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Home My WebLink About21420-zFORM NO. 4 TOWN OF BOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23033 Date JUNE 10, 1994 THIS CERTIFIES that the building Location of Property 4405 MAIN ROAD House No. County Tax Map No. 1000 Section 125 Subdivision OWE FAMILY DWELLING Street Hamlet Block 1 Lot 10 Filed Map Ho. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 13, 1993 ~ursuant to which Building Permit No. 21420-E dated MAY 19, 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 A SINGLE FAMILY DWELLING WITH AN UNFINSHED SECOND FLOOR AS APPLIED FOR. The certificate is issued to WARREN G. WIELT of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N299674 & H038736 PLUMBERS CERTIFICATION DATED Rev. 1/81 93-S0-37 DECEMBER 20, 1993 PHCONIC PLUMBING & HEATING TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. ¥. BUILDING PERMIT (THIS PEPu¥.IT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) N?_N'? ~lJ~OZ Permission is hereby granted to: ........ .~~.. ~.,~ ....... .~. ,. .... ~:3">~ ............... ....... ~......~.~. ...................... ~ ............. ,o ......................................................................... ~...~.'.~/. ................................................ ~.'~......~.......~. .~ .z::?.z>~..~.....~.... ./:..~.....~'~..~"~. ./..'~../.~.... ..~..~. ..~.... .............. at premises located at .........· .~..~ ...... L'.~.~.../...~......../....C~..'. .......................................................... ..................................................... .~..~4 ....... ~ ........................................................... ............................................................... ~/.~:~ ........... C .............................................................. County Tax Map No. 1000 Section .... ./..~.....~... ....... Block ......... .~../. ...... Lot' No ....... ./...~. ........... pursuant to application dated .............. ~././~. ........................... , 19../~...'~..., and approved by the Building Inspector. Fee $ .................... Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 ~ith accurate location of all buildings, property lines, streets, and unusual natural or topographic feathres. 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. f6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '.'pre-existing" land uses: i. 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 CerPificate of Occupancy - Residential $15.00, Commercial $15.00 ~ Date ...... ~../.~/.~. ~. ~. ............. ' ......... New Construction ....... Old Or Pre-existing Building ................. Location of Property .... .~.~.~..~. ............ -~ .~..~.~.~....~.~..~. ............ .~..~.~.~.../~.. .... House No. Street Hamlet Onwer or Owners of Property....~..~.~.~.~..~... ~..., . .~/./.~..f~..7~. .................................... County Tax Map No 1000, Section..J.~..~. ...... Block...C~.7 ........... not..K~. ................ Subdivision ................................ .. .. Filed Map ............ Lot ..................... . Permit No..5./..~.~..~.~...Date Of Permit...~/Z.~../~.w? ..... Applicant..~..~.~.~?.~.~ .~...~./.~.~..~. ....... Health Dept. Approval. . .Underwriters Approval ......................... Planning Board Approval ........................ Request: f~r: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $...~...~.~ .~..~. .................. TOWN OF TbWN HALL SOUTHOLD~ N,Y, ! 765-i 802 Building Permit No Owner' (please prznt ) ' (~leas~ Print) certify that the Solde~ used cgntains less than' 2/10 of l%'lead~ 'stem n to b~fore m~ this _ day of {~L' llotary Public, / county THE NEW YORK BOARD OF FIRE UNDERWRITERS t 1.00 I07 ] BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date I)~(',~IHB[IR 2(~t:[!19,~ ~pplieationNo. onfile ~,~83693/~ ~ ~D~?~ THIS CERTIFIES THAT o~y the ~lectrical equipment ~ ~scrib~ below a~ intr~uc~ by t~ applicant ~m~ on the a~e applicati~ nu tuber in the prem~es of inthefollowinglocatlon; ~ Easement [] IstFI. [] 2nd FL ~TT~(~/OII~~ Section Block tt~s examined on D ~I U~I~18 ['I R %~ i I,')93 attd found to be in compliance with the Natiottal Electrical Code. Lot FIXTURE OUTLETS ?' DRYERS SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS SYSTEMS NO. OF FEET E OTHER APPARATUS: COND. 2/0 C OF HI,LEG BOX 21.5 80U?HOI, D, ~Y, 1.1971 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 BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. THE NEW YORK BOARD OF FIRE UNDERWRITERS :1~')4~ 7 ~ 2 BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW NEW YORK YORK. 10038 Date Dh(,~ ~'IB~ ~3 Application No. onfile ~(~93/9~ J~ THIS CERTIFIES THAT I?