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Home My WebLink About11872-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17193 Date AUGUST 12, 1988 THIS CERTIFIES tha% the buildin~ ALTERATION Location of Property 420 LAKEVIEW TERRACE, House No. Street County Tax Map No. 1000 Section 031 Block 09 Subdivision Filed Map. No. EAST MARION, N.Y. Hamlet Lot 011 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 21, 1982 pursuant to which Building Permit No. 11872-Z dated AUGUST 24, 1982 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 ONE FAMILY DWELLING The certificate is issued to MARK & SHARON MIDDLETON (owner, ~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HKALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N808733 - MAY 11, 1987 Building Inspector 'Rev. 1/81 FOF,~ NO. ~ TOWN,OF SOUIIt0U:} ? BUILDING DEPARTMENT TOWN HALL SOUTH'OLD, N~ Y. } BUILDING P, ERM!Ti (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL ~ULL COMPLETION OF THE WORK AUTHORIZED) N? ~1872 Z Dote ... ~ ...... ~..~. .......... , Permission is hereby granted to: ..~.~...X.~,.,,o .~ .............. .~ ~Zm~.~.,..~.~..~,...~/,~ ,o ..~ .... ~~.~r;~....,.~D ~.~~.. ~o~,~,,o~.~....~~/~-~ ....... ~. ............ ~ .......................... .......................................................................................... ~z..z~/~)....~..¢ co~,~ ,~ ~.~ uo. ~00o s~o~ ~.~.~ ......... ~k ~.~ .......... ~o~ ,o..~Z ............. Building Ihspector. F..,/.~ ...... ..... ; ' Building~lnSPector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions UT. oLD __ A. This application must be filled in wpewriter OR ink, and submitted ~ Immm,mm~ 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 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 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 informa- tion required to prepare a certificate. C. Fees: Addlt£oas 825.00 ?OOL$ $25.00AL?ERATTON 825.00 l. Certificate of oecupancy New Dwe[[ia~ $25.Q0, Accessory'.~lO.00 Business $50.0Q 2. Certificate of occupancy on pre-existing dwelling $ 50. O0 3. Copy of certificate of occupancy $ 5.00~ over 5 years 4.Vacant Land C.O. $ 20.00 5. Updated C.O. $ 50.00 Date ..... .~./. ~../. ~.~. ~. ......... NewCons t~uction ...... Old or Pre-existing Building ....~.. ...... Vacant Land ............. ,_ocat on of Property .... .... ...... House No. ' ........ Owner or Owners of Property ../~../~'~ .-~:...~. ...... County Tax Map No. 1000 Section ...... ~..~.. / .... Block ...... ~.~. ..... Lot ....... ~,// ..... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No..} ~ .~.. Date of Permit'~ .... Applicant .... Health Dept. Approval ........................ Labor Dept. Approval ..................... ;.. Underwriters Approval ........................ Planning Board Approval .............. Request for Temporary Cer~:ificate ..................... Final Certificate ........ .v....... . Fee Submitted $ ............................. Construction on above described buitding and per~i.~ me.ets all applicable codes and regulations. .... ......... R~. 10-10-78 TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because,of the following reasons. ._ An application for Certificate of Occupancy ~ _~/ is not on file. / No Underwriters Certificate on file. /? The check is(~/not on file.)$~,073 /-/ No Health Dept. Approval on file. /--/ No final inspection has been made. Please contact bUr'~ffice on this matter. Thank you for your cooperation. Building Dept. ~**/~/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) THE NEW YORK BOARD OF FIRE UNDERWRITERS, 85 JOHN STREET, NEW YORK, NEW YORK 10038 only the el~trwal equ,pTent ~ ~scr, bed be~w a~ ,ntr~uc~ ~y. t~ applicant ~med on the, ~sexaminedon ~ 4~ OUTLETS SWITCHES *13 36 19 13 DRYERS FURNACE SERVICE DISCONNECT MULTI-OUTLET , ' DIMMERS ' SYSTEMS NO. OF FEET . . East Marion~ ................ ; N.Y. 11939 :',' 2."~, :!'~':: .:::..~,:., -:., , .: ..... ,~_. r .: This certificate must not be altered m any manner; return to the'offig~ ~f't~ ~odrd if in~6rr~ct. {nspectors may be id~nt}fied ~y ;hei~ FIELD I~SPECTION FOUNDATION (1st) FOUNDATION (2nd) COMMENTS ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY G~ODE o FINAL ADDITIONAL COMMENTS: ':OWN OF SOUTHOLD BUILDtNG DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 TEL.: 765-1802 ...... D~sapproved a/c ,, .