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Home My WebLink About7403-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No .... Z16971 Date June 9, 1988 THIS CERTIFIES that the building addit ion Location of Property 2575 Pvt. Rd. #7, Diedriok's Road Orient . h3~ ~io: ....................... 'S'de~i ....................... hZ, r~ie, County Tax Map No. 1000 Section ...... 1.8 ..... Block ..... 3 ..... Lot l Subdivision ............. .X ................. Filed Map No. X .... Lot No. X conforms substantially to the Application for Building Po}mit heretofore filed in this office dated ·...J.u. ly..1.0.,. 1974 pursuant to which Building Permit No. 7403Z dated ..... J..u. ly.. 1.21,' .1.9.7.4 ........... 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 on'to existing dwelling. ' The certificate is issued to ......... nAem[ ~!. ~A~lIS ............ 7 l ll l&j ................. : .... of the aforesaid building. Suffolk County Department of Health Approvar N/A N733677 UNDERWRITERS CERTIFICATE NO .................................................. PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 IrOBM NO. ~ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON TH.E PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7 03 Z Permission is hereby granted to: ...~._~.r~r~.. ~ .. ~xe~l.y~..~ea~raz .......................... .................... .o.~.L~.~. ...... i ...................................... to ...huf~.z~..ad~£t Lo~..on..ezLstLug...d~LLLt~ ............................................................. at premises located at ..~r.t..~oaA..~. ......... ~:be~r;Lc~..~ ............................................................. ....................................................... ~.te~t~....l~ oY.. ............................................................................ pursuant to application dated ........................... ~'a~y.l~ .............. , 19.~J~.., and approved by the Building Inspector. ~xamined. ..... .(~''~'~ ~' ...... , 19...'Z...~ '~ ,iq~)ficatlon' ~o. ?....~.....~....~.....' ........... '~'~ 19......~Permit No. .../~ ............................. " 4,~.'{~' 7.~,?.' AppIICATIOHFO~BUILD~HGI'IRMI?~ ~~.z,,ff ~ .~ app? ~ INSTRUCTIONS a lication must be completely filled in by typewriter or..in ink and submitted in triplicate to the Bullding~ Inspector, with 3 set~ of plans, accurato plae plan to ~ Fee occordmg to schedule. · b. Pie? p. la.n showy, ing..Ioca, tion. o.f. lot a.r~l, of buildings on premises, relationship to adjoining premises or public streets o!"~ areas, aha g~vlng a aeraJma ae~cnpt,on ot layout otpmperty must be drown 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. U~D aPProval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit~/ shall be pt on the premises ava lable for mpect on throughout the work. e. No building shall be occupied or used in whole or in part for any purpase 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 Buildina Permit oursuont to the _Build!r~.. Zo? Ordinance of the Town of Southold, Suffolk County, New York, and other al~li~able Laws', Ordinances orr .~geeU!at~s, Tor the construction o.f building.s, additions or a!terations, or for re .mov?l or demolition, as herein described. ,e .?pp .m. an.t ag.r.ees to comply with all apphcable laws, ordmancas, building code, housing code, and regulations, and to aam~ aumonzea nspectors on prom,scs and In buildings for necessary Inspectlom. ..... ......... :...:} {$1grmture of ~Pl~licant, or marne, it ~ corpon~l'ion) (Address of applicant) State whether a~cant is owner, lessee, agent, amhitect, engineer, general commctor, electrician, :plumber or builder. ......................... .......................................................................................................................................... : .... ' rem ses . ..~...~.. Name of oWher of p ............. y ............................ ~....i~.:.....~..! ................ .~. ............................................... if applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Tmde's License No ....................... 1. Location of land on which proposed Map No.: t ~ ~orkl~lLbe done. Mc .................................... Lot No .................. . ..... : Street and Number~.~*[~j~:~r~e~j~.L~.~(~F.~~~r[~ .~ ..... ' Munt"¢ilxdil~ State existing use and occupancy of premises and intended use and occupancy of p~ construction: a. Exisiting use and occupancy ..~:'......~.~J~....~.~-.~..~..'.~.~)~..~...'[...~.....~.~...~ ......................... b. Intended use and occupanCy .~....~.~..~'.:~.~A~]~.~~..'.....~.~..~..?...~...~. ,..., 3. Nature of work (check which applicable): New Building.. ................. Addition ......~.... ...... Alteration ................. Repal~ .................. Removal .................. Demolition .................... Other Work ..................................................... (De~ription) 4. ~tlr~ted ~ ............................................................ l:ee ........................................................................................ 5. If dwelling, number of d~lling unit~ .......... ..~,. ,. ..'