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20404-z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21197 Date DECEMBER 4, 1992 THiS CERTIFIES that the building NEW~DWELLING Location of Property 205 OAK DRIVE SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section BO Block 1 Lot 30 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 23, 1992 pursuant to which Building Permit No. 20404-Z dated JANUARY 24, 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 ONE FAMILY DWELLING WITH ATTACHED GARAGE AS APPLIED FOR. The certificate is issued to EDWARD & ADELAIDE McGURN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 91-SO-103-NOV. 23, 1992 UNDERWRITERS CERTIFICATE N0. N-241521 - JULY 6, 1992 PLUMBERS CERTIFICATION DATED MARCH 27, 1992 - TRT PLUMBING & HEATING Building Inspector Rev. 1/81 ~f. roast xo. s TowN of aouTFlo~D BUILDING DEPARTMENT TAWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) . N o 2 0 4 0 4 2 Date ..~.,~e 19~~.`~.. Permission is hereby gr me to: ~"~:~"...r.~..:...~~.. ~ ~~yy , at premises located of ...o`~...~..a ....4.~~,~......~.... ...................................................~.0... . ICI County Tox Map No. 1000 Seetion Block Lot No.....-~...~-f II pursuant to oppiication dated ......~~d~..~ 19.~w~and approved by the Building Inspector. Q Fee $..7`.4~~./..:.. Id ng Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD i4 i" i~ ~ ~ r; BUILDING DEPARTMENT a TOWN HALL ~ ~ u ~ 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPAN Y T0WNiDPSt8U7Fi LD 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 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-4 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 17 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, 1457) non-conforming uses, or buildings and "pre-existing" land uses: ~l. 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 - Residentia~~l~~ $15.00, Commercial $15.00 Date ...f:?•:~ fz New Construction..... Old Or Pre-existing Building Location of Property...~~5~ ...............f~,AK '~2~,~E'..................SosTMO~~........... House•No. Street Hamlet Onwer or Owners of Property ...~:y9~~?... s. /-lD~L~i~E....~ ~Gu2N County Tax Map No 1000, Section....d.B ~ .....B1ock.......~........Lot.... 3 Subdivision...~~Y{7:`N..... ,SF/GR rS , , ,Filed Map ~.j ......Lot f Y.~"~i.Y~i a°..... . Permit No..~.°.y:'.~~.. ....Date Of Permit..~/L.y~~Z....Applicant.L~.~Crf ~ler~cJ .._,~,vC: Health Dept. Approval ..........................Underwriters Approval.... Planning Board Approval Request for: Temporary Certificate........... Final Gerticate...Y.~...... Fee Submitted: 25:, ~ ~ Q ~ APPLICANT /w C G~ r,M t TEL. 7G5-1802 S~~~Q~-C TOti°JN OF SOYJT~O~D o ~'c ~ OFFICE OF BUILDING INSPECTOR ~ 3 P.o. Box ns `s'~`• TOWN HALL >yO~MO~ ~b~~ SOUTHOLD, N.Y. 11971 C E R T I F I C A T I O N , Date ~7 g Building Permit No. ZG+/oy - ~ Owner ~7J~.p~~ "~e~~~~~r' `G~,aiv. (please print) / Plumber 7r~nAi„[~ •79~f3 7 %~T r~~-~s-Ri,v6 Y!Y-A'T~~-+L) (please print) I certify that the soldez used in the water supply system contains less than 2/10 of la lead. (plumber's signature) Sworn to before me t.is day of ~ , ~ 197/, ~ Notary Public Notary Public, Count y~~gagerd n. tgTARY PUBLIC. State of dew York _ SuNdk County"";°` ~°.