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Home My WebLink About8546-zFORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23662 Date MAY 25, 1995 THIS CERTIFIES that the buildin~ DWELLING Location of Propert~ 300 HILL ST~ET SOU'r~OLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 70 Block 4 Lot 37.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 28, 1976 pursuant to which Building Permit No. B546Z dated APRIL 28, 1976 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 ONE FAMILY DWELLING WITH ATTACHED GARAGE * The certificate is issued to CLAUS & DOROTHY ROBOHM (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL OCT. 26, 1976- R. Villa UNDERWRITERS CERTIFICATE NO. N-304163 - SEPT. 20, 1976 PLUMBERS CERTIFICATION DATED N/A *NOTE: THIS UPDATES CO Z-7539 DATED FEBRUARY 25, 1977. ' -- /-Bu~ing fnspec~or Rev. 1/81 W lqO.~ TOWN OF SOUTHOLD BUILDINg, DEPARTMENT Town ~lerk'8 Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at .. ;4i!2...haed ............... Street Map No... xx ....... Block No .... x~c .... Lot No. xx... Sauthold.. h...I/. .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... A.p=ll...28.., 19.76. pursuant to which Building Permit No. 8~1+6Z,. dated .......... .~,p..r.t.1...~.8.-, 19~.6.., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .. Pri~a~e..one..f.a~ilY.. dw.~ll~g ...................................... The certificate is issued to . .Cla.~s. arid .~Or. QthY..~O~]~n ..... .0.~7~$ .............. (owner, lessee or tenant ) of the aforesaid building. Suffolk County Department of Health Approval . .0c.t... 26... 197/~... by..Ii,..V.111a... UNDERWRITERS CERTIFICATE No..N~0~.1.6~ ..... Sep.t.. 20... 19~.6 ............. HOUSE NUMBER .... ~00. ...... Street .. Hill. itaad ....... dautho_ld ............ ~mldmg inspector / FOB~I 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? 8546 Permission is hereby granted to: $outholcl ~o ...~.)~i.~.~CL..~.:.e.~...9.~.e.....t..~.'u.~.~-.;h...~.:~.e..~..i.~.~. .................................................................................. at premises located at ........~{.~...[~J,l~..~.C,l~, ....................................................................................... ........................................................ Sau~,holcl.....bl. ~. ........................................................................ pursuant to application dated .............................. ;~pz'il ....... 2.J~.., 19.~'.6.., and approved by the Building inspector. Fee $..1.1.9.~ ~.Q ........ ................ /--~..-~.: ............... ~ ....... ~r ......... Budding ~nspector TOWN OF SOUTHOLD , Building Depurtmenf Town Clerks Office $outhold, N. Y. 1197] APPLICATION FOR CERTIFICATE OF OCCUPANCY instructions A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector 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 installations, a certificate of Code compJiance 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 pertinent in- formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 / / Rte .... .//..Z./.../.7..'Z ....................... New Building ~x/ Addition Old or Pre-existing Building ................ Vacant Land Location Of Property ..... ~.L~...~......A~?~f..~.Z'2 ........ .~.~...~.~...~.~?.. ................................................................ Owner Or Owners Of Property .....~/<.~.~.Z~....~...~..~..~/....~..'~..m...~...~..~/..~. ................................................................ Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Permit No....~....~.'.~..Z Date,/Of Permit .~.~.~.'~..~..Applicant ..~.~..~...~....~...¢¢~...~.,......~.~./....~..'~.N~....~../. ......... Health Dept. Approval ../,~.~. ................................. Labor Dept. Approval ................................................ Underwriters Approval .... z..; ...................................... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate / Fee Submitted $ ...c,~.... .......................... Sworn to before me this , ~-~// ~/-~7~' :~ ~ ..... day of ......... ....... stom o,,oa, Nota~ Public ............. ~~ Coun~ ~ Form No. 6 TOWN OF SOUTtlOLD I~UILDING DSP~RTNENT TOWN IIALL 765-1802 APPLICATION FOR CgRTIFICATS OF OCeUPANEY This application must be filled in by typewriter OR ink and submitted to the building inspector wigh the following: for now building or nec use: 1. Final surve~ of property with accurate location of all buildlng~, proper~y lines, street~, and unusual natural or topographic features, 2. Final Approval from }{e~lth Dept, of water supply and sewerage-diDposal(S-9 form). 