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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24638 Date SEPTEMBER 19, 1996
THIS CERTIFIES that the building ADDITION
Location of Property 550 GROVE DR. SOUTHOLD, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 80 Block 4 Lot 23
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 19, 1994 pursuant to which
Building Permit No. 22536-Z dated DECEMBER 19, 1994
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 & DORMER TO EXISTING ONE FAMILY DWELLING
The certificate is issued to DENIS & MELINDA NONCARROW
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. H-048287 - JUNE 26, 1996
PLUMBERS CERTIFICATION DATED SEPT. 4, 1996-DENIS NONCARROW
u' ding Inspector
Rev. 1/81
FORM NO.3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
.
Date 1:°~Ilf......................................... 19..2.~-,1
N2 2 s2,53~6 Z
Permission Is hereby granted to,
Ole 9411~
/4 Y• .r ....clot. ~ . r~~. 15
...,..V~- /~.t`l
to .C~ .....e" ^
at premises located at.... s .
County Tax Map No. 1000 Section d/........ Block Lot No.
pursuant to application dated ~/..7•y-••••••••••••.•••. 19 and approved by the
_4e 4e~
' Building Inspector.
Fee Z~e- .
?I~/oz.~ v~S~7~
Building Inspector
Rev. 6/30/80
G , - FORM NO.
TOWN OF SOUTHOLD . M
BUILDING DEFAkTMENT,
CLERK'S -04kE
TOWN-'
SOUTH'OLD;,N Y ,
BUILDING PERMIT .
(THIS PERMIT MUST BE KEPT ON -TH.E,PREMISE8 UNTIL FULL
COMPLETION OFTHE WORK AUTHORIZED)
NO Z Date wT 14.
5$_47 .
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Permissions hereby granted to:'
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t,..rL~kra
to ..c.6lli .;p€'ld$ M !1>t..~lealp~t'Cdtd'.:.....
c ,
at premises located at-.,.:.~tl
4 ...............~ype.ae 91«i
+ ".$l -
.to application doted..:.. approved b
pursuant y'the.
' Building inspector
Fee
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'Buildin9InSpe6toi
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Town Nell, 53095 Maim Road x Fax (518) 785.1823
O. Box 1179 Telephone (518) 785-1802
Soulhold, Now York 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C E R T I F I C A T I O N
DATE:
Building Permit No. Z a 3
owner : D ~ II/1 5 011(A(-f'0W
(please print)
Plumber:
(please print)
I certify that the solder used in the wager supply system
contains less than 2/10 of 1% lead.
ow4//
Sworn to before me this
~It- BARBARA C. REUSCHLE _R G day of S F- PrCM,e. 19 >CC' Notary Public, State of New York
No. 01 RE5036625
Notary Public, a-d County Qualified in Suffolk County
Commission Expires December 5, t9 6
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Town Hall, 53095 Main Road p Fax (516) 765-1823
P. O. Box 1179 Telephone (516) 765-1802
Southold, New York 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
April 30, 1996
Mr. Denis Noncarrow
550 Grove Drive
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 not on file. $25.00
No Health Department Approval on file.
No final inspection has been made.
xx No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 22536-Z
Please contact our office on this matter. Thank you for
cooperation.
/ r SOUTHOLD TOWN BUILDING DEPT.
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Town Hall, 53095 Main Road p • Fax (516) 765-1823
Telephone (516) 765-1802
P. 0. ew York 9 11971
Southold,
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
April 30, 1996
Mr. Denis Noncarrow
550 Grove Drive
Southold, NY 11971
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
_Ax not on file. (Enclosed)
\ xx No Underwriters Certificate on file.
\ xx The check is not on file. $25.00
No Health Department Approval on file.
No final inspection has been made.
xx No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 22536-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
K 19
H V,
FOUNDATION (1st)t
FOUNDATION (2nd)
z
0
ROUGH FRAME &
PLUMBING
3. M
M .
