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Home My WebLink About20155-z t ~ FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Tawas Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20238 Date SEPTEMBER 25, 1991 THIS CERTIFIES that the building ALTERATION Location of Property 535 MAJORS PATH SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 54 Block 1 Lot 24 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 15, 1991 pursuant to which Building Permit No. 20155-Z dated SEPTEMBER 23, 1991 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 ALTERATIONS FOR NON-HABITABLE STORAGE ROOM IN ATTIC AS BUILT The certificate is issued to FLORENCE GOLDSHOLLE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. H-024643 -SEPTEMBER 24 1991 PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 . 10iBai NO. A TOWN OF SOUTH04D BIi1LDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILD1Nd PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N 2 0 1 5 5 Z Date .....9.:~::~ 19..9,x.. Permission is hereby granted t • ~~'~~~""f~ ~~'('"/~~~,J'-~~ to ...~~-~:.1.....~~.~'::::...... at premises lasted at .c..~.:.-~.,~.,.~((.`'..'..... C.~..sZ~i~°~&~.....~ ...............................................S1..1..~.. County Tox Map No. 1000 Section Blak L/ot No....~'.I'..~.......... pursuant to application doted ......~~~!a~ 19..~/,., and approved by the Bulldfng Inspector. Fee S.'~~J..y~~ Bu ng Inspector Rev.6/30/80 , .T..~__-~,._~ , Ttf~ l~EW 1FORK BOARD Of I~tt~E UND~tt1MRtTL~tRS RO'1,'ic; t6 9a sull/wu OF ELECZY~CTI S}•PTENNSR 24, ] 99~HN STRE NEW YORK, M1~1NlY~f~ 14,038 h p'7.4ti4 3 Dote Appficottaw No. on file I1 / THI$ CERTIFIES THAT i, only tke sloetelwl oyuipmowt «dfa.Nett 6olsto owi lwero~teot! fty eM orgrlicawe MRfed ow tM fdAOOe Yyrliwf4ts wwfkfr iwtko pnwfiwt q/ i i9RS, e'I~ukf;NC6 GOLDSNOf,1,;N1, 535 PIA.TOR~ FA't'(i, 50U't'HO60,. W.Y. n mm in tkefdlotet,efs laeu~Pel~~~,e~t15Y IAt FI. ~ Swd F!. SertJaw Mock Lot s_ woes eremined un andfownd to 6e iR rnmpliawce ritk the reyuiroments ~ tkie Aw.d. AQK b1MT016 T f OIn1lIf NCANflfClNT RUOMiQMT OTNKR AMT. K. W. AMT. - K. W. AMT. CW. K: W. AMT. N, t. BlYaf RIMIAC! •ADTORf Ret1$! kNYAdEJt lrMi !flGAL fIlC'iK NMt+kO•Itf Mµ Nt•I I1WY OIIAMIAf AMT. K. W. OR N. I. OAS N. I. AMT. NO. A. W.O. AMT. AAN. AMT. AM/f. AMi.- w AMT. WA715 9nRVIfA Mf>pORlf•ET tq.0! S • R V 1- G AMT. AMI. TnK • , r tw , .o7r+ t ~ tw t A Aw No. a conc. No. eN N4l[6 9~' Mo. or MTOIIIAIf a }~uiii otlw •t?kfutun z' ?.N?) }•t.00R STOR2~ ROOH ONLY- I - ANO VTSIlAL DEFECTS: "An atrrtrica~ eurveY has been made of Che r~xp~s~d ~].ecr.rica3. equipment i.n thn premis.~-s i.ndicated." "Nn ol?vinus nntiari_sfaetorp condition was fnunr. FLORENCE, GO),DSNOLt~N: G/O 3 P'FTER C(7l)PP1R HO,Ah NE;N YORK, NY; 1 OOi.I) fl?•fl~t 1t Per TAit cortiltcwto nwN not tta alNrod in a t1loRnor; ntum a 1b! ~f •Ilt d t; 4? c i INSPECTORS ~ V (516) 765-1802 y;' j,~;)s~?)l'(A~~ • VICTORLESSARD,Principai ~~}~';`v" SCOTtL.HARRIS,Supervisor CURTIS HORTON, Senior !.f %a~ Southold Town Hall VINCENT R. WIECZOREK, Ordinance FS • _ r, k,'~s' ~ ~ P.O. Box 1179, 53095 Main Road ROBERT FISHER, Assistant Fire '•-•3s; Southold, New York 11971 Building Inspectors ~ , Fax (516) 765-1823 v • ~'r'~jy Telephone (516) 765-1800 THOMAS FISHER GARY FISH ~ ~~t 1~' OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD F A R C O V E R S H E E T T0: ~ ~ ~f "Q,@2.