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Home My WebLink About22287-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23237 Date SEPTEMBER 19, 1994 THIS CERTIFIES that the building ALTERATION Location of Property 1275 MILL CREEK DRIVE House No. Street County Tax Map No. 1000 Section 135 Block 3 Subdivision Filed Map No. SOUTHOLD, NY Hamlet Lot 41 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 10, 1994 ~ursuant to which Building Permit No. 22287-Z dated AUGUST 29, 1994 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 ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL INSPECTION SERVICE 5309 PLUMBERS CERTIFICATION DATED Rev. 1/81 THOMAS & MARIE MAC DOUGALL N/A SEPTEMBER 14, 1994 N/A Building Ins~ctor 1�T FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23237 Date SEPTEMBER 19, 1994 THIS CERTIFIES that the building ALTERATION Location of Property 1275 MILL CREEK DRIVE SOUTHOLD, NY House No. Street Hamlet County Tax Map No. 1000 Section 135 Block 3 Lot 41 Subdivision Filed Map No. Lot No. conforms• substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 10, 1994 pursuant to which Building Permit No. 22287—Z dated AUGUST 29, 1994 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 ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to THOMAS & MARIE MAC DOUGALL . (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL INSPECTION SERVICE 5309 SEPTEMBER 14, 1994 PLUMBERS CERTIFICATION DATED N/A !X4 Building Ins ctor 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) 9V- N222287 Z Date............. ............................... 19..../.. . . Permission is hereby granted to: 5....... ......MA. .... G?.�( 9�l........ . ...... 1 . .... , , ........... lv ... .........�.� r ... :..:......1/ �/..�../ji� to ...//.�f��— .............. ....... /-r ... .,., ......,. "...... ..................... w45.�..............ems.......... .......................................................... .....................................:............................................................................................................................ .... .. ..: .... ........................................ at premises located at......................... 5.... ��/........`-r ..... ............................... ................................................................................................................................................................ County Tax Map No. 1000 Section ... 3 .....:.. Block.......0.......... Lot No. ....... ............ pursuant to application dated .......... . ..................... 19.../..�.. and approved by the Building Inspector. Fee$.....?�. ...... '.... r ............................ Building Inspector Rev. 6/30/80 suiLDiNc DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [!i]'FINAL REMARKS: �/ /� ,.;, DATE RIX& INSPECTOR Form No. 6 v D - TOTdN OF SOUT1i0LD R 0 ll Nk BUILDING DEPARTMENT T u Oj1N HALL 3 0 1994 765-1802 BLD . DEPT. APPLICATION FOR CERTIFICATE OF OCCUPANCY TOWN OFSOUTHOLD A. This application must be filled in b t inspector with the following: for newbuildingrorrFnewkused submitted to the building 1 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,pre-existing" land uses: 1957) non-conforming uses, or buildings and '•' 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a 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-dwellin • Alterations to dwellingg $25.00, $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 - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date New Construction... . .. , Old Or Pre-existing Building. , . . . . . . . . . • . . • Location of Property. . . o , , ,�f,�4X k �T�D . . House No. Street . . . .� . . . . . . . . Hamlet Onwer or Owners of Property./(0-4 , ,�� . . A��DU� ��. . • . • • ••. . . County Tax Map No 1000, Section. ../ s . . . .Block. . . . 6,3, , , , , , , ..��. . . . . . . . . . . . . . .Lot. . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. Permit No. Y•�' • . •Date Of Permit. Q :; ;?L,7/, ,A . . .•. . . �G.��t�(� f� pp I cant :iealth Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . ?lanning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . :tequest for: Temporary Certificate. . . . . . . . , , . Final Certicate. . . .ee Submitted: $„ � . . . . .. . . . . . pop 9PL . . .. . . . . .APPLICANT 'G 1 O0Qa000,O:OGA0000`OO.GO,OOQO®000000000000'00.000GOOOGO"C0®O®0C> 0 (516) 286-6642 ELECTRICAL INSPECTION SERVICE, INC. 0 375 DUNTON AVENUE . EAST PATCHOGUE, NEW YORK 11772 530 _ O Dale CJ--14- 4 APPLICATION No.ON FILE O 0 0 ADDRESS: .�ii°71 ('rIP Dr- VILLAGE: Swthvld TOWN: SOUtbold O 0 ISSUED TO: Thip a Mae ilnlllll giL 7 0 INTRODUCED BY HCW Owl LIC. NO.J 0 0 was examined.on •.%_ 4_Q_4 and found to be in compliance with the National Electrical Code. - __________________________________--_____________________ O 0 — — O LOCATION BASE. �, 1st. 2nd 3rd Attic Pool 0 DET. GARAGE HOT TUB O —----- ®. 0 FIXTURE . RECEPTACLES SWITCHES G. F. C. L. DIMMERS FANS AIR. COND.. O 0 0 DISHWASHER DRYER CLOTHES WASH. GAR. DISP. RANGE OVEN SMK. DET. 0 FU R NACE OIL-., GAS ` CIRS" , MOTORS BELL TRAN. SERVICE DISCONNECT :O Mete rs m s._ ase O 0 i' •® 0 President o O This certificate must not be altered in any manner. 0 Inspectors may be identified by their credentials. o 0 ti 0000000000000000®OOOOOOOOOr00000..000000000000000000'0000 d 0 00 0.c�0 *coo*C.> Of . , (511$)`.2186--6IM2`, ELECTRICAL INSPECTION SERVICE'',-INC. 37 5'D U N T 0 WAV E N U E EAST PATCH 0 G UE,'N EW.,Y10 AK 11772 5309 Date. 8-3-94- APPLICATION No.ON FILE op O 0 ADDRESS: 1275 16.11 Creek Dr. —Vi,LLAGE: -Southold TOWN: SOUthOW O ISSUED TO: T&Ms' Mae DougaU _j M " INTRODUCED BY me .Omer _LIC. NO. was examined on and found to be in compliance with the National Electrical Code. ------------ LOCATION -71X'BASE' 1st.. 2ncl 3rd Attic Pool bET. GARAGE HOT TUB —-----O --------—------ --——----------—--- 7 FIXTURE - RECEPTACLES'.RECEPTACLES SWITCHES G. 'F...C. DIMMERS, FA S,, AIR,. CON D 4 4''; DISHWASHER DRYER CLOTHES WASH. GAiR.,DIS.P'.' RANGE OVEN SMK.. DET. FURNACE MOTORS BELL TRAN, SERVICE DISCONNECT 0 f.' 1 _ e•ers m s. ase- 7 o GWMDG 00 -SERVICE AND GFIC,BE LACED.OMSIDE IN. HAS 95APresident o 4M RE TRICALSU W 4 L G10141(los. tkEl EXPOSE ' OD -1,606. This certificate must not be aliered1n.any:manner. Inspectors may be identified by t heir credentials. 0000e000e0000000e000eoe®e000eoe000000000e®0000000000 Op00000000000000000,00.000000®0'000000000000000000000000 0, (516j'286=s642 ELECTRICAL INSPECTION SERVICE, INC. :� •. ® 375;DUNTON AU..ENUE'; 0 EAST PATCHOGUE', NEW::VORK 1177:2 53C9 ` 0 0 DatA 8/3/��. APPLICATION No iyN FILE ADDRESS 12�� .Mil . Creek IB�`VILLAGE S011t$®ld TOWN sdutl .ply ISSUED TO:. Th®ffia' MacDougall " ;® N Q INTRODUCED BY n6meowne= IC. NO _ ° p 0 r ram, - .. ,.•., - O} r K �« T. O was examined,on 8/3/9e4 and found to be in'compliance with the National Electrical:Code LOCATION XX BASE. 1st. 2nd 3rd Attic Pool O. O ' O DET GARAGE HOT TUB kESIDEATCE/CIITSY'DE O 0 FIXTURE.' RECEPTACLES SWITCHES . '•G.:F. C I DIMMERS ;: FANS :AIR COND.,. 0 0 DISHWASHER DRYER CLOTHES WASH. GAR:•DISP.. RANGE OVEN SNIK. DET. O. 0 0 O O O FURNACE OIL GAS CIR. MOTORS BELL TRAN. SERVICE DISCONNECT 0 O Meters m s. ase O o Groulndimmg u ; :$ervice> tnei GAF:C��..,-_:0a0laceel;,�ra�:sid�r= s r u: 0 , .c 0 0 0 0 President 0 o 0 This certificate must not be altered in any manner O Inspectors maybe identified by their.credentials O , OO.o000;0000P0000:lip 00400.:00000 000000;0000000000,00000000000 OUNDATION ( 1 s t) in 'OUNDATIOJJ ( 2nd ) r' ;OUCH FRAME & •PLUMBING to . H ;l � \'1 n _IISULATIO;J PER N . Y. • • a STATE ENERGY CODE I T r i ►-3 lS� FINAL ADDITIONAL C ENTS : ° x p • H o��S�ffO(��OG Town Hall,53095 Main Road y Z Fax(516)765-1823 P. 0. Box 1179 Telephone(516)765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD September 6, 1994 Mr. & Mrs . Thomas Mac Dougall 1275 Mill Creek Drive Southold, NY 