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Home My WebLink About16817-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20964 Date AUGUST 24, 1992 'PHIS CERTIFIES that the building. RENOVATION Location of Property 1600 MT. BEULAH AVE. SOUTHOLD~ NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 5t Block 8 Lot 2.9 subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 7¢ 1988 pursuant to which Building PermitNo. 16817-Z dated I~RCH 15{ 1988 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 RENOVATE 2ND FLOOR BATHROOM & BEDROOM AS APPLIED FOR. The certificate is issued to ~ENRY & HOPE TATE (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N-170567 - JANUARY 23~ 1991 JULY 27~ 1992 - H.SMITH PLUMB&HEAT~ INC. Building Inspector Rev. 1/81 FORM NO. ~ TO~N OF $O~TNOI. D BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ...~.~.~.,~,~..-......I..~.~.t.~ ................ ,o ................ County Tax Mop No. 1000 Section ...... .~...~..,I ....... Block ......~.,.~ ........... Lot No....~...~..~. ............. pursuant to application dated ...~.~/~..~...~. ......................... , 10.~)..~.., and approved by the Building Inspector. 'i~' Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink 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 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 I% lead. 5. 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, 3. For existing buildings (prior to April 9, 1957) non-c~nforming uses or buildings and '-'pre-existing" land uses: ' 1: Accurate survey of property showing all property lines, streets, building and 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. '. Fees i. 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 5 years - $10.00 4.Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 zw Construction ........... Old Or Pre-existing Building. .......... ~cation of Property.. ;.b~,%,..O. ....... ~'~'-t-'.~.lr.~.~.. ~.V.g.~.~.~ ~,~d~h.3~-lJeO~,.J~ IIouse No. Street Hamlet · ~wer or Owners of Property ...... . ...... ~ unty Tax ,ap po ~000, Section .... a~..I....~loc~ .... .O..~ ...... ~ot .... '.2..:.? ............ bdivision .......... (, '7' ........................ ............ .................... rmit No '" ........ Date Of Permit ................ Applicant ........................... alth Dept. Approval ...................... .... Underwriters Approval ....................... arming Board Approval .................... ~uest for: Temporary Certificate ........... Final Certicate ........... ~o~¢¥ ................ ¢o~ ' ' ' .... APPLICAN? ........ H. SMITH PLUMBING & HEATING, INC. MAIN ROAD SOUTHOLD, N.Y. 11971 (516) 765-3690 CERTIFICATION Date July 27~ 1992 Building Permit No. 16817Z Owner Henry Tate Plumber: H. Smith Plumbing & Heatin~r Inc. I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this 27th day of July 19 92 Notary Public, Suffolk County I~RNAIDETTE L TAPLIN I~;'OTARY PUBLIC M84.4893 State of New York Residing. in Suffe4k County O~mmissiofl Expires Sept, 30, TL9 Notary Public / INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building In.spec~or Thomas Fisher Building Inspector Gary Fish Building Ittspector Vincent R. Wieezorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 SCOTT L, HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Sourhold, New York 11971 Fax (516) 76%1823 Telephone (516) 765-1800 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD JIJLY 6, 1992 HENRY & HOPE TATE 1600MT BEULAH AVENUE SOIYrItOLD, NY 11971 3rd NOTICg 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) No Underwriters Certificate on file. The check is (outdated/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 ~ 16817-z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. TOTrN OF £OUTtIOLD OFFICF2 OF BUILDING INSPECTOR ILO. BOX I I79 TOWN IIALL $OUTIIOI. D, N.Y. 11971 Harch 13, 1991 TEL. 765-1802 Henry & Hope Tare 1600 Mt. Beulah Ave. Southold, N.Y. 11971 To Whom This May Concern, 2ND NOTICE We are unable co complete your Certificate of Occupancy because.of thc following reasons. /_}//An application for Certificate of Occupancy is /lot on file. (ENCLOSED) /~/5'/'~I° Underwriters Certificate on.file. /~/ [he check it;(~K~/not on file.) $25.00 /'~/ NO 1leal. th Dept. Approval on file. /-~/ No final ins[~ect, ion has "been made. Plea:;e contact ()ur office on this matter. Thank you for your cooperation. lh~ildir;g Perm[k t! I 6 8 I 7 Z Building Dept. *~/_~'/Ho Plumber solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) THIS BUILDING PERMIT HAS EXFIRED, OCCUPANCY OR USE IS UNLAWFUL WITHOUT A CERTIFICATE OF OCCUPANCY. PLEASE CLEAR I/P THIS MATTER IMMEDIATELYi TOWN, OF SOUTFIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLO, N.Y. 11971 Augus~ 14, 1990 TEL. 765~1802 Henry & Hope Tare 16001~k BEULAH AVE. SOUTHOLD, N.Y. 11971 TO Whom This:;May Cogcern, We are unable ~o complete your Certificate of Occupancy because .of the following reasons. /- /~n application for Certificate of Occupancy /is not on file2 '(ENCLOSED) /~//~o Underwritero Certificate on file. /~/ The check is(9~/not on file.) $25.00 /Z/ No llealth Dept. Approval on file. /~/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation~. Building Permit tl I 6 8 I 7 Z Buil~ Dept. ***/-~ NO Plumber Solder Certificate on file. all permits involving plumbing being after April 1,1984 ) FOUNDATION {1st) FOUNDATION (2nd) ROUGH FRAME & INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765.t802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. DATE ~, ~;~ INSPEC~ / 76S-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [~ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL DATE INSPECTOR, 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ 'i ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ~,~AL REMARKS: ~ DATE INSPECTOR THE NEW YORK BOARD OF FIRE UNDERWRITERS J~ 85 JOHN STREET, NEW YORK, NEW YORK 100:38 Date Application No. on file THIS CERTIFIE~ THAT Ba ~ IstFI. ~ grid FL DRYERS FURNACE FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R OTHER APPARATUS: I C E ' O~E~C,~COND A, W O NO OF HI-LEO A W O NO. OF NEUTRALS A W O OF CC COND OF HI-LEG OF NEUTRAI. ' '//0 ] 2 / 0 GENERAL MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFI HOTBE ALTERED IN ANY MANNER. BOARD OF HEALTH ..