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Home My WebLink About23108-zFORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HAIl SOUTH, OLD, N.Y. No_ 23108 Z BUILDING PERMIT (THIS PERMIT MU$1 BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is herebvgra.,q, ted to: ~__ ~ / - / .......... "~' ....... ,7'"~ ............................ CouniyTox Mop No. 1000 Section .......... ..~.,4~. ..... Block ...... ../~....~.... ........... LotNo. ~ pursuont to opplicotion dated ................ ,,~,,.,~.....~.,.y ...... ~ 9...,~,,,~d approved bvthe Building Inspector, Fee $...Z~.,,. ............ Rev, 6~30~80 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24086 Date DECEMBER 18, 1995 THIS CERTIFIES that the buildin~ ADDITION Location of Property 2650 PINE NECK ROAD SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 70 Block 10 Lot 2 Subdivision Filed Map No, Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 24, 1995 pursuant to which Building Permit NO. 23108-Z dated NOVEMBER 16, 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 INST~?W.RTION OF A NEW OIL FIRED HEATING SYSTEM IN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to of the aforesaid building. JAMES HAWTHOi~/~E (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-371523 - NOVEMBER 30, 1995 PLUMBERS CERTIFICATION DATED NOV. 19, 1995-ROGER CULLEN Rev. 1/81 ~ /~il~ing I~spector Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ,.; ~,.)t' ~ g 1995 765-1802 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 Under~riters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of i% 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: 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 Buildin~ - $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 ate .......... New Construction ........... Old Or Pre-existing Buil'ding....~.~ ...... ,-. . ,0, e .............. .... ........... Location of Property ................. House No. Street . Hamlet 0nwer or 0vmers of Property .... ~.[~.~. .... . .................................... County Tax Map No 1000, Section...~P ....... Block .... /fO. ......... Lot ...... ~. ............... Subdivision .................................... Filed Map ............ Lot ...................... Health De t. Ap royal ......... Underwriters Approval .... ~t/~t~G ........... P P ................. --~ /,--:- ~ k Planning Board Approval ........................ cate Final Certicate -- Request for: Temporary Certifi ...................... Fee Submitted: $~C ....... '~'C: ~' '~' ............. '-~'~ ,~.~Lf ~ ov.s ................. , ......... (~. SO~g~ ICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS ~'13~1~7 BUREAU OF ELECTRICITY ~'~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date NOV~F~R 30,1995 ~pplicationNo. onfile 1~7~295/95 ~ 371523 THIS CE~IFIE~ THAT in ~he following location; ~ Easement ~ Ist FI, ~ 2nd ~, Sect~n ~k ~t ~s examined on ~0~ 20 , ~ 99~ and found to be in compliance ~ith the NaMonal Electdcal Code. FIXTURE ~ECEPTACLES] SWITCHES FIXTURES RANGES C~KINGDECKS OVENS DISH WASHERS EXHAUST FANS DRYERS ~ mRNACE ~TGRS ~ FUIU. A~,AN~ .EDERS ISPE~ALREC*PT TIMECLOCKS~ BELL ~UNITHEATER$ MULTI-.UTL T DIMMERS ~T K,W 0 H P GAS H.P, ~T NO. A.W.G. AMT ~P. ~Z.' ~PS TRANS. H.P. N~E~T AMT, WATTS JA~ES MURRAY P, O. BOX 3O5 LAUREL, NY, 11948 LIC.#36§3 ~ GENERAL MAHAOER 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. Town Hall, 53095 Main Road P. O. Box 1179 Southeld, New york 1197'I Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD CERTIFICATION Bullding Permit No. ~3 (please print) Plumber: (please print) I contains less than 2/10 of 1% lead. certify that the solder used in the water supply system (plUs~ Si~gnature~. Sworn to before me this ~/~ day of ~J/'~Z~"~'~,-a,..,__ Notary Public, Notary Pubhc, State ot New York No, 52.8200218, Suffolk C'o,~/ Commission Expires , 19~~ County Town Hall, 53095 Main Road P. O. Box 1179 Southold, NewYork 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD December 11, 1995 R. Cullen Project Management P.O. Box 901 Shelter Island, NY 11964 Re: Jim Hawthorne - SCTM%1000-70-10-2Prem: Neck Road, Southold 2650 Pine To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) xx No Underwriters Certificate on file. 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. (Ail permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 23108-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. FOUNDAT I ON (2ND) F[EI.D I-N,S. PI~CCr].ON RI~PORT DATE i ......... FOIINDATION (IST) ROIJGI1 FRAHI~ & PLIJHB I big II. ADDITIONAl. COMMENTS: tn l [~..L,~ L~ U ~/ I~ ~ ~ , BLDG· DEP~ , ~ TOWN OF SOUTHOI D ~, ~ . Approved ............. , 19 Permit No. ~ FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT; TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapproved a/c ................................ 2 . .:. BO,;~RD OF HEALTtt ......... 3 SEfS OF PLANS ......... SURVEY .................. ClIECK ......... t ......... SEPTIC F O RI'I NOTI PY ~ CALL FLAIL TO: Date. ].