HomeMy WebLinkAbout23678-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-25139 Date JULY 18, 1997
THIS CERTIFIES that the building DWELLING
Location of Property 1475 REYDON DRIVE SOUTHOLD, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 80 Block 2 Lot 15.2
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 27, 1996 pursuant to which
Building Permit No. 23678—Z dated SEPTEMBER 12, 1996
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 DEMOLISH EXISTING DWELLING & REPLACE WITH NEW ONE FAMILY
DWELLING AS APPLIED FOR.
The certificate is issued to JOHN & WILMA MEEHAN
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-424419 — JULY 1, 1997
PLUMBERS CERTIFICATION DATED JUNE 13, 1997—HENRY P. SMITH PLUMB.&HEAT.
r
Build' g Inspect
Rev. 1/81
FORM NO. f
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)
N° 23678 Z Date ........ ........ .........�.......................
Permission is hereby grant to:
............ .. .'. ....... ...................................
... . ... . ... .... ... .',1f. �.,�.,.....//.lel..............;
to . ............ ..A": ..... ....... ...................+ .,:�lr� a .� `Lr .��:^�•'•
` !.e.o, .
................. .,, a...�/ `..... `. . .-..... .........................
atpremises located at ......................... ...,x... . ....... ....... . ..... ....��............................................
............................................................. . . . ....f. ................................................................
.................................................................................................................................................................
County Tax Map No. 1000 Section ...........Q.. ..... Block .......e�:........ Lot No. ..r:S .y.......pursuant to application dated .......
... . 7.................. 19..1.q
and approved by the
Building In�ector.
0.40~ 1 rho n
Fee $..... � ..
............ ..�1......,..... ....
... . .......... .. ...................
Building Inspector
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. 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.
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
'-'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.
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 Buildina - $100.00
3. Copy of Certificate of Occupancy - .25c,
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00,, Commercial $15.00
/ Date . .JLI:�/ ,�� ,�,�9Q7. . . . . . . . . . . . . . . . . . . . .
New Construction. . .L. . . . . . . .. Old Or Pre-existing Builddinng. . ./. . . . . . . . . . .
Location of Property. . .1�4 .7r. . . . . . .. . �/,Qd!1�.:�ll� :. . . . . . . . . . . . . . So 46
. . . . . . . . . . .
House No. // �-^ Street �,- / Hamlet
Onwer or Owners of Property..A�-4,� -4mvA .V�3 .�YL F �t !. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. . . . . . . . .. . . ..B1ock. .4. . . . . . . . . . .Lot.??g. .)31;? . . . . . . . . . . .
Subdivision.e- 4 ,YM!q:S/`.�.:f1t6. . . . . . . . . . . . . . . . . .Filed Lap. . . . . . . . . . . .Lot. .�. . 3Z-. . . . . . . . . .
Permit Noc.24W(P.�. . . . .Date Of PermitjeW/-�j/f . . .Applicant. �.c/C. !t�' . . . . . . . . .
Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. .L' . . .
Fee Submitted: $. ... . . . . . . . . . . . . . . . . . . . . . . .
.//.9.91
�3 X61 APPLICA.APPLICANT�-
Town Hall, 53095 Main Road ;. Fax (516) 765-1823
P. O, Box 1179 ✓p � � Telephone (516) 765-1802
Southold, New York 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C E R T I F I C A T I O N
DATE: June 13 , 1997
Building Permit No. 23678
Owner: William Meehan
(please print)
Plumber: Henry P. Smith Plumbing and Heating, Inc.
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of l% lead.
i
(P1 ers Signature)
Sworn to before me this ° � �0i-' BERNADETTE L.TAPLIN
A b NOTARY PUBLIC OW893
day of A At 1 19 qjStete of New York
Residing in Su#olk County
Commission Expires Sept 30,ILV
Notary Public, �(� � County
0
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 2
10@1@71 BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NY 10038
Date JULY 01 ,1997 Application No.on file 1241,7696/96 N 424415
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
WILMA MEEHAN, 1475 REYDON DRIVE, SOUTHOLD, N.Y.
