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Home My WebLink About18304-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19245 Date JULY 26, 1990 THIS CERTIFIES that the building ADDITION Location of Property_ 4710 OLD NORTH ROAD SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 55 Block 2 Lot 8.4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3ULY 10, 1989 pursuant to which Building Permit No. 18304-Z dated JULY 12, 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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR• The certificate is issued to GARY A. & NANCY A. LILLIS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N-122070 - APRIL 6, 1990 PLUMBERS CERTIFICATION DATED JUNE 10, 1990-PECONEC PLUMBING & HEATING Bu' ding Inspector Rev. 1/81 FOBM NO. TOWN OF SOUTHOLD 6UILDING DEPARTMLNT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°- 18 3 ~ 4 Z Date ~2.- 19..1.. Permission is hereby granted to: ta ...1........~.~~~r~~-,~......a~~~.~-~.~~........-~..~al~:~~n~ ~ ~~tt,,~~ at premises located at ....l....7~0......~.~ ...............................................~Y•• County Tox Map No. 1000 Section ..........J.~..`~. Block Lot Na.........~f...7`:... pursuant to application doted .......~~.~.Q 19...~,,~.., and approved by the Building Inspector. D d Fee $...l.:l..li' ji~~" ~Buiidi 1 for Rev. 6I30I80 . TOLJN OP SOUTIIOLp ~`V ~ \`q~I BUILDING DEPART;SEtiT~ p ~b~~ TONN HALL \y~\1,m7, SOUTIIOLD, NEN YOKK 1 (97 ( ~ ~ ~ ~ N 765 - 1802 TOWN OF SOUTHpi_i~ APPLICATION FOR CERTIFICATE OF OCCIIPANCY n .,1 DATE- . . NEN CONSTRUCTION ,.,,OLD OR PRE-E%ISTING BUILDING......VACANT LAND.... /~~Drn/tl.uJ . . Location of Property. ~~fC~_.(~LZ~. 11/D27fi~./~o..S~~_._:-~2(:?~P~v HOUSE NO. - STREET - - / RAREFY - Owner or Owners of Property...~~''~'j /U~''r/~L9 G County Tax Hap No. 1000 Section SS Block ~ " Lot~....._... Subdivision Filed Map _.......LoC...__.. 4 ~ ' Pcrnit Ho. ~~..Date of Permit Applicant pp Health Dept. Approval Underwriters ApprovalLr~/~Q~1'? ~S PlanninE Board Approval Request for Temporary Certificate Final Certificate _ Pee Submitted: ~JC..q~ Q . t° APPLICANT. .?mss e ~~v• 10/14/88 ~,.svc, 0 ( ~ ~o~I~~~F.S _ FORM NO. 6 TORN OF SOUTIIOLD . r nom! ~ ~wr.j BUILDING DEPARTMENT ~g r .r TOWN ML ,,~'j .I~+L 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS A. This application must be filed in typewriter OR ink and submitted to the Building Inspector with the following; for new buildings or new use: I. Final survey of property with accurate location of all buildings, property tines, streets, and unusual 'natural or topographic features. 2. Final approval of IIealth Dept. of water supply and sewerage-disposal~S-9 form). 3. Approval of electricall installation from Boaid of Fire Underwriters. 4. Sworn statement from~'plumber certifying that solder used in system contains less thaw 2/10 of IZ lead. _ _ 5. Commercial buildings; industrial buildings, multiple residences and similar. . buildings and installations, a certificate of code compliance from Che Architect or Engineer responsible for the building. 6. Submit Planning $oard 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, buildings and a unusual natural or topographic features. 