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Home My WebLink About11883-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z~q772 Date July q~ ... .................................................. 19 83 THIS CERTIFIES that the building . .3Je~. ~ellJ_ng ................................ Location of Property . .'l 3.60. Co~ey. C:n. eek...Lame ................ ~ou,tho~_d ........... House No. Street Ham/et County Tax Map No. 1000 Section ...0.7?. ...... Block Subdivision..¢9:v.e.y. O:v.e. ek. ~gs.~a~cos ....... Filed Map No...z~92.3 .Lot No ...... 27 ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ·.. ,&~glz~.~;.. 2D. ..... ,1~2. pursuant to which Building Permit No .... -qd$@3g ........... dated ... g.ugus.~..3q .............. 19 g2, 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 ......... Fo~ a one family dwellin~ The certificate is issued to WA2Lr~ER ~RAPPE & FLgRIE~r~E BA~ES ..................... ~;~,,'o'r,'/3ide'dr'r'o3~,,'d ..................... of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO. 2PENDING ~olu~ .NO; ~ TOWN OF $oUTHO~D i~ BUILDING DEPARTMi:NT TOWN H~LL SOUTH'OLD, N~ Y. BUILDING P, ERMI'~ (THIS PERMIT MUST BE KEPT ON THE PR'E~I~ES uNTIL ~:ULL COMPLETION OF THE WORK AUTHORIZED) ~? ~ss3 z ~ .~~Z.~....~.~ ............. permission is hereby gronted to: : ~ ~.....~.....~.~ ........... ........ c~.~~...o~.....~~,~~~ ....... to ..... :...~~...z~~..~:.~ ~~~~ ~~~ ~..~.~ ......................... ~ T,,~ ,=,~ ~ ..~ro......c~....~ ~...z~..~.: ........................... ..~ ..... ~ .............................................................................. ~.... ....... ~z~.z~...~.~.~. ...... ~.~.. ~..~..~ .~....m., ....... g ~:: ........... ~z~~ -~.7 · : ~~nd opproved b B~lBIn~ Inspector. 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 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 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 on pre-existing dwelling ~/r land use $/~/$5.00 Certificate of occupancy $5.00 2. 3. Copy of certificate of occupancy $1.00 Date . New Building .... ~. ........ Old or Pre-existing Building(Z) ........ .~ fVacant Land ....... Location of Property . ./3~,'~o...4~.~.~/~ ~.y"r~.~.~....~.~1. .............. ?.~.~-~.~.'~,~.~..z~,~_ .......... House No. Street Ham/et Owner or Owners of Property .. ~.,f:).../-?:~f /.~./~t~)'/~./._??, .¢ ./~. ?~'~. ?.~-..~-~..-~..;..~.z'.~..~.~,(~ ............ County Tax Map No. 1000 Section ....4~ ~..~. ...... Block .... .~. ~'. ....... Lot ...... ~./'.~. ...... Subdivision..~"~,~.~./~..~'~¢.,: ./~....~.--~?:,~..~.~.~'. .... Filed Map No. ~..~.~..~. .... Lot No .... ~. ~. ...... Permit No.///..~.o¢r2.~... Date of Permit~/-/~. ?.////~Y~..'Z. Applicant ......~-~:'../~.....~"~ .... .~,~'~.. ..... Health Dept. Approval ........................ Labor Dept. Approval ...................... ,.. Underwriters Approval ........................ Planning Board Approval .................. Request for Temporary Certificate ..................... Final Certificat~ ........ - ......... Fee Submitted $ ............................. ~. Construction on above describedAppllcantbU ilding and, P~/~ ~_. e~c~e~,n~~.u/,~~~r~tion/~ Rev. 10-10-78 ~ I I PERMIT NO. NEW ¥o~ STATE DEP^RTMENT OF ENYmONMENT^L CONSERVATION ~ 15276--036/+ PERMIT UNDER THE ENVIRON/~TAL CONSERVATION LAW ARTICLE 15, (Protection of Water) ~ ARTICLE 2S,.(Tidal Wetb~ds) ARTICLE 24, (Freshwater Wetlands) L._J ARTICLE 36 (Constructio~t ~ifl Fl~ood Hazard Areas) PERMIT ISSUED TO William B. Smith for Henry Hammerschlag ADDRESS OF PERMI1TEE P. O. Box 1~6 Southold, N. Y. 11971 LOCATION OF PROJECT (Section of stream, tidal wetland, dam, building) Corem Creek Lot #27, "Map of Corem Creek Estates" DESCRIPTION OF PROJECT Construct one family dwellings34' x 34' no greater than 35' s/o northern prop erty l~ne. Construct sanitary system between dwelling and CoreM Creek Road. COMMUNITY NAME (City, Town, Village) $outhold COUNTY Suffolk IFIA GENERAL 1. The permittee shall file in the oJfice of the appropriate Regional Permit Administrator, a notice of intention to commence work at least 48 hours in advance of the time of commencement and shall also notify him prompt fy in writing of the completion of the work. 2. The permitted work shall be subject to inspection by an authorized representative of the Department of Environmental Conservation who may order the work suspended if the public interest so requires. 