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Home My WebLink About13187-Z �o�SUfFOL��OGy� Town of Southold 5/3/2024 P.O.Box 1179 co 53095 Main Rd G41 �a Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 12798 Date: 9/20/1984 THIS CERTIFIES that the building COMMERCIAL Location of Property: 1045 Love Ln, Mattituck SCTM#: 473889 Sec/Block/Lot: 140.-1-21.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/4/1984 pursuant to which Building Permit No. 13187 dated 5/30/1984 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: (One Family Dwelling)to a Professional Office. 4/30/2024 Corrected for Suffolk County Tax Map Number only. The certificate is issued to Mercier,TR&B Irry Trt of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. N658911 PLUMBERS CERTIFICATION DATED utho iz S nature FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building...P.c.Q ~..e.s.~.~.9 .n.a.~..O. ~.~.~.qe. ....................... Location of Property ... 4. 9.0.5. ...... C.~. y....Ed.. 9.4.~. ............. ~..a.'c..~.L..u.qk. ............ House No. Street Ham/et County Tax Map No. 1000 Section ...~. 4..1 ...... Block ..... 0..1 ........Lot .... 0. 2. .1 .......... Subdivision .... X. .......................... Filed Map No ......... Lot No .............. conforms substantially to the ApPlication for Building Permit heretofore Fried in this office dated · .I~l~y...~.0 ........... ,19 .8.4. pursuant to which Building Permit No...1. 3..1.8.7. Z. ............ dated ........ J.u..rig..4. ............. 19 .8 .4., 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 ......... (One Family Dwelling) to a Professional Office MERCIER, THOMAS & BARBARA The certificate is issued to ............... , ........................................... (owner, I-essee.er-tena~)- of the aforesaid building. Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO. N 6 5 8 911 Building Inspector Rw. 1/81 FORM NO. 6 TOWN OF SOUTHOLD Building Depaf b,~ent Town Hall ,~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitte~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. 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 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. Fees: 1. Certificate of occupancy $5.00 / 2. Certificate of occupancy on pre-existing dwelling/ land 3. Copy of certificate of occupancy $1.00 use--Pre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 New Building ....~. ........ Old or Pre-existing Building .. Vacant Land ............. Location of Property ...~..~.O..~. .............. .~..'~Ca. de- ~ ~ ... House No. Street Ham/et Owner or Owners of Property . ~l,?q .~....~....(~,,~4, .~....~'~. ~. ~. '.~.. .... County Tax Map No. 1000 Section j ~1. I Block (:~ ~ Lot .... .~. ~ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. [.~.~ .~.~..~... Date of Permit..GJ~./. ~..~...Applicant...T..~..q).r~l.~..3l..~ .C,./~.. Health Dept. Approval ...... .¥/.R .............. Labor Dept. Approval ........................ Underwriters Approval .r?H .~--~L/...~.. ) ~L~ .~1 ..... Planning Board Approval ...... Request for Temporary Certificate ..................... Final Certificate ...~, .................. Fee Submitted $...~.,. ~ .................... Construction on above described building and permit meets all appl Applicant. Rw. 10-1~78 able codes and regulations. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ ES JOHN STREET, NEW YORK. NEW YORK 10038 ~,te ~ 07, ~ 386512184 .,pp,,c.,,o. No. o.~,e N 658911 THIS CE~IFIES THAT ~ eram~d on ~ ~ ~ ~ a~found to ~ in compliance ~ith the requi~ments of this B~rd. RXTURE RXTUDRS RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES . FLUORESCENT 19 36 19 1~ 5 DRYERS ',.,, FURNACE MOTORS FUTURE APFUANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTUEI' DIMMERS SYSTEMS NO. OF FEET SERVICE DISCO~T OTHER API~ARATUS: ~o~; 1-Z.~., S E R V I C E A. W, G, NO, OF NEUTRALS A.W.G. 3/O 3/0 · h~ee 'C" ][~eCt;. In=. Rt. I !~ ~ Mound Ave. glverl~l, N.Y. 11901 IA=133~7 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. F~'EDD-INSPECTION FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING 3. INSULATION PER N. STATE ENERGY ODE FINAL ADDITIONAL COMMENTS: YWO REQU, I RE.D : . FOq. P.'"URED, CC qGRETE' ·" ': ' 2 '6,O~GH -.FRA~M IG'&'PLUMB NG ' ',"3 '!13l~U! Am!~'N · , ' · ' P=.,~'t"?! rTE F(~R C.O. .: ', · . ./ 'ALL ~Ik'$?R'JCTIOq SH'.~,LL".MEET . ?] · THE 1~01 u~EMENT;'.OF' 'TME. N.~¥. ' .~. STATM .COI~!STRUCT ION' &" ENI~RG¥ -.~ '. CODE.'~ NOT, REi;P~)NSIBL~' FOR// . .' '1,.:...'1 I~ '- '.'",1 ~-.'" ~'~/~~ · SOLDER USED IN WATER S UPPL Y SYSTEM CANNOT ~XCEED 2/10 of I% LEAD. ~ PLUMBE_~? CERTIFICATION ON LEAD CONTENT BEFORE CERTI£ICA TE OF OCCUPANCY If copper tubing is used for water distributing sys em; piping shall be of types K or L only W^~T..TNG :I EX'AM ROOM ~'1 BATH EXAM ROOM RECEPTION EXAM 'ROOH'~3 ~ I0' A)5' PROPOSAL FOR PROFESSIONAL OFFICE THOMAg R. MERCIER, M.D. ,~.,. .,... ,. ~ 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-180:a :~amined...