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20374-z
0 ~ a, 1~`~ FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall SoutY~old, N.Y. CERTIFICATE OF OCCUPANCY No Z-22205 Date MARCH 23, 1993 THIS CERTIFIES that the building ADDITION Location of Property_ 405 WEST SHORE DRIVE SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 80 Biock 2 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 17, 1989 pursuant to which Building Permit No. 20374-Z dated JANUARY 9, 1992 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for whioh this certificate is issued is ADDTTION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JAMES B. SMITH (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N-217627 - FEBRUARY 23 1993 PLUMBERS CERTIFICATION DATED JAN. 19 1993 - JAMES B. SMITH i Buil ing Inspector Rev. 1/81 roses xo. a 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° 2 3 7 4 Z Date . ~9 19.x, 0 Permission is hereb( ro~ted to: w _ Y g 23` ~ l30°/ ~ r.....~~ , aYpremises located at .........ach.~....7~~...... ~ ...~°....,?~Y~~::t:~.r....E?5.ll..C?. ? ....................................................................pp........................................................................................... County Tax Map No. 1000 Section .......O..Q......... Block Z:........~.~Lrot No......~^ pursuant to application doted .....~1.~~ 19.°.,1..., and opproved by the Building Inspector. Fee 3..~~9.l.. ~s,,,~..,..... midi I for Rev. 6/30/80 1 FOIBM NO. f 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) No 18665 Z Date ...~.~:~~.....~-2:........., 198q Permission is hereby grouted .....!~°.~.....1... 3: z z to ...~:.t?:.^.-4/.v'.wa.S~... ~!:?.....0.r61. ..(1~eu:^f1.....1N.....Arn......~:fisr...Ll:l1.R. ~ ....ate... at premises located at ~.:°:.9~.........J..?.!Z,~......C;,J.~';~,~"~.;•~ ~ , ....l.,r ........................t3.~.......... M.:~............................................................................................. County ox Map No. 1000 Section1 ......fi~.}3.©...... Block .....G:l.?c:....... Lot No....C'•}.Z........... pursuant to application dated ../U.P.:+:~:!':~~~-:...~.7 19.9..., and approved by the Building Inspeppctor. Fee $...~.~.`.~.t..7.!~..... ..a4.C'..~`.'~: . . . Building Inspector Rev. 6/30!80 Form No. 6 ~r/J1/~ ~n"~~ TOWN OF SOUTHOLD C~ - " ~ ~ ~ ~ ~ BUILDING DEPARTMENT TOWN HALL ~I~ 765-1802 Il APPLICATION FOR CERTIFICATE OP OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building ar new use: I. 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 ly, 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. B. 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 S.' Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date New Construction...... ~jOld Or Prfe-existin[$'Building. Location of Property.... E~....~.~ f!~f ...,-?~0 f~~..~.~C.~l::~L-....... ~~?U.-:~. House Nom. /n~ lyS~t,~reet Hamlet Onwer or Owners of Property., F,(./.J~~~... ~.J...W~.l~l~ County Tax Map No 1000, Section. ~'~........B1ock...~.~........Lot... ~.~Z., a......,,.., Subdivision ....................................Filed Map............Lot.............. r~~j y > /,,s F^ Permit No~ a. T. 4 4-...Date Of Permit..!,/ Vl. ...Applicant.~,.!!~'l?.~. ~i. ~~~~j^7 Health Dept. Approval ..........................Underwriters Approval...~.~! Planning Board Approval , Request for: Temporary Certificate..........: Final Certicate........... Fee,~gSubmitted: $ ^ w V~.l.C.