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Home My WebLink About22582-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. ~ERTIFICATE OF OCuumANCY No Z-24109 Date JANUARY 5, 1996 THIS CERTIFIES that the buildin~ ALTERATION Location of Propert~ 1050 YOUNGS AVEN~E SOu'r~OLD, N.Y. House No. Street County Tax Map No. 1000 Section 61 Block 2. Lot 16 Subdivision Filed Map No. Lot No. Hamlet conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 26, 1995 pursuant to which Building Permit No. 22582-E dated FEBRUARY 1, 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 ~%MP ADDITION & ALTERATION TO EXISTING OFFICE BUILDING AS APPLIED FOR. The certificate is issued to of the aforesaid building. NANCY C. PEARSON (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N-363256 - SEPTEMBER 12, 1995 Building Inspect~ NO 22582 Z FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HAU. $OUTHOID, N.Y. BUILDING (THIS PERMIT MUST BE KEPT THE PREMISES UN1 Date, CounlyTax Map No. 1000 Section ............ .~...../~.... Block ......... ~ ........ LotNo.....~....~.... ............... pursuant to application dated ................ ~......~,,~., 19 .~..~ , and approved byihe Building Inspect~;L. Fee ~-5~,....,.~.. Rev. 6/30/80 Building In!~ 'IOI4H 0~ SOUTI[OI,I) BU!LDING DEPARTI TOUN IIALI, 765~1802 APPI )CATION l"O1( CEI('I'IFICA'I'E OF OCCUPANCY A. ThJ. s aPPlication must be ILl..Led ~ll by t. yl)eV~tt, tet OR J. uk and submitted to the J-USl)ectoc ~.~ith ~)la [elLo4[.g. [or ne~ buiJ. d[ng or ne~ usc: 1. Final. survey e[ property ~[th ac:ur~ te It cat ~ou o[ all bultdLngs, property 2. Flnul Approval. from lIgal.~ Dept. of w ~er supply and se~erage_dlsl)osa~(S_V [orm). 3. Al~P~evu~ o[ electrJ, cad [n~allatj. on [rom Board of F/re Umler~v~et-s. 4. S~o~u ~tatement [~omtph)mbe~ certifying that the so~der used ~n system . , .' ~ ' -~- '- ' ' Co )lJ. aece [re, architect or eugJnet~r 4 resI)oos~te for the bu~t(lt.g. . , 6. Sub,d.b Ptamd. e~ ))oard Al)prover of cur, pie[mi si(:e plan req ~I3. For ex~.stlng buJ. ld~ngs (prior to Ap~].l 9, 195Z) t~on-conform~ng uses, or b ildfl~gs aud 1. Accurate survey o~ property shm~].ng o[1 property l.&nes, streets, bu~ldJ, ng and mlUSUal ua~ural or topographic 2. A properly co,npteted apl.L~(atJ, ou and a cousent I:o Juspect. si. gned by the appl [canE. [[ a (;Qt'L[[lcat. e o[ Occupancy is den.ted, the gu[kdl, ng ]-uspector shaJ. 1 st;lie the reasons there[or ~.n ~r~ttng [o [he appli, cant. C. Fess I. Certificate o[ Occupancy - Ne~4 dxqe[J.i, ng $25.00, Additions to d~eJ. lj, ng $25.O0, Al~ot-a~j. ons to d~e[.[J, ug $25.00, St~immJng pooJ. $25.00, Accessory bt zld~.ug $25.00, Addlttons ~o accessory building $25.00. 3us~.nesses $50.00. 2. Certi[(caLe o[ Occopancy ou l're-exj, stieg guildlnu - $1OO.O0 3. Copy o[ Cer[~[).cate o[ Occupaucy - 4. Updated CertJ.[~cat. e o~ Occupaucy - $50.00 5. Temporary Certificate of Occupaucy - RnsJdenklaI $15.OO, Cmnmerc~a~ $15.OO Neu ' , Const:ruct~on ........... Ol.d Or Pre-exJ. stiug 'A lO3. Y 4b bocattou of Property ....... Q.. ~2 ~ House No, ...... ~ ........ ~ ...................................... . ~ ? Street Hamlet Onuer or Ouners ,.,[ l'roperty. ~y ..~ Cuunty Tax Hal~ No I000, Sec~lou .............. Block ......... ; ...... Lot ....... ........................ Flied Hap ............ Lot ...................... ................ A >1 ~.c: qeal. th l)el)~' Approval .... /~ .... ~ ............ Under,er~ters Approval .... 'lam)trig Board Approva[...~.~.' ........... (equest [or: Temporary Certlflcnte ........... Fi. ual CertJ. cate. FIELD INSPECTION P~PORT II~)AT~ II CnU~4~.~.e II FOUNI)nTION ([ST) II Il FOUNDATION (2ND) - ~1 I~ ROUGN FP, AI~ & PLOI~ING INSIILATION PER N. Y. STAT~ EN~R~ CODE II II 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 July 27, 1995 Nancy Pearson, M.D. 3258 South Harbor Road 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. XX The check is not on file. $50.00 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 # 22582-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGHPLBG, [ ] FOUNDATION 2ND [ ] IN/SULATION [ ] FRAMING [ ~J FINAL [ ] FIREPLACE & CHIMNEY 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROUGH PLBG. [ ~ ] I~LATION [/~ FINAL [ ] FIREPLACE & CHIMNEY DATE~//~~ .~~IN S PEC~ 765.18~2 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ~-FI~AL REMARKS: . / DATE ~~ INSPE~~~~ '// THE NEW YORK BOARD OF FIRE UNDERWRITERS P ,GE 1 'I{~5~'~5 BUREAU OF ELECTRICITY [~ 85 JOHN STREET. NEW YORK. NEW YORK 10038 Date SEPTEMBER 12,1995 ~pptic.tion~o, onfile [~9~995/95 N 363256 THIS CERTIFIES THAT o~y the electrical equipment ~ ~scrlbed ~w .~ int~uc~ by t~ epplicent ~med on the e~e application nu tuber in t~ prem~es o~ i. thefo,owl.g h,c.tlo.; [] Baseme. t [] I~t FI. t~s exami.ed on SEPTEMBER 06,1995 RXTUEE OUTLETS SWITCHES 4 2 FIXTURES INCANDESCENT FLUORESCENT 4 [] 2nd FI. Section Block Lot and found to be in compliance with the National Electrical Code. RANGES OVENS DiSH WA.~r'g-~ EXHAUST FANS OTHER DRYERS )THER APPARATUS: E R NO. O~E RCC,~CON V. A. WG OF HI-LEG JOHN C. D'ARIES 70 HAIGAT STREET DEER PARK, NY, 11729 LIC. #3910-E GENERAL MANAGER This certificate must not be altered in ony manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. TH S COPY OF CERTIFIEATEMUST NOT BE ALTERED NANY MANNER. