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Home My WebLink About11878-zFORM NO, 4 TOWN OF SOUTHOLD BUH_DING DEPARTMENT Office of the Building inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z/ 1396 Date December 21 .................................................. 19.82.. 'I'ltlS CEfC['IFIES that the building ................................................ Location of Property . ./.~ .5.5 ................ Tg.qao, 9. .............. ..... House No. Street Ham/et County Tax Map No. i000 Section . . .C)5:) ...... Block ...0.5~ .......... Lot ...q0.~ ........... Subdivision Southo2d ,Shores .Filed Map No, 3.85.3. .Lot No. 48 conforms substantially to the Application for Building Permit heretofore filed in this office dated · . . .~.u, g 9 ~ .t,.. ]..9 ........ 19 ,8.2. pursuant to which Building Permit No. ] ~ 878 Z dated .... fi.qi~ .u ~.t.. ~ ~ ............. t9.8.~., was issued, and conforms to all of the requirements of the applicabh~ pro¥isions of the law. The occupancy for which this certificate is issued is ......... ...... a.. ppAv..a.~.q .9 .n~.-.~.a. tn.~.Z.y.. ??.~ J:$.n~ .. ...................................... The certificate is Jsstled to LEON/~RD & BETTY L. ~ALTERS ..................... b¥,,'d','/~'~;t~,~;,'~ ...................... of the aforesaid building. Suffolk County Department of Health Approval . .?:-:59.-.7.6. ,. .1.]./. ~.4/.8.2. ~..R.o.b..t,... UNDERWRITERS CERTIFICATE NO .......... P. e. r.~ .d.i.n.~; ................................ Rev, 1/81 TOWN 01~ $OUTHOLj~ BUILDING DEPARTME~NTi TOWN HALL SOUTHOLD, N~ ¥. BUILDING'PERMIT (THIS PERMIT MUST BE KEPT ON 'I~H,£ PRE/~ISI~S UNTIL ~' ~ULL COMPLETION OF THE WORK AUTHORIZED) ; . Permission is hereby granted to: / :: : : ...... ~-~.~....~~ ....... ,.... ...... ~,.....~.~..:~..;....: ................. : : ..... ~..~¥~..~.~,~:.....~ ,0....C'.~...~..~.~.~:..~.~......~.,.~ :....~./.z~.~.2~': .......... : .......................... ot ~e~,se~ ,o~oted at ........... '~'~r~ ...... ~ :.:~.~.~.~./~ ........ ~:~ ........ .:.:....~?./~:x~..:~ ............... County TaX Map No. 1000 Section . ~,~,, ...... ;. Block !:.~:~: ...... ;i:Lot No. ~..~..'~., ....... pursbont to application doted ;, I~.., and approved by the Buil lng Inspector. Fee :$.; ... '~--~,~v.: 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, N.Y, 11@71 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and subr~ tted n duplicate to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of ali buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal--iS.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, 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, 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 New Building ,. ~. ......... Old or Pre-existing Building(X) .. ........ =/Vacant Land -. ............ Location of Property...~¢..~ ............. '~"¢:' '~' '~''' -~' '~/.~.~ .... "¢~¢¢,~../¢~..Z77 ...... gou~ No. S(reer Ham/et Owner or Owners of Property .. ~¢~...~~....~X~¢~' ................... County Tax Map No..1000 Section . ~ ...... Block . . .~ ........ Lot .... Su baivision. ~,~ ~/f¢~ ~ .~ ~ ......... F lied Map N o.. ¢~... Lot No, .. '. ~ ...... Health Dept. Approval ........................ Labor Dept. Approval ..................... ..,.. Unde~ri~ers Approval ........................ P~ann[ng Board Approval .................. Request for Temporary Certificate ..................... Final Certificat~ ........ - ......... ,,e ~,~,,,d S ..... ~;.¢~ .................. Constr, ct'ono, ab~vedesc~,bed builOJngandpe~mee,sallapp~cabJ~odesa~dreguiatio~s. , '-Th '. .'.- FIELD~INst~EcTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: ,: V'AC~,N r) --,--~c)O.O TO I'"¢,IN D3AD-" 52'~'V/ t20.00 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ · o f~.~.. .... ..m.~..W.~...~.. .... . .?.~. ~. ,~....~../...z:~. ............. PLEASE TAKE NOTICE that y~pplicationd at ed .. ~. ~..~f~ ,19 for peru, it to construct..~..~.. '~'%~: '~/7' ~ '(~' '2~'/r5'~' ' ' ..................... at ~o~,t~o. o~ e~o~,y. ~ ........ ~~:... ~ ,. ...... ~~:. & House No. / Street I ~ Hamlet County Tax Map No. 1000 Section . .~ ..... Block ..... ~.~ .... Lot . ~ ..... Subdivisi~f~~ Filed Map No.. ~f~7~ ..... Lot No... ~ ......... ' is returned herewith and disapproved on the following grounds ~..~&~..~..~.~ Bfiilding Inspector RV 1/80 TOWN OF SOUTHOLD " '-~ BUILDING DEPARTMENT "g '"~-'~'" r .