�
ryL ATTIC/OUT
in the following locotio Basement L`7 IAt Fl. ❑ 2nd F1. Section Block Lot
was examined on '1997 and found to be in compliance with the National Electrical Code.
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS REIT UNIT HEATERS MULTI-OUTLET DIMMERS
AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. N ► SYSTEMS AMT. WATTS
NO.OF FLET
SERVICE DISCONNECT NO.OF S E R V I C E
AML AMP. TYPE - METER I f'2W 1 jr 3W 3 i'3W 3 0 IW NO.OF CC.COND. A.W.G. HO.OF HIAEG A.W.G. NO.OF NEUTRALS A.W.G.
EQUIP• PER A OF CC.GOND. OF HI-LEG OF NEUTRAL
OTHER APPARATUS:
Ij 13b
G & S CONTRACTOR LIC.#578-E L `L,�LBOX 215 ANN
SOUTHOLD, NY, 11571 GENERAL MANAGER
Per
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
DOPY FOR 'BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1001071 BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NY 10038
Date JULY 01,1997 Application No.on file 12437696/96 N 424419
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
o
WILMA MEEHAN, 1475 RE'YDON DRIVE, SOUTHOLD, N.Y.
in thefollowinglocation; ® Basement ® lst Fl. ❑ 2nd Fl. ATTIC/OUT Section Block Lot
was examined on `UNE 25,199 J and found to be in compliance with the National Electrical Code.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS ECE►TACLES SWITCHES INCANDESCENT FLUORESCENT I OTHER AMT, K.W. AMT. K.W. AMT. K.W. AMT. K.W. ' AMT. H.P.
46 41 41 42 1 4 1 1 1.2 3 F
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'►T TIME CLOCKS I SELL UNIT HEATERS MULTI-OUTLET DIMMERS
AMT. K.W. Olt H.P. GAS H.P. AMT. NO, A.W.G. AMT. AMP. AMT. I AMPS. TRANS. AMT. H.►. SYSTEMS AMT. WATTS
NO.OF FEET
3 F 2 - 1 2 600
SERVICE DISCONNECT NO.OF S E R V I C E
AMT. AMP. TYPE METER
I A 7W 1/3W 3 d 3W 3,94W NO.OF CC.COND. A.W.G. NO.OF HIAEG A.W.G. NO.OF NEUTRALS A.W.G.
Raw. PER/ OF CC.COND. OF HIAEG OF NEUTRAL
1 200 CB 1 X 1 4/0 1 4/0
OTHER APPARATUS:
PADDLE FANS-5
WELL PUMP-1
AIR CONDITIONER 3 TON-1
MOTORS:5--F H.P. ,1--F H.P. ,1-F H.P. ,1-3 H.P.
PANELBOARDS:1-1 CIR. 60
G.F.C.I:-7
SMOKE DETECTOR:-4 r
<<< Continued on Page 2 >>> E l
GENERAL MANAGER
iD Per
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
ZRAMING [ ] FINAL
IREPLACE 8 CHIMNEY
REMARKS:
DATE q7 INSPECTOR
X65.1802
BUILDING DEPT.
PECTION
[ ] UNDATION IST [ ] ROUGH PLBG.
[ FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLAC & CHIMNEY
REMARKS:
'DATE D INSPECTOR
78
suauINa oar.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] 1 CATION
[ ] FRAMING [ FINAL
[ j FIREPLACE & CHIMNEY
REMARKS: ���� �• v
DATE �110 // 7 INSPECTOR
7GS-1802
BUILDING DEPT.
SPECTION
[ FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: G�-i�
J,
"OOK
DATE O� INSPECTOR
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] OUGN PLBG.
[ ] FOUNDATION 2ND [INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
.i �r/J,ch �
r
42k e&
DATE 3 S 1� INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ Vf ROUGH PLBG.
