, 1997 N/A Building Inspecto~ Rev. 1/81 lvO~ NO. B TO%VN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER, MIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 24061 Z Permission is hereby gronte~: .~.......:~.~~ ................ ~.....~.~..:../....,,~....~.Z .............................. ..~,,¢~ ...... ~....~..~ .~.........~ to ............................ ..~.... ........... ~......~..x-~........~ ....... ~...~ ..................... .......... ...-4.. ...... ~...~...~,d..,- .... County Tax Mop No. 1000 Section ..d ..~.~... ......... Block ..... ...~....~... ....... Lot No .........~..,~.,. .......... Building Inspector, Rev. 6/30/80 Fornl I,Io. 6 TOWN OF SOUTIIOLD BU ILl) ING I) EPAP, TIIL~HT TOUN IIALL 765- 1802 APPL£CATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR i.k and submitted Lo the building · nspector ~ith the following: for new building or new nsc: I. Final survey of property with accurate locatiou o[ all buildings, property lines, streets, and unusual ,atural or topographic features. 2. Final Approval from llchlth Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electric~ installation from Board o[ Fire Under~riters. 4. Sworn statement from'plumber certifying that the solder used in system contairs less than 2/IO of 1% lead. 5. Commercial building, industrial buil~iag, and installations,~a certificate of Code multiple residences aad similar buildings Compliance frum architect or engineer responsible for tqm b.ilding. 6. Submit Plaoning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '.'pre-existiag" land uses: 1. Accurate survey of property showiag all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application aud a consent to inspect signed by the applicant I[ a et'tzfzcate of Occupancy is denied, the Buildiog Inspector shall state the reasons therefor in writing to the applicant. ~C. Fees I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.O0,-- Alteratious to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, ~ Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupaucy on Pre-existing Buildine - $100.00 3. Copy of Certificate of Occupaacy - $20.00 " 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00., Commercial $15.OO' 'I Da te ......................................... ,~ Co,,s,~o~,~on ........... o~a 0~ ~e-~D~a~g..~Z~ ....... , , .............. ......... ..... llouse No. Streetllamlet Onwer or Owoers ,.,f Property .... ~ .. co~.,y ~ ~. ~o ~000. ~o,~o,..Lq/ ...... B,,ok ...... f ........ ~o, .... . Subdivision .................................... Filed Map ............ Lot ...................... ......... Dato Of Pertnlt ................ Applicant.. ~ ................ Ilealth Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ 2equest for: Temporary Certificate ........... Final Certicate...~... --~ so~,,~: $~ ...................... e o --2.~5 OIL BURNER Certificate of Inspection N a m e-~!~OP_OT~l:Pf x. rl_CTO_~_~A AP_m+..! 5074 Cocatiom 100 OAK STREET, MATTITUCK, NY 11952 PETRO 1NC. Applicant: Address: P.O. BOX 788, SMITHTOWN, NY 11787 Tel. No. 686-1954 LJc. Na 2901-RE Expir~: ELECTRICAL INSPECTION SERVICE, INC. 375 DUNTON AVENUE EAST PATCHOGUE, NEW YORK 11772 TEL: (516) 286-6642 ,~.~..,~.~. ....................... .~.o.~.~ ......... ~;~ 1,05 , 121 105 91 8xSx 15 81.4 ' 1,35 1t6 136 117 8xSxl$ 81.3 . L6~ igl 166 143 6xgx15 61,Z ',, 1,90 221 192 t66 8xgx IS 91.5 "2.35 266' 2~ 8X 12x 15 H/A 2.35 275' 239 - 8 x ~2 x 15 ~/A ' ' ' V-?87' :22 and A$4 ale float mounted. quipment: : '~. ' i BURNHAM COI~PO~ATION 81.9 82.0 NIA 83.8 Fo~m NO. 4258E-6/93- .50,. M~ J 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: [ ] ROUGH PLBG. [ ] INSULATION [ ~]~INAL DATE CATIONS 1.05 ,' 121 105 91 8XSXI$ 1.90 221 192 166 SxSx IS Equipment: 6 · APff f~ t99"f TOWN HALL 'i ' ....... ~Lb~."}i;. ;-/ ........... SOUTHOLD, N.Y. 11971 ' ,¢ ToW,'Or ~ot', ~ TEL.: 765-1802 Disapproved a/c ' FORM NO. 1 TOWN 'OF SOUTHOLD BUILDING DEPARTMENT APPLICATION FOR BUILDING'PERMIT CALL HAI~L INSTRUCTIONS Date ' ' ' ~" 19 a. This application must be completely filled in by typewriter 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 sti'eets or areas, and giving a detailed description of layout of property mint 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 Insp6ctor v~ill i~sued 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 }?y the Building Inspector. · APPLICATION IS HEREBY MADE to the Building Departmefit 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, o}dinances, building code, housing code, and reguiat!ons, and to admit authorized inspectors on premises and in building for ne6essary inspections./~_.,~ . -- (Signature of applicant, oAname, if a corporation) · : .... . (Mailing address o[ applicant) /. S,ate.. whetber appliqant is owner, lessee, 'agent, architect, engineer, general!,contractor, electrician, plumber or.builder._ -- ,. ' ...........