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Home My WebLink About21395-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22647 Date OCTOBER 8, 1993 THIS CERTIFIES that the building ALTERATION Location of Property 285 NORTH OAKWOOD DRIVE House No. Street County Tax Map No. 1000 Section 127 Block 7 Subdivision Filed Map No. LAUREL ~ N.Y. Hamlet Lot 18 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated D~PRIL 30, 1993 pursuant to which Building Permit No. 21395-Z dated MAY 7~ 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 ALTERATIONS & REPAIRS TO F~fISTING ONE FAMILY DW~I~LING AS APPLIED FOR. The certificate is issued to of the aforesaid building. THOMAS (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-286177 - AUGUST 13~ 1993 PLUMBERS CERTIFICATION DATED OCT. 1, 1993 - THOMAS P. SH~VFER¥ 18lng Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. N~_~T? BU,LD,N~ .E.~,'r (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ~l~Ii Z Dote .....~.../.~.. ........................................... , ,9~. Permission is hereJa~ granted to:~ ~ _ ~ , __ . ........... . , ....~. ........ ~.-.~ ~,..~..-~,~.~, ~.......:~~.:.....~. ........................................................ ~ at premises located at ...~,,..¢~T:.~........~~.i~ ................................................... County Tax Map No. 1000 Section ..... /. ............... Block ~ Lot No. /~F" pursuant to application dated ..... '~.//~..,.~.. ................................... , 19..?.~.,, and approved by the Building Inspector. Fee $..../. ~...~.. f~. Rev. 6/30/80 Form No. 6 TOWN OF SOUTttOLD 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 2/10 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. 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 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 .l.O.l.J.t..~..~. ......................... . . ~ew Construction ........... Old Or Pre-existing Building....~... .......... ,ocation of ~ropernv .................... . House No. Street Hamlet Inwer or Owners of Property. ..~.A.~.2. f ~ I~ ~/~ /g{/ · . . ..... ....... OUnty Tax Map No 1000, Section .............. Block .............. .. Lot .......... · · ....... Filed Map ............ Lot ...................... ubdivision ........................... ermit No.~.~.~..~..~..~.~%....Date Of Permit ......... · · .. ...Applicant. ~..6~....~..~9..~...~ ........ ealth Dept. Approval ......................... · Underwriters Approval ......................... lanning Board Approval ......... ~ . equest for: Temporary Certificate ........... Final Certicate ........ ~.. Submitted: $ ............................. .......... ................. A PL C T . INSPECTORS Thomas Fisher Building Inspector Gary Fish Building Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD SCOTT L, HARRIS, Supervisor Southold Town Hall P.O. Box 1179; 53095 Main Road' Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 CERTIFICATION Building Vemit No. 01 [ ~ c~ ,7 7__ (please print) Plumber: --/~ ~,~ ~ ~. (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1I lead. (Plumbers Signa~fire) / Swor~n~o before me th, is /~-----~ day o~f~, 19..q~ . Notary Public ~ounty // Notary Public HELENE O. HORNE Notary Public, State of New York ~o. 495 ~ 364 Qualified in Suff01k Coun~ Commission Expires May 22, THE NEW YORK BOARD OF FIRE UNDERWRITERS ~:~', ~ ~,~0~:~l~[ BUREAU OF ELECTRICITY j~ 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date ~(~I~'I~ ~3~'19~ ~pplicationNo, onfile ~0~99~:~/93 ~ ~i'~'~ THI~ CERTI~IE~ THAT o~y t~ e}~trical ~uipment ~ ~scribed b~lo~ and introduced by t~ applicant ~d on t~ a~ve application nu tuber in the prances of Lot FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT OTHER DRYERS SYSTEMS E OTHER APPARATUS: R R V I C OF CC. COND, NO. OF HI-LEG NO OF NEUTRALS ~ /C4A' W, O. OF NEUTRAI. GENERAL MANAGER 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. THE NEW YORK BOARD OF FIRE UNDERWRITERS t.(~.~l.~ BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date THl~ CERTIFIES THAT Lot FIXTURE f~ :l 7 [IXTURES OUTLETS ECEPTACLRS SWITCHES INCANDESCENT FLUORESCENT OTHER 18 '? 2',> l SERVI~ DI~ONNECT NO. OF S OTHER APPARATUS: MOTORS~2-F }t.P, S~OKE DfiTfiC'POR~-3 TRRCK LIGlli'f~6 ~ '1,2 RANGES ~PECIAL REC'PT R COOKING DECKS OVENS DISH WASHERS I C E EXHAUST FANS AMT. H, P DIMMERS 2^~T ~i;~TS BOg 1 6 , S 'I' 1'I,,I ~ A~I'~I R .C. LH'CIIOGIIi? ~ NY, [1935 GENERAL MANAGER 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 BLIILDIi'~G DEPAMY~EM'F. ¥HI$ COPY OF CE~tT~F~CATE ~U$'T I~OT BE ALTEFtED I1~ AAIV ~iA~NE~. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION ZND ~/INSULATION FRAMING FINAL REMAI~KS: ~, INSPECTOR ~~ 76S-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [] FRAMING [ F~I~L ~U~D£TI 0__.