HomeMy WebLinkAbout18111-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 218308 Date AUGUST 25, 1989
THIS CERTIFIES that the building ALTERATION TO DWELLING
Location of Property 1775 MILL CREW DRIVE SOUTHOLD
House No. Street Hamlet
County Tax Map No. 1000 Section 51 Block 6 Lot 33
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 24, 1989 pursuant to which
Building Permit No. 181112 dated MAY 11, 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 TO EXISTING ONE FAMILY DWELLING.
The certificate is issued to RICHARD 6 (~lRLOTPE MULLEN
(owner, )
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N080651
PLUMBERS CERTIFICATION DATEDJOHN E. WALTERS PLUMBING & HEATING 7/21/89
Building Inspector
Rev. 1/81
e~osvc xa s
TOWN OP SOUTNOLD
BUILDING DEPARTMlNT
TOWN NALL
SOUTHOLD, N. Y.
6UILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N 18111 Z mot... 19.s~~
Permission is hereby gwnted to•
~Q.....d~~~ ..:7..~P9
to ~ r~ ' ...o,..~.,~..
~?~~.?.7~.....~~.....
of premises Mcated at ...~..c ~.tf~~ ...~.?.1.4!/..Y
..........................................~Q..~~~.'.41........................................................................................
.
County Tax Map No. 1000 Section~l........r..~,/........ Block G.......,.~gLot No...:33
pursuant to application ed ....T~!G~.~ 19.x.1.., and approved by the
Building Inspector. `~/o%
00
Pee i.....~..4
•
Rev. 6/30/80
FORM N0.6 ,,.,mm.,..~ ~f"~
,..-e
TOWN OF SOUTHOLD ~y ~ ~C~ L
Building Department ~ { ~1 °t.,~ .a..~--~
Town Hall J }
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANC g~pG, DEPT.
Instructions TOWN OF SOUTfiOLD
A. This application must be filled in typewriter OR ink, and submitted w ~ to the Building Inspec-
torwith the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, acertificate of Code compliance from the Architect or Engineer responsible for the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of plnperty showing all property lines, streets, buildings and unusual natural or
topographic features.
2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling $15 .00
3. Copy of certificate of occupancy $1.00
4.Vacant Land C.O. $5.00
Date ...J1/~x.25, .14$9......... .
New Building .............Old orPre-existing Building ....X....... Vacant Land .
7?~
Location of Property ...................Mill. ize~lc Px1Ve............. Ss=~Pt)2old, , , , , .
House No. Street Namlet
Owner or Owners of Property R:LcxtaY:d&Chax;lotte,N[u,7,lep,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
County Tax Map No, 1000 Section .......5,7. , , , , Block 6........... Lot 3"`33
Subdivision .................................Filed Map No. ..........Lot No. .
Permit No. .1&117..2.. Date of Permit ..........Applicant Rc;n, Morizzo, Builder,. Inc.
Health Dept. Approval ........................Labor Dept. Approval .
Underwriters Approval ........................Planning Board Approval
Request for Temporary Certificate ...............Final Certificate X .
Fee Submitted $ .15.00. ~.~~~®d .
Constr~u{ction on above described building an emit me s all applicable codes and regulations.
C.~~`tt'~t~~~ APPlicant .
. 3~0~~
Rev. 10-1048
y
TEL. 765-1802
~Oc~VYF~L/i ~O~, TOWN OF SOUTIIOb,D
O "
; c OFFICE OF IIUILDIIQG INSPECTOR
o P.O. BOX 728
~ -e TOWN HALL
~~0~ SOUTHOLD, N.Y. ] 1971
C E R T I F I C A T I O N
Date JLi_
I_~7 j9~~
Building Perm/~iyqt No.~~
Owner (~~CN~A~I lil(,r~reY)~
(please print)
Plumber ~ak~ (,t0¢}~~
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1, lead.
(plumber's signature)
Sworn to before me this p
~~-day of -w~~ ~_-~r
19~ Public
Notary Public, ~i.~ T/ o County ELiZABETHANNNEVILLE
Note Peb6c, State of New York
No, s~-8126860. SuNolk
1Mm Expiros octobw at.1c'93
THE NEW YORK BOARD OF FIRE UNDERWRITERS '
i9tll~;.21
BUREAU OF ELECTRICITY
88 JOHN STREET, NEW YORK, NEW YORK 10038
Jt7SrY g:,,~9ttei =.>2~1NZ24tlf~`~ OSt)6~~i1
Dote Application No. on file
THIS CERTIFIES THAT
only the electrical egnipment as described below and introduced 6y the applicant Homed on the above application number in the premises of
ft'CCDf~,1ti? I4t3[d,1~3?D :112., Si.Qi.Et.t< +'~,(~1~ 'DR,"f.~VL, S~JIrt`?It?iLlJ, ~.1r.
