The URL can be used to link to this page

Home My WebLink About11608-zFORM NO. 4 TOWN OF SOU-f-HOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Ne. Z1:10.*.7.. .......... Date June 25 19 82 THIS CERTIFIES that the. bnilding ................................................ Location of Property . :>.1.30 ........... .$.r.ay. Avenu~ L. aure]: House No. ' ..................................... treet Hamlet County Tax Map No. 1000 Section . 126 ........ Block . .07 ............ Lot ...q .1.8 ........... Subdivision ... Geo~'ge..I ·. 3',, t;hl.l.L ....... Filed Map No. 661 ..... Lot No.. 7.9. ....... '.. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·.Aprll. 1 ............ 1902. pursuant to which Building Permit No....1.1.6A8...g ...... ..... - dated ...t[pp;[.l~ .2 ................. 19.8.2., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... .... ~n .~¢¢.e.~sO~y. ~wo-car g.a.~a.$.e, buildin6. The certificate is issued to .....tta¢lt..q,. ~.e.~.~? .t.J..1. . roJ. ..................... of the aforesaid building. Suffolk County Department of Health Approval n./..a UNDERWRITERS CERTIFICATE NO .............. /1,/.0 ................ Building Inspector Rev. 1/81 TOWN OF! $~L(THOL~ ~' BUILDING DEPARTMENT:"i TOW~ H~LL SougH'oLD, H~ Y. ~ BUILDING ~gE~lI ~ WORK ~TMORIZ~} ~ - Permissioniis hereby gronted to: ........... UNTIL F JLL Building In;spector. ' No. O,X'. ~.,: ........... ~and dpproved by the FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, 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 Buitding 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 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 peoperty showing all property lines, ~treets, 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. Copy of certificate of occupancy $1.00 Date .. New BuddingS..~.g..~. Old or Pre-existing Building(Z) ........ = ZVacant Land ........... Hou~ No. Street Ham/et Owner or Owners of Property .. ~ ~ ~ Cou, yNo. 0oo s.o o, .... ...... mook ..... ........ .... ........ Permit No./~,.. Date of Permit ~.Applicant . ./~/~F. .. Health Dept. Approval ........................ Labor Dept. Approval ...................... ,.. Unde~riters Approval ........................ Planning 8oard Approval .................. . Request for Temporary Certificate ..................... Final Certificate ................ Fee Submitted $. ~ -- __C°nstructi°n on above described building and permit'meets all apP~cable~codes and regulations. Rev. 10'10-78 -" '~ ~ ' ' ' ~ ' TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O, BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 17 June 1982 TEL. 765-1802 William 2ehnnewald Box 2~ MattStumk: NY 11Q%2 - Applicant Dear Mr. Merrill : This is to advise you t.hat the job under Building Permit No. 11608 issued to Wm, Schonewald on 4-2-82 foraccessory to garage is completed and a final inspection has/~ has not/r~ been done. In order to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form(s)~ return same to the above office with a check for $5.00 payable to the Town of Southold. Please indicate to whom the Certificate of Occupancy is to be mailed, and arrange with this office for an inspection date. Thank you for your prompt attention. Very truly yours, Victor Lessard Administrator VL:ec Enclosures FIELD FOUNDATION (1st) COMMENTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE FINAL FORM NO. 1 TCWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1802 Disapproved a/c ....... '...'..%"; :';--". ....... .~ .......... '. / ................... .......... .&.. ...... /:/. ,./ . ~ (Building Inspector) APPLICATION FOR BUILDING PERMIT INST RUCTIONS Application No... t/~..(~. ~.' ...... Date .... '"" '¢ ......... , 19,~ a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buiklk Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan s owing location of lot and of buildings on premises, relationship to adjoining promises or public stres or areas, and giving a detailed description of layout of property must be drawn on the dia~am which is part ~this app: cation. c. Tl~e work covered by this application may not be commenced before issuance of Building Pe~it. d. Upon apprc.'al of tiffs application, the Building Inspector will issue a Building Pe~it to the applicant. Such penn shall be kept on the premises available for inspection throughont the work. e. No building shall be occupied or used in whole or in pa~ for any purpose whatever until a Certificate of Occupam: shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for th~ issuance of a Building Pe~it pursuant to ti Buildiug Zone Ordinance of the Town bf Southold, Suffolk County, New York, and other applicable Laws, Ordinances, Regulations, for the constroction of bnildings, additions or alterations, or for removal or demolition, as herein describe~ The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and re~Hations, ~d admit authorized inspectors on p{emiscs and in buildings for necessaw inspections. .... (Signature of applicant, or name, if a corporation) ~ (Mailing address ~fapplicant) - State whether applicant is o~w~er, lessee, agent, architect, engineer, general contra~t6r, elect¢ian, plumber or builde ................. ~4v.