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Home My WebLink About3044-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No Z-23584 Date APRIL 4, 1995 THIS CERTIFIES that the building Location of Property 1580 HOBART ROAD House No. County Tax Map No. 100O Section 64 Subdivision DWELLING SOUTHOLD, N.Y. Street Hamlet Block 3 Lot 2.2 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 5, 1966 pursuant to which Building Permit No. 3044-Z dated APRIL 7, 1966 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 OWE FAMILY DWELLING WITH ATTACHED GARAGE * The certificate is issued to DORIS H. GENSEL ( owner ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL SEPT. 2, 1966-EY R. VILLA UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *NOTE: THIS UPDATES CO E-2516 DATED 9/6/66, & ALSO INCLUDES PR~ EXISTING ACCESSORY BOAT SHED & GAZEBO AS SHOWN ON PRECO Z-10442 DATED 4/8/81. ' / /Bui'ldin~' Ins~pector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT '~OWN CLERK'S OFFICE SOUTHOLD, N. ¥. OEi~TIFll]ATE OF O~OUI~ANO¥ No.. 7,..e~'16... Date ................ ~ep.~.. ~. ....... 19.66. THIS CERTIFIES that the building located at W/.S...HOba$*.~ .Ro~d .......... Street Map No ............. Block No ............. Lot No ..................................... conforms substantially to the Applicati,on for Building Permit heretof~O~e filed in this office dated ............ AI}~*.t.~...~.., 19..6.6. pursuant to which Building Permit No..3.0.lt1.~:..~. dated ............... Ap.~il...~, 19..1~6 was issued, and conforms to all of the require- ments ,of the applicable provisions of the law. The .o.ccupancy for which this certificate is issued is .P~'~-va~e · one..f, am. ily..dweil~ng ........................................... The certificate is issued t,o . .F.~..e.d.e..~'~ql.% .P.,..t~..~.qh. ............0 mer. ................. (owner, lessee or tenant) of the aforesaid building. ,Suffolk County Department of Health Approval ........ Sept...2~. 196~5.. by. R,..V. illa Building Inspector 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? 3044 z Permission is hereby granted to: G .W · ~m.~.~h.. ~-. f~e~.....A./(~...~e~}e~.~:ot~..D~...~e~ ................. 80~l~he]:.8: ........................................... to . JDli].d.. zte.~., t~n~..l~m&.t~r...d~et.t.~tg ..................................................................................... , at premises located at .-..Iq/~.'"-I'IOb~Z*~"Roac} ................................................................................... ............................................. ~ot~t ~14 ~ ...~{. :g. ~ ................................................................................... pursuant to application dated ............................... jkpt.*.:~.J~.....~ ........... 19..~., and approved by the Building Inspector Fee $"t0.'(~0 .......... Building Inspector s-9 TO WHOM IT MAY CONCERN.. SUFFOLK COUNTY DEPARTMENT OF HEALTH Date Permit No. .... The sewage disposal facilities for a structure located at --~i~e deed location)/ .... have been inspected by this Department and found to be satisfactory. Distriot Enginee~ DistriCt Engineer ~3LOG. DGP'L "OWN O¢ SOUTHOLD Form No. 6 TOWN OF SOUTIIOLD BUILDING DEBARTHENT TOWN tlALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: 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 H~lth Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrica~l installation from Board of Fire Underwriters. 4. Sworn statement from fplumber certifying that the solder used in system contairs less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations,Ks 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: 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 i. 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 Buildin2 - $100.00 (4. Updated Certificate of Occupancy - ~50.00 ~ ~= oz occupancy - ~esiuentia± $15.00., Commercial $15.00 House No. Street Hamlet ' Onwer or Owners ~f Property .~. ~ , County Tax Map No 1000, Section...~.~ ....... Block. '~ .Lot...~.~. ............. Subdivision .............................. Filed Map ............ Lot ...................... Permit .............. Date Of Permit ................ Applicant ................ .3 a W IIealth Dept Approval ' ' ...................... Uuderwriters Approval .................... Planning Board Approval Request for: Temporary Certificate ........... Final Certicate .... Fee Submitted: · ~O, ~ ,:' ¥,, Z Z - ,, , ~: m m I FORM NO. 1 TO~,VN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ........................................ , 19...?... Permit No ............................. Application No ............................ Disapproved a/c~~~ ................. ....................................................... ~~ ........ .~[..' . ................. ................................. (Bu~or) ...... APPLICATION FOR BUILDING PERMIT Date .......... ............... , .... 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 part of this 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. The applicant agrees to comply with all applicable laws, ordinances, building code and r~gulations. (Sig~j~'ure,,~pp!!cant, o.~r name, if a corporation) ................ .......................... (A ross of applicc~ft) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ................................................................................................................................. If applicon~xi/~]~ corpor, at~?sign~re~uthorized officer. / ~ ' ~~......z '-'~'."" (Name and title of corporate officer) u icipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o, Existing use and occupancy ~...'.~] ........................................ b. Intended use end occupancy ........................................................................................... 3. Not~re of work (check which applicable): New Building ......... Addition .................. Alteration .................. Repmr ................ ,,,~Removol .................. Demolition .................. Other Work (Describe) ........................... ~ ............ 4. Estir rated Cost ..(~..qC~(~..~:~..~. ..................................... Fee ............................................................................. ............. (to be pard on filing this application) 5. If d'velling, number of dwelling units ..~ .......... Number of dwelling units on each floor ............... ............. If g( irage, number of cars ...... ~ ................................................................................................................... , ...... 6. If Jsiness, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dim,msions of existing structures, if any: Front ............................ Rear ................................Depth .................... Hei ht ........................ Number of Stories ................................................................................................................. Dim',,nsions of same structure with a,lterations or additions: Front .................................... Rear ............................ Deplh ................................Height ........... - ............... Number of Stories ................................ Hei ht .~,~.../. ......... Number of Stories ..~ ....................................................................................... i ............. 10. Dot~ of Purchase ........................................................Name of Former Owner ........................................................ 1 t. Zon,'~ or use district in which premises are situated ./:~.~... ......................................................................... ! ............. 12. Doe~ proposed construction violate any, zonlng~ Jaw, ordinance or 13. Na4e of Owner of ........ Address ~..~..~...~./~..... Phone No ....... ; ............. Nar~e of Architect .................................. /,2 ........ ,~.....Ad ress ......... ~ ............. ~ ................. Phone No ..................... Nar~e of Contractor~c~.:.~..~~ddress .~~..~..~.~..... Phone No ..................... PLOT DIAGRAM L.ocat~ clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-back dimensions from property lihes. Give street and block number or description according to deed, and show street names and indicate whether in erJor or corner lot. STATE aFl NEW YORK, ~ e c COUNTY ...................'~..~~ ............ being duly sworn, deposes and says that he is the applicant Name of individual signing application) · above na~ed. He is the ................. (~~ .............................................................................................. (Contractor, agent, corporate officer, etc.); of said ay'net or owners, and is duly authorized to perform or have performed the said work and to make,and file this appli( ~tion; that all statements contained in this application are true to the best of his knowledge and b~lief; and that the w ,rk will be performed in the manner set forth in the application filed therewith. //~ ' Sworn to ~ ~fore me this // ~- ~ ~-'~//~ ~/ ,~ ......................, day of ............................................ , t9 ........ ..........~~ ' Notol¥ Pu bJic, . ........................................................... County (Signature of applicant)