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Home My WebLink About16875-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18756 Date FEBRUARY 2~ 1990 THIS CERTIFIES that the building Location of Property 575 RAMBLER ROAD House No. County Tax Map No. 1000 Section 88 Subdivision ADDITION SOUTHOLD r NEW YORK Street Hamlet Block 5 Filed Map No. Lot 33 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 30, 1988 pursuant to which Building Permit No. 16875-Z dated APRIL ir 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 ADDITION TO EXISTING ONE FAMILY DW~TI,ING AS APPLIED FOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROUAL UNDERWRITERS CERTIFICATE NO PLUMBERS CERTIFICATION DATED Rev. 1/81 GEORGE & JEAN PATTERSON N-027809 - AUGUST 15~ 1988 / ' // /ulldlng Inspector TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUiLDiNG PERMIT (THIS PER/v~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N_o 16875 z Building Inspector Rev 6/30/80 TO~N OF SODT~DLD ~UILDIN~ D~PART~IENT TOUN ~ALL SOUTUOLD~ N~ YORK 7B5 - 18o2 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONST~IUCTION ....... OLD OR PRE-EIISTING BUILDING.~...VACANT LAND ,.o~t~o~ o~ ~'ro~ert,~ .... ~ ........ ~&~.~' ...................... HOUSE NO. STREET ~AHLET 0~ o~ o~ o~ ~...~.?~.~.~ .... ~~ ............ co~t~ ==~ ~ ~o. ,000 s~o... ~o~ .). .... ~o= ..~.~.. ~.~o~ ....................... ~ ~. ~./..~ .......... ~ ~o. ~$~.7J.~. o~ ~ .......... ~. ................... Bealth Dept. Approval .................. Underwriters Approval .............. Plauuiug Board Approval ................ Request for Temporary Certificate ....... Fee Submitted: $ ..... ~E .&~. ......... Final Certificate APPLICANT ....... ~.. rev. 10114/88 FORM NO. TONN OF SO.[F~IOLD BUILDING DCPAKTI'~:NT TONN IIALL 765- 1802 2%PPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS This application must be filed in typewriter OR ink and submitted to the Bnildimg Inspector with the following; for new buildings or mew use: ]. Final anrvey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of 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 solder used in system contains less' than 2/10 of IZ lead. 5. Commercial buildings, industrial buildings, multiple residences and similar buildings and installations, a certificate of code compliance from the Architect or Engineer responsible for the building. 6. Submit Planning Board Approval of compIeted site plan requirements. For existing buildings (Prior to April 9, 1957] non-conforming uses, or buildings a~d "pre-existing" land uses: ]. Accurate su~-~ey of property showinE all property lines, streets, buildings amd 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 amd separate ownership of the entire lot prior to April 9, 1957. If a Certificate of Oceupaucy is denied, the Building Inspector shall state the reasons therefor io writing to the applicaut. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent information required to prepare a certificate. For Vacant Land Certificate of Occupancy: ]. 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. FEES: 1. CERTIFICATE OF OCCUPANCY -- New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwelling $25.00, Swiping Pool, $25.00. 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 - over 5 years - $10.00 4. Vacant Land Certificate of Occupancy - $20.00 5. Updated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy - $]5.00 Res{dential Cormmercial er. 10/I4/$8 TOWN OF SOUTtlOLD OFFICE OF BUILDINO INSPECTOR P.O. BOX 728 TOWN HALL SOUTHoLD, N.Y. 1197I TEL. 765-1802 December 12, 1989 Mr. George Patterson 575 Rambler Road Southold, N. Y. 11971 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. /~/ -No Underwriters Certificate on file. /_~X The check is(o~xk~d/not on file.) $25.00 /~/ No Health Dept. Approval on file. /~/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit # _1_ § -~.