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Home My WebLink About16869-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19523 Date NOVEMBER 20, 1990 THIS CERTIFIES that the building. Location of Property 3745 MILL LANE House No. County Tax Map No. 1000 Section 67 Subdivision ALTERATION Street Block 2 Filed Map No. PECONICr ~EWYORK Hamlet Lot i0 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 29, 1988 pursuant to which Building Permit No. i6869-Z dated MARCH 31, 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 ALTERATION TO EXISTING OWE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT BERNARD (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO_ 1686? z Perm~sston ,s hereby granted to: ( x i ..J.;..'~...~..~~....~....... ~~...~.;¥., .;.:.: ?.~ 1. .... ~ , ....... ......................... premises Iocoted ot ...,,~..~.~.. ......... .~..~ ..C~.~, ..~...~...q~.. ................. co~,ty To× Mop No ~000 Se~*,o, ..... .~..'l.. ~o~k ...... ..~.~ ..... tot No .L.O.. ...... pursuant to opphcot~on dated Budding Inspector. Fee $..':e~....: .....'~.. · ..... ...... 19.~ ~, ond approved by the Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY NOV I 91990 ,OF sOOTHO?~- This application must be filled in by typewriter OK ink and submitted to the buzlding znspector with the following: for new buxlding or new use: 1. Final survey of property with accurate locatzon of all buildzngs, property lznes, streets, and unusual natural or topographic features. 2. Fznal Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwrzters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5, Commercial buzlding, industrial buitdmng, multiple residences and simmlar bumldings and installatzons, a certzficate of Code Compliance from archztect or engzneer responsible for the building. 6, Submit Plannzng Board Approval of completed site plan requirements. For existing buildzngs (prior to Aprml 9, 1957) non-conformzng uses, or buildzngs and "pre-exzsting" land uses: 1. Accurate survey of property showing all property lines, streets, buzldzng and unusual natural or topographic features. 2. A properly completed applxcatzon and a consent to znspect szgned by the applmcant. If a Certifzcate of Occupancy zs denzed, the Buildzng Inspector shall state the reasons therefor in wrmting to the applicant. ,. Fees 1. Certificate of Occupancy - New dwellzng $25.00, Additzons to dwellzng $25.00, ~Alterations to dwellzng $25.00, Swmmming pool $25.00, Accessory buzlding $25.00, Addztzons to accessory bumldzng $25.00. Businesses $50.00. 2. Certzficate of Occupancy on Pre-exmstzng Building - $100.00 3. Copy of Certzficate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Resldentmal $15.00, Commercial $15.00 Date Q M;',~' .~z '-~4~ .... .ew Construction ........... 01d Or Pre-exist~ng Build~ng...~.. ........... ' House No. Street Hamlet ,nwer or Owners of Property..a~.~.~t .]~1~ k ........... ..ii ~[ ounty Tax Map No 1000, Sec ion ..... ~ ..... B oc ........ ~ o ..... ealth Dept Approval .............. Underwrmters Approval ......................... lannmng Board Approval ........................ equest for: Temporary Certificate ....... Fznal Certmcate ...... November 1, 1990 Robert Bernard 3745 Mill Lane Peconic, N.Y. 11958 RE: BP16869Z Alteration dated March 31, 1988 Dear Mr. Bernard: I am writing to you regarding the above permit. This permit has explred. On 4/8/88 you had an inspection for lnsulatzon and passed. You have never called for the final inspection. If the work is completed please call for a final inspection and if you pass the lnspectzon please file for your Certifi- cate of Occupancy. If you have any questions please call our office. Yours truly, cie. Mark Finne Secretary 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [~INSULATION [~RAMING [ ] FINAL DATE ,.S,'ECTO. I/~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ]ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION FRAMING [ ]FINAL REMARKS: DATE I NSPECT"~~ BUILDING DEPT. INSPECTION [ ] I~UNDATION ~,ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [£ ~~.L~ [ ] I~IAMING FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAHE & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: INSPECTORS (516) 765-1802 VICTOR LESSARD, Pnnc~pal CURTIS I-1ORTON, Senior VINCENT R. W'IECZOREK, Or&nance ROBERT FISHER, A~s~stant Fire Bulldms Inspectors THOMAS FISHER GARY FISH SCOTT L. HARRIS, Supemsor Soudmld Town Hall PO Box 1179, 55095 MamRoad Southold, New York 11971 F~ (516) 765.1823 Telephone (516) Ov'~elCE OF BUILDING INSPECTOR TOWN OF SOUTHOLD November 1, 1990 Robert Bernard 3745 Mill Lane Peconic, N.Y. 11958 RE: BP16869Z Alteration dated March 31, 1988 Dear Mr. Bernard: I am writing to you regarding the above permit. This permit has expired. On 4/8/88 you had an inspection for insulation and passed. You have never called for the final inspection. If the work is completed please call for a final inspection and if you pass the Inspection please file for your Certifi- cate of Occupancy. If you have any questions please call our office. C.Ce Mark Finne Yours truly, Secretary O~CUPAN~Y OR USE !$ UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCy T~ BOARD OF HEALTH ...... 3 SETS OF PLANS ....... FORM NO I SURVEY . TOWN OF SOUTHOLD BUILDING DEPARTMENT SEPTIC POEM ............. TOWN HALL NOTIFY SOUTHOLD, N,Y 11971 TEL.- 765-1802 CALL ................ Examined .'~$~ .c~.cJ~.. Disapproved a/c (Budding Inspector) MAIL TO: APPLICATION FOR BUILDING PERI,AlT Date -~ . .,I9.. INSTRUCTIONS a. This apphcahon must be completely filled m by typewriter or ~n Ink and submitted to the Budding Inspector, with sets of plans, accurate plot plan to scale. Fee according to schedule b Plot plan showing locatmn of lot and of buddings on premises, relatmnsh~p to adjoining premmes or pubhc stree or areas, and g~vmg a detailed descnphon of layout of property must be drawn on the dmgram which m part of this app carton. c. The work covered by this apphcatmn may not be commenced before ~ssuance of Budding Permit d. Upon approval of this apphcatlon, the Bmld~ng Inspector will ~ssued a Buddmg Permit to the apphcant Such perm shall be kept on the premises available for inspection throughout the work e No budding shall be occupied or used m whole or In part for any purpose whatever untd a Certfficate of Occupam shall have been granted by the Budding Inspector APPLICATION IS HEREBY MADE to the Budding Department for the msuance of a Bmldmg Permit pursuant to tl Bmld~ng Zone Or&nance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances Regulations, for the construction of bmldmgs, ad&frans or alteratmns, or for removal or demohtlon, as hereto describe, The apphcant agrees to comply w~th all apphcable laws, ordmances, bmldmg code, housing code, and regulahons, and admit authorized inspectors on premises and ~n budding for necessary ~nspechons. (S~gnature of applicant, or name, ~f a corporatlon) State whether apphcant m owner, lessee, agent, architect, engineer, general contractor, electncmn, plumber or buflde Name of owner of premises (as on the tax roll or latest deed) If apphcant [sa corporation, signature of duly authorized officer (Name and title of corporate officer) ALL CONTRACTOR'S MUST ~E S_UEFOLK COUNTY LICENSED Braider's License No /,~.O.~..~ f'/..~ Plumber's License No Electmcmn's L,cense No Other Trade's L~cense No .......... Location of land on whmh proposed work w~ll be done· . .*~. ~.Q) ~/.~-~' .................. ........ House Number Street Hainlet County Tax Map No 1000 Section · ~. 7 Block . ~.. .. Lot /t~ ...... Subdiv~mon Fried Map No .... Lot (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction a. Exmtmg use and occupancy *" ~/~-..~.~, ~ .... b Intended use and occupancy . .~ ......... ' ........................ 3 Repatr .... Removal Nature of work (check winch applicable) New Buddxng Add~tlon ., .,. Alteranon v l& 4. Estimated Cost ~-~ 00 ~'~ 5. If dwelling, number of dwelling umts If garage, number of cars ........ · Demohtmn .... ' O[her Work. .. (Descnp. Fee ....................... ' (to be paid on fihng tins application) .... Number of dwelling units on each floor .... 6 If business, commercml or mixed occupancy, specify nature and extent of each type of use .. 7. Dlmensmns of existing structures, ff any Front ... Rear ..... Depth ....... Height .. Number'of Stones .......... Dmxenslons of same structure with alterations or additions Front ........ Rear ....... Depth ....... Height ............ Number of Stones. 8. Dimensions of entire new construction. Front ...... Rear ........ Depth .... Height ....... Number of Stories ...................... 9. Size of lot Front .... Rear ............. Depth ..... 10. Date of Purchase ................ Name of Former Owner ......... 1 1 Zone or use district m which premmes are s~tuated ................... 1 2 Does proposed construction violate any zoning law, ordinance or regulation ...... z¥ o. .............. 13. Wffl lot be regraded ................ Wilt excess fill be removed from premises z//,~*t.~Zes No 14 Name of Owner of premises ~.o~.~'-/~.~'7~,~Address ,~..~./.~..z.z~..~. Phone No Name of Architect ............. .~ Address ....... ~... Phone No. . .,.~: ? ... ,... Name of Contractor ./2/,~//~/~?F..~'' .... Address/.,¢7°.(/S//./-/,Z'q~.4~Phone No 7~? T g .~' ... 15. IS this property located w~th~n 300 feet of a tzdal wetland? *Yes ..... No ..'~... *If yes, Southold Town Trustees Permzt maybe required. PLO'r DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate ail set-back dnnens~ons from property hnes 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. .. (Name of individual signing contract) above named being duly sworn, deposes and says that lie ,s the apphcant He is the (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file tins application, that all statements contmned in this application are true to the best of his knowledge and belief, and that the work w~ll be performed in the manner set forth m the apphcatmn filed therewith. Sworn to before me this ....... .~.~. .... day of Notary Pub,,c ..... ~...~.' .~ .~/,~':~.. HTIIN K. DE VOE , ~ ~UBL~ ~ ~ ~ ~ .. (Signature of applicant)