HomeMy WebLinkAbout18718-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23592 Date APRIL 6, 1995
THIS CERTIFIES that the building ALTERATION
2830 PIKE STRSST &
Location of Property 14825 MAIN ROAD MATTITUCR NY
House No. Street Hamlet
County Tax Map No. 1000 Section 114 Block 8 Lot 4
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 3, 1990 pursuant to which
Building Permit No. 18718-Z dated JANUARY 4, 1989
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 ALTERATION FOR A HOME OCCUPATION (PROFESSIONAL OFFICE) IN AN
EXISTING`ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to JAMES AINSCH
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N132818 JONS 4, 1990
PLUMBERS CERTIFICATION DATED MARCH 31, 1995 EAST END PLIIMBING
~f
uil ing Inspector
Rev. 1/81
rosat xo. s
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
~.87~.8 ~c,
N~ Z Date a9..~!.l.
Permission is hereby granted to:
~ l... .7 7 .
c remises locate at .........................~.y~....~....................~..,../..........................................................
................................................c~. ~ .........1... .
Caunty Tox Map No. 1000 Section ......~!/~T....... Block ........(1........... Lot No...........J~.~..........
pursuant to application doted .......,.~.,1.,~ 19.~~, and approved by the
Building Inspector.
Fee
0
..o.~.... ..~z............
B Idin I ctor~
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD 3
BUILDING DEPARTMHNT °~f~~ ~ ~a ~ ~wr ~ ~.1 ~ ~ ~ ti
TOWN HALL ~ ti ~.J m tis~9-~- s y 4
765-1802 'G ~
~i;~~'y APR 2 41990 ~
APPLICATION FOR CERTIFICATE OF OCCUPANC 1\'
A. This application must be filled in by typewriter OR ink and su~it~odAafo°~"Ctf~ "B~i~ding
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
r 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 S years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
y/- ZS-~ v
Date
New Construction........... Old Or Pre-exist//,i~~,,ng Building _
Location of Property..~y~,25
..............!':[.~`~~!1..1'e:~:..................N'~c.~F;~vG~.......
House No. Street Hamlet
~ /
Onwer or Owners of Property.....:
~.~5/~l:e s...~:..(:7.d~s~
County Tax Map No 1000, Section. 11.1... L~...Block ................Lot......................
Subdivision ....................................Filed Map............Lot......................
Permit No..~.o .~(.U 4(....Date Of Permit ................Applicant.............................
Health Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval
Request for: Temporary Certificate........... Final Certicate.°....~~......
Fee Submitt~led: $ ~ l~Y~~i/ 'il
X35 ta-- ~ ~'APPLICANT
;c
APR - 54995
~
.rt~-,:~. _w ..._l,_._.._.__.
Town Hall, 53095 Main Road .i _ ~ Fax (516) 765-1823
P. O. Box 1179 ~ ;v Telephone (516) 765-1802
Southold, New York 11971 ~ ' - ~
~ ;
,y'
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C E R T I F I C A T I O N
DATE:
Building~Pr-ermit ~~~~1No.I / 07~ 0 _Z
Owner: ~G.w~es Y~. l~~vSC~-`
(please print)
Plumber: (,~~ov~«-~c~ (2e,,vlPe ~~as~ ~(c,w,~~~J
(please prin )
I certify that the solder used in the water supply system
contains less than 2/10 of 1~ lead.
.
(Plumbers Signature)
Sworn to before`~me- this
3( day of U1~-e.~-- 19~7J ~/e K
Notary Public, C.J County
ROSEANN GRIFFTTfi
Nbtaty Pbb13a, 9tato of New Yo~
No. 4814567
f3ualified in Sni'folk County
' Commission E;xp~rer, [vFw~'..89,-~8~'
~~3r, l~r~i~
~o~~gpFFO(X~OGy
o ~
Town Hall, 53095 Main Road °y Z Fax (516) 765-t 823
P. O, Box 1179 W ~ Telephone (516) 765-1802
Southold, New York 11971 ~,fi~~
~ ~~p! ~ y ,
i
APR - 519A6
OFFICE OF THE BUILDING INSPECTOR
TOWN OFSOUTHOLD
March 22, 1995
Dr. James A. Hinsch
P.O. Box 1177
Main Road
Mattituck, NY 11952
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.
xx The check is outdated. $25.00
No Health Department Approval on file.
No final inspection has been made.
xx No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 18718-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
- ACCORDING TO THE CODE OF THE TOWN OF SOUTHOLD, IT IS
UNLAWFUL TO OCCUPY OR USE SAID STRUCTURE UNTIL A
CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED.
