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Home My WebLink About19581-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20691 Date APRIL 30, 1992 THIS CERTIFIES that the buildin~ RENOVATION Location of Property 20485 SOUND VIE~ A~EN~JE House No. Street County Tax Map No. 1000 Section 51 Block 4 Subdivision Filed Map No. SOUTHOLD ~ N. Y. Hamlet Lot i0 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 12~ i990 . pursuant to which Building Permit No. 19581-Z dated DECEMBER 13, 1990 wa~ issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is RENOVATION TO EXISTING ONE FAMILY DWELLING 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 THEODORE M. GOLD & CAROL A. WEICK N-232830 - APRIL 21~ 1992 DECEMBER 27~ 1990-HENRY J. SMITH & SON /~ Building Inspector Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREAAISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 19581 Z Permission is hereby granted tq: , ~.L..~...'~J~....~.., .......... ~;:~,~...,.....~.:~..: ...... ;.~..~.;~..~. ...... ~...:~.. Coun~ Tox Mop No. 7000 ~ctio. ..... ..~.~..L ...... mock ..... ..~...~. ........ Lot No...J..Q ............... ~-~~ .~ ~ 19,,~..~,, and approved by the pursuant to application dated ..... :..~r~r...~r.;,; .............................. Building Inspector. Fee $...~ .................. Rev. 6/30/80 Form No. 6 APR 2 9 1992 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY is 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 i% 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. 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 ..................... New Construction ........... Old Or Pre-existing Building .... Location of Property ............. ~.~ .~/~ ....................... House No. Street Hamlet g.. 44' Onwer or Owners of Property.. '~ ~"~-. ~- ¢ .-.~- ....... ,. J.O ........... County Tax Map No 1000, Section. ~.~/.~...Block....~.~.~.~.'.~. ..... Lot..~.~....O..~..~. ........ Subdivision .................................... Filed Map.~./.'%~J%<~.Lot...~ ....... .. ...... . Permit No.Z~'./.......~ .Date Of Permit. Z.~..~../.~.~..Applicant.~.~.~.~.~ ...... ,~/~ ........ Health Dept. Approval ........ Underwriters Approval Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ .... .~..~;~ ..................· ' / ·...... .... INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD MARCH 6, 1992 JOSEPB N. DIAZ 48 WILNARTHAVENUE GRgEI~ORT, NY 11944 RE: TI~ODORE lq. GOLD & AgIO To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. The check is ~~not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (Ail permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT ~ 1958]-Z Please contact our office on this matter. cooperation. cc: Thank you for SOUTHOLD TOWN BUILDING DEPT. T~EODOREM. GOLD &ANO HENRY,J. SMITH & SON, PLUMEING. HEATING & FUE1 OIL MAIN ROAD SOUTHOLD, N,Y, 11971 (516) 765--3690 InC. CERTIFICATION D a t.e _ _D_e_c_e m he_ r_ ~V. _l _q_90 _ Building Permit Owner__~R~pj~_~i~,: Plumber HenrZ J. Smith & Sonm Inc. I certify that the solder used in the water supply system contains less than 2/10 of 1% lead, Sworn to 19~__. before me this of Notary Public, Suffolk County gERNAOETTE L. I'APLIN NOTARY puBLiC ~844893 State ot New Ysrk ~m salon ExpKe$ Sept, 30, THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ 1 1-~0'I.~)~1~ BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT ia thefollowing h,catlon~ ~ Basement ~ Ist ~. ~ 2nd ~. Section BI~k Lot ~,as examined on ~P~ ~ L 1¢,~992 andfoundtobelncompliance~'iththerequirentents~fthisBoard* FIXTURE FIXTURES RANGES C~KINGDECKS OVENS DISH WASHERS EXHAUST FANS / OUTLETS JRI CEPTACLES SWITCHES FLUORESCENT DRYERS OTHER SYSTEMS NO, OF FEET E OTHER APPARATUS: E R V I C A.W G NO OF HI,LEG iD, OF NEUTRALS BOE 215 This certificate must not be altered in any manner; return to the office of the Board if incorrect, inspectors may be identified by fheir credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT ~ ALTERED IN ANY MANNER. FOUNDATION ( ls t) FOUNDATION 2. (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION :~ND [;/~' fRAMING [ h'I~6UG H PLBG. INSULATION fINAL DATE/~//~/?(~ INSPECTOR APPROVED AS ~01'£D NOT~FY BUILDING DEPA~TMEP~T 765-1802 9 AM TO ~ ~M F'O[~ THE FOLLOWING INSPECTIONS 1. FOUNDATION TWO FOR POURED CONCRETE 2, ROUGH - FRA~NG & PLU~BJ~G 3, INSULATION 4, FINAL CONSTRUCTION ~UST 8E COMPLETE FOR C.O ALL CONSTRUCTION SHALL ME~T THE REQUIREMENTS OF ~HE SlaTE CONSTrUCtION & '9~G~ O~ CO~ST~UC*~O~ ERRORS 765-~802 9 ~/I TO 4 P;,A FO~ FOLLOWI~6 FOR POURED CONCREI' 2. ROUGH FRAMING & 3. INSULATION 4. FINAL COf~%TRUcTION ~ ,' · BE COMPLETE FOr~ C 0 ALL CONSTRUSFION SHALL MEET .THE REQUIRE~4ENTS OF THE N ;STATE CONSTRUCTION & ENERGY CODES. NOT ;RESPONSIBLE FOR DESIGN OR CONS'rRUCr¢ON I?RROF~S ,4, users WI OUT OF OCt Approved .-"~...~....~... !.~., 197.~. Permit No./.(~.?.g./..