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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 2-24176 Date FEBRUARY 22, 1996
THIS CERTIFIES that the building ADDITION
945 MIDWOOD ROAD &
Location of Property 35 HOLDEN AVENUE CUTCHOGUE NY
House No. Street Hamlet
County Tax Map No. 1000 Section 110 Block 2 Lot 11
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 29, 1993 pursuant to which
Building Permit No. 21870-Z dated JANUARY 12, 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 A ONE STORY ADDITION TO AN EXISTING SINGLE FAMILY DWELLING
AS APLPIED FOR.
The certificate is issued to JOHN & MARY ELLEN MCGIRR
(owner's)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N352376 MAY 19, 1995
PLUMBERS CERTIFICATION DATED JANUARY 26, 1996 EDWARD F. SCHILLER
ofy
Building 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)
N® 21870 Z Date L................................, 191Y
Permisslon Is hereby granted to:
Jar.~...4':./.~?A.~.~~~.~.?.......~''~..~.1~-~.~~.......
to .....COQ/ rec~ c6 7 ..7~c i7..et
G~/~/?bra 5......... > 4.:..........................................,...,.
at premises located at .............................1../~/l. l~...!/.~
County Tax Map No. 1000 Section //0.............. CBllock a-,Z Lot No. `1.................
aq,
pursuant to ppplicatlon dated .....,..d?-i.r........CT . / 19.4
and approved by the
Building Inspector. Fee$.... ~i:Jd~
Building Inspector
\ Rev. 6/30/80
a
765.1802
BUILDING DEPT.
INSPECTION
( ] FOUNDATION 1ST [ )ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
( ] FRAMING [ ] FINAL
[ ] FIREPLACE IMNEY
REMARKS:
CC~
DATE 17,4NSPECTOR
A-10K4
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ FINAL
REMARKS: 6~X 7
DATE INSPECTOR
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [/~~GH PLBG.
FOUNDATION 2ND [ INSULATION
[ FRAMING [ ] FINAL
'~~G~9G',~`~
REMARKS:
7,
~ DATE ~ INSPECTOR A4&4qAe~\
r
02 lk1D
765-1802
BUILDING DEPT.
INSPECTION
[ J FOUNDATION iST ( ] ROUGH PLBG.
[ J FOUNDATION 2ND [ J INSULATION
MING FINAL
REMARKS:
~~r,~-..ire. 7lat_~ ~.e.•t•-~,~
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f ~
DATE INSPECTOR
i
70
765-1802
BUILDING DEPT.
INSPECTION
NDATION 1ST [ ] ROUGH PLBG.
[ FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING 0 [ ] FINAL
RE S: io lt-~
e-4
DATE INSPECTO
Form No. 6S L~
TOWN OF SOUTHOLD SE 22 5 1995
BUILDING DEPARTMENT
TOWN HALL BLDG. DEPT.
765-1802 TpWN FS UT OLD APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. 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 IZ 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.
B. 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.
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 Buildine - $100.00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residentiale~$15.00, Commercial $15.00
Date .....`/J ~.GZ
New Construction............ Old Or Pre-existing Building
Location of Property....
House No. Street Hamlet
7nwer or Owners of Property 71101 Lq d~f2
:';ounty Tax Map No 1000, Section B.lock.. k............Lot.. A
Subdivision ....................................F.i/led Map............. Lot ............/..........t...
"ermit No. ART 00% ..Date Of Permit ....'.~12 ..G1 ...Applicant,.0
IealLh Dept. Approval ..........................Underwriters Approval.......
'lanning Board Approval
request for: Temporary Certificate........... Final Certicate.
r
~eee Submitted:
Z h0 -l a ~s -I D-2~
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1015088 BUREAU OF ELECTRICITY
F 85 JOHN STREET, NEW YORK, NEW YORK 10038
Date MAY 19,1995 Application No. on file 87097495/95 N 35237E
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the abode application number in the premises of
MRS.JOHN MCGIRR, 30 HOLDEN AVE., CUTCHOGUE, N.Y.
in the following location; ® Basement ® lst Fl. ? 2nd Fl. GAR/OUT Section Block Lot
was examined on MAY 15 ,1995 and found to be in compliance with the National Electrical Code.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS ECEPTACLE$ SWITCHES INCANDESCENT FLUORESCENT OTHER AMT K. W. AMT. K W. AMT. KW. T. K W. AMT. H P.
