HomeMy WebLinkAbout19059-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19093 Date JUNE 1, 1990
THIS CERTIFIES that the building ALTERATION
Location of Property 1585 ACKERLY POND ROAD SOUTHOLD N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 69 Block 5 Lot 5
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 30, 1990 pursuant to which
Building Permit No. 19059-Z dated MAY 31, 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 ALTER EXISTING BUILDING TO A ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to JOSEPH & ALICE CORNELL
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N-55(}840 - FEBRUARY 12, 1952
PLUMBERS CERTIFICATION DATED N/A
Building Inspector
Rev. 1/Sl
1POSAB NO. S
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN NALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
~(0 1 ~ ~9 ~ Z' Date )9..~..1J
Permission is hereby granted to• n - - - ~ D
......C.......
.~.s~:.~
:4~
N..:~.:.....1.1.9.
Z' I d~:;~ I
to ..~t.4:~.ssv.....9-I.~ ...~I. gs.....1?3:4R,:
at premises located at ~.~.....~-5 ...~~7~,.....~...........
..........................................................................q.....................................................................................,
F County Tax Map No. 1000 Seetion .....~..4e.g....... Block .....Q..~i.'........ Lot No... tl.~~
pursuant to application dated ...........~..;..~.a 19q~'.., and approved by the
Building Inspector.
Fee S~•~••~.
Building Inspector
Rev. 6/30/80
i
FORM N0.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
No.....?9692....... Date September. ~5 19 .79
THIS CERTIFIES that the building .
Location of Property ~ 8$5, Ackerly Pond Lane Southold
House No. Street Hamlet
County Tax Map No. 1000 Section 69 .....Block 5.........Lot 5.......... .
Subdivision ...............................Filed Map No. ........Lot No. .
Requirements for a one famil~s dwelling built prior to
conforms substantially to the
Certificate of Occupancy
~Rxi~-. 23........ , 195.7. ,pursuant to which No. ......29692........ .
dated ...September. 25 , , , _ , . 19 79 ,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 .
.................One, Family ,Dwelling ...(non-habitable)...................
The certificate is issued to ,C,ounty. ,q~, S.t1~~A~-~G .
Towner, rua~sxnrfsrxzrr/
of the aforesaid building.
Suffolk County Department of Health Approval N/R
UNDERWRITERS CERTIFICATE NO . . . N/R
Building Inspector
Rev 4/79
t 7~ `J' ~9~ ~ Form No. G ~ M~~1~
TOWN OF SOUTllOLD
BUILDING DEPARTMENT y
TOWN (TALL t N ~7 ~
7G5-LB02
BLDG. DEPT. ~
TOWN 4F SOUTHQID
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 17 lead.
S. 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.
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
.,.Y unusual natural or topographic features.
~2. A propeily completed application and a consent to inspect signed by the applicant.
I Zf 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 huilding $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"La.Y..~~~..1.~9~
New Construction........... Old Or Pre-existing Building...X
Location of Property..1885..Acknxllr. P.4nd. L.driD ........................SA1Lth07-d............
House No. Stxeet HamleC
Onwer or Owners of Propcrty...Jose~h.and Alice Cornell
County Tax Map No 1000, Section...69.........Block.... 5..........Lot...5
Subdivision.... N~A
............................Filed Map............Lot......................
Permit No ................Date Of Permit................Applicant.,Joseph C. Cornell
Health DepC. Approval.,not.required ,,,,,Underwriters Approval' .
Planning Board Approval.not.Yec(wired
Request for: Temporary Certificate........... Final Certicate...X.......
Fee Submitted: 2~;00
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ul"~;OOIa~~4nII~IIIIUIIIT~i_~ull~ll>~';1I~IIIIIYI~I~2KII B0~4RD OF FIRE "UNDERWRITERS
II III IILIII III IIL-III=III III 111=III ul II ~1- BUREAU OF ELECTRICITY -
I (il III -III-III III III III III III -ylr Bk U~HN'ISTREET' NEW YORK, NEW.YORK 1008
I III 1h'-T III III III=III III III 'h TTI i ~
'll IDaiJ III:- , ~ Ir i„ I III i, III++ 'I I /
In_III III m I~'~r4?axy u~2b 1382 { Apprcatign rvG. qn fire 099435 80 N 5 ~J fl 8 ~ 0
THIS ICEk2'TJFIE~,ITHATII III U III'- i i q' !
