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Home My WebLink About20166-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20387 Date DECEMBER 1~ 1991 THIS CERTIFIES that the building Location of Property 465 THERESA DRIVE House No. County Tax Map No. 1000 Section 115 Subdivision ALTERATION Block 15 Filed Map No. MATTITUCK~ MEW YORK Street Hamlet Lot 4 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 17, 1991 pursuant to which Building Permit No. 20166-Z dated SEPTEMBER 25, 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 REPAIR FIRE DAMAGE TO EXISTING ONE FAMILY DWELLING The certificate is issued to FRED FINCKEN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N-207941 - OCTOBER 15~ 1991 N/A Rev. 1/81 Inspector 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) 20166 Z Permission is hereby granted to: / / . , /'/ _ . // ~ ,o.~ ........ ~..~.~..~ ..~....~ .... .~~: ...... ~, ~,,m,,, ,~,~ ~, ..~...~~...~~ .................................................... ......................................... .................................................................................... Building Inspector. Fee $....~ approved by the Rev. 6/30/80 OWN OP SOOT O D ...... ., ~ BUILDING DEPARTMENT TO~N IIALL 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 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. · J. For existing buildings (prior to April 9, I957) 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. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building In§pector shall state the reasons therefor in writing to the applicant. C. Fees I. 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 ......... . . " Construction Old Or Pr existing B ilding !.oeation of Property....~..~. .'~..~S'f~ ~U~ H~use No. Street Hamlet · hi.er or Owners of Property ...... ~.~.-.~R~ ~ Couoty Tax Map No 1000, Sectmon. (/~ Block ' ' ......................... Lot ..... ~ Jobd ivision ...................... Filed Map Lot Permit" .,o. .Date Of Permit ...Applicant. ~[ealtb Dept. Approval ...... ~A ............... Underwriters Approval./~3]...~.~ '"~"~ Board Approval ..................... egucs~ [o~: Temporary Cer¢ifleate ........... Final Ce~tZcate ........... ( o {203 7 ~PLICANT 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 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 JOltN STEWART P. O. BOX 521 MAIN ROAD MATTIT~CK, NY 11952 FRED NOVgMBER 25, 1991 NOV 2 7' 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 (Y~/not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (Ail permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT ~ 20166-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. CC: FRED FINCKEN INSPECTORS Victor Lessard Pringipal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wleezorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD 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 IqOVFa'4BER 25, 1991 JOHN STEWART P. O. BOX 521 MAIN ROAD MATTITUCK, NY ! 1952 Rg: FRED FINCKEN To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: x~x An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. xxx The check is (~/not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT ~ 20166-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. CC: F~ED FINCKEN THE THIS CERTIFIES THAT NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK N.EW Y~RK 10038 Appl~'~tlon No. on file only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of FIXTURE OUTLETS i SWITCHES DRYERS FURNACE MOTORS [] 2nd FI, ..... \ Section Block and found to be in coo pi a~ce u, th the re~tulreme~[s ~f this Board. Lot FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OTHER FUTURE APPLIANCE FEEDERS TIME CLOCKS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I C NO, OF CC. COND A W O NO OF HI-LEO A W 0, ~O OF NEUTRALS A,W G, OF HI-LEO OF NEUTRAL OTHER APPARATUS: GENERAL MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDII, IG DEPARTIVEHT. THIS COPY OF CERTIfiCATE,MUST ROT BE ALTERED IN ANY/vlANNER. ~OU~DATION (1st) 'OUNDATIO~$ (2nd) '~0UGH FRAME & .PLUMBING ];SULATION PER N. STATE ENERGY CODE FI:IAL ADDITIONA'L COMMENTS: Exami~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved .. ? ..... 19... Permit No..~..Z.~..t~...~ Disapproved a/c ..................................... . ( Bu~ldino ~l~(spector ) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH .......... 3 SETS OF PL.INS .......... SURVEY ................... ClIECK ................... ~ SEPTIC F O aI'l ............ ,,. HAIL TO: INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and s~ubmitted to the Building Inspector, with 3 *~ 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 tkis application may not be cbmmenced 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 milding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or '~egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. 'he applicant agrees to comply with ali applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for necessary inspections~, O,~.~ ~.._, " (Si0nature of applicant, or ~'e~ if a corporatio'n) (Mailing address of applicant) ;rate whetber applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... '' . '' ~ "~ ' ~' t ........... ,~ame of owner of premises .. ~.~....~?..~....~,'./.'~..~..~..~..~57 ......... '. ;.'; !... :2 .... .............. (as on the t,ax roll b'~ latest deed): ' f applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. /.~.O~"('g~' .~..' Plmnber's License No ......... ' ................ Electncmn s License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. ....................... llouse Number Street Hamlet Map No. 1000 Section ....... //~4.~. ..... Block ...... /d9"7. ........ Lot.. 4 .............. County Tax Subdivision ............ ' ......................... Fried Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~'/ar ~4~/.~.~. .~..~.~.q~. b. Intended use and occupancy ......................... Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair . .~.7~1~.' ...... Removlal .............. Demolition ........ Other Work ..~/~rO~~ /_~ ' ' (D rii~ion) esc 4. Estimated Cost . o .... " ......................... Fee i (to be paid on filing this appiication) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor If garage number of cars ~ ................ 6 If business commercial or mixed 0ccnpancy specify nature an'd' .......................................... · ' , extent of each type of use 7 Dimensions of existing structures iif any: Front Rear ..................... Height Num~6r of Stories ............................. Depth ............... Dimensions of same structure wit~ alterations or additions: Front ................. Rear D pth Height .................. 8 e ..................... ¢ .............. NumberofStories ..................... Dimensio s of ti dti F ' Height nen re new coi~stz~ ;~: font ............... Rear ............... Depth ..... 9 ............... u i r Stories .............. ' ......... Size of lot: Front Rear .......................................... · ' .... i ..... D pth 10 Dat of P b ................................. e ...................... N eofForme O ' · e urc ase ............ ~ . am · . ................ r wner .................... 1 I. Zone or use district in which premfses are situated 12. Does proposed construction wolat¢ any zoning law, ordinance or regulation: ........................ 13. Will lot be regraded ........... 1 ................. Will excess fill be removed from premises: Ye~ No fp 14. Name of Owner o remises ..... ~ ............... Address ................... Phone No ................ Name of Architect ~ --- · · '~.~ .... ;: .:~ ............ asaress ................... Phone No. Name of Contractor...-~,p~tg'.~M..~.. ~..'~/1~.~. ?... Address. ~,~ .~eZ..~,,~ / .... Phone No. 15. Is this property within 300 feet of a tidal wetland? *Yes' . .... '. · If yes, Sonthold To~n Trustees Permit may be requirgd. · ~o>~ ...... .... I 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 coruer lot. OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUP/ NCY TATE OF NEW YORK, S~S OUNTy OF ................. UND~WRITERS C£RTIHCA'I'E liE(IUIREI) ~'ROVED AS NOTED FEE. ~ BY: NO~:iFY ~ DEPA~ 765~1802 9 AM TO 4 PM FOR THE ~. FOUNDATION . ~O REQUIRED FOR POURED C~NCRETE 2 ROUGH ~ FRAMING & PLUMBING 3. ~SULATION ' 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET 'T~E REOUIREMENTS OF THE N.Y. ~5~TE CONSTRUCTION & ENERGY NOT RESPONSIBLE FOR OE%~GN OR CONSTRUCTION ERRORS ................... ' ............................ being duly sworn, deposes and says that he is the applicant (Name of individual signing ~ontract) )ore named. , e is the ......................... i ............................................................... ' (Contractor agent corporate officer etc) · said owner or owners, and is duly au[horized to perform or have performed the said work and to make and file this plication; that all statements containedI in this application are true to the best of his knowledge and belief; and that the ~rk will be performed in the manner set [forth in the application filed therewith. eom to before me this ~ .......... ~' r'x ....... day of .~.., '19. )tary Public,..~ · · .J~. · :..~.'.~ County I~NoIY Publl~, ~t~te of New Y~ ,49522~, Su~k Cou Term E~ires Jane 12, 19 ~ (Signature of applicant)