~Q~Og~FFOCK~OGy
~ ~
Town Hall, 53095 Main Road y T Fax (516} 765-1823
P. O. Box 1179 ~ • yC Telephone (516) 765-1802
Southold, New York 11971 .j~ p!
~ipl ~ ~a
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
March 22, 1995
Dr. James A. Hinsch
P.O. Box 1177
Main Road
Mattituck, NY 11952
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.
xx The check is outdated. $25.00
No Health Department Approval on file.
No final inspection has been made.
xx No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 18718-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
- ACCORDING TO THE CODE OF THE TOWN OF SOUTHOLD, IT I5
UNLAWFUL TO OCCUPY OR USE SAID STRUCTURE UNTIL A
CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED.
1
EAST END PLUMBING & HEATING
POST OFFICE BOX 528
54 RIVERHEAD ROAD
WESTHAMPTON BEACH, N.Y. 11978
516-288-3129
LEONARD T. REMPE, INC. , , , a~a
~ ~ '
L1pei1 'S, 199 ,`C F, ~
~ ~ ~ Q66! L Z ~
To~i~rn of ~'outhol
Buil'ing "~e»t.
~~fain :oad
' outhoJ_c~ , Ne~~~ York 7.1'71
To whom it may concern:
Z^hi:' i<~~ to certify that ~~11 r~ol~3er used in the nlumbin~
~rTork at the Jamey Hin~ch residence located a.t Main p_oad
in Mattituck i~ 7_ead free.
"incer.Ply,
I,eonaY d T. R.empe,
iresident
Lic. x'161.'7-P
r'iELD I~:SP~O:iU~1 ,~llAin ( i;UMMENT°
ro
~ `TJ
~ va
H p~
FOUtdDATION (1st)
C~
ti
FOUNDATIOIJ ( 2nd ) ~
2. ~ ~
ROUGH FRAME &
.PLUMBING
(0 0
y
3.
H
IIJSULATIOPI PER N. Y. ~ ~ ~
STATE ENERGY `
CODE x
b
y..
r
4. - y
FIiJAL ~1
o~\
ADDITIOPIAL COMMENTS:
x`
w
H
9 '~\p
' y ~Y\
H
O
2
1
x
a
y~
. - x
d
m
-o
H
~ '765-1802
BUILDING DEPT.
INSPECTION
[ ~ FOUNDATION 1ST ROUGH PLBG.
[ ] FOU DATION 2ND [ ]INSULATION
[ ~ RAMING [ ]FINAL
/~~I
REMA KS: ~i'/~2.
_
r.Qe~.
- - G j~
DATE INSPECTOR
G ~ 765_18®2
BUILDING DEPT.
f NSPECT ON
[ ]FOUNDATION i5T ~ ) ROUGH PLBG.
[)FOUNDATION 2ND [)INSULATION
[)FRAMING [)FINAL
rj~
REMARKS: ------=~r`I"' ~it~r"
DATE ~ ~ INSPECTOR
'29 o Ik11A~ES NEED
TESTING 9ES~~RE CpVERINt3
PLUMBER CERTIFICATION k~
DN LEAD CONTENT BEFORE , ~ ~ ~ ~ ~ ~ ~
CERTIFICATE Of O~Ci1PANCY _
~,.z....- ~-4i----~----~--~..._._.
SOLl3~~ER USED IN WATER ~ 1
SUPPdY SYSTEM CANN(JT ~
EXCEL~D 2/10 of 1 % LEAD. ~ '
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BOARD OF HEALTH
' 3 SETS OF PLANS
FORM NO.1 SURVEY
TOWN OFSOUTHOLDCHECK ......Y
BUILDING DEPARTMENT .SEPTIC FORM
TOWN HALL
$OUTHOLD, N.Y. 11971 NOTIFY'a
~~LL ,PCB TEL.: 765-1802 CALL
Examined • ~~7.. • • • • • • 19u/ MAIL T0:
Approved 19~Pcrmi[ No. ~t~,~~cQ~
DisaPProveda/c D
..f. 1~~.... ~ w ~ ~
uil - Inspectors gip;;
~j~~-t, -
TOWN OF 5UC3TF#gLt7
AppLiCATIOP UR BUILDING PERMIT
Date . , 15 ~,d
INSTRUCTIONS
a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with ~
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 io adjoining premises or public streets
or areas, and giving a detailed description of layout of property must be dradvn 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
Rc;ula[ions, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
T11e applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in buildutg for necessary i eciions. 'y ~ ~
• •(Si n cure of applicant, or name, if a corporatton)
Matting address of applicant)
State whether. applicant iS~-owner, ilessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of ow eit ) tremiseS .:`:~~.11i!l.P_S.!Y:...!':iU~a~1..... ~'Q~~/1:trC~-c;st. . `~i~?J;~'.1:~......