- .7 .-.5. Z Building Dept. ***/5/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) THE NEW YORK BOARD OF FIRE uNDERWRITERS BUREAU OF EI.ECTRIC~ITY 85 JOHN STREET. NEW YORK, NEW YORK 10038 THIS CE~IFIES THAT u~s examln~ on and found to be ~n ~mpl~an~ ~i~h th~ ~ui~menls of th~ ~rd. FIXTUI~ FIXTUIIff$ RANG~ OVENS EXHAUST FANS OUTLETS SWITCHES 8 DRYERS )0 6 8 OTHER AI~MIATUS: S E R V I C E NO, OF CC. COND. W.O. ] A.W.G. [ A.W.G. ] ?,/0 ~ 2/0 This certificate must not be C~PY FOR , manner; return to the office of the Board if im:Oemct DIPMllldI~IT. THIS ~ 0F CIRTIFIC~TE IdUST IGT be identified by their credentials. /~? ?~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION FRAMING I ] ROUGH PLBG. 2ND [ ] INSULATION r~FINAL REMARKS 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST I ] ROUGH PLBG. [,/~] FOUNDATION 2ND [ ] INSULATION FRAMING REMARKS: FINAL , NSPECTOR~~.~ 7G5-~802 BUILDING DF. PT. INSPECTION FOUNDATION 1ST [ ].~OUGH PLBG. / FOUNDATION 2ND [~,'~ INSULATION FRAMING [ ] FINAL REMARKS: DATE INSPECTOR FOUNDATION { 1st) FOUNDATION 12nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINA/ ADDITIO~AL COMMENTS: -.I CEE -~: ~___8¥ Y. NOTIFY BUILD~MG DFPARTMENT FOLLOWING INSPECTIONS FOUNDATION ~'0 REQUIRED FOR POURE[) ROUGH FRAMINL~ ~ PLUMBING 5. INSU~TI~~ 4, FINAL COnSTRUCtiON MUST BE COMPLE~ b F[)R ALL CONSTRUCTION SH~LL THE REQUIP~MENT5 OF JH~ ,~[E CONSTRUCt~()~ ~ ENERGY ~OO~ NOT MESPONSIBL~ ~OR ~IGN ON CO~STR~C ~'t~)N ~RROR~ -- T - -- Exammed 0~~j) .! Approved~a.~ I Disapproved a/c BOARD OF HEALTH ...... 3 SETS OF PLANS ....... FORM NO I SURVEY TOWN OF 80UTHOLD BUILDING DEPARTMENT SEPTIC FORM ............. ; TOWN HALL SOUTHOLD, NY 11971 TEL 765-1802 · 19'~8 Permit No J (*77 (Bufidmg Inspector) APPLICATION FOIl BUILDING PERMIT INSTRUCTIONS NOTIFY CALL ................ MAIL TO' Date a. Tins apphcat~on must be completely filled m by typewriter or m mk and submitted to the Buildmg Inspector, sets of plans, accurate plot plan to scale Fee accordmg to schedule b. Plot plan show~ng locatmn of lot and of bmldmgs on premmes, relabonsinp to adjommg premises or pubhc stre, or areas, and g~vmg a detmled description of layout of property must be drawn on the dlagmm winch is part of tins apl cation. c The work covered by tins apphcatlon ma3, not be commenced before issuance of Buildmg Perm¢. d. Upon approval of th~s apphcatmn, the Bmld~ng Inspector will ~ssued a Buildmg Penmt to the apphcant Such pen~ shall be kept on the premises available for mspectlon throughout the work ~. No buildmg shall be occupied or used ~n whole or m part for any purpose whatever until a Certfficate of Occupan shall have been granted by the Budding Inspector ~APPLICATION IS HEREBY MADE to the Buildmg Department for the issuance of a Bmldmg Permit pursuant to t Bml&ng Zone Ordmance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordmances Regulations, for the constructmn of bufldmgs, add~bons or alterations, or for removal or demohtmn, as herein describe The apphcant agrees to comply with all apphcable laws, or&nances, bufldmg code, housmg code, and regulations, and admit authorized mspectors on premises and m buddmg for necessary mspectlons. ~--~a C...~c ~.~. -8.0 ~.