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HomeMy WebLinkAbout24360-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of Che Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26715 Date: 10/04/99 THIS CERTIFIES that the building ACCESSORY Location of PropErty: 525 GREEN HILL LA GREENPORT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 33 Block 2 Lot 46 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 21, 1997 pursuant to which Building Permit No. 24360-Z dated SEPTEMBER 18r 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 ACCESSORY SHED AS APPLIED FOR. The certificate is issued to ALVIN L & MADELINE ROBINS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A S/yng n,pectcr Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26721 Date: 10/04/99 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property: 525 GREEN HILL LA GREENPORT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 33 Block 2 Lot 46 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 21f 1997 pursuant to which Building Permit No. 24360-Z dated SEPTEMBER 18~ 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 GARAGE ALTERATION AND DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ALVIN L & MADELINE ROBINS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N 452404 05/01/98 PLUMBERS CERTIFICATION DATED 09/28/99 WALTER MARCZEWSKI~ JR. /~B~i 1 ~ ' ng/I n~Spec t o r Rev. 1/81 TOWN OF $OUTHOLD IIJILDING D~PARTMEHT TOWN HALL SOUTHOLD, N. Y. BUILDING PEIUalT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) tO oppltcotion doted ........................./~°'~--~.z~./......, 19Z/'....,~:~'~ and pursuant Build~n~ Inspector. approved by the Rev. 6/30/80 THE NEW 1~1093 Date I~I~Y O1 t 1990 THIS CERTIFIES THAT YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET, NEW YORK, NY 10038 Application No. on file 15342098/98 N 452404 only the electrical equipment as described below and introduced by the applicant named ot~ the above application number is in the premises of t'ffi. & HRS. ROBINS, 525 GREENHILL LA., GREENPORT, NY in the following location: [] Basement [] 1st Fl. [] 2nd Fl. Section Block was examined on A~RIL 23 ~ I9'98 and found to be in compliance with the National Electrical Code. Lot 4 FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS FLUORESCENT OTHER 3 12 7 DRYERS DIMMERS SYSTEMS OTHER APPARATUS: PADDLE FANS- 2 G.F.C.I:-I SHOKE DETECTOR: -3 S E R V I C NO, OFNEUTRALS DOROSKI ELEC. INC. LIC.#2941- 425 MONSELL IA~E ~ CUTCHOGUE, NY, [1935 ~ This certificate must not be altered in a~,y manner; return to the office of the Board if incorrecl. Inspectors may be identified by their credentials. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMIHG [ ] ROUGH PLBG, [ ] INSULATION [ [ ] FIREPLACE & CHIMNEY , ii DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] /RGUGH PLBG. FOUNDATION 2ND It./] INSULATION [ ] FRAMII~JG [ ] FINAL [ ] FIREPLACE & CHIMNEY ,D/~, ~A.~.~.~, DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECT [ ] FOUNDATION 15T [ i ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMI.G [ ] FINAL [ ] FIREPLACE & CHIMNEY DATE //~/~/ff'~ INSPECTO ' ' ~IOJ.O'~dSN I A::iNINIHO '~ 30Vld:::UId [ ] lvm=i [ ] NOI.I.VlflSNI [ ] ON~VdVU,.' ~ ] aNt: NOI.LVQN on~d [ ] 'OeCd Honou [ ] ,i. SI. NOI,LVGNrlo;:I [ ] NOI133dSNI ',Ld3Q Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the buildinf 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 buildi~ 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings a~ "pre-existing" land uses: i. 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 applicanl If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees i. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, 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 ~ccupancy on Pre-existin~ Buildin~ - $1OO.00 3. Copy of Certificate of Occupancy - -2~ 4. Updated Certificate of Occupancy - ~50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ate. .......................... New Construction ........... Old Or Pre-existing Building ................. Location of Property .... M...(P..~.M?..-~Z-/~--- .......... ttouse No. Street Hamlet Onwer or Owners of Property ............................................................... County Tax Map No 1000, Section.. ~ ...Block. ~ .Lot ..... .~.~ Subdivision .................................... Filed Map ............ Lot ................... Permit Xo..~.-.~.~..~..O..~Te~..Date Of Permit.~. ~ ~.2~ ..... Applicant.~.~..A-/.~../.~-~.~¥~--~. ..... Health Dept. Approval ........................... Underwriters Approval ..................... Planning Board Approval ........................ / Request for: Temporary Certificate ........... Final Certicate .......... .~... BLDG. DEPT. ~ain Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765 -1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD CERTIFICATION Building Permit No. ~~ Owner: /~ ~ ~F;/1 ~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers SignatUre) Swor~before me ~s~ ~day of ~-~ , 19 ~ N~ry Public, ~~ fh County ~RE ~ ~ ~ ~bl~ ~ ~ N~ York ~l~J~ in S~olk Cou~ ~ ~m~ion ~p~ D~, 8, ~ ~ ~ ~ BLDG DEPT. TOWN OF $OUTHOL~ PLUM~ER CF.R ON LEAD C©~VTET',,"? SOLDER US~D //V [4¢~;FE'R SUPPLY SYSTEM ROBINS CARPENTRY. P.O. Box 678 Greenport, NY 119~ ' ~16-477-1708 -- BOARD OF HEALTH ............... ~] TOWN OF SOUTtlOLD SURVEY ........................ BUILDING DEPAR~NT CIIECK ......................... T0~ HALL SEPTIC FO~ ................... SOUTHOLD, N.Y. I]971 TEL: 765- 1802 NOTIFY: ~~LO ~ c~ .................. e~t ~ ................... ~-.~.. ~. ~:7~ .......... m ~w~. ~/c .................................... ~~ ~; ~..~t~. - A~~)ING PE~IT INSTRUCTIONS a. 'fids a~li~ti~ ~t ~ ~letely fill~ in by t~iter or in i~ a~ ~itt~ ~o ~ ~]ildi~ Ins~tor 3 ~s of pl~, ~a~e plo~ plan co ~ale. F~ ~i~ to ~le. b. Plot pl~ ~i~ l~tion of lot ~ of ~ildi~s ~ ~s, ~lati~)ip to ~joini~ pr~i~s or ~)lic s[r~ts or areas, ~ givi~ a ~cail~ ~ripti~ of last of pm~rty ~mt ~ dr~ ~ fl~ dia~ ~id~ is ~rt of rids a~li~i~. c. ~ ~ ~r~ ~ ~fis a~lica~i~ ~ ~ ~ ~ ~fore isle of ~ildi~ Pemit. d. ~ at~,~al of fids a~licati~, tim ~ildi~ Ins~ctor will i~ a ~ildi~ Pe~ic to the ~licanc. ~mi~ ~11 ~.~pt m ~ ~s ~ail~le for ia~[i~ th~mC ~ m~. e. ~ ~ildi~ ~11 ~ ~i~ or ~ in ~le or in ~r~ for ~ ~ ~a[~r ~il a ~r[i[ica[e ~I~ IS ~' H ~o ~ ~ildi~ ~rmut for ~ is~ of a ~ildi~ Pe~t ~r~[ ~o [he ~ildi~ ~ ~i~ of ~ T~ o[ ~ld, ~f[olk ~, ~ Yo~, ~ other a~li~le ~s, ~i~es or ~llati~, for t~ ~t~i~ of ~ildi~, ~i~i~s or alterables, or for ~1 ~ ~lltion, ~ he, in ~scri~. ~ a~lic~ ~s to ~ly ~ all a~li~ble I~, o~i~es, ~ildi~ ~, ~i~ re~la~i~s, ~ Eo ~ic ~ri~ i~tors ~ ~s ~ ia ~ildi~ for ~e~ (~ili~ ~as o[ ~lic~O State ~t~eti~er applicant ' essee, agent, architect, eagineer, general contractor, electrician, pluuber or (,as on tim tax roll or latest deed) If applicant is a corporation, slgua~re of duly authorized officer. (Naue and title o[ corporate officer) l~ilders License No .......................... Plutl~rs License Ro .......................... Electricians License No ...................... Other Trada's License No ..................... I. l~cation of la~l on whicl~ proposed ~ork will be ck~ .............................................................. .... 67.x ................................................. llot~e Nt~ber Street ' llantet Cam~y Tax Nap NO. 1000 Section .... ~..~. ........ B]eck .... ..~. ......... Lot ...4~ ......... &ubdivision ...................................... Filed Map No ................ LOt ............... (~n~) State existing use and occupancy of premises and intended use amd occupancy of trcoposed construction: a. F isting oc .. .......................... b. In,~xied ~se and occupanc~ ...";1 ......... ~'~...~-~t'~].~-.~. o.~.~.~T~.~' '' II. 14. 15. If garage, ~l~r of ~r8 ...................................... Diu~nsi~ of entire ~ ust~ti~: ~a~t ................ kar ............... ~pth .............. ~ or ~ district in ~idt pr~i~s a~ si~t~ ............................................................. ~ill lot ~ ~r~ ...~ .......... ~ill ~ss fill ~ r~ fr~ ~i~s: ~ of A~it~t .................................... ~ress .............................. ~ ~ .......... ~ of O~tr~tor ................................... ~ress ............................... ~ ~ .......... PI.OT D I AGRAt4 locate clearly and distinctly all buildings, ~t~ettmr existing or pro~, ~ i~icate all ~t-l~ di~nsi~s pr~rty li~s. gi~ sC~t ~ bl~k ~mr or ~scripti~ ~co~ix~ to ~, ~ ~ strut ~s ~1 i~lieaCe ~tl~r interior or ~t' lot. SS ......... .~.F...~/.~...~. ~.~.~'. ...................... ~,~; a,,~y ~,,, ,~,~ ~,~ ~ u,~c ~ i~ u~ ~,~,~ (~ of h~ivid~l signing c~tracC) ~e r~, ,~ i~ tn~ ...... ~~. ............................................................................... (C~LracCor, ~ent, cor~rate afflcer~ eCe.) of m~id ~r or ~rs, a~l is ~dy ~t.hor~ Co i~rfom o~ h~e l~rEo~ the ~id ~tk m~l to ~ke atxl file thi~ a[q~llcati~; LhaL ~[ ~L~t~nLa c~tai~ in Ih[~ ~l[cati~ are tn~ Co the tmsL off hi~ k~]~e m~ I~lief~ a~l ~ to t~fore ~ this HELENE O. HORNE Not,.ry Public, State of New York Ne. 4.951 Qualified in Suffolk County Commission Expires May 2Z, 19.~ ,,~,