~..~..O~..~. ....... 197.f INSTRUCTIONS a. This apl~lication must be completely filled in by typewriter or in ink and subznitted to the Building Inspector, with 3 f sets of plans, accurate plot plan to scale. Fee according to schedule. · Plot plan showing locahon of lot and of bufldmgs on premises, relationship to adjoining premises or public sti-eets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- 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 igsued 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 Occupancy 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 South61d, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions'or alterations, or for remo__val or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building cf.~/housipg--~e, ~cJ)reg~ations, and to admit authorized inspectors on premises and in building for necessary inspec~~ ~ i.,~, ..~j ~>]~ '(Mailing address of applicant) /tq~q-- State whether applicant is owner, lessee, 'agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises , .. O ('APe- (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authoriied officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's Licease No ......................... Electrician's License No../. ...............~.~,. Other Trade's License No...~..~...~.~/'...~. ........ Location of land on which proposed work will be done. ~ ' ¢~.~_C.~ · House Number Street Hamlet Connty Tax Map No. 1000 Section . '. ' ........... Block .... J..0 ........ ;... Lot Snbdivislon ' Filed Map No ............... Lot ............... (Name) , State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use arid occupancy ': :~ .'.. ~?..~.~...e.../~/.~ lOv.~ ' b. Intended use and occupancy ..................... ' ............................................... k ( k whi ppli bi ) Additi .3. Nature of wot chec ch a ca e: New Building ·. on .......... Alteration ........ Repair .............. Removal ......... Demolition .............. Other Wor 4. EstlmatedCost ,..[].~ i .. . ' .. 5. If dwelling, nmnber of dwelling Units ..... ~ '. ....... (to be paid on filing this application) If garage, number of cars .... ~, , Number of dwelling units on each floor ............ 6. If business, co~nmercial or mixed~ occupancy, specify nature and extent oLeach type of use 7. Dimensionsot existingst~ct~re~ if any. Front C , ~ ' , ~ ' ...... ' ......... ~ ..... } ,. ..'..:~ . x,.: .... ear ............. Depth ............. ~e~gnt ............... Number of Stories ................... ' .... ~ ................. : ............. Dimensions of shme structure wi~h alterations or additions: Front Depth .... ~ ................... Height } ................. Rear ................... ·,: ........ Number of Stores ' ' 8 Dimensions of entire new constniction: Fr~t ..... '*' ' ' ......... Height Number of Sto~es ....... ' ........ ; Rear .......... Depth -'~ ...................... Depth ...................... 10 Date fP ct * ~ ....... '.' ...... ...NameofF Ow 11' Z o ur rosei ~} .......... omler ncr .................. ,: ....... . one or use distr c n which pre~ises are situated ................. .......................... 12 Do d c tion violet ni g law rdinafi ~,~: ' · any gulation: .... . espropose onstruc e zo n ,o ceorre .. .,... 13. Will otbere~raded . .~.O~ -.. ~ ' ................ x, ....... ~ , ' '. 'M,7 ..... H ' ' ' '~" .'/;w wm excess nn ~e removed from premmes: Yes No ,, , ..... ..... ~ · ~o ~,~...~.~.~noneNo .. . ........ -..' ............. Address ................... Phone No .... Nmne of Contractor ~ ~[[~ . Address~O ~I .~ f ~ ~ ~' , ' ~,'] ~'~/~ z :~"' 15. Is this property ~ithin 3Q0 feet of a tidal wetland? *Yes ....... ~ ' '' . *If yes, Soutbold T~wn Trustees Permit may be raquired~ ............ .. PLOT DIAG~ Locate clearly and distinctly M1 b2uildings, Whether existing or proposed, and, indicate all set-back d~ensions from prope~y lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. REQUIRED AP ROVfD NOT[ _/ NOTIFY BUILDING DE~ 765-1802 9 AM TO 4 ~M FOR THE ~,,:,~,~,'~5~,.,~ ~",~i~]~ ~ %~ ~ 1. FOUNDATION . TWO REQUIRED , ' FOR POURED CONCRETE ~ ~,--,~-,,~, ~ ~, ~,~, 3. INSIJ~TION ; ~ ~} , , ~ ;~[~ ~( 4, FINAL . CONSTRUCTION MUST ......... ~'~ ~" "~ ~" At.L CO~mFRLJCTION SHALL MEET iTATE OF NEW YORK, 'fHF, r~ :O' 'tEMr';;Dq OF THE N,Y, , t.L,.gLl. FOR ......... '(Name of individual signing being dt ly sworn, depose.s an~ says that he ~s fl~e applicant f said owner or owners, ~d is duly auiflmrized to perform or have perfo~ed the said work and to m~e and file this pplication; that all statements contained N this'application are {rue to the best of his knowledge and belief and that the fork w~l be perfomed in the manner set,fort ~ m the application filed therewith. worn to before me this , ' ......... ~..;w...day · .~~'.,' .... 19~ [otaw ubhc, HELENE O. HOR~E " ....... Notary Public, Stero of Now York ................ No. 4~Bi364 : ' / / ' (SYgnature of applicant) Oualifiod in buHolk Coun~ ~