~,~. 3 SETS OF PLANS .~.. .. FORM NO. I SURVEY . · . ,, TOWN OF SOUTHOLD CHECK ~': '~ ~ -~-' BUILDING DEPARTMENT SF, 2TI¢ FORM ............. TOWN HALL $OUTHOLD, N,Y, 11971 TEL.: 765-1802 MAILCALL;::-~-~'~ Examined·..~od~,~9.,,.'~"7..., 19 .'1.'8. Approved..~0,~.. ~ .~..., 19~.~. Permit No. ·/. k.~.].'}. · . Disapproved a/c ............................. ' ' ' 'f'N ' ................................ (Building Inspector) Date ..... 2/~./. ....... 19 .~. qC> APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 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, ~e 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 Regulations, 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 admit authorized inspectom on premises and in building for necessary inspections.~ ~ (Signature--~' of applicant, or name, if a corporation) · lbg?.. N:'./.. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises... ~..~.-.~..~'.~(....~..'.....~..T'.~.....~. iLlS...~ff....~/.,...'7~.~7~", ................ (as on the tax roi1 or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ALL CON, TRACTOR'S MUST BE. SUFFOLK Builder s License No .... .~.7...~...~... Plumber's License No. Electrician's License No..~..O..~ .~..'T..~. ..... Other Trade's License No ...................... 1. Location of land on which proposed work will be done~ ................................................. · .... ....... House Nmnber Street Hamlet County Tax Map No. 1000 Section .... ~.-~--..7 ...... Block .... ~..~.,..C)?.' .... Lot...~..~..~. ~...~...(.2,.~.... Subdivision .~.1~....~¢]./.[~..].L.. ~..Cf~..X ........ Filed Map No...~.~.~..¢. · . Lot ..... & ........ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... .' .~./. ¢.'? .'~./~ ,~-- .... ~J.~. d.&. ~. ................................ :: b. Intended use and occupancy ...J/.¥f. ~.b./fi. .... '.~..~..~.. ?.'.L~ ................................ 3. c I 1 ang_ emolition .~f~_., ~ i (Descrip~tion) 4. Estimated Cost ....... >.O..O..~. ..................... Fee ....... i ............................. " (to ble paid on filing this application) 5. If dwelling, number of dwelling units ....... /. ....... Number of dwelling units on each floor ................ number of cars ' If garage ......................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each tYpe of use 7. Dimensions of existing structures, ifany: Front .... d.:~.~. .......Rear ...,~..~ ........ Height ............... Number of Stories ...~. ..................... i ............................. Dimensions'of same structure with alterations or additions: Front .......... I ...... Rear .................. Depth ...................... Height ...................... Number Of Stories ...................... .... 8.Dimensions of entire new construction: Front .......... ..... Rear .... : Depth Height ............... Number of Stories .......................... ~ ............................. 9. Size oflot: Front ...................... Rear ..................... i Depth ...2 ................. 10. Date of Purchase .. J~.~/~ O,.I.'J...~..~. / ~ .~ ~. .... Name of Former Owner i..~J~ .~../~7..~.'Y ~'....~.OO. ZJ/:... 11. Zone or use district in which premises are situated ....................... i ............................. 12. Does proposed construction violate any zoning law, ordinance or regulation: .~.~ ............................ 13. Will lot be regraded ... ~,[0 ...................... Will excess fill be remoyed from premises: Yes 14. Name of Owner of premises .1~.~.~};... '.~. ~'t~ .... Address ~2~'..~'. ~./. ?.r./~..~-.C-.. Phone No. Name of Architect ............ ~ .............. Address ........ J Phone NO ................ Nmne of Contractor [4~$~(.].[..g~l;'.~.~r.~j.o.~. .... Address/~.-I'.t. :/.~.~?.' .~tl .~t~)~ i Phone N~.~.IP).7.~.'.~..~[. 15. Is this property located within 300 feet of a tidal wetland? ~¥es ..... No";..v~.... *If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRA~ Locate clearly and distinctly all buildings, whether existing or proposed, and~ {ndicate all set-back dimensions from property l/nes. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................. ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. ~. He is the ....................... !.' ....... i ......... ............................. ............... · .... (Contractor, agent, corporate office~. of said owner or owners, and is duly authorized to perform or have performed 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 mb this ~ Notary Public,..~q~..~'....?;..~/.'..~.' i ...... County HELEN IL DE VOE NOTARY PUBLIC, State of New York ' ' ' · · · ~ No, 4707878, Suffolk County/70