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Home My WebLink About19220-z R FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20285 Date OCTOBER 16, 1991 THIS CERTIFIES that the building ADDITION Location of Property 580 GIN LANE SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section $8 Block 3 Lot 8.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 17, 1990 pursuant to which Building Permit No. 19220-Z dated JULY 23, 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 DORMER ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to ARTHUR 0. & ROSE M. WELLS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL. N/A UNDERWRITERS CERTIFICATE NO. H-024883 - OCTOBER 8, 1991 PLUMBERS CERTIFICATION DATED N/A uil ng Inspector Rev. 1/81 7lO8ffi N®. m TOWN OF SOUTHOLD BUILDING DEPdlRTMENT TOWN HALL SOUTHOLD, N. 1'. BUILDINGa PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Np ~ ~''~'Ei~'1 Z Date ...~~~~f..~ 19.~~ i Permission is hereby granted/t~o~ j 4:~~1~f~.,......Q.~....GlF..~.~.ra,... 23f ` i to . . . a ~ ~j 1~ ..G~........... ~ ..~...~.....Gj~~'r-/yz ri. at premises located at ...~!..~i~ ~l~fi,ti. j : County Tax Map No. 1000 Section ~..7....~Il.......... Block Lot No........lJr..,L........ pursuant to application dated ........1~.~ 19~C.~, and approved by the Building Inspector. i f3 Fee ~?.:'!l~ ' uildi for Rev. 6/30/80 i . ~~s d3e3S Form No. 6 TOWN OF SOUT[IOLD BUILDING DEPARTMENT ocr - 41991 TOWN HALL 765-1802 Fil.pG. U~PT. YD~JN uTM~td APPLICATION POR CERTIFICATE OF OCCUPANCY .1. This application musC be filled in by typewriter OF, 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 17 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. :S, 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 Cherefor in writing to the applicant. L. 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 ®~:~s..`'P{..~.y.q.~ ::ew Construction........... Old Or Pre-existing Building.. ? location of Property...../N. : 7. House No. ~J f~ Street /f.~",/,, 5~~ Hamlet Unwer or Owners of Property.../.7•~?fj'tl,R,,,~;,-,;~!-,~.IQSF•...•'••...,!V,~.I2 County Tax Map No 1000, Section...~~.:~.......Block....~...........Lot.. Sr. .I :subdivision ....................................Filed Mnp............Lot...................... i'crmL[ No..~~ ~i A ....Date Of Permie..~~.-:Z 3 :.9~...Applicant.~~t ~.h.~~ x.4.5 iiealtli DepC. Approval ..........................Underwriters Approval......................... :l:~nning Board Approval ::equcst for: Temporary Certificate........... Final Certicate........... S~~e Submiteed: $..~~.-':f7G 7~".,~~~~5 APPLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS x1~~so.+ , BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 _ Date `1l"~f'~i's l?;i (1Ft,}9"•,I Applioatian No. on file ~Ct (891~G/~17 t? 4, jd;; kt't = THIS CERTIFIES THAT - only the electrical equipment as described below and introduced 6y the applicwnt homed on the above application number in the premises of NTi i'S~Iiiri (ib(1`I,il`:lr r1 il4i G'f. iV illlCd lS; :ii.5i!'I'ii(l"lrS.i ,~~,,{y-~I~k_Y. in the ollowin iocati n• ? 8a» ment ,p 1»t FY. u 2nd F't. k j } ~ Sertion Rlock Lot = J R ;a lei", P;7'}tieJYi F;1+. 'S (7, r.`i'a, ` was exornined on and found to 6e'in carrtyliance with th¢reyuirontenR»of this lloord. I FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANbESCENT FIUORESCENT OTHEP AMT K W. AMT N.W AMT NW AML K.W AMT. H.P iD I ~ fii DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS PMT K. W Oll H. P GAS H. P PMi NO. A W. G AML. AMP. AMT.' AMPS. TRANS. AMi H P SYSTEMS qM1 WAi15 NO.OF FEET - SERVICE DISCONNECT 110.0E 5 E -R V I C E METER NO. OF CC COND A W G. A W. G. A W G. AMi. AMP. TYPE EpUlp 1 ]W 1 $ 3W 3,9 dW 3,e' 4W PER A QF CC CONE NO. OF HIiEG ~ p-{EG NO OF NEUTRALS ~ NEUTRAL ` OTHER APPARATUS: PFLtdRLfSrJdlRp;>zl~°I (`Cii, 1.