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Home My WebLink About23106-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. ~ERTIFICATE OF OCCUPANCY No Z-24419 Date JUNE 11, 1996 THIS CERTIFIES that the buildin~ Location of Propert~ 40100 MAIN ROAD House No. County Tax Map No. 1000 Section 86 Subdivision ALTERATION & RENOVATION PECONIC NY Street Block 4 Lot Filed Map No. Lot No. H~let 1.5 conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 24, 1995 pursuant to which Building Permit No. 23106-Z dated NOVEMBER 6, 1995 was issued, and conforms to all of the requirements of the applicable provisions cf the law. The occupancy for which this certificate is issued is ALTER AND RENOVATE AN EXISTING ORE FAMILY DWELLING AND ATTAu~D G~.]~%GN AS APPLIED FOR. NON-HABITABLE.) The certificate is issued to (SPACE OVER G~R~GN IS MONICAKNEUER of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N375602 PLUMBERS CERTIFICATION DATED F~%R~H 8w 1996 (owner) N/A JANUARY 18, 1996 WALTER MAREZEWSKI JR. Rev. 1/81 FORM NO,?* TOWN OF $OUTHOLO BUILDING DEPARTMENT Town HALL $OUTi'IOLD, N.Y. 23106 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby granted to~ ~.,~;~ ....... ~.~.,~.~. ...... ~,/.¢..~...... ~.2........~ ............................ .... ~,~./~.~,.... ~.~....zz..~ ........ : ............ ~ .................................................................................... ................................... at premises ............... ~. ....... ~...,:; .................... '; ........................................................... Counh/Tax Map No. 1000 Sectlon........~... ............. Block ......... ~ ........ ;. LotNo ....... ./.'....."~... ............ and approved b{, the pursuant to application dated .......... .¢ .................... 19..../.'~f..,..., Building Inspector. Building Inspector Rev. 6/30/80 Form No. 6 %~~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ]~I~C~ £~i~.-~-.a APPLICATION FOR CERTIFICATE OF OCCUPANCY 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '{pre-existing" land uses: i. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. g. 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 Buildinm - $i00.00 3. Copy of Certificate of Occupancy - % .25~~ 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 ................. Location of Property..qO~.~.. ...... House No. Street Hamlet Onwer or Owners of Property ............................ County Tax .ap NO 1000, Section .... ~. ...... Block ..... .~ ......... Lot...7.'..~.. ............. Subdivision ~"' Filed Map Lot Permit No...~..~.!.~.~..~-......Date Of Permit. .. J.//~. . ./.~.~. . . .Applicant. .~[.~. . . .~.~.~. . .~. ./~. . . Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: APPLICANT Town Hall, 53095 Main 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 January 19, 1996 Joel Daly, Builder 52 Wilmarth Avenue Greenport, N.Y. 11944 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) No Underwriters Certificate on file.~ XX XX XX 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 # 23106-Z (KNEUER) Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. 765-1802 BUILDING DEPT. [ ] FOUNDATION I ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: INSPECTION [~OUGH PLBG. [ ] INSULATION [ ] FINAL DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGHPLBG. [ ] FOUNDATION 2ND [ ,~'~SULATION [ ] FRAMING [ ]FINAL [ ] FIREPLACE & CHIMNEY DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION [~MING [ ] FINAL REMARKS: / * -~-,~,~-~//~'~' ~" THE NEW YORK BOARD OF FIRE UNDERWRITERS 1001071 BUREAU OF ELECTRICITY ~- 85 JOHN STREET. NEW YORK. NEW YORK 1003B Date JANUARY 18,1996 ~pptJ~.tlo. Mo. o. Iite 10804895/95 N 375602 THIS CERTIFIES THAT MONICA KNEUER, 40100 RT 25, PECONIC, N,Y. u~s examined on JA~R~ARY 15,1996 and found to be in compliance with the National Electrical Code. Lot FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS 4 8 DRYERS SYSTEMS NO, OF FEET E OTHER APPARATUS: PADDLE FANS-2 MOTORS: 2*',F H.P. SMOKE DETECTOR ~ - 1 S E R NO. O~ERCC~COND AWG. O~t CC, COND C NO OF HI.LEG NO OF NEUTRALS G & S CONTRACTOR BOX 215 SOUTHOLD, NY, 11971 LIC. #578 E ANg GENERAL MANAGER This certificate must not be altered in any manner; return to the office of the Boa~r~ if incorrect. Inspectors may be identified by their credentials. COPY FOB BUILDING DEPARTMSNT. TH~S COPY OF CERTiFiCATE MUS~?OT~ BE ALTERED IN ANY, MANNER. Town Hall, 53095 Main 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 DATE: Building Permit No. Owner: (please print) Plumber: ij~/~/p~',,~ /~h~ ~ ~ ~fG~, (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers Sigrf~tur~) Sworn to before me this _~--day of ~~ t 1~'~ Notary Public, ~ /~_~ ~. County Notary Public, State of New York No. 4879505 /Q / Qualified.in Suffolk CounW ~ (_ ~mmission Expires December 8, 19 ~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ~] IN~TION~ [ ] FRAMING [/*~ FINAL [ ] FIREPLAC/F.~& CHIMNEY REMARKS: ~ DATE ~ ~/~./~ INSPECT / ,, ~,~ ~ '~L~~ ~ ~ ] LT~P~ .... JOEL DALY .