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INSULATION PER N. Y. H
STATE ENERGY , p
CODE
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4. ec, QUO ~iC SS /bS B.f s~ c
FINAL
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AD TIONAL COMMENTS:
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VICTOR LESSARD Town Hall, 53095 Main Road
PRINCIPAL BUILDING INSPECTOR P.O. Box 1179
(516) 765-1802a Southold, New York 11971
FAX (516) 765-1823 `'"'9
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OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
April 19, 1990
Mr Edward J. McGurn:
7 Caxton St.
Melville, New York 11747
Re: Building Permit #58472 (1972)
Suff. Co. Tax Map #1000-80-4-23
Premises: 550 Grove Rd, Southold, N.Y.
Dear Mr. McGurn:
The above building permit has expired and a Certificate
of occupancy has never been issued.
You are in violation of the Code of the Town of Southold
as this building permit has now been voided.
Please contact this office immediately to avoid legal
action.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
Victor Lessard,
Principal Building Inspector
VL:gar
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[FRAMING [ ] FINAL
REMARKS:
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DATE INSPECIr
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ],,ROUGH PLBG.
r
[ ] FOUNDATION 2ND [ f INSULATION
] FRAIAI11 G [ I [:hNAL
RkMARKS' " / / ' l
rr r
DATl k)-'`~ INSPECTORS A~
T6S-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST f ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
/le
REMARKS:
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41 ~r4ie,,
DATE'drr ii'- INSPE16TOR
S
I
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
8052420
BUREAU OF ELECTRICITY ~
" 85 JOHN STREET, NEW YORK, NY 10038
JUNE 26, `89,6 87216495/95 H 0¢8287
Dote' Application No, 4n felt'
THIS CERTIFIES THAT - - T
only the electrical equipment as described below and introduced by 6h applicant named on the above application number in the premises of I
DENIS NONGARROW, 550 -''GROVE DRIVE, SOUTHOLD,, N.Y:.,
.
in thefollowing location; ?'Basement [n ls¢ Ff t~ 2od h. Section Blark I, of
DECEE}t 28 , 995 a ound
wasexaminedon nA./ to be in compliance with the Natio»lil Elecdncal Code
~
FIXTURE FIXTLIRE' RAN_ ES" COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
ECEPTACLES SVYITCHES
~J '1 „ INCANDESCENT PIUORESCENi -"bTHER AMi . W. AMT. N. W AMT K W. WT. K W. AML H P. R
OUTLETS
15 14 16 7.0 5 1 1.2 1 F y®!"
DRYERS ;FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CIOCKS'j-',BELL " UNIT HEATERS' MULTI-OUTLET DIMME§S " 'D
SYSTEMS'
AMT. K.W. OIL H. P. GAS H. P. AMT. NO. A. W. G. AMT WF- AML" AMPS. TRANS' AMT. H F. . NO: OF FEET AML. WATTS
€&lilCR-A.18SONN T>., E ;s~ _ .E_ -.a . ~iN•.._ ~1,-. ..n,..._ h
METER NO.OF CC COND A W G. A W G b W G„ J[
AMT. AMP. TYPE EQUIP. 1 p tW 1 O SW 3 a dW 3A' AW PER 8 OF Cf CO NO Of HI lfG OF HI`LEG NO OF NEUTRALS a OF NEUTRAL""
OTHER APPARATUS:
RENOVATION'BED-BATH-KITCHEN-1
G.F.C.I:-3
SMOKE DETECTORj =2.I,„.,,.,.,...,-
tT _ .R.' e. r
! NC AMOUNT
G
1 MEASE REMIT GY CHECK' OR MONEY
^ - 'YORK T ARD of FREE UNDOF THE NNW
ERWMI
DENIS' NONGARROTI AS LASH SENT eY a A'.E K AT
950'dROVE DRIVEL, RISK OF SENDER.