[ ] F NDATION 2ND [ j INSULATION
[ FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: 9,e�yw �e e�)k
DATE INSPECTOR 2X4
I'11i1,D SIN;;I,L,""I'IOIlItI'1,0It'1, 1)ATE. COMM "Wi'i
FOI INDAT I ON ( I ST)
FOUNDATION (2
II x�
111.11M111 NC II
INSULATION I'F.lt N. Y .
STATE ENFIRCY
COI)1'' I Q
II
,
II
F1 NAI, I JI
L---- --__. _------------ -- -_----------
ADDITIONAL
-ADDITIONAL C OMM1WFS:
044- -
0
d
BOARD OF 11EA1.Tn . . . . . . . . . . . . . . .
r' ! S FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . .
TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
BUILDING DEPARTMENT '11ECR
z 7 TOWN UALi. SEPTIC FORM . . . . . . . . . . . . . . . . . . .
SOUTIIOLD, N.Y- 11971
TEL: 765-1802 NOTIFY:
C:A1.1. . 7&5-5.30.9
Exam;recl.. �. Z 19.. MA11, TO: /47M J*VAIM.Nkr-
Approved.. . ..l� 19.� Permit No. ..� ....L
Di sapprov"I a/c .................................. ....
................................................. ---
ilding Inspector)
APPI. ATION FOR BUILDiNG PERMIT 99 pp
DateA��$�4
L Ns7'RucrloNs
a. 'Ibis application roust be cottpletely filled in by typearriter or in ink and strltmitted to the iltrilding Inspector with
3 setts of plans, accurate plot plan to scale. Fee according to schedule.
it. Plot plan Allowing location of lot- and of Wildings on premises, relationship to adjoining premises or lxnblic
streets or areas, and giving a detailed description of layout: of property mast be drnan on the diagr.w wideli is pari of
this application.
c_ The work covered by this application Play not be comnenced before issuance of Building Permit.
d. Ippon approval of this application, lite Njildinp, Inspector will issue a Bcrilding Permit to the applicant. Such
permit shall be kept. on Ute premises available for inspection thratghout the work.
e. No Wilding shall be occupied or used in whole or in part: for any purpose whatever until a Certificate of
Occupancy sltal.l have been granted by t:1re Ihrilding Inspector,
A1.111:1(ATION IS HEREBY MA JE to tie i><rilding Department for the issuance of a Building Permit lxrrsuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regcrlaticxrs, for the construction of Ixrildings, additions or alterations, or for removal or demolition, as herein
described. 'Ibe applicant agrees to comply with all. applicable laws, 'ordinances, Wilding code, lxxrsing code, and
relnilaLicnis, and to admit anaU-torized inspectors on premises and in lnrildin necessary ins tins.
(Sigrkrlure of licanl, or name, if a corporation)
.................
(Flailing address of applicant)
Stale wi►ether applicant is owner, lessee, agent, architect, engineer, general comLracLor, electrician, piutier or- Wilder.
........................................................................................................
Natte o f o;,aw r of premises ..L'YliC 1g�!1/.Q..�,/Q ..Mi /4�1/...................................................
(as (n late tax roll or latest deed)
If applicant is a corporation, signalure of duly aut.porized officer.
.........................................................
(N::rtte and title of corporate officer)
Wilde_rs License No. .�3�.Q,71..HI-----
Plullbers License No. .........................
Electricians License No. .....................
Other Trade's License No. ....................
I. lax-atioxn of larxl on which proposed work will. be done..............................................................
...................& yj).o.AJ.D�,... ate. ,e, ......SOc!r n4.0 .....................
Ikrtise Number Street �✓' MA let_
F r
County Wax Mil No. 1OOnSectio n ..... ..... Bpox-k ...5........_..
Fxtlxlivision ../?zy_Qor,)..sHo.e.kEM........... Filed Map No. ............... Jot Aq.-: .2._....