2. A properly completed', application, a consent to inspect signed by the applicant and a certified abstract of title issued by a title company which shall ~ show single and separate ownership of the entire lot prior to April 9, 1957. ,If a Certificate of Occupancy is denied, the Building Inspector shall state the , reasons therefor in writing to the applicant, 3. Date of any housing code or safety inspection of buildings or premises, or ocher pertinent information required to prepare a certificate, C. For Vacant Land Certificate of Occupancy: 1. An application for vacant land Certificate of Occupancy shall be submitted, and a certified abstract of title issued by a title company showing single and separate ownership of the entire lot prior to April 9, 1957 shall also accompany the application. If'a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. D., FEES: II 1. CERTIPIC.ATE OF OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00, Altcrati.on to Dwelling $25.00, Swimming Pool, $25.OO.,Accessory building $25.00 Addition to Accessory buildings, $25.00 - Businesses $50.00. 2. Certificate of Occupancy on pre-existing dwelling - $100.00. 3. Copy of Certificate of Occupancy - $5.00 - aver 5 years - $10.00 4. Vacant Land Certificate of Occupancy - $20.00 S. IIpdated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy -$15.00 Residential Commercial ev, 10/14/S8 TEL. 7GS-1802 ` S~FF~L,`~~, TO'~N OF SO~JTF~ObD ~ ~ 's . Ol< OFFICE OF BUILDING INSPECTOR , ~ a T, P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 ~ t+ a~ M=~ ,z - a a'( zai~ , C E R T I F I CAT I O N 1{\\ p ~U~ ~ ~ a ~..~.TOVdN C~?F ~C~U7t OL€3 ,a. , J, - - ~ Ua~e - - ~ Building Permit No. Z owner~ii//~.yCt~ .~.LLi;~ lease pri t) JJ I,r~. Plumber %CG'> >C_ ~ ~J/ Q~~IR/ sl~~ y (please rant) I certify that the solder used in the water supply system contains less than 2/10 of to lead. ( m er's sin turel Sworn to before me this ___(~__day of ~ , 19~, Notary PuNbota~~~~OWSKi Notary Public, G C n ~ ~'~"~~~•St~eotlu~yy~ ~mCuapfled i~ k lfiloll a ,m . r T t'AFt 5 THE N!W YORK OF ~ tJ1TEM 1195112 EUS)(iJ1/.1 OF ELEGTINGtf'1i BS JOHN STIlE N8W VORRt. N~'W YORIQ 1SI6fSB ANRII. g6,199U ApplicotionNo.onftk G675HAfS9Jfl9' N 11'lU7O TNti Cd~i !T(FfEf TH11T ' ~'sAy ~Iat:teMesi agalpasentadsectl6ed 6alats and inttodaced 6Y tAa apptloatst atawwdaw:tAvr a6ese ap}ifa~eMn number tntMpretnisa of GARY 1.14.L15, 6710 OLU NORTH RI)., U. C,0-&~, SOUiligt.U, N.Y. ineMfdfom7ritf location; ? Basement ~ let Fl. ? Ynd FI. UU7 9aet9en. Mock Lot toes en MA R f, tl q 8 , 199q and found to 6e in compliance udth the reyakeapntA uJ tAG Board. OW~tI !Celt tYt1iQIK ' BILKS T F q arXtK 'MAT. C W. nes. IL'M.. AAa. C1f[. IIMr. K: W: AMT. M. r. e v 9 1 9 i 1 ot,+~s ItIIIIICI AW(OK ilrtull , p AMr. K. w. at x. r. C.et a. r. AMr. ra. A w. a ,wr Ater. AiotY. ~ - : x. a . IRIT AMr. wAm 1 3q 1 r,uq IMMQ OISCOfM~CT tMtOmOle S E R V 1 C AMT. AMr.mt IOUI. tlxw t.r tw owow ow wv ra.a tx. A. w. waM wxta~w. rw.wuetnws oi, u~iut OAMt:YNiRA71K: - LIINING F'qR NkF) AOOli1ON ONLY-1 G.r.c.r:-t s iB- .t~o~ SARK: 8 t.AUt:MANN 1Nt;. I..IC.0563SWC t'. 0, BO7( 1 76fi ;i0f1iti0l,U, NY, 11911 M~L~IARNAOlR X11 ~ - s ,tell tat u Ktatne~:_Tap~rn ~.t>~1.~_~1lM~Ml~:.~ ~ + ~hx,.