`~S~Py7- - .APPLICANT co-~~aaos O~O~~F F Q(~-COQ TEL. 7G5-1802 TORN OI'' SOtJTFfOLD . lr~" . •'I" < OFFICE OF BUILDIPIG INSPECTOR o ~:'Y~ ~ cn ~~i~, rn P.O. BOX 728 o~/~~ TOWN HALL 'fie'' SOUTHOLD, N.Y. 11971 ~ ~ C E R T I F I C A T I O N Date f Building Permit No. ra--~-= Owner I1~'/7/z'S' ~ / T /f (please print) Plumber _1 ~9~7r ~ T/-~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of to lead. (plumber's signature) Sworn to before me this day of ~ , 19~ otary Pu 1c Notary Public~~~~~L~ -County 6ARBARq SiEPNOWSKI Nalary Public, State o(Nyy~ York ~OuaAl(edinSufl k0ou~y m~sbn Yes ~W.3o,19~ o ~ ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS a>~;Ur; 701~1c,77 r BUREAU OF ELECTRICITY 83 JOHN STREET, NEW YORK, NEW YORK 10038 Date ~'F;(iRUA72Y' 2:~~7991 gpplicationNo.anfile ~78;7HEi99/96 27,7627 THIS CERTIFIES THAT ' only the electrical equipment as Fleacribed below and introduced 6y the applicant homed on the above application number in the premises of JrM ~rrrr~t, =79, ~~r,s~l~~--g~lIsrrq[l,3 nR~rly-~~I, ~otrr.errry~alrL~, r7.~. in the following location' LJ Basement LJ Ist Fl. u 2nd FT. J9;~ r r" t J177 ` Ser[ion Block Lot was exornined on ~ r' ~ b rail ri IZ 9. , 9 ~ 7, and found to be in compliance with the National Electrical Code. FIxTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FIUORESCFNT OTHER AMi K.W. AMT. K.W AMi. K.W. M1i K W AMi H P DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECPT TIME CLOCKS RELL UNIT HEATERS MULTIAUTLET DIMMERS AMT. K. W. Oll H. P. GAS H P AMT N0. A. W G AMi. AMP. AMi. AMPS TRANS, pMT. H P. SYSTEMS qMT. WATiS NO.OF FEET 7 5. ` P 1 6t7~ SERVICE DISCONNECT NO.OF S E R V 1 C E AMT. AMP. TYPE METER 1,a' ]W 1 q 3W 3.e' ~W 3 p 4W NO.OF CC COND. q. W. G. A W G. A. W G. EOUIP. PER 9 Of CC. COND. NO OF HI~LEG OF NI-LEG NO.OF NEUTRALS ~ NEUTRAL 1 7 C;E 7. X 1 ~t ~ ry OTHER APPARATUS: ~,T',C.~t L~ ;~I~on~~ >2r;lr>ar.TOt~.-z G c< 5 CpNSk2k1CTQR 7,rr.#5'tS G RO?t 215 uf1Ui"(7qT )lr NY, 1.9.991 6ENERAI MANAGER 1.1 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. , ' S~FFO~Ii TEL. 7G5-1802 To~rr or sor~~'~o~.o o~° ~ l:"~ ~`~'7•'t' OFFICE OF BUILDII~IC INSPECTOR t°n `fir, ~F'-3^1,m~k~' n. P.O. BOX 1179 c?s ~a,~; TOWN HgLL %~pZ' SOUTHOLD, N.Y. 1 1971 C E R T I F I C A T I O N Date ~ Buildirq Permit No. (please print) Plumber ~~y,~~~ ~ ,Sf7/7/~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1, lead. (plumber's signature) S~w~-o~r-n~to before e this -~_.'daY of - >.9~. Uotar• ~ Notary Publa.c f I ublic, l~~ I County Cl.AIREL6LEW Notary Publio, State of New YorR Qudlifiedoin Suf fo k Courtty Commlasion Expires Decamber8, 78~ INSPECTORS ~OSUFFO~~-cO (516) 765-1802 ~~O G,y SCOTT L.HARRIS,Supervisor VICTOR LESSARD, Principal ~ ~ CiJRTIS HORTON, Senior y Southold Town Hall VINCENT R. WIECZOREK, Ordinance p P.O. Box 1179, 53095 Main Road ROBERT FISHER, Assistant Fire y ~ 0!~ Southold, New York 11971 Building Inspectors 'h0,( ~ ~`a Fax (516) 765-1823 Telephone (516) 765-1800 THOMAS FISHER GARY FISH OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD March 3, 1993 Mr. James B. Smith, Jr. 405 West Shore Drive Southold, N.Y. 11971 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. XX The checks are nat on file. $50.00 PLEASE SUBMIT SO THAT CO'S CAN BE ISSUED. No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 20374-Z & BP#15254-Z* Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. *NOTE: BUILDING PERMIT #153542 HAS EXPIRED. INSPECTORS u~,. Victor Lessard 5~FF0(;~~' Principal Building Inspector ©`i~ _ ~'pG~ Curtis Horton tip' SCOTT L. HARRIS, Supervisor Senior Building Inspector