(t1.-ane)
2. Stage existing use and occlrpkarxy of premises and intended use//aril cx7culkjtxy of prrrposed eonstrueLion:
a. i:x i sC i ng use and occarp>trrx_y ...�..� /L ...................................
b. intended use arxl occuparrwy ..�..��I?/L//C/..�4V.AtUd 4jg...........................................
I Rome of %.A)iik (check %Addk alI)licable): 41j Milding, . . . .. . .. . . Aikii L i0i I . .. . . . .. . . Alteration . . . ... .. ..
. .. . . . . . W-lix Yva I .......... . . . DolVol i t ion 01 her U)l k . . . . . . .. . . . . .... . ... . . . . ... . . ... . .
De f;(-.r i 1)1:icy))
4. Ent i1flated 0)fit .. . ..................... . fee. ... .... ............ ..... ......... ... .... ......
(to lx> paid off H I ing this applicill:i(X))
5. 1 iol", IRAlber of: AAA I ill; 11114t; . .. .1. . ... .. tiledwr of &,el I hip, tud(s oil each I fi(x)r .. ......... .. ...
It: gatilge, 11116er of cars . ....... .. ... . . . . .... . ... ... ... ... . .. .
6 If Ixudiv--sii, ctimieucial or mixed ocnipawy, specify oahile fjIXI extent. of each (.ype of one.......... ....... . . . . .
0'
7.
Di11it-911.9 i0118 Of eXiMl illg fATIVAIllefi, if any: 1?I-0fil .. ..22 . . ..... Rear .Z.2_ .. ..... ... ..... . - ... . ... .... .
� I .1.Ik!iI�IL 4 ......... . . e . . ... .. . ...... .. . .
Dillvosiotis of style strticttire with all.erat.ioos or a(klit-ions: Front . .. . . . . . .. . .. .. Rear .. . ... . .. ......
lk!pt 11 .... .. .. ....... . .... lit!i&( .. . ... . ... ... . . .. .. . Raiber of Stories; ...............
It. Dillensiolls of: entire lx:w c.ollstitt(A NMI: Flool . ... .. ... ... .... Real. . . . . . . . ....... . Depth I . . . . . .... .....
lktijlt(: ... . . . ..... . ............ . UstlVer of Stories .. . .. .... ........ . ...
9. w,.e o 1: 1 of : F lo(ll .. . ...... It'-fil .. . .IR.40. . ... . . .... Depth /00.41......... .
10. Mile of lolchase . ... ..... ........ ... . Halt! of FoIller (Mel. ..... .... .. ... .... . .. ..... ........ ..... .
11. 7.(XW-- or 11.1;e (lifil I iC[ ill lA)idl I)t011iSeS are sitililled ... . . . ..... . . .. .... ..... ...... ......... . ........ .. .... . .. . . . ..
12. lkwn IlrolVoned coilsilwi.ion violate ally vAntillf" 111w, oldiomwe or uegulal.ion: ... . ....................
I1. Will lot be iegrimled .. ... .... .. .... ..... Will excess fill be romwed frofn prallises: Yr.s U)
Ill. t1flive.-I of Ownt-r- of plollit;es . .. ............. ........... tu it I r es fj . ...... ..... . ..... ..... ....... I'llont! NO. .. . ... ... . ..
Haw of Ardwitef-L P. .......... ... ... .... ... . .. .. . .. AtItIrefis . . . .. ... . .... .. .. .... ......... lit-w! No. . ..... . .. .. .
N"Ife of: 0XII ract or .... ...4Go.,6.rvv-c ........ .. .... Nkife-,is .. .... .. ................ ....... . .. .. ... ... . .
15 Is (his I)TX)IXlrl.y within NX) feet: of a Lidat w0antl? * YI'-'; .. ........ N) ... ...... .
All? Yl--S, R11111)[1) 'IXAM '11AKIMS HUNIT MAY IV?, IUAIII(lq).