~_~J~,%.~!i-~ Erg i~' !i ~']..i~~~. j-mm Commission I ~9 ~,NZ~,_cca,^,~~ ~ _ ~ F ~.1~~ tJL~ 2 ~ € J a. ~,~w~ t3LUG. il~P"t: FOt~~NvOF tif34k1"4iQ[, ~ , • THE NEW YORK' BOARQ OF FIRE UNDERWRITERS encE 1 1195@84 ~ BUREAU,OF ELECTRICITY - ~ ~fi; _ 85 JOHN STREET, NEW YORK. NEW YORK 10038 ' 1 Date JULY @6,1992 Application No. on file 17125692/92 N 241521 THIS CERTIFIES THAT ' only the electrical equipment as deaeribed below and introduced by the appliconi named on the obove application number in the premises of HcGURN, OAK DRIPS, SOUTHOLD, N.Y. in thefollowinR location; ®Basement ? tat Fl. ? 2nd b't. OUT .Section Block Lot _ I was examined un JUNE 2 6 , 19 9 2 and found iu be in contpliu:.ce :cith zhe rrynir¢ner:LZA of this Board. FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING OEOKS OVENS DISHWASHERS EXHAUST FANS = OUTLETS MCANDESCENi ftUORESCENi OTHER AMT. K.W. AMi. K. W. AMT. K.w AMT. K.W. AMT. N.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECPT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET ~ DIMMERS SYSTEMS AMT. K. W. ' Oll N. P. GAS N. P AMT. NO. A. W. G. AMT. AMP. AMT. AMPS. TRANS. AMT N. P Nq, OF FEET MIT. WATTS SERVICE •DISCONNECT NO.OF S E R V ~ 1 G E AM(. AMP. (ypE METER 1,a' 4W 1 ,e 3W 3 R 3W 9,e 4W NO. OF CC COND. A W. G. NO Of M-LEG A' W' G' NO. OF NEU1RAt5 ~ ~ A. W. G. EQUIP. PER <r Of CG COND. OF HbIEG OF NEUTFAI 1 150 CB 1~ % 1 1 1 1 OTHER APPARATUS: Q~ SCHARADIN ELECTRIC LIC.Ik354@-E C~/~f!/`" BO% 1@77 MAIN ROAD CUTCHOGUE, NY„ 11935 GENERAL MANAGER _ 11 Per This certificate must not be altered irV any manner; return to the office of tfie Booed if incorrect. Inspectors may be identified by their credentials. i ,_.i , ~ ~ t1EC 2 ~ € ~ TOWN OF SOUTIi040 I INSPECTORS Victor Lessard pc,UFFO( Principal Building Inspector p Curtis Horton ~;~>i 4~ O~ SCOTT L. HARRIS, Supervisor Senior Building Inspector a i i'"' Thomas Fisher ~!t~ ' = Southold Town Hall P.O. Box 1179, 53095 Main Road Building Inspector d ~ Gary Fish A~j~d So Fax 516) 765or 823971 Building Inspector Telephone (516) 765-1800 Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD AUGUST 31, 1992 LYNCH HOMBS, INC. 1725 ROUTE 58 RIVERHEAD, NY 11901 RE: EDWARD S ADELAIDE McGURN 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) %x% No Underwriters Certificate on file. Bffit The check is not on file.)$25.00 &4R No Health Department Approval on file. No final inspection has been made. %Sx No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 20404-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. I =1BLJ SliS._ _:J:i ~~J„; j~ ~Uigi4F:NT.^, c ~ _ I y ~~1 ?OUNDATION (1st) ~I _ ~ }yL 1 ~ \,l ? c 'OUNDATION (2nd) _ ~Nr 2 s ~ ~ 0 :OUGN FRAME & (~f~n • "1 PLUMBING ~ ` ~ N 3. v Y ~ " ra L17SULATIDP7 PER N. Y. ~ y STATE EPJERGY CODE ~ JJJ ' ~i ~ H ~L~ I r FZ;IAL~/~ G . z ~C ADDITIOPIAL COMMENTS: l` r_ 1 rY `'Y~'e'~y ` ~ ro . H ~ x r 1 ~ ~ ~ ~.y~ m v " -o y W ~ %j2z~~ 765-1802 l~/ BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION j ]FRAMING [ ]FINAL ~ REMARKS: ~ ~ DATE 9 INSPECTOR / ~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ~ MING [ ]FINAL REMARKS~_ ~r~-~...