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HomeMy WebLinkAbout11818-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N,Y. Certificate Of Occupancy No. Z13016 Date November 23 198..4 THIS CERTIFIES that the building..~.d..d.~.t.J:.q .n ..................................... Location of Property . $ ~.0 .................... M. $.1.1..C..r~.e.k. Dr. Southold Houso No. County Tax Map No. 1000 Section . . .1.3.5. ...... Block .... .0.3. ........ Lot .. 9.4.3 ............ Subdivision ........ .X ...................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·..~..u. g .e ..... .2 .8 ........ 19.8..2 pursuant to which Building Permit No ....... .1.1.8.1. 8..g ........ dated ........ .~.u. 1. y .... 2. .2 .........19.8. 2., 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 ......... ...D.c..c.k. 34.d.~.%~.o..n..%q..~.x.~.s.~..~.n.~..D..w.e.~.~. ~..n¢ ..................................... The certificate is issued to VINCENT SMYTH of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO ........................... Rev. 1/81 Building Inspector FOJt~ NO. 9 TOwN,OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD~ N~ Y. BUILDING pERMIT (THIS PERMIT MUST BE KEPT ON THE PREMisES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ...... '; .................... , 19.. Permission is hereby granted to:_.~ · 7~' . .. x · · ...:..~~.,.:.~..7...~:c;., ~ i~..e..~.~..~,~..,.~,..~....~ ................. ~ ~o .......... ~a~~......~.~. ~.~ ........ ~ ............ ~,~c~z ::~~ ~ ~ ~,..,, ~ ~.; ~. , ................................ at premises Ioc~ at ~;~.......~.~....~;*.....~...' ....... ~ ................................. ..... ~...~ .......................... : ...... : ........ .................... :~~./~....~..~..~ cou.u r.~ M.~ No. ]000 'Se~.o...Z~:~;L.... ,~o~ ..,,~.5. ...... Lot No...~.~ ...... :' and a~prov~ by the pu~uant to application dated ... .~. ...... 1 , Buildi9g Inspector. ~ ,l..~.........~. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department, Town Hall Sou~hold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and subr~itted in duplicate 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 o'r Engineer responsible for the building. 5.Submit Planning Board approval of completed site plan requirements where applicab{e. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: " 1. Accurate survey of peopertv 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 informa- tion 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. Cop,/of certificate of occupancy $1.00 New Building ............. Old or Pre-existing Building(:~) .._~( ....... = ZVacant Land ' House No. Street Ham/et Owner or Owners of Property .....~¢~5...C.. 4[ ~..%.~.._._.._ . i C County Tax Map No. 000 Section ..... ....B,oo ..... ....... Lot ...... . .. Subdivision ................................. Filed Map No .... .-... ~..Lot No. ~ ......... Health Dept. Approval ........................ Labor Dept. Approval ...................... ,. · Underwriters Approval '--- Planning Board Approval FeeSubmttedS . ~ ' ;'-, ~~ L ~[ ~ Construction on above described building and ~tt*~e~.al'~p ~~ulations, FORM NO. 1 TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1809 APPLICATION FOR BUILDING PERMIT Application No../~(~. ....... INSTRUCTIONS a, This application must b~ completely filled in by typewriter or in ink and submitted in triplicate to the Buildint 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 street, or areas, and giving a detailed description of layout of property mnst be drawn on the diagram which is part of this appli cation. 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 sha]l be kept on the premises available for inspection throughout th~ work. e. No building shall he occupied or used in whole or in part for any purpose whatever until a Certificate o£ Occupanc.~ 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 th~ Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construcfion of buildings, additions or alterations, or for removal or demolition, as herein described The applicant agrees to comply with all applicable laws, ordh~ances, building code, housing code, and regulations, and tc admit authorized inspectors on premises and in buildings for necessary inspections, (Signature of applicant, or name, if a corporation) · , .~. ~.~..~,~...~ ~ ~.L...~.~ ~ .... ~/~fur, ofduly,uthori,edo~C~f~$c;rn, thetaxr°ll°rhtestdeed~ ............. /, 1. Locationof~andonwhichprop~edworkwillbedone .................................................. ...... ~. . ~ ................. ~, ~. ~,: ~ ~4. . ~ ~., ~.~ ......... ~.~ . . House Number Street Hamlet co~ty ~a~ u~p ~o~ ~o00 s~*fio~ ...... ~ ...... ~o~k ...... ~ ......... ~ot ..... M.g ......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State exi~ting u~e an~ ~cupanc7 ~f premi~e~ and intended us~ and ~ccupan~y ~f pr~p~sed c~nstructi~n: ~,~in~=~o,,~ ..... ~.~'~.,~.~ ........... % ...... : ...................... .~. Nature of work (check which applicable): New Building .......... Addit~oa .......... AlterationS. ........ .f_.. Repa/r .............. Removal .............. Demolition .......... Other Work... (Description) (to be paid on filing this application) 5. If dwelling, number o£ dwelling units ............... Number o f dwelling units on each lloor ................ If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type o£ use ..................... 7. DLmensions of ~xisting structur0s, if any: Front ...... .q.~. ..... Rear .... t~'.~5 ....... Depth ....~..~. ...... Height .../,~. ,~, ....... Number o£$tories .... .=~ .................................................. Dinlcn~ions of same stracture with alterations or additions: Front .... ~ ~q. .......... Rear .~'.~ ...... Depth ...... .j~. ~.<~ .......... Height ...... ~.~ ............. Number of Stories 8. Dimensions of entire new construction: Front ..... ~©. ........ Rear .... ~.q~ ....... Depth .../. ........... Height . .?