' ` (as on the tax roll or latest deed)
. ,.,t~;t;~,
]f applicant is a corporation, signature of duly authorized officer.
.
(Narst'e and•'title'of dorporate officer)
' 1%. .Y~t'1 ,ii -
Builder's•Licei~seY,Nb, , , . . . .
. : ~,,,y
Pimnber's Licen3e'No'. .
Electrician's License No . '
Outer Trade's License No . . .
1. Location of land on which proposed work will be done; '
NouseNumbcr • Street Hamlet
County Tax ~\1ap No. 1000 Section ~ ~ • . ~ Block Lot , _ ,
' Subdivision Filed t\lap No. Lot '
•(N:une)
State existing use and occupancy of premises and inten1~d,Jed use and o~cAC~upancy of proposed constntction:
a. Existing use and occupancy • ~n t•'•r • • • ~ s ~ ~ •`,f,1,"~~,{e...... .
b, Intended use and occupancy Y 1 •~y • • ~ • • • . • • • . • • , , _ • . • •
~t otyti . Ol:'.t.~:
. .
wll!
3. Nature ofwork (check whit![ applicabl,e): New t3uilding Addition Alteration .
Rrpair . , Removal i...... Demolition ..............Swimming pool .
Tennis Court Accessory $uilding..........Fehce ....,..Other Work..
4,- Estimated Cost ~.5r.°oo ; Fee
S.. IC dwelling number of dwelling units .I (to be paid on filing this application)
y, Number of dwelling units on each floor .
IC'garace,numbcrofcars .
6., If business, commercial or mixed occupancy, specify nature and extent of each type of use .
7, Dimensions of existing structures, if arty: Front Rear Depth . .
Hci;ttt , ka.,,,... Number of Stories . .
Dimensidh~:of:~arfrif s,t}~i~ture with alterations or additions: Front Rear •
Depth , Height ......................Number of Stories .
ft. Dimensions f entire new,'~pnstntctiotj: Front Rear Depth ,
Hei;ht~.~::.~.. ,Number of Stories .
`d. Size of lot: Front ~ Rear Dc th , , .
lli, Date of Purchase , 28f _g~j'` Na c o Fo cr Ot ~r}},,er p..... . .
1 1. 2:one or use district in auhic premises; are situated . °'~r! f?.,.~t , • , . , ,
1'1.. Uoes proposed construction viola e arjy zoning law, ordinance or regulation: , Y.~ . . . .
1 il. \VIII lot bo regraded . \Vill exc~5s t"Il'be rcmovcd,f prCt premises: Yes NAP
t Name of Owner of premises ,~9 l~~w?~~Address , Y:°, !(77 . Phone No...~`~~.: 5./. .
Name of Architect ...Address ..Phone No .
Name of Contractor , I ...Address . ..Phone No..... .
1,3.Ys this property locatedj•within 100 feet. of a tidal wetland? *Y1;S...:NO~.
*If yes, Southold Town Trustees Permit may be required.
~ PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dunensions from
f>ropt:rty lines. Give street and block number or'description according to deed, and show street names and indicate whether
interior or corner lot. ~
< - ~ ~
~ Boa ~ ~r ~ ~ ~ ioa~~•~/~
AP, EA AS NOTED
DATE: ~ ~ S.P, 8 7/
~ ~
j N E. Bt11L NG DEPART AT
766-1802 8 AM TO 4 PM FOR THE
FOL40WINC INSPECTIONS:
1. FOUNDATION TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULA110N
Q. FINAL. - CONSTAt1CTION MU8T
BE COMPLETE FOR C.Q.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION 8 ENERGY
COIaES. NOT RESPONSIBC'~ FOR
STATE OF NE1V YORE, S S C?FSICsN OR CONSTRUCTION ERRORS
COUNTY OF .
being duly sworn, deposes and says that he is the applicant
• (Name of individual signing~contract)
above named.
Fk istltc
(Contractor, agent, corporate officer, ere.)
of said owner or owners, and is duly ;juthorized to perform or have performed the said work and to make and file this
application; that all statements contained fn this application arc tttte to the best of his knowledge and belief; and that the
work will be performed in the manner sCt forth in the application tiled therewith. '
Sworn to bctorc me this !i ~
f
.day,~o/f . / / 19 ~4.
Notary Public, , . , ~~::=Y!K:...r.:: ,j~z (/d2:.... County ~
k1tYfARY PUBLIC, State of kew Park (Signature o f app titan U
No. A707878, Suffolk IbnMy
Twm ExPlres March 30, 28 '