~..q .... <pproved . ~.'~..~...,19 ~i. Permit No. t.~..I.~.: :. Disapproved a/c ..................................... Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets 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 Jr areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ration. 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 ,hall 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 ;hail 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 3uilding Z6ne 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. Fhe applicant agrees to comply with ail applicable laws, ordinances, building code, housing code, and regulations, and to tdmit authorized inspectom on premises and in building for n~? ~spect~n~s._ , (Signature of applicant, or name, if a corporation) gO: .&..~../~.~ ,.~t~.~: ~, ~g./.t.~.~:.~. ........ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... 0.~.~ .................................................................................. Name of owner of premises .7~ .~.~.9... ~.. fl~. .... .~.~..~...~...~..~..~..~. !..~. ............................ (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 ...................... Location of land on which proposed work will be done .. ~905. ...... ~i v.~ ~,¢:...~.~..~ ........................ ~77.i. .. ......~'¢..~. ...................... House Number Street Hamlet County Tax Map No. 1000 Section .... I.q.I ........... Block .... .O.j ........... Lot .... .~. I ............ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use a:~d occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... ,...~. ................................................. Intended use and occu,~.~ncy .... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteratio!~.. ~... Repair ...)<- ......... Removal .............. Demolition .............. Other Work ............... i~ ! .,~.,jj) 0~) (Description) 4 Estimated Cost ........................... Fee ............. '" (to be paid on filing this application) 5. If dwelling, number of dwelling units ............. Number of dwelling units on each floor ................ If garage, number of cars ................................................... m ................ ,~. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of usc 'J'Jl~ ?lr'"~'~....1~. ' .... 7. Dimensions of existing structures, if any: Front ~"2.'i~..'~..~.~ ..... Rear .............. Depth ............... Height .(h/~. ~ .... Number of Stories .. / Dimensions of same structure with alterations or additions: Front . .'~.-/.'..K.~.q?. ..... Rear .................. Depth ...................... Height ...................... Number of Stories... | .................. 8. Dimensions of entire new construction: Front . .A}M7../(~/n~p~eilr,_, . ............ Depth ............... Height ............... Number of Stories ................................................ ',.-.-.,.' r)~-~- · 9. Size of lot: Front ...................... ,, Rear ...................... Depth ...................... 10. Date of Purchase . .l~.J.~.J~-3 ..................... Name of Former Owner.. ......................... ,,,. 11. Zone or use district in which premises are situated .... 12. Does proposed construction.¥iolate any zoning law, ordinance or regulation: ... dO~ ......................... 13. Will lot be regraded ..... ~.{~ .................... Will excess fill bc removed from premises: Yes No 14. Name of Owner of premise% .... ,. ............... Address ................... Phone No ................ Name of Architect ..... /~..T.....tl'~.. L. ~..0~. I:.['. .... Address ................... Phone No ................ Name of Contractor ..... 61.0.T.....~.{Pb.'Y~0.~... Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from ~roperty lines. Give street and block number or description according to deed, and show street'names and indicate whether nterior or corner lot. T g' e Wit[ 5 Ffecno% 1,o. ;TATE OF NEW YORK, S.S :OUNTY OF ................. ... ~ .... ~ .L..~. ~....CC. i..~.~ ............ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) bore named. re is the .... ~ ~.~J~ ........................................................................... (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 0plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the 'ork will be performed in the manner set forth in the application filed therewith. worn to before me this 301~ dayof ....~ ......... ,19~..~'.' n0~,v PUa~C. sm, o~ ,,, vr (Signature of applicant) NO. 4707878, Suffolk Term Expires March 30,