F
S,OUTHOLD,_NY, 11971 `
11
Per
f -,*A
I THIS IS YOUR DILL FOR SERVICE RENDERED AND IS NOT A CERTIFICATE OF COMPLIANCE, THIS GILL PAYABLE AFTNE NEW YORK OFFICE, 83 JOHN STREET, NEW YORK, N. Y. 10038
FORM NO. I
TOWN OF SOUTHOLD
BUILDING DEPARTMENTµ r f (cl,S ff 7TOWN CLERK'S OFFICE 17
SOUTHOLD, N. Y. 0
Examined al. 19. Application No. ~S
Approved q T~ ~
19........ Pemit No....................................
Disapproved a/c
(Building Ins ector)
k-rl
APPLICATION FOR BUILDING PERMIT M
G
Date ..4.-4 c 19.,7
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 areas, and
giving a detailed description of layout of property must be drawn on diagram which is part of this application.
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 issue 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. C
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 all applicable laws,
ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections.
p,~ ? v deA0
(Signature of applicant, or name, if a corporation)
dress of applicant)
I State whether applicant tiisowner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
N. C.0./11i.~'f?~` j '
Name of owner of premises lJCC)p~ . J Qgk-a;> R ~ ~u ~ r
If applic is a corporate gn re f duly authorized officer.
r
(Nam and or
f corporate officer)
1. Location of land on which proposed work will be done. Map No.: L-9"o..........
Street and Number C Rx° ee!.1/.o............... Aa...........................................
Municipality
2. State existing use and occupancy of premises and intended use a/nq occupancy of proposed construction:
a. Existing use and occupancy 7.
b. Intended use and occupancy I.......z~A..'27.........JS..
v
r
.
3. Natuae of wbrk (check which applicable): New Building Addition . Alteration..:.~~
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost p od, oo Fee
(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 s
6. If business, commercial mixed occupancy,
d occupancy, specify nature and extent of each type of use ...N//&
yes, if any: Front .....~.a......... Rear ........s& Depth r.Z:P.......................
7. Dimensions of existing structur
Height ......................°1........ Number of Stories ..................a
Dimensions of same structure with alterations or additions: Front :Ik........... Rear
Z . ...,i o2 '
Number of Stories
Depth ....................3.... Height ~
IF I. 8. Dimensions of entire new construction: Front Rear Depth .......69
. Number of Stories ...................1.......
Height 61/.
9. Size of lot: Front ,~1-9. ~ Rear .........Ie2D.. Depth . A~ /.~0.................
Number of-Semi s
10. Date of Purchaser 44.y...~~.ir... Name of Former Owner
11. Zone or use district in which premises are situated
proposed 12. Does construction violate any zoning law, ordinance or regulation: .....AIA
13. Will lotberegraded ! N/D Will excess fill be remo d from premises: X Yes [ ] No
ov.5 1J~.YE
. .........-71 i~/.~/.................
14. Name of Owner of premises 9..°a........ I ..~i~ .t c~tJ.44k
i (Address) (Phone No.)
Name of Architect .............../Y.............................................................................................................................
.............,I (Address) (Phone No.)
Name of Contractor ~~/`/G(Sf. o~?s T, ii'x•'r.r!~, . ~l? r!Jri~!r? ~J ~Z.:.td.?~............
(Address) ' W, (Phone No.)
I
PLOT DIAGRAM
I
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate wheth-
er interior or corner lot.
4 ,
4A.95
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STATE OF NEW YORK, )
COUNTY OF ..........................................,:..........1
i
(Name of individual sighing
He is the,... ~T y being duly sworn, deposes and says that he is the applicant above named.
contract)
........Q.F........Lc"..~?.....L~a!.st....C~~...................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly a?thorized to perform or have performed the said work and to make and file this application; that all
statements contained 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.
oz...........day of 19 ..I. Y...%//
NOTARY f40d.4 C, State of uav Y...c
ar bier° Qaaafiod.lo.5uffak.000nty County
No. 52.5586090 (Signature of applicant)
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