(lf7 i Y r E Alf;}I[ir: OVI{;1,115 E , ~ • FLO p128 bi)AS 4i rs4X~ 17(Jr1 $[)i1TNCii,17, I`,Er, 3 t, ~S'1"i ~ GENERAL MANAGER i 1 Per This ceriifiicate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. E COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. , INSPECTORS Principal Building Inspector O~OSOffO(,~-COG Curtie Horton y~ SCOTT L. HARRIS, Supervisor Senior Building Inspector y Z Southold Town Hall Thomas Fisher u- P.O. Box 1179, 53095 Main Road Building Inspector ~ • ~ ,y Ot- Southold, New York 11971 Bui'lding Inspectar X01 ~ ~a 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 October 10, 1991 Mr. & Mrs. Arthur Wells 580 Gin Lane Southold, N.Y. 11971 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) XX 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. (All permits involving plumbing being issued after April 1, 1984}, BUILDING PERMIT # 19220-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. INSPECTORS Victor Lessard gUFFO(,~ Principal Building Inspector ~~0 COG Curtis Horton y~ SCOTT L. HARRIS, Supervisor Senior Building Inspector H x Southold Town Hall Thomas Fisher u- P.O. Box 1179, 53095 Main Road Building Inspector ~ • ~ Southold, New York 11971 Building nspectar ~Ol ~ 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 October 10, 1991 Mr. & Mrs. Arthur Wells 580 Gin Lane Southold, N.Y. 11971 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} XX 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. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 19220-Z Please contact our office on this matter. Thank ycu for cooperation. SOUTHOLD TOWN BUILDING DEPT. r1cLD 1~~.`,•~~--U.~ ~~J,,.a I~ ~v:`1L9bNTS b n, • f I ~ lv`V,YV H~ FOUI7DATION (1st) ~ ~ ti FOUNDATIOid (2nd} m c 2. i o ~ ROUGH FRAME & O PLUMBING y H 3. x m m ~ y I77SULATIOPf PER N, Y, STATE EPIERGY CODE a -r m H _ r C FI;1AL • c ~ ~ ADDITTOPIAL COMMENTS: x . . ro . x ro H x O x m i. r y . x o i - - _ H ~ i (9zz'° 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ~ }ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU TION [ ]FRAMING [ FINAL REMARKS: DATE ~ ~ INSPECTOR l 765.1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN CATION [ ]FRAMING FINAL REMARKS: - C~~ ~ , i i DATE INSPECTOR f ~1i2~ 765-1802 V BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [~RAMING [ ]FINAL a REMARKS: /~~.,~-^-C.. _ i DATE U INSPECTOR ~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. FOUNDATION 2ND [ NSULATION [ ]FRAMING [ )FINAL REMARKS: C~~ DATE ~ INSPECTOR Y d~ ~ U~~'tlc~ ~i' ~ 9 ~ s'-b =u 765-1802 BUILDING DEPT. { INSPECTION [ ]FOUNDATION i5T [ ] ROUGH PLBG. 5' [ ] FOUNDATION 2ND [ ] INSUL„s4T10N [ ]FRAMING [ INAL REMARKS : ~ f w - ] 'a DATE ~ INSPECTOR . - r ~ .e... ..._.~.~a..v iSS...crx.rca~ul~al..eHLe.-``v1ffiSa.v3S. 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Tltis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with Q sets of plans, accurate plot plan tUscale. 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 Rcculations, 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 ai 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. ..~..W..~Y.~:l~ 'game of owner of premises ./.-E.~• ,T!`?