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Home My WebLink About20646-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20965 Date AUGUST 24, 1992 THIS CERTIFIES that the building Location of Property 500 BEEBE DRIVE House No. County Tax Map No. 1000 Section 97 Subdivision ALTERATION C~JTCHOGUE~ N.Y. Street Hamlet Block 7 Lot 4 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 15~ 1992 pursuant to which Building Permit No. 20646-Z dated MAY 21~ i992 was issued, and conforms to ail of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ALTER AN EXISTING TWO CAR GARAGE TO A FAMILY ROOM AS APPLIED FOR. The certificate is issued to THOMAS~ JANE & JOHN LEVIEN (owner) of the aforesaid building. SUFFOLK COUNTY DEPAR~4ENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N-245375 - AU~US~ 3~ ~992 hUG. l?~ ~992 - PEi:~EC~ION PLLr~.&H.,~_~. / Bui~lding Inspector Rev. 1/81 FOI~,~ NO. Il TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Z Permission is hereby granted to: at /~mises Iocdted of ''" .................................................................................................................................................................~ , Coun~ Tax Map No. 1000 Section .....~Z. ............. Bilk Lot No. pursuant to application dated ....... '~'.~..~.../...~.......J~.i.."~. ...................... , 19..~...'~....,'~- and approved by the Building Inspector~ Fee $.~.:...C~... ......... /~Building Inspector Rev. 6/30/80 .... -- AUG I t ;-,J2 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filted in typewriter OR ink, and submitted ~ ~ to the Building In~)ec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3.Approval of e~ectrica~ installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5.Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to Apri~ 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate ~r~ey of p~:operty showing all property lines, streets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 ?OOLS $25.00AL?ERATION $25.00 1. Certificate of occupancy New Dwelting $25.00, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 ,o.oo 5.Updated C.O. $ 50.00 Date., o~..~. .......... NewCono truc t ion ...... Old or Pre-existing Building ............ Vacant Land ............. L°cati°n °f Pr°perty ~'"1~' ' ' '~' '~ :House No. Street ......... Owner or Owners of Property .... ~ ...................... County Tax Map No. 1000 Section (~.'7, ,~ ........ Block., '*7 Lot Subdivision ................................. Filed Map No ........... Lot No .............. Perm it No.~. {~.~..~,~Date o f Permit '~./2.~.~/~. ~A p p Iic a n t Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building a~,rmit meets all,~pplicable codes and regulations. A P P ' ica ~ . .~..-¢x~ · ./~<~. ,~;' ¼_~j .......................... Rev. 10-10-78 TOWN OF SOUTttOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. ~0~ Owner · (please print) (please print) ' ' Date I certify that the solder used contains less than 2/10 of 1% lead. in the water supply system ~Worn to before me this NOtary Public, ~o~c.. County lam [~Jes Mo~ 31,19~ (plumber's signature) 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [~"I~ISU~TION [~ING [ ] FINAL -/ -:__-'~: ,. . THE NEW YORK BOARD OF FIRE UNDERWRITERS 1.,~0[0?.1. BUREAU OF ELECTRICITY ~- 85 JOHN STREET, N~,W YORK, NEW YORK 10038 Date A[[GIJ~? q)3t1992 Application No. onfile 77~32092/92 ~ 245375 THIs CERTIFIES THAT only the electrical equipment ~ ~scribed be~w and introduced by t~ appl~ant ~mod on the a~o applica t~n number in the premises of Lot FIXTURE FIXTURES RANGES COOKING DECKS OVENS EXHAUST FANS OUTLETS EWITCHES FLUORESCENT OTHER MULTI-OUTLET SYSTEMS NO. OF FEET OTHER APPARAIUS: S E R NO, A. WG OF CC, CONO I C E NO OF HI-LEG AWG OF HL[EO NO, OF NEUTRALS BOX 21.5 SO~J~IIOLI~ , GENERAl. MANAGER Per 'f 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. FOU~;DATION (1st) FOUNDATIO:4 (2r ROUGH FRAME & -PLUMBING e INSULATION PER N. Y. STATE ENERGY CODE FI~IAL ADDITIONA'L COMMENTS: TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 ..................................... APPLI~AT]ON FOR BUILDING PERMIT BOARD OP HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CUECK ................... SEPTIC FORb! ................ /..(~ALL' i ......... ' ........ ~iAIL TO INSTRUCTIONS a. Tllis application must be completely filled in by typewriter orin ink and submittad to the Building inspector, with 3 *ets 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 premisex or public streets o,r areas, and giving a detailed description of l~yout of property must be drawn on the diagram which is part of this appli. chtlon. ¢. 