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Home My WebLink About20957-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22401 Date JUNE 18~ 1993 THIS CERTIFIES that the building REPAIR Location of Property 380 MIDWAY ROAD House No. Street Coun{y Tax Map No. 1000 Section 90 Block 2 Subdivision Filed Map No. SOUTHOLD~ N.Y. Hamlet Lot 4 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 14~ 1992 pursuant to which Building Permit No. 20957-Z dated SEPTEMBER 15~ 1992 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 REPAIRS TO EXISTING ONE FAMILY DWELLING FROM FIRE DAMAGE AS APPLIED FOR. The certificate is issued to ALFRED iS/~END (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-279168 - JUNE 10p 1993 PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 FOK~ NO. ~ TOWN OF $OUT~OLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No-N°, 20957Z Permission is hereby granted to: ,o at premises ~/~ated at ~.~l~'.....,.~x.~~~ ..~--~.~; ................................................. County Tax Map No. 1000 Section ........ ~..1~.. ....... Block ......... ,~ .......Lot No ............. ~ ..... pursuant to application dated .......... .~'..~.~..~... ............................... , 19..~.~r and approved by the Building Inspector. Rev. 6/30/80 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 815 JOHN STREET. NEW YORK, NEW YORK 100,38 J~l~ l~,1997, ~09637,93/~3 N 279168 Date ~pplicatlon No. on fi;e THIS CE~IFIES THAT o~y the electric~ equipment ~ ~zcri~ be~w e~ intr~ced by t~ ~pplicent ~med on the a~e application n~mber in the premises of in ,he following h,ca~i~~ ~ ~ ,. Section Bilk Lot ~s examined on and found to be in complionce with the Na~onal Elect~col Cod~. FIXTURE OUTLETS SWITCHES FIXTURES RANGES :OOKINGDECKS OVENS DISH WASHERS EXHAUST FAN~, DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEOERS TIME C~LOCKS UNiT HSAISflS N~ULTt-OU~LET D~MMERS SYSTEMS NO. OF FRET SERVICE DISCONNECT S E R V I C NO. OF CC. COt, ID, A.W,G. NO, OF HI,LEG A W,G, NO. OF N~U?RALS A.w O, ~ CC COND, OF HI-LEG OF NEUTRAL OTHER APPARATUS: GENr~AL MANAGI~ Per ]his 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. Form No. 6 TOWN OF SOUTHOLD 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 I% 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 ,. Vpre-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 si~ned 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 - $i00.00 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 o~, ...... New~ Construction ........... 0la .................. Or Pre-existing Bu~lding..V~..;~. .......... ....... [.. Location of Property ....... L~.. House No. Street Hamlet Onwer or Owners of Property..,.~.~..f~ .... ~<...a~ .... ~.~ ........................ . County Tax Map No 1000, Section..Q~,,~ Subdivision .................................... Filed Map ......... Lot ............... . Permit No...~.~.~..Date Of Permit...~7.~,~..Applicant..'~q;~%...~...~.... Health Dept Approval Underwriters Approval .......... Planning Board Approval ..................... ... Request for: Temporary Certificate ........ Final Certicate.~.... Fee Submitted: $ ................... .. ..... .. . ..... .... ................... INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Buildin~ Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 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 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD ~ 7, 1993 J. R. HOME ]MPROVEi~NTS 36 SOUTH STREET P. O. BOX 314 GREENPORT, NY I ] 94/+ RE: ALFRED J. AI~IEND & ~ 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. The check is ,__x~~_~not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plun~ber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT ~ 20951-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TO%4N BUILDING DEPT. CC: ALFRED J. & MARY ELLEN AMEND 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND ~ ~ I.~JLATION FRAMING ~/~ FINAL DATE 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. ~ ] ~/~UNDATION ZND [ ] INSULATION [//~' FRAMING [ ] FINAL REMARKS-./-~ ~~,,~.~-//~ ~ DATE /~/~/~/~/...//"~ ,NSPI:CTOR .//~///~/ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ I~LATION [ ] FRAMING REMARKS: [ ] FINAL DATE INSPECTOR rOUNDA'TION ?OUNDATIO,'~ 2. ROUGH FRAME & IIISULATION .PLUMBING PER N. ADDITIONA'L COMMENTS (lst) (2nd) FI:;AL STATE ENERGY CODE FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT SEP I 4 1992 TOWN HALL ; ~ :, ,: SOUTHOLD, NY. 11971 ~'* ~'"-~,'i~:f"~"~i,. ~:,~ :: :, TEL.: 765-1802 I ...... }isapproved a/c ...................... ' ............... / · / ,,.- · APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTII. SURVEY ............. c,cc~ .,~.~OG.