+~k':::s ~ CCItY !'OR NNLDpiG 'hlKi Nf' R 1cLD I~:S: c~.lUii ~IUhi ~ ~GMMLNT° -v 1T ~ Q e ~ ~ H 'OUt]DATION ( t) ' c 'OUNDATIOi1 ( 2uYd ) ~ L`I > 6 ~ ^ ~ TOUGH FRAME & QOM PLUMBING 9 ~ r~' o 3. ~ rn INSULATIOPI PER N. Y. y STATE ENERGY ~a COpE x a FIiJAL ADDITIOPlAL COMMENTS: s~ m x ro~ H a o m a~ r H . - ~ d -v H 765-1802 BUILDING DEPT. INS~PECTtON ( ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION FRAMING [ ]FINAL REMARKS: ~f~ ( / DATE INSPECT 765-1802 T BUILDING DEPT. INSPECTION UNDATION 1ST ( ] ROUGH PLBG. [ FOUNDATION 2ND [ ]INSULATION [ 7 FRAMING [ ]FINAL REMARKS:. 7~Z~~~~~ ~~O p ~ < DATE / INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ~ ROUGH PLBG. [ ]FOUNDATION 2ND [ SULATION [ l FRAMING [ ]FINAL/7 REMARKS: t ~ DATE ~ ° INSPECTO S~Ff O(K~4~ TEL. 7G5-1802 ~~0 OG~; TOWN OI' SOUTIIOLD ~ OPFiCL' OP BUILDING INSPECTOR rn P.O. BOY 728 ~ ~ TOiVN HALL °y/ol ~ ~~o~- SOUTfIOLD, N.Y. 11971 3~+~~~4c a~ ~ Tm~ThisLMay Concern, We are unable to complete your Certificate o~f Oc'c'upancy because of the following reasons. /Ie-'/" 11n at~plication for Certificate of Occupancy ,i:; not on Lilc. /I_/~ _NO Underwriters Certificate on file. /f~'/y JThc check is'(outdated/not on films. pYz;~ No ttcalth Dept. Approval on file. Nu final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Bui]di.ng Permit Ik. ~ ~ ~ (~l/ Z I3u.ilding Dept. ~+F--- No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) 4 BOARD OF HEALTH , FORM1t NO. 1 ~ SETS OF PL.1NS • • • • SURVEY TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM • • • • • • ~ ~ T06VNHALL • ~OUTHOLD, N. Y. 11977 NOTIFY Q TEL.:705~7302 CALL Examined ~2,//„q? 19 c DfA I L T0: . • . • • • • • • . .\pprovcd..~l,,,,,,,., 1~PermitNo.~a~~~~ Disapproved a/c D (7~..rq~•(~~~-(' U lJ t~ 1 ~~(Bwl ; I Spector) ~ 70WN Of SOUTH Loa ~ APPLICATIO FOR BUILDING PERMIT • Date /°!„gs:/,. IS • INSTRUCTIONS a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, u•. 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 st: ar areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this a :anon. 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 pe; 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 Certiftcate of Occupy shall have been granted by the Building Inspector. APPLICATION IS HEREBY hfADE to the Buildin; Department for the issuance of a Building Permit pu^uant to 3uilding Zoh~ Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, O:d:nyzce Re^_ulations. for the construction of buildings, additions or alterations, or for removal or demolition. as herein desc :c Tite applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regularors, anc edmit authorized inspectors on premises and in building for necessary ins . ~p^ections. ' • ~ ~(S • \ ~ture~ot a~ lit, or~m~•a corpo:auonj P • _ • • • . (1`failing address of applicant) ~ ~ ~ • • • ~ • State whether applicant is~~otvc~ner, lessee, agent, architect, engineer, general contractor, electrician, plumL•er or build • . J~aw~~~ .../Q to ni ~ . \ameofon•nerofpremises ...m(~;~:~ns;,,~s,Qez~„r! °L~ 5 r, , (as on the tax roll or latest deed) ~ ~ ~ ~ ~ " If applicant is a corporation, signature of duly authorized officer. • (Name and title of corporate officer) Builder's Liccnsc No.... ~;1 `j../F Z , , • • . , • . • Plum bcr's License No. . Electrician's Liccnsc No. , , , , , , , OtlterTradc'sLiccnscNo, ' Locatinyoln/"7oC land on which/'pro,,pDose/d~~wor1k'will be donne. , , , , , , Flousc Number ~ ........