o i Thomas Fisher z ~ Southold Town Hall ~'y P.O. Box 1179, 53095 Main Road Building Inspector a,' ~ 4v Gary Fish ''~O~ ~ ~ So Fax (516) 765-1823971 Building Inspector Vincent R. Wieczorek Telephone (516) 765-1800 Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD JANUARY 6, 1993 JAMES B. SMITH, JR. 405 WEST SHORE DRIVE SOUTHOLD, NY 1197) To Whom This May Concern: .D We are unable to complete your Certificate of Occupancy because of the following reasons: ? x>~ An application for Certificate of Occupancy is not on file. (Enclosed) ffi No Underwriters Certificate on file. x~ The check is not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. • No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 20374-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. ~ic.LD ~::5' c .'_U; ~~'Jn:~ p~ ~GMMLNTC *I OU77DATIO:Iw (7st) r-~ I i ?OUIJDATION • (2nd) - m f _ ti 0 .',OUGH FRAME & ! ~ U~ .PLUMBING 4 N ~j 3 , m Fp _NSULATIOfJ PER N. Y. ( y _ A STATE EPJERGY Y6 6 G~7'f CODE 3 ~ 7 C9 - s } r FI;JAL ~ o ADDITIOIJAL COMMEIITS: x • m F' \ m - ~ H • f7 . m ro H r ~ T6S-1802 ~Xil, BUILDING DEPT. INSPECTION [~UNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]/FINAL REMARKS: 7~~,.. DATE L INSPECTOR ~'-~J r~ ~~~7' T65-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ INAL REMARKS: ~ j DATE / ~ ~ INSPECTOR rss-iso2 BUILDING DEPT. INSPECTION [ ]FOUNDATION iST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ )INSULATION [ ]FRAMING [ mkt " 'REMARKS: t ~ ' r p ~iaa F ~ DATE INSPECTOR ~~~~5 765.1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. . [ ] FOUNDATION 2ND [INSULATION [ ]FRAMING G [ ]FINAL REMARKS: ~--^~%'~~~t~~-~J~%/ DATE ~ © INSPECTOR NYi~ T6S-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. ( ] FO TION 2ND ( SULATION [ ]FRAMING [ ]FINAL REMARKS: L ~ 9 LLf~./.r' n72~ DATE ~ ~ INSPECTOR BOARD OF HE.\LTH 3 SETS `OFD PL.\NS FORM NO. 1 SURVEY TOWN OF SOUTHOLD CHECK , , , , , , , . BUILDING DEPARTMENT SEPTIC FORtt TOWN HALL SOUTHOLD, N.Y. 11971 NOT r TEL.:7G5-1802 Sl~.o7~j, p Examined .~r?`:~Q'::^:~?^. 1:?., 19~`~. MAIL T0: ~3y~ Approved ~??,`°'!^:,;~w:. 199. Permit No.1 ~Sl'~ T p C~C~C~Cl~v1("~ Disapproved a/c fu''i ~I. X17 BLDG. Ctcr''7 (Bulldinq TncnectoP) TOWN OF SOUieTOtl) APPLICATION FOR BUILDING PERPAIT / ~ - Date ,lI~.L~ 19 INSTRUCTIONS a. Tlus application must be completely filled in by typewriter or in ink and submitted to fhe Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lat and of buildings on premises, relationship to adjoining premises or public streets 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 petanit 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 of demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, hog c de, an regulations, and to admit authorized inspectors on premises and in building for necessary-inspe ions. - ff • (Sig ure of applicant, or name, if a corporatton) ' (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~~iz~..~.. I:-~... ~~`7.~Tf7~... . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corpora oviirv~~'l Builder's License No. . /O Plumber's License No . . Electrician s License No . . C1 'r Otter Trade's License No . . I. Loc~~a//lion of land on which proposedd~ work will be done. - Ilouse Number Street, • " " " " " - Hamlet ~.Q. County Tax \tap No. 1000 Section BI'ock ..c~y , , , , , , , , , , , , , Lot , ' Subdivision Filed Map No. Lot . (Name) 2. State existing use and occupancy of pr9emises and intendQed use and "occupancy of proposed construction: a. Existing use and occupancy v~~• ~~~l~ • • ....