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Home My WebLink About19811-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19948 Date JUNE 5, 1991 THIS CERTIFIES that the building ALTERATION Location of Propert~ 3760 MINNE~HAHABLVD. House No. Street County Tax Map No. 1000 Section 87 Block 3 Subdivision Filed Map No. SOUTHOLD, N.Y. Hamlet Lot 4 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 22~ 1991 pursuant to which Building Permit No. t9811-Z dated APRIL 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 BATHROOM ADDITION IN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to ~N & SANDRA McMAHON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PENDING - JUNE 3, 1991 PLUMBERS CERTIFICATION DATED MAY 4~ 1991 - MICHAEL DAWSON Rev. 1/81 //Bu~'lding Inspector TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No- 19811 Z Permission is hereby gronted to: .,~ ' .. ~.. /Ye- ....~~ ....... .Y. ........ / ............ .7. ...... ,o ..... at premises located at . .-~..~..~.~.......~.~.~.~j...o~ .:~ ~,~ L County Tox .... · ~..,~.~ ...... ,,~k .... .~..~ ........ Lot No....~.~ .............. No. 1000 Section ..... t,,~-.....~...-..~.. ................ , 19..~.J.., and approved by the pursuant to application dated V Building Inspector. Fee $. .L .... Rev. 6/30/80 Form No. 6 TOWN OF SOUTtIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANC 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 archiuect or engineer responsible for the building. 6. Submi~ Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Vpre-existing" land uses: i. 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. ~ 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 Da me....~..././~.~ZZ~./ ......................... low Construction ........... Old Or Pre-existin~ Building.'./... ............ House No. Street Hamlet Inwer or Owners of Property ....... '..~z.~ ..... .~.~?.... ~.~ ......................... ~ounty Tax Map No 1000, Section ........ ~lock. L~ ........ ~ .... ./. ..................... Filed Map ............ Lot ............... ermit No ........ Date Of Permit ...... pp t ....... ..... A lican ................ ealth Dept. Approval .......................... Underwriters A equest for: Temporary Certificate ........... Final Certicate...< ....... ee Submitted: $''' ~'~ ..~ ~ 0 ;~) (~i~1./~E APPLICANT TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 C E RTI F I CAT I O N~~ TEL. 765-1802 Date Y~ &/-- ~ / Building Permit No. /~//~ Owner John McMahofi (please print) Plumber fllc/~,q,~L~ ~/; ~o'~'~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber's signature) Sworn to before me this 4thday of May 19 )J Notary Public, .~'~fpd ~/~_County I' . N. ot~ary Public Notary Public, State of New York #4694688 Qualified in Suffolk County Commission expires 3/30/93 OFFICE OF BUILDING INSPECTOR ,qSq~^~, Daniel L. Fischer Y~ ,,~:-:'~i~: Box 79 ~' ~ ~ ~' ' Orient, N.Y. 11957 Re: McMahon To Whom This May Co,~cern, We are unable to complete your Certificate of Occupancy because.of the following reasons. / /~J An application for Certificate of Occupancy //s not on file. ('ENCLOSED) /_~//No Underwriters Certificate on file.' /~/ Thc check is(MR~g%d/not on file.) $25.00 /~/ No llealth Dept. Approval on file. /~/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Permit tt I 9 '8 I ] Z Bui] dj.no BuildJ. nq Dept. ***~/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN tlALL SOUTItOLD, N.Y. 11971 Daniel L. Fischer Box 79 Orient, N.Y. 11957 May I0, 1991 ELy765-1802 To Whom This May Co.ncern, We are unable to complete your Certificate of Occupancy because .of the following reasons. / /_~/ An application for Certificate of Occupancy ___/~Ns not on file. ('ENCLOSED) / o Underwriters Certificate on file. /_--~/ Thc check is(~l~Zdi~g~d/not on file.) $25.00 /_-/ No tlealth Dept. Approval on file. /_--/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit tt I 9 '8 I I Z Building Dept. ***/_/ No Plumber solder Certificate on file. ( all permits involving plumbing being .issued after April 1,1984 ) 765-."802 BUILDING DEPT. INSPECTION [ ] FOUNDATION '"ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [~I~NSuLATION [ ] FRAMING REMARKS: [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION FOUNDATION IST [ H PLBG. FOUNDATION 2ND [ ] INSULATION [~/]'~RAMING [ ] FINAL ~REMAR S:~ , DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: FOUNDATION (1st) FOUNDATION 2. ROUGH FRAME & .PLUMBING 3. INSULATION PER N. STATE ENERGY CODE (2nd) FINAL ADDITIONAL COMMENTS: FOR POURED ( 3!',!" ~:f-'T: 4. FINAL CONSTRucT¢¢)r~ t,~UST BE COMPLETE FOR C,O ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N Y, STATE CONSTRUCTION & ENERGY COOES. N~ RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS 5~ COt~PI F I ~ FOF; C.O ALL C(~i~iS'i'~h~CTION SHALL THE REQUIR[MENT$ OF THE N Y, STAYE CON~'F~UCTJON ~ ENERG¢ CODES. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-18013 ., 19 ., 19~. Permit No..~ .ti .~. [[..~.. Examined ~. ~.. Approved... ~ .... Disapproved a/d ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ..... SEPTIC FORH .............. CALL HAIL TO: Date ....... ; .......... , 19 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and Submitted to the Building Inspector, with 3 sets 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 or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. , 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 shrill 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 shall 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 Building 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. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............. ........................................................... Name of owner of premises ...v~. 7?'. ....... ...:: ........ '. :~ ..: ....................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No....//.ff. ff~..~./,/../ ............ Plumber's License No ......................... Electrician's License No.. ~?.?.'~, ~ ............ Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section ...... ~.~ ......... Block ..... ~ ........... Lot.. 7 ............... .~ ~, t~E~ ' ....... Filed Map No ............... Lot ............... Subdivision ...... ~"' ~ ' '(~'a~) ......... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . .~ ..... ~/ .. ~ ~ ~.? ..... , ................ b. Intended use and occupancy ....................... U,~.:¢F-,: .'.fi,g'd ~ ~.¢~h.,lgi~3 ................ 3. Nature of work (eheckwhich applicable): New Building .......... Addition .......... Alteration . Repair .............. Removal .......... Demolition ..... Other ' ~.. :'.. .... (Description) 4 Estimated Cost T...,~.~.'~ ....... ........................ Fee ...................................... (to be paid on filing this application) 5 If dwelli number of dwelling~Units .~.' Number of dwelling nits o each floor If garage, number of cars .... ~'.. ............. 6. If business, commercial or mixedl occupancy, specify nature and extent of each type of use ..................... 7 Dimensions of existing stmcture~ if any: Front ,4./~/~./l.~./E:,~,~.~ ~[~ear Depth · Dimensions of same structure with alterations or additions: Front ~ .~...~.,~t.//~(~,,~f~. Rear Depth ' Height Number of Stories 8. Dimensions of entire new constrUction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front ........... ~ .......... Rear ...................... Depth ...................... 10. Date of Purchase ........... ; ........ ......... Name of Former Owner ....................... 11. Zone or use district in which pre,HideS are situated../[/.:~/.~:4~.~'./?../'' . ' ..... 12. Does proposed construction~/)o.~te any zoning law, ordmanceorregulatmn: .~.'t~ ........................ 13. Will lot be regraded ..... ~['~.. I ....... ~,' ......... Will excess fill be removed from premises: Yes 14. Name of Owner of premises . ~fff~. f/'~/~'~//~...Address.~.~, ff.~[~.~.( t~.~4~,V Phone No Nme of Architect ........................... Address ................... Phone No ................ Name of Contractor .~7.J/y/f&..ZI .p.'/f.~..//~ ........ Address Z~/J~.ff..~.~ ?/?. ~ff¢ffff. F.. Phone No. ,Y~ .~7?.q.~ff. .... Is this property within 300~ feet of a tidal wetlandg. *Yes ...... ~.. . No ......... *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly ail ,buildings, whether existing or proposed, an& indicate all set-back dimensions from property lines. Give street and block fiumber or description according to deed, and show street names and indicate whethel' interior or coruer lot. 15. · .Z~.~./..~. / ~..~.~.l..~.. ~fj'.u~...f ................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. ,' He is the ...................... ; ...... ..~ ................. . ................................... i ~_~ontractor,~gent, corporate officer, etc.) . of said owner or owners, and is duly authorize-~IT6-~/~rform or have performed the smd work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manneriset forth in the application filed therewith. Sworn to before me this i NotaryPubhc . .. County ~ / ,~ ,--. ~-~*~ t~ignature of applicant)