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Home My WebLink About20855-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPART~4ENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22494 Date AUGUST 2~ 1993 THIS CERTIFIES that the buildin~ ALTERATION Location of Property 4295 CAMP MINEOLA ROAD ~ATTITUCK~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 123 Block 5 Lot 24.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JDLY 22w 1992 pursuant to which Building Permit No. 20855-Z dated JULY 28, 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 INSTALL A NEW WINDOW &DOOR INAN EXISTING ONE FANILYDW~I, LING AS APPLIED FOR. The certificate is issued to of the aforesaid building. JOHN HOLST (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 FORM NO. ~1 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*-N? 2085~Z Permission is hereby granted to: .,~.zc.....~~.....~..~ _.~.:.~ .... ...... ~:_/...~'.. .......... ~ ..................... · da, .......... ~____/.~__.~,~. f/~..~~.... · . ................. , .... .~. :~..,,~r~../.~ ..: ....... ................................................. ~.. ................... /~~ ............ .~ ............................... County Tox Map No. 1000 Sectgn//' /;~-/~..-.~. ............ Block .......... ~ .... Lot No......~....~..'..../.. ..... ~...o., ,o opp,,~at,o. ~o,~ ................. ..F...~...~..~ ...................... . ,9..~.~. ond opproYe~ Building Inspector· Fee $ ........................ /~ildt~. Insf~ctor Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 B~;-~45 ~ APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must b~ filled in by typewriter OR ink~nd~.~submitt~d~g,._the,~bu~idi~.~ _. $~p~ctQr with~:~h~ f,o~t~wing: ,/: for ~'new,'~b~'l~i~,~,,:~i~'{'~' 'fi::~?f,~::/~'!':',?: : '~ ~,:, ~ :,~,-.~ 1,, F%nal sut~ey~of property wzth,accurate-~iocatio~ Of:,al1 buildings ;~oheft~ ~,k; . ~ ~u, na unusuam, natura~ or"to~og~aphid f~atures. ' 2. Final Approval from.Health Dept. of water supply and sewerage-disposal(S-9 form). Approval of electrical installa[ion from Board of Fire Underwriters. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 6f ig 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 signed by the applicant. If a Certificate of Occupancy is denied, the Buil'ding Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. C~rtificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $~5.00, 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 - Residential $15.00, Commercial $15.00 Date ... ~ .~.l a~. ~..C~. ........................ New Construction ........... Old Or Pre-ex~t~ Building ......... Location of Property...~1.~. ............. a. '.~.. ~.1~.(07~.....~ House No. Street Hamlet Onwer or Owners of Property ...... O. ............................................... County Tax Map No 1000, Section../.~.~ ....... Block ..... ~.~. ...... Lot....~..~2.! ............ Subdivision .................................... Filed Map ............ Lot ...................... Permit No.~.O..~.~.~..~Date Permit. ~l~.~..,A lican~l..F-q.Mh~ /~F-'~ ~ .._ Of , . . pp ....... ~ ........... ~ O~ Oct) rO~t'~ ''. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Car tificate..., ....... F ~l~ % <~.,,~/~[ ~ Fee Submitted: $..~..~...~. ...... ;...,. ...... ?""/ . ~~/~"/' ~ ' ' , : · ~,~ .~r...~ ~....~-~.~. THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ I, BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW NEW YORK 10038 YORK, THIS CERTIFIES THAT in the foltowlng t.cation; ~ a.~o~.t ~ t~t rt. ~ ~.d ~'t. 0~'~ S~aon at~ rot ~sexaminedon ,~UL~ 3~ r1,993 and found to be in compl~nce with the Naaonal Elect~cal Code. FIXTURE FIXTURES RANGES OVENS [DISH WASHERS EXHAUST FANS DRYERS TIME CLOCKS SYSTEMS NO. OF FEET E OTHER APPARATUS: S E R V I C A,W.G. NO OF NEUTRALS A.W G. OF HMEG OF NEUTRAL [~&tl[, R, BIIRtIS 275 '?OW§ }I/%RBOR I, AN~ SOU~'HOLD, ~Y, 1197t GENERAL MANAGER 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. INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD SCOTT 1., HARRIS, Supervistn Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 JULY 30, 1993 ENVIRONMENT EAST, INC. 3015 INDIAN NECKLANE PECONIC, NY 11958 RE: JOI~N ~OLST 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) No Underwriters Certificate on file. 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 % 20855-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. J ~)UNDATION ZND [ ] INSULATION FRAMING ~ ] FINAL INSPECTOR FOUNDATION (lst) FOU~{D^TIO|~ 2. (2nd) ROUGH FRAME & .PLUMBING ADDITIO~;A'L COMME~;TS: I~SULATION PER N. STATE ENERGY CODE FI;;AL ' '~' "· ' TOWN OFSOUTHOLD ' ; '°' BUILDING DEPAtlTMENT · ,JUL 2 2 oo',) TOWN HALL '," , , , ~. · ,~OUTHOLD. N.y. 11971 ......... TEL,: 765-1802 ....... : , &~roved' ~,, ~ . , 19 PennR No )isap~roved ale (B~ild'rg inspector) ..... .APPLICATION FOR BUILDING BOARD 3 SET SUI{V~, ' CIIECK SEPTIC FORN , ' NOT~y CALL . ---,* " '" 'Date .... - ~..' .i~,:, '" INSTRUCTIONS ",?~ ,' .a., Tl~s apphcation must be completely filled in by tYpewrlt2r or in Ink hnd submitted to the Braiding Inspe~tor~wRh ts o[ ~[a~s~ ac2urat~ pIo~ plan to scal~. F~e according to sclmdulo. ~b." ~lot pl~,showing location of lot and of buildhm- , ' '-' , , ', ~ ' , , ' ~reas, and gWmg a d~t~l~d de.~m,. ~ ,. .... ~ on pmm~ses, rela~io~k~ ..... ' .... ,.. ~ ~,~ ,' ' ~on.' : . ~.,~don o~ myout of nro,~ert ..... · L , ...... V ~y aujmmng premises o~ ub~gs ' '- ~ ~ .... at oe Umwn on bm dlagmm whichls ua~r-.,- ,,c,, The work covered by tl~s a ~ ' ' ' ' ~ -~r-~m~ ~'d~tUnon'a ...... ~ .... ~ phcahon may not b~ conuneq~-, ~ ~ · ~ ' '"' .. _ ~ ~v-u~ Ol [111~ applmation, tim Bu 1-"~ ' , ~u oe~ore I~sugnc~ of Bu~dinu Pe ,., an oe kept on tlle'premlses avaU-~-~ - · . umg Inspector w~l issued a B,,m'- ,) .. ~ [nll[., .... , , e. , No bulldog shall be oc--~J~ mr lnsI?~ctton throu~tout the work. -..mC x e~tt to tile appUc~t. Such Pe~it';l Buildh~g ,Inspector. all imve been ~-r,~u or useu m whole or in part for agy purpose whatever until a Certificate of Occu~ · A~LICATION IS HEREBY MADE to the Building De ~tment . ' ' ' ,, fild~ng Zone Ordinance of the Town of Southold .... ~P- for the issuance of a BMldin · '~gulations. for the construction of buU-' .... ~ autlom Uonnty, New York, ~d other ...v ~.~e~nR pursuant to'the~ te .applicant ,agrees to comnlv ...:,~. ,, um~, ~oltions or alterations, or for; ..... , -,-~.