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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23841 Date SEPTEMBER 1, 1995
THIS CERTIFIES that the building ALTERATION
Location of Property 650 CEDAR POINT DRIVE EAST SOUTHOLD NY
House No. Street Hamlet
County Tax Map No. 1000 Section 90 Block 2 Lot 17
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 17, 1990 pursuant to which
Building Permit No. 18748-Z dated JANUARY 23, 1990
was ieaued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
ieaued is ALTERATIONS TO AN EXISTING ONS FAMILY DWELLING AS APPLIED FOR
The certificate is issued to ELLEN VIOLSTT
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N(A '
PLUMBERS CERTIFICATION DATED N/A
u' din Inspector
Rev. 1J81
rosaet xo. s
TOWN OP 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)
N 8 7 4 8 2 Date ~..3 . 9.~Q.
Permission is hereby granted t
ro .lr,'~r~.,.~~~~y{/~+/.e/(~/~/~~i1.••.••~r.'.~a..~. awn...~/k-//~~..~~.JJ.:.F~.........~'~..1:.. ...ti9..: .....dxz.e
of premises locatre///d at ....fct.c.?~..a.....~~k~.,n~~~.~.1.....,~f.••-.~,~r.......~....
..............................................~"~~~~~I.®.............................................................................
County Tax Map No. 1000 Section .........~p Block ...............i2..:..c.
iLot No...............?...
pursuant to application dated ..1.] 19..1. and approved by the
Building Inspector.
Fee $~Q.
uildln nspector
Rev. 6/30/80
ie ` ~ Form No. 6
"1'Ot~1N OF SOU'1'NOLD
I3U1LD1NG DLPAR'1'MGNT
'T'OWN kIALL
765-1f302
APPLICA'LION FOR CEA"1'IFICA'fE OF OCCUPANCY "
A. 'this application must be filled in by typewriter OP, i-nk 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 unusua]. natural or topographic features.
2. Final Approval from Health Deft. of water supply and sewerage-disposal (S-0 form).
3. Approval of elecCrical installation from Board of sire Underwriters.
4. Sworn statement feom 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 certi.ficaCe of Code Compliance from architect or engineer
responsible for the building.
6. Submit P].anninp, Board Approval of completed siCe plan reyuirements.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-existing" lane{ uses:
1. Accurate survey of propert}~ showin¢ all. property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and a consent to inspecC si-fined by the applicant.
If a Certi[icate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
C. tees
1. Certificate of Occupancy - New dwe.Ll.ing $25.00, Additions to dwelling 525.00,
Alterations to dwelling $25.00, Swi-coming pool $25.00, Accessory building $'15.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certif.].caCe of Occupancy on Pre-existing. Build].ue - $100.00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Cer.tiflcate of Occupancy - ResidentiailL,~$15.0O, Commercial .$1n5.400
.
New Construction....b.~//.... Old Or. Pre-existing 1}wilding. ;~4SS.~.~. 1U. ~1~'"L~~yJ~]
Location of Property..G.~~
..............~~f.•5...~.~b.6N~~V.1-.~-: f, ~OU-IJI.~..,J.4-~_ -
House No. _ ~ ~q xhS~treet Hamlet J
Onwer or Owners of Property....~.I~~='Yl...~.~.Y.r.~'~~'.J
.......................h............
County 'l'ax Map No 1000, SecCion ..............L'luck.......,........hot...~..~
Subdivision ....................................}'filed AYap............I,ot.........
--r^7 r,^ !!,,``~q ,ry``
Permit No.~.~~.~ $..~//i)ute Of Fermi-l ........App] Lcnnt..'~~~'M1... Y.4.V....
11ealUr Uept. Approval.r./
........................linderwr]-I:ers Approval>/.....................
E'l.anning 1loard Appro~rtl.~
1<equest for: Temporary Certif].caCe........... Fines Certicate....?....
KK--LL ..JJ~J ~cc--~~y``1III .........lr: I- I . V ..1..... ~ - - -
Q.CC ~'a`~'-~l APPLICANT
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Town Hall, 53095 Main Road p • ~ Fax (516) 765-1823
P. O. Box 1179 Telephone (516) 765-1802
Southold, New York 11971 ~
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
August 18, 1995
Ms. Ellen Violett
230 E. 50th Street
New York, NY 10022
SECOND NOTICE
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
xx An application for Certificate of Occupancy
not on file. (Enclosed) G~
No Underwriters Certificate on file. ~
~
~
xx The check is not on file. $25.00 'n , ~
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 # 18748-Z
,L ~ ~ Please contact our office on this matter Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
J~~ - 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.