~R~{~ ~(), in the followlng location~ ~ ~sement ~ Ist Fl. ~ 2,d FL 0 [~[* S~tion Bilk Lot u~sexamlnedon ~} ~ C ~ ~([~ ~ ~i,~993 and found to be in compliance with the Na~onal Elect~cal Code. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUSTNOT BE ALTERED IN ANY MANNER. Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD March 8, 1194 Mr. Warren Wiect P.O. Box 66 Main Road Laurel, NY 11948 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: XXX An application for Certificate of Occupancy is not on file. (Enclosed) XXX No Underwriters Certificate on file. XXX The check is not on file. ($25.00) XXX No Health Department Approval on file. No final inspection has been made. XXX No Pluraber Solder Certificate on File. (All permits involving plumbing being issued after April 1, 1984.) BUILDING PERMIT # __BP# 21420Z Please contact our office on this matter. Thank you for your cooperation. SOUTHOLD TOWN BUILDING DEPT. Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD March 8, 1194 Mr. Warren Wiect P.O. Box 66 Main Road Laurel, NY 11948 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: _XXX_ An application for Certificate of Occupancy is not on file. (Enclosed) XXX No Underwriters Certificate on file. _XXX_ The check is not on file. ($25.00) _XXX_ No Health Department Approval on file. No final inspection has been made. XXX No Plumber Solder Certificate on File. (Ail permits involving plumbing being issued after April 1, 1984.) BUILDING PERMIT # BP# 21420Z Please contact our office on this matter. Thank you for your cooperation. SOUTHOLD TOWN BUILDING DEPT. 765-1802 BUILDING DEPT. INSPECTION ] FOUNDATION 1ST [ ] ROUGH~BG. ] FOUNDATION 2ND [ ]~TION ] FRAMING ~]'~FINAL INSPECTOR 765-~802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ].~)UGH PLBG. / [ ] FOUNDATION 2ND [/] INSULATION [ ] FRAMING [ ] FINAL DATE INSPECTOR 7~5-1~02 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [,~ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ~I~RAMING FINAL REMARKS: INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ~FOUNDATION 1ST [ ,/]~OUNDATION 2ND ROUGH PLBG. INSULATION FRAMING [ ] FINAL REMARKS: DATE / / INSPECTOR~'//~-~ ~OUNDATION -~OUNDATIOU .~. ~,OUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FI;IAL Ye ADDITIONA'L COMMENTS: AREA = 1.233 Acres EXCAV~T[O~ I~S~ECTigN REQUIED ~ ~ _** .~ ..... ¢~....,,,.~,..,.,.. ~ I SURVEY FOR ~ "~",~;;.::.~*.,?'::?;.=.~.:~:.?.~:.~'~;?~?p" 'DANIEL WIEL T & CHRISTINE TO WN OF SOUTHOLD l / , t ~S THREE Y~aS mOM DA~ OF APPROVAL 1000 - 120 - Ol- lO ,,,, , I " Scale: 1"= 40' Mar. 10, 1993 AREA = [233 Acres /7' DANIEL SURVEY FOR W/EL T& CHRISTINE A. JONES AT , LAUREL TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. 1000 - 125- 01- 10 Scale: 1" = 40' Mar. 10; 1993 June 24,1993 (found.) N.Y,S. LIC, NO. 49618 Prepared in accordance with /he minimum stonderds for lille surveys es es/ob#shed by /he L.I.A.L.$. end epproved end edopted fo.r. such use by The New York State Lend Title Association. . ~1~?/~ ~o~;~ . The locations of we/Is end cesspools shown hereon ore from field observations and or from date ob]ained from others, ELEVATIONS ARE REFERENCED TO AN ASSUMED DA TUM. 93-151 .J L .,So AREA = 1.255 Acres EXCAVATION INSPECTION REQUIRED ROAD SO~THOLD, N.Y. I1~?1 LIC. NO. 49618 )AN/EL SURVEY FOR LAUREL TO WN,OF SOUTHOLD SUFFOLK COUNTY, N. K 1000- 125- 01- 10 Sca/e: 1" = 40' Mar. 10, 1993 Prepored /n accordance with the minimum stendords for t/tie surveys es es/ob#shed ~o the L.I.A.L.S, end ~proVed ~nd ~d~pted such use by The New York S/ate Lend Title As=ocle/Ion. APR ~8 1~9~5 S.C, DEPT. OF HEALTH SERVICES The locations of wells end cesspools shown hereon ore from field observotions end or from dota ob Joined from others, ELEVADONS ARE REFERENCED TO AN ASSUMED DATUM, 93-151 FORM NO. I %c~'[~ BbARD OF HEALTH TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 ~SURVEY CHECK .... --...