111.01' DIAGRAM
Iocme clearly anil dint:hwuly all Intildiops, %Aiellier exisl:ijlg or I)r0I)0Sed, Illkl inilicate all set-back ditivotflow,
1-1(111 property I iwas. Give. sLy-eet- aril block ividwr or deser il)L ioti according Lo deed, antl diow street runes mul intlicate
lAwther interior or corlwr lot.
Rk, MrD AS ED
NOT
U
"'j r
B.P 9
/A4262
ere SUILDNG 0EPA N T AT
0 F
ti 15 1802 9 ANI TO 4 FOR THE
��'UOVV17w-; f)"'IsPECTIONS:
0 ("o! f0 REQUIRED
R� UGH i-P,"'AiflNG PLUMBING
D,
3
<5�-A IN-SULA110N
to r--
- 00 4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION St ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
!NMF. (M-' 11114 Y(ft, 1;';
0XIMY (X'. .. .... . . . ... . . .. .......
. . . ... . ... . . . .. . . . ... . . . . . .Iwillg duly d(!IX)nef' )Iwl says Ilial he if; the ;11)1)1 ic'11)1
(MBIX! of ilmlividVial signilig cont lact.
Ahm! wil(vd, (l
lit! i!; lilt! .. .. .I.E. . I ... . . .. .. . ./&'0 410—
.. . .... . . . . .. . .. .. . . . . . . . .. ....... ... . .. ... ... . . .. ........... . . ......... .. .. . .
(0111t factor, al"evit , corIx)ra(e officer, el c-)
of, .:lid (moor or (MIX!I t" .11KI it; duly allillog im-41 to lx!r fomi of have lxerforuxed (lie said ;.x)ii( inxi to nuke afxl file I hi
-11110 coill ail)(41 in this .11)1)1 ical i(lo are I'llie to the 1)(!I;l of his Itot)wledi"o nod NO i(![ ;11XI
Ilm[ (he VA)11( will Iw the Iwnlwl wA Iol0k in the applicill.ioll filed thel(mil.h.
.")fit to Iwrole nire thin
atoflol
..... .
. .. . .. .. day of .. ... . ..
n)lary INIblic
JOYCE M.WILKINS
Notary Public,State of Now York
No.4952246,Suffolk CourML
Term Expires June 12,1
h BOARD (1P iII!.A AIA
,.
t ° FORM NO. 1 3 SINS OF PIANS
TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
BUIiDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . .
TOWN IIAi.I. SEPTIC FORM . . . . . . . . . . . . . . . . . . .
SOUT1101.1), N.Y. 11971
TEL: 765- 1802 NOTIFY:
�j cnr.r, t
I:x�-rrlirx'(l. ....�y.-, 19.. MAI i. TO: A.029-0J . .
x
Approved 19/a Permit No. . ............ J`.%u't� IAI...................
Disapproved a/c .................................. ..S...t aan� 0.PS JA.V-Af7J.
...................................... Allklilding
Inspector)
AR BUILDiNG PERMIT //����
Date 4.4 V5701 . . . , 19
INSTRUCTIONS
a. "Ibis application moist Ile completely filled in by typxwriter or in ink aryl submitted to the Wilding Inspector with
3 sets of plans, accurate plot plan to scale. Fee according to schechtle.
b. Plot plan Allowing location of: lot and of Wildings on premises, relationship to adjoining premises or imblis
streets or areas, arxl giving a detailed description of layoxrt of property whist be draun on the diagram which is part of
this application.
c. The work covered by this application Przy not be comwnced before issuance of. Building Permit.
d. Upon approval of this application, the rluilding Inspector will issue a Iknilding Permit to Lite applicant. Such
,permit shall be kept on tl►e premises available for inspection througlxxit the work.
e. No Wilding shall toe occupied or used in whole or in part for any jurpose whatever until a Certificate of
Oro-ti><-xxy shall. have been granted by the ibrilding Inspector.
