HomeMy WebLinkAbout8568-zFORM NO. 4
TOWN OF SOUTEOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
UPDATED
CERTIFICATE OF OCCUPANCY
No Z-23207
Date SEPTEMBER 12, 1994
THIS CERTIFIES that the buildin~ ~D~I~ING
Location of Property. 1315 NORTH P~ISH DRIVE SOUTHOLD, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 71 Block 1 Lot 13
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Suilding Permit heretofore
filed in this office dated MAY 7, 1976 .pursuant to which
Building Permit No. 8568-Z dated MAY 7, 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 TWOATTACHED DECKS *
The certificate is issued to PAUL & MARTHA KNOKE (owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL F~B. 8, 1977 - R. VILI~%
UNDERWRITERS CERTIFICATE NO. N-309632 - OCT. 28, 1976
PLUMBERS CERTIFICATION DATED N/A
*NOTE: THIS UPDATES CO Z-7556 DATED MARCH 9, 1977.
Rev. 1/81
FOKM NO. ~
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificnte Of Occupnncy
No. Z. 7.~.~.6. ...... Date ............. I~!~r ..... ~ ......, 19.7.7.
THIS CERTIFIES that the building located at .~o.g.~.h..P. g?.r. 5..s.h..B.~. ........ Street
Map No...x.x. ........ Block No...x:x. ...... Lot No, . .x..x .... ~.o.u.g.h...o.~.d....~:.~.: ........
'conforms substantially to the Application for Building Permit heretofore filed in this office
· dated ............ !~:r.. 7..., 197.6.. pursuant to which Building Permit No...8.~.(57.Z..
dated .......... l~.~.y...? ......, 197.6. ., 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 .P?.~.v..a~;.e..o.~..;Ifa..m.~:'[.>.~..~-.v(e?.~..~g ........................................
The certificate is issued to . .P.a.u.~. ~(~.qk.o...&..},i~...~.t.h.a.. ~4.~.o~e. ..... ~.w..n.e.r.s. .............
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval . .F.e.b... 8...].~?.~....bT..R. :..V.:[.~.~..a .....
UNDERWRITERS CERTIFICATE No...~(3.0.9.6.3..2...0.9.~...2.8...].9.7.6 .................
HOUSE NUMBER ... ? ~3.1.~. ......Street.. .: .... S. 9.u.t.h. 9.~.d. ..........
Building Inspector[
TOWH OF SOUTHeLD
BUILDIHG DEPARTMB41'
TOWH CLERK'S ~
SOUTHOLD, )¢. Y.
BUILDING PiR~IT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
8568 Z
Permission is hereby granted to: ~, E ~ k'l,~/A~&/I::'.~K~ I
........ .........
T '(~( ~ -~1 ~'~°
at premim located at ............. ~...0.~....~.. ...... ...-~...~.. ...............................................................................
................................................................... ~..U....U...T..~!...o.L...~ ...............................................................
Building
Fee ~ ......... :.'. ............
PERMIT INCLUDES API~OYAL
TO REMOVE EXCE~ fiLL ....... '
FROM ABOVE PREMISES BY
REGRADING LOT
D~tVEWAY CONSTRUCTION
CESSPOOL CONSTRUCTION
CELLAR CONSTRUCTION u..,' _
OTHER ~
..... ..Z../.....Z..~....~ ...............
Building Inspect~
!~01~.~ NO, ~
TOWN O~ $OUTNOL~
o Building Deporfme#t
Town Clerks Office
$outhold, N. Y. 11971
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 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 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
New Building ................ Addition ................ Old or Pre-existing Building ................ Vacant Land ..............
Location Of Property ............................................................................................ .~. ....................................
Owner Or Owners Of Property ......... ~..U....~. ....... ../~.~.;...../~..A../.,D.~E~ ....... .~....../~...,~...~.~/?/.~.. ....... ./?...A~...D...AX,..L;T' .........
Subdivision .............................. ~ .............................. Lot No ....... ..~... Block No...~.. ........ House No./...3.....5...
Permit No......~.~.6...~..~.~... Date Of Permit ..~/..A...Y,..,7[../.?.?./~pplicant ...... ,~...L.-~ ........ ..~.,/'.u',.~.....,/~...k.~,.~....~..! ...............
Health Dept. Approval ...~ ................. .~ .................. L.aoor Dept. Approval ................................................
............. !Z. ......................
