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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20704 Date MAY 7, 1992
THIS CERTIFIES that the building ACCESSORY
hocation of Property 825 OAK DRIVE SOUTHOLD N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 80 Block 1 Lot 35
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 18, 1990 pursuant to which
Building Permit No. 19597-2 dated DECEMBER 20, 1990
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 ACCESSORY GARAGE AS APPLIED FOR.
The certificate is issued to THOMAS & ANN BRADY
(owners)
of the aforesaid building.
SUFFOLX COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Building Inspector
Rev. 1/81
rox>.t xa s
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)
........r?.Sf?:
~.~.^.-.'4t~.~.....s~. 19..`3.
U
' N° 1 9597 Z Date I _
Permission is hereby granted to:
......Jr..~,:K~s~1..r.....:.Y...:.~.. !C. ~.Z.9.......
o ..~~w~di:kkS~.......~.....~f:S: EEEEEE~::.. .~C........4°.....~~.
..C~~:1....
~j
of premises located at ..A~.~.,~.
County Tax Map No. 1000 Section ~ Block ......~1..~....... Lot No.....~..~:.........
' pursuant to application doted ...1..,1..R.S.Rrr..~:a~:S.Ra.......~...8.........., 19.9 and approved by the
Building Insple~ctor.
Fee 5....~ ~?.l..l..l.,......
.
wilding Inspector
Rev. 6/30/80
~ ~ Form No. 6 - ~ ,~s_~_,~,
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TOWN OF SOUT[IOLD
BUILDING DEPARTMENT ~d~, ~gp~
i4 r . @"lPi~ l
TOWN HALL y w. „
765-1802 ~3~.
1'~"t~,rit. is
APPLICATION FOR CERTIFICATE OF OCCUPANCY ,.F.."
A. This application must be filled in by typewriter OP, 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 19 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.
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 y/.5,/7i
New Construction..... Old Or Pre-existing Building..../.
r
Location of Property...~~5. ~.~C....~A~IG:~E.........I~~~~JG~,S„ri~C1,.......~~CQ~IfC.~`~~...
House No. j Street Hamlet
Onwer or Owners of Property.....•JrfG~~S„5,,,~/1J/Z~,,,,~~~/,~,1~,,,,,,,,,,,,,,,,,,,,,,,,,,
County Tax Map No 1000, Section....~.~'L~•••..Block... ~'.(.........Lot...,,5 ~
Subdivision...~.1..t~13{ ...................Filed Map.,~.3(......Lot..'~7.}..~.2C~?~~....~~.~_
/ ~ /
Permit No...I~..~.7..~.Date Of Permit.. ~°".'~:j,.~~;,,,App7.icant.C{,il~tpvYl~G~.94..~;•Y~:.~.
f
klealth Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval
Request for; Temporary Certificate........... Final Certicate...........
Fee Submitted:
eon. ae~oy APPLI~ANT( i
INSPECTORS
Victor Lessard . ~J'rl'IJr?ff
Principal Building Inspector ~oLi' Z'®~,
Curtis Horton , ~ ~ SCOTT L. HARRIS, Supervisor
Senior Building Inspector +-a `
rsy ~ t'f:~'^'lr- Southold Town Hall
Thomas Fisher w ~ ~"<'~%'i,> ~ P,O. Box 1179, 53095 Main Road
Building Inspector S;~~u<*:%"'"
Southold New York 11971
Gary Fish ~`J~t31 4,rys Fax (516) 765-1823
Building Inspector Telephone (516) 765-1800
Vincent R. Wieczorek
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR
Telephone (516) 765-1802 TOWN OF SOUTHOLD ;
ii
NI~tY ~
APRIL 3, 1992 '1~`~y~ ~
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, ,
THOMAS BRADY
44 FRANKLIN AVENUE
SEA CLIFF, NY 11579
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 1(113~I~I~18~ 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 # 19597-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
INSPECTORS y
py~z
Victor Lessard ~~~FFO(,(-~
Principal Building Inspector w Q
Curtis Horton ' v;~ lO~ SCOTT L, HARRIS, Supervisor
,a
Senior Building Inspector ~ Southold Town Hall
Thomas Fisher w .,ti; "«,t ~ P.O. Box 1179, 53095 Main Road
Building Inspector ~a ~
Gar Fish '~f'v~ Southold, New York 11971
Building Inspector `~d P Fax (516) 765-1823
Vincent R. Wieczorek Telephone (516) 765-1800
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR
' Telephone (516) 765-1802 TOWN OF SOUTHOLD
APRIL 3, 1992
THOMAS BRADY
44 FRANKLIN AVENUE
SEA CLIFF, NY 11579
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 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 # 19597-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
"c'IELD I::SP.~.CiIU27 ~~Un^.E ~ COMMENT
4~ W
1~ ~ ar ~ ~ b ~
FOUtJtJATION ( 1st ) °
~S
FOUNDATIOtJ (2nd) _ - v
2. z
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V
P,OUGH FRAME & ~
PLUMBING
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3. m
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IIJSULATIOPI PER N. Y,
STATE ENERGY
CODE m
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FIiJAL
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ADDITIOP]AL COMMENTS: x
x
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765-1802
BUILDING DEPT.