~ I BUILDER ~2 '~/ILMARTH AVE · GR£ENPORT. NY 1194,'1. ' '.ii OCT 2~11995 !:" Examined ......... ~ ...... , 19.. · Approved ......... //~&7" 19... me~it No. ¢. Disapproved a/c ..................................... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTM,ENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ............. ~ ..... CIIECK .................... SEPTIC FORM .............. ;7..' ....... ...... blAIL ......... ,, (Bu/~d~g Irfspector) APPLICATION FOR BUILDING PERMIT Date .............. , · INSTRUCTIONS 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 streets ~r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appil- 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 Inspector will issued 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 Occ¢pancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department 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 ali applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on-premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, genera, 1 contractor, electrician, plumber or builder. .. ,0. ,~, O~ .'% .................................................................................. Name of owner of premises ... ll~,O.19. I.~.O .... ~ tO~.. I~.~.-~. . ............................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. } ~ O ¢ ~ ~] Plumber's License No ........ : ................ Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done ....... : .......................................... q.o. i .o.o. ....................... ~, .~/~l,..~.o~ ~ ............... . .~.~¢.~. ,~t c.. ............... House Number Street Hamlet County Tax Map'No. 1000 Section .... .~..~. · . . Block ....... .~ .... ...... Lot .... J.°. ~. ........... Subdivision..~.~-O. 01~....~.~.~....~ ~.~r.~. .......... Filed Map ~o..7.t.5.~...Lot., ..~.......... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy P~,L~.~TI~..~'.. ~ ............... '; ." ;~' .... : ............. b. Intended use and occupancy ................................................................... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ....... Repair .............. RemOval ........... D '' '" a/ . .. emolmon .............. Othe, r Work.~ttgl$$. 4. Estimated Cost ....... /,.~'/.tbp~ .................... Fee ............. i (to be paid on filing this application) 5. If dwelling, number of dwelling hnits ... ] Number of dwelling units on each floor ...."~.. ....... If garage, number of cars .... i ' '" .... · 6. ~.busm.ess, co, mmercial or mixe 'Oc&a~c~, s~ec'i~ n~;ure and extent if e'ach tl;; ,~f';~'~ .................... 7. ~l .mens'ons of existing structures if any:Front .~.qt ..~. Re~. 6,%~ ..... ,~":"';,'2~ ....... Height .... ~.O. ........ Num[ber of Stories ,.~. · · ,~ ...... -r ....... IJeptn ., ~.~. ......... Dnnenslons of same structure w~,th alterations or addmons: Front ... ~] ~ R~ar ~, t./~ ' ' Depth .$o .... u~ ~,,, HD~e~n*. ' ' . .... I· x~*t~a ...................... Number of Stories... .... ~ ............. 8. stuns of entire new co,,nstm., ctlon: Front... ~../~j,,//,] ,,l~YRear .MO.. A/~.... Depth ............. ~,s-[ ............... l~umper of Stories ...,...~..././. 9. Sizeoflot Front li~Z~t , ~^~_ " t~'~'i ......... ~-~'","t ........... 10. DateofPurchase .~.d..t.,~. [~..~ ,,~ .... ' '",4' ..... ~¢,v~",:2:''''*''~'~' .... : ..... :,.,, ' '.t ......... ' ......... *~a.le o~ i~ormer owner .. ~/~'~ll~g--, .~.~-,~/~..~'..A~ 11. Zone or use district in which premises are situated ........................................ ............. 12 Does proposed construction violate'any zoning law ordinance or regulation: 13. ,W, ill lot ?e,,regradeJ .... .... ~',,~i/,.;~i ' ' '.7,; L: '.' :~," Will ex.tess .fill be, removed from premises: Yes No 14/ ~ame or owner or premises .,:,yffj.c,g.. K-/It~/,~&.t-,f~,Address Name of Architect . . ^~ ........ ' ' ' · ' ' ' ~ ............ rtu~a ................... i'D. one INO ............... Name of Contractor ,,~.e~,~ .~)~1,,.~ ............. Address~rgrAy~.~.,~.yT/ ....... Phone No. 15, Is this property within 300 feet of a tidal wetland? *Yes ........ No..~, · If yes, Southold T~wn Trustees Permit may be required. '''' ". i PLOT DIAGRAM Locate clearly and distinctly ail buildings, whether existing*or proposed, and. indicate all set-back dimensions from property lines. Give street and block n:umber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF S.$ ....... ~.0jq ~ .i~]~.. ~/~..! .................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. ~is the (Contractor, agent, corporate officer etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this pphcatmn; that all statements contan~d m this application are trueito the best of his knowledge and belief; and that the work will be performed in the manner s~t forth in the application filed therewith. Sworn to before me this 6/ .. ELl .Z~_ B£THANN NI~VltLE ~" .............. ~~'~it-~7~or~ ' (Signature of applicant) No. 52-8125850; Suffolk CoUDty.. lerm Expires October 31, 19.~(~