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Home My WebLink About19580-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19693 Date JANUARY 29~ 1991 THIS CERTIFIES that the buildin~ Location of Property 4690 BERGEN AVE. House No. County Tax Map No. 1000 Section li3 Subdivision ALTERATION MATTITUCK~ N.Y. Street Hamlet Block 7 Lot 2.5 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 11, 1990 ~ursuant to which Building Permit No. 19580-Z dated DECEMBER 13, 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 GIRDER TO ASSIST IN WEIGHT SUPPORT ON EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to WILLIAM A. LINDSAY, JR. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A / Building Inspector Rev. 1/81 l~l~ l~O. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERNtIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N-o 19580 Z Permission is hereby granted to: . ~"). . ~....~..~... .................. ...~.~.J~.....~.:~.,....)./.~...e...~.;.. . ~ ~.....~....~.~~~~-;...--~- ~,,~ ~. ~..~.. ~. ~~....~...: ................... · '~_'-~'""'~ .................. ~..~.~ at prem,ses Iocatea' '*at----.~..~...(~...~.......~..~.~.......-~l.J...~?.~......~m.......u:.~.....'. ....... ............... County Tax Map No. 1000 Section ......... J./...-,,%. ...... Block ...... ,.~..,~,., ........ Lot No ..... ,.~..:...~.. ........ pursuant to application dated ..~..~,,~d~.....!.1. ............... , 19..~...~.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 · PLICATION FOR CERTIFICATE OF OCCUPANCY Thi~:a~i~'tion 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 ail 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 - $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 .... ~'~....~.~J...~/ ................ New Construction ........... Old Or Pre-existing~Building...~ ............. Location of Property ........................ ~ ..... ~ ............ t ~.-'. .... House No. ~reet Hamlet Onwer or Owners of Property ....... .~.J~(.I.~D~- . .~.~ ................ County Tax Map No 1000, Section...! ...... Block ..... ? .......... Lot ...................... Subdivision ........................... Filed Map ........... Lot ............. Permit No ................ Date Of Permit .......... .... .. Applicant .......................... ... Health Dept. Approval ............... .. ....... .. Underwriters Approval ................. ... ..... Planning Board Approval ...................... Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: TOW~ OF $OUTIIOLD OlVlqCl£ OF BUILDING INSPECTOR ILO. BOX 1179 TOWN IIALL SOUTIIOLD, N.Y. 11971 January 2, 1990 TEL. 765-IS02 ~ILLIAH & FRANCES LINDSA¥, JR. COX NECK ROAD HATTITUCK~ N.Y. il952 To whom This May Concern, We are unable r.o complete your Certificate of Occupancy because .of the following reasons. /~/ An application for Certificate of Occupancy is not on file. (ENCLOSED) /--//>~o Underwritcrs Certificate on file. /~/ The check i:; (cK~G~Xnot on file. ) $25.00 /~/ No Health Dept. Approval on file. /-~/ No final insi-,ection has been made. Please contact ()ur offic~ on this Thank you for you~' cooperation. lh~il(ling Permit ~ I 9 5 8 0 Z Building Dept. matter. Plumber :solder Certificate on file. all permits involv~.ng plumbing being issued after April 1,1984 FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & -?LUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: Io 7G5-'~802 BUILDING DEPT, INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUNDATION ZND [ ] INSULATION [ ] FRAMING REMARKS: ~ 2. ROUGF . FRAMING 3. INSU[ATION ~-~ F NAt. CONsTRLICT~ON 8~COMPLETE FO~ t' 0 -.~'~CO'NST~UoT~ON' SHA ,.L ,~;H~ R~,OU REMENTS OF THE N STATE CONSTRUCTION CODES, NOT, RESPONSIBLE DESIGN OR CONS"FRdCTiON ERRORs OF O¢¢uP4~Oy ' ~ F~: ~. -- _~Y:_~._~: NOTIFY BUILDING OEPARTMENT AT 765 1802 9 AM 1'O *~ PM F'OFi I'HE FOLLOWING INSPECTIONS. FOR POUaED CONCRETE 2 ROUGH . FRAMING & THE NEW YORK BOARD OF FIRE UNDERWRITERS~ ,qf)~'t ~qOg BUREAU OF ELECTRICITY JOHN STREET, NEW YORK, NEW YORK 10038 THiS CE~IFIES T~AT only the electrical equipment ~ ~scrlbed below and introduced by the appllcan t ~med on the above applicat~n number in the premises of DRYERS this certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credenfiaJs. COPY FOR BUILDING DEPARTMENT. TNIS CO~ OF CERTIFICATE MUST NOT BE ALTERED IN ANY ~NNER~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180;~ Examined i .-~~../3. 19~.O. Approved .~..~c...