V
APPi:I(%1'I'IGN IS IIEIl HY tWJE to the Wilding Department for the issuance of. a Building Permit pursuant to the
Ikiilding Zone Ordinance of tl a Town of SmLlrold, Suffolk Canty, New York, aryl other applicable laws, Ordinances or
Regulations, for the construction of Wildings, ackl.itions or alterations, or for removal or dermlition, as herein
described. The applicant agrees to comply with all. applicable laws, ordinances, Wilding code, Ixxnsing code, and
regulations, and to admit authorized inspectors on premises arxl in lxtilcl' , r pec . ry inspections.
(Siff_ a of applicant, or naw, if a corporation)
10
(Mail ing a(klress of app]icant)
State ietlrer��pap�p�licant is owner, lessee, agent, architect, engineer, p,eneral caltractor, electrician, pluder or Imilcler.
... ,U.l�t(J .....................................................................................................
Name of owner of premises .Lia!/l� P¢ �s.1.-ddA7 v.-/VaAV................................................
(as on tax- tax roll or latest (teed)
if applicant is a corporation, sijgmutre of duly auttrorized officer.
.........................................................
(N:me aril tittle of corporate officer)
Ituilders license No. �3/.� 1 ../Z .......
Plcrdners License No. .........................
Electricians License No. .....................
Other 'rrxle's i..icense No. ....................
I. iocaticn of larx] or which proposed work will be ckxne..............................................................
.....................eC:�061J.,Q,,40... .�,lis , .c.4oumb/-' J.................. .
Iknse Nrn#ger Street et
Ccxtnty Tn ax Map No. RM Sectio ....�...... itIo ck ..V ........... i of
S(ilxlivision I�R ............... Filed Kip No. .............. int
2. State existing use aril occoparx:y o(1f pre/m'is'ers atxl interxk(lnuse awl occ-uparxy of proposed catatruction:
a. Existing use and occupancy ..V,/elrb�'��✓.G�/..rCI.W�(2C!/k�► ......................................
b. intemk-A use aixl occupancy ...v/ }yf/{ .................................................................
). t lline of tn,(k 0:11(! k %A1i(J► al411i(able): fk'_w Ik,ilding .>\.. . . AckliIion . . . . . .... . Alteration F -
ILtfu1 i r .. .. .... .... lldrrnral . ...... . .. ... DenioI i L ion ..... .. .... . 0(her lkn k .... . . ..... . .......... . . ... .. ... . .
r� (1)esc:ri pt.iof1)
4. 1'.af in,1l((1 lost `.X. d00.. .... ....... fec .. . .... ..... ....... . .............. ... .... ......
(to IX- paid Oft filing t.his appl icaL'(on)
'i. If AAMing, iwoil,er of (kA-fling units ...... )2<ulxr of: Ax!lIfill, units ca, each floor .... ........ . . .
If: garage, ►wrrdrer of Cara . .. .... ... . ... . .... .. . . .. . . . . . . .. . . . . .
h. If Ixrsiri:ss, ccunw-rcial or alim(l cx:c-opao:y, sl,ecify nahne and extent. of eadi type of use........ . ... .. ... .. ...
1. Uiwens ions of: exist ing st r►►c:tures, i f any: FI oot .. .. k2n Z- . ._ .._ Rear ... . . ..... . Ik.Plb ..S.Z� ... . .. .. ...
i
Ik:tlllrl. ..�5... .. .... . . ....... . RXINn of Slories .. . /. ... .. . ... ... . . . .
Dimensions of: saw- st.niaure Willi alleraLi(x►s or a(Mitions: Front. . ... . .. . .. . . . .. Rear .. .... . .. ......
Il(tptII .... .. ......... ..... Ilei1)it .. ...._ ..... . . . .. .. . Nlrtix r of Stories ... .. .. ... .... .
11. Dinensions oI: entire 1x:w cot is(itw:I iow Frcxlt .67/..... . .... Itear .(P./../. . ...... . lleptlr 3J....... ..
lk-igltl. .vC ....... ..........//.... IAmd)er of 8(or ies . .... .... . ... . . . .
