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Home My WebLink About23586-zFOB/~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF O~CUPANCY No Z24555 Date August 6, 1996 THIS CERTIFIES that the building accessor~ Location of Propert~ 3600 South Harbor Road, Southold House No. Street Hamlet County Tax Map NO. 1000 Section 75 Block 8 Lot 3.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated June 28, 1996 pursuant to which Building Permit NO. 23586Z dated Jul~ 16, 1996 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 a hot water heater in an existing one famil~ dwelling as applied for. The certificate is issued to Robel:~c and Imogene Thompson (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 12083 PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A dated June 19, 1996 · 1996 Building Inspe~or FORM NO. o TOWN OF SOU'U3.1OLD 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.° 23586 Z County Tox Map No. 1000 Section ...................~..~ Block .......... .~.... ..... Lot No. ........................ 2. / pursuant to application dated ............ ...~..~.....ZT...~... ........... , 19...~...~--~ o.d approved by the Building Inspector. Fee $..Z~.~..~ Rev. 6/30/80 [;orln No. 6 '['OWN OF SOUTIIOLD ~,.~ ~.~=; ...... ;~,~..,.~:: 765-1802 ~ , APPLICA't'ION FOR CERTLFICATI,; OF OCCUPANCY [ .~QWNO~$oufHo~ ': This aPPlicatiou must be filled in by typewriter OR ink and submitted to the boilding inspector with the following: ~or uew boildieg or new use: 1. Final survey of property with accurate location of all beildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Hehlth Dept. of water supply aud sewerage-disposal(S-9 form). 3. Approval of electric~[ installation from Board of Fire U derwriters. 4. S~4orn statement from 'plumber certifying that the solder used in system contairs less than 2/10 of 1% lead. 5. Co,unercial building, industrial huildieg, multiple residences and similar buildings and installations,~%a certificate of Code Compliance from architect or e~gineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-cooforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property sho~ing all property lines, streets, building and nnusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant~ If a Certificate of Occupaucy is denied, the Building Lnspector shall state the reasoes therefor in writing to the applicant. Fees l. Certificate of Occupancy - New dwelliug $25.00, Additions to dwelling $25.00,-- Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory buildieg $25.00. Busiuesses $50.00. 2. Certificate of Occupancy on Pre-existinR Buildine - $[00.00 3. Copy of Certificate of Occupaucy - $20.00 4. UDdated Certificate of Occupancy - $50.O0 5. Temporary Certificate of Occupancy - Residential $15.00., Commercial $15.OO New Construction ........... Old uildinE ................. Location of prope ty.. b.O.Q ..... llouse No. Street llamlet O.~¢er or Owners L,f Proper y ....................... County Tax Hap No ~000, Section .............. Block ............. Lot ..... ' ............... Subdivision ................................... F~I d . . e ~¢ap ............ Lot ...................... Permit ~o ................ Date Of Permit. [ i ~.~ .......... -:¢.q ........ .............. I{ealth Del)t. Approval .......................... UnderwriEers Approval ........... Plan']inE Board Approval ........................ -(equest for: Temporary Certificate ........... Final Certica~e ........... ",. ................ Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD CERTIFICATION DATE Building Permit No. Owner: ~O~i~W{ ~/QO~ (please print) Plumber: (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers S~gnluure) Sworn to before me this Notary Public, County ~, ?~ ........ ~, .~..,.~. ~ VI'I'O E, FRACCALVIERI ;J NOillY Public, State of New York ~ ~ /, ~, NO. $2 4652699 -~ OIL BURNER Certificate of Inspection Name Robert Thompson APPel2083 Location: 3600 South Harbor Road, Southold, NY Applicant: Reliance Fuel Oil Assoc. Inc. Address: 77 South Street, Patchoc3ue, NY 11772 Tel. No. 475-4770 Ua Nb 2901-RE Expir~: ELECTRICAL INSPECTION SERVICE, INC. 375 UUNTON AVENUE ~/~'hhhl EAST ?ATCHOGUE, NEW YORK 11772 .,-7 TEL: ($16) 286-66 ..... ~.~.2~?.~ ........................................... 76S-1802 BUILDING DEPT. INSPECTION FOUNDATION I ST [ ] ROUG~PLBG. [[ ]] :ORAUMNiDNA~ION 2ND [[,~1NAIN'~LLATION FIREPLACE & CHIMNEY F I ELI) I HSPECT 1 ON REPORT DATE COMHENT$ ..... ~===~>~ ...................... ~T ..... '~ ................................................. FOUNDATION (JRT) II FOUNDATION (2ND) II PLUMBING II/ INSUI.ATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAl. COMHENTS: xamined . ! pproved .~. Disappr~ved'~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTNOLD, N.Y. 11971 TEL.: 765-1802 INSTRUCTIONS BOARD OF HEALTII ....... ' 3 SETS OF PLANS ....... SURVEY ................. CIIECK t:OTl PY HAIL a. Tiffs apl~lication must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with ets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan sliowing location of lot and of buildings on premises, relationship to adjoining premises or public st?ce' r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appl ation. · 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 i~sued a Building Permit to the applicant. Such penni lall 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 Occupanc iall have been granted by the Building Inspector. r~I~'ATi~,i~,;{~,,.H.