INSPECTION
[ FOUNDATION 1ST [ ]ROUGH PLBG.
(]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS: ~1~ n7"~--
~J7,p , s
DATE ~ INSPECTOR
BOAFD OF HEALTH
3 SETS ~ PL,\NS
FORM N0. 7 SURVEY ,
TOWN OF SOUTNOLD CItCCR : ~~`1~3......... .
DUILDING DEPARTMENT SEPTIC FORT•1 .
TOWN HALL
• $OUTHCILD.. N_Y_ 11271 Nt7T i FY
TEL.:7~5-1II02 CALL
r~ ~
Examine . •rF'+'~p~. 197 MAIL TO - . • . •
~^•:^V-!~ ? ° 196. Pc ~ q S ~'7 ~.C~~-~L~~n?-P~ .
Approv rmit No.. 1.......~ ,_.:~~.~rr,•... ~ ~ J'.I~.. .
Disapproved a/c a{ ~ (~;'s i r. r
~~s °a { ~ ~ ' f Si
}t
~l.,~s ~P`-:-.... DECi ~ 8191
(Building Inspector)
~.E ~a.~.~
~ijc;~"ins=Nr: ~
APPLICATION FOR BUILDING PERMIT I'C+"°Ol~,,.-~t,,~H®LD
Date . ~02 1540
INSTRUCTIONS
a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Building Inspectnr, with
sets of plans, accurate plot plan to scale. Fee ~ccortting to schedule.
b. Piot plan showing location of tot and of buildings on premises, relationship to adjoining premises or public strce
or areas, and giving a detailed description of ]ayout of property must be drawn on the diagram which is part of this app
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 perm
shall be kept on the premises available for inspection throu;ttout the work.
+ e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupant
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 th
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances c
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describes
The applicant agrees to comply with alL applicable laws, ordinances, building code, housing code, and regulations, and t,
admit authorized inspectors on premises and in building far necessary inspe ns.
~(5ignature of applicant, o name, if a corporation)
N.. ~.r~.cn~k~,lt~ .~zve ~a.S oft k~ri ~'2.
. e~ C I tnl3il~ng address o~~pk~c-~a+n°t) ddd~~.~,,,~y'• • •
Stale whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
D.N~h~!~.....
Name of owner of premises ID Cl'1Cc,~... , t ~.'!~.l') . ~ r~7~
(as on the tax roll or latest deed)
if applicant is a corporation, signature of duly authorized officer.
(Name and title of corporaterryyolffic~e(r)
Builder's License No...... ~.~J. ~..C ! . l i .
Plumber's Liccnsc No. ....~NrOn:e
Electrician's License No...1~~Q:2 '
Otltcr Trade's Liccnsc No. . JIID.rf$ .
1. Location of land on which proposed work will be done;
.B.a.J~... QGi.~...~t.+.Y.~.. .......~.a.t1~P. tcl
!louse Number Street. Hamlet
County Tax \lap No. 1000 Section .....O.~f.~• • • • • Block .1..... Q~ , , , , , , , , , , Lot a~~.... '
Subdivision . ~P1~~.Cat(•I...~.~1prF.5 Fi{cd Atap No. , .0~.~~(~.:a~3~/`Lot .a.~~. v'ii~.t`c~~ .