. ...... Numb*r of ~elling units on ~ch.floor ~. ........................... I{ garage, number of c~r~ ............................................................................................................................................. 6. If busing, comr~mlal or mixed °Ccu~an~/, ~pecif¥ nature and e~ont of ~ch h~ of u~ ............................ 7. Dim~nsior~ of ~i~ting stru~ur~, if any: Front ............................ ~r ................................ ~ .................... H~iflht ........................ ~u~r o{ $tori~ ................................................................................................................. Dim~i~ o{ m~ ~m wi~ ~l~r~i~ or addition*: Front .................................... ~r ............................ ~pth ................................ H~i0ht ....... 2 ................... ~umb~r o~ Stori~ ................................ H~lflht .................... ~um~r o{ S~ri~ ...................................................................................................................... 9. Size Of lot: Fret ' .............. Z~..~. ........................... R~r .......................................... ~ ...,./&~ ................ ~0'. Dat of Pure ~ ....... ~..~.w ........................................ Name of Fo~er ~ner ............................. 11. Z~ or u~ di~rict in which premi~ are situated ...... ~.~.~.~.~,~.~ .......................................................... 12. D~S p~ c~st~ion violate any zoning Iow, ordi~nce or r~ulati~: ..... ~ ............................................ 13. Will lot ~ r~ ............................ · L ~Will exce, fill ~ rem~ ~f~o~i~:~( )~Y, ( ~ ~e - 14. Nam~ of ~er of prem,~ ~..~.....~..~~ ~.~...~:~ Na~ of Archit~t .............................................................. A~ ................................ ~ ~ ...... : ................ Na~e of C~mctor A~r~ ................................ ~ ~ ....................... PLOT DIAG~M ~o~ cl~ly a~ d,~a~ y,~ll ~uddm~s, ~et~er ~x,~t,ng or p~d, a~ indicate all ~k di~i~ f~ p~ .~. ~ ~ ana D ~K number or ~r pt on accordtng to d~, a~ sh~ ~ ~ and J~icate whirr in~rior or corner I~. . STATE OF~ NEW YORK, I S S COUNT~ OF ................................ }' · ................. ~ ............................................................................... being duly, .swam, dep ~oses and says that he is the applicam ,. !(N.arne; ~f individual Signing contrac~ - . , - abov~ named. He is the ~ ................................................................................................................................................................................ · (Contractor, agent, corpo.rat~, officer, of. said ..o~r?.r Or OWners,~a~d is duly authorized to perform of ha~'performed the said work and to make and file t.h,s a. pphcat,o?,.',..t~at all. st. ater~e., n~ contalhed ip .this .app!icoti ~o~. qre t .r~.,. to the best of his knowledge and belief; and ~a~ the Work w,, ~e.per~ormea4ei ~m manrmr set'torth in the application flied therewith. Sw°m~°~be(~re me thiSday of ub ic, ..... i ........... ....... co,my ..... .......... ~ (Signa~re of a~licant) / FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ 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 property 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 3ertinent informa- tion required to prepare a certificate. C. Fees: Additions Q~2~5~ 1. Certificate of occupancy New Dwelling $25.00, Accessory ~$ ~0.00 Bus~ness $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .... .~.O./?.~..~. ,.! .~.~.~. .... New C OhS t ruc t ± on ...... Old or Pre-existing Building ............ Vacant [.and ............. · . ...... ::..;h;:...' ...................... .......... '. County Tax Map No. 1000 Section / ~/ Block ~ Lot.., Subdivision ................................. Filed Map No ........... Lot No .............. Permit No..r/.~,O~. .... Date of Permit .-7//.P./.~....Z?{Applicant .~. ~,,~"j.. F,~. :..~...~,/%,,,~.~.~. ....... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ....... ~ ........ Construction on above described building and permit meets all applicable codes and regulations. ~ ~.,)xgO' 3~.~7/ Applicant= .............. Rev. 10-1o-7a ].ooo121 THE NEW YORK BOARD OF FIRE UNDERWRITERS r'~ BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK, NEW YORK 10038 iio-,. January 30,1986 A..~ica,io,,,~o.o.ji~. 379715-86 N733677 THIS CERTIFIES THAT ~'~ - Harry Mearns, Private Road (on Sound Rd.), Orient,.N.Y. ~ in,hefotiovringIocazlon; [] B~eme.t [] t,~rt, [] ~nd ~'l. outside s,~tlo. Bl~ Lo, &o. ~.&.,i.~d o. Jan. 27 ~ 1986 .~d fo..d to be in cornpliance .'itl, tit. reqa,;r~menls of ,his Board. fiXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS Paul Burma 275 Town Harbor Lane · .Southold, N.~Y.'l1971 lic, 282E .~ G~,~A~.J?~.i ~ ' P e rJ~-~- __ This certificate must not be altered in any manner; return to the office of the Board if incorrect· inspectors may be identified by their credentials. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND £ ] INSULATION [ ] FRAMING [,~"~INAL REMARKS. ~ ~'~ ' DATE / / / 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING [~NAL REMARKS: DATE_~i~/ ' INSPECTOR _~.~