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Home My WebLink About21404-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22828 Date JANUARY 7~ 1994 THIS CERTIFIES that the building Location of Property 325 GOLDIN AVENUE House No. Street County Tax Map No. 1000 Section 135 Block 2 Lot 14.1 Subdivision Filed Map No. Lot No. NEW DWELLING SOUTHOLD~ NEW YORK Hamlet conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 5, 1993 pursuant to which Building Permit No. 21404-Z dated MAY 12, 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 ONE FAMILY DWELLING WITH ATTACHED DECK~ AS APPLIED FOR. The certificate is issued to JAMES & JI3LIAFOLEY (owners} of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 92-SO-110-DEC. 1, 1993 UNDERWRITERS CERTIFICATE NO. N-297696 - DEC. 2~ 1993 PLUMBERS CERTIFICATION DATED OCT. 13~ 1993 - TRT PLUMBING & HEATING Rev. 1/81 · OR~ bO. 0 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°-N.° 21~04 Z Permission is hereby granted to~ / ,n / ~. . ~ // -- ~ ~ ................. ~ ........ ~ ...... ~.~..~... . . .:~~~.~....~.~...~ ........... . - ~,,_ ..................... .................................................. ~~~ ........................................................................ County Tax Map No. 1000 Section ......... ./.,~.., ,,~., Block ......... ~ ...... Lot No .....L. ,.~,Z ..... pursuant to application dated ....~..~ ....................................... , 19,.~-~., and approved by the Building Inspector. Rev. 6/30180 ..... Form No. 6 TOWN OF $OUTHOI .~ ~PLICATION FOR CERTIFICATE OF OCCUPANCY TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 unusnal 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 solde~ 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. 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 .../. ¢,~/~..~'?. ............................. ~ew Construction...........~ Old Or Pre-existing Building ................. ~ocation o ~roperny ......................................................................... House No. Street Hamlet )nwer or Owners of Property...~..~ ~ounty Tax Map No 1000, Section..../..~.~..~?.°.. ;ubdivision ?fZPf.g.~V/...~V.~.~..~................../~ 6~'~ .Filed Map ............ Lot. ...... ~..Z! $ ~Zo..~.~..7.<.ZO. ~ermit No °~/ ...Date Of Permit.. Applicant ................. lealth Dept. Approval .......................... Underwriters Approval ......................... ~lanning Board Approval ........................ ~equest for: Temporary Certificate ........... Final Certicate...~. .... 'ee Submitted: $.. Zf~oo , ............... ,.3 .' TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. Owner --~-~f (please print) Plumber (please print) ' b I certify that the solder used contains less than 2/10 of 1% lead. in the water supply system (plumber's signature) Sworn to before me this Notary Public, County/, .N°~ary Public THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK. NEW YORK 10038 Date ~)~(~{[]~,~ ~, Ch~ Application No. onfile ~2~5~/~ ~] ~9169~ in the following location; [] Bo~sement [] I st FI. t~s examined on ~] 0 ~'~ l'{ I.~ ~ ~. 29,~.993 FIXTURE OUTUET$ DRYERS [] 2nd Fl. ~r~,[C~/O[~ Section Block and found to be in compliance ~ith the National Electrical Code. Lot FIXTURES RANGES OVENS I EXHAUST FLUORESCENT OTHER FURNACE FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: t'iO'I' ~0 ~ DETBC~'OR-.1 R V CC. COND. NO, OF HI-LEG c E A, W. O NO. OF NEUTRALS OF HI-LEG 1 OF NEUTRAL C[/~CIIOOiI~ NY, 1~935 GENEBAL 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. ~DU~DATION (1st) ~UND~TIO:! (2nd) ~UGH FRAME & .PLUMBING ~SULATIO,~! PER N. Y. STATE ENERGY CODE Ii FI;;AL hDDITIONA'L CO.~.MENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. i' ] FOUNDATION 2ND [ ] IN~UIJIiTION [ ] FRAMING [/.>']'"FINAL REMARKS: BUiL~ 76S 1802 INSPECTION~ ~ [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] INS/ULATION------..---,--------- [ ] FOUNDATION 2ND [~NAL~FI [] FRAMING l DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] R~H PLBG. FOUNDATION 2ND [,/]- INSULATION [ ] FRAMING [ ] FINAL 76~-~802 BUILDING DEPT. INSPECTION [ ] FOUNDATION t5T [ GH PLBG. [ ~FRAMING [ ] FOUNDATION 2ND [ ] INSULATION [ ] FINAL REMARKS: DATE INSPECTOR 7GS-XS02 BUILDING DEPT. INSPECTION ] F/~UNDATION 1ST [ ] ROUGH PLBG. / FOUNDATION 2ND [ ] INSULATION [ ] FRAMING £ ] FINAL REMARKS: , , DATE ~(2/,~//y_~ INSPECTOR //~ ~//~ 765-1802 BUILDING DEPTi ~ '°u"~INSPECTION [ F~OUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: ~ . - ~_~ ~OR~,~ NO. 1 TOWN OF SOUTHOLO. ,,,, o BUILDING DEPARTMENT ,:~., , TOWN HALL .' ; ~OUTHOLD, N.Y. 11971 '.