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Home My WebLink About23849-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25116 Date JULY 7, 1997 THIS CERTIFIES that the buildin~ Location of Property. 380 PLATT RD. House No. County Tax Map No. 1000 Section 18 Subdivision ADDITION ORIENT, N.Y. Block 5 Filed Map No. Street Hamlet Lot 20 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 25, 1996 pursuant to which Building Permit No. 23849-Z dated DE~EMBHR 9, 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 ADDITION TO EXISTING ONE F~ILY DWELLING AS APPLIED FOR. The certificate is issued to ANNE S. HOPKINS (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N-423759 - JIP~E 25, PLUMBERS CERTIFICATION DATED 1997 JULY 28, 1997- KING PL%~4BING Rev. 1/81 / Inspector FOR,~ NO. It TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. N? BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ~s~z ~o,. .......... ~-.....~ ................... . ,,.~ Permission is hereby g.ranted..t,o: . _ / ,~ ~ , . ~- ..... _~...~.....~.~.(~,~....,._~,~, .......... ~.~.....Z..~..../..~ ........................ .......... ~~.....~...ff..~ ...................... ........................................ at pr ' s o~atecl of ............................ .~.~...., ..~.,./,~.....~; ............................................. County Tax Map No. I000 Section .......... ~..,,~,, ..... Block ~'~r~'~ Lot No. ~/_2 pursuant to application dated ~ '~'~'- 19..~.~..., and approved by the Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ~PPLICATION 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 Ppre-existing" land uses: 1. Accurate sqrvey 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. ~. 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 Buildinm - $100.00 3. Copy of Certificate of Occupancy - $20~00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ~..~ ~....~.~ ~ .... New Construction....~. ...... Old Or Pre-existing Building ................. / z Location of Property .... ,~.j~..o. ......................... ... ....x ..... House No. Street Hamlet Onwer or Owners of Property ........................................................... County Tax Map No 1000, Section... /..~. ..... Block .... ~ ........ Lot .... ~-. c~ Subdivision Filed Map Lot .. .. · Permit No..~. ~ .~. ~. Z .~ .Date Of Permit..~.? .~. Health Dept. Approval .... .~//.z? ................ Underwriters Approval ......................... Planning Board Approval ./w./.z?. . Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ ....... .~-~-'~ ~ I;OUi~tt~^T tOl'l (2i'11)) Town Hall, 53095 Main Road P. O. 8ox 1179 Southolc~, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD CERTIFICATION Plumber: (please print) ( please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. / (Plumbers Signature) Sworn to before me this 2~J~ day of ~ UL7 , 19 q~ Notary Public, ~__.~'~'~::~,,~r... County Ken Str~ctun Jr** President MACDONALD WOODWORKING CORP. P.O. Box 145 Hog Porto Road Orient, New York 11957 (516) 323-2716 (51 {~) 323-1235-Fax TO: NAME: FIRM: M ESSAG E: TELEFAX COVER LETTER ~/~. //¥-..., DATE: / TOTAL NUMBER OF PAGES INCLUDING THIS COVER LETTER. ~-- Ken Strachan Jr., President MACDONALD WOODWORKING CORP. P.O. Box 145 Hog Pond Road Orient, New York 1195'7 f\ Z66LL ~tJOA MeN 'lueiJo peoM puod ~oH gt,~ xoI3 'O'd 'd~lO;) ~)NI)II~IO,*,&(IOO/~ I00.0 I00.0 [0o, 0 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST ~- ] ROUGH PLBG. /~Z ~ ~UNDATION 2ND [ ]INSULATION FRAMING FINAL 765-1802 BUILDIN( DEPT. [ ] FOUNDATION 1ST INSPECTION [ ]~ROUGH PLBG. [ ] FOUNDATION 2ND [ ~FRAMING [ ] INSULATION [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: [ ~GH PLBG. [ I//] INSULATION [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: [ ]ROUGH PLBG. [ ] INSULATION [~l~L INSPECTOR '~: .... '~ 'THE 'NEW"YORK BOARD OF FIRE UNDERWRITERS PA~E I].95~9 ' ' , BUREAU OF ECECTRICITY F 85 JOHN STREET, NEW YORK, NY 10038 O~t~ JU~ 25,1997 ~i~o~,o./~ ~41~897/97 N 42~759 THIS CE~IFIES THAT o~y the e~tric~ ~uipment ~ ~scd~ be~w a~ i~t~uc~ by t~ apphcant Mined on the a~ve ap~i~t;on numar m t~ prem~es of A.S. HOPKINS, PlaTT RO~, ORIENT, ~s examined on 18,1997 and found to be in compliance with the NaMonal Elect~c~ Code. FIXTURE' / ' )' ' I r ' FIXTURES~ ' RANGES IC~KINGDECKSl OVEN~ IDISHWASHERS EXHAUST FANS ~RVIG DI~ONNECT ~.OF OTHER APPARATUS: SPECI~ RECEPT~ ~-~P. G.F.E.I: ~3. . 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. JIH SAGE ELEC. INC. PO BOX 38 GR~ENPORT, NY, 11944-~38 CoPY FOR BUI~bING DEP~RTMENT.' THIS COPY OF ~ER~'IFICATE MUST NOT BE ALTERED IN ANY MANNER. i i '; '~', '( FORM NO. 1 TOWN OF SOUTHOLD ' ~ 5 ~ ...... BUILDING DEPARTMENT ,' ~ TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined.. .~....,19 9)~ .... Disapproved a/c ..................................... I~OARD OF HEALTIt ......... 3 SETS OF PLAI;S .......... SURVEY ................... CIIECK .................... SEPTIC FOR~I .............. CALL ..... ./.'rE. ......... INSTRUCTIONS ................. , 19. a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 erg 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 streets ~r.areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. c. The work covered by this application may not be cbmmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit hail 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 hall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bu/lding Permit pursuant to the .uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or '.egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. 