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Home My WebLink About19528-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin~ Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19798 Date MARCH 15, 1991 THIS CERTIFIES that the buildin~ ALTERATIONS Location of Property 3745 MILL LANE PECONIC House No. Street Hamlet County Tax Map No. 1000 Section 67 Block 02 Lot 10 Subdivision Filed Map No. Lot No. conforms substantially to th9 Application for Building Permit heretofore filed in this office dated NOVEMBER 19, 1990 pursuant to which Building Permit No. i9528Z dated NOVEMBER 21~ 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 ALTERATIONS TO EXISTING ONE FAMILY DWELLING. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N171694 JAN. PLUMBERS CERTIFICATION DATED Rev. 1/81 ROBERT & ABBIE BERNARD 30, 1991 N/A - ~j~ il~d~ing~inspector YOWl40~ $OUYHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEP~v~IT MUST BE KEPT ON THE PREMISES UNTIL. FULL COMPLETION OF TIlE WOP~K ^UTHOPJZ£D} Ne 19528 Z ...~, .~~.,..~...,./~.~,.~ ..... .. ~~......~.....~.~....~ ............................................................................... at premises ,~'ated at .....~....'.~..~..~....~.......~...~....~. ................................................................ ....................................... ~.~...~..~.../..... ............................ : ............................................... County Tox Mop No. 1000 Section .......... ~..~... .... Block ........... ~ ..... Lot No ....... ../....~.. .......... pursuant to application dated ...... ./'././.~/.....~... ................................. , )9.~..~...., and approved by the Building Inspector. ~ Fee $...~..~../~//~... ......................... ng magector Rev. 6130/80 Form No, 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submztte~-to the inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings~ 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 responoible for the build~ng ........ . 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. ]. 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 $15.00 Date ........ ~ I .~1 ......................... ~ew Construction ........... Old Or Pre-existing Building....~. ........... .ocation of Property, ,3,7,q~ ,--'-,, ~,//Z., ,~/~,~,~ ............ ',~/J~J~, ~,/~..z.~/.~ ..... House No, Street )nwer or Owners of Property... f~.~.~. ~...~.. ~.~..~.~.~.~.~. .... % ......... ~ounty Tax Map No 1000, Section .... ~../. ..... Block .... ~ ......... Lot...~.~/. ............... ~ubdivision .................................... F/led Map ............ Lot ....... ~~ iealth Dept. Approval ........................ Underwriters Approval .... . ......... ~lanning Board Approval ........................ .equest for: Temporary Certificate ..... Final Certicate. / OUNDATION (1st) OUNDATIO:! (2nd) OUGH FRAME .PLUMBi~ 1;SULATION PER N. STATE ENERGY CODE · FINAL ADDITIONAL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS I )0 , , ,~ BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT o~ly t~ electrical equipment ~ ~scribed belo~ a~ int~duced by the ap~icant ~med on the above application number in the premises of in the follo~lng h,catlon; ~ B~em~nt ~ Ist FI. ~ 2nd FI. Sectlon~'~ Bilk ~s examined on '] ~ ~ ~ ~ ~ ~ ~ ] q ~ '~ arid found to be in compllanee ~'it h the reqttirements of this Board. ECEP'ACLES SWITCHES ,NCANOESCENT FFLIu~TRE~E~ OTHER ~,RANG~ C A~.ING ~KS ~VE~.~ O',$~? WASKH~RS E~,~UST ~NS ~T. K.W, OIL H,P, GAS H.P ~T NO. A. WG. AMT ~P. ~t AMPS, TRANS.~ NO. OFFEET 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 ~OR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY ~NNER. 765.180:~ BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [~INSULATION i -F~'~RAMING [ ]FINAL REMARKS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL TEL.; 765-1802 Examined . / / ........ lgf~ Disapproved ale ........... (~id~n~pe&or) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH 3 SETS or PL^NS CI1ECK ........ SEPTIC ~OR~ .......... CALL ................. INSTRUCTIONS t I. °F°°°' .... llousc Number Street ' " .......... Hamlet ............. County Tax Map No. I000 Suction ............ ~ Block .... . .c~.... Lot...I.0. Subdivision.. C.~Q S.q-.. ~ p.r.f~,. ....... Eilcd Map No.... 3.1.