~/~.~ TEL.: 765o1802 ~is~pproved afc .......................... ........... .............................. ) ...... eclat APPLICATION FOR BUILDING PERMIT · ' INSTRUCTIONS CALL tIAI L ~. Tiffs application m~t be completely filled ih by typewriter or in ink and submitted to the Building Inspector, with -~t~ of pl~ns. ~ccur~to plot pl~n to ~cale, FQ~ accor~Eng to schedule.' ]- ~---, ~ ~vm~ u ue[~zeu o~scmpuon o[A~yout 0t property 'm~t be drawn on the dla-ra~ which is n P ~ st c 'c. The xvork co ered by tMs application may not b¢ commenced,before issuance o~ BuQding Pc~it. . ,,.'..~: ~po~ apEroval o[this ap~ticafion,~he Building Inspector w~l issued a,~uild~$.Pc~it to the app~c~t. Such ~ ~ Kept on the premises ava~:ble tar mspcctlon/hrou~out ~hc work. ' ' , .~i N~ bufld~g shall be occu?~t or ~ed in whol~or in part for aO~ purpose whatever until a Certificate of Occup~c. ,nat~nav~ oeen granted by ~c Building Inspector. . ' ' , APPLICATION IS HEREBy MAD~ to th~ Building Dgp~ment for the issuance of a B~Iding Pcrm/~ pu~uant to th. ~ui[din~ Zone Ordinance of the Town of Sou/hdld, Suffolk County. New York, ~d other nppIicable Laws, Ord~c:s o ~gubtions, fo~ thc Construction o~ bufld~gs, additions or alterations, or tar femoral or demolition, ns hc :~ ' ~nc applicant Ugrc~s to comply with all. app[ica~e laws. ordinances, bufld~g code- hous/n- .~...~ ..... ~ .,_ described ~l~lttng a~ore~s of applic~t) ~t~te 'w~¢th~ ~pplicant is owner, l¢ssee..agent. ~chit~cg. engins~r, g~ncral contractor. ~lectrichn. plambsr or builder. ~' ' . ~ g.. ' g . (as o~ tho tax roll orhtcst deed) ......... If apphcant Is a corporat:on~ slgnatur~ of duty authoriz~d (Name and tiU~ of coworat~ OfficeO " . /.l.a.,.. Builder's Llc~nsc No. ~, , .............. oqo P ' art's Li ' Elccrricl c~nse No, "' ,Locatton of land on wh[ch proposed workwtll bu done.. . .......... /. ~.~ .,.;;.~y~ .......... ..t{ous~ Number Strcc~ ' HamMt ......... .CountyTax a o. 1000 Section ........... ; Bloc~... · .......... Lot ...... ; Subd[vmon .... . .....Eilcd Mop No ............... Lot . , .. State cxhtlng rise and occupancy of premises and m/ended tt~ ~,d 9ccupancy of proposed construction: a. Exhting usc and occupancy ..................... . ...... . .............................. b. intended us~ and occupancy ' '. 3. Nature m'wor~ (¢hec~ which ap~i~=abl~): Now Buildtn8 .. Addition ..... ~ .... ~tcrat(on ....... R~p~r Remo¢~l ' D~m~fldon ' O~hcr Work 4 ~stimat~d Cost Fc~ , ~ (to bg paid on ~llng this appllzalion) .,,S. Ifdwdling. nu,nborordwellinsumntt~ ~W~ ...... Numbur0rdw,~llingunitsoncuchfloor .~. ., , .. 6, Ir.business, commercml or mine occupancy, speed y natnro und extent or each typ= of uso . ... .... , .... ? D' 'onsol'exnhn' ' - ' ir any Front' ~ Roar Dupth Hgight Numb=r of StOd=s ' Dimensions of ~am= st~ctum wt(h altera'tmns' o~ addltmns: Front .... , ..... ; 'Roar ................ u. ' Depth m tlot~t ' r ' : NumbcrofgtoHcs Dlmensmnsprentiro newco~s(~gtton.: Front.,, J,~ ~,,.;,,,, car ,,~/ ........ Depth ,J~,l ........ t0, ~at~ otPurch~so, ,~,, [ ,.~ ....... . ...... : ......... Namcor Fp~cr Owner ........................ 12, Docs proposed cons[ruction violMc any zoning laxv, ordJnsncc or regulation: . . '" ' ' PLOT DIAG~M... ' '. ' j .... go;at~, ck~ly ~d d~stmctl~ ~l~bufld~gs,'Who~h~r eximng or pro~os~d; ptolemy 5n:~. Gh~ ztr~ ~ block numb=r o~ des~Hption according to int:~or or comer lot. TATE O F N E~r 'rg~.R K, ,... OUNTY OF, .:~.%fiiq,. ......... i '~'~ ' ,',~,ke, e,D, .~,,, ?-, ,t..~,~ ~ ~0, ~ ...... ;'i ¢,', .....bdit~gi'duly swOm,'dop'oscs ~d says that he is th: applica~ (Name of individual. $igo,ing con,tract) named., m ~' ~tor th , agent, co~poratc officer, crc,) ~?~ ?~nc[ or owners, =d is d~J[ authorized to perform 'or have performed tho said work and to m~c and file ~n~ano'nl that a statements contained tn tllis a licatlo: " , · , · · ,. , ..n,, .... . ............ PP ,, ?c trtm to Utc beat of his knowlcdgc and bch~f, and tllat [0 betoa mc tllls~/~ ~ (g~..~// , , ~ ~ ' / .. ' " .................. -< z C Z .< Z I(~ . ! 0 C z