'he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for necessary-inspections~ - : . _ ]T~f{fi'~'D ~tlt?l~t~ ....'~./Y.q .~.o. ~n¢.~. ~,...~.~. ??..~f..o~. ~ ~..~4. ?...~ o ~,~ -- ~t~fltUgt$ (Signature ofapplicant, or name, if a corporation) ~ o. /.q.~...q.~--..,.~.,ff..TT. ~o .~. (Mailing address of applicant) :tare whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · .................. /2. g./..~. ~'. ~../-:. ........................................ .~ ....................... lame of owner of premises . .~./Y.,q..~.....~:../'ti..o..~..,~..< ./g....~ ............................................ (as on the t~ roll or latest deed) ~ applicant is a corporation, signature of duly authorized officer. " (Name and title of corporate officer) · Builder's License No ..... /..?. ~...~.. ~...../'L./.... Plumber's License No ' Electrician s hcense No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. ...... ................. r W .& o House Number Street Hamlet County Tax Map No. 1000 Section ..... /~ Block 5' Lot.. ,2 c?.... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .,q. 7 /. .~..ff' & .~'..,q'.~ ~ ,- ~2 b. Intended use and occupancy 3. Nature of work (check which a,,-u~-~ · ,.r. r~.::.~._ ...... · ~.~..,..u~e/: L~ew .uu.ul.~ .......... /~.umtlon .......... Alteration .......... Repair .............. RemovaI ............ Demolition . .te-'A~.... Other Work ............... i (Description) 4. Estimated Cost ..... ? ................................ Fee ..................................... i (to be paid on filing this application) 5. If dwelling, number of dwelling uhits . ./ ............. Number of dwelling units on each floor If garage, number of cars ..... 6. ~ .e o..m~ r.c i d ~ cup ; c'i~y ure'a'nd t'o'f ~ t~;;'of' s'e'i ii .... ' . '..' .... · ures,I if a i .... 7 J~mens~ons et ex~stmg street ny: Front ........... Rear ..... Depth Height ............... Numbler of Stories . .77~ .o. .... ens ons of same structure w~th alterations or additions: Front ................. Rear ....... ' .......... Depth ..................... !. Height ................ Number of Stories ................ eti o .' ...... 8. Dimensions of entire new constm on: Front ~ ...... ?, , . · ......... Rear ............... Depth ../..%:.. Height ............... Number of Stones ..... .~..,~.~. ...... 9. Size of lot: Front .. ~'A' .~.... ~r.l-&%~f.~.. Rr~a¥ .~.~..,?..r' 10. Date of Purchase ~ ............. Depth ...................... ................. ' ......... Name of Former Owner 11. Zone or use district in ' " ' . · . winch prermses are s~tuated ..... ~'~c?'~' '~'~/Y.T./..~.+~ i i i i i i i i i i i i i i i i i i i. 12. Does proposed construction violat~ any zonin, law or'~: .......... ~ ~ 13. nm Jo[ De regraaea ~ .,. ' ...................... ~- · · · ........................ wm excess fill be removed from premises: Yes / No 14. Name of Owner of premises e[~.~'./Y .o.~.~'. t'.~. ~. .... Address . .~'.~. OF..r..,~ ,~ o,~,(C'?Phone No. Name of Architect . . · J iiiiiii ............... ................... Address ........... i Phone No .............. Name of Contractor ,er~: ~ p.q~..~.q! .~..~,. op~,,- ~,, .-~-~ ?,°. :4¥ .-r. * .'r-tc-~5..7.... Phone No... ~ z. ?...a...~ ?.~. ............ Address .. . .. I5. Is th±s property w±t:h±n 300 feet of a t:±dal wetland? *Yes ........ No...¢'77 .... ~]'f yes, Southold Town Trustees Perm±t: may be requ±red. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block m tuber or descriptioh according to deed, and show street names and indicate whether interior or comer lot. '- 2. ..x S , SUPPLy 8VSTEI 7 C U IVOT PLUMBING I ALL PLUMBING WA T i & WATER LINES NEED ~E~T i~ G 8Et-OLdE COV~RII~ G APPROVED AS IqOTED _ ' .... NOTII~ [It_IILOING OEPAi~I~'R~ d ~. ~ ~ ,.~:~ ~,, AM ~ 4 PM FOR THE If copper tubing is used for water distributing system; piping shall be I. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3, INSULATION 4. FINAL CONSTRUCTION MUST 818 COMPLETE FOR C.G. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR ~TATE OF NE'C/~RK t'~/xT// ,. :OUNTY OF.., ~x~.~j:;i~, .~.~'t~. ,*'~ .~ ~ DESIGN OR CONS~U~ON ERRORS ....... ~'~ ~'5/~ ~0.~ .... being duly sworn, deposes and says that he is the applicant (Name of individual signing cpntract) bore named. e is the .... i ~.~ ~r~gent, corporate officer, etc.) .......... C said owner or owners, ~d is duly au~~rfom or have perfomed the said work and to make and file this PLacation, that all statements conta~ned[m tMs apphcat~on are true to the best of his knowledge and belief; and that the or~ will be perfomed in the manner set forth in the application filed therewith. yom to before me this ; , ............. , )taw Public hi X;~ ~ ' " "'~ . C~IRE .~EW .. N~a~ Publia, State of No No. 4879505 : -- Qualifiod in Suffolk CouCty ~ [_ ' ..... ' ....... Commlss~n 6xpires Oeoembet 8, 19-~ (Signa~m~applicant)