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Home My WebLink About21619-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARE~4ENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPD~NCY No' Z-22557 Date AUGUST 27r 1993 THIS CERTIFIES that the building. ALTERATION Location of Property 3520 MINNEHAHA BLVD. SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 87 Block 3 Lot 8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 13, 1993 pursuant to which Building Permit No. 21619-Z dated AUGUST 23{ 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 TO ENCLOSE EXISTING PORCH "AS BUILT" JAMES J. ~ EILEEN YOUNG The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A // Building Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22558 Date AUGUST 27, 1993 THIS CERTIFIES that the building. ACCESSORY Location of Property 3520 MINNEHAHA BLVD. House No. Street County Tax Map No. 1000 Section 87 Block 3 Subdivision Filed Map No. SOUTHOLD~ N.Y. Hamlet Lot 8 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 13, 1993 pursuant to which Building Permit No. 21629-Z dated AUGUST 23~ 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 REPLACEMENT OF AN EXISTING ACCESSORY BUILDING "AS BUILT" The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A JAMES J. & EILEEN YOUNG Rev. 1/81 /~ildlng Inspector FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ........................................................... 19 .... at premises located at...... ,~....O~..~ .......... ¢~,/._,,?(C,,,,,,O~, ,/~.=...?/Z,A~..,."Z,. ...... ~..~....~(,.~..: ................................ CountyTax Map No. 1000 Section ......~...Z. ......... BI/ock....,..~....-~.. ............. Lot No... ,~..~., ................. pursuant to application dated .......,~../-~,.~,...~.../..-~....../ ................... 19... ,~.~.. ..... and approved by the Building Inspector. / ~ull~ng inspector Rev, 6/30/80 · ~ '~- Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-I802 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 2/10 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and qpre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. ~ 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 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 Occ6pancy - Residential $15.00, Commercial $15.OO New Construction ........... Old Or Pre-existing Building ................. Location of Property .... 3520.MI~6~.~LV~ .......... $O~T~OLD,.~EW~QRK ...................... House No. Street Hamlet Onwer or Owners of Property ...... .J..A~..S..J: .&..E.!.L~.E.N..Y.O..UN.G' ..................................... County Tax Map No 1000, Section .... ~ ........ Block .... ~ ........... Lot .... ~ ................. Subdivision .................................... Filed Map ............ Lot ...................... Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ .... .2.5:.0.0 .................... Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~65-1802 ~ AI~PLICATION 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(g-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. 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. ~ 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. 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 Occdpancy - Residential $15.00, Commercial $15.00 Date ..... ~q%.~%.!~ ....................... New Construction ........... Old Or Pre-existing Building ................. Location of Property .... 3520.MI~l~g~.~gVp .......... $O~%HOLD..~'~W.%ORK ...................... House No. Street Hamlet 0nwer or Owners of Property JAMES J. & EILEEN YOUNG Co ty Tax M p N 1000 Section 87 Block 3 Lot ' 8 Subdivision .................................... Filed Map ............ Lot .................... . . Permit No...~7~......Date Of Permit..~P~.23, ........ ~993 Applzcant.' .~..~.~.~%I~.~QI~I~ ....... Health Dept. Approval ...................... · · .. Underwriters Approval ...................... . . . Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ .... 25.00 ! i i .) THE NEW YORK BOARD OF FIRE UNDERWRITERS sAcs~ lOO~3 .U.EAU OF E.EC*R,C,TY ~- 40 FULTON STREET, NEW YORK, NY 10038 Date FEBRLtgRY 17,1999 Application No. on file 17683999/99 !'1 480681 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant'named on thc above application number is in ihe premises of DUANE PA~CArlP 3520 HINLrEI~-P. BLVD., SOUTHOLD, NY in the following location; [] Basement [] 1st Fl. [] 2nd Fl. OU~ Section Block was examined on F~BRIJA~¥ c~8,1999 and found to be in compliance with the National Electrical Code. Lot FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS FIXTURE OUTLETS RECEPTACLES FLUORESCENT OTHER 2 5 DRYERS SYSTEMS NO, OF FEET S E R V I C OTHER APPARATUS: BACK YARD ~HED ~ GOODALE ELECTRIC 7355 }U~IN ROAD ~ATT~TUCK, NY, 11952 LIC. #783E 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. