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Home My WebLink About17042-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. ' CERTIFICATE OF OCCUPANCY No 217359 Date SEPT. 28, 1988 THIS CERTIFIES that the building ADDITION Location of Property 6015 PECONIC BAY BLVD. MATTITUCK House No. Street Hamlet County Tax Map No. 1000 Section 128 Block O1 Lot O1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 25, 1988 pursuant to which Building Permit No. 170422 dated MAY 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 ADDITION TO BATHROOM TO AN EXISTING ONE FAMILY DWELLING. The certificate is issued to RICHARD K. COLLINS (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N029845 AUGUST 25, 1988 PLUMBERS CERTIFICATION DATED N/A Building I Spector Rev. 1/81 r~osai xo. s TOYdN OF SOUTMOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT ffHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N o 017 0 4 2 Z Date 31 19d? g. Permission is hereby granted to: ~ ~ ~ J~~ .........1~..~-~..2......~i..... ..............q..~,~.... , ~:~.~..~.~,x~...a~.:~~~....~ of premises located at ...~'a f7 P ',5,,,,,,,).,.1},gi... .e........~.~:.}$..hAA2.:w:~.. County Tax Map No. 1000 Section ....I.aZ..~.......... Block Lot No......Q..~............ pursuant to application doted .s~l? 19.Q..9.,, and approved by the Building Inspector. Fee 5..~~.....~~... ding Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department ~ ~ 8 Town Hall Southold, N.Y. 11971 BLOC, bEp7; N OF SOl17pOLp APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- torwith the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unu~al 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, acertificate 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 peoperty showing all property lines, streets, buildings and unusual natural or topographic features. 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. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 rr\\ ~ {n-(% nA'' Date ..~a~~C [ • U • . New Building Ol(d~or Pre-e//xyi~~sting Building/7~...~..... Vacant Land . . Location of Property c7"°~'••••••••••• House No. lo~ reet ti Hamlet Owner or Owners of Property y~.. ~ County lax Map No. 1000 Section ....~rtl~..... Block ...Q 1......... Lot... u./.......... Subdivision .................................Filed Map No., ...Lot No. . >1 / ~ r PermitNo.~~U.!~ of Permit/.~~~~ppolicant.~~l.~/(•\~'~`t/7..rrf~':'":~:":"~. . Date p Health Dept. Approval :...............Labor Dept. Approval Underwriters Approval .N.o.~.~p• . L~~ • ..Planning Board Approval . Request for Tempor y Certificate .....................Final Certificate . Fee Submitted $ . pp permit meets II applicabl~~co~desand regulat/io~ns,. Construction on above describ A b lican 9 and`i''(1' .1~~~ ` ......~j•a'~'_`.t...... . Rev. 10-10J8 ~ lY LL Q~.~s CD 'z/~35`/° ~ COMMENTS y FIELD TNSPECTION DATE - a 'ro _ ~,y 1 : ,.c H ~ N FOUNDATION (1st) C ~ ~ FOUNDATION (2nd) ~ 2. z o ~ 0 ROUGH FRAME & v~ PLUMBING b, _ _ ~ H 3. - ~ ~ H INSULATION PER N. Y. STATE ENERGY CSODE a p~ r y 4. FINAL 0 . z`" ~ ADDITIONAL COMMENTS: ~ n ~ ro ~ H H ~ H ~ O z 1 x ra a H ti' x - v~ m .d H THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGB ] ,L000?.8~ F3UREAV OF ELECTRICITY •83 JOHN STREET, NEW YORK, NEW YORK 10038 Datr AUGUST 25,1988 Appli.•nrionNa.onJNe 55339688/88 N 029845 THIS CERTIFIES THAT only the electrical equipment as describ¢d below and introduced by the opp(fcant Homed on the above applicotion number in the premises of RICHARD COLLINS, 5925 PECONIC ~~BIAIY BLVD, POLE#NYT#48, LAUREL, N.Y. in fhefo(lowinp location; ? 8aaern¢nt LAI let F'L ? 2nd F1. 