~u Ii~il! I III i11=-I !i ,II if
only the I
~ tectriFBf ilqurp' rfFen.t i a IldearlFl4, d 6p/o~o qpd introdrfced by the applicant Hamad on the oboue applicotion'numher in the premiaea of
' I ulsornel~li Sose , I,W/S iAckerTy Pond Lane S/0 Norrh Road N/0 Ma Rd. Southold N. Y.
, III III III III III-III III I~I+I III h IF r f P ,
' Iil III=III III III Iil~l I' -III-1'I ,I h
sn thefp(fawir~g lolcodonP+{'I_ ~Bgserryent I~i/tt Fl. ~ 2nd Fl. Section' Block Lot
wqg, exam;ned pit , ,"I''~-(III ~I+ I II III and~ound to he''in com fiance with the requireme~nta of this Board.
~i IL-= I II, I I :II II ~ ~ II- I ,_II f P
- I+ I - III fl , I. „ I ,
"FIXTURE - _ 'i u m r. FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXNAUSTFANS
OUTtETS!I , KEPi~ACLES SWI~GHES INCANDESCENT RUORESCEM yAPOR ' AMT K W AMT i K. WWII =AMi.I KW ! AMCI =''{K. W+I ',AML.. - N. P.
I I=1 I III 111=111 Ill III III=)I .I I' :ICI I' =I8 II(' ,I .I I i I_ , I I Ir d~ I
I t- , I i' ~ , 1:=
6 l l-IZ' 11 0 I I ' ~ III I Ii a 11 F
II lII. ~ Ill Iil , 'i 6 i' ,I 0,. i, , i ,
DRYERS + I"`,+j `FURNACE MOTORS FUTURE AOPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BEII UNIT HEATERS 'MULTI-OUTLET :I'~. DIMMERS
AA}T, ly, ytll i, ILL ~ ~p p GAS ! 71. P.r AMt NO A W G. AMi ,AMP AML AMPS TRANS AMT H. P.
SYSTEMSn
II II=_I!I NO.OF FEET ~'~^T+ "waits
i II I ~-III II-.111 ~ hl'I !i II -1ii i' I '
~ f p: Ill III -Ill°II' III IfF Ill III III=i' II~,-1' I"i'II~ i , ,.T4 IE a _ , , ' ` q' I I
_ _
+
ijiSERVICE DISCO NECT-n+.NO.OF ,T~+L-+ -m-~ lT. .5 ;r_., E -ir ' _
MLL.., 'AMP.`+-_ TYPE ~ EQUIP. 'I$TN 7$3Wi3$[W'3$dW NO.OF CC COND ~A w. G. v I. C E
i ~ PER 8 OF CC. COND_ ' NO. Of H4lEG OF H
~IEG NO. OF NEUTRALS ' A~ W G.
OF NEUTRAL
1. 200 CB X 1 4/0 1 4/0
OTHERiAPPARATUS:IIS i I =11 , 11 t i
E7ectr~cllroom ~TOaters}„ 1,1 751aa 2-1.5kw. ,4-1.Okw. ;1-.5kw:
I~anelbq~r,~is,tl'X-13cir,.;20Qamps~t
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Motors: nl-F L+ +I - n . ~ ,
1,-G F L.~-'~iu~ ~ ~ ' I
2 `Szroke,detfsctors ~ " i
1=41 5kw+li:I~t,w~ter kieater I
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III ill I y AI! NI III 11! I i
IIF. m I ' i ~ i+I i'~
+ i
~ i I u I iLIIi III i I+ , '
u II ,
, ~IChfford'i'Co~rnelTa (EECO Elect. Corp) f ~ ~
` II i I `n 325. ,Wi,11ow 1'o~Tnt Road ; cEithRA ~~1~ ; I
, „ Southold`,' N' Y.I °119 1 .II Lic2816E : ~
' i i I G III II' -I , I' nl i 71, Per
This certificate mustlnot be altered inl any manner;'~refum to the, office of the Board if incorrect. Inspectors may. be. identified b 'eir redentials.
_
- - _ ~ 5 T _ _ _
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE ~
1000174 BUREAU OF ELECTRICITY
83 JOHN STREET. NEW YORK, NEW YORK 10038
pate JUNE 18,.1.996 gpplicetionNo.onfile 69191890/90 N 135099
THIS GERTIFIE3 THAT
only the electrlcd equipment a descrihed hektrv and introduced by the applicant named on the above application number Jn the promisea qj
JOSEPH & ALICE CORNELL, 1885 ACKERLY POND 4ANE, SOUTHOLD, N.Y.
in thefoilolcing hecationq ? Basement ? let Fl. ? Ynd Fl. GAR ,Sertiun69 Blocks Lot 5
uNU examined un JUNE 04,1990 ondfound to 6e in camplianre with the reyuiremenG UJ thu Buard.