Underwriters Approval ..... :.J.k/...~.~.?...~..~....~ ............. Planning Board Approval /~/'-
Request For Temporary Certificate ........................................ Find Certificate
~0
Fee Submitted $ ......... ~.. .......................
Construction on above described building and permit, meets all al~licable codes and regulations.
Applicant ........................ .~ ...............
S orn to b fo,e me th,
............ day of ...................
.....................
. 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:
Final survey of property yith accurate location of all buildings, property lines,
streets, and unusua~ natural or topographic features.
2. Final Approval from Health Dept.' of water supply and sewerage-disposal(S-9 furm).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn stage~ent from plumber certifying that =he solder used in
less than 2/10 of 1% lead. ,'
5. Commsrcial building, indus, trial building~ multiple residences and similar buildings
and installations, a 'certificage of Coda 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=
l. 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 o~ Occupancy is denied, the Building Inspector shall sta~e the
reasons therefor l~ writing to the applicant.
~. Cer~ificate of Occupancy - New dwellins $~5.00, Addltioms to dwelling $25.00,
~Alterations to dwelling $25.00, Swi~,ing pool $25.00~ Accessory building $25.00,
Sdditions to accessory building $25.00. Businessea $50.00.
Certificage 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
Temporary Certificate of Occupancy - Residential $15.00, Commercial. $15.00
Date September 8, 1994
xx
Now Construction ..... . ..... Old Or Pre-existing Building .................
% 1315 North Parish Drfve Southold
Loc~t on of Property.... ................. .... ...............................................
House No. Stree~ Hamlet
Onwer or 0Whets of Property .............. Paul A. Knoke, Jr. and Martha V.K. Knoke
County Tax Hap No 1000, e~ction 071.00 013.000
................. P.A 99 ....... ......................
Subdivision ' Filed Map Lot
' " ' 5 7~76
~ermit No .... ~..'~..'.Date Of Permit.../ ...... owners
...... Applicant .............................
Realth Dept. Approval...X~2A.~y.A.,~%~A..Underwriters Approval.~.q~..%Q~A~ ....
Planning Board Approval ........................
. Updated
Request for: Temporary Certificate.~ ......... ~{Y~XCerticate.~· ,~p~ ~rivate one-
family dwelting with two (2) attached pcrshas~
Fee Subml~ed~ $ .... ~Q,.0.~... ................
........ ................ "
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
85 JOHN STREET. NEW YORK, NEW YORK 10038
,,,,,,'0ct, ob~ 2~, ~7~
THIS CERTiFi[~g THAT
Paul ';noke, 1315 Nort~ Parish Drive, e/side, Southold, L.I.
~,,'~,,'.~"~'"'"~'~"~'~"~'~ k: ~"'""~""' ~ ~,F~, ~ ~.~] F~. outside
~,,,~,~,,,,,~,,~-~,,,, October 21~ 1976
FIXTURES ~ RANGES iCOOKING g~C~KS~ OVENS ~S ! EXHAUST FANS
SERVICE DISCONt,JECT j No oF I~- s R R V I c E
Motor/s: l-1/2hp
Ru].and Elec. Co,,
P,O.Box 143
;.~attituck, L.I. 11952
Llc. 242E
D
~deatiols,
' · TOWN OF ~OUTNOLD
BUI~IN~ DEPA~TMENT~K~
TOWN CLERK'S OFFICE ,/~/~ ~.
~U~OLD, N. Y. ~
................... ........... ........ .................................
Disapproved a/c ....................... 2~ ........................................................ .~L,..,
........................................................... ~Z~ .............. ~ ............. :27.; ............... L.~
.................... ~'~;:~ .............. ~ ......... ~'~ .................. V'"""'l'"
APPLIGATION FOR BUILDING PE~iT
................... H&.,:...U ....... ,
INSTRU~IONS
a. This application must be completely fill~ in by ~pewriter o~ in ink and submi~ed in triplicate to the Building
Inspector, with 3 sets of plans, accurate pl~ plan to ~ale. Fee acco~ing to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to ~joining premises or public streets
areas, and giving a detail~ description of layout ofpr~e~ must be drawn on the diagram which is
c. The work covered by this application may n~ be commenc~ before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. ~uch permit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be ~cupied or used in whole or in pa~ for any pu~ose whoever until a Ce~ificate of ~cupancy
sh~ll have been granted by the Building Insp~tor.
APPLICATION IS HEREBY NLADE 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, os 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)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.................... ..................................................................................................................................................
Name of owner of premises ................... ~..../~...(.?.~. ........... ~. ........... (..~....~..{:...l_.~..~: ................................................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No ................... ;.~......C-w..~r. ...................