~ ............. SEPTIC FORH .............. CALL HAIL TO: a. ins apphcahon must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 :ts 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 publlo streets : areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- :don. c. The work covered by tl~s applidation may no~ 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 15el-mit" :all be'kept on the premises available for inspection throughout the w~rk. e, No building shall be occupied or, used in whole or in part for any ~urpose whatever until a Certificate of Occupancy all?ave been granted by the Building Inspector. ; .p. PPLICATION IS HEREBY MADE to the Building'Department for the issuance of a Building Permit pursuant to the ]il~ljng Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances orl .:g~ations, for the constrUction of buildings, additions or alterations, or for removal or demolition, as herein describedJ l~mpplicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t¢ building for necessa insp ctions -- : O'(Sighature df '... J.n. HOME IMPRO~/EMF. NI~ .......... 36.80U. TH $?. p:.~ :!~_ _X aj.4 ............... :ate whether applicant is owner, lessee, agent, architect, engineer,,?neral e.ontracto_r, electrician, plumber or builder. o,'ownerofpremlses AL (as on the tax roil or latest deed) a~pJiTt isa corporation, signature of duly auth?rized officer. -- Ct ~ ' (Name and title of corporate officer). . u,dcr's License No.. :5.q.o.-3.: Plumber's License No Electrician's License Nb ' Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. IIouse Number Strfiet Hamlet County Tax Mai, No. I000 Section .. ~: ~.Q ....... Block . .Q~,~ ......... Lot...~5, Qn ........ Subdivision ....................... , .............. Filed Map No .... ??.. Lot ebff .~L~ ...... (Name) ........... State exlsdng use and occupancy of premises and intended use and occupancy of proposed construction: '. Exisdng usc and occupancy~. Intended usc and occupancy · · X'~.~... 3.r u~ of work (che,clg wh~ch!apphcable):' ' ' N (Repair) ~ .r'~.; p~J,fi~), ew Bu~din~ .......... Addition .......... Alteration ......... · . i ~ .Re"m°val ......... Demolition ............ Other Work ..... ' ~ ~'"ooo'oo '" (Description) 4. Estimated Cost ..... ~ ................................ Fee . I ~ (to be paid on filing this application) 5 If dwelting number 6f dwellifig units ~ Number of dwelling units on each If garage numberof I ~ floor.,. .,, .......... If business, commercial or mi~ed occupancy specify nature and extent of each t e ~ . 7. Dimension~ofexistingstmctfires if any Front ~ ,. ~ 7:~yp of rise ....... ~ ........ . ~.¢~ ...................... ear ~.,. Hewht . .. xd.~o. . ~ .......... Depth.~. .......... Dimensions of sgme., structure ~lwith alterations or add,trans. Front .7~ ............. ~ Rear .. 7~' ~.. Depth .... ~ ........ ~ ....[ .... el~t ...~ ....... ' .... ...... Number of Stories ............. ..... ..... 8. B ~imensions of entire new con~tmction: Front . ~, ......... Rear .. T~6 ....... Depth . ~,~,~ ...... eight . ~ ........ NUmber of Stories...'~,~.. ' 9. Sizeoflot Front .y.~ .l ~ ; .................... 7 ................. ~eqthx.~l~.' ..... 10. Date of Purchase~[5~ ..,. - ' ....... ' ' ;~';is'i :~;'[.[[[;""Name of Fo=er Owner .'S(q~,~p..a.. II. Zone or use distric~i~ xvhich ~r i r~o,~a~ut.. ..... ~ ................................... 12. Does proposed construction vi'elate ~ny zoning law, ordinance or regulation' .~ ..... . 13. Will lot be re,reded . .~ .'. ~ .......... ' ..................... ~ - · ' IX't' ' '; .... t ......... W~ll excess nil.ge removeg from premises: Yes2 14."~,me muwner' ~ oI prem:ses .,DC.. ~n& .... '., Address 17..O'r&,r~.¢,¢v, 9~hone No. ~ 77.~5 JJ ..... Name of Architect ........ ~ . .~, ...... ,~ ' · ~ ........... ~aaress ........ Phone ~ ~15 · .es.~ ...... No ......... ' · s thZS property within 300 feet of a tidal wetlandg' ,v i/ ..t ..................... ,,.,.-~ .... ~. *If yes, Southold~, Town Trustees Permit may be required. ... j PLOT DIAG~ Locate clearly ~d distinctly ~l bulldMgs, whether existing or proposed, ~d. indicate all set-back d~ensions from r ~nes. Give street =d block number or description accordMg to deed, and show street names and indicate whether or comer lot. ~ .- .,,,, ., ,, -/ ~", ~,,.,;'~ ¢. ~ :"~ -.,, .~,, ,, .... :. j - . . . . ,,~, ~ ............. ~ '- ~ 1.-,' ~r"; _l ' ~ ' '~ '-:' . .i ': ' ' : , *,~ . ~ ,," .,,,," ; ' "t '; ..... ~.:1 "~ ~ ;~ >..~" ~ '~',, ; ~ '~': . . ~ , ,. ,. . H ~ ~,.~ ~ .- "' .... ~' +/ " ' ' ...... ...... ~ ...... ~ 4 q , STATE OF NEW YORK, S.S · - ~YOF ......... :...,... . ...... , .................... ~ ~ (Name ofindlvidualsignin contract) . :bore named. '", .... :'~ ;;;,,L ;;;;;;~;; ;6~;&,;i;.~'" ' ' ' ......... '"'"'"......-.. ,f said owner or owners, ~d is dull'authorized to perform or have performed the said Work hnd to make and file this pi cat,on; that all statements conta~ined M this application are true to the best of his knowledge and belief; and that .'ork will be perfo~ed in the manne? set forth in the application filed therewith. ;worn to before ~ne this 'J ................. dayof, ... · .... ~ 19. · /~ ~ ~ ............... .count~ C,-t-I