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Home My WebLink About16890-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17398 Date OCTOBER i1~ 1988 THIS CERTIFIES that the buildin~ ALTERATION Location of Property 2575 OLD ORCHARD RD. House No. Street County Tax Map No. 1000 Section 37 Block 6 Subdivision Filed Map No. EAST MARION~ N.Y. Hamlet Lot 7.1 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 31~ 1988 pursuant to which Building Permit No. 16890-Z dated APRIL 14~ 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 ALTER ROOF FROM SHED ROOF TO GABLE ROOF & EXTENDING EXISTING DECK ON EXISTING ONE FAMILY DW~I~INGASAPPLIED FOR The certificate is issued to ROBERT & JOSEPHINE LUSTGARTEN (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED lessee or tenant) N-037134 - OCTOBER 3~ 1988 ~ 20~ 1988 - KING PLUMBING & HEATING BuildingOInspector Rev. 1/81 !~0~'~' NO. · 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) N-° 16890 z Permission is hereby granted to: ~ _ / -- .~ , ............. County Tax Map No. 1000 Section .......... ...~...../~... .... Block ~ Lot No ..... ~..~.Z .......... pursuant to application dated ......... ~..~..~.. ................................ , 19.~..~., and approved by the Building Inspector. Rev. 6/30/80 InstrUctions A. This application must be filled in typewriter OR ink, and submitted m ~ 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 features. 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 inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Additions $25.00 POOLS $2,5.00 AL~ERATIO~25.00~ C. Fees: 1. Certificate of occupancy New Dwelling $25.00, Accessory $10.00 Business 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.Ct0 ,o.oo 5.Updated C.O. $ 50.00 Date ............. NewC°nstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of .......... House No. ' Street Owner or Owners of Property..0.?.-~...~ p.~(.l./~..~.~-..~....~..o.~.'?......~. ?. ?~..-~.~/~.. ~.. ~;,~../~. .... County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. ~.,z.v ...... Date of Permit .Applicant . qc?..~.. .~..~./.~.,..~. ~ ......... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $. frs.../..~ ..................... codes and regulations. Rev. 10-10-TS 76S-'f802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING r~NAL REMARKS~. DATE "-'//l ,'~/</f~r'' PAGE THE NEW YORK BOARD OF FIRE UNDERWRITERS 100012! BUREAU OF ELECTRICITY ~- ocTo.~ 0~,,9~ JOHN ST.E.. ,,E~ ~o.K, ~/F~3E . 0~ THIS CE~IFIES THAT ~y t~ e~tr~ ~uip~nt ~ ~ ~ ~ ing~ by t~ ~t ~ on t~ a~ ~pl~et~ numar in t~ p~m~s o~ ROBERT LUSTGARTEN, O~D ORCHARD RO~D, EAST MARIOn, ~*Y. [qXTUI[! FIXTURES RANGIS OVENS EXHAUST FANS 3 5 3 ENIYEIIS FIJIINACE MOTORS FUTUIIE AI~lIJANC! I~IDLSRS TIME CLOCKS ~JNqT HEATERS MULTI-OUTLET D~4MEI~S SYSTEMS SERVICE m fa'ONN~CT S E R V I C TRACK LIGNTING:-4 ~ SOUTBOLD, NY, 11971 ~ m~ ~is ce~if~ m~t not ~ aber~ in any manner; ~urfl to ~ office of t~ ~ard if incorr~. {ns~ors may ~ identified by their cmdefltials. . ~ ~.~ DEPArt. ~S ~ ~ CE~IF~TE ~T ~ BE ALT~ IH ~ ~.~ Town Of $OLITHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 TOWN OF $OUTI*~OLD CERTIFICATION Date June 20 1988 Buxldlng Permit No. 16890 Z Owner Robt. Lustgarten (please print) Plumber King Plumbing & Hea%ing Inc. (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber' s signature) Sworn to before me this ~ day of ~L 19 . Notary Publ~c,~County Notary Public T~tm Exp~ mmh 30, l~...~/ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION ZST FOUNDATION ZND £~/FRAMING [~/ROUGH PLBG. [/INSULATION ~/o/"~ ~" "" ~//~ [ ] FINAL INSPECTOR TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR. P.O BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1 gOZ To Whom This May Concern, We are unable to complete your Certificate of Occupancy because.of the following reasons. /_~ An application for Certificate of Occupancy is not on file. __~. NO Underwriters Certificate on f~le. The check is(outdated/not o~ile.)~2~-~ /5/ No Health Dept. Approval on file. /Z/ No final lnspect~on has been made. Please contact our office on this matter. Thank you for your coeperat~ono ~uild~ng Permlt ~ ~_ ~ ~ ~ ~ Z Building Dept. ***~No Plumber Solder Certificate on file. ( all permits involving plumbing being ~ssued after April 1,1984 ) 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION J, ST ~- ] ROUGH PLBG. ~. J FOUNDATION 2ND [ ] INSULA~ [~RAMING [ ] FINAl,/ , ~ ...~-~ REMARKS: ~ DATE DUNDATION ( 1st ) DUNDATION (2nd) 3UGH FRAME & PLUMBING ~SULATION PER N. Y. STATE ENERGY CODE FINAL ADDITION P~L COMMEI1T$ · I I FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N Y. 11971 ,,,// TEL.. 765-1802 Examined .... 19 Approved ~/~.;' ..., 19 .~ermit No Disapproved a/c ............... BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... CHECK .......... SEPTIC FORM ............. : NOTIFY CALL ................ MAlL TO: APPLICATION FOR BUILDING PERMIT rate ,19. INSTRUCTIONS a. This apphcatlon must be completely filled m by typewriter or m ink and submitted to the Budding Inspector, w~th sets of plans, accurate plot plan to scale. Fee according to schedule b. Plot plan showing locatmn of lot and of buddings on premises, relahonshlp to adjommg premises or pubhc streel or areas, and g~vmg a detaded descnptmn of layout of property must be drawn on the 4mgram which is part of tbas appl cation c. The work covered by this apphcatmn may not be commenced before ISSUance of Building Permit d. Upon approval of th~s apphcatlon, the Bmldmg Inspector will ~ssued a Bufldmg Permit to the apphcant Such perm~ shall be kept on the premmes available for mspectmn throughout the work e. No bmldmg shall be occupied or used in whole or m part for any purpose whatever until a Certificate of Occupanc shall have been granted by ~ APPLICATION IS HEREBY ~ the Budding Department for the issuance of a Btaldlng Permit pumuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and 9ther apph~cable Laws, Ordinances o Regulations, for the construction of buddings, ad&irons or alterations, or fcr~r~J~v~ 9r~emoh'~), as herem described The applicant agrees to comply with all apphcable laws, ordinances, buddm~.ff'j~/flg/jsjlhg' c'odd~ind regulations, and tt admit authorized inspectors on premises and m bmldmg for necessary inspec~/~f~/~/ff//~( ~_ (S~gnaXm;e of'apphctmt, or name, if a corporanon) (Maihng address of applicant) State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electncmn, plumber or builder. ( roc. .............. Name of owner of premises '~.~ d~ '3 ?"~" -~'"~7" ~'''0 (as on the tax roll or latest deed) If apphcant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No ............ Plumber's License No Electrician's License No Other Trade's License No .......... Location of land on which proposed work will be done House Number Street County Tax Map No 1000 Section 3 Q .... Block Hamlet 4. ..Lot .. Z( ......... Subdivision ' ' ' (NaiVe) . Filed Map No Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction a Ex,sting use occupanoy . ............ b. Intended use and occupancy ........................... x ..................... 3 Nature of work (check winch applicable) New Building . Addltmn .. Demolition 4 Estimated Cost a~. ~Oo. ............. Fee .. .... Alteration · Other Work (DescnpBon) (to be paid on filing this apphcat]on) 5. If dwelhng, number of dwelling umts . / .... Number of dwelling units on each floor t~ If garage, number of cars . .'-- ............................. 6. If business, commermal or mixed occupancy, spemfy nature and extent of each type of use ...... 7 D~menslons of existing structures, if any Front. . Rear ....... Depth Hmght ... Number'of Stones .. / .................... Dtmenslons of same structure with alterations or additions. Front ............... Rear ............... Depth ........ Hmght ............ Number of Stones ....... 8 Dlmensmns of entire new construction Front . t(. ..... Rear ........... Depti~ . .O-.. ' ..... Height 5- ' ... . Number of Stones ................. Size of lot Front ........ Rear ..... ~ .... Depth .............. Date of Purchase .................. Name of Former Owner .................... Zone or use d~strict in which premises are situated ........................... Does proposed construction violate any zoning law, ordinance or regulation ~ ~ Will lot be regmded ........... Will excess fill be removed from premises' Yes No Name of Owner of premises ..... Address ........ Phone No ...... Name of Arcintect ............... Address . ... .VhoneNo ........ Nan~e of Contractor .............. ^auress . Phone No. '-/~. ,~fl, ,~..~.~... 10 11. 12 13 14 15. Is this property located withzn 300 feet of a tzdal wetland? *Yes ..... *If yes, Southold Town Trustees Permzt maybe requzred. PLOT DIAGRA~ Locate clearly and d~stmctly all buddings, whether existing or proposed, and indicate all set-back dLmens~ons from property hnes Give street and block number or descnptmn according to deed, and show street names and ~ndmate whether mtenor or corner lot. OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY APPROy=O AS E' '~ BY' '* l, FOUNDATION - ~O REQUIR~O FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3 INSU~T~ON 4. FINAL - C~NSTRUCTION MUST BE COham FmF FOR C O ALL cONSTRUCT:ON SHALL ME~ THE REOtJIpEMEbtTS OF THE N Y STATE CoNqTRUCTION & ENERGY CODES NDT RESPONSIBLE FOR DESIGN OR ¢ONSI~TION ERROR~ STATE OF NEW YORK, S S COUNTY OF .. (Name of individual stgmng contract) above named. ·. bemg duly sworn, deposes and says that he is the apphcan 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 tlu apphcatlon, that all statements contained in this apphcabon are true to the best of his knowledge and belief, and that th work will be performed in the manner set forth in the application filed therewith. Sworn to before me tlns .............. day Notary Pubhc, .~: ~:...~...~ .~...,~t'/~%.... County ~f~//~. ~. 80~ gRI~ & I~ V0[ (Signature of apphcan, i