~EREBY MADE to the Building Department for the issuance of a Building Permit pursuant to th. uilding Zone o~&(~ifdg of thc Town of Southold, Suffolk County, New York, and other appticable Laws, Ordinances o egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described he applicant agrees to comply with all applicable laws, ordinances, building, code, housing code, and regula,tions, and lmit authorized inspectors on premises and in building for necessa~..W inspections. , (Sig4ature of applicant, or name, if a.corporation) - (Mailing address of applicanf) :ate whether applicant is owner, lessee, ~agent, architect, engineer, general contractor, electrician, plumber or builder. ......... .~..~..~..~ .c.~. ? ...... · · . "~' . ' (as o~the tax roll or latest deed) ' ' ayp~can,~ ~ a':~rp~,~n, s,gnature of duly ant mrized officer. ~uilder's License ~o .......................... ElectridaWs Lice,sC ~o .......... Other Trade's License No ...................... Location ofia.d on which proposed work will b~ '~o.~ .................................................. lIouse Number Street Hamlet Couhty Tax Map No. 1000 Section ~ Block ~ ~ { ............................... Lot.. : ............... Subdivision ........ . ............................ '. Filed Map No. (Name) .............. Lot ............... Stat~ existing use and occupancy of premises and intended Use and occupancy of proposed construction: a. Existing use and occupancy I ~ ~ ~/-~ i - I b, lntended use and occupancy ............. ~g. ~ ~ l~~-~a,~ k ( ' hflppl * ' .3. Natpre ofwor check whzc mable): New Building .......... Addition .......... Alterati6r ....... Repair .............. Re,royal .............. Demo ition .... : ...... Other Work i,q~ ?<~ c~;}~ o_~_0 (Description) 4 Estimated Cost ' ~ .(.~. 5. If dwelling, number of dwellin!g u fits .... ' ........ ' .(to be paid on filing this application) If garage, number of cars . Number of dwelhng umts on eec ~ floor . 6. If bus~ness, commercial or mixled occu.-,,,~,~, ~,~,.,- ~,~ 2,:,' ......................................... . , ~--.,,-:,, ,~,w.,., ,,uture eno extent of.each type of use ................. 7. Dimensions of existing sin c~res if a--. r*,,,, - 'gl ~ ' "~' ........ i ........... Rear .... ........... Depth Hm ~t ............... Nutnbei' of Stories .. . ............. f h witl It liti ;s ~ ..................................... Dimensions o s me structure I aerations or edt el · rent ' Depth.. ~ ...... ] H igl ' ' ' ................ R .............. e it · ear ............... 8 Di i ................. ~. ,. · Number of Stories ......... mensions of entire new cons ruction: Front ............ Rear ....... De I .. ttig! N mb fSt "' · ....... pti e ~t . .. ............ u ere eries ............... . ...... 9 Si F ' . .............. · zeoflot, font ......... .'I ............ Rear .......... ..'l~;it~ ii:i:ii .............. 10. Date of Purchase ......... i ........ ' ......... ........... ' ........ . Name of Former Owner .... 11. Zone or use district in which premises are situated .... ' .......................... 12. Does proposed construction vic? ................................ 13. Will 0t be reeraded late any zoning law, ordinance or regulation: ..... ' .............. .... . ,'~,- :-44: .......... W~ I excess fill be removed fro ~ re ' 14. l'~mneo~uwnerofprenuses 777 .~.r~ ~rtov'~r'~o'v,,,.~ ,',, ....... ,3~ p mines: Yes N Name of Architect ... , ......... ~-~ ·. ,~uuress m4. ,.izr:t..h9.'.'.'3..q°.%~9°.~Phone No. 7.6'~. 77~9.B..C2. . ~ ."-~.. ] ..... , .................. Address ................... Phone No. i ..... " ...... Name of Contracto I'~q .~.. i~.%e-J .O.i.L ~.~.S'..~.,... Address ....................... ne No... ~20 ' 5. I.s this property within 300 feet of a tidal wetland? *Yes ........ Re ...... ' ......... · If yes, Southold ~own Trustees Permit may be required. ''' i PLOT DIAGRAM Locate clearly and distinctly alli buildings, Whetlmr existing or proposed, end, indicate all set-back dimensions from Iroperty lines. Give street and block Inumber or description according to deed, and show street names and indicate whethe; nterior or corner lot. pLUMBER CERTIFICATIOIV ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY . I SOLDER USED IN WATER SUPPLY SYSTEM CANNOT EXCEED 2/10 of 1% LEAO. PLUMBING ALL PLUMBING WASTE & WATER LINES NEED TESTING BEFORE COVERING ' ~TE OF NEW YORK. . UNTY OF . ~ V,.4~...~.~ .... S4 ...... ,:~ .'v~,..: e~..~.-e.. (Name of individual signin ye named. UNDERWRITERS CERTIFICATE REQUIRED If copper tubing is used for' water distributino systerrt; piping shall be of types FOLLoWiNG INSPECTIONs: THE I. FOUNDATION . ~0 REQUIRED FOR POURED CONCRETE 2. ROUGH. F ~ ' CONSTRU~o , BE COMPL~EF NMUST )g,a, .~.~.O... ......... being duly sworn, deposes m~d says that he is the applicant contract) . (Contractor agent corporate officer ) ' aid owner or owners, and is duly attthorized to perform or have performed the said work and to make and file this ication; that all statements contained ~n this application are true to tile best of his knowledge and belief; and that the ~ will be performed in the manner sell forth in the application filed therewith. m to before me this ! ,',:~m .o;~ ~?lOSuffok, c b.~, A % ' ' ~o,~,~aLurc ol appncaHt)