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Home My WebLink About5691-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19062 Date MAY 21~ 1990 THIS CERTIFIES that the buildin~ ADDITION Location of Property #18 Private Rd. (Ha~tt Rd.) House No. Street County Tax Map No. 1000 Section 50 Block I Subdivision Filed Map No. Southold, N.Y. Hamlet Lot 8 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 6~ 1972 pursuant to which Building Permit No. 5691-Z dated JANUARY 6~ 1972 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 ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED MICHAEL REISE~ DECEASED. MIA N-407598 - OCTOBER 25~ 1978 N/A Building Inspector Rev. 1/81 FOEM 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) No. 5691 Z Permission is hereby granted to: · .. &,.. J,/~,tt,....~,/C.....~lmel..ll~se ........ at premises located at ....;.....~,/JJ...J:~TJ..,J~....J~J~t~.~J~J..JJ) ................................................. .................................. ll~'t.~ ..1~ e.. J~m'~l~ ................................................................................ pursuan¢ to application dated ............................. ~...~IL ...... .1~ .............. , 19...~JJ, and approved by the Building Inspector. Building Insp'e~'to~ ( ., [, Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 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. Con~nercial 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. 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 1. 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 Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date MAY 18, 1~90 .... New Construction.. ~ .~.~'01d Or Pre-existing Building ................. ~18 PVT. RD (HYATT RD.) SOUTHOLD, N.Y. Location of Property ................................ House No. Street Hamlet Onwer or Owners of Property MICHAEL REISE,. ..DECEASED. .... Coun Tax No 1000, Section.. 50 .. Block...! ...Lot .... 8 ty Map ...................................... Subdivision......... ......................... .. Filed Map ............ Lot ...................... Permit No.}~I-Z l!~? mppli MICHAEL REISE ........... Date Of Permit ........... cant ............................. Health Dept Approval . Underwriters Approval .................. · Planning Board Approval . Request for: Temporary Certificate ...... Fee Submitted: $ .... ..... Final Certicate ........... ., 160 '~:" ~- ~ ~-' BUILDINGTOWN OFDEPARTMENT¢,~.A,~SOUTHOL~ ~"~' ~' ~ ~ q (~ TOWN CLE~'S ~FICE H ,~. " : " Ex, mined ...~. ....... 6', ........ , 1~...7.~. Application No ...... 5~g~ ................. ~proved ........... ~ ............... ,! .......... , 19...~:~..Pemit No .....~63.1.....~ ......... ~' ~- ~ ~ ~sa rove= a/c ~ ............................... ~ ~~~ PP ...................................................................................... ~ · / / - ....... ,~ .......................................... ~ Y.~ /~ ......... · :.¥ ........ ,.:::;..~.:~ ................................................................................... ~ q~- ~ Z~ APPLICATION FOR BUILDING PE~IT ; ...~ -~ ~,~ ~ ~,~ . ~-~.~' r~~-t _~ , .. , ....... ......... a. This o~lication must be completely filled in by ~ewri~or in i~k and s~bmitt~ in ~1 ~ ~ lui~' Inspects['I '~~~~~ b. at p an showing I~ation of lot and of buildi~s ~ praises, relationship to ~n~ ~ ~ areas, and giving o detailed de~ription of layout ofpr~ ~esr b~mwn on the diagram Akh is ~ of c. ~e wo~ covered by this a~licotion may ~t be ~me~ before issuance of BUi~ Permit. d. Upon opp~l of this application, a~ Budding Insp~tor will iss~ a ~uilding Permit te the applier. ~h permit.~ sholl be kept ~ the premises av~il~le for in~ection thr~ghout the p~ress of the work. e. No buildi~ ~11 be ~cupied or used in whole or in po~ for ~ny purpose whoever u~iil o Ce~ifkote of ~cupancy shall have been granted by the Bud ng In~ector. APPLICATI~ IS HEREBY ~DE to the Building Depaffment f~ the ~s~once of o ~lding Per~ Pu~ont to the ~uilding Zone' Ordinance of the Town of Southold, Suffolk Count,. New York~ and other ~pl cob e~s, ~es or ~u~o,~n,. for,~ :o.~,r.:,~on o~ b.i~d~.,,, ~ddi.~, or ~,~.,.,, or for ~v~ o, ~o', on, o.-~.