11971 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. (Enclosed) xx No Underwriters Certificate on file. (Living Rm) The check is (outdated/not on file. ) $25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 22287-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. BOARD OF HEALTH . . . . . . . LV��J 1155 u VV 15 rb FORM NO. 1 /, SETS OF PLANS TOWN OF SOUTHOLDSURVEY . . . . . _ _ . . . . . . . , Al,IG 10 1994 ; BUILDING DEPARTMENT C11ECK . . . . . . _ _ _ . . . , , . , _ . TOWN HALL /SEPTIC FORH _ . . , SOUTHOLD, N.Y. 11971 SLDG.DEPT. T E L.: 765-1802 t:a<<F't TOWN OF SOt!T�? ��r,� i .* s 7� Examincd . . '1 ____"J 9 CALL . ! - .. . . . JJJ 17 ��"7 y MAIL TO : Approved . . . . . . . . 9• . ., 116cr'mit No. -��'r!-/.L: . . . . . . _ . . . . . . . . . . . Disapproved,a/c . . . . . . . . . . . . . . . . . . . . . _ _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . t . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . (B ilding Inspector) - APPLICATION FOR BUILDING PERMIT Date . . . : . : . . . . . . . . . :, 19� INSTRUCTIONS a. This application must be completely filled in b sets of plans,accurate plot plan to scale. Fee according to schedule or in ink and submitted to the Building Inspector,with b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public street, 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 corn° .r-ei-:c.:' before issuance of Building Permit. d. Upon approval of this application, the Building Inspectoz ,: ws :::;sued a Building Permit to the applicant. Such permit- shall be kept on the premises available for inspection throughout i ;c :vork. . 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 altera±io?3s, Cr for removal or dertloliti d. The applica.7at agrees to comply .,with all applicable laws, ordinances, bu•.thing code, housing code, and regulations,as herein sande to admit authorized inspectors on premises and in building for necessary `ns tuns. ( ibnature of applican , or name, if orporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . fv R. . Name of owner of premises `00ARS . - ��J G1 � - - . . . . . . . . (as on the tax roll or latest deed). . . . . . . . . . . . . . . . . . . . . . . . - If applicant is a corporation, signature of duly authorised 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 which proposed work will be done. . . . . • , , 1. 7� . . . . . . . . . 1�< . . . _, . . . . ce ,fr.o . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . Douse Number Street ' ' '•' ' ' ' • • • • - Hamlet County Tax Map No. 1000 Section ;• �,, - � Block Lot . . . . . . . . . . Subdivision . . • - . . . . . . . . . . . . Filed Map No o. . . . . . . Lot . . . . -: State existiiib use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occu anc In b. Intended use and occupancy . . . . . . . n •3. Nature.of work (check which applicable): New Building . / Repair . . . . . . . . . . Removal . . . . . . . . . . Addition . . . . . . . . . Alteration;! • . . . . . . . . . . . Demolition __. . . . . . . . . . . . Other W' ork . , 4. Estimated Cost ,w�. .D��. _ . . + . • - - (Description) . . . . Fee _ . . . . ._ -- 5. If dwelling,number of dwelling units . . , , - . i (t® be Paid on filing this application) If garage, number . • • • • • • . - Number of dwelling units on each floor .g. g of cars • • • . . . . . 6. If business, commercial ormixed• . p . " ' " " " ' • • • • • • • • • • • • • • • • . . . . occupancy, specify nature and extent ofeac}1 type of use . . . . . . . 7. Dimensions of existing structures, if any: Front . ' ' . Height • • . . . . . . . . . . . Rear . . • - • . g . Number of Stories Depth . . . . . . . . . . . . . . Dimensions of same structure with • ' ' ' h alterations or additions: Front ' ' ' ' ' ' Dept . . . . . -- ---- ._...._ • • , Height - - -- - - - car . . . , 8. Dimensions of entire new consGru Number of Stories . . . . . . . . . .Height coon: Front . . . . . . . . . . . . . Rear. . . . . . . . . . . . . . . Depth . . . . . . . . . . 