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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-23184 Date AUGUST 26, 1994
THIS CERTIFIES that the building NEW DWELLING
Location of Property 230 PARK AVSNUE SOUTHOLD, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 56 Block 1 Lot 2.13
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 14, 1994 pursuant to which
Building Permit No. 21950-Z dated MARCH 21, 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 ONE FAMILY DWELLING WITH ATTACHED THREE CAR GARAGE & FRONT
PORCH WITH ROOF OVER AS APPLIED FOR.
The certificate is issued to THOMAS DUNCAN
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R-10-94-0002- AUG 9, 1994
UNDERWRITERS CERTIFICATE NO.-N-324180 - AUGUST 18, 1994
PLUMBERS CERTIFICATION DATED AUG. 23, 1994 - BERTSAND PLUMBING & HEATING
Building nspect
Rev. 1/81
I
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)
F
Date 19...9}
N° 21950 Z
Permission Is hereby granted to; S
1.7
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..!7~......,,.~...... r~~'....... !~............zz
l 's (x d..........Y............. a ve4 .
21 s.......,..%!°.G.........
1 , c jJ ' .
at premises located at...........~ ~~T?
County Tax Map No. 1000 Section 1-.'( ll/............ Block (2........... Lot No.
pursuant to applicatlon dated ~1.. 19.... and approved by the
Building Inspector.
l? o
Fee
7 uiidi g Inspector
Rev. 6/30/80
Form No. 6
F TOWN S0UTHOLD
BUILD'_.',; T z7ARTMENT
HATL
A "I
9E
55-18C.
BLDG. DEPT.
APPLICATION FOR CERTIFICATE OF OCCUPAN --3O-WN SSOUTNOL -D
°W°°
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 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.
3. 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
z 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 Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15,00
Date e ."2j-
New Construction....
Old Or Pre-e/xJisting Building..
Location of Property.. 30.74~..~7./ ~e
,House No. Street Hamlet
Onwer or Owners of Property... . .A m, 5-t ..s 6PP?1~ ~.n
County Tax Map No X10000, Section....: 6 .....Block..... Lot. : / 3.......... ,
Subdivision /6?1'..'4n(,, .Filed //Map.. .037~i.Lot..Ir.../......./......... .
Permit No. QQ
~f,L,d7 ..pp,,Date Of Permit..-,-4:/:lT....Applicant.
/.I:GhQ~P
Health Dept. Approval /L~Q.: ~U:z .......Underwriters Approval
Planning Board Approval
Request for: Temporary Certificate........... Final Certicate...........
Fee Submitted: $..4C. a,,,,,,,,,,,,,,,,,,,
C~.~e,2318~ APPL ANT
Co t a31&-y
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1155013 BUREAU OF ELECTRICITY
F 88 JOHN STREET, NEW YORK, NEW YORK 10038
Date AUGUST 18,1994 Application No. on file 84692694/94 N 3211180
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
MOHRING ENTERPRISES, 230 PARK AVENUE, SOUTHOW, N.Y.
in the following location; ® Basement ® Ist FL ® 2nd Fl. GAR/OUT Section Block Lot 18
was examined on AUGUST 18 ,1994 and found to be in compliance with the National Electrical Code.
FIXTURE ECEPTAClES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K W. AMT. KIN AMT. K.W. AMT K.W AMT. H. P.
37 67 45 37 2 F
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALREC'PT TIME CLOCKS BELL UN17HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
AMT. K. W. OIL H. P. GAS H. P AMT NO A. W.G. AMT AMP AMT. AMPS .RANI. AMT H. P NO. OF FEET AMr. WATTS
1 F 3 - 2 - 1
SERVICE DISCONNECT 140-OF S E R V I C E
G NO OF HLLEG A. W' NO Of NEUTRALS A. W G.
AMT. AMP. ME METER 1, . YW I ~W 3.0' ~W 3 %4W 11-OF fC. COND. A. W G
EQUIP. PER 9 OF CC.COND. OF NbI. OF NEUTRAL
1 200 CS 1 X 1 2/0 1 2/0
OTHER APPARATUS:
,
JACUZZI-1
' MOT0RS%1-F H.P.
j G.F.C-.I.-5
SMOKE DETECTOR.-1
390 OPERATING CORP. LTC.#268
1555 LOCUST AVE.
BOHEMIA, NY, 11716 GENERAL MANAGRl1..