Plumber's License No.....~.;i:L~.~...~../../~, ...... (.~..{...R..~-:..! ~ ~'~
Electrician's License No ....... (~i./4../../..~...~..~..';; ......... *.2/ t: ~--
Other Trede's License No ...............................................
Locotion of land on which proposed work will be done. Map No.: ........................................ Lot No .........................
IX/(' C"7 ~ I"- ./~. : ~- '- ~
Street and Number ....................... /. ...... ~.'~ .......... ~.,~../......~ .............. .~.B;.LL/./~ ....... .~ ........... ,~3/~.,z.~..&.~_~ ...........
/ Municipality
Stote existing use and occupancy of premises and intended use and occupancy of proposed construction:
o. Exisiting use and occupancy .......................L../~..(, ........... /..J~.:.,,..l~, ....................................................................
b. Intended use and occupancy .................. /.......~,.~.C/.LI.L.~ .......... ~l~.!.,.'.j~.~..Z.../.../y......~... ........................................
3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration
Repair .................. Removal .................. Demolitior .................... Other Work ....................................................
(~ L') 00 Fee 7 y' t/) ~ ~" (Description)
4. Estimated Cost ............. -~.....I ................................................................................................................................
/, (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 ....................... 1 ....................................................................................................................
6. If business, commercial or mixed occupancy, spe~,~,.~.~ure,, and extent of each type of use ...... ~ ........
7. Dimensions of existing structures, if any: Front ....:;;/;: ................. Rear ................................ Depth ....................
Height ........................ Number of Stories .................................................................................................................
Dimensions of same structure with alterations or additions: Front ....................................Rear ............................
Depth ................................ Height ........................... ;..h~ur~ber of Stories ................................
8. Dimensions of entire new construction: Front , , Rear ............................ Depth ........................
'"~';XtZ .....................
Height .................... Number of Stories .............................................. 'y"/"'O ................................. ~'"~""(.; ...............
/¢P
9. Size of lot: Front ........................................................ Rear ............................... l[7~.iy.. De~ ~:.~.~,-~, ..................
10. Date of Purchase ........................................................ Nome of Former_Ow,.l~g ........................................................
1 1. Zone or use district Jn which premises are situated ...................................................... ./~k:7. i~,~ ......................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................
13. Will lot be regraded . ..........-...~ ........... Will excess fill be removed from premises: Yes ( ) No
14. Name of Owner of premises .................................................... Address ................................ Phone No .......................
Name of Architect "['li'[ .......... ............... Address ................................ Phone No.~.~.~..:..
Name of Contractor ............................................................ Address ................................ Phone No .......................
PLOT DIAGRAM
Locate clearly and distinctly ail buildings, whether existing or proposed, and indicate all set-back dimensions frorn
property lines. Give street and block r~_b,,e)%,gr~ description ~,~c~c~'6ipg to deed, and show street names and indicate
whether nterior or co.m.~r_l..o~. __. ,-,~ ~,LZz.:~,,_.------.--~--',--~--'---_,~-_ --._-
STATE OF NEWYORK, C~i~
COUNTY OF .................... -C.: .......... f"'"~
L~L '' ' 1~ ': P'~ ~: ~"' I
....................... ; .............. ....... ; .................................................. being duly sworn, deposes and soys that he is the applicon~
(Name of individual signing contract)
above named.
He is the .................................................................................................................................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file
this application; that all statements contained in this application are true to the best of his knowledge and belief; and
that the work will be performed Jn the manner set forth in the application filed therewith.
Sworn to before me this
................. . ...doyof ................................ Z," ....... ,').'
N r .Pub c,. ...................... ..................... ?.. ..... .............................
r4 ~"J ,/,,~"nf"~ /' ~ ~J ~ ..~// (Signature of applicant)
ELIZABETH ANN NEVILLE
NOTARY pU~]LIC, State of New YOI~
No. 52-8125850, Suttolk Count..~
PAUL A.
AJAP OF 'LOT
goaI?,
APPROVED ,AS NOTED
FEE: '~-05~ BY_ ~
NOTIFY BUILDING DEPARTMENT A1
76S-2660 9AM TO 4PM FOR R£QUII,,
EL) iNSPECTIONS:
1 BkFORE BACKFILLING FOUNDA~
TluN OR START FRAMING
2. BEPOR~ C~V[RING PIPELINE
~. PINAL WHEN lOB COMPLETED
o L