~. ~e~r~bed. e applicant ogrees to comply with oil applicable I~, ordinances, building c~e, housing x c~e, and . ( ddress of agl,~) ;' ....... State whether~licant is ~ne~, !es~e, agent, architect, engineer, general contractor, electrician, plu~ or builder. ............................................ ........................................... ....... : ...... ........................ Name of owner of premises ::~.~.~[~~ ~.~.~ If appl cant s a co~mte, ~ gnature of du y author zed off cer ..................... ........ (Name a~ title of co~orate officer) 1. ~at on of a~ ~n whi~ pr~osed wRrk will be done. Map No' ~ ~ L~ No ~treet ~d Number .;.~.~.~....~.~... ~ ~.~.~" ~;'~' '~ ' ..................... ..................................................... ae~ ................... ~. State exis~ng use o c~nc~ o . ise ~ cu~nc~ of p c~st~ct~: ~; ~isiting use o~ ~cupancy ........ ~..~..~.~.~.~.~ ................................................................ b. Intended use ~nd ~cu~ncy ..................................... ~.....~ ....................... ~: ........................ Nature of work (check which applicable): New Building .................. Addition / Alteration Repair ............... '/~b~_~Rem°val .................. Demolition .................. Other Work (Describe) ........................................ · ~w 4. Est~rnated Cost ....... PP~..~ ............................................ 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~ ....... ~....:.~....~.. ....................................................................................................... ~ ............... 6. If business, commerc a or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, Jf any: Front ............. ...~. .......... Rear .....:~e..~:. ............... .~. Depth ..'~c...~ ......... Height ........ ..... Number of Stories ..... ...~?.. ........ ~,...~..~....~..~...~..~.......~e,...A~....~:...~.. ................. ~'"'r ............. Dimensions o( s~e structure with alteration~ or additions: Front ....~.,..~. ......... [,~,~r ............. Rear ....~:. ................. · Depth ........ I~...~. ............... Height ....../..a~r. .............. Number of Stories .....~.....~.1~.~1~'~- 8. Dimensions of entj~re new construction: Front ........... .~L~ ..................... Rear ....... .~....~. ............ Depth .~t.~ ................ Height ........ ..... Number of S ries ..... ......... ............................................ 9. Size of lot: Front ............................ Rear .............. ~ ..................... Depth ................................ 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 Iow, ordinance or regulation? ./..~....O. ................................................. 13. Name of Owner of~ premises ..~.~.~g.L.~.~.Address ....~..e~....~te~....~.,.~., Phone No.~..~.~3.f' ~Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of ContraCtor ..j~g~.~.~....~..,~.~.~k...~...~..~..Address'~' -- ~------- ...... ~.~]~/~..~.~). ......... Phone N o. 'L..~..-,.~.~ .~..~. PLOT DIAGPuedV~ '~ ' Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and block number or description according to deed, and shew street names and indicate whether interior or comer lot. STATE OF NEW i'~ORI~ .~ ! 1 ~ ~ .......... ~~ .................................. b*in~ duly ~worn, d~os~* ond sey~ t~t h~ i~ t~ ~pplic~n~ (Name of individua~gning application) · above named. He is the . ~u ~ ~ ................ ' . . (Contractor, ag~t, co~omte officer, etc.) of said ~ner or owners, and is duly authorized to pe~orm or have performed the said wor~' and to ~ke and file this application; that all statements contained in this application are t~ue to the best of his knowledge and belief; and ~at the ~rk will be performed in the manner set forth in the applicati~ filed t~rewith. .Swam to ~fom me this ~ ~ ..... ........ ........ : ...... . ~ ~A..~ ~. ~ I .... '~ ..~.~.~.n: ....... :..~ ......... ~ ....... x ....... x ......................... Term Expires M~ 30, l~ '~ THE NEW YORK OF Fi~E IBt.q~BAU OF BLECTRI~ITY ?-'~.,/, ~ JOHN ~. WW YO~ NEW YORK 1OO~ ~ ~. o~o~.~ ~% [~7~ ~..~-r~ ~3[~ N407598 ~l~ CE~IE~ THAT ~lke ~eeae~oundvle~ Ave, ~e/o Ho~on~ Rd. ~outhol~.Z. ~ FUaNA~MOTOaS 4/0~ Hall Elect. 760 Long Creek Dx, 3outhold,N.Y. 11971