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.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
TEL. 765-1802
0 S~FFOC/, ~O`~ TOWN OF SOUTHOLD
OFFICE OF BUILDIi•IG INSPECTOR
P.O. BOX 1179
TOWN HALL E) ' n;
C/ SOUTHOLD, N.Y. 11971 i .
~Ql QUO 2 4 1.994 .r
F 6LDG DEPT
SOUTFfpLD i .
11 01:
C E R T I F I C A T I O N
Date
Building Permit No. 02 /oreZ
Owner IY`jemr~_f ~,s 7P (d /-q
(please print)/
Plumber 2~~,C,,-„/
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
(plumber's signature?
Sworn to before me this
0, day of
199, ALL c%
Not6ry Public 61
Notary Public, County SO~RY
No.9wsis/1s
®udAW In Nam Owift
Comnbgiaa F~gwas aus• 3D.It 10-4z
Town Hall, 53095 Main Road
CA Fax (516) 765-1823
P. 0. Box 1179 W- Telephone (516) 765-1802
Southold, Now York 11971 i:p
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
August 25, 1994
Mohring Enterprises Inc.
323 Glen Cove Avenue
Sea Cliff, NY 11579
Re: Thomas Duncan
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)
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.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 21950-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
S-0 L
M-1602
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INS ION
[ ] FRAMING INAL
REMARKS:
DATE INSPECTOR
i f
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST t ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INS TION
[ ] FRAMING [ NAL
REMARKS
DATE INSPECTO
6 sss 765-lW2
BUILDING DEPT.
1 NSPECTI N
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL f~ eo~~
REMARKS: _ ljaoo. /
r-
c
DATE INSPECTOR
M-1802
BUILDING DEPT.
INSPECT! N
[ ] FOUNDATION 1ST [ ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINA,L~~
REMARKS: ? - ®T.
' GCo
i P
DATE INSPECTOR t c~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ) ROUGH PLBG.
[ J FO DATION 2ND [ ] INSULATION
[ FRAMING FINAL
, REMARKS:
2~ - CJ -ell
-AftlF
~ le
DATE INSPECTOR
755-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[l...4, 'FOUNDATION 2ND [ ] INSULATION
i
[ ] FRAMING [ ] FINAL
REMARKS: a
i
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E
f~. C
DATE INSPECTS/;r
i
M-1$02
BUILDING DEPT.
INSPECTION
[ OUNDATION 1ST [ } ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS: e111 sue, ~C~
t
l
DATE 4ZAVlq~l INSPECTOR r
i
M-1so2
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] UGH PLBG.
[ ] FOUNDATION 2ND INSULATION
[ ] FRAMING [ I FINAL
REMARKS:
t
y
DATE INSPE
4
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COMMENTS
FOUNDATION ^ (1st) ~ ~
FOUNDATIOtI (2nd) yb
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ROUGH FRAME a~i,
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ri
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NSULATION PER N. Y.
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STATE ENERGY
CODE - 41
4. GC/L~a' L d x 'v-
FINAL
C7`
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ADDITIONAL COMMENTS:
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Builder and Land Developer
323 Glen Cove Avenue
Sea Cliff, New York 11579
(516)671.0481
March 9, 1994
Town of Southold
Building Department
Town Hall
53095 Main Road
P.O. Box 1179
Southold, New York 11971
t
Re: S.C.T.M.#1000-56-1-2.13
Long Pond Estates II, Lot #18
Southold, New York
Dear Sir:
Enclosed, please find a building application, three
sets of plans, one survey, and check for the above
captioned property in Southold.
If you should have any questions, or require additional
i information, please feel free to call. Thank you.
i
I
Very truly yours,
Richard Mohring~
i
RM: sc
Enclosures
:f
Builder and Land Developer
323 Glen Cove Avenue
Sea Cliff, New York 11579
(516) 671-0481
May 2, 1994
Southold Building Department
53095 Main Road
P.O. Box 1179
Southold, New York 11971
Re: Building Permit #21950Z
l S.C.T.M.#1000-56-1-2.13
p
Dear Sirs:
Enclosed, please find a foundation location survey
in regard to the above referenced property in
II Southold for your review.