~cR. ~,,0.c.. (Signature of apphcant, or name, ~f a corporation) (Marling address of apphcant) t t ?,~ State whether apphcant ~s owner, lessee, agent, architect, engineer, general contractor, electncmn, plumber or bufldc .'.a~ ~.~ .o.~.r< ........... Nameofownerofprem~ses . ~.c:K~.C- .'~.WT~F,'SC,~ ............ (as on the tax roll or latest deed) If apphcant ~s a corporation, s~gnature of duly authorized officer .. . . ~/ (Name and ntle of corpora/re officer) ALL CONTRACTOR'S PIUST BE SUFFOLK COUNTY LICENSED Bmlder's License No. 16'.) p.2?~_f~- Plumber's L~cense No Electncmn's Lmense No Other Trade's License No ....... Locatmn of land on which proposed work wdl be done ................ _vT~ .... ~.~x~x. ~ . . ~0.~,-r~c z> .... House Number Street Hamlet County Tax Map No 1000 Section ~ [P .... Block ~q' . .. Lot. . .3.. ~ Subdiwmon ' (~qam~) .. Filed Map No .... Lot , State emst~ng use and occupancy of premises and ~ntended use and occupancy of proposed construction a Exmnnguseandoccupancy c,/4~ . ~Vi~. ¢-.c-~.~.al.~g. ....... b. Intended use and occupancy t~fl-- .~ ~, /Z~, ~O~.~ ~c. ~ ~.. W ~¢.. N~~ .~)~ . 3. Nature of work (check whlch apphcable) New Budding .. Ad&tmn ~/'. . Alteration .. Repatr . Removal .... Demoht~on ...... Other Work .... (Descnpllon) 4 Estimated Cost .. ? .~. ?.d}~. ~ Fee (to be paid on filing th,s application) 5. If dwelhng, 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 Dwnenslons of existing structures, if any Front ..... Rear .. Depth Height ....... Number of Stories ................ : ....... D~mension~'9[ same struqture with alterations or additions Front ........ Rear ......... Depth . . l~] [ e - ~ . .. Height ....... Number of Stones ....... , ..... 8. Dlmension{~{&~,"~ n~w construction Front ...... Rear . . t.~ '-. o.'. . Depth . ~.~./' £ :'. . Height - ~b - Numar of Stones . e..d~' ........................ 9. Size of lot ~..'~7..'~.L.:...-'"'~. .... Rear ...................... Depth ................... 10. Date of Purchase ................ Name of Former Owner ....... I 1 Zone or use district in which premzses are situated ..................... 12. Does proposed construction violate any zoning law, ordinance or regulation' . . M 1~ .................. 13 Will lot be regraded ..... ,.. .~_ ._~ ..... Will excess fill be removed from premises Yes N, I4 Name of Owner of premlses u-.ecr, c,e ]~t575~.xON..Address ..... PhoneNo .?=Q.~?:..~... · Address ......... Phone No .... ~.. .,.. NameName of ArchlteCtof Contractor .~-th? '2. ......... ~r~' ~,;~p~ 'F~oe Address P'). fi. oX ~c.,g. fi...31/~.m.,/Phone No .~ ~ - ~;;,F,.M 15. Is th:~s property located withJ, n 300 feet ot5 a tidal ~etland? ~Yes ..... No .x~.i2 ....... *If yes, Southold Town Trustees Permit maybe required. PLO7 DIAGRA~ Locate clearly and dmttnctly all braidings, whether exlstmg or proposed, and intimate all set-back dtmenslons fron property hues. Give street and block number or descnpnon according to deed, and show street names and intimate whethe mtenor or comer lot. STATE OF NEW YORK, COUNTY OF. SS (Name of individual s~gmng contract) above named · . . being duly sworn, deposes and says that he is the apphcan tie 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 tlu application; that all statements continued m this application are true to the best of his knowledge and belief, and that th~ work wdl be performed in the manner set forth in the application filed therewith. Sworn to before me thru ........... ~.0. dayof ..~r/a..x<~. ...... 19.~o NotaryPubhc ....... ~ .~....~).~.41/~..County tFI,.,JEN K. DE W)E Yolt NOTARY PUBtIC, State of New Ne, 4707878, Sm"foP~ CountYr.,~ Te~m Exlxres March ~8, ltt.--.~ (Signature of applicant