~ .... ~ (Name) .. Lot. . ..... State e" mtended use and ocCupancy of proposed construction: x Shag use and occupancy of premises and ' · , A. Existing use and occupancy. .%.~ ~ ~ . . ~.~ .... . .. ~ ~ ............... ....... (Name and title of corporate officer) guildcrk License No Humber's License No ...... ~/~ .............. Electrician's Lic0nse No .Q/~+. Otb Tr de% Li CF a COn 0 ..... Location of land on which proposed work will be done: a. Tiffs application must be completely filled in by typewriter or in ink find submitted to the Building llmpeCtor, with sets of plan, a,emarate plot plan to scale. Fee ~C~ording to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stree or areas, and -' ' o o~Vmo a detailed description of layout of property must be drawn on the diagram which is part of tkis app5 cation. ' ¢. The work covered by tkis 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. s,hall be kept on the premises available for inspection throughout the work. Such perm i e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupa~c 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 Regulations, for the construct/on of bufldi~gs,-addit, ions or alterations, or for i'cmoval or demolition, as h ' . o The applicant agrees to omply w~th all apphcable laws, ordinances, building code, housing code, and regulations, and tr c ' ' " erem described · admit authorized inspectms on premises and in bmldmg for necessa.~pections. - . (Signature oe ~icant/o; ~. if~Xc'o~l~ri~i~n')''- J.r.T el.. .Q.,,2.1 J (Mailing address of applic~nt) State wh~ther applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buil'der. (as on the tax roll or lal~est deed) ' If applicant is a corporation, signature of duly authorized officer· 3. Nature of work (check which pplicable): New Building .......... Addition .......... ,/Ute'ration ...... Repair' . ....... i .. ....Removal ............ ;. Demolition ............ Swimming pool. .......... (ta ha paid on filing ~his avplicat]on~ 5. Itdwelling, number of dwelling units ... 1 ........... Nnmber of dwelling units on each floor...1 ......... Ifgaraee number of cars ' 6. If business, commercial or mixOd occupancy, specify nature and extent of each type of uso · · 7. Dimensions of existing stmctuies, if any: Front..~.O ....... Rear .... .~.~ ..... Depth. ~]22~' Height ... t~ ......... Number of Stories... ~.q~ Dimensions of same structure With alterations or additions: Front . ~.~ ..... Rear . .~.~.. 8. Dimensions of entire new conagmction: Front . .~.~.. Rear .... ~,. Depth . .~,~ Height ~ ~ Nomber of Stories ~ ' ' I0. Date of Purchase .. 1~ ~..::. ...... ~j .......... Name of Foyer Owner . .S~ ~ ............. 11 Zone or use district in which ' ' ' · p[em~sesaremtuated ................................................ . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: ...O.~. ........................ 13. W~l lot be regraded ....... 2~.' .............. Will excess fill be removed from pr~: . N~e of Architect ..... ~[~ ................. Address .... ~! J~. ,Q~. Phone No ....... ~ ...... N~e of Contractor ... ~, ........ j ........ Address ................... Phone No ....; ........ l~.~a ~ia property lock.ted within'~o0 feet of a tidal wetland? *YES .... HO .... tlf yes, Southold To~n Truatees Permit may be required. PLOT DIAG~M Locate cle~ly ~d dist~ctly ~1 buHd~gs, whether existing or proposed, ~d. indicate MI set-back d~en=ien; :: propemy Hnes. Give street ~d b[oc~ number or description accord~g to deed, ~d show stree{ nines and ~dicate wac::. interior or comer lot. ~ NOTIFY BUILDING OEPART~T AT , t, FOUNDATION '~0 REQUIRED WITHOUT CERTIFICATE , , 2. ROUGH - FRAMING & PLUMBING OF OCCUPANGY 4. ~INAL CONSTRUCTION BE COMPLETE FOR C.C. ~ ~ ~ N ~ ' ' ' ALL CONSTRUCTION SHA~ ME~ COUNTY OF. J~ fi.~, S.S THE REQUIR~EN~ OF THE N.Y. · STATE CONSTRU~ION & ENERGY (Name of individual sieniug contract) NSTR above na~ed. ' i (Contrac~r, agent,~offporate officer, etc.) of said owner or owners, ~d is du y authorized to pe,rform or have perfo~ed the said work and to application: that all statements coptained in this application are true to the best of his knowledge and belief; and that WOrk will be perforated in the m~er set forth in the application filed therewith. Sworn to before me this t ..................... . ~ (Signature of applic~