~?m ~aws, OrdM~ces mis authorized h,specto~ o~ ~r;~:;'.~'t~?n~a0J~, ~aws, ordinances, bundS. ;;~;~l~.?~?eino~Rmn,.as hereM Oescdbed,~,[ ) ,...:, ~ , . . , ~ ..~.~ uuu m, uuuumg rot necessa~ inspections. ' .... *mC coue, ann regulations, and to . a~ure et applicant, or name l(~'dn;~.~,' ' ~' ' '"~ ' " , 'l,'r7 5- 4- WI) ........... ~ "~ -~'Vv~atlOll " - .' . ~ 77'' ~~g~ra~ontmctor, electrician, Cumber or burden?,' ~:'.. ,,,(, ',' ~y~~ture of duly authorized omcer. ' FEE.~-~ .y:~"7~/ ~,, ',. (~a,~ and titl~)[~r~~ ~}~r~TM ...... . 765-1802 9 AM ~ 4 PM FOR';IH~, ....... FOLLOWING INSPECTIONS: "' ' ' ' FOR POURED coNCRETE '. ':Plumber's License No, .., . Electrician's License No .... 2. ROUGH - FRAM NG 4. FINAL - CONSTRUCTION MUST" ' ii: .... ' ' BE COMPLETEFOR;C,O.. '" ..Oilier Trade's License No, ALL CONSTRUCT ON SHALL THE REQUIREMENTS OF THE ~,~ Lo,cation of land on '~Mch ~ro,.--e.' ..-~'- ._., ,_ , STATE CONSTRUCTION' & """LI m c, ~ ~o. wy,%,v,, o~.vone .... ."" ......... '. ...... ¢9P~, ,~?T RESpONSIB~ r~R ,.,,~.~ .... ~_ . [ ~ ~..,~,~,1,~. PC~ ' ~' D~SIGNORC~TR~TIONERR~,S ' ' " ' '~ ' ~ .... , ~ Hamlet .,,5 ~" . ','""'r'~al*~"'a;' ' .oun xMap o,,lO00S~ction'.; ........ , .... ' ' " : ....' ': ' ' · ' ck., ';~..', ...... 'ubdivlsioll.; ......... ~:;' ' ...................... Fxlled Map No. , ,. y,. . ?~, , ,.., ',,c 4Name) .... ,,.. Lot ...,,.,.,,,,~,, , , , l$~,.g uae and occupancy of pre n scs ........ ' t SC and occt pallcy , ' late ex' ~;- and intended ~ ofproposed constructionl " . Existing use and occupancy " . . ¢.~, , . , ,Intended Use and occupancy ~ ~ ' ' ,~, I', ~..,.,// -~ ..... "t":'. ....~?",'"',',.,,..,,,, . p,; wo ( c ~cc w ~ c ~ a ca c : Nuw Buiidin§ ..... ' ..... Addition ~te[atio ~ liti Otb rW k ' . ' 5', 4, ' Eatimatffd Cost .... ~d. ~ lO ' . (D~scflption) , 1 5~ lfdl Iii g~ obopatd h n flsa ca on .... ,, : ~ vo rig, IlUlll~er of dwellin nits ............... Numbur of dwelling units on each floor,,, }a~ ,spc RUmandaxtcntofeq Itvooofuso "' igl ' um~ ' ' y 'ont, ~,~ ......... Rear . .;.,. ....... ~,., D~ptl '" ' Dimensions of same st~cture w talterationaor oils: Front .;,~ .............. Rear 8'. ~l~t~na'oPsofentironuwconstmction: Front ,}~..~ : ~ ' · rtatgnt ... , Rear .............. Depth ............ ,.. ........... N.mher oF Sto~ea ....................................... , : .. . , 9 8ize~lot:Front .... ; ........... Rear ..... ~t ............... Depth ,,,~ ., I . , ~e regrad~d ...... . ......... , 14, N~e or ~w,..~ ~r ..... ~..-~.'tlfi~l~ ............ wm e~¢~ss ql~ oe relnp~d from premises Yes , , Aaron0 ofCmRractor ~P~¢ e ~ ~ ~ ~ ..... , - , F ~. ' ......... ,~* ~u p~oc~:lumoer or aescnpt~on according to deed; ~d show street atones and'~dlca[a whath., mt6no~or, go~rlot. . ' ' ' . '"' ' ' '.' ~ being duly sworn, deposes ~d says that ho Is tho ap~ll~ai ..,!?~,p~vqer or, owners,.~zd .mI dull autho~%rfonn or have performed the said work and to m~'and }P/ica?on; that all stateme ~ts'c,ontamed l ~ this appl cMio i are true to t e '- ..... ' '- ',', .... ' ' , ' OUSt Ol Ills KIIOWI~U 00RO rk,wUl, bc performed 111 tho m<llgr scl forth m tho apphcattop filed therewith. ' ' 4 ~',,