`. v.l~...C?.. S . (as on the tax roll or latest deed) f applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) A~p„? ~cemrt.~ Builder's License No . . Plumber's License No . " Electrician's License No . . Otltcr Trade's License No . • Location o(land on which proposed work will be done; f[ouse Number Street. Hamlet ~ • ~ G i County Tax i\lap No. 1000 Section t~`!f...... • Block , , _ • , , , , • • , , , • Lot .......4.•-.f... ~ Subdivision . /..1i~`~. , ~ffU/=~/, . Filed D1ap No. Lot . (Nnme) Stztc existing use and occupancy of premises and intended use and occupancy of proposed construction: , A. Existing use and occupancy...... ~.f. ~.G:~ .....,~~p/I4~Pr.. . ~fk.¢ . B. Intended use and occupancy ........................5:`.`PS..... I p j^ ° v .t~ ~ .a.._. ~ Na~lture'of work (checl: which aPPlic~ble): New Uuilding • Addition . ~ . . Repair R~movalj Demolition 1} . ` ~+q " . , Tennis Court Accessory Building..........Fence ...t:. tJ i ' .Fee . ' Estimated Cost .~~h:('...T~~G[-~9-~--fit........... . „ g (to be paid on filing this application] If dtvcllin number of dwellin units ~ Number of dwelling units on each door • If'arage.numbcrofcars If ~usiness, commercial or mixed occupancy, specify nature and extent of each type of use Di~[tensions of existing structures, if'lany: Front .....a Rear . s3 • • • • Depth , , . . Hotght Number o f Stories /.,rice.-= -t.................... . . Dimensions of same s[ructure with alterations or additions: Front . °~z':........... Rear ~ . . Depth :?!f~~ Flcight ;2~ f:~ :.r Number of Stories ; ...t......... . , Ditncnsions of entire new constn[ctipn; Front . p?:b; , , Rear Depth 1.° . . . . . . . Height : NVmber'of Stories . , l .r . . Sic of lot: Front . ~ , . Rear ..1.~. d Depth .1.Y``.-4................ . Date of Purchase 9.~1 rS~.....~i ......Name of Former Owner . Zone ar use district in which prcmisgs arc situated . . Does proposed construction violate any zoning law, ordinance or regulation: . ,1.~1.U • . Wi~l lot be regraded ~ V . ..Will excess fill be removed from premises: No • • , N~r»e of Owner of premises ~~,T,ry; ; ~?,~~E°~-~.. Address S. ff~, ~:'!N..G:~ i%z. Phone Na?~s~ : ~3. S.. . . Name of Architect .............i,.... .........Address ...................Phone No................ . N~tne of Contractor ....:........Address . ..Phone No._ • . S.Is this property loe~ted within 300 feeC of a tidal wetland? •..NO...• , *I€ yes, Southold Town TXustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly.al! bu>ldings, whether existing or proposed, and, indicate all set-back dimensions from opert'y lines. Give street and block nutr'ber or description according to deed, and show street names and indicate whether teriozf or corner lot. I I i . t I • I' f ~'i it i i I I .i ~I rATe~or• tiEty Yoax, S.S', ~UN'~Y OF being duly sworn, deposes and says that he is the applicant ,.(Name of individual signing Contract) i love named. :istlic ........................i ~ (Contractor, agent, corporate officer, etc,) • ' said~owncr or owners, and is duly at~thorizcd to perform or have performed the said work and to make and file this +plica~ion; that all statements contained in this application arc true to the best of l+is knowledge and belief; and that th o nrl: tv 11 be perforated in lire manner seS forth in the application filed therewith. ~rom ~o bciorc me this ~ ~ ~ ~ .t.r]. .day of ...L.~..........., 19 ~G. ~ otary~Public, ......b`i~-~`:.. k,~.~f~,-.. County ~,p ~j~~j NEtENKBEYOE I (3ignature of applicanq ! NOt71RY PUBLIC, Sate of New Yerlt No.4707878,SuHelkCo Term ~xplres MAr~h 30,19(