The URL can be used to link to this page

Home My WebLink About11998-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N,Y. Certificate Of Occupancy THIS CERTIFIES that the building ................................................ Location of Property 510 Custer Avenue, Southold County Tax M~p No, 1000 Section . ,QT,0 ....... Block ...0,8. .......... ]Lot .... 0.,3.3 .......... Subdivision, F. air~.iew. Pz~ck .............. Filed Map No. 3.3.8.8. .... Lot No...1.1 .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated · · · Ootobe.r.. 2 1 ...... , 1 9' ~2 pursuant to Whi'ch Building Permit No... ~ .1.9.9.8. ~ ............ dated .... N.ovemtaex. ~, ............ 1 9 13.2., 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 ......... ........ alteration..to, existing. Ow, ell.i.n.q ..by..m. qv..1.n.g, ,~.a.r.a.g.e.: ............ The certificate is issued to . .Johr~ .Basile ...... /oh .b;.'~i:d~ 7.,-':34~;~; ...................... of the aforesaid building. ,. Suffolk County Department of Health ApprovaI .... B1/A .................................. UNDERWRITERS CERTIFICATE NO ............ 51../.P, ................................... Building hupector Rev. 1/81 ~o~.~ ~o. ~ TOW~ 0~. SOt~ aOL~ BUILDING DEPARTMENT TOWN HALL SOUTHOLD,' BUILDING P, ER/vUT N°. 1:1998 (THIS PERMIT MUST BE KEPT ON THE PP, E/~',IS~S UNTIL ~ULL COMPLETION OF THE WORK AUTHORIZED) z ~o,. ..... ~.~ ~..~...~...., ,,.&( Permission is hereby granted to: ~,: ~ ....... ~..~,.,..~.....~.,.-,,.~,. ....... ~ ....... ~u. ....... ~:.o.~z~.,~, ........ i~ .......... _~.~:~z~....~,.~.~ ....... ~.,. ~ . ,o.. ~.~...~~.. ~ .~x~~. ~z~¢ ...... ~¢ ...... ...z~z~: ....... ~~&...~..f~/~ .............. ~ ........................................ .... ........... : .......................... ,......>. .......................... ,...~: .......... ~....?~ ...... ,:~o~z~...~.~.~.~ ~ ~ ~,~ ..~.~....~.....~~......~.,:~~.,.~. .......... ~., ......................... ........ .......... Coun~ T ~p ~o. 1000 Soctio~ .....~.~.~ ...... Bilk ~,. Building I~spector. ~ ' Bdild~g~l~tor Rev.' 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall SouthoM, N.Y. ~i@71 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and sub~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 topogra[:hic features. 2.Final approval of Health Dept. of ~vater 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 building~ 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, 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. Copy of certificate of occupancy $1.00 Date ..... New Building ............. Old or Pre-existing Building(X) .. - --=/Vacant Land Hou~ No. / Stree( County Tax Map No..lOqO Section , , ~ ~ . Health Dept, Approval ........................ Labor Dept. Approval ............ Unde~riters Approval ........................ Planning Board Approval .................. Request for Temporary Certificate Final Certificat~ Fee Submitted S ............................. Construction on above described building Applicant Rev, 10-10,78 and perr~it'meets all appl-~cable~codes and r~gulations. FIELD INSPECTIO~ 1. FOUNDATION (1st) FOUNDATION ( 2nd ) 2. ROUGH FRAME & COMMENTS ' PLUMBING INSULATION FERN. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS APr~.~D AS NOTED NOTI:v ,~,,) L_, NG DEP~,RTA~NT AT 765-'i802 9 A~ %O ~ PM FOR THE ~,¢ ~ ~ i~,?ECTfOk~S- FOL .... , ,.~ *F~ ~Uq=D CONCRETE ~. RCU~u -~ ~ -RA~JF~_ ~ PLUMBING 3~ !N~U~ A~ ,- BE: C~:'~; "~: :OR C 0 ALL CON~ ~ ,., ,.N _ __ MEET STATE ~0NSTRUCTION & ENERGY CODES. , NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. i' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180~ ' ' (l uilding Inspector) ' APPLICATION FOR BUILDING PERMIT INSTRUCTIONs a. This application must be completely filed in by typewriter or in ink and submitted to the ~ lmpector, with 3 sets of plans, accurate plot phm to scale. Fee accordi~ to schedule. b. Plot phm ~howing location of lot and of buildinp on premises, relationship to edjo'ming premis~ or public or arms, and ~iving a d~taned description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The wodc covered by this application may not be commenced before issuance of ~ P~nit. d. Upon approvel of this application, the Buildin~ Inspector will issued a Building Permit to the applie, snt Such permit shall be kept on the premises avalhbie for inspection throu~hont the work. e. No bulldlu.