I
22 17 19 18 4 1 1.5 1 F
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIMECLOCK$ BELL UNIT HEATERS MULTI-OUTLET DIMMERS
AMT. K. W. OIL H. P. GAS H. P. AMT. NO. A. W. G AMT. AMP AMT. AMPS TRANS. AMT H. P SYSTEMS pMT. WATTS
NO. OF FEET
2
t
SERVICE DISCONNECT NO.OF S E R V I C E
A W G.
AMT. AMP. TYPE METER 1,6']W I,e'tW t.b'JW 3$4W NO .OF CC COND. A.W CC.. NO. OF HI-LE OF
G A W-LEG'G NO. OF NEUTRALS OF NEUTRAL
EQUIP. .e' HI-
PER OF CG COND
( OTHER APPARATUS-.
3 LINE VOLTAGE THERMOSTAT-1
ELEC. ROOM HEATERSEI-.50 K.W.,1-.75 K.W.,3-1.0 K.N.
ELEC. ROOM HEATERSt1-1.5 K.W.,1-1.8 K.W.
` MOTORSE3-E H.P.
t G.F.C.II-3
I
G & G ELECTRIC LIC.#3733E
81 A SOUND AVE,
RIVERHEAD, NY, 11901 GENERAL MANAGER,
11
Per.
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 CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
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Town Hall, 53095 Main Road Fax (516) 7651823
i-.
P.O. Box 1179 Telephone (516) 765-1802
Southold, New York 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C E R T I F I C A T I O.N
DATE : /9 ~b
Building Permit No.
Owner: ~e
war,
(please print)
Plumber: 0 ~ VFcg !'L
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
G (Plumbers gnatur-e)
Sworn to before me this
S day of _69 4< c 199(-
Notary Public, _ County
9 ¢e~Q ~g ~y e~J LINDAA COOPER
Notary Public, State of New York
No. 4822563, Suffolk County
Tenn Expires December 31,19_
f' C II II - M1'h alii'IPI.?E!3 ..*c»~,. r~.,r .w. w. ~`~'fi?!q~.myyr~y,..
c 1;iLD~ af..,.1: , I N U UniE CUMMENTS `
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7OUI1DATION ( 1 Lai y ( }
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ROUGH FRAME &
PLUMBING G
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INSULATION PER N. Y. m
STATE ENERGY
CODE
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FINAL
ADDITIONAL COMME S; s
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-3. Nature of work (check which applicable): New Building • , ? %
Repair Removal . Addition Alteration
Demolition Other Work .
/11"/4. Estimated Cost •.6051 vdsi Fee .Is (Description)
.......Od......`"
`'ADDtTtoM AN'D A,LTE1zsAT1*Q Tb &XIS'nN& SjWCL•~E (to be paid on filing this application)
S. If dwelling, number of dwelling units FAMILj -DWdW.N6',u 1,be,MI t dwelling units on each floor.....:
t
If garage, number of cars .N.•~; , , • •
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..N; A. . • • . • ' ' ' ' '
7. Dimensions of exi sting structures, if any: Front ...5;~t,-,?ryy", , , Rear ..115 De th
Height I9 . Number of Stories Z . , , . , , P 9 . • , , , ,
Dimensions of same structure with alterations or additions: Front . !53= . • • • , • , • Rear ,
Depth Height ~,Q.'~ • , , , , , , ; , . Number of Stories ...?r •
8. Dimensions of entire new construction: FrontA$vfs Rear . ,
Height . Cy", Number of Stories J. Depth
y. Size of lot: I•ront . ...t}01 Rear ...~02, i1for , oxjt.:..
