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Home My WebLink About19017-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219288 Date AUGUST 13, 1990 THIS CERTIFIES that the building RENOVATION Location of Property 53795 MAIN ROAD SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 061 Block O1 Lot I6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 7 1990 pursuant to which Building Permit No. 190172 dated MAY 14, 1990 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is RENOVATE AND MODIFY THE FRONT ENTRANCE AND WINDOWS issued is OF COMMERCIAL BUILDING. The certificate is issued to LEWIS EDSON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N144288 AUGUST 6, 1990 PLUMBERS CERTIFICATION DATED N/A -2/~~ C+IJ~- Bu. ding Inspector Rev. 1/81 sosaa po. s TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDIN~a PERMIT (THIS PERMIT MUST BE KEPT ON 7HE PREMISES UNTIL PULL COMPLETION OF THE WORK AUTHORIZED) N~ i 9(~1 Z oats .......................Y~'1.~...1..~.........., )9..9. Permission is hereby granted 40: of Premises located at .:K...~+.~.95..........~C/..~-....~........... County Tax Map No. 1000 Section ......~.~0..~....... Block Lot No.....I..~ If pursuant to application doted .............••••r•r••~...•• 19.4•x•, and approved by the 4 Building Inspector. } Fee 5..~•~•••~~ i i ........1~v!..~ ~ Building Inspector i / I 1 ' Rev. 6130/80 Form No. 6 TOWN ('i SOUTHOLD BUILD:_:G DEPARTMENT '1 w'~s :iALL :55-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This 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 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer resgonr,ible for tike 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 il.V.l~(.. Z.3~. New Construction........... 01d Or Pre-existing Building.. ~ Location of Property..... Jr.~.~g~ ...............4:~ay!„ ~r~ ....~"~.~,'!)nc!`-0Y........ House No. Street Hamlet Onwer or Owners of Property..... e.~::'1.5....1 d~4!~ County Tax Map No 1000, Section.. ~L~......Block...... Q.~......Lot......~ ~ Subdivision ....................................Filed Map............Lot...................... Permit No. ~.~Q.~.~...4~..Date Of Permit..~9~/.. ~ y./.w:Applicant..~~'.F.,..t~k~t~:e: rl'MPYP~?r?~ Health Dept. Approval........:-:-,-a...........`...Underwriters Approval Planning Board Approval Request for: Temporary Certificate........... Final Certicate...V...... Fee Submitted: ``O a 6 8 ~te5 . ..~l1,``.~ . ~ r3/~6 ..APPLI• u„.~. ~ ;;ocrMCUrs r'1c:LD i;:S:'EC; iU,7 m ..o 1 ~ FOUtJDATION (1st) `~"a J~ G ro~ FOUNDATIOW (2nd) _ z 2. ~ ~ J P,OUGH FRAME & ~ v'S PLUMBING y H ~ a~.. 3. I17SULATIOPI PER N. Y. STATE ENERGY x CODE r ~ C . o . y 4 . a9~ FINAL S~ o ~ z ~ m ADDITIOPIAL COMMENTS: ~ . C, o. . x ro= H ti 9 • H .A O ~ Z x m ' a ' H~~. d [*1 H . i THE NEW YORK BOARD OF FIRE UNDERWRITERS ' '~~~1'(17) BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date ACtC;IDS'I' (j (i, `lNll APPlico[ion No. on file f9t2'Y$7 ~1~f`~CI ~f .I~~F,~~k'4 THIS CERTIFIES THAT only the electrical equipment as described below and introduced 6y the applicant named on the above application number in the premises of rL~,at k:r~sc,ra, ~~x~ itr,~, ,l~>rrl°11r~.atn, e~.v. in thefallowing locat,Sq~A~, LJ 8gg~rtFent ? 1st FI. ? 2nd FT. 3evtion Block Lot was examined un )VV ff SI) 11 1! and found to be en conLplianee with the reyuiremenfs q(t{tis Roord. FIXTURE FCEPTACLE$ SWITCHES fIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT, K W, AMT. K W AMT K W AMT % W pMi. H P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS SELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT W. OIL H P GAS N. P. AMT. NO. A, W. G AMi. AMP PMi AMPS TRANS. AMT H P SYSTEMS AMi WAi15 NO.OF FEET SERVICE DISCONNECT NO.OF S E R V 1 C E AMl AMP rypp METER 1,e'RW 1,6'3W J%3W J,e'4W NO. OF CC COND A W G. NO OF HbIEG A W NO OF NEUTRALS A, W.G EQUIP. PEP % Of CC.tOND i OF HbIEG OF NEUTRAL i Lht1 Cl'1 7 Y, I :?l0 ~ ern OTHER APPARATUS: l ~ \ c & S Ct7NTR,'iC;'yQ9+ - L]',I".#'i7zi-~; 1t~lX ? t $(917`t'Ii~[L71, i`dY, Y1,97"} GENERAL MANAGER t.i Per '"'r^ This certificate must not be altered in any manner; return }o the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. TWIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. 