HomeMy WebLinkAbout10604-ZTown of Southold
P.O. Box 1179
53095 Main Rd
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 35777 Date:
THIS CERTIFIES that the building
Location of Property:
SCTM #: 473889
Subdivision:
RESIDENTIAL ADDITION
3360 Minnehaha Blvd, Southold
Sec/Block/Lot: 87.-3-66.4
Filed Map No.
5/27/2015
6/25/2012
Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
3/27/1980 pursuant to which Building Permit No. 10604 dated 3/27/1980
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/alteration to an existing one family dwelling as applied for.
Corrected on 5/20/2015 to change application date from 1/1/1900 to 3/27/1980.
The certificate is issued to Sean & Jennifer McCoyd
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N495431 10/1/80
7"ed ignatu e
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Town of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
6/25/2012
No: 35777 Date: 6/25/2012
THIS CERTIFIES that the building RESIDENTIAL ADDITION
Location of Property:
SCTM #: 473889
Subdivision:
3360 Minnehaha Blvd, Southold,
See/Block/Lot: 87.-3-66.4
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
1/1/1900 pursuant to which Building Permit No. 10604 dated 3/27/1980
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/alteration to an existing one family dwelling as applied for.
The certificate is issued to Stiber, Natalie
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N495431
10/1/80
Autho ' e Sip6iure
FORM NO. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERIC'S OFFICE
SOUTHOLD, N;. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 10604 Z Date ... / '.l ........ :;�. `7..........,
Permission is hereby granted-to-
.........................
rantedto;. M
t 4�;- �9d lc fQ, i1. ?. .....`F......44e%,�'../�/ /G ekw) ../. ......
to........ .... ` ..... j
................... L ............ ....................
at remises located at m.. ` �....... �I .f +G/� ./ !'0�'1�.�/ ....;ro !/;0 ...."' ,�°�% fl41P.. k '
................................................................................................................................................................
.....................................................................................................................c..... .......................
pursuant to application dated ...........p ......v.......'�".7.......... 11? ., and approved by the
Building Inspector.
Fee $.../1Z ^......
Building Inspector
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY.
Instructions
A. This application must be filled in typewriter OR ink, and submitted in duplicate 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 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
Date August.8.,.1980 ............
New Building ............. Old or Pre-existing Building ............ Vacant Land .............
Location of Property . 3310 YAnnehaha Blvd. SOathold. .. ... .. .
House No. Street Hamlet
Owner or Owners of Property . Seymeur Stiber .... . , . .
County Tax Map No. 1000 Section 87........... Block .. 0?........... Lot. 97...
Lot 3'?
Subdivision .................................Filed Map No. .........Lot No. .... ...... .
3/ 7/co
Permit No. . 1°604 .Date of Permit . 80...Applicant ..`.®n Construction...... , .. , ... .
Health Dept. Approval .... ..................Labor Dept. Approval ........................
Underwriters Approval ....XX
.. .................Planning Board Approval ......................
Request for Temporary Certificate . ...................Final Certificate . ....................
Fee Submitted 0!99 ..........................
Construction on above described building an Qerm meets all appli abl codes and regulations.
.. .............. .APPlicant . ..
Rev. 10-10-78
THE NEW YORK BOARD 'OF -FIRE UNDERWRITERS.-`-'-.__,: ,
BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, -'NEW YORK 10038
Date October 1, 1980 Application No. on,file 076335 - _I
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced'by he applicant named on'the above ap lication number, in the premises of :
�B
Dr. Seymour Stiber, E/S Mirmehaha. vd. ,, Owaissa Ave ,& OpeMe, Aver e
Southold, N.Y.
in the following location; El Basement N' 1sGFl. ❑ 2nd Fl: 'Section, :'Block'
was examined on September 2f ,9 1980 and found to be in compliance with the requirements of this Board
- I�,
FIXTURE
RECEPTACLES
SWITCHES
FIXTURES RANGES COOKING DECKS OVENS.' DISH WASHERS .EXHAUST
FANS
FLUORESCENT
MERCURY
VAPOR AMT:
K. W. AMT. K. W. AMT.
-
K.W. AMT. K. W. -
AMT.
, H.P.
OUTLETS
INCANDESCENT.
4
7
5
4
DRYERS FURNACE MOTORS FUTURE
APPLIANCE FEEDERS
SPECIAL REC'PT
TIME CLOCKS
BELL UNIT
TRANS.
HEATERS
MULTI -OUTLET
SYSTEMS NO. OF FEET
' DIMMERS
OIL H. P.
