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Home My WebLink About16822-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17436 Date OCTOBER 20, 1988 THIS CERTIFIES that the buildin~ Location of Property 850 House No. County Tax Map No. 1000 Section Subdivision RENOVATION BLUE MARLIN DRIVE 57 Block Filed Map No. SOUTHOLD Street Hamlet Lot 30 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 10~ 1988 pursuant to which Building Permit No. i6822Z dated MA/{CH 16, 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 EXISTING KITCHEN TO ONE FAMILY DWELLING. The certificate is issued to MICHAEL MESBAH (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROV~L UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 9/16/88 Rev. 1/81 N038803 JOHN E. WALTERS PLUMBING & HEATING Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NE 16822 Z Permission is hereby granted to: ...... ..~...A..o...~ .............................................. .~.~.~....~.,,v~,...~....%.?../..~..~... at premises located at ..~:~,.~..O.......~.......~...~(~¥J,,~f~.../...~..(.~.;""~ '~" '-" ' ' '"~ ........ ~ .............. County Tax Map No. 1000 Section .... .C~..~..~. ........ Block ...... ,,~..,~ ........ Lot No ...... .~.0. ........... pursuant to application dated ..... ,..~.,CL~..e~I.-...,/....~. ................. , 19..~..~., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted -. ~ to the Building Inspec- tor with 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 featu res. 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, a certificate 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 p~operty showing all property lines, streets, buildings and unusual natural or topographic featu res. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspect'ion of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25 . 00 ALTERATION $25.00 1. Certificate of occupancy New Dwellin, g $25.00, Accessory ,$10.00 Business $50,00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5 00, over 5 years $10 lO01 4.Vacant Land C.O. $ 20.00 ' ~']_ / ~.~ 5.Updated C.O. $ 50.00 //Date .... ~.'t.~./...~'. NewConst,ruction OdorPreexstngBu dng .V'/ Vaca~tL~nd~ ~ '''' '' . ....... Location of Property ~'5-~ bJ~ .-... House No. Street Hamlet Owner or Owners of Property ..... /~ $ ~. I.~A~ .L~... J~.~'.S~L~ .............................. .. County Tax Map No. 1000 Section .... 0..~.' ~. ...... Block ..... 0..j ........ Lot.. Subdivision ................................. Filed Map No ........... Lot No ........... PermitNo. '.~f,.~.... Date of Permit .~../'.~/~.~..Applicant ~J"~'~' C~ ~)~)~ Health Dept. Approval ........................ Labor Dept. Approval ..................... Underwriters Approval ........................ Planning Board Approval .................. Request for Temporary Certificate ..................... Final Certificate . ' .~ ........ Construction on above described building and permit meets all applj.cab[e codes ~and regulations. ........ "' ...... TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 BLDG. DEPT. l..~ TO. W~N~?~F S, OUTNOL,~D ....... CERTIFICATION Building Permit No. Owner ~ (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this day of ~/~/~ ) , 19 ~. Notary Public, ~~ County (plumber' s signature) Notary Public UNDA J. C00~1~ ~ / Nota~ Pul)lie, b'tate of New TOWN OF 80UTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 ?. o. 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. o Underwriters Certificate on file. he check is(outdated/not on file.~.O~ /Z/ No Health Dept. Approval on file. /Z/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. ~ Building Permit # L ~._~ ._~ ~ Z Z Building Dept. ~~ ***/Z/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME~'/ .PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL JOHN 12. BORN BUILDER FR^MING-DECKS INTERIOR FINISHING MODIFICATIONS RENOVATIONS 510~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ;ZND [ ] INSULATION FRAMING [~FINAL REMARKS: DATE · 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ~/FINAL DATE. / / INSPECTOR, ~ ?~/d~/ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION :)ND [ ] INSULATION FRAMING [~/~INAL REMARKS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [J/FOUNDATION ZND [ ] INsuLATION / ~ FRAMING [ ] FINAL REMARKS:~ THE~ IJ~W YORK BOARD OF FIRE UNDERWRITERS BUItffAU OF BLECYRIcrrY ~l~ CE~FIE~ ~AT ~SBAH. 6bug M~,~N DR~. /POL~ ~, SOUTHOI,~. N.Y. ~ examln~ ~ ~d~nd to ~ iff ~m~iaflce with the ~ui~menlx of t~ ~. IqJtl~A(~ MOT(W~ m SAG~: & I,AD~a~.RN h[Ct,iNS~; NO. 363.6 ~ P#r~__., _,.. l--.,l.' . ...il ,g.:.