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Home My WebLink About19770-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20750 Date MAY 21, 1992 THIS CERTIFIES that the buildin~ ADDITION Location of Property 30170 CABOTS WOOD RD. (PVT RD. #28) PECONIC,~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 73 Block 4 Lot 2.2 subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 11, 1991 pursuant to which Building Permit No. i9770-Z dated APRIL 11~ 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 INSTALLATION OF NEW HEATING SYSTEM AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED RICHARD & SOPHIA GREENFIELD PENDING - MAY 5~ 1992 N/A Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne- 19770 Z Permission is hereby granted to: ~-~ -- .....'~ ~..~..~...~. ...................................... ~~ ...... ~...~:. ......... LI...~..~h ......... . ~. ................................. ~. ....... ~ ........... ~.....~...: ............... ~< ................. ~ .................................... at premises located, at ...~......)...~1....~ ...... ~. ...... .~...~ ............ . .~.~.~;...~.~r. ............................... County Tax Map No. I000 Section ........ .~....~ ....... Block ...... ..~...~.. ........ Lot No. ~-' ~ pursuant to application dated ....... lj ........................ , 19..~..[.., and approved by the Building Inspector. Building Inspector Re~ 6/30/80 Form No. 6 .., BUILDING DEPARTMENT : TOWN HALL IL~~ 765-1802 . '£0w~ OFSOOTMOLD 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. 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. 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, Co~ercial $15.00 Datel }2 .' ."ii'! New Construction ........... 01d Or Pre-ex~st~ng Buz . . Location of Prep rty tIouse No. Street Hamlet 0nwer or Owners of Property. ~+~ ~ County Tax Map No 1000, Section...~.~. ....... Block...~ ........... Lot. Subdivision ................................. ~..Filed Map ............ Lot ...................... Permit No..~..~. ~.~. i..Date Of Permit.. ~(/~.! ...... Applicant.~..~ .~...~.~..~. ~..~ . .~4.'~ . . Iealth Dept. Approval ............... ~ -~O......-~.. · . .Underwriters Approval...~..~.~.~.~./.~.. ~lanning Board Approval ........................ lequest for: Temporary Certificate ..... ~i 'ee Submitted: $ ....................... THE NEW YORK BOARD OF FIRE UNDERWRITERS 1.0~(~31~ BUREAU OF ELECTRICITY ~- 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date THIS CERTIFIES THAT only the electrical equipment ~ ~scr~bed be~w e~ int~duced by t~ applicant ~med on the a~ve application nomber in the premises of in the following location; ~ Basement ~ Ist ~. ~ 2nd FI. 0 ~? Section Bilk Lot u~sexaminedon ~[~Y 0~9~ andfoundtobeincompliancewiththereqairementsqfthisBoard. FIXTURE3 § FIXTURES RANGES OVENS DISH WASHERS FANS OUTLETS SWITCHES INCANDESCENT FtUORESCENT OTHER 35 ~0 7~ DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI.OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I C E 4,/0 OF HI-LEG NO. OF NEUTRALS OF NEUTRAL 1 ~/0 C~CHO~, NY, 1193~ OENI~RAL MANAGER 11 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. FOUNDATION ( ls t ) FOUNDATION (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: .LIINH~ld DNla'llfi~] HO:/NOI.LVDIqddV ................ H}lOd DIId3S ...................... ..................... ............ t{~q¥~H ~0 O~VOa 'IqVH NMOJ. -LN31NJ. HVd3CI DNIO'IIflD O,'lOHJ. flOS gO NMO.L 'ON INHO4 · Nature of work (check which applicable): New Building . .' ....... Addition .......... /alteration ..... Rc r ............. Re vel ..... , ........ Demoliti6n .............. Other Work .......... Estimated Cost ' t . If g welling, number of d~ ailing unit~ .... ember of dwellin¢ units on each floor .......... stage, number of ~ara: .............................................. uminesa, commeroal o mixed occupancy, specil~ n~tt~re'ahd extent of eec Dimemions o exiatingmtmctures, ifany: Front...~ ...... Rear ............ De ight ' ' ~ ' ' pth H~ ............... Number of Stories ........... '' ' · .......... Dimensions of same stm~ur~ with alterations or addi ' : . ~?th L .............. I ....... tlei.h~ twn$ Front ...: ........... L' R~ar .......... D:men~tona of entir~ new eonstn~tln~ ' '; ....... ~:~'~ ....... Number of Stones .......... '" ' DateofPurchase ..... ~'.~&~. t~ear .... <Eff...~<~ ....... Doeth .~ff~/ ....... Zone or use dmtnct ~. w~.~. -- ~ . ' ...... Name of Fo~er Owner .......... Ptemmes are situated ..... ~.6 - ~g; ~ ....... ' ' ' ~ ............... Does proposed construction viol-. ........ .. Wm ~+ ~' .... a_~ I -L~y ~unlng law, oralnanc~ or regulation: ... ~0. ......... .Is ghis property located of a tidal web,and? ail yes, Southo~d ~o~n vithin300 fe~t .................... PhonoNo ............ · rusgees Permi~ may be ~equlred. ** i - PLOT DIAG~M Locate cle~l~ ~d dht~cfiy ~1 bu~d~-s .......... · · ' , ~, wnemer exzsung or proposed, ~d. indicato ~1 set-back d~ensions i ~y Enes. G:w Street ~d block number or description accordi ~ dot or cO~ar lot. no to deed, ~d show street n~e~ and ~dicate whe '/0o6 -. FEOFNEX~t'y..ORK.t ... ' i named. - ........... ~",,~ ~ontract) · · being duly sworn, deposes and says that ...... lie is the appllcm (Contracter agent , , corporate officer, etc.) ................. a owTeF or ow;e .' d is ,,iy a.tl,o :e :etlon. that aq -. ........... ~_, .~ . _.u to p~rlorm or hav~ Perfo~ed the said Work and to m~e and file .... · ~,,,~,,~ ~un~am~ m this application are true to tile best of hie knowledge and belief; and that th will b= Perfo~ed in the m~n~r set forth in tho application filed therewith. i to bcfor~ me thi~ ' '' I .... LL q LoC <3 'l