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Home My WebLink About20184-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21128 Date NOVEMBER 2, 1992 THIS CERTIFIES that the building Location of Property 1495 VILLAGE LANE House No. County Tax Map No. 1000 Section 25 Subdivision ALTERATION ORIENT, N.Y. Street Hamlet Block 3 Lot 2.1 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 27~ 1991 pursuant to which Building Permit No. 20184-Z dated OCTOBER 4~ 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 ALTERATION TO REPLACE EXISTING KITCHEN IN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL CLYDE & ROXANNA MELLINGER (owners) M/A UNDERWRITERS CERTIFICATE NO. PENDING NOVEMBER 2, 1992 PLUMBERS CERTIFICATION DATED FEBRUARY 11, 1992-KING PLUMB.&HEATING INC. Rev. 1/81 FO~ NO. ~ 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) 20184 Z Dote Permission is hereby grante~ to; , ~ ~/~..~~~.~.~.,..~~ ..... .~......~.~ ....... ~...... ............................. ,o ...... ~., '.-.~..¢ ....... ~:~...~.......~~........' '--~ ........................ -'~ .................... ~ ~,~,.~o,, o, ...~.~~~......,./....~. ........................................................ Co,,.~, To,, Mop No. lO00 Se~.o. ...... .2...~ ...... mo<:~ ...... ,~ ........... ~t No ...... ~..;.../.. ....... pursuont to application doted ...... .~..../... ..................................... ~'~ .~.. , 19.~/~., and approved by the Building Inspector. Fee $..~..?...~y.. Rev. 6/30/80 TOWN OF SOUTIIOLD BUILDINC DEPARTMENT TOWN HALL 765-1802 ~OWN OF SOUTHOLD~ - ...- -: ~ 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 Plauning Board Approval of completed site plan requirements. 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 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 - $i00.00 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.__ ~-- ~-- .----~ .~.Z~ .~/.~ ........................... New Construction ....!<..... Old Or Pre-exi ting Location of Property ......./~ .~.~.. .~./..~...~...~. ....... ...~?..~.. ...~..~.~..~.?. House No. Street Hamlet Onwer or Owners of Property ....... ~¢ ............... County Tax Map No 1000, Sectiom.....~...j ..... Block .... ~. ........ Lot...=~.! ~ ... Subdivision ............................... ....... Filed Map .......... Lot ...................... Permit No. ~.~.~.~..~.. ~.Date Of Permit..~.~P/.~./.~ .... Applicant.~% .~~/~~' Health Dept Approval .. Underwriters Approval Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ ............................. ..... ; .......... TOWN OF SOUTkTOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-I 802 CERTIFICATioN Date Building Permit No._~d~/~ (p }'ease print) Pl um2~e r. [please ' I certify that the solder used contains less' than 2/10 of 1% lead. in the water supply system (plumber' s,/S~natu~e) ' 19~. tlOtary Public, Notary Public 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 MARCH 4, 1992 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 HR. &l'ffiS. CLYDE L. HELLINGER, JR. 1~95 VILLAGE LANE P. O. BOX 3 0RIgNT, NY 11957 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) No Underwriters Certificate on file. The check is (outdated/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 ~ 20184-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. REV. CLYDE L. MELLINGER, ~R. 1495 Village Lan~ Box 3 Orient, Ncw York 11957 ~OUNDA'TION (1st) 'OUNDATION (2nd) ~OUGH FRAME & -PLUMBING ]]SULATION PER N. Y. STATE ENERGY CODE FI;;AL ADDITIONA'L COMMENTS 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [~NAL INSPECTOR 7GS-1802 BUILDING DEPT. INSPECTION /~UGH PLBG. FOUNDATION 1ST [ ] FOUNDATION 2ND [~2/'INSULATION [ ] FRAMING [ ] FINAL' REMARKS: ~ DATE 765-1802 BUILDING DEPT. INSPECTION * .,[. ] FOUNDATION 1ST PLBG. FOUNDATION 2ND [ ] INSULATION [~RAMING [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION UNDATION 1ST [ ] ROUGH PLBG. [~FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: //P.~,~/~~/r//, ,/.~, ~ ~.