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Town Hall, 53095 Main Road p • ~ Fax (516) 765-1823
Southold, New York 911971 y~O~ ~ ~~0~ Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
August 18, 1995
Ms. Ellen Violett
230 E. 50th Street
New York, NY 10022
SECOND NOTICE
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
xx An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
xx The check is not on file. $25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 18748-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
- ACCORDING TO THE CODE OF THE TOWN OF SOUTHOLD, IT IS
UNLAWFUL TO OCCUPY OR USE SAID STRUCTURE UNTIL A
CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED.
i.
TEL. 7GS-1802
~;~~FOtkc
~p Op TOWN OF SOUTIIOLD
:.1' OI'PICE O[' BUILDING INSPECTOR
~ P.O. BOX 728
y TOIYN HALL
041 ~ ~aO~ SOUTIiOLp, N.Y. 1 1971
July 30, 1990
Richard Saetta
4Bootleg Alley
Greenport, N.Y. 119G4
RE: ELLEN VIOLETT
To Whom This;. May Concern,
We are unable to complete your Certificate
o~upancy because of the following reasons. ,
An application for Certificate of Occupancy
is not on file. (ENCLOSED)
No Underwriters Ccrtificate)on file.
J / The check is (c$~~~$~~e~~not on file.) $25.00
/ / No Stealth Dept. T:pproval on file.
No final inspection has been made.
Please contact our office on this matter.
Thank you for your cooperation.
Duildi.ng Permit ff 1 $ ~ 4 8 Z
I3uildincJ Dept.
/ No Plumber Solder Certificate on file.
( all permits involving plumbing being
.i:,sucd after npril 1,19B4 )
.
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765-1802
1 BUILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T [ } ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ FINAL
REMARKS: - ~
DATE ~ INSPECTOR
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ItISULATION PER N. Y. H
ST;,TE El1ERGY~
CODE
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ADDITIOPIAL COi^.ME71TS:
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D -~~-t BOARD OF HEALTH
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3 SETS OF.PLANS
FORM NO. 1 SURVEY
TOWN OF SOUTHOLD CHECK ~ .t ~.q .
BLDG.OEPT,. BUILDING DEPARTMENT SEPTIC FOar1 .
MOWN OF SOU'1ta0LD TOWN HALL
$OUTHOLD, N.Y. 11971 NOTIFY
TEL.:7G5-1802 CALL
MAIL T0:
Examined ..I~ c.~........, 19 .9 .
Approved 19 Permit No..~L. 9.~.~.~~ .
DisaPProveda/c
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. ~ ~ ~ .(Boil g Ins ctor)
APPLICATION FOR "BUILDING PERMIT
Date ..:~.~:~....1.~...., IS Q9
INSTRUCTIONS
' C3 -
a. Tltis application must be completely filled in by typewriter or (n 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 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 tltis application, the Building Inspector will issued a Building Permit to the applicant. Such permit
shall be kept on the premises available for inspection throt+ghout 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
Re;ulations, 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
aurriY authorized inspectors on premises and ir. buildso For necsssa;
y irspecticns.
Prex ~~gn`~
(Signature of app cant, or nam , if a corporatton)
(M3~ting add~Fess of applicant)
State whether applicant is owner, lessee,-1agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of o~vner of premises ......r .I.I.er.~n....V. ! .4. ~ .
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer) ~ g~a
y~
Builde'rt$ Llt:ensetNo. ~ ~D: ,tea .
Plumbers License No. ......'I?~ . . . ~ ~ ~
Electrician's License No. !1~.1~........... ~
Otltcr Trade's License No. ....../,V. ~ .
1. Location of land on which proposed work will be done; -
........S.S's~..........G~:~. ..~o,.Y..~°~...fi~r.. FMS.~:......~®~~"~®•`.49:.......
House Number p Street, Hamlet
County Tax Map No. 1000 Section . !O Block ~ Lot ' , ,
Subdivision . Filed Map No. Lot .