-~_ DATE I/~~~ INSPECTOR G j~~' ~ T65-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ) RO H PLBG. [ ]FOUNDATION 2ND INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~~X~r~,7 DATE ~ ~ INSPECTOR ~65-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION [ ]FRAMING y ~ [ ]FINAL REMARKS: ~C~.,~f-f J'~ C~ DATE ~ NSPECTOR 765-1802 BUILDING DEPT. f NSPECTION [ ] FO DATION 1ST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: E i t i K ' DATE ~ INSPECTOR ~ 7ss-1802 BUILDING DEPT. f NSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL 9 REMA KS: mL DATE L INSPECTOR BO,lnO OF HEALTft FORM NO. 1 3 SETS OF PL.ItiS 1/, , TOWN OFSOUTHOLD SUAV6Y ~ ~ BUILDING DEPARTMENT CIIECF: _ _ _ , , , TOWN HALL SEPTIC FOR:1 . . . SOUTHOLD, N. Y. 11971 TEL: 7651802 t:o<I F'f ; 1~i~"©~~ CALL ! Fxantincd./. ,-~„','7;,.,,,,. 19~'~ F1AIL T0: :~pprovcd . ~,.`y........ 19~-'ti. Pennif No~ . . Disapproved a/c _ _ . ~ilding I , pector) APPLICATION FOR BUILDING PERMIT Date i 19 INSTRUCTIONS r a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ~s 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 streets tr areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- :ation. 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 Bullding Permit to the applicant. Such permit i 1ta11 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 hall have been granted by the Building Inspector. APPLICATION IS HEREBY bfADE to the Buildin; Department for the issuance of a Building Permit pursuant to the 3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Zc;ulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. he applicant agrees to comply with all applicable laws, ordinances, buIlding code, housing code, and regulations, and to dmit au[ltorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) 17~Q5..RO~cTi? 58 ~r~'rk'/>tU~14 /l 9D~ (lviailing address of applicant) ' Mate whether applicant is owner; lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....3c,~ ~ ~.p~!Z ~amcofowncrofprcmises ~DI!~1~21~ AtVfJ h}TjEL/}rl,~r ~'C-»f~/.er.f (as on the t:rY roll or latest deed) t applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer] Builder's License No. , . ~ Plumber's License No. c~.O~I;C~ L-Icctrician's License No. ..~5~10 Cw Other Trade's License No . o~~? Locationof land on which proposed work will be done. . ~{l~! t~Ury®e,~ LOI ~ ~{7y.y£}ry~l,~~?..,....~I'~K„~~tv.~,.~~i,Rr'VFkrE'fPOr~A~...~jc~Lt.~ri-Fc~r._.1~. house Number ' ~ ' Street Hamlet ~I C.L.: 3D County Tax itlap No. 1000 Section ...e?.~Q......... Block r............ Lot ..y.~,. ~l,S.t~i. j r S~, Subdivision M~.7 D~ ~~-y~o(~ St~e~2.~5 . Piled Dfap No. ~ ~ Lot ...`'...~L~.K C- (Namc) State c~isting use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....V.~~ ~N.1 ...Lr.f~. N b. Intended use and occupancy .~?N~,~?'~?~(~..`?1.IUC'jLE•~'(~rl~liw4/ R~e`xil`~1;'NC~G A~IT(1CHEI7~C~ • ka i ja:r r r t:,sr C=~, (-I2fl~C`a C 3, R`etnir of work (check which aPPlicable): New Building Addition Alteration P Removal Demolition yd' Other 1Vork . 