~. ~./. ~., 19 ? 9. Permit No. l .9..,_%--..~.~...qr. Disapproved a/c ..................................... ................................ (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CIIECK .................... SEPTIC FORH .............. NOTIFY; CALL ................... ..... 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 shall 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 co~9, and regulations, and to admit authorized inspectors on premises and in building for necessary inspectig'ns. /, ~/ ,,/ (,:~nature 9f applicant;, or name, ffJarcorporation), / (Mailing addresf of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ............ .~..~.....~--~. .................................................... (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 ...... .~,/.~-x ............ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ..... ~.~...~.~. ..... ~..'tCt..~ .............. House Number Street Hamlet County Tax Map No. 1000 Section .... /./..~. .......... Block . ..~.. .............. Lot.. ,~t..5 ........... 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 ......... .~.... '.~..,¢'-~../... ~~ .................................. b. Intended use and occupancy ............ .~. ~..} ........................................... 10. 11. 12. 13. 14. 15. property lines. Give street and block humber or interior or corner lot. Nature of w,ork. Jrflf~ck which aqplicable): New Building .......... Addition .......... Alteration ... '. ..... '. Repair ... ~' .... .~ ~. ·. Remo'~l r ..... Demolition .......... Other Work ............... -'// (Description) Estimated Cost ............... q .... ~].Q ~,.~ .. Fee ~) ........ (to b~ paid on filing this application) If dwelling, number of dwellingluniB ............... Number of dwelling units on each floor ................ If garage number of c~s ! If bus~ness, commercial or mixeg occupancy, specify nature and extent of each type of use .................... D~mens~ons oI ex~stmg structures, ffany: Front ............... Rear .............. Depth ............... Height ............... Nu~ bet of Stories ........................................................ ' ' fs '~th It ti dditi R D~enslons o amc structure w a era ons or a OhS: Front ................. ear .................. Depth ' HeiSt Number of Stories Dimensions of entire new const~ction:~ Front ............... Rear....... .... ... . Depth ... ........... . Height .. Number of Stohes of o ohtl. .... i ........... .................... ..................... Date of Purchase ' Name of Fomer Owner Zone or use district in which pr{mists are situated ........................... Does proposed construction violate any zoning law, ordinance or regulation: ............................ Will lot be regraded ~ ......... ~ ................... Will excess fill be removed from premises: Yes No Nme of Owner of premises ...~ ................. Address ................... Phone No ................ Name of Architect.................I ........... Address .............. ..... PhoneNo ................ N~e of Contractor ~ Address Phone No Is thSa property wSthSn $00 feet of a tSdal wetIand? ~Yas..~ ..... No ......... ~If yes, Southold Town Trustees Permit may be requSred. PLOT DIAG~ Locate clearly ~d distinctly ~l[build~gs, whether existing or proposed, ~d. indicate ~1 set-back d~ensions from desc~ption accord~g to deed, and show street nines and ~dicate whether APPROVED RS NOTED NffrlFY BUILDING DEPARTMENT AT ~/65.1802 9 AM TO ¢ PM FOR THE FOLLOWING INSPECT'ION~. 1. FOUNDATION TW[~ REQUIRED FOR POURED CONCRETE 2. ROUGH * FRAMING ~ PLUMBING 3. INSULATION ' 4~ FINAL CONSTRUCTION MUST ~E COMPLETE FOR ALL CONGTRUCTION S~ALL MEET THE REQUIREMENTS OF THE N.Y, STATE CONSTRUCTION ~& ENERGY CODES, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS OCCUPANCY STATE OF NEW YORK, COUNTY OF ................. ~.S .............................. ! ................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ....................... i ............ ,,' (Contractor , agent , corporate officer , etc . ) of said owner or owners, and is dulyi authorized to perform or have performed the said 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 manner jet forth in the application filed therewith. Sworn to before me this Notary Public ...... £ ..... County HELEN f(. O£ NOTARY PUBLIC, State of NOw 1~SrkNo. 4707878, S~ffo k County~ / ~// (6gignature of applicant) Ten'n Expires ~arch 30,