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 orin 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 ~emoval or demolition, as herein described. The applicant agrees to comply with all applicable laxvs, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspectionS. -- · . /. . .4- - /% . . (S~gnature o~ applican/, or name/i~a e'orpo'rr~;ic~n') ' ' ' (Mmhng address a State wh~ther applicant is owner, lesse~e, agent, architect, engineer, general contractor, electrician, plumber or builder. .... ............... ....................................... Name of owner of premises ~,' ~4 c ( DATE: (as on the tax roll or late~ESe.~) If'applicant i~ a corporation, signature of duly authorized officer. NOTI~ BUlL.DING DEPARTMENT ........ ~/;~i ;~ci 'title' of ~;~(~rate ofh~r') Builder's License No ..... (. l f~.&. f.~.' 4 ......... ~Sff ]$ UNLAWFUL , · }~IJTNO~T CErTiFICATE ~]umbcr s Lzccnsc ~o ....................... OCCUPanCy EJcctrJcJ~a's License No...~ . Otl T o's Li N . UNDERWRITERS CERI'IRCATE let fad ceuse o ................. 7&5-1BO2 9 AM TO 4 PM FOR THE FOLLOW~NG INSPECTIONS: 1, FOUNDATION TWO REQUIRED FOi~ POURED CONCRETE 2, ROUGH ~ FRAMING & PLUM~NG 3. ~NSULATION 4. FINAL CONSTRUCTION MUST ~E COMPLETE FOR ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION ~ ENERGY CODES. NOT RESPONSIBLE FOR 1. Location o[land on wllich proposed wof~ will be done: .,. O~$1GN OR CONSTRUCTION ERRORS ........................... . ............ : ..... % tlouse Number Street Hamlet CountyTax Map No~ I000 Section ........ ~...i ..... i Block ............... Lot...~. /'; Subdivision .... .............................. Eiled Map No. Lot ' (Name) ............................ " [ ' State existing nsc and occupancy of premises and intended use and 0c npancy of proposed construction: ' - a. Existing usc and occupancy .~[~.~ WS,.,a 2 a,'~,' ~D · :; ,, " b Intended Use and occupancy ........ ' ' ' ' ~'"' ':: -':' -;" '[": ~, } O 3. Nature of work (check which appl,:cable): Ne~v Building .......... Addition ........ ... Alteration ¢ .......... Repair .............. R~mov~l .......... DemoLition ... ............ Swimming -pool'. ........... Tennis Court ......... ~,'>z3£A~cess°ry ~gi{Jing ........[ ~ Fa,ce ....... Other Work ........... ,. ~ (to be paid on filin~ this application~ S. If dwelling number pC dwelling units ............... Number of dwe lb~g units on each floor...~.~ ......... If ~arage, number of cars ...... ~ ................................................... ~4~ ......... 6. lfbuainess, commercialormixcd~ccupancy spccifynatureandextentofeachtypeoftse ...~ ~ ~ .... 7. Dmensionaofexstngstmcture~l fany Front ...... Rear . . .. . Demth~' ~ ' Henht ............ N.,nber oCSton= ............. D~menmons of sam~ structure w th a terations or addit oas: Front ......... Rear ~cpth ..................... ~. HelOt ...................... Number of Stones ......... ~'. 8. DimcnSions o~entire new construction: Front ............... Rear ........... ~ ....Depth . .~.. 5~, Height ............... ~umb~r of Stories .............. ; ................................... ~ . 9. Size of lot: Front ............ I ..... ' ...... Rear ...................... Depth .... ~ ............... 11. Zon or use d:stnct :n wtuch premises are situated... ~.%.~.~ ~. ~ 1 .<~ <... r ........................... 12. Does proposed Construction v}ola{e any zoning law. ordinance or ragu ation: .... ~O ......................... 14. p P ' ~ ' ' · ~.. ~ .... A ess .{~ ............... Phone No.'~'. ~J~ ~ ..... N~e'of Architect ........... i ........... ~ .....Address . ~ ................ Phon= No~,..,...~:. ~ ..... N~e ~fContractor ~¢,j FC~C~=C~5~it~OW address ~0~ Phone No./~ ~ ~t~ :. . IS.Is thxs property locat~]ed within lO0 feat of a tida~ wetland? · If yes, Southold Town ]Trustees Permit may be required. PLOT DIAC,~M Locate cle~ly =d distMctly ~1 bu~dMgs, wh~ther existing or proposed, ~d. innicate mt s~t-oac< ~ensions xrom prope~y ~nes GiT street ~d block n6mber or descfi tion acco~a~no to a-ed ---' ~' inte~or or com=r lot. STATE 0 F N EW__Y9 gK..~ t k" ~ - - COUNTY OF .......... Z ............ being du,y s,vor., deposes=d says fha, he,sthe app.can, · . (Name of individual signi~ilg contract) above named. ....................... i ............... .__~:'. ...................... : ................. ~ :.' is tile , ! (Contractor,~rfl~ent~ c~rporate officer, etc.) , £ sa~d. owner or owners, and Is duly a~thorized to pe,rforMPcr~ave performed t ~e said work and to make and file this application: that all statements fontal,ned in this application are true to the best of his knowledge and belief; and that the Work will be performed in the manner]set forth in the application filed therewith. Sworn to before mc tills ' [ ' '. "" ........ : ..... day or ........ Notary Public, . . County No. 48791i0~ .o -- / ' '~"' '~;'."-~-.(~ ......... Qualified In Suffolk Cgun~/..a~'~ ~ L..../ pplicant)