3eetion Rlork l.ot aas exomined an AUGUST 11 , 19$$ and found to be in consp(ianre ai Nr drr rrquirenrrnfs q/'thix Qonrd. FIXiuRE FIXTURES RANOES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS FCEPTACLES SWITCHES INCANDESCENT fIUORE5CEN1 •~q AML K. W. AMT. K W. MIL K W. AMT K. W AMT. N P. 1 1 2 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDEkS SPECIAL REC'PT TIME CLOCKS REII UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K. W. OU H. P. GAS H. P. AMt. NO. A. W. G. AMT. AMP. AMi AMPS. TRANS. AMT. H. p. SYSTEMS AML WARS NO.OF FEET SERVICE DISCONNECT NO.OF 5 E R Y ( C E METER NO. OF CC COND. A W O. AML. AMP. TYPE EQUIP. I,e YW 1 ,e KW 3 6 RW 3,e 4W pER A' OF CC. COND. NO. OF HIAEG OF MI{ G NO OF NEViRAIa OF NEUtRAL 1 150 CB 1 X 1 1/0 J_ 1 1/0 OTNFR APPARATUS: WALTER FINGRR C//~~ 405 AIRCH LANE CUTCHOGUE, NY, 11935 OENfRAE NA E 11 LICENSE N0. 1845E Per This certificate must not be altered in any manner; return to the of}ice of the Board if incorrect. Inspectors may be identified by their credentials. C ~ ~ ~ I~ ~ I ~ ~ I l ~ ~ ~ ~ ~~yc ~ ~ c~ ^y1 _J 1 1 M}~~r ~~qi 4 i Y ~ ~ a~ a 6\ I fi? 7 C x~° 3 ~ 3~ ems- ~ ~ ^ I ~ ~ ~ i ~ ~ 2y ~~CfDCCarC x~ $ d~ ~~~OZDapin~' I oL TmT~~,, r ~ ~ n ~o ~ oG fA 2 ~ z z . ; ; r~ a D ' O ~ m ~ ~a ~ ~ ~~F z ~ p o~~ off, ~ ~~j~Zm C Z m . 717 ~ ~~i L7 4 m a ....p C~ ~ c n1 ~ ~ w ~ ~ FORM N0. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ...\.~'Y~ 3~ 19$~. Application No . Approved 19g.~PermitNo..I~~•1a:1'. • ~ ~e Disapproved a/c (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ..~1,~' 19~ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 issue 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 inspectors on premises and in buildings for necess/arAy ins~pectio~s/./ (Signature of applicant, or name, if a corporation) ll ~1 (Mailing addres~applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No . . Plumber's License No . . Electrician's License No . . Other Trade's License No . . 1. Location of land on hich proposed w r will be done. (r " "r . House Number treet f Hamlet County Tax Map No. 1000 Section (a~ Block t 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 ^ n ~ 4~.. ^ .~C".tailea,~'l . a~x+ ,gas .:,..fir w~3t~1 itm~xvk S..X...vJ.~: ~'~y b. Intended use and occupancy -.~lYr~:~~~~ ~~,._'~.'~k5~}b~'Y~ 3. Nature of work (check which applicable): New Building Addition Alteration . Repair Removal Demolition ..............Other Work . v_,.. (Description) 4. Estimated Cost j.~.~..." Fee . (to be paid on filing this application) S. If dwelling, number of dwelling units Number of dwelling units on each floor . I:f garage, number of cars P"+-~d~_ . 6. I:f business, commercial or mixed occupancy, specify nature and extent of each type of use . 7. Dimensions pf existing structures, if any: Front ...............Rear Depth . Height ...............Number of Stories........................................................ Dimensions of same structure w}th alterations or additions: Front Rear . Depth 8 He'ghtsrons ofG t're new cons ~ Height Number of Stories s..; . ' ruction: Front Rear Depth :..li..... . ( Nu berofStories........~ ize o ot: ront Rear Depth 10. I>ate of Purchase . ..................Name of Former Owner . 11. 7,one or use district in which premises are situated . 12. Does proposed construction violate any zoning law, ordinance or regulation : . 13. Will lot be regraded / n ~y~... Will excess fill ,'ere-m-o~-e~ from premises: Yes Nor/ 14. Name of Owner of premises0?-r~~`•. GO:G.C'~YAddress .~2i'2~~'~-~. • ...Phone No. ~~:.~'~~P T 7 Name of Architect , Address ...................Phone No. ~~1~~~ ~j~ Name of Contractor ~~!K +.~-Address ~~.e-l .....Phone No. .r~.-~p li. a'C~ PLOT DIAGRAM Locate clearly and distinctly all, buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block ;number or description according to deed, and show street names and indicate whether interior or corner lot. S I~ STATE OF NEW R S.5 COUNTY OF . ..i :•~4.c~9 being duly sworn, deposes and says that he is the applicant (Na e of individual signing contract) above named. He is the .......................I ntracto agent, corporate officer, etc.) of said owner or owners, and is dull 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 methis -7~ .day of ~ 19 Notary Pub~io, ' County ClA1RE L ~ ~ /f Nourlr ~b,4~N~wYak ....~.,5~./c-a.~r~.n~ CarMnl~ ~i ~ S 1 ~ (Signature of applicant)