3~ Approval of electrical installation from Board of Fire Underwriters. ~, Sworn ~tat~ment fromfplumber c~rtifying [hat th~ solder used in system eontail-s less than 2/10 of lZ lead. 5. Commercial buildin~, industrial building, mulgiple ran,dentes and similar buildings and in~slla~ions,~a certificate of Co~e Compliance from architect or engineer responsible for the building, 6. Submit Planning Board Approval of completed sits plan requirements. F~r existing 5uildings (prior to April 9, 1957) non-co,forming us~$, or buildings and "pre-existing" land uses: 1, Accurate survey of property showing all property lines, streets, building ned unusual natural or topographic feagures. 2, A properly completed application and a consent to inspect, si§ned by ~he applican~, Ifa Certificate of Occupancy is d~nied, the Building Inspector shall ~tate the rmasens ~herefor in writing to the applicant. i. Certificate of Occupancy ~ New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building Add£tiona to accessory building $25.00. Businesses $~O.00, 2. Certificate of Occupancy on Pre-existin~ Buildin~ - $[00.00 3, Copy of Certificate of Occupancy ~ $20.00 Updated Certificate of Occupancy - $50.00 5, Temporary Certificate of Occupancy - Residential $15.00., Commercial $I5.00' Data ...... ~¥.~$,,1995 ....................... New Construction ........... Old Or Pre-existing Building .... UpT~ped. Qertificate of Occupancy Location of Property .... ~D ................. ~.$~99~ .................... $Qu~914 .......... }louse ~o. Street Hamlet Onwer or Owners ,.,f Property. PPrpSb¥,g,.go~Pb$,.~uryi¥$~g,~¢~,by,th~,¢~tir~t~.gf.ql~uq,8,.gobohm County Tax Map No 1000, Sen~iog .... 70 ........ Block,..~ ............ Lot ...... Subdivision .................................... Pi[cd Mnp ............ Lot., .................. Permit No..~3J~ ......... Date Of Permi~.6728776 ........ Applic.mt..Abigail.A,.Wiekkam,.A~=n~y Health Dept ApproVai Undnrwriters ~pprow~l . . Planning Board Approvnl ........................ ~equest for: Temporary C~rtificste ........... Final Cart,ease ...... Wp-dated Certificate THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~-~ak 85 JOHN STREET, NEW YORK, NEW YORK 10038 ,ate September 20, 1976 A""'ic"ti°"N°'°"f'e856108 N 304163 THIS CERTIFIES THAT only the electrical eq.ipment a~ described be~o~v a.d i.troduced by Ehe applican£ ~arned on the above appl~atlon .umber i~ the prem~ez of, Dr. C. Robohm, Hill Road, Calves Neck, Wells & Harper, Southold ~. I. ~ 2.a Fl. outside in the yallowing location~ L~ Basement ~ 1st FI. SecEion Block Lot ~ ~a,,~i,edon Sep temb eX' 16, 19 ? 6 and found to be ~n compliance with the requirements of this Board. FIX?ORE fiXTURES RANGES OVENS 35 42 6 SERVICE DISCONNECT E R C E OTHER APPARATUS: PanelboaX'd/s: 1-3cir. 70amps. 1 G.F.C.I. 1-60amp. Transfer switch 1 Smoke Detector 1-5 Ton A. C. Unit 2_ Post lights 760 Long Creek Drive, Southold, L.I. 11971 Lio.65?EP~_ i~i'iL~ ~ This certificate must not be altered in any malqner; return fo the office of the Board if incorrect· Inspectors mayas ide TOWN OF' SOUTHOLD BUILDING DEPARTMENT TOWN CLERKS SOUTHOLD, No Y. Ex°mined ....... ...... _ (/,, ~Pdz- "~P~ ......................... 9'~ ...~...~"'~ Approved D,,appraved a/c ............... ................. ............................... ~ :. ...................... ~ .............. ._;.~?,~ ..... ,., ..... ~ (Building Inspector) AI~PLIGATION FOE BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or' in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plat plan to scale. Fee according to schedule. to adjoining premises or public streets b. Plot plan showing location of lot and of buildings on premises, relationship and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this applicatio~ 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 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, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. .......... ..................... (Signature of applicant, or name, if a corporation) ........ .......................................... (Address o~r applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......................................................... . .~.. iZ..~ ~.. ~z~ z~--- ..... Name of owner of premises ............. :~.~..~/..Z.c~...~.......~..~-~..4~..Z;~'.~ ...................................................................... If app,~icant is a c~rpj~ra~te, ~i~J~ature of duly,eiJthorizegl officer. (Name f? ~',:l'~e of~rporate/officer) Builder's Lic~'e No ..................................................... Plumber's,License No....