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Home My WebLink About22663-zFORM NO. 4 TOWN OF SOUTBOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. ~RTIFICATE OF OCCUPANCY No Z-23745 Date JUNE 29, 1995 THIS CERTIFIES that the buildin~ ADDITION Location of Propert~ 55200 MAIN AD. & 45 MAPLE LA. House No. Street County Tax Map No. 1000 Section 62 Block 2 Subdivision Filed Map No. SOUTHOLD, N.Y. Hamlet Lot 4.1 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated F~%RCH 20, 1995 ~ursuant to which Building Permit No. 22663-Z dated P~PRIL 6, 1995 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 WOOD SHED ADDITION & RAMP ADDITION TO EXISTING MUSEUM AS APPLIED FOR. The certificate is issued to SOUTHOLD HISTORICAL SOCIETY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N-353884 - JUN~ 5, 1995 N/A FORM NO,$ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y, 22663 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: .. ..P.....~..~../... ..................................................... ~ ~ ,,,/,/.:../..,;......~//~z/... . atprem,s2's,~~' ............................................. Coun~yTox Mop No. 1000 Section ...... ~...~.. .......... Block ......... ~ ............ LotNo ....... ..~.f..../.. .......... pursuant ,o application dated ................. ,,.~../.~...~.. ..................... ,9....~...~......, and approved bythe Building inspector. ~ee ~,.ll.0..,::~ ....... Rev. 6/30/80 TOUH OF SOU'['II()LD BULLDIN(; D EI'ARTHE,UT TOWN IIALL 765-1802 JUb, I 2 8 APPLLCATION FOR CERTIF[CA'I'E OF OCCUPANCY This apPlication must be filied ie by typewriter OR ink and submitted to Cbc beiiding inspector with the following: for new building or new use: 1. Final survey of properly with accurate ]ocation of ail buildings, properly lines, streets, sBd unusual natural or topographic features. 2. Final Approval {rom l[eaith Dept. of writer snpply and sewerage-disposal(S-9 form). 3. Approval of eiectricm[ installation from Board of Fire Underwriters. 4. Sworll statement from tp]umber certifying that the solder used in system contaiFs less tham 2/10 of 1% lead. 5. Co~,vrcial buildin,g, industrial bnilding multiple residences and similar buildings an~ lns~latlous,,~a certificate of Code Compliance from architect or eogineer responszDle for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing boiidings (prior to April 9, 1957) eon-conforming uses or buildiugs and pre-existing" land uses: ' I. Accurate survey of property showing ali property lines, streets, building and unusual natural or topographic features. 2. A properly completed application aed a consent to inspect signed by the applicant. If a Certificate of Occupaucy is denied, the Building Inspector shall state ti~e reasons therefor in writing to the applicant. 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. Busioesses $50.00. 2. Certificate of Occupancy oll Pre-existing Buil¢lin~ - $100.00 3. Copy of Certificate of Occupaucy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00., Commercial $15.OO ' t'~ ' · e-existing Buzlding ............ ~treet Hamlet Onwer or Owners uf Property ............ ~''' .~, . ................. Filed Hap ............ Lot ...... ~aDning Board App~ova~ Request for: Temporary CeFtificate ........... Final Certicate...~ ...... Town Hall, 53095 Main Road P. O. Box 1179 Southold, NewYon~ 11971 Fax {516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD May 18, 1995 Southold Historical Society P.O. Box 1 Southold, NY 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. xx The check is (outdated/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 # 22663-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1035137 BUREAU OF ELECTRICITY . ~-- 85 JOHN STREET, NEW YORK, NEW YORK 10038 J)ate ~ 05 t 1995 Application No. onfile 07182595/95 N 353684 THIS CERTIFIES THAT only the electrical equipment os described below and introduced by the applicant named on the abo~e application number in the premises of S.HOLD HISTORIAL SOCIETY, 54325 MAIN ROAD, SOUTHOLD, N,Y. in the following location; [] Basement [] Ist Fl. [] 2nd FL Section Block ~s examined on MAY 08, ~ 995 and found to be in compliance svith the National Electrical Code. Lot FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT OTHER I 1 DRYERS OIMMERS R V I C A. W.G. NO OF HI-LEG A W. G NO OF NEU'~RAI. SA, W* G, OF HI.LEO OF NEUTRAL OTHER APPARA'f US: SHED,-1 G.F.C.I,-1 HI-LITE ELECTRIC INC. LIC.#3992-E ~ ~~ JOHN cm~GEMT /-/ ~J 6 JUPITER ROAD S~NERAL MANASBR / HI 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.. "~I COPY FOR BUILDING DEPARTMENT. THiS COPY OF ~ERTIFICATE MUST NOT BE ALTERED IN ANY ~IANNER. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND FRAMING [ ] IN,~,~JI. ATION [/~INAL [ ] FIREPLACE & CHIMNEY~,~ FIELD INSPECTION REPORT I~DATE I~ = COI~IENTS = ~O~A~OS (~S~) 11 , FO~ATION (2~) II INSULATION PER N. Y. STATE ENERGY CODE FORM NO. 1 TOWN OF: SOUTHOLD BU I L D L~&o-· DEPARTMENT. TOWN HALL SOUTHOLD, N,Y. 11971 TEL,: 765-1802 fl, B~ing Inspector) ' APPLICATION FOR BUILDING' PERM IT BOARD OF HEALTH ........ 3 SETS OF PLAk'IS ........ SURVEY ................. CIIECK NOTI Py ~ . NAIL TO: INSTRUCTIONS Date ..... .g.q ..... a. his apphcat~on must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 st~'eet or areas, and giving a detailed descriptioh of layout of property mu~t be drawn on the diagram which is part of this appL cation. ¢. ' The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspdctor will i~sued a Building Permit to the app/icant. Such permi 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 Occupanc' shall have been granted ~,y the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southbld, .Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of buildings, additions or alterations, or for removal or 4emglit~on, a.s herein described The applicant agrees to comply with all applicable laws, ordinances, building code, horsing c¢¢e, and reguiations, and t( admit authorized inspectors on premises and in building for necessary inspections. ...5'..~.~Th~..~.~.... ~(~..~... ... (Signature of applicant, or name if a cbrpora~on) , (I~ailing address o~gapplicant). "' State whether applicant is owner, lessee, 'agent, architect, engineer, generai 'contractor, electrician, plumber or builder. Name of.owner of premises ..................................................... (as on the tax roi1 or latest deed) II' app, t,~ant lsa corporation, signature o/duly au~horiz~ed officer.' k amc and title of corporate officc~r) 0 ' Builder's License No ]~'~?1- ' Plumber's License No.. i~ ~ '. Electrician's License No Other T ' · fade s License No ...................... House Number Street Hamlet Cou;~t~ Ta× ~ap ~o. lO00 Section ... :. ~'~...~... ..... mock '. .... .~.. ' ~ot .... .~,. / .......... (Name) .............. Lot ............... 2, $i:~te existing use and occupancy or premises and intended use and occupancy of proposed construction: a. Existing use and occupancy , .' .,~¢~. ---~.~ ...................................................... b. inten&d use and oecu '. ........ pancy . k ( h.i h ~ppli : ,~dditi .~. ' '3. Nature of wot check w c cable): New Building .: ....... on ...... Alteration .... ~... Repair .............. Rerhoval .............. . Demolition ..... : ......./..~. Other Work...- .......... Es ~'~'0 ' (Description) 4 timated Cost .~..Op . (to be paid on filing this application) 5 If dwelling number of dwellir g units". ~ Number of dwelling units on each floor If garage number of cars ' 6 If business commercial or mixed occupancy specify ............................................... ' .... · Dimension[ of existing structhtes if any: Fr;nt nature and eXtent of.each type of use . Height Number of Stories ·. ! ............, Rear. ............... . Depth ............... . Dimensions of shine structure with ~ or add tions: Front ........... Rear ............ ' Depth ~... i He'~' ' ...... ~ ' ,, ,-, · ,' ...... : · ~gnt .......... ' ..... : Number of Stories · lmenslons otenhre new construction Front ,~ . r, oo~ ,. . ga[ ............... l'mmoer ot ~tones .................... , . ' 9. Size of lot: Front ~/2.7-,. ' . ...................... I ........ Rear ....... ~, .~'..)--r · ~. zone or use d~stnct ~n which premises are situated ' ' ' ' .... , 2. Does proposed constructm,~x?late any zomng law, ordinance or regulatmn: .3/O ....... .................. 13. Will 16t be regraded ....~/~'..! ..................... Will excess fill b~ removed from premises: 5.r~ "1'~o rqame o~ contractor ..... l ~.~ ................. Address ..... . Ph,~r.n Mr, ' ' 15. I.s th±s property within iR00 feat of a tidal wet:J, and? *~'e~' ........ ~,~,-'""-)~Y ..... "~ ............ , If yes, Southold lTown Trustees Permit may.,be requzred. ' P~OT DIAGRAM : Locate clearly and distinctly alI buildings, Whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blockinumber or description aceordin to interior or corner lot. g deed, and show street names and indicate whether .{ APPROVED AS NoTEo 765-1802 9 AM TO 4 PM FOR THE , '. FOLLOWING INSPECTIONS: , f~E 1. FOUNDATION - TWO REQUIRED ~ ~ FOR POURED CONCRETE RW~J~F[~S CERTJF/ 2. ROUGH - FRAMING & PLUMI)ING 3. INSULATION 4. FINAL, -. CONSTRUCTION M,US? SE COMPLETE FOR C,O. At:L CONSTRUCTION SHALL MEET THE. REQUIREMENTS OF THE STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE ~=OR , DESIGN OR CONSTRUCTION ERR DRS STATE OF'NEW YORK. , 2.S' COUNTy OF. W.. Fa .C47.. ...... , ....... ./'/';....~.~: .7'..~./..~. ...... . ...... being duly sworn, depose~ and says that he is the applicant (Name of individual ' ' s gmr~g contract) above named. ~Ie is the. /£ ....... ............ . " ' ' ] (Contractor, agent, cor'porate officer, etc.) ............... )f said owner or owners, and is dulyi ' ' lauthonzed to perform or have performed the said work and to make and file this tpplication; that all statements contaiaed in this'application are l~rue to the best of his knowledge and belief; and that the york will be performed in the manner ~et forth in the application filed therewith. ;worn to before me this ..... . ._.ry ~,.~.~ ount . ' JOH~'KR^M£R . , , ' NOTARY ?OBUC, StaL~ of'New York No 4~s~3~, s,tlo;l~ c0ua, (Signature of applicant) OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCC,LIPANCY 17- / ( \ / /