in thefollotvinq [ocat'o s rfnent ? /st FL ? 2nd Fl. Section Bloek Lat
~11>"~~
uns examined on and foundW be in comp/ianvc uith the reyuireneents u(this (Foard.
fl%TURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DI'iH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLVORESCENi OTHEn bNi K W. AMi K. W AMT. KW. pMT. K.W AMT. H P
11 ,1
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULiI.OUTIET DIMMERS
AMT. K. W. OIL H. P. GAS N P. AMT. NO A. W G AMi qMp. AMi AMPS. TRANS. AMT H p SYSTEMS AMT. WAiiS
NO.OF FEET
GU€d
SERVICE DISCONNECT NO.OF 5 E R V I G E
AMT. MAP. TYPE METER a, ]W ' R ~W 3 ~ ~W 9 W NO. OF CC. COND A W G NO. OF HI-LEG A. W NO OF NEUTRALS A. W. G'
EQUIP. PER .6' OF CG COND OF MIiEG OF NEUTRAL
OTHER APPARATUS:
Ss.1'' a t.'..
PAIDD, HIIRfd`i 2,7L<~2t1?--~
2.75 7`US3t~ TiAhllt)it iLTaiYi;
S(?CgTJfCtjeD3r n{s~, 11~n~~
GENER MANAGER
F
r ~ ~
Per
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identif ed by their credentials.
COPY FOR BUILDING DEPARTMENT. TNIS COPY OF CERTIFICATE MIDST NOT BE ALTERED IN ANY MANNER.
RON ,
~r,~
BUILDER INC A _ ~ i ,f ~
~;t
~ • MUG i°~~.~
P.O. Box 789 • Main Road, Southold, NY 11971 • (516) 765-5772 2'Q ~
TOWN OF
gD6PT. ~I,d
007'MOLD
August 23, 1989
Town of Southold
Building Department
Town Hall
Main Road
Southold, N. Y. 11971
Re: Mullen, West Mill Creek Dr., Southold, NY
Permit #18111
Gentlemen:
Enclosed herewith please find our check in
the amount of $10.00, check # 3916 for the additional
charge for the above referenced matter.
Thank you.
C~~~ry truly yours,
Ron Mori
President
RM/d
Encl.
c'1ELD ii;SPEC;IOii ~~llATr. ~ COMMENT°
1. - ~
rOUIJDATION (1st)- •
_ a
rr^OUNDATIOtJ (2nd) m
2.
o
ROUGH FRAME & CwT~
PLUMBING
ti
H
3. ~
c~
IIJSULATIOPJ PER N. Y.
H ~7
STATE ENERGY
CODE
. y
p
4. 4 ~ y
FIiJAL
z
ADDITIOPJAL COMMENTS: ~
' x
b
H
77 \
9
H
H
O
Z
. ~
m
a
• r
_ H
d
[*1
-n
H
f~i~i
765-1802
BUILDING DEPT.
INSI~ECTION
[ )FOUNDATION 1ST ( ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[)FRAMING ~ FINAL
REMARKS:
DATE ~ INSPECTOR
,r r
1'f
i, ~ I f~l ~ ~ BOARD OF HEAr TH .
j~ l 3 SETS OF PLANS
k ~,'FORMN0.1 SURVEY
~ s~ ~ I TOWN OFSOUTHOLD CHECK
~lll E;i~J
s ~ ~ BUILDING DEPARTMENT SEPTIC FORC4
B~:7G. otP7 TOWN HALL
TOWN OFSCU'iwOLD NOTIFY
SOUTHOLD, N.Y. 11971 CALL
TEL.: 765-1802 MAIL T0: F'Q 7~~~Iy
Examined .'S 19~.~~. ~ot-W~-~~'
Approved 19 ~~Permit No.,l~~~~ . .
Disapproved a/c
(Bdildingdfispcctor)
APPLICATION FOR BUILDING PERMIT
Date Apri1.24 , , , , , , , 19 $9
INSTRUCTIONS
a. This 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 to adjoining premises or public stree
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app:
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 perm
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 Occupant
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 tl
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances ~
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and ~
admi± a~!thorized inspectors on premises and in building for necessary inspections.
Ron Morizzo Builder, Inc.
(Signature of appljcant, pr name, if a corporation)
P.0. Box 789, Southold;-N.Y. .11971.
(Mailing address of applicant)
State whethpi pppljcant is_owner, lessee, agent, architect, engineer, general contractor; electrician, plumber. or builde
,k ='Cdeher~l..Coht~actor ` ,
1
Name`of ow~r,ol;pl~ls~s 3.rRi chard F.. ~ Charlotte Mullen , . ,
,.~.t,e ~1hC5G~~, , y ,,t3 ~ (as on the tax roll or latest deed)
If ' Iii~At 1~ cr~ij~y`11aTllre of duly authorized officer.