9. Size of fol : Frcw,l 1.204(6. ....... .... (Lear .. .A26... .. .. . .... I)ept1► ..�st��..7•/. ...
I0. Mile of 11,rcl,ase ... ..... . ... .... ... . . M xw of Form.(- 0,)I ar .. . .. .... . . ..... ... . .... ... . ...... ..... .
11. %.Xxw or u;;(- dist(icl. in %Akicl► premises are silualed ... ... . .. .. .. ...... ... .. ..``.//... .. .. .. ... ........... ... .. .. . . . . .
i: (xt
12. Ikws proliosed ctxlslrtLiviolate ancxw:
y zting law, ordina► e or regulatnN
io
: . p.. ............ .....
I'). Will lot Ix. regrimkd ........... ......... Will excess fill be re1rN I Iran pre ices. YES 1JO
M. tJ:w(res of Ot,rrer of. I a Ii- s !!4kalf f,,/ W. Akwft) . ... luklress . Xrld11.✓.tl./�./ .... ............. 11)or>L No. .. .... . .. . ..
Mae of ArcIdtecL ..��rilk+r�Wkt/g .. ... ... ..... Acklrs �'JYJ/.A.4i
es .I ..z �^rT, llixx1 140. wMQ,YO.D. .
Nsnw! of: ('cxil raclor , i .VLte�f2V�i l s.. ...... luklress ,/;D,.� J..eL?/ . ... .... .......11,or►e No.17,Z '5-,?Qf4.
Pi. Is 111is prolx!rt:y within AM feet: of it tidal weLlciwl? * YRS .... .. .. . . ND .. . .......
*IF YES, RXIIIIND 'ICAM 'IlAMITS 19'sl(t•IT NAY HE Itls(�111[(F.U.
PLOT DIAGRAM •
Icx:ale clearly arrcl disriw-tly all Imildirtgs, Wltetl)er existing or profw)sed, aril irxlicate all set-Imck dimensions
fr(n, property lines. Give sLreeL all(] block nmi)er or description according (o deed, aryl show street rumtes alxl htilical:e
%Awtbev interior or corner loL.
1
SfA•Il,. OF M14 Y(ft,
S'3
(IIIIIIIY (ll* . ........II. . . .. . . .. .... ...
+� ..�..l.Ql/Ajs/ . . . . . . .. .. . . . . . .. . . . . . .Iwinl, (filly taAun, dc:lx)se;; alwl says LbaC be is Ibe nppl Ic:,nl
(N:•tx; of irwlividual signing conlract.)
r,lxrve milled, /►,�]/
lk: is tOw . ... ..X5ex G/-,,O z... ... . ..... .. .... . ... . . ...... .. . .. . .. ...... . . .. ...... . ... ..................
Mmtraclur, ngeot, corlx,ra(e officer, etc.)
Of :::►id 0%41wer or owtwrs, mwl is (filly aulborize(I to I)erfonn or Irave fx:rfornwed the said murk atxl Lo make aril file 11►ia
:grill icnJill; Ibn( :111 stalemen(a conlai(w:(1 in 11(is nppl ical ion are t.rt,e to file lwnt of his luw,Wledge arwl Iw?I ief; :awl
11111 (he- WOlk Will Ix� I)QrfontwHl in Ilie nclrnw!r set: forth in Ibe applicniAm filed 11►eriuvill►.
`")In to Ix (ore raw! Ibis
. . . . .t .?. .. . .. . . .( •► or .... .. ' ... 19.. . . . .
(!9igna(ure of )ill icnol.)
JOYCE M.WILKINS
Notary Public,State of New YG*
No.4952246,Suffolk
.
Term Expires June 12.
°��gpFFO��coG
Town Hall, 53095 Main Road y Z Fax(516)765-1823
P. 0. Box 1179 �y� • Telephone(516)765-1802
Southold, New York 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
June 27, 1997
Peter Johnstone
P.O. Box 91
Southold, N.Y. 11971
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons :
✓ XX An application for Certificate of Occupancy is
not on file. (Enclosed)
XX No Underwriters Certificate on file.
