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Home My WebLink About8272-zFORM NO. 4 TOWN OF SOUTNOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED C~RTIFICATEOF OCC~JPANCY NO Z-23709 Date JUNE 16, 1995 THIS CERTIFIES that the building ADDITION Location of Propert~ 1600 WATERVIEW DRIVE House No. Street County Tax Map No. 1000 Section 78 Block 7 Subdivision Filed Map No. SOUTHOLD, N.Y. Hamlet Lot 33 Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 29, 1975 pursuant to which Building Permit No. 8272-Z dated OCTOBER 29, 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 BEDROOM & REAR DECK ADDITION TO EXISTING ONE FAMILY DWELLING * The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED BRETT A. & LINDA S. CARLSON N/A N-276193 - MARCH 30, 1976 N/A *THIS UPDATES CO Z-6963 ISSUED ON APRIL 5, 1976. ~ / / Buil~ I~spect6r ' Rev. 1/81 FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH~Ot.D, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 8272 Z Permission is hereby granted to: i. ~.~ t ~E ·. +'ie.~ [ e,-z~ .................................................. ............. ~,~,~z,~r.~ e~,,..~.~r ............... ~ c~z~No ~ .... to~jj.Z~. ~ ..~,~..,~t~ .~ j.,,z~.., c, ~.~l..~ 3.,~ ~;.~.~ ~ .. ~: ~; ,. J,,~z.~ ......................................... at premises located at ...L{./~.....~,~;~t~-v,.~W..~-~.~9.e ......................................................................... ..................................................... ,~ o~.t ]~ 14. ....... iI~. ~ ~? ,- ....................................................................... pursuant to application dated .........................r~.~¢. ......... ~..c) ......... , 19~'....., and approved by the Building Inspector. Fee .~. ~. ~ .C.~.Q ............. Building Inspector Form No. 6 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL ~65-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by t~pewriter 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 ali buildings, property lines, streets, and unusual naturat 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. 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 requirement~. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '!pre-existing" land uses: t. 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 th~ 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 $i5.00, Commercial $15.00 Date February 22, 1995 . . . New'Construction ........... Old Or Pre-existing Building.................UPDATED CERTIFICATE OF OCCUPANCY 1600 Waterview Drive Southold iLocation of Property ........... House No. Street Hamlet Brett A Carlson and Linda S. Carlson, his wife ~0nwer or Owners of croperty .......... · ........................................................ County Tax Map No 1000, Sectio-~..........078' 00 ...glock..9~;~ ...... L~t 033. 000 iSubdivision ................................ · .- . Filed Map ........... . Lot ..................... . iPermit No ~q~TP Date Of · ........... Permit ................ Applicant ............................. A roval 04/02/74 Underwriters Approval Health Dept. pp ........................... Planning. Board Approval Request for: Temporary Certificate.Final Certicate. XX · · ............ FORM NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Cerli icnle Occupnncy THIS CERTIFIES that the building located at . ~;/~ .~:~a.t.e.r.¥i.e.w..D..~,.i.y%. .... Street Map No. .~-~.. Block No. xx. .Lot No, .Xx..X.....Sp.u.t..h?.l.d. ~ N ,'~, conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... .0.q~...2~9.., 19.7.~.. pursuant to which Building Permit No.. dated Oct 29 19 ?~ 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 Private one family dwal~tn~ with an addition The certificate is issued to . .I.~v.i.n.g .~;(e.x.l.~, ..... .0}.~e.r. ............................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .~!:~.~: ............................... UNDERWRITERS CERTIFICATE No.I~.27.~ ~ 93 .... .M.e~. 3.0... ] 97.6. .................. HOUSE NUMBER .1.6Q.0. ....Street datervie,,~ ~ ~'~' - .................... ?[~.t V.e ..................... Building Inspector / TOWIq OF $OUTHOLD , Building Department Town Clerks Office 5outhold, ~. Y. 11971 APPLICATION FOR CER'TIFICATE 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. 9. Final approval of Health Dept. of water supply and sewerage disposals(S-9 form or equal). 3. Approval of electrical installation from Board of Fire U~lderwriters. 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 ]957), 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 formation required to prepare o certificate. C. Fees: ]. 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 Date ...... ~...~.~ ~.g ~.~.. ~'...2 ~. ~ o. ~1, ~).~. New BHilding ................ Addition ..... ~ ..... Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ......... ~./..~..]~.9,.~.(~.:~.'v:~.~.~.....~.~...J..~.~ .......... ..S.~.~.~.~.~...~.,.....~..., ................................. Owner Or Owners Of Property ...o~l~.~'~,Tt~..~.~:7~e~ ................................................................................... Subdivision .......... ~ ................................................. Lot No. ,.~:.... Block No...:~ ..... House Permit No..~...~.7~..~. ........ Date Of Permit .~..O.../..~..~/.~.~..Applicant ....... .~...~.~.J...~....~...e.~..~.e_~.. ........................... Health Dept. Approval ....... ~ff'~ .............................. labor Dept. Approval ........ ~/~ ................................ Underwriters Approval .... ~...t(.~.~..,~..~..Z.~..~. ........... Planning Board Approval ....... ~/.~ ......................... Request For Temporary Certificate ........................................ Fined Certificate ......... i..-~.~. ........................... Fee Submitted $ ..~.*.O.O, ........................ Construction on above described building and/~'~er~mit meets all alc~lica~l~ cedes and regulations. // · S..,w.:.r.:~;fa°::)fm..:,.~~;.~/~,!..~...:~..,~. ~/ (stamp or s ~)e~e~/~ Examined ........................................ , 19.. . Approved ......................................... 19., , Permit No ..................................... TOWN OF SOUT.OLD BUILDING L DEPARTMENT' TOWN CLERK's OFFICE ~UTHOLD, N. Y. ....... ... · ........................................................................... · 'P'~'"':: .............. wv ~~ --. f .lA_~ ~ '~ ~ . APPLICATION FOR BUILDING PE~IT ~/~/~ /~ O/~ C'. Date ............................................... , INST~UCTIONS o. This oppficotion must be complotely {iliad in by t~powritor o~ in ink ond *~mitt~d in tripllc~to to th~ Insp*ctor, with 3 *et* o~ plans, ~ccumto plot plan to ~1o. F~ occord n~ t~ schedulo. ' b. Plot plan showino Iocotion of lot ond of buildings on promises, relotlonship to ~d~oinin~ promisos or public ore~s~ and Oivin~ ~ dotoilod doscription o{ layout ofproporty must be drown 0n tho dio~rom which is pa~ of this opplic*tion. c. Tho work coverod by this opplic~tion mo~ not bo commencod beforO issu*nco of Buildin~ d. ~pon ~pprovol of this ~pplicotion, the Buddino Inspoctor will issuo ~ ~uildin~ ~ormit to tho opplicont. Such sh~l[ be kept on tho premises ,v~ilable {or inspoctlon throughout the work~ e. ~o buddin~ sholl be occupied or usod in whole or in port for ong purposo whoever until ~ Co~i{ic~te o{ sh~ll h~ve been ~ronted by the Buildin~ Inspector. APPWCATIO~ IS HfiRfi~Y MADE to the Buildin~ Oep~rtment for the issuance o{ * 8uildino Permit pursuant Bu din~ Zone Ordinance o~ the Town of Southo d, Suffolk County, New York, ~nd othor opplicoblo Lows, Ordinonces Re~ulotions, {or tho construction o{ buildings, odditlons or oltorotions, or for removol or domolition, ~s horoin The ~pplicont ~r*es to comply with *11 opplicoble I~ws, ordin~ncos, ~ulldi~ c~e~ hoUsinO codo, ~nd ro~ul~tions, odmit outhofi~ed inspectors on premisos ond i~ bulldin~ {or (Si~noture of a~imnt, or n~me, ff ~ corporation) Soutnold ~ ..... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................................................ 9~.~*.~ ~. .................................................. ......................................................................... Name of owner of premises ......... ~.~I.~J.~..jL:~/p..¥f~..o.T: ............................................................................................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......... ,d,,,..,,~.,~,,o,,A~ .......................... Plumber's License No ..... ... . ... ................................. ..., . Electrician's License No ...... t,¼L~kg,~C~ .......................... Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Mop No.: ........... ~f ........................ Lot No ....... ~ .............. Street and Number ...... .~../~...)?~..~.c.~.~.V.$~...1~.~.-~.~ .......... ~..o~.~,.~.,O.~.~.. .................................................................. Municipality 2. State existing use and occupancy of premises and intended use and :occupancy of proposed construction: o. Exisiting use and occupancy ...... ~.~:z..~.~!~._~..~.& ...................................................................................................... b. Intended use and occupancy ........ .,~.~.~...~.~.rJ,..~.-~.~....a.f!i].~.~,.~.°.~-.,~ ................. ] ...................................................... 3. Nature of work (check which applicable): New Building.. ................. Addition ....~ ........ Alteration ...~i; Repair .................. Removal .................. Demolition .................... Other Work ................................................ .... c-~ (Description) 4. Estimated Cost ........................ '. ................................... Fee 'J ~'' 00 (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... .?..z?. ............... 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 of entire new construction: Front ............ ~..0. .................... Rear ....... ~..0. ................ Depth ......... ~..0. .......... I-bight .................... Number of Stories ..... .o...~..e. ......................................................................................................... 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 ..?.~!.. ~,,$,~J~ ............................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ...G.O. ................................................ 13. Will lot be regraded . ......~C~ ................ Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ..:$.~.&.~.z.g..~.e...~.~.'9.~ .................. Address ,.)outhold Phone No. Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ...~1......)~.o..~.~.. ....................................... Address southolcl Phone No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate ~vhether interior or corner Iol. STATE OF NEW ~¥OR~< COUNTY OP .... ........... ........................... ZZ'.~.~-q_B...?J£~.]cl ~Z' ...................................... being duly sworn, deposes and says that he is the applicam (Nome of individual signing contract) above named. He is the .................. .0.!/.~ ................................................................................................................................................... (Contractor, agent, corporate officer, otc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this applicetion are true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ~ ~ ,4' // .................. 2.9.. day of .................. Notary Public,. ..................... .~.~..~. ~.~i .°..! .~.. ............ County ............ ~] - ..~... ~q ../....~...].-...~...~ ........................... ($i~ature of/pplicant) '~UMU~IF.L NOTARY~PUBLIC, Sf.t.~o{ New York No. 52-452202& - Suffolk CouMy /