~ ~ be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy ~ have b~en ~ranted by the Bulldin~ Inspector. APPLICATION IS HEREBY MADE to the Building Depertmant for the i~uance of a Bulldi~ Pmmit pmmumt to the Buildt~ Zorn O~div~nce of the Town of Southold, Suffolk County, l~w York, and other appi/~bie La~ O~h~ces or R~ulatiom, for the comtmction of building, additions or alterations, or for removal or demolition, u ~ d~cflbed. The applicant ~ to comply with an ~pplicabie laws, ordinances, building code, hous/~ co~, and r~htiom, and to adl~it autho~4.~ed insp~to~ on p£~llises and in building for nece~y in ' ns. (S~0~re 6f applicant, or name, ff a corp?ra~n~-~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, senend contractor, electriclau, plumber or builder. (as on the tax roll or latest deed) If applicant is a corporation, sisnature of duly authorized officer. (Name and t/tie of corporate officer) Builder's Licensc No. A~..(-~lS.~.: ........... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Locat/on of land on which proposed work will be done .... ~ ~..gT~;tO. ]g~ .... ~. :/-./. . .~.; 7.< .......... House Number Street Hamlet ....... ~. ........ Block ...... ~. .......... Lot...,~,~ .......... County Tax M_~ No,. 1000 Sect/on~ Subdivision.-T~ ).~-. -~!..~'~?)' .... ?. ?.'~...' ........... Filed Map No..~.,,-~..?.~.... Lot... ~/../,..' ...... (Name) 2. State existing u~e and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy...."~..../'~'..~..)./.....~..'~.././. ( .t .~.'. ~,.~. 9; ~ .... ,,.: ............ , .......;..'i:'i ' · ........... .......... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration . .~. ..... Repair .............. Remgval .............. Demolition .............. Other Work ............... ' .~...~..~... i /.~.7 ~-.o..~.. (Description) 4. Estimated Cost. ~'J Fee , ! ,/T'x (to be paid on filing this application) 5. If dwelling, number of dwelling :units/ ..........~ t/.~J. Number of dwelling units on each floor ................ If gara e, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .. ~.-,. .................... 7. Dimensions of exiqting structures, if any: Front .... -~..'~.. ~...-~.... Rear . .~'. f.../.C ....Devth...'.2:. J/.././. ?.././. ttmght ..../{..~.. ¢ .... Number of Stories .... ~ A~.~. ............................................. DimensionLof same structure w~th alterations or additions~ Front .... -J~ .~. ~.C ..... Rear . .--..~.z-,a ~= ........ Depth ,_~..~.2-~..~7 ......... ~.. Height .. ,-J~../*..,~Y...~ .......... Number of Stories ri ~7-~..~-~ ............ 8. I)lmensmn.s~__of entire new construction: Front ~ :,~... ~ ./4-.' ~'l(ear . .,~.,~.~m ~: ....... Depth .--f~/?-,. ~- ....... Height ,-~. ~ff. ,~.~.. ......Number of Stories ...-W. ~/.-~. ~ ....... ,...~ ................ ~. .....,, .......... 9. Size of lot: Front . ./.f.f.-;. '7'f'' '~'~'--~ ..... Rear..././. ~U..,. ~..~.. )~..~..... Depth ..x~. ~q'.~...~= ......... 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 law, ordinance or regulation: /~'.~ ............................ 13. Will lot be regraded ......... ~ ......,~ ............ Will excess fill be removed from premises: 14. Name of Owner of premises '.~.o~ Yes No ...... ~.~..r½/~. .... Address ~..q .~...-f~..rd .fdf.~... Phone No..'~.~.'/..'.~.~.,/~.x['.~ Name of Architect ............................ Address Phone No. . Name 0fContractor/x'.4.]..~.~.'7~/..?.~..,I-~A'./.~.~.~ Address ~'~.'O.' i .~. 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 NEV(~RK, COUNTY .... .... · .}-~z2~,.N~di~r~l.s~..~ .0~¢--¢. beingduly sworn, deposesand says that~ is the applicant t ' ' ' ig ~ngcontract) above named. : ofe is the ...... i ......~Z-~,~~ ............................................................... ' (Contractor, agent, corporate officer, etc.) said owner or owners, and is dul~ 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 in the manner set forth in the application filed therewith. Sworn to before me this ............. day off ....... , 19 ~'~.c-~- Notary,Public, ................. f? ] ' ~ : [[..~ASE~H ANN NL~flLL~ ...... " , Il0, ~,Sl2§SSO Suffolk CouAty/ ' i ~1~ ~.lres March 30,