X The check is (not on file. ) ;25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984 ) .
BUILDING PERMIT # 23678-Z (MEEHAN)
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
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NgLAMP
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,Yo,1u�v�yoe
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�ou►r�c►.v!�eClli�l�l.0 .�IJFFdC.rC4�c/NTr Al
GREENPORT PLUMBING & HEATING
affiliated with
COUNTRY CESSPOOL & DRAIN SERVICE
168 Central Avenue
Greenport, New York 11944
(516) 477-0540
Meehan
1475 Raydon Shores
Southold , N.Y.
L
4-6-93 STATEMENT
Proposal
Install one 900 gallon grease trap
Install one 8x8 overflow leaching pool
Trench for all piping and install new 4 " sewer
pipe from house to grease trap
Fill in old cesspool w/dirt ( if accesible by machine )
Total price : 1850.00
Deposit required: - 925..00. ibS�
Balance owed: 925 .00
* Balance payable in full upon completion of job .
�o5�FF01K��Gy
1
JUDITH T. TERRY Town Hall. 53095 Main Road
TOWN CLERK 1T P.O. Box 1 179
REGISTRAR OF VITAL STATISTICS Ln Southold, New York 11971
MARRIAGE OFFICERy0`• �' Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER �'�lQ/ Telephone (516) 765-1801
FREEDOM OF INFORMATION OFFICER 11
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 986 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : COUNTRY CESSPOOL
Address 1 : 168 CENTRAL AVENUE
City St Zip GREENPORT NY 11944
Descripton of Proposed Construction or Alteration
INSTALL NEW CESSPOOL SYSTEM TO EXISTING DWELLING.
APPROVED AS SUBMITTED. EXCAVTION INSPECTION REQUIRED. CALL 765-1802
FOR INSPECTION OF NEW WORK. REMOVE EXISTING POOL CONSTRUCTION
MATERIAL AND TAKE TO LANDFILL BEFORE FILLING IN.
Name Of Owner MEEHAN, WILMA
------------------------------
Mailing Address 1 131 DOBORS AVENUE
------------------------------
------ -----------------------
City St Zip SEA CLIFF NY 11579
-------------------- -- ----------
Property Address 1 1475 REYDON SHORES
------------------------------
- ----------------------------
City St Zip SOUTHOLD NY 11971
-------------------- -- ----------
Tax Map No. section 80.00 block 2 lot 15.002
Cross Street LAKE DRIVE
------------------------------
Building Permit Number Cross Reference:
-- ----------------------- ----
Issue Date: 4/27/93 Judith T. Terry
------ Southold Town Clerk
(TOWN SEAL)
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Tn UT CERTIFUTE
0OF10 AP W AS.NOTE
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c1cDATE: �l B.
UPANCY
FEE: RV6
7 / r NOTIFY BUILDING DE MENT
765-1802 J AM 70 4 THE
FOLLOWING INSPECTIONS: '
ONL �. FOUDATION - TwoRUMBERCERT/FICAT/ON Eau R
ED
FOR POURED CONCRETE COTENTBEFQRE2.. ROUGH - FRAMING & PLUMBING
,
CERTIFICATE OF OCCUPANCY 4. I NA��o CO STRUGTl0N M
1 S 6 SOLDER USED IN WA TER BE COMPLETE FOR C.O. MUST
R ALL CONSTRUCTION SHALL
SUPPLY SYSTEI(!I.CANNOT> THE- REQUIREMENTS OF MEET,
GEED 2/1Q of 1% THE N.Y.
. �.W+
o STATE CONSTRUCTION 8e ENERGY
LEAD. ... _ CODE S. NOT : RESPONSIBLE FOR
DESIGN OR CONSTRUCTMO _ -
. I N
ERRORS _
PLUMBING
ALL PLUMBING WIASTE U Copper tubing is usW.
f &WATER LINES NEED for Water distributing
TESTING BEFORE COVERING, iry8ter11; pip
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