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Home My WebLink About32631-Z FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32153 Date: 01/22/07 THIS CERTIFIES that the building HEATING SYSTEM Location of Property: 500 GROVE (HOUSE NO.) County Tax Map No. 473889 Section 80 DR (STREET) Block 4 SOUTHOLD (HAMLET) Lot 22 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 16, 2007 pursuant to which Building Permit NO. 32631-Z dated JANUARY 16, 2007 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 NEW HEATING SYSTEM INSTALLED IN AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOAN C. & EDWARD T. SMITH, JR (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A -~?:i_,"~ Rev. 1/81 FORM NO. 3 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) PERMIT NO. 32631 Z Date JANUARY 16, 2007 permission is hereby granted to: EDWARD J SMITH JR AND JOAN 32 HIGHWAY DRIVE FORT SALONGA,NY 11768 for : INSTALL A NEW HEATING SYSTEM IN AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. THIS PERMIT REPLACES BP 23128. at premises located at 500 GROVE DR SOUTHOLD County Tax Map No. 473889 Section 080 Block 0004 Lot No. 022 pursuant to application dated JANUARY 16, 2007 and approved by the Building Inspector to expire on JULY Fee $ 200.00 " Signature ORIGINAL Rev. 5/8/02 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building 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 from 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 the solder used in system contains less than 2/10 of 1 % lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: I. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00.. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. 1- 1- L - ~ ? Old or Pre-existing Building: 011". ) {If V"t ~ Q Ie/... Street ~ ......'l'"tl i ------- (check one) New Construction: Location of Property: .r ().ef ~I^Q V' ~ House No. I ;C/, v: ..J / Hamlet Suffolk County Tax Map No 1000, Section T. ?O ") ~<tv\' c.>v...d't. Owner or Owners of Property: ~.i tutJt V'd.. Block 't Lot ~2-- Subdivision Filed Map. Applicant: tJ '" "'" ~ V Lot: Permit No. J ^ " 1 I Date of Permit. I - ((, -0 ") Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) tI:;;,;;:: ~ f- Fee Submitted: $ 6Z-<<.. 7170 ( C(J~3JJ53 ,.- -- ----. ~ ~- ?2-~3/~ TOWN OF~THOLD B~~ING DEPT. _?65.~~.~ INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN~TION [ ] FRAMING I STRAPPING [ ~NAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRAT10N REMARM::S ~~::~/;~ /~ ;;/77 . DATE i INSPECTO o ~ ~ ,,- ~~ <.. ------------- ~ ~ --~----------------- m~ ~ t-l ~ ~~\;-!!\l~-~~~!l~L~r-E~J-~~~~~~:~~=:=-=~ =~_~_~~===~=~~::~~==_~\I~_!1~~~~_-=~_~=_=: :==:=:::~~ i "- ~ _________11____________________________ - - ___m______n_________________________ ----- " " I[ ---------11----- -- ---------------------------- ---- ---------------- -- ---- ------- ~ ----- _un 11____________________ ------- n_____________________ - --- !:2~~J.l~!!Q~____i~NO) _ _I[=~~=~~ II-~~_=_~-=_~-=---- -------~_=_------------------------ - - - -- - - - -- - ------=-- ==-= =-~-------- I- -- --=------ --- ==----= - - --=--=--===~ == =-~ = ---===-= --= =-~=. II II ! ____un_un _____________________________ ____ ______ II II __________m_ -- n --- ----11----------- ------------ -- --------- ------------------- 5 II " 1--------11------------------------ -------- ----- -11------------------------------------------------ I- " I ----~~ 11--- -------~-----~-----~-__________ I " ================~=======- ~~======~===============================================~=======- I ' i l-------ll---------------- - - ~ 11---------11--------------------------------------------------- H H I i-------+--- -- ___________n_ - II----------II------------~------------------- 11------- :1---------------- ------------------- ==-~~~~===---~-=-===-----~--======~--=-==._----=~===----====---~---===_:_-===~~~~~~~~~ ~ / ~~ / 0 i~__~~s-l~ c:i2_1e. _C~'F VJ4;~ 6/'/ l1fl fJ II ~n__ v.J ~ 1------IIF~ r t'rrt/- ~ -' II II 11i~~Z-- GO~_~ ~ --=-:~::~_=====_____==_=_i~======l==_ ==___====~~-~==-----===-------===~~ FOil NIIATl ON ( 1ST) IWIJCIJ FHAHI' Ii pI.IlHnlNG I NSllfXfTON PEH N _ Y_ STATE ENlmGY COlli, M10ITIONAI. COHHENTS: ===================-=----=---=--=======--===-=======-~=====-=======--=-=-=----============ ... ---._~~----~ ---_._--------~~-----_.._-----~-----_._~--------------- ~ ---- -- -- ----------- --~-- ----- - -- -- ----~----- --~-- ---.--.-.---..--------------.---------------------..---.------------..--.----.----..---.-.------+------.---.-------- .. . _ _~._ _ .. __ ..__m...._.__..._____.._____. _ _.______.__...__...___ _______________ ___.__.__._._____._________________.._____.____. n. -- -.-- ______.______________________.._.___ ____.__..~___ _________________n___ __.__ _.~___~~__.~_____..______o____ .. -.- -.--.-- -.--..-.--. ------~-------------_ -._._0._ ____ _...____n._____ _____.____.___.....-..___h_._.._________._~_______ n_ __..__.... _ ____ ~ 0- r l \ ~ M rl ~ 1 F.l > r ~~ rl' ~ .. .. ' t1iiI ~ ~I d'is-c ~ SOUTHOLD PROPERTY RECORD CARD .::j l , ~9( ~/2- i ~ Ja I DIST. I -J- , -(:lJ'IIe. I COUNTY TAX MAP NO. I My~/ S)I(',/r'r?'s 'f .J(J 9-// Ii VILLAGE ~1riIt;"u~@.7:ii4c ((eN'P~.~f: 02/6 LAND IMP. TOTAL DATE REMARKS: 6d6 .s~o 6 .J9a" ,/ .iJl.", :T.w;J,H' I -5foph6S f-D f) '1 6/)n I ~cL,., ./ -- ----- - ---- -.L .- j I --- -- - ---- -- - - =~]~--~~----- I -- - . I - [ -- --- J I ----~ . ... I -'-r-- - - -- -- - -r--- -- --- - -- -----r-----n- .. L I I .. .. )"", . ;i ~ ( I , I ...... rl IrIIl I'.... .~ :- l- i' .., D .- . .. .' . ~ II z.- " ~ ~ ).. , ~ I "" r~ I , . - . . .. "l.. ~ h .~ 10- K.. -. ~~.. t- lufl ~t'I!jr,":.I~ /c;CI'Uf/ Ie J-OX3r 3.s"'b , Bath M. Bldg. b 22- tf(? '. Foundation ~ Extension ')...~ Y'3 ;> (, If b 3~ ).6 f.CJ BaSement F loars /.. /IV , Extension 8' I "11 :3 1 .~ Ext. Walls Interior Finish \ \ ) " Extension Fire Place Hem -~-- p,1 J. : , Porch Attic i !Jl " I} . ..1'1) ")-- Pf'll> (D Porch Rooms 1st Floor Breezeway Patio Roams 2nd Floor Garage /, ~ '{ .....l & }-If I ~ 't.t! Driveway ,. 2!'b O. B. !VOlE: -s- ull. FAa LIV, .srAC" IN GAR ~ 81< Fuu... k/lf. "<-'J J r ("j .....;.~_.. . ., . I'" _'''':>0 ""l - - 2.~:'i;l9)Y!!~t:2f~'!2,,~J!1Q~l?i;P 2~!!.!~B~,!;2~jfc~RD' ", }"""~".",'(.,~i't",,~,:,',:,,,',l:! !li!".,f.;,'",_,i.;,;,,;~, ,"-",T,I D"',E,'"'",F:r,,',,.'H!,"',-,":,.:,'~,",.f;",~,'~,'Tf,,,~,"'-,'.~,';;',;,"':,','~,'~,,',);:~,,,;I,',',_,',',',',", '1i'~,",{,'f,;,' VILLAGE'f{k,\~~'k~""Ji,';;~l,ii' DISI'D leT " SUB' "'~~"_ ,tt....!;' 7,!',:~',,,, ''', , "',,,.,T~"';'~,,"""i0~~4,'~i '"",,,,, H'",~':". ... ,~\t~~___'\.;~j,it~" --.....~,~~_t"i:~~i - ------- -"=""" - ~~r/ ,;\ " SEAS, ) LAND IMP. 'l' . / ..., . \: r:z,OdZ',,- rI/4. II b i' f-rJ.!.!. >0" 1. 