4. Estimated Cost ./•c~ C?C~~C~ s lrl~'scription) Fce S. If dwelling (to be paid on filing this application) d, number of dwelling units ; , , , , , , • , , , , , , , Number of dwelling units on cacti floor . . . . . . . . If garage, number of cars W U 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ~ • • • • 7. Dimensions of existing structure's, if any: Front . , , , , , , , ,Rear , , , , , , , , ~ • ~ ~ • • ~ ~ ' ' ' ' ' ' Heig}tt ; Number of Stories Depth ; . imensions of same structure with alterations or additions: Front E/, , , , , • ~ • • ~ ~ • • ~ • ' ' ' ' ' ' ePth : : ' . hleight . , Rear . ; . 8. Dimensions of entire new constri'ICtion: Front ~~Y's;',.G+° ~ ~ • ~ ' ' ' ' Ntrntbcr of Stories , , , , , , , , , . • • Hcigltt , .Number of Stories .Tw O Rear ,7~; 8 , , , , , ,Depth ; CJ" 9. Size of lot: Front ..l.l.a; ~ ' • • • ~ ~ ~ • • 10. Date of Purchase Rear., Q6r 1' Depth ~'.4?!''-.".. ~.:/.7!~..... 1 I. Zone or use district in which prcr'nises are situated • ,,(Name of Former Owner . 13, Does proposed construction violate any zottin~ S!•I?E/Urirrt~. d law, ordinance or rem AJ • ~ ~ ~ • ~ • ~ " " " " " " " " ' 13. IViII lot be regraded ,N• ,O, i ,ulation: , d, , , , , , , , • • , 14. Name of Owner of premises F~~•~~!-(~!v , , , , , , , , , Addrelss 55S4eCT?2pd~Q2 5ri~d/ temises:~• ~ •Yes . • . • No Name of Architect . ~;y!iJc~t, ~ 5 T~~• one No. ?~45-,c?a~f•7, , r, y~tlS/t ~ • ..Address/.7.a~'RrSB,R/?~ihe„ Phone No..Z?;7.'. o3at Name of Contractor ES ,.i cy l5. Is thislfr~e$rtSouthold T ~ / ~ ' • Address .,~t2y~e phone No, sa'?">r-?",`? ~-/J<'~I" * 00 feet of a tidal wetland? ~yes.••,,,,,, No..',,,,,,, own 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 whether interior or corner lot. i i TATG OF NE1V YORK,MM''~ OUN'TYOF......s~uTty\~.. S.S!i ~ ~2.e. w1..... C 2 >r .S .t . , being duly sworn, deposes and says that he is the applicant (ivamc of individual signing contract) ~ovc Warned. --~'Sisthc I~ (C tractor, agent, corporate officer, etc.) ' ~ ~ • ' ' ' ' ' ' ' ' ' • • • said owner or owners, and is duly au'thorizcd to perform or have performed the said work and to make and file this itlication; that all statements containcc~ in this application arc true to the best of his knowledge and belief; and that the irk will be performed in the mannerset;forth in the application filed therewith. orn to before me this ~ ..........~`SroQ,. a Of.. ..~..Nal,:tu.. ~~J 19 42 tary Public, ../.7i.X~C(_' • S"~•{~~ z ~trty ROBERT I. SCOTT, JR. NOTARY PUBUC, State .Y. • • • . No. 47250i~, Suffolk , TermExpit May 91,~9~ (Signature of applicant) ~ ~ r~ ~ ~ ,v ~ q , ~ eJ~., ~~fl f.7 p*p {F= z ~ ~S 4 U~tJI i..~rr~~ 0~ ~ 1~y ! lip p - 1 ~ j n7 en ~ at ~ c+~ J ~ i' r ~ 7 Csl,pi n ~m~r~~_i a ~~t{~It,'3 ~ i i , ~ r' f~? t~ 'tic ~f~ - - - ~~~t ,r.', ~ S ~ ~v I~ i It~n `ti iC) N / r ~ t r rn ~ m ~ ~ i r'C ~ ~ i ~°'.7~ ~ ' ~ F~~ /-P~ ~trJ G ~ ~ c 5 ~ ~ -aa~ ~ ~ Ij tv~c ~ r` ~ r~ x ~ ~ ~ ~ e~ . ~ ~ ~t-n i I ~ Y4 ~ _ ,6g ~ ,}t 7 ~ ~ ~ n~ f % / ~~I ~ ~ I - ~ ~ m / ~ ~ 1 ~ ~_r _ ~g o i ~ } 'cf~ ~ i ins ~ C ° ~i ' ~ J 6~ , ~ ~ r • ~ (VACANT , L i R. CJ f r~ "C..) ~ ~ f ; ~ . . ! ~ S s m < ' c, ' t r_. ~ ~ ~ ~ ~ m ar ~y ~.i ~J r. .`l ~ _ ~ c,, ~f`"I a ~ v ~ k,i1 Cp t G m m ~ 3 ~ ; ~~S - r'~3. 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