10. Date of Purclthtse , ,7VN.6..1-•1,19fs Depth . 1`} ?t:.......
• • • Name of Former Owner .7N?MAs. p.e"N
11. Zone or use district in which premises are situated , • • • - •
12. Does proposed construction violate any zoning law, oord !ancto~gulation: . N~
13. Will lot be regraded ..NQ, , , , • , , Will excess fill be removed from NA •
14. Name of Owner of premises4?HN,,MA(j 6,LUgd0!4( premises: Yes Nc
9/iAddress3,5, N..d.N AVt; Ct4LNaw6Phone No.0413
Name of Architect ALM .I,N?. P!AN
.AcldressP~,ST,•,N•,yt(J.y;Phone NAVA~lR:l1.1~'.•
Name of Contractor NAr, `Itrt ~At= 4*u • Address . t '
15. Is this property within 300 feet of a tidal wetlando , *Yes " • No.Phone o :
• *If yes, Southold Town Trustees Permit may be required. " ~ " ' •
PLUS mew g•(,"Inrlpgl5to'D,.12~o"NibH v65ngO1LmNb FRoMr of 6kis71NG kousE
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 whether
interior or corner lot.
M1Dtri°oD ~oAA • ~ ,
GoR.rIER
Lo T' - '
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,1 Ir AvD tto H ;MG S1 MAP No.
USE tiv
Q cl 1.too' Z STORrES' WSW Rt . < t31-0~ No. 2
HW4 tCOeF "4AHAN& Lor hto 11
o
o +n E%1ST)N6 35`
_ C r-' l~ARAG6
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PLOT DIAGK,a H I/3a"-1L0
"
i STATE OF NEW YORK,
COUNTY OF Iffy:... S.S
T- I ' n~L she
' " ~-"a" M A
'N'••••••• Q • • • • • • • • • • • • • • • • • • . . being duly sworn, deposes andsa sthat
(Name of individual signing contract) Y is the applicant
ibove named.
she
is the A.....RG..H.I.T.-.6 . C.-r
(Contractor, agent, corporate officer, e1c.)
,f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
pplication; that all statements contained in this application are true to th•elbest of his knowledge and belief; and that the
:ork will be performed in the manner set forth in the application filed therewith.
worn to before me this DEC 2 a, im
Td a
.................119...
otary Public, „County
JOSEPH SCHWA -
Notary Public, state of
.
No. 24-487
ZA
Qualified in Ki gs Co
cennicate Filed In orkLYounty (Signature of applicant)
Commission Expires Sept. 30, 1994
BOARD OF HEALTH
FORM NO.1 SETS OF PLANS
TOWN OFSOUTHOLD jSURVFY
BUILDING DEPARTMENT - /CIIECK _
UEC 2 91993 TOWN HALL SEPTIC FO RN
pp SOUTHOLD, N.Y. 11071
§L' TEL.:765.1802 N(>7IPY;
Ex WN J4''SE7t1, CALL
• ' A...,, .,,,.II9 MA I L TO:
Approved lL I ermit No: ~t ~oz
rten Disapproved. a/c
y
(Bu' d . pn~ cctor)
APPLICATION FOR BUILDING PERMIT
Dated L}°M13EtZ 2g tAS
INS'T`RUCTIONS
a. This application must be completely filled in b
by typewriter or in ink and submitted to the Building Inspector; with
1 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`stice
or areas, and giving a detailed description,of layout of„property%must be' drawn on the diagram which is part of this apph
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 perm;
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 by the Building Inspector.
i
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 Southold, Suffolk County, New York, and other applicable Laws, Ordinances o
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, b ing code, ho/using code, and regulations, and tc
admit _ authorized inspectors on pre Li tpises and in building for necessary i~~;~tion
k(
(Signature of applicant, or name, if corporation)
FRIwe g iRP.16 ",NEW YoRKIN•y•, 10012
(Mailing address of applicant)
State whether applicant is owner, Ilessee, 'agent, architect, engineer, general contractor, electrician, plumber or builder.
•gtZcHlr~~r'
• •1 • ,
Name of owner of premises °H N AND MARY I:LL&hi M G'GI KK
(as, on the tax roll or latest deed)
If applicant is a corporation, signature of duly'authoriied officer.
' ~ .orate officer) ,C NNDE4 /
(Name and title of co or• • • • f • ~Qep ARpy
Builder's License No.
kt ve?
tY
Plumbers License No.
Electrician's License No. J; No. 1s3ae O
Other Trade's License No.A. NO. 5385 TgTF OF NEB
n
1, Location of land on which proposed work will be done.
GUTGa-lo6U't; .