~.. Disapp?oved a/¢ ..................................... .. FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL 8OUTHQLD.. Iq.y_ till7 t TEL.: 765-1802 (Building Inspector) APR LICATION FOR BUILDING PERM IT BOARD OF HEALTH ./... SU~vEx ~. ........ ~.. ~ ~ CllECK . SEPTIC '~0~ ............... i'; O.T I ~y ~ 2 ....... HAIL TO: INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink ~nd submitted to the Building Ikxpeetar, witt sets of plans, acx'urat~ plot plan to scale. Fee sorrowing to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or publ~c strew, or areas, and -' ' - ,,tvm= a detailed description of layout of property must be drawn on the diagram which is part of tiffs apl: cation.. ~ ¢. The work Covered by th/s 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 she, Il be kept on the premises available for inspection throu~_hout the work. the applicant. Such perrr ¢. No building shall be occupied or used in whole or ~n part for any purpose whatever until a Certificate of OCCUp~"It shall have been granted by the Building Inspector.· APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit purruant to ti Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for ~emovai or demolition, as herein describer The applicant agrees to comply with all applicable laws, ordinances, building code, ' · admit authorized inspectors on premises and in building for necessa housmg code, and regulations, and ' · . t...tmgnatttl,e o~ applicant, or na~co}~&ifio'n')' ' (Mailing address of af=plicant) ' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ............................ '" ';i " ' (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ........ ii, i;,; ;;?ii; ........ e o r e r) ..... ,' lu,nber,LicenseNo Electrician's License No.. .% ./.~... Other Trade's License No !. Location of land on which proposed work will be done; · ....... .... so ,,,u . ...................... · .. ... S'o ~,~ llous~: Number SIreet, Hamlet ......... Coonty Wa.~ ,X~ap No. 1000 S~ction . P...~.I.~'~ ..... : mock a..5(..a..~ SubdiviSion . '' ' ........ Lot.CP../{5~.* tgOC/ ,' ................. F. ilcd Map ......... :' ' State e" (Name) : No. :>' [T'a'Y'.'7'./.O.. Lot ........ · xs mgUSeandoccupancyofpremisesandintendedusemldoccu . ' ' - . ' ...... Panty of proposed construCnon: A. Exlstlng usc and occupancy ....... ',c/q ....... , · Intended use and occupancy.. ............................................. 3. Nature of work (check which applicable): New Building .......... Addition ....... /dictation ...M.~. Repmr' . .... ~ ....... R!em,oval .............. Demolition ........... Sw£nuning pool. " Tennis Court 'Accessory Building .......... Fence ....... Other Work; .......... 4. Estimated Cost .................................... Fee .................................. (ts ho paid on filing this application} 5. If dwelling, number of dwellingI units .... Z'. ......... Number of dwelling units on each floor ....... Ifgaraee number of cars ~ ..... 6. If business, commercial or mixeld occupancy, specify nature and extent of each type of use ................. 7 Dimensions of existingstructur~s if any: Front · ' ............... Rear ............. Depth ..... Heieht ....... i . i .... ......... Number of Stones .......... Depth .... .~ ~:~- ..... ~.. Height ....-.~.+~ .~t....--~.. ' Z z .... ~ · ........ Number of Stones . · ./.~l~t ........ 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ........... H N ' St eight ............... umber of odes ............. , . , 9. Sizeoflot: Fioot ..?~/ ! ...................................... Zoe ' ' ' ' .............. '.w.' ...... 11. n or use dmtnct m w uch pr tomes are situated ........................... 12. Does proposed construction violate any zealot, law ~.4: ...... ' ..... 1' Nome "'" = " · ' TM'' '~''' ..... ~-.'5 .... ~vm excess fill be removed from premta~: ,t/o. Name of Architect ......... i ................ ^'~d .... ~ '(Y' /- nh Name of Contractor .~ ! .4', ' ' e.. / [~.~.a th. rs Droperty located within 300 feet of'a tidal ~etl. and? mYES .... NO .... ~If ~es, $outhold Tow9 Trustees Permit may be required. PLOT DIAGRAM Locate clearly ~nd distinctly al! buildings, whether existing or proposed, and. indicate all set-back property lines. Give street and block[number or description according to deed, and show street names and indicate wa.z::. interior or comer lot. STATE OF NEW YORK, COUNT~OF .............. 3.._~,.!S'S '' 'v~n a rr~cd(.~)fi~ e o £5n' ~i. ' .............. being duly sworn, deposes and says that he is the applies:. dzvld }.g~con tract) abe bio is the ' (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file th application: that all statements contained in this application are true to the best of his knowledge and belief; and that Work will be performed in t ~e manner set forth in the application Qled therewith. Sxvorn to before me this ............. :.4. ....... day or!'.. ,9 Notary Public ........ ~ '' · .. County HELEN K. DE VOE ' NOTARY PUBLIC, State of New York ! tpxm Exp res ~8~ch 30,19 t',/ i· applic'~n'