(Name)
State existing use and occupancy of premises and intended use and accupancy of proposed construction:
a. Existing use and occupancy 4~.. ~ ~y • • •~~5.~~q..~q~ .
b. Intended use and occupancy ~G w.~.... " " . ' . • • • • • • • . . . . . . . .
_ -
3. Nature of work (check which applicable): New l3uilding Addition , , AJt °~q ;i .
Repair RRmoval Demolition ..............Stuimning ~~...t!'? , .
Tennis Court Adcessory Building..........Ferlce .Other Work:......
d
4. Estimated Cost • . ~d Q4!'3 i Fee s~fd~ .
5. If dtveltin~ number of dtvellin u d (to a paid on filing this application]
g nits !,{r~.C.', iVumber of dwelling units on each floor o ;r?':~......
If garage, number of cars ~ • • • • • • • . 7~
b. if business, commercial or mixed occupancy, specify nature and extent of each type of use ....?.V/.>ra . . . . .
7. Dimensions of existing structures,',if any: Front ..°i..~t.l.~ ~'a.`::~.. Rear ..C,~~~~~"~4. .Depth ~,~ls,-~:'tv,~ , , ,
Height ,~.~.I~~J~~ Numb~r of Stories , : T.~ 43.x, , , , ~ . .
Dimensions of same cture witl} alterations or additions: Front , ~f-T-vw.@ Rear . .
Depth Fleight Number oC Stories
8• Dimensions of entire new constntction; Front ..../.x/.79....... Rear Depth , ,
Height . (`lumber of Stories .
9. Size of lot: Front i.......... Rear Depth .
10. Date of Purchase ...............:NameofFormerOwner
11. Zone or use district in which premises are situated , .
12. Does proposed consfruction viola}e any zoning law, ordinance or regulation: ....~Q
l3. Nill lot be regraded . ...Will excess fill be removed from premises: ,Yes ; No .
1~. Nanre of Owner of premises • . , .Address Phone No............... '
Name of Architect . . .Address • ..Phone No..... '
Name of Contractor , I , , .Address . • Phone No.. ~ .
15.Is this property located within 100 feet of a tidal wetland? *YL~S...t.~NO....
*If yes, Southold Town'iTrustees 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 tjumber or description according to deed, and show street names and indicate whether
interior or corner lot.
s
f3•zsY !~%Ul~ot~v ~'c-u~fzl~(e~r` ~~,~-E,~
6fU S/N~7-~- ~ ~
A RA ~Ep AS wor~~~~~•
DATE/~~Z~~@.P. k f O
FEE:,. oA BY:
NOTIFY IIL ING UEFA E T AT
{~~IVt ems, 765-1802 9 AM 1T1 4 P FOR THE
~ FOLLOWIt~IG lNSPEC710NS:
~A 1. FOUNDATION TWO REQUIRED
v~~,+° , . FOR POURED CONCRETE
2. ROUGH -FRAMING & PLUM@tNG
~~~~a s. INSUl.A71UN
N t~ ~ 4. FpNAL - CONSTRUCTION MUST
b~ ALLBECO STRUC710N &MICLI: MEET
®i`lli THE RE4UIREMENTS OF THE N.Y.
STATE CONSTRUCTION a: ENERGY
STATE OF NE1V YORK, CODES. NOT RESPONSt`•~t,lf FOR
COUNTY OF . j S'S ~E:SIGN OR CONSTRUCTION ERRORS
(Name of individual stn • ~ ~ ' ' ' ' ' ' ' ' • being duly sworn, deposes and says that he is the applicant
..g ing contract)
above named. ,
Ho is the ~
(Contractor, agent, corporate officer, etc.)
of said owner ar owners, and is duly authorized to perform or have performed the said work and to make and Gle this
application; [hat all statements consained in this application arc true to the best of his knowledge and belief; and that the
work will be performed in the manner set forth in the application Glcd tttcrcwith: ' ~
Swom to before me this ~ ~
d a .......dayo~f 19 .^T.Q
Notary Public, ~ , /i%2
.4!4,''e: , , , , , , , , , County
NEIEN K. DEyp~ s : ;E9~/?• • .
Iwnutr rtietrc Sate of New ulna
No.4707878; SuBolaCoun (Signature of applicant)
Term Expires Merch 30,11