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Home My WebLink About21793-zFORM NO. 4 TOWN OF SOUTNOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF O~CumANCY No Z-23126 Date JULY 28, 1994 THIS CERTIFIES that the buildin~ Location of Propert~ 435 RILEY AVENUE House No. County Tax Map No. 1000 Section 143 Subdivision ALTERATION & ADDITION MATTITUCK, NY Street Hamlet Block 4 Lot 18 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 8, 1993 pursuant to which Building Permit No. 21793-Z dated NOVEMBER 20, 1993 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 ALTERATION & SECOND FLOOR BEDROOM & BA'£~KOOM ADDITION AS APPLIED FOR. The certificate is issued to of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL INSPECTION SERVICE 4029 (owner's) N/A JUNE 23, 1994 PLUMBERS CERTIFICATION DATED VAN ETTEN PLUMBING & HEATING JULY 28, 1994 Rev. 1/81 FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENt TOWN HALL SOUTHOLD, N.Y. N~ ~1793 ~ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED') Permission Is hereby granted to', ~ , .~...~......¢..~.. ..................................................... , ~~..~.....,...z~.z.~.c....;. to ....... ...................... ...................... ...... ....... ~~.....~~.....~.....~ .............................................. at premises located at ......... CountyTax Map No. 1000 Section ......... .~.....~..,,~...... Block ............ ~ ...... Lot No ....... .~....~.., ........... pursuant to application dated ......Z .~..~.. ....................................... 19.....?...~., and approved by the Building Inspector, lng Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 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 Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/i0 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. 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 I. 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~lS.O0, Commercial $15,00 Loca House No. Subdivision. Permit No I~ealth Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ......... ; .............. ~,equest for: Temporary Certificate ........... Final Certicate ....... INSPECTORS Thomas Fisher Building Inspector Gary Fish Building Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 SCOTT D.,~RR1S, Supervisor · SoutholltTown Hall P.'~, Box 1179, 5309510lain Road "-~SS~3%thold, New Yoik 11971 x'~;~pa~o(:el ~5)/6~ 5~ ~852-138 0 0 . OFFICE OF BUILDING INSPECTOR TOVffN OF SOUTHOLD CERTIFICATION Building Permit Ovmer: Plumber: (please print) (please print) .~//~o~'~, wO Z ,'c- ?o~>oo I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers Signature) JOYCE a. WILKIN6 Notary Public, State of.New Yodc No. 4952246, Suffolk County Term F. xpir~ June 12, 19,,~*~ 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, 1994 Mr. Michael Verity P.O. Box 476 Greenport, NY 11944 Re: Allan & Ellen Wexler 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. $25.00 No Health Department Approval on file. No final inspection has been made. xx No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 21793-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [' ] ROUGH PLBG. FOUNDATION :~ND [ ] I~ULATION FRAMING [g,]~INAL REMARKS: ~/,,, ///~ · DATE '~//~/~:~ INSPECTOR ELECTRICAL INSPECTION SERVICE, INC. 375 DUNTON AVENUE EAST PATCHOGUE, NEW YORK 11772 4029 Date 6/23/94 APPLICATION No, ON FILE ADDRESS: 43.5 Ril~ven~ VILLAGE: Hattituek TOWN: Southold ISSUED TO: Allen Wexler INSTALLED BY: Lademann Electric 1st Floor, Outside, Residence was exam/ned on 6/23/94 F,x~ru.E 17 9 SWITCHES 9 LIC. NO. 4141-E and found lo be in compliance with Ihe Nalional Electrical Code. G.F.I. FAN AMT K.W. AMT K.W. AMI K.W. ! . SERVICE OI$CONNECi' President .o.o.._, ,oo...i o. Smoke De,actor Thl~ certificate mrJst In~l~ctors mey ~ Iderdifl.d ]1'65-1802 BUILDING DEPT. INSPECTIO~N~ FOUNDATION 1ST [ ] R~H PLBG.' FOUNDATION 2ND [~/]' INSULATION* FRAMING [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [,~'~ROUGH PLBG. J FO~DATION 2ND [ ] INSULATION FRAMING [ .~] FINAL REMARKS. ~ /_/-~----~ DATE 7014 (i'm:l: 5} 6,000 {: All I~lc~ Bya~et~ ~o n~e~ Ue~{liJ~e.~nt:a o~ 7B14.13 FOUND~_TION (1st) FOUNDATION (2nd) ROUGH FRAME & .PLUMBING 3. INSULATION PER N. STATE ENERGY CO'DE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOU~THOLD BUILDIN(~ DEPA~T,~ ENT TOWN H ~L"k SOUTHOLD, N.Y, 11971 TEL,; 765-180;2 Approved .............. , 1 . Permit No ........ Disapproved a/c ..................................... - . , , C/ns APPLICATION FOR BUILDING'PERMIT BOARD OF HEALTH SURVEY ......... CII~cK SEPTIC .................... ;ORH t;OT 1 Fy; CALL ~IA~L TO: INSTRUCTIONS 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 sfi'eets or/~reas, 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 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 ~y 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 all applicable laws, ordinances, building code, housing code, and regulations, and to admit authofizedinspectorsonpremisesandinbuildingforneeessaryin~,j..~. . . . .....~ ~ .__~_..~ . -- ' . (Si°nature of applicant; (~ ~l~/n'e' ii; c;;~gr'a~/o'n')' ' ' .- (Mailing address of applicant) ,//~,~ State whether applicant is owner, lessee, ag_ent, arc~hitect, engineer general 'contractor, electrician, plumber or builder. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) llder s License No .................... PIumber'sLicense No.. ~. {~...~..~..."...~. Other Trade's License No ...................... Location ofiand on which prop. osed work will bedone ............. ' ............ :. ,. House Number Street Hamlet Cou~ty Tax Map No. 100OSection .'.:. .. Block ....... .'... Lot..~.~. ............ Subdivision ........................... · ......... '. Filed Map No. · (Name) .............. Lot ............... Stat~ ex/sting use and occupancy of premises and intended use and occupancy of proposed ;onstrl~ctiow ' ' ' '......_.?..... · 3. Nature of work (check which ~pPlicable): New Building . ' ........ Addition .,, Repair ......... ,:~. · · Removal .............. Demolition ..... ; ..... 4. Estimated Cost ~>O 0 (to be paid on filin a lcation 5. If dwelling, number of dwellin~ units ..... ....... Number of dwelling units on eac oor ..... ~.. .... Ifg , . h fl · arage, number of cars .... I ................ ' ' ' · 6. f business, commercial or mixed occupancy, specify natur%and extent of each typ~.of use ......... r ....... 7. Dimensionsofexistingstruct~es, ifany: Front .... .~. ~..~ .... Rear . .c~...~. ....... Depth .~.~' . ~H.eight ............... Number of Stories ..... i..~.~. . .. - .... · ~lmensions o~f s~a~e structure with alterations or additions' ~'r~)~t .... c~-i~ 't' ....... ,~ ....... ,Z,'2' ;, ......... 8. Dimensions of entire new construction: Front. ,/Z/: r . ~.. Numbe~/~S/tones ..... ~...~.~._.: ? ........ ...... /' ,'"~" .. ............... · Nam_0 of..Foxmer Owner .......... 1 I. none or use uistnct ~n which pr'cruises are situated ~.~,,...t~ .............. ~: ....... 14. I5. ' ...... Alteration ...... Other Work ............... (Description) Does proposed construction violate any zoning law ordinance or re ulation' Will lot be regraded ~ _ ,,,., ..... · ...... ...... ,,"Yl/~" ' ',4' ,~...-)'~........,~ . Will eXCeSS HII D.eremoved from premises: Yes Name of Owner of premises (~ .~.. ~,if, ff4'.,~..~.~dress .~.~.'~ ~. _R~.... ph,,,~ *¢,, c-~ ~ ~' . Name of Architect , . ~ ';;h~'~g~ .................. .~. ·. · .~'~..ff. · · ....... . .............. auuress . 4. ;':;';:.'V;'.. Name of Contractor ~.~.~ .~ '/2J, ~;,,;.,;Z,,~ ~' '.' ' ': Phone No. ,; ..... _~ .,..; .... T~ ~h~- -- _ '"'.~;'.''~',%,,' ';'~' .......... ,~uaress c~,:'.;~.~.,~..¥'(.~....~..PhoneNo -~ ...~ property w~tn~n ~uu rear of a tidal wetland? ,v .... "'[~ ~' .................. · *If yes, Southold ~own Trustees Permit may be-req~rS~['''''' t~o../Q~x ..... PLOT DIAGRAM Whether existing or proposed, and, indicate all set-back d/mensions from ~umber or description according to deed, and show street names'and indicate whether Locate clearly and distinctly allj buildings, property lines. Give street and block interior or corner lot. STATE OF NEBLYORK~.P_ / . (Name of individual signing contracij''/ anove named. · being duly sworn, depose9 and says that he is the applicant is the....... .................. 4" ..~..'71~ ....... ...' ............. .. ' · .: agent, corporate officer, etc. ..................... said Owner or owners, and is duly ! · ~ ' outhofize--~o perform or have performed the said work and to make and file this tpplication; that all statements conta nled in this application are ~rue to the bes~ of his knowledge and belief; and that the york w~l be perfomed in the manner s~t forth in the application filed therewith.' ;worn to before me ~his a . · N~wPubllo, Statoof ~ewYo~ ' , ' ' ///~ ~ ~/ ~ ,' . ' Oualifledin SuffNk',oun~',,~ .~ ............ ~:..~/./ ...... ..... ;'.'~ ... ~mm~lonE reaD~orlberu~l~l , ' ~/ ' '~- · '::d,~. ~ .. *~t · ',' · . ~ . ' ~ignatureofappbc~t). ;, FROH FlU T~:TT f .q4E T $0 u 1_ PLUMBING ALL PU,~; WASTE & ~TER LINES NEED · ST~NG BEFO.~E COVE~:NG ~orc°pper tubin9 is used Water distributing sYStem; PiPing ~hall be of PLUMBER CERTIFICATION .~ ,',n TENT BEFORE ON LEAD ,..vN CERTIFICATE OF OCCUPANCY SOLDER USED IN W.~TER sUPPLY SYSTEM CANNOT EXCEED ~/~0 OF ~% LEAD. J I ! ~"~ ID' -% .... LLZAI..L..N.6.W. (-¢MS, TgL,~TIOIO. 'P_.....X.~ ~ ii. .I · ,. . ..... I '~i · ~ ·