3 U~F01~'~~ TEL. 7G5-1802 4~ , ~OG~~ TOWN Or SOUTIIOLI~ (,£sh~i ~ OFFICE OP BUILDING INSPECTOR ~ ti4w• c°n ~ur,§ ~H, rn P.O. BOY 728 ~ T01VN HALL y/~l SOUTIIOLD, N.Y. 1 1971 JITLY 19, 1990 LEWIS EDSON P.O. BO% 1526 SOUTHOLD, N.Y. 11971 - To p7hom 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 Lile.ENCLOSED ~ / No Undcrwri.ters Certificate on file. ~ / Tlic check is (outdated/not on file. ) $50.00 No health Dept. Approval on file. No final i.ns.pection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit II 1 9 0 1 7 Z BUSINESS ALTERATION Building Dept. No Plumber Solder Certificate on file. ( all permits involving plumbing being .issued after April 1,198 ) cc. R S R HOME IMP P.O. BO% 676 GREENPORT, N.Y. 11944 D ~ ~ u BOARD OF HEALTH 3 SETS OF PLANS J~......... ~~p1~ FORM NO.1 SURVEY II TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM aLOG. oEaT. TOWN HALL . ~ s'/z/rn TOWN OF SOIJTHOt~,D SOUTHOLD, N.Y. 11971 NOTIFY TEL.: 765.1802 CALL MAIL T0: Examined ....~.....7,., 199 Approved 19~ Permit No. i ~ ~ ~ ~ ~ Disapproved a/c ......v (Bui mg Inspector) APPLICATION FOR BUILDING PERMIT Date Cl!1.~.y.. ~ 19q 0 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 stall 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 code, and regulations, and to admit authorized inspectors on premises and in building for necessary ins ections. ~ ~ }-Iovn~.l,wtPro~ewte~It"~'8~~~~~w Z'~vc, . (Sigr}ature of applicant, or name, if a corporattotl') e/ p 0: Box . i'.?.~.~ .~'-'i reer~~art~,r`! :i.. J l `14.1• (Mailing address of applicant) State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber' or builder. ...........~?.yl~~,e 2 ....................ff........................................................ Name of owner of premises ,-"~~`:`tig...1^ H$°. ~ (as on the tax roll or latest deed) If ap nt is a~nr tion 5t at t~ of duly authorized officer. . C C~~.. . ame and title of corporate officer uilder's License No. ~~~.3Q Plumber's License No . . Electrician's License No . . Other Trade's License No . . 1. Location of land on which proposed work will be done. . ..................It!IA•1N..I~~,o~................ ~,au~d~d.................. House Number St/reet Hamlet / County Tax Map No. 1000 Section ......lo. { Block Lot . Subdivision Filed Map No. Lot . (Name) 2. State existing use and occupancy of premmises and intended use and occupancy of proposed construction: a. Existing use and occupancy L 'S~.l'~N1er~.t~9`L . b. Intended use and occupancy C•.41^.~.t:''? a re,~9 L • • • • • • " ^ " i ' . C . a.~:_. ~''~l 3. NatPure of work (check which applicable): New Building Addition , Re air Removal . Demolition Other 1'~ (Description) 4. Estimated Cost 0.0.~?r.°~ Fee ~/.aa, D'~~....................... (to be paid on filing this application) 5. If dwelling, number of dwelling,units Number of dwelling units on each floor . If garage, number of cars . . . . . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . V~q~T;3:.t,s:~. 7, Dimensions of existing structures, if any: Front Rear , Depth , . Height ...............NurriberofStories........................................................ Dimensions of same structure with alterations or additions: Front . Rear , . Depth . . .Height ......................Number of Stories , " 8. Dimensions of entire new construction: Front Rear De th p Height,. ..............NunjberofStories............ 9. Size ofiot:Front Rear Depth 10. Date of Purchase ..................Name of Former Owner . 11. Zone or use district in which promises are situated . . . . P P 14, Name of Ow er of stremises violate any zoning law, ordinance or regulation: ...A~~ . • , . 13. Will lot be regraded , ..Will excess fill be removed fro~~t premises: Yes No p Let^"•S • • t ~~°yv ....Address 1`.hra:g~,-. ~~e•, ,S°' ,'ri~."!r3'hone No. Name of Architect ~RmF.§ ..~;4~~4!', , , ,Address 615,' 7'~---~5•I'. ,rj ,phone No. ~ J9f~ Name of Contractor ~`!~!y ..~4!4~.?:.......... Address P0; Bpi; 67b~,, ~ , • phone No..rf. ~ ~.:~a,s r . 15.Is this property ca'ted within 300 feet of a tidal wetland? *YES....NO.~ *If yes, Southold Town Trustees Permit may be required. • PLOT DIAGRAM Locate cleazly and distinctly all, buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF . • • ~ • • • • • • • • • • • g • • • • • • • • • • being duly sworn, deposes and says that he is the applicant (Name of individual si njng contract) above named. He 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 this application; that all statements contyined in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before ma this I ................`]..:....day of'... ~ , 19 Notary Public, ./.....o.C,i~;-. , County . NEIEN K ~ VOE NOfARYPUBIIC,SteteofNewYak (Signature of applicant) Na 4707878, SuBolk, uMe~~,~~ Term Expires Mercb 38,'tl...~lL