· ............. , .... ,. . Name of owner of premises ....../..~)~ 0//2/ · ........... f~ . . (as on'th~ tax roll or latest deed~ppll01~ED g$ NOTI~I) If. appliqaJat is a ~, sig.,gatt)~ of duii¢ at~'Irorized qfficei~ ' DATE: ~a P # ''~ ' (Namean, tit,[ ofcorpora~ officer) ' ~, /~ o NOTIFY BUILDING D~EoN~TTHAI i , ~ ~-~-~ ~ ,,~C/,~) 765-1802 ? AM TO 4 PM FOR .... --" -, ' / , FOLLOWING iNSPECTIONS: l~UUCler s ~lcense l'qo .......................... ~,~c,~__ 1. FOUNDATION - TWO REQUIRED Plumber's License No .................. ~../(.~...~...~. . UNDERWRITERS CERTIFICATE FOR POURED CONCRETE -- . REQUIRED 2, ROUGH - FRAMING & PLUMBING / 3, INSULATION Electrician's License No. .............. -',''','',' 4. FINAL - CONS1RUCTIO~N MUST , BE COMPLETE FOR C,O. Other Trade's License No... .................... ALL CONSTRUCTION SHALL MEET '' THE REQ'UIRECv3ENTS OF THE N.Y. 1. Location of land on which proposed work will be'done ................... ~-TA.TE, ~ONSIRt~TIt>N .&. EHERG~/..'. r,',>, ' . S ONSI E ., ....... ' .............. .C/.~..~.. ..... ::'.....'..: .... ././~g~.¢~,~rmu¢~,o~: ~,~,~ORS.. · ltouse Number Street Hamlet -Cou'nty Tax Map No. i'000 Section ............... Block ...... /. ...... ' Lot. · ..... Subdivislor/..; ..... . ................... ' ......... '. Filed Map No ............... Lot ..... . ........... (Name) '. ' , ' ~, 2. Stat~ existing use and occupancy of premises and intended use and occupancy of proposed construction! a. Existing use and occupancy.....~?..~./..~/.~..~.~.~. ~ ..... ' ........ } .... i ...... ' .......... / ........ '...'. b.,. Intended use 'and occupancy...~'~.~' ~.'//.. .... a~44?A//)/"('//'/... . ~//~,ff.~'~: ¥',, ':.., ';"/;:. i, ........... . . i'.. .... '3. N~ture of work (check which applicable): New Building . ' ....... ' .~.ddition .......... Alteratior. ct(...;...~ R pal R in I D liti Other Workc i-~ ' ' ' . (Description) 4. Estimated Cost. ·: .... F . ' ' , ' ' ' (to be paid on filing this application) 5. If dwelling, number of dwelli~ g units ............... , umber Of dwelling units on each floor.., ............. If garage, number of cars ' ' If busin.ess commercial or mi~ed occupancy ~pecify nature and extent of each type of use 7~ ffany: Front.. ,. ~ Rear..... ............ "''''' ' ' ' : ""' .... Dimensions o[ existing structu:res Height N~m~er of Stories : .......... Depth ............... Dimensions ' ' ' or additions: Front ....... " ..... of same structure W~th alterations · ' Rear D.epth ; i Height , Number of Stories ' ' 8. Dlm6nsions of entire new construction. Front , Rear Depth Height Nu~nber of Stories .......... 9 Size ofl0t: Front ..... ' ..... ~ Rear ' Depth 10.::'; Date of Purchase.......""'"."i..' ...... ... .' ? ' ".. Name of Former Owner " . 11 Zone .... ~ " ........ ' .................. r: ....... or use dmtnct zn which plrem~ses are situated 1 2. Does proposed construction vi61ate any zoning law, ordinahce Or regulation: .... , ............ 13 Will lot' be regraded ...,~ .. ,,.. t/. .. ..... ' Will excess fill be e-- ........ em~ses. , 14. NameorOwnero~premises~.o.'.,9.0~.~.'~./.~.)',~ Address/.O.d,~;~,~~l~;e ..... '/,',' ;~': ' k' ~' '_'_;- ..... Address ~,. ',,.. · .~,. · ~ · .2,; .... Phone No .............. ,/.. · ~ame.o.~ Contractor/~-.,q~f'..~..,(/~..~", ./.zf~.,~/?..z~.'~..~¢ .... Address/~.~,'7,,{.~..-3f~/.7~',////////~ Phone No ~'~.' .~/.~.5.~'(-~,.. 15. £s this property withini300 feet of a tidal 'wetland? *y~o [~ ' . ' ~'' : *If yes, Southold Town Trustees Permit may..be requ~''"''" ........ ''' . . '." ~.. ' PLOT DIAGRAM . . . Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensiohs from property lines. Give street and block · interior or corner lot. number or description according to deed, and show street names and indicate w, hether '1 STATE OF'NEW YORK, C . OIJNTY OF ........... ' ' · .... ........ (Name of]ndlvidual signing contract) above nanled. ' He is the , ~ (Contractor agent corporate officer etc ) ............. of said owner:or owners, ~d is duly[aut mfized t~ perfom or have perfomed the said work and to m~e and file this "a~ l" ' ' '~ ~ ~,: pp lcahon, that all statements contmged m tht. s'apphcatmn' ' are ime tO the best of his knowledge and belief and that the 'work will be perfo~ed in the manner ~et forth m tim application filed therewith. ' ' Sworn to b~fore mthis .,.., ..... . ...... ...... . -C~ ................ '~' ''~ ............ e . } :,~,,. ~ , .. · .... :... ' ~0 01~lS0401~4, Suff01~0t~ . . . . ] ' (Signature ofapphc~t) t~rm ExBites Maroh 8, 1~ being duly sworn, depose~ and says that he, is Iht applicant