~ u FROM: ~ DATE : v4/ 9~ 9/ ll OF PAGES: OC Additional Comments: IF ALL PAGES ARE NOT RECEIVED, PLEASE CALL THIS OFFICE AT (516) 765-1802. Form No. 6 L~l~%~! TOWN OF SOUTHOLD ` h BUILDING DEPARTMENT SLP' ~ 6 ~9Jt :~~f i? 765N1802L ,,,.<_t Y? l3 LI.i: L.iL ~~~m n4-. YOVe4V Car„CtL~71{i;; ~ AP LIGATION I'OR CERTII'ICATE OF OCCUPANCY 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-9 form). 3. Approval of electrical installation from Board of sire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1~ 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. i 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 - Residential $15.00, Commercial $15.00 Date ..T.~j 1~.1 [Jew ConsCruction...... Old Or Pre-existing Building.. Location of Property.. J,~ $...,°~I~J"01C S' ............S~U~~}p~ House No. Street Hamlet J Onwer or Owners of Property...T. ~'o~c~~..... ,U~c~~} 0 C,C~ . . . ...q........... County Tax Map No 1000, Section....~~.....Block.... ~..........Lot..~! ~ Subdivision ....................................Filed Map............Lot...................... Permit No ................Date Of Permit................Applicant............................. {{ealth Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... Pee Submitted: $ l U ~C Oo73 0 APPLICANT Q"-1 "`'~G~d'~ Y~^' ~C.~SHoLt.~' ~~~vSc~ ~ PSG? ~S ~ ~ ~ -r----~-~---~~. ~ ~ ~ o 0 ~ ~ 0 -Z 9 p ~K~ m ~-`~~p 4~: ~ 4 ~ ; 1 ~ . ~ SEP 161991 . ~ u s~ ~~.rsc a,~r~z: ~ ~ -rowrv car ~c~~' ~ ~ - - ~ iJl~._fir3, g.3taai~Pv1C3A. 1 166V g I d3S j !t~~~.~ A ~ ~ ~ ~ ~ -2 ~ , - n~ ~5~~~ s~-~-r-1sCn9~1 - _ j i r ) ~ r ~ _ r r ~ ml~_Ir1~ ~ ~ ~ ' C~ C,~ c~1 a. ~ ~ ~ i ~ C"` i~ _ L r E s 1 i . ~~..r r.. ~ ~ ~,..~.,5• ~ 7 ~ f ~~C1~~~ ~ ,-.p~S;Sk~ ti`s --------r...~___._.~:~. ; I ~9" ~~~SEP ~ 161991 r* P Gerry Go~ds6olle 3 Peter Cooper Rood, Apr. s G ~ew Yor~, ~ew Yor~ 10010 ~~RC~L~ i lt~If e .S`~u`~7~~~-~~ SEP ! 6199f t ~ s t..{ ~ bY~...a „m, ; i N' M/~., 6A/~~( ~~u~t;,~. ^y~~' 'I t rtl; ~,~A 5~,,.~~--~ `-LPG-c_-~-, , ~"7~ c.,~ . ` r~ c C~, o C~-c c_ ate-, ~ ~ l ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ a~[ ~ ~ • BOe\FD OF HEALTH FORMN0.1 3 SETS OF PL.1N5 {-C' ~ TOWN OF SOUTHOLD SURVEY ~D C' ~~!-~.~~V~~ ~ BUILDING DEPARTMENT CHCCi; _ • - • • - • . TOWN HALL SEPTIC FOftri S~P ~ ~ )9~~ ~ ~ i ~ SOUTHOLD, N.Y. 11971 ~ j,; l;i TEL.: 765-1802 t:OTIFY; CALL Examine L: 9 ~ h1 A I L T O ..f , . Approved 19lr'.. Permit No.~~ _ . Disapproved a/c . o~T" B lding Inspector) APPLIOOOOOOCATION FOR BUILDING PERMIT c~ Date '~.~7.~! ~ 19 l INSTRUCTIONS '~a. This application must be completely filled in by typewriter or in ink and submitted 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 premises or public streets ~r 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 Building Permit to the applicant. Such permit ;hall 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 MADE to the Building 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 regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. Che applicant agrees to comply with all applicable laws, ordinances, building ode, housing code, and regu tions, and to idmit authorized inspectors on premises and in building for necessa specti n . v UNDERWRITERS CERTI~IQAT~ (Signature of applicant, or name, if a corporation ..REQUIRED p~ C.~o Pz%~L.. A FIB $ fa'r' (Mailing address of applicant) t,,; . State whether applicant•i$ owner, lessee, agent; architect, engineer, general contractor, electrician, plumber or builder. .............W:N ~.2: :~..`f:.;. A<~ ,v~~~ Y.. !N..~~?