(Name)
State existin^ use and occupancy of premises and intended use and occupadcy of proposed•constnrction:
0
A. Existing use and occupancy......n~~~.°,~••2
B. Intended use and occupancy.~.....~(1~~2
• ~i /
~ ~
r •V
3. Nature of work (check which applicable): New puihling Addition Alteration .
Repair R~mpval , , , , , Demolition ..............Swimming Pool . ,
Tennis Court , ~Acces
sory Building..........Fence .....Other Work:
4. Estimated Cost ~1Jr ppp.0,Q 1 Fee ..,~,d.~~..........................•
stn be paid on filing this aPPlication~
5. If dwcllin„ number oC dwclling~,units , , , , , , , , , , , , , , , Number of dwelling units on each floor .
If garate. numbcf of cars . .
6. If business, commercial or mtxe'd occupancy, specify nature and extent of each type of use .
7. Dimensions of existing structures, iC any: Pcont . , G1A,~,'?:.... , Rcar . Depth .
Hci~ht Number of Stories , , .
Dimensions of same structure wlith alterations or additions: Front Rear
Depth . E , ,Height Number oC Stories . ~ • ~ , , ,
8, Dimensions of entire newconsihtction: Front , .~,,H:r....... Rear Depth ....aZ:'(,~
Hci;Itt,,A, Nur3tberofStorics.c~,....... l:. a T...'........... .
9. Size ot`l~t:`~'roni ....9~• P.car . qJ7.. Depth .~.'l8 , ~ .
10, Date of Purchase 9f~~~~'S," Name of Po cr Owner ,~du.tard..-k. sir-z4t~...~Y.rt
11. Zone or use district in which pr,'cmiscs are situated et~GdA?! , ,s~ n.D,r,~.g, , r . : . . . . . . .
12. Does proposed constructionv~''Q'laic any zoning law, ordinance or regulation: O
13. 1Vill lot be regraded ~`t u , ,1Vill excess fill be removed f o~ premises: Iv D Yv. I
1~. Name of Owner ofprcmise~(?D'1'11FtS.r,,~,nn,~j[~2'.Address~?;S.QA1~ P~Y~qq~~I~I-'honcNo..'z~s.:J`~..`1~...
Name of Architect lt. ~ µ~ttlsPnd, t.~v.rf , Address~lU~Px,~P0~l~4,~~tYSt Ct~ti'hone No.. . .
Name of Contractor~:PY.~P h!^~}4n? , , , ; , , , , , , , Address~.U.~XRI. ~PVtrio :4 Phone No7~P,~.:~?`.3 R9.
15_Ls this property looted with in~300 £eet o£ a tidal wetland? =YES....NO.I:~4.
*If yes, Southold Town Trustees Permit may be required.
i PLOT DIAGRAM
Locate cleazly and distinctly all buildings, whether existing or proposed, and.indicate all set-back dime..^.siora is
property lines. Give street and block', number or description according to deed, and show street names and indicate n•i:c::.
interior or comer lot. I .
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STATL OP NE1V YORK, S.S
COUP TY OF
• r• ,~d'~`~""'/, ^ . being duly sworn, deposes and says that he is the applica:
. (N~ c of inttullr'vrdual signing contract) ,
above named.
Fie is the ......L~t~d~-..... _
(Contracto , agent ~ orporate officer, etc.)
of said otvncr or owners, and is duly authorized to perform or Jtavc performed tltc said work and to make and file tle
application; that all statements contained in this application arc true to the best of his knowledge and belief; and that t
work will be perforntcd in the manger set forth in the application filed therewith.
Swom to bciorc me this
.~f .......daypf ..~.../~~?'c-; 1994.
Notary Public, , x~.,',. 9! , , , County ~ ,
~l ~ t j v"•"~'ra o
• (Signature oCa !rear
NOTARY PUBIC S~~~of
Now York • • pp
No. 47078'18, Suttolk Cou i
' T4rm Expires Mxrch;i0,19~1