~~/.r~,/,`2~~ ~/,~vtt~,4,~p!{~ , , , , , , _ _ . b. Intended use and occupancy V.~!?..li: ~/.~~i9 , . " 3• RNet air of work (check which applicable): New f3uildinS • • • • Addition ..v , . Alteratign . p .Removal . Demolition Other 1Vork . (Description) 4. Estimated Cost L140«.~a........ Fee . (to be paid on filing this application) 5• If stvellin~ number of dwelling units , , , , , , , Number of dwelling units on each floor . If ara_e, number of cars f 6• If business, commercial or mixed occupancy, specify natgre and extent of each ty e/pf use ~ , , ~ . , • . ' g ~ >o......... Rear . . Height ures, tf any: C'ront Depth a~....... . ....N Dimensions of sametstructureumber of Stories . . . ;with alterations or additions: Front ~ ~ • • ~ ° ~ • ' ' ' Depth . . . IIeight . ...,~.6........... Rear ..ass........... . ' 8. Dimensions o ' ' ' ' ' ' ' • • ~ • • • • • • • • • Number of Stories . t~selnpry~o>lstntction: Front , , , , , , , Rear . Depth ~ ~ ~ ~ ~ • Height • Number of ~tories . ' • • ' 9. Size of lot: Front ~,.~J.l t Q, . Rear , ~QaO.:y........ Depth ...h5.`7~Q, . . ate of Purchase 1 I. Zone or lase atstnct in winch ~ • ~ ~ ~ ' ° ' ' ' ° • ° • Narne of Former Owner ' ' premises are situated ...~1.ESZA~,~!'P1f?!- . . . . ' ' ' . 12. Does proposed constructiat violate any zoning law, ordinance or re ulation: ~ • • 13. \Villlotberegraded g "~4""'••'••^•••••••••• • • •~'p• • • • • • ..Will excess fill be removed f om premises: Yes 14. Name of Owner of premises F)./.7.~„$', ,Address ,f, j,/~'rf~pg,~~/~ Phone No. Name of Architect Name of Contractor .~~~•~•••••~~•~•°""'••..Address ...................PhoneNo............... 15.1s this property located within 'Address . PhoneNo...;i.. *Tf yes, Southold Town Trustees Pemitemay bearequir wetland? *Y1:S..,,.NO.... PLOT DIAGRAM Locate clearly and distinctly ull buildings, whether existing or proposed, and, indicate all set-back dunensions fTotr property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. A \J ' STATE OP NEN YORE, COUNTY OF . S.S • • ~ • ~ • • ° ~ • ' ' ' ' • • being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. Ile is the (Contractor, agent, corporate 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; pnd that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this 19 j./.~`J' ......day of, ~/~/?`.~'"~.~.°G!-; , Notary Public, , ~(U..~. ~.L(//~.~.'- County HELEN K. DE YOE ' ' ~ • . • • . • . • ~bTARY PUBLIC, Stole of New YorlFlF Na.4701878,SuffolkCaun}yc~~ (Signature of applicant) Term Ezpires Morch 30,19..J,t ~ 4 Q W 4 ~ ~ aaaror~y Z ~ ~ b1' e tC~N~~ \ v 0 _ Q~ ~ W i ~ J ti ~q w w w ~ 4 V ~ov~~ ~ ~ ~ 7g 1n ~ ~ u+ 2 ~ y ~ S~ ' ~ r1 Q9 ~ o w Yl M Cry a ~ 1~ o a u~ w Q T ~ ~ 4 ~ o~ a o 0 0 ~~a~ ~ ~ O o O p p p 0 N° o~ `r1 ~ ~ n ~ m a \ Q - Q ~ \ • K ~ ~ a. e.. U ~ ~ a Q 2 ~ ~ e3 ~ ~ ~ Q Q Q ~ cJ r M C~ U d W Q Q W w W ~ Q. w D ~ ~ o ~ W 4 ~ d ~ I ~ ~ t " Q ~ N~HM C7 ,,I ~ V ~ \ 4 ~ ~ ~ ~ ~ ~ ~ . ~ W W M_ ~ 'N i, ~ , ~ ~ ~ d ~ ~ h~~ ~ ° } Q Q ~ ~ ~ ~mou~nw b ~ ~ a w ~ a W ~ ~ ~ ~ 2 ~ ~ H°~zH~z J W `4 ~ ~ ~ v ~V ~U y ~ E` zz~~r7~~~n5 W v ~ N HHw~W~ ~ar~ C~'!Ve !pr;va;~ roads.`. `i i`'I) SGHf?EMMEl2 ~!u/ _ N y - a' N. ZO'I !'2O'~E. - l59.0 4 y 2 w M,'~1-t ~ C 6., ~ i- Fy 4, ~ i. i a - ~ ~ w ~ ~ ~C ail i ~ 3 ~ - Y-~t/'1 ~ u ~ ~ H ~ S 2C:.'°! 1'20-W. - 744.4p ~ ' C i ~ I ( ~6~ h I j i\v : (-~x~-r~~'~r;LD X17 C 4 i" ~ i~K31'.iA'". t_' LO.--gyp - ~ f ' ' ,S .r ~ i g yy r ' _ - s~ sfi ~a~ <L 'x~~~~mF ~y > -x s~ - n` > P J 7 ' n~ - a = ~ ~ c _ -rn ^ ~ ~ 2 b f r t f fl ~ _