- . / TOWN HALL I ~ v~ ~/ ~'~ ~UTHOLD, N.Y, 11971 TEL.: ~180~ APPLICATION FOR BUILDING PERMIT Date ....... , INSTRUCTIONS a. This application must be completely fdled in by typewriter or in ink and submitted i=:~aipti~m~ to the Buildin[ 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 ~escription of layout of property must be drawn on the dia&ram 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 i~uance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southotd, Suffolk County, New York, and other applicable Laws, Ordinances o~ Regulations, for the constroction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with ali applicable laws, ordinances, building code, housing code, and re~J~,~tions, and tc ........... ~ ~. ether applicant is ~ le~, a~nt, amhitect, engineer, ~neral contractor, electrician, pluml~- or builder. Name of owner of premises . ~. ~.'~,q~'~;;,~./) .... 6.~.~'~.../ze~,~/'~-.'~ ................................. (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 .... ~ .[..~...; ........... 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 No. 1000 Section .,.~ ...... ~.~.. ..... Block ....... ~.. ....... Lot .............. Subdivmion ~'~.~.~7: ~.~ o~u~..,Ffled Map No. ' ' ~!'.~'~. Lot .~!~. ....... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing u~ and o~U..l~cy9 ................................................................. '''' ' b. Intendod u~ ~m~'Bccupen~ ................................................ . . .. . --~9. ~10. 11. 12. 13. 14. 3. Nature of work (check which applicable): New Building .... ~ .~Q/.... Addition .......... Alteration .......... Repair .............. Remloval .............. Demolition .............. Other Work ............... 4 Estimated Cost - . ... Fee ................... i (to be paid on filing this application) 5. If dwelling, number of dwellinl units Number of dwelling units on each floor ................ If garage, number of cars .... : .................................................................... 6. If business, commercial or m~ked occ~lp~ncy, sp'ecify nature an~fl bx'f~fit' ofe~.ch type of use .... .~ ................ 7. Dimensions of existing structures, if any: Front ............... Rear .............. D'eptll ................ Height ............... Number of Stories ........................................................ Dimensions of same structure 'with alterations or additions: Front ................. Rear ............... .... Depth' Height Number of Stories 8. Dimensions of entire new construct/on: Front .... ,~. ...... Rear ... ~ ...... Depth . ~ .......... Height ............... Nur, aber of Stories .............. ,' .t ......................... v .............. bize of lot: Front .... J~., ........... Rear ..... ,J,-~O ............. Depth .../~..,.~'. ............... Date of Purchase ....... ,~.j~ 7/~°~ ........... ~'Name,of Former Owner ',J-J~..~.a!-. ~7..~. ~4 .~t?. Zone or use district in which premises are situated ....... ~ ........................................... Does proposed construction wotate any zoning law, ordinance or regulation: , .: ........................ Will lot be regraded ........ I .................... Will excess fill be removed from premises: Yes No Name~ofOwner ofpremises .~-~ott/~O.~Y.'de~. ~.//tt,/'agAddress m,t,n, tlO . :~. ~. .~f..,i~. . ~. .~. .. .. : Name bf Arct~itect .....--,... ~ ,'.;. ~ ........... Address ' '~ ~,ut-~c~.~,/~ ..... Phone No. .................. Phone No. Name iof Contractor ~./,t.,)~..~. Address Phone No PLOT DIAGRAM Locate clearly and distinctly ali 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 comer lot. STATE OF ,NEW YO~K, -- COUNTy OF. (Name of individual signing contract) above named. : (Contractor, agent, corporate officer, etc.) of said owher or owners, ~d is duly authorized to perform or have perfomed the said work and to make ~d file this application[ that all statements cont¢ined ~ this application are true to the best of his knowledge and belief; and that the work w~l be perfomed in the m~ner set forth ~ the application filed therewith. Sworn to before me this [ ~gnamro oJ appucam) ,:Term E~ptre~ ~ar~h 30 APPROY. ED AS 'NOTED DATE~B.P. '~ ~/'/ ,~f~' FEE: ' NOTIFY BUJLDI'NG D~PARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOP. POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CON'STRUCTION MUST BE COMPLETE FOR C. O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FO~ DESIGN OR CONSTRUCTION ERROI~S. OCCIJ?I~HC¥ OR ~ US[. IS tltlU~ftlt. -V~I'i[~[T CEP, TIFIC~TE Q[ OCCIJ?MIC'I[ O0 O0 "7 ~7 ~ ~ T~¢ D~FE COA-~ MA[:~ DATA :1~- 53- 5- 5},. ~/ ,- I ~ ~: (.~_, ' ............ ~ I A~ 5~[~VF?YU~. dA'L,..$ ,~ ~,~' '-I--