NxiUEE RXTURES RANmES tbOElNOfxcRS OVENS BNN WASHERS EXHAUST FANS
OUTIETf ACIlS SYt1TCNE5 INCANDESCENT FLUORESCENT OTHER AMT. K. W. AMi. K. W. AMi. K.W. MIT. K. W. AMT. N. P.
4 9 4 4
DRYERS RIRNACE MOTORS NITUE! ARNANCE IlEOlES SMCIAL Ell:'?T TIME ClOC1I5 pLL UNIT NEAIEEf MUITI-0UTIlT ONt1A1lRS ~
AMT. K. W. Oll N. P. GAS N. P. AMT. NO. A. W. G. AMT. AMI. AMT. AMPS. TEAKS. AMT. M. 1. ~
~
~T AMT. WARS ~
SWVKE MSCOFNNCT NO.OF 5 E R V 1 C E G~
ANT. AAV. TYPE ~ 1J'tW 1F]W ]/]W ]/~W ~~rCOND. OF CC
COND. NO. OF NFLEG ND.q NEUTRA4S Or-~YTAAI
OltfiE AFMRATUS:
PANELBOARDS:1-4 CIR. ].O6
ELEC. HATER HEATERS::1-4.5 K.A.
G. F.C.I:-2
i
B. E.C.O.ELBCTRIC CORP. LIC.~2816-E
35656 CO1)NTRY RD.48
• PECONIC, NY, 11958 EIMIMNIR
11~ 1.
Pn
This artiRcoM mutt not be ahered in any manner; return to tM ofiice of tha Board ii incwrad InspeNOrs may ba ' ~ by Moir cradantioh.
COPY FOR BUILDING DEPARTIABIT. TN15 DOPY OF PIG E AWST NOT !E ALTl1~D MI ANT MAIMIER.
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ItJSULATIOPI PER N. Y. ~
STATE ENERGY ~
CODE x
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l SETS OF PL.\;i5
~1r fORrANO.1 SURVEY
~7w ~ I ~ TOWN OF SOUTNOLD CIIEC~ .
_ BUILDING DEPARTMENT SEPTIC t'ORP3 .
BLDG.OEP7 TOWN HALL
TOWN Of SOUTHOLO $OUTliOLD. N.Y. 11971 NOTIFY ;
TEL..7G5•1II0~ CALL
~ L9gD PIAIL T0:
Exaurined _ .
Approved . , ....y.}~ . stir 19 ~a. Permit No. d .
Disapproveda)c
....................~~-.rk-r,. .
(Building Inspector}
APPLICATION FOR BUILDING PERP4IT
Date 15...
INSTRUCTIONS
u; ,
a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Buildir>;Iitspector, 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 isparz 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 keen granted by the Building Inspector.
APPLICATION IS HEIZEHY 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
Rc=ulatians, for the construction of buildings, additions or alterations, or for removal or demolition, as herin described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housin^ code, and reetiations, and to
admit authotizedvnspectors on premises and in building for necessary inspections.
. ~ •(Signature of applicant, or name, if a corpora~wn}~
P.O. Box 823., Southold, NY 11971
. (Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder,
Owner
.
Name of owner of premises ..~i~lfi? JPS.eR1?. C....Cornell
(as on the tax roll or latest deed) -
Ifapplicant is a corporation, signature of duly authorized officer. '
(Name and title of corporate officer)
Builder 5 Liccnsc No. N ;A; , oFlt}~X~, , , . -
Plumber's License No. .N.B...' .
Electrician's License No. .281.6,
:>r .
OtltcrTradc's Liccnsc No. N.••A...(Pw.neY~....,
Location of land on which proposcJ work will be done;
18'85 Ackerly Pond Lane Southold
IiouseNumber..•.....•••...•• •••,StreeL•..... •.•••,........Hatttlct...,..•..•...•••.•••.••.
County Tax \1ap No. 1000 Section .....fz9 • • • • • • • • • ~ Bluck 5........... , Lot ...5
•.i:
Subdivision filled Atap No. Lot ,
iNmuc)
State ecisting use and occupancy of premises and intended use and occupancy of proposed construction_ _
a. Existinguscartdoccupancy Residence
h. Intended use rod oecnplney • • R2S i derice . .
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