~ -//' /, / DATE INSPECTOR il :l Approved .......... Permit Disapproved a/c ..................................... FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1802 §OARD OF HEALTtt ~ 3 SETS OF~/PLANS survEY ................... cll~cK 4e'. .................. SEPTIC FORH .............. NOTIFY ~ CALL .... HAIL TO: (~dilding~fsp ector) APPLICATION FOIl BUILDING PERMIT INSTRUCTIONS a. *Fl~s app~icati~n must be c~mp~ete~y ~~~ed in by typewriter ~r in ink and submitted t~ the Bui~ding ~nsp~ct~r~ with 3 ,ets of plans, accur0te 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 chmmenced 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 thc 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 ~.egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. Fhe applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to ~dmit authorized inspectors on premises and in building for necessary~~ ~ ~ ~) (~'nature of applicant, or nam~df a O~p'6ration) z .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of o',vnei* bf pre~niseS .............. -....N~...... ~ .~..~lP~..fi~,/~.. .~../' .~. q.~.t~-.~ ........... (as on the t,ax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No../.,~..q~..~./. '~. / .......... Plumber's License No ......................... Electrician s L cense No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done. ~"~-~...~,,z~,..Z:.;,'~,..~.. g~,~o~,~:k,.. ~-'~. ~ llouse Number Street Hamlet County Tax Map No. 1000 Section .. ~ .......... Block .. ~ ............. Lot. ~q ./. ............ 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...)~..?7..~.Y' .,-~.4~/'~LZ~... (~../. ~.~,~. ) ......................... b. Intended use and occupancy . 3. Nature of work (check which applicable): New Building .......... Addition .... Alteration Repair .............. Rem0val.~:. ,..~ ....... Demolit, ion .............. Other Work ~ ........... ~../,~/.,..~...d~.. '.~..-~:~c:t/,/'770(/ ~ ,~-~, .~?~.~2~7~(DA/ (Description) 4. Estimated Cos ....... Fee ................ (to be paid on filing this application) 5. If dwelling, number of dwelling ~nits ............... Number of dwelling units on each floor ....... If garage number of cars I ......... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............ 7. D~mensionsofexistingstmcturei, ifany:Front .... 'd)'~?.~ ~I>.r. ." ......... ...... Rear ......... Depth./'~;: ......... Height .. t~..~. ........ NUmber of Stories .../. ............. Dimensions of same structure wikh alterations or additions' F'r'ont' "~.~: ........................... · · .............. Rear ~/. ............ ........ I' '< ............... · ii" ' u fs ones ..... ., 8. sion ti e new con t .. Depth ,-~'.. ¥.~.--. ..... Height ./.~. ~. Numc .... ............. 9er o~ atones.../... 9. Size of lot Front ~.~.. / i ~,~ ' ................ ................... Depth ./~...~'. ................ 10. Date of Purchase .,~.<g~.~. ~. ~ ~ ./~[i~a~. .......... Name of Former Owner /~..~-~/_ z~/.<2./tt/~r~) .... . .... 11. Zone or use d:stmct ~n which premises are situated.. 12. Does proposed construct/on vioI~te any zoning law ordinance or regulation' 13. Will lot be re~raded .././ff..~... , .............. -' -~ ~ - · ~f/t~ '/1~Ix-J);;/~.:~"..a' .... wm excess nu o~removea ~rom premises: t,.Yes) No 14. mame el uwner et prem:ses . .~./X./.r/.~A/,/~/~... Address~l~. ~ ~t/~..... Phone No.,_m~.~~. Name of Architect ........... i ............. .. Address ................... Phone No ................ Name of Contractor ~,~_2~t~:r~'O' ~/.'' '.'.'.' .Addres.s~A~ ,~¥,~' i~>A6~f/-~.' Phone~qo.-'~..~. 15. Is this property within 300 feet of a nzoa± wetlana't *Yes ........ ~ ~,' · If yes, Southold T~wn 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 coruer lot. APPR~V~D AS NOTED 7~5. I802. ~ AIV) TO 4 PM FOR THE SP CT ONS: I. FOUNDATION . IWORECIUIRED FOR POURED CONCRETE 2, ROUGH. FRAMING & PLUMBING 3. INSULATION 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C.G. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS ~TATE OF NEW YORK, S.S eve named. being duly sworn, deposes and says that he is the applicant is the ........................ (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly ahthorized to perform or have performed the said work and to make and file this :~plication; 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 selt forth in the application filed therewith. worn to before me this I ......... ~. 7'~. ,.~..day of. ~~....1 o~ ..... // ' '.: Term ~ ~l~l, IS ~ ~ ~ ~,uLurl oI applicant)