If you should have any questions, please feel free
to call. Thank you.
I
Very truly yours,
Richard Mohring
RM:sc g"
Enclosure
}
it
44 - 1 BOARD OF HEALTH ~
.211 FOHMN0.1 3 SETS OF LAMS
TOWN OFSOUTHOLD SURVEY
BUILDING DEPARTMENT CHECK
TOWN HALL sEr~TiC roRrl tom...........
SOUTHOLD, N.Y. 11971
TEL.: 765-1802 t:oTZFY: r// = m
/ ~j CALL V
Examined 71, 19 ~ t1A I L TO :
Approved ....4 19F~Permit No.. ~9 • • . • • • .
Disapproved a/c
(B mg I sn'pector)
APPLICATION FOR BUILDING PERMIT U
Date ..1 %l4Gl!.`3r....., 19`fz(
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 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 issued a Building Permit to the applicant. Such permit
s'nall 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 her applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for re ova or de litio , as herein scribed.
The applicant agrees to comply with all applicable laws, ordinances, building o e, ousin od ul us, a to
admit authorized inspectors on premises and in building for necessary inspect' ns
(Signa re of applicant, or na e, if a c o tion)
(Mailing address of applicant) rl
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
........................UCvj/~ ARAO1/C rw.............................................
Name of owner of premises ......~«lj~;S... 7 !~lh.G/Q .
(as on the tax roll or latest deed)
If applicant 's c por 'on, i a of au orized officer.
(Name and title of c porate I r)
Builder's License No . .
Plumber's License No. y
Electrician's License No.
Other Trade's License No . .
1. Location of land on which propose work will be done . .
f 3c J.r~, .e............ c uf~rv/
house Number Sttreet Hamlet
County Tax tMap No. 1000 Section Block I. Lot 13......... .
Subdivision t,bH,}.. M ~~AACS • • • • • Filed Map No. a0 3 V...... Lot ~ .
U (Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy
b. Intended use and occupancy rl.n L,~, , , , , ,~wf~/ . .
3. Repair Nature of work of work (check which applicable): New Building Addition Alteration I',
Rem oval Demolition Other Work .
(Description)
4. Estimated Cost...... . ~-P/.:..I Fee......................................
.
(to 5. If dwelling, number of dwelling u its Number of dwelling nita on each filing floor application)
If garage, number of cars .
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use , , , , , • , , •
7. Dimensions of existing structures, if any: Front Rear Depth , , .
Height Number ofStories
.I..........
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Numb r of ones r
8. Dimensions f entire new construction: Front . -77 f.~ 1....... Rear ~.4........ Depth 24,' /o
Height , . Nu ber of Stories .
9. Size of lot: Front llt.G. t ~ Rear . f . , . • • , , .
10. Date o ro Purchase
proposed construct premises Name of Former Owner' v.u. e{.u ' . • .
11. Zone or use district in which ' v . ~ .
12. Does
p p situated
' n • violate I, , , , , , • .
zoning law, ordinance or regulation: ??Q
13. Will lot be regraded ...e5.. Will excess fill be removed from premises: Yes No
14. Name of Owner of re rises .7~lpwcuS, ~Z.-
p h~Ai k, Address Phone No. W ! . ? .
Name of Architect . A*UPr...' . , . Address Iq 4114AK 4*4q- Phone No..(P.;?:j9
Name of Contractor .45 3 is 4 . Address O' A4 &t' , . Phone No. AA
15. Is this within 00 feet of a tidal wetland? *A's L
property No./C......
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
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.
{
,
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II,
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STATE OF NEW YORIPR S .S
COUNTY OF. .
' ' ' ' ' • • • • being duly sworn deposes and says that he is fh'e applicant
(Name of individual signing contra
above named.
He is the l1?7ZGlC,TC7
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is dulyauthorized 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; aprd that the
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
7
/.......day of . l?• ,aaczti9
Notary Public, , , , , County
NMR0
NO?/MY'pltm.ICr'&~me
M N. VMk . r
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