~-r, , ~ ,a;•; , t:~ Via.. . ~ . Vame of owner of remises;.; :a Lb'~ c` ~ ~ t` ~rO L ~ S F~ C' c.J Cep P T (as on the tax roll or latest deed) [f applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No . ~ ~ ~i9 e+~~ Plumber's License No. ~ ~ Electrician's License No . Other Trade's License No . 1 I . Location of land on which proposed work will be done. ! ~`"1 ~ `St` C-',~ l~a~is house Number S,trLeet 'Hamlet County Tax Map No. 1000 Section Block Lot . . Subdivision Filed Map No. Lot . (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~ y...~~s. ~ rVCs1~! C~ . . . b. Intended use and occupancy .......S~?':e~ R , , , , , , r?~1-G~~ 1'1`~Clev i~rr,) dr S'~(~2~ 3. Nature of work (check whicRhora Oplicable): New Building Addition Alteration epair val Demolition ...Other Work . / OU°/ • • • • (Description) 4. Estimated Cost bt ~ . : Fee . (to be paid on filing this application) 5. If dwelling, number of dwelling ynits ~ o . C~,A~~' • , , , Number of dwelling units on each floor . If garage, number of cars . 6. If b~ siness, commercigl or Num ~ oc ~ , s ec' y nature and extant of each type of use , . Hei ht Dimensions of same stmctur .b if ~ ny~~ ' ' 'Rear Depth . e wit er of Stories . imensions of existin structures~h alterations or additi6ns: ~ront .e~'`~'~ ~(y...~-~~:..... L ea e gth ....................action: Front . I!o C~.~~.. Rear . Hei ht ...............Numb. Height Number of Stories . ......Depth erofStories 9. 3i e' of lot SFronttire new constni • • • . • • Rear Depth . 11C. Sone or usecdistrict inlw~hich •pre ~ ~ • • ' ' ' ' • Name of Former Owner .J,~)a'r!a:rf~.6.•+0,'!l , , • , , , , , , , • , • miles are situated ~5l~A!°C,).A Z . P P ate any zoning law, ordinance or regulation: . ~ U, . 13. Will lot be regraded (`Q.ct Will excess fill be removed from premises: Yes No n~ r,~ W t2~s!'I ~ r" ~ l.p 4 14. Name of AOrchiteot premises v3~a ~ }lddress ...................Phone No............... . Name of Contractor • ' ' ' ' ' • • Address ...................Phone No......... . .Address . , .Phone No. . I5. Is this property within 3(!50 feet of a tidal wetland? eyes.. .•.No.. " *If yes, Southold Town Trustees Permit may be required. I PLOT DIAGRAM ~ Locate clearly and distinctly all ?luildings, 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 o corner lot. ~ PR ED AS NOTE'Cl . I7ATE`~,r~3 B.P a ~/cr~s" I, ~ 101 BUh~~~DEPART T T 7Ei5-t8pl 9 AM TO Q PM FOR THE G~Ol,1-~WINC, INSPECTIONS: `L,~~,~~~~7~ ro. FOURtDATiON - TWOREOUIRED U~y~°-I~~ (S'fi FOR POU~E+DSONGRETE i ~ 2. ROUGH - FRAI~l1N &'PLUMBING JS ~ eC,i-~ 3. INSULATION , taj°- FINAL - CONSTRUCTIO UST BE COMPLETE FOR C.O. _ - ALL CONSTRUCTION SHALL ME --~i - ~ THE REQUIREMENTS OF THE N. . / STATE CONSTRUCTION 19t ENER Y ( CODES. NOT RESPONSIBLE FO DESIGN-ORGONSTRUOTION-ERROR SLATE OF NEW YORK, ~ 'O NTY OT ..~'~FE4! :t!~...... S'f ~ • ~o•Ga~'~ • • • • • • • • • • • • • being duly sworn, deposes and says that he is the applicant (Name of individual si mng contract) bove named. le is the .~`!'~!`c~~{..i.`~'.. Lr~w ~ .b.2,/~r~1.. ~ r~ ~7~ +~0~ ~Wl2L'1dC~ ~oLO.SliOll.~ (Contractor, agent, corporate officer, etc.) f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this Pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the ork will be performed in the manner sit forth in the application filed therewith. wom to before me this `,mss ~ ~ p,- ~ ~~173aN1~( v~-T' LA',ti^I ~ c~ vu3~~ FYP~'u cIS-,,rT ~ /r ~}•DTI,-l~•S~~-~'~L6~--~..~~:~.~~.~~~j9 U~r3E~Z" t'lv~-~a'~ °l~ l°t~.C~ti~ fotary Public . County /S ~ ~I; ~ 9~ . J (Signature of applicant) C~~~~ ~~,~~9~J