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Home My WebLink About7682-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No Z-22704 Date NOVEMBER 4, 1993 THIS CERTIFIES that the building DWELLING Location of Property 615 GRANGE ROAD SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 75 Block 4 Lot 17 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore Oct. 27, 1972 filed in this office dated Jan. 7, 1975 pursuant to which 6229-Z Nov. 6, 1972 Building Permit No._7682-Z dated Jan. 7. 1975 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 & WOOD DECK * The certificate is issued to MILDRED LONG & OTHERS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 4/30/73 - R. Villa UNDERWRITERS CERTIFICATE NO. N-100687 - 7/3/1973 PLUMBERS CERTIFICATION DATED' N/A *THIS UPDATES CO Z-5241 DATED 7/3/73 & CO Z-6282 DATED 1/7/75 Ca uild'ng nspector Rev. 1/81 E - FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. 26282 Date Jan 7 , 19. 75 THIS CERTIFIES that the building located at . . Grasp .toad Street Map No.$. .$ar.b0r. .gNott No. Lot No. 0 Southold if N.Y. conforms substantially to the Application for Building Permit heretofore filed in this office dated JOS. . _•j. ., 19.7f. pursuant to which Building Permit No. 7682Z dated Jori 7 , 19.75., 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 . .Prinats. .on.. badly .dm llirid. with. Wal addition The certificate is issued to . .Chaa.. .!lohr Oxnsr. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval tet• UNDERWRITERS CERTIFICATE No. .R.14$411 HOUSE NUMBER 615 Street . . . amnia .Rosi ALA). Building P Ins ecto^—� r FORM NO. 2 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) N9 7682 1 Date J.Ut.r7 , Permission is hereby granted to: ir Grnrwbe ((Ad outrto1,4 to ..huild...an..a izr az...exist:i.r.fj .;lize at premises located at .1o.t. 15 Sau.th. u xtbox :4 o-vp Grande Raid Southold pursuant to application dated j n 7 19 , and approved by the Building Inspector. Fee $15•°C1 ( (Cy" Building Inspector TOWN OF SOUTHOLD 71,_C_'7`?,-52- BUILDING DEPARTMENT TOWN HALL - 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 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 v- less than 2/10 of 1% lead. 5. Commercial 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. 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. .. 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 K4. Updated Certificate of Occupancy - $50.00SEC 5. Temporary Certificate of Occupancy — Residential$15.0, Commercial $15.00 Date �a .27 X993 ew Construction v•----- • Old Or Pre-existing Building ocation of Property P/h ji.avnnX Tice -0 /fid House No. Street !`�H Hamlet ower or Owners of Property h1 O 7`- Chas ( m4 s m,,._ ?,,,,.,,fit at .0 . 'unty Tax Map No 1000, Section / d' /Block G� (. ..Lot. . . .(.� . . .. . . . . . .bdivision " " Filed Map Lot. . 2rmit No b90 ? Z. . . . .K �72 c4�7. . ... . . . . . . . . Date Of Permit. . �� . .Applicant -alth Dept. Approval Underwriters Approval -anning Board Approval quest for: Temporary Certificate FPS (Q --- Final Corticate. . . ... . . . . 'e Submitted: $ dnt cAsie_ de ak & p. 76 '2-Z - 17T/79— �I i( � Alr S�PX�.�}. ��iO� t /�c,,��,� / yW .V4P Co / / 7 skid" APPLICANT v ' FORM NO. 1 TOWN OF SOUTHOLD /14a BUILDING DEPARTMENT. O TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined 0-A^- 7 , 19 73 7 / 2 Application No. 7C EZ Approved (l 7 , 19.LPermit No. r `� �� Disapproved a/c (:uilding Inspector) APPLICATION FOR BUILDING PERMIT Date 19/ r 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 plot plan to scale. Fee according to schedule. 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 work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupant shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment 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. l( .414447 RC2. (Sigodtu.re ooffaapplicant, or name, if a aa corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..! 7/Ztel- t2 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 Trade's License No. '/ ,y am 1. Location of land on which proposed work will be done. Map No • '(�` Lot No. + Street and Number 3/5 t-'1.,,,,_„ #C &,f. -SR --4 Municipality 2. State existing use and occupancy of pre ises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy b. Intended use and occupancy i d " /L. J u• 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolitior Other Work _ (Description) 4. Estimated Cost sc) r 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: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions ofgntire new construction: Front Rear Depth Height - 0 Number of Stories 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 low, ordinance or regulation: 13. Will lot be regraded // Willeexcess fill be removed fro pre es: ( )_Yes ( ) No 14. Name of Owner of premises �-C/1.4-r✓ tAlaly74" / Address S crerde hone No. Name of Architect Address Phone No. Nome of Contractor Address Phone No. ...................... PLOT DIAGRAM Locate clearly 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 interior or corner lot. STATE OF NEW YORK, 1 S.S COUNT F� �� being duly sworn, deposes and says that he is the applicant (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 thar the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this /ace . day of .... r G GLL led Notary Public, _- � County (Signature of applicant) attaaer. IlRt1S NOTARY PUBLIC, Slate of Now York No. 52-1522026 $nF?•il, r::nri ly. Cnnnnislnrc r .; ne Li nth 3Cy I?.�, A GRANGE , 11 5 . 0 g10000 - _ — - ' 950w „41V \ N 85°0950 t - S 850 \kS° I . � r �� 0. 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