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. AU6 I 31993 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TOW~ 'i..:~2~/~, " TEL.: 765-1803 .xa,, ..... nl< ...... i;j ' A roved ' /~3 19?~ Permit Disapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT B~)ARD OF HEALTH 3 SETS OF PLANS SURVEY C,l c .;..,: ............ SEPTIC FOR,! ~.. ........... t,O~ ~PY ~ CALL · HAIL TO: Date "~ ~.t> ... ............. 19 9,~.. , INSTRUCTIONS a. T~s ap~iea~n must be c~mp~ete~y ~ed in by typewriter ~r in ink and submitted t~ the Bui~ding.Inspect~r~ with3 . sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location olf lot and of buildings on premises, relationship to adjoining premises or public sti'eets or areas, and giving a detailed description of layout of property mint be drawn on the diagram which ls 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 i~sued a Building Permit to the applicant. Such permit shall be kept on the premises availablb for inspection throughont 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 Buildif~g 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 South01d, .Suffolk County, New York, and otlier 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 building for necessa~ inspections. . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, generai 'contractor, electrician, plumber or builder. Name of owner of premises ........................................................................ (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 .......................... Plumber's License No ............... , ......... : Electrician's License No ...... , ................. Other Trade's License No ..... , ................. Location of land on which proposed, work will be'done .................................................. 3 ',a o ' Bt wp : .'.t.&qCU/.,q.6 .wA're House Number Street Hamlet Cou'nty Tax Map No. 1000Sectio, .~...' ........... Block ..~ ......... ;... Lot.~P~ ............ Subdivision ........ . ......... ; ..... . ....... ~ ..... '. Filed Map No ............... Lot ............... (Nmne) Stat~ existing use and occupancy of premises and intended use and occupancy of proposed construction: E i ti nd p a. x S ng use a occu ancy. --......... -.. ............... ~,~:*"~ *'~'=' 2 b. Intended use and occupancy I' . · 3. Nature of work (check which applicable): New Building ~ Addition Alteration Repa/r .............. Removal .............. Demolition .. . . . Other Work ........ ~ '"" , ~,, (Description) 4. Estimated Cost .¥..~.o.o. ........ ' 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 .... ] ............................................... i .......... 6. If business, commercial or mixed occupancy, specify nature and extent of.each type of use ..... ~. ............... Dimensions of existing structures, ~ 7. if any: Front.. ~.q .......... Rear ~-o ' Depth ..?~ .......... Height . .t.q. J .......... Number of Stories .... /. i ............. ' ............. ' ' Dimension?,o,f shme structure with alterations or additions: Front .~.a ' Rea- ~ a ~ Depth ?...~ Height Iq t' '' '.,;'';''''~'~''' 't .................. 8. D~mensionsofentirenewconstruction. Front St°~ l * . P~ A^% " '~ ',["[~ ;~'~; ....... ,n..e,gnt ...t.j. ........ 3' Number of Stories . (..~...r~.6..t..o.S..~-~..??~.~.~.,] ....... . ,~' ',' · · aize of lot Front Iqo ' Rear Iz3' 3,' ' T' '/'o'~ ~'' 'LC 3 : ....... , .................................. ~eptn ..... .~. t¥~. ........... Date of Purchase ............................. Name of Former Owner . .~,4g}". ~cpe~.~/~a...~. ......... Zone or use district in which prexnises are situated..4¥.uy~.q~.~. · Does proposed construction violate any zoning law, ordinance or regulation: . .~.¢, ........................... ~mnill lot be regraded . . ..t~..o.: ......... · ·: ......... Will excess fill be removed fronl premises: eofOwnerofpremises~/~.~.~c 'r'~q.,q~ Address~"ot/~_~Vr4'a~/~t~ r~n~-~,, ., ,~,, Yes _ Name of Architect ........... ' ................... -..i.a.~rr. rhone v4o..o.~.~ .~.qt ...... .~.~¢~. ........................... Address ........ ' ........... Phone No .................. Name of Contractor Address Phone No ' 15.' I.s this property within 300 feet of a tidal wetland? *Yes...~.... No ......... · 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 hnes. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ~-" 10. 11. .12. 13. 14. STATE OF N~IP~YO~ j b S S COUNTy OF.o..4. %.. ' .......S. 5 ...... 0...U<<. ...... .. ........ above named. being duly sworn, deposes and says that he is the applicant (Signature of applicant) Heis the ~ ~.....". ......... (Contractor, agent, cor'porate officer, etc.) of said owner or owners, and is duly authorized 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. 5worn to before me this CLAIRE [ NotaW Publlo, State of New Yo~ . No. 4879505 ,q f . Oualifiad in Suffolk Count*/ commission Expires December 8, ~9.~,l