. ~ ~9~~~INCY OR
>~tXRM~I lei orate officer)
ALBuildeNS LAensa No. .M 6772 HI, SUFFOLK COUNTY LICtE~S~!11~~~~#P~IiAWFUI
Plumber's`Ll'CiY''IS$'No WITHOUT CERTIFICATE
Electrician's License No . OF OCCUPANCY
Other Trade's License N'o . .
1. Loc/ationof lDan~d~on which proposed work will be done
. .
(7~`~ . T~ ........1E.,Mi11,Creek.Drive ................SoUth9ld.............:...........
House Number Street Hamlet ,-3~
r /
County Tax Map No. 1000 Section ~ ~ -Block ...~P Lot . ~ . .
Subdivision Filed Map No. Lot:.............
(Name)
2. State existin, use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy Single, family. dwelling, , , , , , , , , , , , , , , , , , , , , , , , , ,
b. Intended use and occupancy .....Single, fainzly,_, dwe~] j ng- , ,~.?cL'~ ..~~,x . . . . . . . . . .
3. Nature of work (check which applicable): New Building Addition Alteration .
Repair Removal Demolition (her k .
(Description)
r _ Fee .
4. Estimated Cost .....5,' .0.40.
- (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 .
7. Dimensions of existing strnctur'es, if any: Front Rear Depth .
Height ...............NumberofStories......:.................................................
Dimensions'of same structure with alterations or additions: Front Rear .
Depth ...................,...Height Number of Stories .
8. Dimensions of entire new construction: Front Rear Depth , .
Hnjoht , . - Nuinher of Ctoriec .
9. Size of lot: Front..........'I Rear...................... Depth
10. Date of purchase iJame of Former Owner .
11. Zone or use district in which premises are situated .
12. Does proposed construction violate any zoning law, ordinance or regulation : .
' 13. Will lot be regraded ............................Will excess fill be removed from premises: Yes No
14. Name of Owner of premises ....................Address ...................Phone No............... .
Name of Architect ..................Address ...................Phone No..... .
Narne of Contractor ~.~.IM~`~1~?~....... Address ....:..............Phone No. ~~'J.~.~
15. Is this ro ert located within 300 feet of a tidal wetland? *Yes No
P P Y
' *If yes, Southold Town Trustees Permit may be regwired.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and bloc)C number or description according to deed, and show street names and indicate whether
interior ar corner lot.
Of Copp®r tubing Is used
1. Install new kitchen cabinets and sink for water
dlstrlbuttn
1,2. RelhLace kitchen window With same size window $Y$t8m'pjping Shall g
~'i of types K
ors-
~
3. Install skylight in kitchen (30" x 30")
i i~u~ ~ r-yJ ~ AP R VEb A . ~r"',r,
PLUMBER CERTIFICATION NOTIFY lJ L ING • QEPA EN AT
ON LEAD CONTENT BEFORE 765.1802 8 AM TO 4 PM FUR, THE
CERTIF/GATE OF OCCUPANCY FOLLOWING INSP~cTt', ~ -
1, FOUNDATION~''~~ RE4JAR~D
SOLDER USED /N WATER FOR POURED GONCR "`ra`
SUPPLY SYSTEM CANNOT i. RauoN -FRAMING PU~~IASINfa
3. INSULATION . •v"
EXCEED 2/10 of 1 % LEAD. a. FINAL ~ CbNSTRUCT1pNMUST
BE COMPLETE FOR C.!~:~° fit~'~~~ a~
ALL CONSTRUCTION SN11N.E MEET
THE RE4UIRISA@IT8 Of ''IiIE N
Y
STATE WNSIINICIION ~ ~ItiY
H.tjMBIN(3 pig
~j ~CpN~iEp101~18
- ALL PWMSINt; WASTE
i V104TEt1 LINES NEEd
. TIFSitNG frS~ORE OOVERINt3 UNDERWRITERS CERTIFICATE
STATE~OF NEW YOI~!K;y F, i S•S REQUIRED
COUNTY OF'...:.:'...~`.::.... .
(Name of individual sip • • • • • ~ • • ~ ~ ~ ~ • • • ' ' ' ~ • • being duly sworn, deposes and says that ]te is the applicant
fining contract)
above nvned.
He is the
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have perfonned the said work and to make and file this
application; that all statements contained 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 me this
~......da of 199.
Notary Public, . /?Le ~Y!~:.4.Y.~ • • . • • • • • . County
BELENKDEVOE (Signature of applicant
N Nm~4707878, Su9fulktCounry ~ '
Term Expires March 3~f,18..~
I