<e¢ ~X. ~<< ~¢¢~'/e~ ....................... , .................. · ...... ~n¢ or o,,..o~ or pr~..,,o, ...'.~¢~X...~. ~¢'¢¢/5~ ....................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ....... .ox_7...~.~. .............. Plumber's Licens: No. ' Ek:ctrician's License No.' ........... Other Trade's License No ...................... on ,,,h~ch proposed work ,,,,ill ~,e done~,*~ ~.'?./~'~/,*/..-9,~/¥~'./. 1. Location land ............................. e. ................... . .~..e.,q ................ House Number Hamlet County Tax Map No. I000 Section ....... /.2~..~. ..... Block ....... ?. ......... Lot....~..'.'.~.. ......... Subdivision..-..¢, -~. .er. j~...~.Zz'~/.//...~...6.?~..~..... Filed Map No.¢.~. ~. ¢¢. / .... Lot.. ff~.~ ....... (Name) 2. State existing use and occupancy of premises and intended t~ and occupancy of proposed construction: a. Exist n use and occu anc ~_~ g p y ............. ~. ,,',4¢_~,,,,~ ................................... 3. Nature of work (chcck ~luc,, ~pphcabl~): New Building .......... Addition .......... Alteration ......... Repair Removal 4 Domolirlon Other Work 4 Estimated Cost .. 4t ...... ~' ................... Fee .... , ....... ,~ ......... '.i (to be paid on filing this application) Ifd b fd 11' ~ ' N fd lli it hr S. welhng, nl. llll er o we II1 units . ] - e I ............ mnber o we ng un s on eec oor ............... Ifgar..g ,number of cars ... ~ .... .g~[ .... 6. If business, commercial or mix:ed, occupancy, specify hatnre and extent of each type of use. ................... 7. Dimensions of existing structures,, If an.: Front ............... Rear .............. Depth .............. Height Number of Stories Dimensions of same structure ' ' ' or additions: Front Rear }v~tb alte4atlons .................................. Depth ................... !... Hei~tt ...................... Number of Stories. ~. Dimensions of entire new consiruction:lFront,.. ........ o~'.,q'f . Rear ... ~/ ............ Depth . .,e~.'~ ..... ~ ....... Hciglit /.,,g. ' Nuh~ber of ~tofies / ' 9. Size of lot: Front ......... "ff".eg../-'.. i ...... Rear ........ vs..~'..". ......... Depth ....~.~.~7. ........ 10. Date 6fPnrcl,.ase .............. ,. ........... : Name of Former Owner ........................ /I. Zone or use district in which premises a',re s tuated ':. 12. D.oes proposed construct,on vlglate any]zoning law, ordiaance or regulation: ............................. 13. ~}ill lot be regraded ....... .,~.~....,..] .~,: .... }.,,... Will excess fill be removed from premises: Yes (4. Name of Owner of prelnises .~er~'~4'. i .~ff'~a~,~f/'/.. Address ,,e~,~/z .~.,,~¢x-.z'.~.. Phone No.~:~..-;.~'.,(/.~..... Name of Architect ......... ~. ' Address / Phone ~.- Name, of Contractor ~,',~,J//~.,~...,-~.~,~4']k&kY~. Address ~.~ '~'[,?~,~'fi/)~. Phone property lines. Give street and block ;aterior or corner lot. PLOT DIAGRAM Locate clearly ~d distinctly all ' * ~ ot fldlqgs, whether existing or proposed, and. indicate all set-back dimensions from nnmberior description according to deed, and show street names and indicate whether ~'rATE OF NFg~RK., . ! iS S COUNTY , ' · ..... (Name of indivfr. J~al sigiq ~g conb act) above named. -k sworn, deposes and says that he is the applicant ~-te is the ' : ~ontractor, agent, corporate officer, etc.) of said bwner or own'e~, .a, nd is dui{, authorized to pert'otto or have performed thc said work and to m~e and file fl~is c. pplication; that all statements cont:iiaed in ~h[s application are true to the best of his knowledge and belief; and that the Work will be performed in the manner set fort[~ h~ tlie application flied t!,erewitb. -~worn to before me this ~ i ........ · .... day of' .M'otary ubl!.c, . T~rra Exnires March .;.. County ' ' '" " ':' ' ..... ,':, ,.' (Sig ppl/ t) .,,. ,,. .... ,,.~,..~s.., . naturo of a can T If NOTIF'Y BUILDING DEP/~ ~fV~F~IT Am' 765-1802 9 AM TO 4 PM FOR FOLLOWING INSPECTIO"'~S: L ~Ub[F,~TION - TWO REQUIRED~ FOR P,~t. IPED C~NCRrETE~' 2. ROUGed - FRAMING ~ FLU~B~N~ 3, JNCtJ~ A' ALL Cmttc,u~ 'CTION' Sr4AEE THE RFP~'m~MENTS OF THE N~ ~TATF CONqTRUCTI~N ~ · ~ES; NQT RESPO~SIBEE F~ BESfG~' OR CONST~' D~