9. Size of lot: . . . ' • • • Number of Stories . . . . . . . . . . . . . . . . . . , , , • . . . . . . . . . . . Front . . . . . . . . Rear. . . . . . . . . . . . 10. Date of Purchase . . . . . . . . ... . . Depth . . . . • . . . . . . 11. Zone or use district in which re . ' . ' ' ' ' ' . . • • • Name of Former Owner . 12. Does pr p premises . • • . . . . . • _ . . • • . ' • • • - • . . . . Proposed construction violate any zoning law, ordinance or regulation: . . . . . - . . . ' 13. Will Iot be regraded • • • • • • . . . . . . . . . . . . 14. Name of Owner of premises . . . . ' ' ' ' ' ' ' • • • Will excess fill be removed from premises: Yes • . . . • Name of Architect . . . . , . . . ' ' ' ' ' ' ' • • • Address . . . . . . . . . . . . . . . . .Phone No. . . . . . No Address Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . 4. Address . . . . . . . .. . . . . . . • . . . Phone No. . . . . . . . . . . . . 15. ' Is this property within 300 feet of a tidal wetland . , . . ' ' ' ' ' ' . • . • Phone No. . . . . . • • • - *If yes, Southold Town Trustees Per ' YeS. . . . . No• • • . • • .. • . ` • • ' • • . . • . Permit may be required. PLOT DIAGRAM Locate :Nearly and distinctly all buildings, whether existing or proposed, and.indicate all set-back dimensions from propert},• :. ,rs. Give street and block number or description according to deed, and show street names and indicate whether interior oaf lot. TATE OF NEW YORK, . -=uuN S.S being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) cove named. cis the : . . . . . . . . . . . (Contractor; agent, corporate officer, etc:) . ' ' ' ' ' ' ' ' said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this plication; that all statements contained in this application are true to the best of his knowledge)rk will be performed in the manner set forth in the application filed therewith. and belief; and that the ••orn to before me this • : . . . . . /d. C� . . . .day of. . �. . . . . . � � JJ,� . . . . . . .. 19 . . . tary Public, . l '�; ? . . . County JOYCE M.W LKINS Notary Public,State of New York , ' . • • . . . . . . . . . . .. No.495224.6,Suffolk Coun* (Sign re of applicant) Term Expires June 12,19_Zl -F 1 0, 1994 . - ' BLDG.DEPT. ' � - TOWN OF SOUTHOLD ' �'N•.5..•O510 ri - .30.�8 - - - 5z�° 40is . .. kil Ilk • - � .n,9"' sue'.}3 �;r .. t AI.i U:AiDC-i•..'.., AUUMOn TN15 SURVEY IS A VIOLATION OF CTIOIJ 7209 CF THE NEW Y::r;K STATfi� ''..CATION LAW. � \6 - I ! .� F'ES OF THIS SURVEY M:A7 NOT BEARING ^E LAND SUZVEYO"o'er It:'_U LcAL OR _ 2 - :355LD SEAL SHALL I:•-`:E' CLNSIDERED f� . .�, BE A VALIC T..M: CGF';. •._ r` - .. .R 1ARAh4EE5 .slll 4/.� UN IIIf•;:Y TO III, ✓i.S::. K; ..- _ / titC'CGR4 A.ia.v.')i —,__...A'./.—_,-CY AI7o � � ` � kx -�: THE f•i;- ..�.1 .v,,,:.71• \ _ �. D \� r. 0 H MAP. 4F PCjPERTY °'tip i{ T HC�rrlAf L. MAQI� C-. A MAC,PU "AL. � �-iQ � � AT- APZUH.AMLMAQU 1 T�WW GF .0UT1:4401.0, N.Y. k +�UACAWTZED 74 NQ y SCALD : 3Ca� � C141CA60 Tl'MX lN5URAN-6 C-0. ANa S00TA+- 5140IZ6 N ' Fr:flEIZA.L. �AV�etb A 4 LdAtQ' A'S 5'c�i:: F}3 buF=Y&Yf�TQ � N1 a''/ t $ $ Pt Y P—O D 6 iz t C 14 VA hl. Tc l r:, , + '. c:. �"' •:��s�Fsc.ic Ca. Tex r�lo. - - [lrt'l � � � - X UicEN5vD. LAt4D 5014VEYQfL5 16R NP0_ET, tJ.Y. r L- J _7---------- % M6 T ozMA;j TOW BLDG.DEP T --TOW 3-i I- 6j;- -OF-SdUTH T7 OLD' OVE 'AS NOTED 7 'us CY-OR' LDIN11131 fly.'0 PAN i NOTIFY SU DEPARTMENT AT 7 t CCU -IS- U_NL ------ - 765-1802 9 4:PM' FOR THE E —ANFUL FOLLOWING INSPECTIONS:- 111- FOUNDATION TWO REQUIRED II U_T�CER- IN VTHO C�T F--.. OCCU PAN- INSLKATION! 3. CON STRUCT16N-M UST- -i-- ----�..--- -i !f u., COMPLETE FOR C.O. 13E COM A ' CONSTRUCTION EET_L IMN TR UC vo -rHk_lRtQ6REMENTS__, 'OF_!_THt--N.,Y.J STATE CONSTRUCTION 111i ENEMY 7 _CODE1 RESPONSIBLE--FOR-!; —�- --- I ='� —_ ! ---(��' X-C�—'�; �-I�`I v -�`� XGII1'< `�_' Mal og OR CONSTRUCTION ERRORS LA , J- -Z 2 Jldt-,2 T i i j- i i- --- I I I I � I � ; j i i I I � I j I � I � ; � � i ;' � L�'- b, L