~/. BOARD OF HEALTH ...... 3 SETS OF PLANS ....... FORM NO. 1 SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT §EPTIC FORM ............. TOWN HALL NOTIFY $OUTHOLD, N.Y. 11971 TEL.: 765-1802 CALL ................ MA L Examined., .ry. ~ qt&¢,~., . .~.....c~.~. ! .~.., 19~..~, Permit No. [ .le~.~.~'..~-.. Approved Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by Wpewriter 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. 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 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 in building for necessary inspections. 3.~?.~ /~ ~; admit authorized inspectors on premises and ~ ' c , · .4.o.w..c... ?., ............ (Signature of applicant, or name, if a corporation) ..... e,.o !!V. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of promises ...... .~..I.C. IJ~..~. , , ./~..~. f. 8.4.~' ............................................. (as on the tax roll or latest deed) If applicant/IAr~s'~, corporation~I~nature ~duly authorized officer. ......... .......... (~ame and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No ...... I.O.,) ?..~.~../{'.~. ....... Plumber's License No.. ??.m.~. ?.: [~.c..T~..5 ........ Electrician's License No.. ~.~..m....ff..~.~.(. ~...JV.~l.g.c-..L,~bk-mgRm/ Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. House Nmnber Street Hamlet County Tax Map No. I000 Section 'S~' 7 Block . ] Lot. --~ ~ Subdivision ..................................... 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 b. Intended use and occupancy ........ O.~..~. ................................................ Nature of work (check which apPlicable): New Building .... ' . Addition .... Repair .............. RemoVal .............. Demolition ............. ..... Alteration ....~...... Other Work ............... ~ ~ j,&~ (Descrip~tion) 4. Estimated Cost ..... '/: ....... ~ ........................ Fee, ............................ - ......... I (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 stmcture~, if any: Front .............. Rear .............. 'l~e;t'h' '.i iiiii iiiii. Height ............... Number of Stories ........................................................ Dimensions'of same structure with alterations or additions: Front Rear Depth ' Height Number of Stories Dimensions of entire new constrUction: Front .......... ..... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ ~ pth 9. Size of lot: Front ........... ~ .......... Rear ...................... De ...................... 10. Date of Purchase ........... i ................. Name of Former Owner ............................. 1 1. Zone or use district in which pre~nises are situated ..................................................... 12, Does proposed construction violate any zoning law, ordinance or regulation: ...... .~?. ....................... 13. Will lot be regraded ......... , .................. Will excess fill be removed from premmes: Yes No 14. Name of Owner of premises . l~l.~,c.~.,0;.~..tr..~.efi..8.~tq:... Address ................... Phone No .............. Name of Architect ....~ .... ~, .. Nmne of Contractor .~J9 .~. ~0/~q i.~hii~'_~k:' Address ................... Phone No ................ ............ Address ~.p; ./~?~.4°?..~. ~fl.~.ofl.. Phone No. ~,i/.5. 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southoid Town Trustees Permit maybe required. PLOT DIAGRA~ Locate clearly and distinctly all buildings, whether existing or proposed, and~indicate all set-back dimensions from interiorPr°pertYorlineS'cornerGiVelot.Street and block ~umber~ or description according to deed, and show street names and indicate whether STATE OF NEW YORK, . COUN]'Y OF....~.~..:~.~]~.... ~'~ ...... ~ O .~ .N.'~"~-.. i ..~.. O. c. ~ ....... being duly sworn, deposes and says that he is the applicant (Name of individual signifi contract) above named. He is the ...................... .~.~.~"~ ~'...~.... ................................................... .( ~-~(5on. tsact~: agent, corporate officer, etc.) of said owner or owners, and is duP, auTlmvi~d--t~perform or have performed the said work and to make and file tiffs applical:ion; that all statements cont~ ihed 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 Notary Public ............... ~., // LIZABETH ~ Notary Public, $ No. 52-812585( Term Expires Oc NEVILLE e of New York , ruffolk Cou(~/ !bet 31, 19 (2 ~ County ~ (Signature of applicant)