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Home My WebLink About2815-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NC Z-23919 Date SEPTEMBER 27, 1995 THIS CERTIFIES that the building. ADDITION Location of Property 188 WILLOW TEBRACE LA. House No. Street County Tax Map No. 1000 Section 26 Block 2 Subdivision Filed Map No. ORIENT~ NEW YORK Hamlet Lot 5.1 Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 22, 1965 ~ursuant to which Building Permit No. 2815-Z dated JULY 13, 1965 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 EXISTING SEASONAL COTTAGE AS APPROVED BY ZBA The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CENTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 PHILIP C. & JOAN FREY N/A N/A N/A FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2815 z Permission is hereby granted to: . F~'~,. !.~.~g.. ~,,.. JP, r. eF. .......................................... .................. 7.0.. ~.e.te=.oa.. P. lao. .................... ............................ ~lr~.o~ar, e..... ]t, ~r, ................ to ...Te.. }>~ ~ 1 cl..ma., a~l.d~,t, Sx)a .. aa.. ma.. e~l,s t~t, ng... d~e.1.],.~......(~J...a~l~.o~&..bF...~! .o~.. J.~:~,,! ....................................................................................................................................... at premises located at ..~e~[.....~,~.....J~.lJ~...J~t~ ........................................................................... ................................................. O~'J. eatt.....l~.~. .................................................................................. pursuant to application doted ............................... .~J~lr.....~,~, ............. 1~,~'....., and approved by the Building Inspector& ~ of Fee $ 5~1.(~. ............. APPI JCA'['IO,~I I-'01~ (:ERTIF[CATI~ OF OCCUI'ANCY JUL 2 8 1995 A. Thl.,: apl~JLic,.itioU must be [il.Led tn by t. ypewe[ter OR ink m~d submitted I.o the Imi 3. Approval o[ electrtcad iuaLallat:iml from llosrd o[ F'~re .l,e~a Limn 2//O of /Z lead. 5. (,o,m,~rciaJ buildtn~l, industrial, bu.Llding, tau/.tJple reslclence~ and simtlur builtling~ responsib.te Eot thd beilding, 6. Sub d.t Pianuing Boat*d Al)pt;oval of COlllp.l.e~[!d site ptaU t'equ[rementa. B. For existing )tJldJngs (prior; to April. 9, / g7) nou-couformiug uses, or buiJdftll~s asd 1. Accurate survey of property s lute[tiS al.l. property .1. iues, ~treeCs, btJi~dieg sn(J uuustal ,aCural or topogral)hic [eat res. 2.A properly csmpleted aPl)llc~ Lion aud a eminent to inspect signed by the l[ a Uectificate i~[ Occupaucy is deuted, the Buil J. ug l.n~pector shull strife the t'easous therefor itl writi,8 to Lhe uppl. icant. 1. (er i[icate si Uccupancy ~ Ne~4 d~4elJi g $25.OO, Additions to dwelli~$25.O0, Alterations to d~etl[ug $25.00, S~ejmmJt~g pool $25.00, Accessory buiidjn8 Additl. o,s to accessory ;t Hdtn8 $25.00. Businesses $50.00. 2. Certificate of Occupancy mi Pre-existing b 1111 a - $100.O0 3- Copy of Certiflcate of Occupancy -- $20.00 &. Updated Certificate of Occupaucy ~- $50.00 5. Temporary Cet'tiftcate of Occupancy I ' - ~eslde~t~aJ. $~5.0(), Commercial $15.00 Date ......................................... ~ew Cs,struction ........... OLd Or Pre-existing Bul[dj..g ................. llouse No, Street Ilamlet ~ubd i~J s[ou .................................... F i I od Map ............ Lo t ...................... art ~1: ~. - ....... Date Of Permit ................ AppJJc;mL ............................. :h'aJ. th DOpL. Approval ........................... Umler~vrit:ers Approval ......................... ee Submitted: TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ,......~...~...~ (~ & ,o · . ............... . _ ^pp,,cat,on No.,Ylm.~...~,:.~..~ Approved '-~'[ ~'~ ...... , ',;'~';SPe~mit No ~ [ ~ S ~ ................ ....... C"T'"L ................ ........................... ...... ................. ...... . ......................... ~ ........................... ~ ........ ~~..~ ....... (~uildin0 Inspector) APPLICATION FOR BUILDING PERMIT Dote ................................ ~._..~L.. :~£ ....... , 19.6~' ...... INSTRUCTIONS a. This application must be completely filled in bY typewriter or in ink and submitted in duplicate to the Building Inspector. 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 pa.rt of thi.s application. 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 progress of 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 and regulations. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....................................... O~11~.