GAS
H. P.
AMT.
NO. A. W. G.
AMT.,.
AMP.
AMT.
AMPS.
AMT:
'H. P:
AMT.
WATTS _ ,
,
SERVICE DISCONNECT
NO. OF
METER
EQUIP.
S 'E' R V I , C ., 1_1'
AMT.
AMP' TYPE
2w
,B' 3W
3,0' 3W
3,0' 4W
NO. OF CC. COND.
PER el
A. W. G..
OF CC. COND.
NO. OF HI -LEG'-
A. W. G.-
OF HIAEG'
NO. OF NEUTRALS.
- A. W. G,
OF NEUTRAL
OTHER APPARATUS:
1 GFI
Dettner Elec. Co."'
P. O . BOX 482 GENERA L A AG
Riverhead, N.Y. 11901 Lic:#643
This certificate must not be altered in any manner; return to the office of the Board if in'Cor4e6. Inspectors may' be identified, by 'their' pfipnrals
FIELD 1NSPE7TION
DATE
_
y
FOUNDATION (1st)
YI
G
r
FOUNDATION ( 2nd)
2.
-o
'
ROUGH FRAME &
PLUMBING
71
ILA
/
3
n
m
:
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( a
C-►- ,
INSULATION.PER N.Y.
STATE ENERGY
CODE
x
_
ci-
FINAL
m
ADDITIONAL COMMENTS:
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FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined .�r..'Z, 19 0
Approved . ✓JC./�., 19(0 Permit N
Disapproved a/c -ls. ................. ... .
..................................... ,r�.
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
/aco �41
Application N .. ......... .
Date . �_7h 7 .......... 19eA
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, ilding code, housin code, and regulations, and to
admit authorized inspectors on premises and in buildings for necessa ' specti s.
(Signature f applicant, or name, if a corporation)
�i . u. .. dV ....I.. .......
(Mailing address of a plicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
........................................................ .
Name of owner of premises .. C'' . VKQ.L -:. ' ib. �� ............... .......... .
(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. 1 ,.!'t ............ .
Electrician's License No. ��?� ...........
Other Trade's License No . .....................
1. Location of land on which proposed work will be done. . I ............................................... .
tG� ............................ ..................
House Number Street Hamlet
County Tax Map No. 1000 Section ... 2--7 .......... Block . Q. ...... .... 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 .. J. TFn IA. 1VJ � �-�-1 oV ................ ..... ... .........
1(�
b. Intended use and occupancy ....... �� ��0��.�a/�
3. Nature of work (check which applicable): New Building .......... Addition . ✓ ...... Alteration ..........
Repair .............. Removal .............. Demolition .............. Other Work . .............
17
000 , 5f (Description)
4. Estimated Cost...-,.......... ..................... Fee..,1...................................
(to be paid on filing this application)
5. If dwelling; number of dwelling units ...... 1........ Number of dwelling units on each floor,.,.,. .............
If garage, number of cars .......... .....................
6. If business, commercial or mixed occupancy, specify 44ure and extent of eac ype of use'. .. ..........
7. Dimensions of existing structures, if any: Front .. I ....... Rear ....... Depth .?'............ .
Height .) S . .......... Number of Stories . l ................. ".............: W ............
Dimensions o ame structure with alterations or additions: Front .... 7rV ......... Rear
Depth .. z- .............. Height ..... U ........... Number of Stories ...... I ...............
8. Dimensions of entire new construction:. Front Rear ............... Depth ...............
Height Number of Stories ..........................
9. Size of lot: Front ... (0.0 ............... Rear .... A.1................ Depth ...119 ................
10. Date of Purchase ............................. Name of Former Owner .............................
11. Zone 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 6........................ Will excess fill be removed from premises: Yes No
14. Name of Owner of premises .................... Address ................... Phone No............... .
Name of Architect ........................... Address ................... Phone No............... .
Name of Contractor .......................... Address ................... Phone No............... .
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.
.c A w IJ4�-
STATE OF NEW Y RK S
COUNTY OF .
.......... �.......... being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
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 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 filled therewith.
Sworn to before me this
...........2 C--- :..day of ....... 19
Nota ublic, .... County
ELIZABETH ANN NEVILLEI
NOTARY PUBLIC, State of New [R
No. 52-8125850, Suffolk Co ty
Term Expires March 30, 19e
(Signature of applicant)
;� ' • TOWN OF SOUTHOLD �bPERTY
OWNER STREET -' % VILLAGI?
RECORD CARD
DISTRICT SUB. LOT
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