~,<........, - sEPTic Po~.,~'~.. ..... "'"'. ............................... -~ TEL.: 765-1802 Disapproved a/c ',... · (~di~ingqnspector) APPLICATION FOR BUILDING' PERMIT HAIL TO: . . .(~'P:(k~,'..k6. ...... :. · .~,.1o.~,. Date ....... ; ........... 19... 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 sti'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 Yoxk, 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 authorized inspectors on premises and in building for necessary inspections. --' (Signature of applicant, or name, if a corporation) .P.. ¢, (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, 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) Builder's License No... ) ............ ~ ~(~ I.~ ' ........ Plumber s Ltcense No ......................... Electrician's License No ....................... Other Trade's License No... .................... 1. Location of land on which proposed work will be done ................................. ] ................ House Number Street Hamlet Con'nty Tax Map No. 1000 Section ..../.~L~~. ......... Block .~ .......... i... Lot. ~ ......... : .... 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 .... ~. ' :. ' , ~ ~ i '~4~,~,;~i~ ?~'~ ~',~ ............. ......... ~ ...... , ...... ~ ...... ~%.,¢ ~'*~.~.~ ~,)~.~k~ ............. · :3. Nature of work (check which apPheable): New Boildi g ...... ,A, ddition .......... ,Alteration .... ; ..... Repair .............. Remo?al .............. Demolition , ............... Other Work ............... &> ..~...~. !.C~.. ' . (Description) 4. Estimated Cost. ,/. '; .................... Fee ............. . ........ I / ' (to be paid on filing this application) 5. If,dwelling, number of dwelling uhits ............... Number of dwelling units on each floor · If garage, number of cars ...... i ............ ' ............... 6. If business, com~nercial or mixed' · .................... . ioccupancy, specify nature and extent of,each type of use ..................... 7. Dimensions of existing structures if any: Front Rear ' Height . Number of Stories ' · ': ........................... Depth ............... Dimensions of shme structure with alterations or additions: Front Rear ................. Depth ' [Height .................................... · '. Number of Stories ' 8 Dimensions of entire new construction: Front ......... '. · · ........... ' Rear Depth Height Num b,er of Stories ............................................. 9 'Size ofl~i: ............. ' ............................................ ; .......... Front ' ' Rear 10 DateofPurchase ........... ; ....................... · · .................. ' ......... Name of Former Owner ....... Zone ruse d' ictin which p emisesa situated 12 Does proposed co tie violai oni g law dinanc ..... ' ............. · nstruc n eanyz n ,or e or regulation: ...... 4 ' ' ' 13, Will 10t be regraded ....... · 14 .... ; .................. Will excess fill be removed from premises: Yes . .Nfl · Name of Owner of premises .... i ........... ,, · · Address ................... Phone No .......... Name of Architect ........... i ................ Address .. Phone No. Name of Contractor ................................. .......... : ................ Address ................... Phone No ............ ' .... 15.' I.s this property within 300 feet of a tidal wetland? eyes ........ No ......... · If yes, Southold Tdwn 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 whethe4r interior or corner lot. ' ! . STATE OF NEW YORK, COUNTY OF ................. ., S.$ ·.. ')~ G/L/ ~.., [.~- being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) ' ~ above named, f He is the I~ ' , (Contractor, agent, corporate officer, etc.) of said ow.ner or owners, and is duly ~uthorized to perf;~m~'~ have performed the said work and to make and file this application, that all statements contain&d in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner sdt forth in the application filed therewith. ' Sworn to before me this ~ ....... i ·/. '.."~.. ,,,.,, ..... '. i.day of..!.. ~ .... · ..... ,19..~-? , ' ' .... County -, . . /~ -. , NoI.~ Publl;, State of New York No, 4982246, Surf ~o{k~ ,C~=nly ~' (Signature of applicant) Ter? Explre~ June 12,j 19.~