~°i•~`°~"` Strcct. Haut1M County Tax Dlap No. 1000 Section .....:Q.~.S......: Block , ,-~i; Lot.... ':$C'-.'~.,• Subdivision F.ileJ lfap No. . (N:uttc) Lot State outing use and occupancy of premises and intended use and occupancy of proposed construction; a. Existing use and occupancy o c b. Intended use and occupancy ..........J.~91?t.fr........ ~ ....t. r . 3. I~'ature of work (check which applicable): New Repair Uuilding ' Removal . Addition ,Vtcrauon 4. _ Demolition Other 1S' , , • • , EstimatedCosf,fS ~f~ ~~dY_.••••.'••. ork. • Fcc. 5• IC dn•clling, number of dwelling units . • ' •ito be paid ~qn Alin^•Ihis ~ ~ ~ • ~ ~ • • Jf oara.c, number of cars ~ ~ " • • Number of dwelling units on each (loot. , a ~licatlo 6. If business, commcrclal or mixed occupanc • ~ • • " " 7. Dimcnsions~t~ xisun^ sPccil'y nature and ux tent of cacti t• • , . • • • ~ ~ ~ , • • , • • ' • • Hcicltt 1 = siructures, if any: Front ,65' YPc of use . • • Dimrn~ionas"'(`5 e.•..:•1~ . • Number of Stories ' ' ' ' ' • •Rcar , , , , Depth ?rs, • ~ DuP'th ~ 'o' a~r s~tveture with alterations • • • . • • • • • . • ' ~ • . Ilcight , , S r additions. Front • G,,S,I, ' 8. Dimensions of cots( coq cons ~ ~ • ~ ~ • • • • • • ' Rcar ' " ~ • ~~yy~~jj~~ f>ft, traction: Front q • • • Numbc o Stories , : ;~;L!?.,Q,.; 9. Sii'p ` .tl,t•'•NurnbcrofStorics, Rcar.,,~~,~,,,,,,,Dcpth".~~,•..•. 10. Date of Parch ~ut..1J'~i(2! . Rcar : 3 6 1 I. Zone or use distr(c~ im~r • • • • , • • Dc th ...42~! ~ . ~hidl • • • • Namc of Former Owner Q 12. Does proposed constructs' n vpremises arc situated , • • 13. 1ti'ill lot be rec a iolatc any zoning law, ordinance or regulation:. • ~ • • ~ • ~ ~ ~ • • • • • - 14. N _ radcd a/iW s. _ /t,/,o . ame of Owner of prcmisFS b • • • • «'i11 excess fill be rem v ~ • ~ • • " Name of Architect ~yy •~t /~l°s• Q d from premises: Ycs • • NamC of C s"'?~v~o,6 .C~~~'1?t9-. •Cl~o. • .Address C1 /q~ !Uo¢Ylj ,GCc~. , , ,Phone No.7.bs'3s-69 r ontractor . tT'£plSy,c,..,%1Qe4 . • Address YoutU~~°°((S, RY4, .Phone No. . \ 15*If this propertq Zocated Witt[in•~~•'AddressT??';•yS,~cLgl~.•••_• X00 feet of a tidal wetlandonc*No.~6S~3y6.y:: qes, Southold Toc/n Trustees Permit may be required. YES'•••170 Locate clearly and disti,7ctly all building PLOT DIACRAbf p P and. indicat„ all sct•bacl: di.^;-r:sions property Gnes. Give street and block number or dcscript on scco ding to d ed,Iand show street names and ' interior or comer lat. utd:ca[c wn: p~~ ~v.9J>r'1~ ~o~, 7 ~ ~1 fi ~ ~ ~ ~r ~ ~ { . ~ /!'~tt'3o~ { kD A. t xi NN OU\T1'OF~,.Y•ORK: S.S • • • • •(~'~rr!? Oflfldl':ldual SI^~nlllg contract) • • • • ~ ~ • • bcsllg duly sworn, deposes and >ove named. says that }te is the applica= :isthc . said owner • • . • .(Contractor, agent, corporate officer, ctc.)• ~ • • ~ • ~ ~ iheation; thatrall[st tclncnts Icon4aincdt!!n rthu appl canon arc tlnlc tool crbest f hisakno ~lcdgc and belief. • • • • • - rk wdl be pcriomled sn the mannj;r set forth sn the application Glcd thcrcwittL mal:o and Tile th= orrt to baiorc me this ,and that th aryPubli:, / ~.JI; G(l~l (fd~•........ .19~ ~~tt ~pp~~ ~l, • • County ^ ~ Q ~ , N01MtM Ptt9~C, sate o~°f ~tde,,N Yak ~ ' TirmE~ICpI~~rj~rSch~30kI~ ~ 1 (Si.natureofapplicant~ I i