~..:......~...~..~(~ J~/~'~ ...................... Other Zrade's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: .................... :~ .................. Lot No ..................... Street and Number ......................... .,~..~..~.../m.......~.~....~.Z2 ................. .E~....~..K~'..~....g~...~..~L~. ........................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ................................................................................................................................. b. Intended use and occupancy ........ ~.~,.~,~../.~.:.,'~...~..~~ ~ ~.~.~-"' ............................ ; ...................................................... 3 Nc:ture of work (check which applicable): New Building. · ................. Addition .................. Alteration .............. Repair ............... ~'t. Removal .................. Demolitior. ................... Other Work ................................................... .4 ' ~ 0 (Description) 4. Estimated Cost~.....~.,.~ ....................................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, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures~ if any: Fror, t ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ........................... Depth ................................ Height ............................ ..~,~//Number of Stories ................................ ~Z',-~ / 8. Dirnensioos of entire new construction: Front ........ ./.7.,." .................. Rear ............................ Depth ....~...'.~.. .........." Height .................... Number,,,--at Stories ....... /. ................................................................................ ~-,~ ,-~__': ......................... 9. Size of lot: Front ................../~.~. ............................ Rear ........... ..'~..,.'~.../,. ................... Depth .~...~.....'~...~..~....~.. .... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ or use district in which premises are situated .......... ~.~..~./.~;~.~7~(~...~./../~..-~..,....,L.../, ................................... 11. Zone 12, Does proposed constructignlviolate any zoning iow, ordinance or regulation: ............. /,~.¢~.;41, ......... ' ....................... 13. Will lot be regraded ...... ..y...~.~...~k~/¢~ .......... Will exce~s~ fill be removed from premises: ( ) Yes (~,- No 14. Name of ?wner of premise_,~,~,....~,~..~. ,~..~.,...~..~.~.~..~--,,~ ~-~ '~ ,~ ,¢-- Address,~--,~,~ ~-~ ,,. ~'~:- ~Z~ .~.~/,~/~(~..~..Z~.... Phone NONo/ ....................... Name or Architect ..... ~ -- -- .~Z~-~,/~/~...~./~K....,~...,~,.~/~.,/.~ ........... Address Z~C~'~C',~,.,,~r~...~.~...~¢.. Phone ............... Nome of Contractor ....~.~,......~,~.~./,.~..~.~..7~./...,~.. Address .~,/~-,.o,~,.,Z,~.... Phone No ....................... PLOT DIAGRAM Locate dearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interlor or corner lot. ?I-ATE C,F NEW ~,0].~ I SC,.-, ................... ~~-:%,~=~l~ ........ ; .................. being duly sworn, deposes and says thQt he is the appliconl (Name of indiviCat siCnin¢c~ntracf) above named, ~ ~ CO~t~ecto~ He is the ................................................................................................................................................................................ (Contractor, agent, corporate officer, etc.) o~ seid owner or owners, and is duly oufhorized to perform or have performed the said work a~d to make and file d'~[s epp~ication; ~hat aH statements contained in this applicction are true to the best of his knowledge and belieF; end tha~ t'he work will be performed in the manner set fo~h in the application filed therewith, Swam ~ore me this ~.~Z 7~-- (5~~c~~'~ ~' ............................................... ................ ELIZABETtf ANN NEVILLE NOTARy PUBLIC, State of New t~d 52-8125850, Suffolk Cou errn Expires March 30. 19~ JCo/,.¢ : 6c~/a : 60' -- 1" la ,q TO THIS SURVEY IS A VIOLATION OF SECTrON 7209 OF THE NEW YORK STAT~ EDUCAT OH LAW. COPIES OF THIS SURVEY MAP NOT ~EARIN~J I ~,~'~;~'^,?;, ~ ,-:, ., /,Z iU~~, ,,, Iow,,,,. ~ , r~,~. DATE FEE: BY NOIlFY BUILCING DEPARTMENT AT 765-2560 9AM TO 4PM FOR REQUIR. ED INSP~:CTIONS: 1. BEFORE BACKFILLING FCUNDA. TION OP. START FRA~.ING ¥ 'k II DONALD/t DENIS, AQU:M~OOUE AQU'EB,OG[~, N,, ~L 11991 / \\ i II L , l/ DONA,LD ./~ DENIS,/~..I.~., L