~ ~ 'OUNDATIOU (2nd) ~UGH FRAME & -PLUMBING CODE ~DDITION~'L COMME~TS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ~ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING [~/F~NAL DATE 765:1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [,/~RAMING [ ] FINAL DATE I NSPEGTOR 765-~802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ~ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ,~ [ ] FINAL DATE INSPECTOR FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 _,:;,/ .... ' TEL.: 765-1802 Approved - .7~.. ........ , 1~.~. Permit No. Disapproved a/c ..................................... · (.~/ildi~Mspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ......... 3 SETS OF PLANS ......... SURVEY CIIEC~ .._ ............... ., ~EFTICFORH CALL ............. g ..... HAIL TO: INSTRUCTIONS a. Tiffs 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 ·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 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. 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 describbd. 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 necessary inspections. -- (Signature of applicant,----or native, if a corporation) ..... .'77~ . ~ ~. .q . .-~-%. . . . I.,~,.~. . ~. . F,,i.v. . .~. . . . .~/4.. .t t~! (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ' ' ~, £ ~ ?r~ ~,. . ' (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. ;. . ' · ..To.. ge. Plumber s License No ................ Electncmn s L~cense No ....................... Other Tradev. License Nc, 6/ Location of land on which proposed work will be done. ~...('..~. {D$~CO~ FOlk ...4.o.%'.4.7 '. House Number Street Hamlet Count TaxMap o.,000s o ,on ........ lock '...O..?.. ' Lot..t53 ........ ' ..... Subdivision. Filed Map No. Lot (Name) 2: Stat~ existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... { ~, .~,. ,.. ~ b. Intended use and occupancy .... ' ........ .; , · 3 Nature of work (check which ~Pplicable): Ne,e~Bu ' A~. ' Repair ~ Removal--. ~"' ...................... on .... ~ ..... · ' Bemotition Other Work '~(~ OOO '"" ' (D ipti ) 4 · Estimated Cost. · . , escr on ! . (to be paid on ~ling this a lication 5. If dwelling, number of dwellin~units . ~-.~ ...... PP ) ~-- ~ .............. anuniuur Ol owenlng units on each floor .............. · If garage, number of cars . .~. .................. ' ......................................... ..... 6. If business, commercial or mi.xed occupancy, specify nature and extent of.each type of use ...~...... Di ' ' · ' .f r R ' 7. mensions of exmt,ng structu es, ~ any: Front ............... e ........... De ........ Hight N Db fSt /..4 ~ a;...., pth e ............... Ul er o eries ......... ' ...... Dimensions of shme structure with alterations or additions: Front ...-$..~ .~.% ........ Rear D pth ~.~.m. ~i i Hight .~..'q. qrB.. ,~. "' '~' "~'r9 ..... · ... N mbt of Stories .-xR',~.~' ' ' 8 Dime si ns oft ti onstructi Front · ..... u r .... · n o n re new c on: ........... . Rear ............ ................... Depth ............... Height ............. ,,. Number of Stories ........ I ....................... . 9. Sizeoflot: Fro'hr.. k.~.~.(~'i ' 'R;ar" 0.O. ' ,, .· "~ ................ I0. Date of Purchase .... j.~. ~e. ~... ' ..... ~. · .; ........ uepm . ............... Name of Former Owner ~.l¢.~. N..~.~j~S.~....d...,..~..o.~q~ 11. Zone or use district in which pr~mises are situated ~,~:'~ 1 12. Does proposed construction violate any zonine law r,,-ai.,,,d ....... . ' ' '" ........................... '13. Will IA/- h~ ~.~ ~ ~ r~ - o .-_, ...... --~ ur regulau0n ..... , ....... ,, ~ ,, s ~ - . '" '_ ..... ,~ ....,~. ......Will excess fill be removed from nremis~s. 14. c~ameo~wnero~prem~ses . ~o.r~,o >. .r. .~..O.~. .~-q. .Y aaa .... '-;..t F~,-~er ta,~ ,,'- ~ ' Name of Architect f_-Cg }t k ~:.~. .' r" T'~ ..... '"~¢v'O'~l~' ~{)'l,,~,C · rhone No. Name of Contractor . *c~//q~'~*c"~Te' ' ' Phone No...-7~. ~r: .'/.'(615 .... · .O¢/-~ ~ .............. Address ................... Phone No .... ' .. 15.' I.s this property within ~00 feet of a tidal 'wetland? *Y-~s ........ ' ......... · 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· STATE OF NEW~RK~ //'~ oio cou ¥ _ ...... .' '; . · · ~ · .'~ ....... ' .... ; .... being duly sworn, deposes ~d says that he is the applicant (Name of m&v~dual s~gmng contract) ~bove named. {e is the ' ' i (Contractor agent ............................... ' ........... i , , corporate officer, etc.) .. .f said owner or owners, ~d is duly ~uthorized to perfom or have perfo~ed the said work and to m~e and file this pplication; that all statements contain:ed ~ this'application are true to the best of his knowledge and belief; and that the ~ork will be perfomed in the m~ner s~t forth in the application filed therewith. worn to before me this . .............. .~2...day of.., ...... o' ' Y · . County N~ Publlo, State ~of N~Y~ ........ . __ ~u,lWled in Surfak Counw. -~ ~mml~lon ~lres D~mber ~ 19~