~../~.%2.~. ..... Number of Stories ........................................................ 9. Size of lot: Front ...7,..~. .............. Rear ..... ~ .~. ............. Depth .... ./~. ~. ............. lO. Date of Purchase ............................. Name of Former Owner .......................... ~.. 11. Zone or use district m which premises are situated ..... .L~. 7./.. .......................................... 12. Does proposed construction violate any zoning law, ordinance or regular:on: ................................ 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No 14. NameofOwnerofpremises.,~.,...?.,...,c~':/~.. . . Address . ,r.~. U./. . .E.~'.~-.3. . [t. J)..r. : . . Phone No ................ Name of Architect . ,.~.. ~.~.~. ................. Address . .~ ............... Phone No. Name of Contractor ,~.,.~.,,4,~..c-.., ............. Addres,../.{¢.~-~'.~'..',~... .Phone No. PLOT DIAGRAM Locate clearly amd distinctly all buildh~gs, wheflte~- existing or proposed, and. indicate ali set-back dbncnsiot, s property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot, /i/ ~/ STATE OF N R ' ' ....(Name ........ being duly sworn, deposes and says that ho is tho applicant f .... a ent, oorporate officer. ,to.) .......... : ..... ((~. ~H .~t~ [ . ~. .~ L~. . / >.~. . . 4 . i. . .~ .................. FIELD INSP~TI~ COMMENTS FOUNDATION {1st) FOUNDATION 2. ROUGH FRAME & PLUMBING (~nd) INSULATION PER N. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: I ,.2. "~,-'5 -6 7 9 10 11 12 13 14 15 16 17 18 19'20 21 2~-2'3 2N. 25 26 27 28 29 30 31 40 41 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEE.: 765-1802 APPLICATION FOR 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 o[ 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 appli- cation. 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 o~ 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 tc admit authorized inspectors on premises and in buildings for necessary inspections. .... (Signature of applicant, or name, if a corporation) (Mailing address of applicant)/r'~ State whether applicant is owner, lessee, agent, architect, enginee~electrician, plumber or buil~6r. Name of owner o f prem~e,~s...~. · .-~. l~.~. ~.. .... .~. · .~'~-. ~. · .~. '...~ - · · · .~. .................................... ~ /'~/~ ~, ~, 6~as on the tax roll or latest deed) If~pl~~/r/,/~ure of duly authorized of ricer. Builder'~ License No ..... ~../.~..../~ · · · .~.5~-~ Plumber s License No ............. / ............ Electrician's License No. Other Trade's License No..'...: ................ 1. Location of'land on which proposed work will be done ................................................... House Number Street Hamlet County Tax Map N(~. 1000 Section ..... './..~...3: ...... Block ...... .~. ......... Lot ..... .~..~ ......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... c~. ~. ~.--r~..~. ~ ......... ~. ~. ...................... ; ....... - b. Intended use and occupancy ... ~ ~.~ .~ ~.-r.~o.~. ~...~,..~., ............ 3. Nature of work (check which qpplicable): New Building .......... Addition .......... Alteratio ,. Repair .............. Ren~oval .............. Demolition - .... Other Work....q~C,~'A~.,. (Description) 4. Estimate Co. ....... -- Fee I (to be paid on filing this application) 5 ' ' ' Number o f rlwellin~, unit~ on e~eh floor · If dwelhng, number of dwelhn~ units If garage, number of cars ... ~' ......................................................... 6. If business, commercial or mix~ :d occupancy, specify nature and extent of each type of use ................... ?. Dimensions of existing structm ~s, if any: Front ...... .~.c~. ..... Rear .... ~.~c~ ....... Depth .. ,~-i~. i ....... /.~. ~ Nu abet of Stories Height ................................................................... Dimensions of same structure tith alterations or additions: Front .... .~. .......... Rear .... ~'.d .......... j~. ~.<g ...... ~... Height ... / D.epth .......... ~. .............. Number of Stories ........... ~ ........ 8. D~mensions of entire new construction: Front....~. © . . Rear .....~.Q .... Depth ./. .......... Height . .?: ./,.%2-.~. ('-....~Number of Stories .... 9. Sazeoflot:Front ....~. ..... , ............ R .... .~..~. .......... .... Depth ............... 10. Date of Purchase ............................. Name of Former Owner ............................. 11. Zone'6r use district in which pi emises are situated ...... ~. 7/. .......................................... 12. Does proposed construction vk late any zoning law, ordinance or regulation: ...... ~ 9. ...................... 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes ' No 14. Name of Owner of premises .B.~. "~"c~ ~'J~' ' ' ' Address . .FIq ~/./...~.. [t..~...r:.. Phone No ................ Name of Architect .......................... Address .................. Phone No ................ Name of Contractor . . ..~ D..c-.: ............ Address . .q_lr.~-..,.q~ .....Phone No.. V .. . PLOT DIAGRAM .~o~a.e cLar,~ and &stln~tly al~ buildings, whether ex~stmg .or proposed, and, md~ca~e 'ali se~-baoc dnnens~ons ttom property lines. Give street and block number or description accor&ng to deed, and show street names and indicate whether interior or corner lot. ~ ofindividu~ b''~ . being duly sworn, deposes and says that he is tho applicant above named. · H'e,s the . '~" .... r ~ Lt .......... ~ .................................................. d ..... ~agent, corporate officer, etc.) of said owner or owners,~an.d is du)~ au. th.-'~nzed to perform or h,,a, ve performed the said work and to makre' and file this application; that all statem},n_t_s.c_o_nt~ne.d ~in this application are t. ue to the best of his knowledge and belief, and that the work will be performed in the manner] set forth in the application filed therewith. Sworn to before me this .......... 6/ . , ...... , .... ,. .. :