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ........... , 19~. fl,"3. Approved ..... ~...f../.. '.., 19 .~..~ermit No...~...~...~....~?--/- Disapproved a/c ..................................... APP~LI~ATION FOR BUILDING PERMIT BOARD OF HEALTH SURVEY SEPTIC FORH .............. Date .................. ,19... 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 or a[eas, and giving a detailed description of layout of p[operty 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 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 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 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 ail applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary insp~ections. . . ..... r~ o..~ea.. ¢. ~6~.~... t.~.. ............. . -' ~ (Signature of applicant, orname, if a corporation) " ..... .... ~9~....t.t.l.{ .... .sp.~...a.:~...0.~.7.l... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .. % .~, .~.~.....~r~-..~. ~: ..................................................................... Name of owner of premises .. ]~\~... ~cr. l[ ........ (.. t~tr.q~qM-}...~.q .~.~... ?.(~.e.~.q .................. (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...I..'z?.,..~. .~..~....[-[ .~. ....... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be d05e .................................................. .......................... ~o.~.~.~ .~.. g..o~.. .................................................. House Number Street Hamlet County Tax Map No. 1000 Section ....O. ~. l .......... Block ..... G.~g- ......... Lot .... 1.~ ............. 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 ...O. 5~.t'c~'~ ............. C ........ : ........ ,~ .................................. b. Intended use and occupancy 3. Nature of work (cheek which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... ~i (I~escription) 4 Estim rico t ~.~5~00 ' Fee · ate s ........... . ........................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............. Number of dwelling units on each floor ................ · If garage, number of cars ..... ! ................................................................... 6. If business, commercial. or mixed occupancy, specify nature and extent of each type of use ./~.[.[..bv~,.~l:f .... 7. Dimensions of existing strnctur~s, if any: Front..· >.-~ ......... Rear ... 3.~. ....... Depth .¥.Q ........ Height Z~.Q Number of Stories Dimensions of same structure with alterations or additions: Front . .7 .~. ............ Rear . .~..7.. ............. Depth ~.~.. ' Height ~. Number of Stories 8. Dimensions of entire new ' ' Front ............... construchon: Rear ............... Depth ............... Height ............... Number of Stories ............................................. - ........... 6~ ' R ,~...7 pth IEG 9. Size of lot: Front ........ i ........... ear ............. De .. 10 Date of Purchase · Name of Former Owner 11. Zone or use district in which premises are situated ....................................... !ate any zen /~. CD.. .............. 12. Does proposed construction viol ing law, ordinance or regulation: .. : ......................... 13. Will lot be regraded ..... /...Qi ................... Will excess fill be removed from premises: Yes No 14 Name of Owner of premises ' Address Phone No Name of Architect .......... i ................. Address ......... Name of Contractor .~v~.~o..lg.wt.~,,4 ......... Address .~o.~. I~ll ...... i~;~2~' PhonePh°ne No.N°' ]~ 15. Is this property within ~00 feet of a tidal wetland? *Yes ........ No.~.. ...... · If yes, Southold ~own Trustees Permit may be required. PLOT DIAGRA~ Locate clearly and distinctly MI!buildings, whether existing or proposed, and. indicate M1 set-back dimensions from prope~y Hnes. Give street and block ~umbar or description accordLng to deed, and show street names and indicate whether interior or corner lot. . STATE OF NEW~_.yORK, COUNTY OF...~, .~q;:,/.~. .... .S APPROYED' S NOTED . Nora BU,LDIN 'g 765-1802 9 AM 113 4 Plgt FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2, ROUGH - FRAMING & PLUMBING 3. IhBULATION FINAL CONSTRUCTION MUST ~E COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENT~ OF THE STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS .... t ....... ! ................... being duly sworn, deposes and says that he is the applicant (Name of individual signihg contract) above named. ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dulyI authorized to perform or have performed the said work and to make and file this application; that all statements contaihed' in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner !set forth in the application filed therewith. Sworn to before me this~ Notary Public, ~-~o [ IA .! County ' · . ANN O, ROM,~O . . ~.~,~~{ ~-----~"~tary Public, State of New York ................................. I No. 4764227 (Signature of applicant) I Qualified in Suffolk County Corn!mission Expires A'