~ ........................................................................................................................................... Name of owner of premises ..... ~..~;J,&],,J.~....~,,....~.~.-.,~. ........................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer) 1. Location of land on which proposed work will be done. Map No,: ..~ .............................. Lot No.~ ................ Street and Number ~ ~Le.0,.~I~......~..~/~ ..... ~.[~..o.~t ........ 0~e~ .................. ~ ' Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...6.'~; ............................................................................................................ b. ~ntended use and occupancy ....~.~.....~.~..~...~.~.~ ........................................................................ 3. Nat~Jre of work (check w applicable): New Building ................ ddition ._X,XXXX... Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) ................................... 4. Estimated Cost ..... 800..~'/.M ...................................... Fee ............. .~.~, ................................................................... (to be paid on filing this application) 5. If d~e[ling, number of dwelling units ....... O~e ............. Number of dwelling units on each floor ....................... If ~rage, number of cars ..........~.~..8.~.a~e .............................................................................................. 6. If ,usiness, commercial or mixed occupancy, specify nature and extent of each type of use ....................... 7. Di ensJons of existing structures, if any: Front ....... ~0. ............... Rear ........... ~ ............... Depth ......... 2~ .... klei~lht ........................ Number of Stories ......... ~ ............................................................................................ Dim~,nsions of same structure with alterations or additions: Front .................................... Rear ....................... Depth ................................ Height ............................ Number of Stories ................................ 8. Di~ensions of entire new construction: Front ....... ~0 ........................ Rear ..... ~Q ................. Depth ....... ~0 ....... Height .................... Number of Stories ...... ~ ................................................................................................... 9. Size]of lot: Front ............ ~0 ........... Rear ........... ~ ................... Depth ........... 10. Det~ of Purchase ........................................................ Name of Former Owner ....... .D~.],a,~ ........................ 11. Zon~ or use district Jn which premises are situated .....~.~ .................................................................................... 12. Does proposed construction viobte any zoning Iow, ordinance or regulation? ............ ~e~ .................................... 13, Na~e of Owner of premises ...... ~,....~F ................. Address ...... ~ ................... Phone No ................ Na~e of Architect ...................................................... Address ............................................ Phone No ................ Na~e of Contractor ...~ ....................................... Address ............................................ Phone No ................ PLOT DIAGRAM L.ocat~ clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr property lines. Give street and block number or description accord~n~ to ~ed, and show street names and indic whether interior or corner lot. O(~ h~~ ["~ STATE OF NEW YORK, ~ S S COUNTY ,OF .. J~',~/t.£O],~ ............ )' ' ' ................. i. .............. ,P~l..$'l.l.~.~..A.i...~e~' ........................... being duly sworn, deposes and says that he is the applic. I(Nome of individual'signmg app'rication) above no,r~ed. He is the ................... Ow;Ilea' ...... J~H:J.~4:I.~,~. ............................................................................................. ! ,, ' (Contractor, agent,,~carporate officer, etc.) of said ow~ner or owners, and is duly authorized to perform or have performed the said work and to make and this oppli6ation; that all statements contained in this application are true to the best of his knowledge and belief; that the wgrk will be performed in the manner set forth in the application filed therewith. Sworn to b~fore me this -~, ................ !.~,~,. day of ................... }/,~y'. ................. , 19..~.~: Notary Pu hc, ....~,~,.~,~¥,.,~ ',~ .:, ,,,.~,,,:...~.~.~, .~,,.,.-,-~.. County lnature of apl nt) I //'.a'Wig'