~~/ ' ~........_~........ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted.i,~.t:;i;!!%.~t~- 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 1S HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone (Srdinance of the Town of Southotd, 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 cod, e, and regulations, and to admit authorized inspectors on premises and in buildings for necessary/t/~in~ect~s'~ ]/~l~// / · ~~.o~. 4~ 7: .............. \ f (Signatu, re ~f applic_ant, or name, if a corporation) .... (Mailing address o~ applicant) State whether applicant is ow.~ner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner ofpremises ..~/~. ~.'i~~~~;eelI I i i}i i iii :: - If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ....... ~:~' .' '~7~ ....... License No::' '"~---' ~ Plumber Electrician's License No..... '.~. · .~..~~ / Other Trade's License No ...................... /~.. 1. Location of land on which, proposed work will be done· ~..~0r'~~..//.'././..~../.~.~.. ~ ....... · ~ ~ ~,' ................ ~ ..... ~. ~ .,.:..,,.....- .......... :.-,:..~i,%; .7.../.,.~ ............ }louse NumberStreet County Ta~ Map No. 1000 Section .~:/.C.~.'7..//. .... Block .................. Lot ................... Subdivision ..................................... Filed Map No. JY~.~..~.'~..~...'' Lot ............... (Name) 2. State existing use and occupancy of premises and intended use a~d occupar~y of ¢~r, pposed construction: a. Existing use and oecupancy .......... ,~/~.,~f:'~..~...~. '~ .~ .......................... b. Intended use and occupancy ......... ~.2~..~, ................................. Repair .......... ~va! .............. Dcrnoi~tio~ .............. 4. Estimated Cost ......... ~ . ~.~.~ ................ eec ~ .................................... : I (to be paid on filing this application) ' 5. If d~elling, number o f dwelling units .............. Number of dwelling units on each floor ................ If garage,:number of cars ....... ~ ................................................................. 6. If business, comlnercial or mixed occupancy, specify natule and extent of each type of use ............. t ........ 7. Dimensions of existing structures, if any: Front .... ~ ...... Rear .. ~{ ........ Depth... ~. [.. Height ............... Num be.r of Stones ..... /.ff~ ........................................... .... D~tensions of same structure with alterations or additions: Front .... ~. ~ ....... Rear ... ~.( ......... Depth .. :.. ~..t ............. HeiSt ...................... Number of Stories .... ~ .............. 8. Dlmensmns of entire new constmchon: Front .... ~ ....... Rear ... ~ ........ Depth .. ~ ......... . or .... ..................................... . · ............. ~ - . , · . ~ '# 9. Size of lot: Front ....... ~ ............ Rear ....... ~/~; ~ ....... Dev/h .... ~ ............ ~.. 10. v t, ..... ................ 11. Zone or use distriFt in whlc~ premises are situated ....... ~T~~ ............................... '1 ~. Does proposed cqnstruction vioCt~ any zoning law, ordinance or regulation: .... ~ .................... 13. Will lot be regraded ...... ~..~=... ~ .......... Will excess ~1 be r~oveddrom premises: 14. Nmne of Owner of premises .~ ~... Address .. ~,. ~.~. Phone No. Nan~e of :Architect ...... ~Y~ ....... Address . .~~d~... Phone No ................ Name of Contractor .......... , ............... Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all b;uildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block m interior or comer lot. mber or description according to deed, and show street names and indicate whether STATE OF NEW Y_(~K~j~//, ~ ,, COUNTY OF ... 'C::/'~410'/t'k. .... ~'~ .~ .....~. '~~' · ~~------ ................... berg duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named'.' ~; (Contractor, agent, ~orporat~ offi¢~r, of said owner or own~, ~d is dul~ authorized to p~rform or have p~rfo~¢d th~ said work and to m~e and fil~ this application; that all statements contained M this application am tru~ to th~ best of his knowl~dg~ and b~lief; and that th~ work w~l be'performed in th~ m~ne~ set forth in th~ application filed therewith. Sworn to before me this ' ...... ~ ........... dayof'. ............ 19 .. Z/ ~lo~i~a ~i~ sut~oik coun~ ~ (Signature of applic~t) ~, ~o. $~-6~68~ ~l FO.~ 'THE £ ,'l eo boo&