1/1 ~o/7o -" '~.., ,~:,''';' - < . ...~.' ;..". "-..----' -~- '~- Tillable 1 Tillable 2 Tillable, 3 Woodland Swampland Brushland '.. ',~ Hause Plat ". . Total :"1 'fIIiI:aII~,,','li!'~./I'IF ,~~~"",,,,< "'-""''', P' """'~.' i .12 n11~' rlVi'~2'..-; , ~ J'~' -",-::..",,;;, ~.~.",::,..-,--,",:-- LL~ .",,: ~ ^~ iF={ g-q -;-;, ,r''''''''''5/fG BOA~d OF HE~LTH ......... J StTS OF PL~NS ......~.. FORM NO.1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL "'-""~'-'_'_'N'"_",,, ." .--. SOUTHOLD, N.Y. 11971 " . , ./ TEL.: 765.1802 , tI/Jrll 22-- ~r ' ' , . Examined. /-?6'(/......... .,19..r::.. 3~l:,"3 ;t Approved. . .'/.ZnI. .'h~. . ., 191. . Permit No. ~ . ~ NOV - 2 1995 SURVEY ......_............ ClleCK ,.................., SEPTIC FORM _............. t:OTIFY: C^LL H^IL ... .. . .. .. .. .. .. ... .. .. .. .. .. .. .. ... ... . TO: ................................... .. Disapproved alc .. .. .. .. . .. .. .. .. .. .. .. .. .. .. .. .. .. .. . ............... ....... ......... ..... .... ......~ '~ ...... .... ..,', ... ,. :. (Building Inspector) " ...... ......... ... ......... ....... P ICATION FOR BUILDING PERMIT INSTRUCTIONS D".A121H'19r> a. This application must be completely filled in by typewriter 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 OJ areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- .ation. ' '. 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 bee!! granted by. the Building Inspector. APPLICATION I~HER~BY MADE to the Building Department for the issuance of a Building Permit pursua~t 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 an~in building for neces~~~~ . . ad... . .~ '~ '~~. . (Signa~re olJ5'licant, or name, if a cor rat' n) .7.1.'~:~/.f1.. (Mailing address of applicant) :~~?=5E::O~;"'" '"'. "'. ;"~'~~~{~Wld" (as on the tax roll or latest deed) I.~~a~i.o.n, si nature of duly authorized officer. (Name and title of co orate officer) Builder's License No. ......................... Plumber's License No. ... ."^?j ?!t:-:. .Ph. . . . Electrician's License No. ... .Jj?i:.7~./7.F.. .' Other Trade's License No. .. ... .... -,. ......... 1. Location of land on which proposed work will be done. ........................ .... 5..PP....................... .G~.. .l/~....... . House Number Street ' Hamlet County Tax Map No. 1000 Section. ..: J:O......... Block..... '!!:.. '" : . .. Lot. .cf~........... Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . .'. . . . . . . . . '. Filed Map No. .............. Lot............... ' (Name) '. State existing use and occupancy of premises and intended us. e and occu~:, ~ IZ:;d construction: ' a. Existing use and occupancy ........1... ..F~..... .1J~VY:"7""""":"'" ...... .... b. Intended use and occupancy .................................................................... I .-' -'. '.-....' ~,.. ~ ~~~''''<'''''''' '-~"">"'''f_,.-,''''';'''' """"''"~''''< --:"-'~'--""~~~- , . ,3. Natu~e of work (check which aPPlicable): New Building.:..::.... Addition.......... Alterali~n~...,..:.. Repau- .............. Removal . . . . . . . . . . . . .. DemohtJon ....;......... Other Work Itlw' If. . . .' . . . . ' , -" .' . !l7C /'V">) (D scription) 4. Estimated Cost. . . . . . . . . . . . . .. . . . . . ... . . . . . . . . . . . . . . . .. Fee ...... /.~ ~. . . . . . . . . . . . . . . . . . . . . ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units. . . . . . . . . . . . . .. Number of dwelling units on each Iloor 0 . . . . . . . . . . . . . . . . If garage, number of cars . .'.... . . .. . " . . " .... " . '. . 0" . . .. . . " . . .. . " '" . .. . " . " .... . " .. . . .'. .. . 6. If business, commercial or mi,xed Occupancy, specify nature and extent oreach type of use . . . . . . . . . . . . . . . . . . . . . 7. Dimensions of existing structures, if any: Front. . . . . . . . . . . . . . . Rear .............. Depth............... Height ............... Num ber of Stories. . . . . : . . . . . . . . . . . . , . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front .,..,.........,., Rear.................. Depth. . .. : .'. .. .. . . . . . . . . . . , Height.. . . . . . : . . ... .. . . , . . . . . Number of Stories.. . . .. . .. .. ; . .. .. . . .. . 8. Dimensions of entire new construction: Front. . . . . . . . . . . . . ... Rear . . . . . . . . . . . . . . , Depth ............... Height ............... Number of Stories. . .. ". . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . ; . . . . . . . . . . . 9. Size of lot: Front, . . . . . . . . .. . . . . . . . . ..: .. Rear....................... Depth ...................... 10. Date of Purchase ...,.......................... Name of Former Owner ..................... 0 . . . . . . . 11. Zone or use district in which premises are situated. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . .12. D?es proposed c. onstruction v~olate any zonin~la..w, ordi ance or regulatJ.'on: ...............,..:............... 13. Will lot be regraded '....... Q':..: 'L.t.... .... Wlil excess fill be removeg,from premlses''::1!.:1 Ye~'en-No 14. Name of Owner of premises '~/'" ddress ~l?q. .6:(ql(:e,-. V-I:r. Phone No.~, .-:. t(~ {,-.. ' Name of Architect. Jf1'./C .: '_: " ... ',"/1' . /1;'Z':.-;' . Address.. " '0: ::.11' . . fl' t.. Phone No. 'u' ":'; 'Jj"'" . Name of Contractorr:~ .O-U. . .~v. . Address 1.7.~. ..~. Phone No. .'1.7 S. . ~ 7.717. 15.' I~ this property within 300 feet of a tidal wetland? *Yes........ No......... *If yes, Southold Town Trustees Permit may be required. 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 whethe'r interior or corner lot. , , UNDERWRITERS CERTIFICATE . REQUIRED " i ~~~!' IIOTJD3 ( ;..j" ~' DATE: 1(, Z- 1lP.' I ' FElP'1j :r!f:- BY: ~ NOTIf'( BUILDING D~ 186.1802 8 AM TO 4 R , FOLLOWING INSPECTIONS: 1. FOUNDATION. TWO REQUIRED FOR POURED CONCRETE . 2. ROUGH . FRAMING .. PLUMBING 3 INSULATION 4: FINAL . CONSTRUCTION MUST BE COMPLETE FOR C.O. . ALL CONSTRUCTION SHALL MEET 'THE REQUIREMENTS OF THE N,Y. STATE CONSTRUCTION .. ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS '~. b_' ~ri( h) r. G.. 2, : [;:J~f\ TE ,-<- .'~""" , c , ~~/~c. ? ~ ~~7 ~ ., ')' ~TA TE OF NEW YORK, S.S -.'OU~Y OF .. .. .. .. .... ..., . ,--:-1l5.~ ' . ,'. " '. , . . .'. . . . , .. .. being dUly sworn, deposes and says that he is the applicant (Name of individual 19ning contract) ;:7,::m:~X)~..~..Ii~o;l.~................ . (Contractor, agent, corporate officer, etc.) . ,f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this pplication; that all statements contained in this;application arc true to the best of his knowledge and belief; and that the lork will be performed in the manner set forth in the application filed therewith. ' worn to before me this '....",,'" 0, # ..--..~