House Number j Street' Hamlet
County Tax Nlap No. 1000 Seed n , l'l D Block .....2
Subdivision N'
Filcd Map No. . (J . Lot
21 State existing use and occupancy ibf premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy . ,c I NGLE FAMILty~ DWtcLLINCT
b, Intended use and occupancy S(NS~~, ,FAIy1L~ DWELLIrt(T
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NLXoVFUL
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VVI T HOUT CERTI Fl CE 4 FICATE
NEW LINTEL IEN LAR _ £W 3
- ~SW 200?- pG EJ~ STING yJAI-L )ANCY
wIwvoW/ N(S .LL I l_- RKV_ I ra ~L&MAIN _ O OCCUPANCY
New 6A'f WIN<aoly, r- r- WALL To rle gEMoV£D
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1,IINDOW bMov& SAI"T'NG rA-IR5 "',Tl NV
t ' exlsnr+G Lo57;rS. W INDOpI NEw wALL APPRIM0 AS K= NED AS NOTED
n DATE: y 1 /,1 ~ B.B E/1I~70~
Lh/IN& lz-om /l' - rJIµIN C> ILOaM FEE: BY.,
NOTIFY BUILDINr DEPARTI411 INS oEPAfiTIHT`AT
[EKI'yflN V~ CEK15tIN(~~ - 765-1802 9 AM 7 4 PM FI ,M 1 4 PM FOR THE
FOLLOWING INSPEL 'ONS: ISPEL 'ONS:
1. FOUNDATION - , NO REI FOR POURED CONCRETE IN - , NO REQUIRED :D CONCRETE
ill N 2. ROUGH - FRAMING & PLU RAMING & PLUMBING
pa/-WKEr noa PO 3. INSULATION 9"„O00 4. FINAL - CONSTRUCTIOP I
Ar Exl mN~ NG o 2 BE COMPLETE FOR C.O. CONSTRUCTION MUST
OP6NIN(~ TE FOR C.O.
V' ALL CONSTRUCTION SHALL Eri1ST Z THE REQUIREMENTS OF TP ICRON SHALL MEET MENTS OF THE N.Y.
• t3~Plt.ooM Exlsr LwSK- LwSq_ pANrFy G STATE CONSTRUCTION IN E RUCTION & ENERGY
[EKIhYiNG) Oo.. OCuu _ REF• N CODES. NOT RESPONSIBU RESPONSIBLE FOR
INSTRUCTION ERRORS
%Lo Q¢SE WINCON 'TILL ILL b DESIGN OR CONSTRUCTION E I ! _ I
.j ow I ~,N9EN~ARGe N6W SINK Mks -
~~JA~h~ W f ow ~KIS Nb=-'1 4YtiT-IaCAt'IoN-A6ovE PATH F~°eN GOUNTEgS ~EIy°v,kT - 6XI5n NCr - UNDERWRITERS CERTIFICAT RITERS CERTIFICATE
I NEW5I)e N ~ eAR1NEfs- _ REQUIRED REQUIRED
' H Ii V WINGbW
• II NEW New I L/.v I BE WNTEL ~po5r
- PLUMBER CERM PER CERfIFICATION
'111 N 61 ZI - o o ON LEAD CONTEN SINK II en~E = AL-L- NEw LxrLL WAws To uRAMEV wlr1+ CERTIFICATE OF 0( D CONTENT BEFORE
• '~.ELecATEp ti POO ATE OF OCCUPANCY
ATE IsnNb • - NEW Go NC. - h1ATck / 4ovo?S Ey~15r. pANGE,- ~Ln CO'S wlrH rU LL 7EprH 15A1T INSULA7IPN, ;R USED IN WATER
Ar.,ov& eve S FKeL i SOLDER USED /A RAFTE¢5 -To rsE 2xs's MIN. WITH FULL 11ysuLA-r104- fOlSrs SUPPLY SYSTEM
x I To Td,t 2K9'S HIN. 111TH FULL IN51JLlnoN+---_-_- - (SYSTEM CANNOT
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II I.INe>HEI~HT' M' K Ito uZE SEw ER p1P&, 6erIN_ `M d- .0 NEN evNc. rROL6H. - r°LINVATIoNS_ Ar-NEW-APPITIONS Tb gfi pauPeP Lowe, z L,¢-AWL $PAGE ONLY S&Lol,I -AVV jraNS ,
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