3. As a condition of the issuance of this permit, the applicant has ac- cepted expressly, by the execution of the application, the full legal respon. sibifity for all damages, direct or indirect, of whatever nature, and by whom- ever suffered, arising out of the proiect described herein and has agreed to indemnify and save harmless the State from suits, actions, damages and costs of every name and description resulting from the said proiect. 4. Any material dredged in the prosecution of the work herein permitted shah be removed evenly, without leaving large refuse piles, ridges across the bed of the waterway or flood plain or deep holes that may have a tendency to cause injury to navigable channels o? to the banks of the waterway. 5. Any material to be deposited or dumped under this permit, either i~ the waterway or on shore above high-water mark, shall be deposited or dumped at the locality shown on the drawing hereto attached, and, if so prescribed thereon, within or behind a good and substantial bulkhead or bulkheads, such as will prevent escape of the material into the waterway. 6. There shall be no unreasonable interference with navfgation by the work herein authorized. 7: That if future operations by the S~ate of New York require an alteration in the position of the structure or work hereto authorized, or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation of said waters or flood flow~ or endanger the health, safety or welfare of the people of the State, or loss or'destruction of the ~atural resources of the 5tate~ the owner may be ordered by the pepar - merit to remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State; and if, upon the expiration or revocation of this permit, the structure~ fil4 excavation, or other modification of the watercourse hereby authorized shall not be completed, the owners shall, without expense to the gtate~ and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or aJleration. g5.~0-4 (9/75) TOWN Southold COMMUNITY NO. DAM NO. I PER/AlT E PIRATION DATE 6 o/ 2 CONDITIONS 8. That the State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. 9. That if the display of lights and signals on any work hereby authorized is not otherwise provided for by law, such lights and signals as may be pre- scribed by the United States Coast Guard shall be installed and maintained by and at the expense of the owner. 10. All work carried out under this permit shall be perlormed Jn accor- dance with established engineering practice and in a workmanlike manner. ? ti. It grante~ under Artleles 24 or 25, the Department reserves the right to reconsider this approval at any time and after due nohce and hearing to continue, rescind or modify this permit in such a manner as may be found to be just and equitable. If upon the expiration or revocatmn of this permit, the modification of the wetland hereby authorized has not been completed, the applicant shall, without expense to the State, and to such extent and in such time and manner as the Department of Eovironmeuta~Conser~at~on may require, , remove all or any port on of the uncompleted structure or fill and restore the site to its former condition. No claim shail be made against the State of New York on account of any such removal or alteration, 12. This permit shall not be construed as conveying to the applicant any right to trespass upon the lands or interfere with the riparian rights of others to perform the ~ermitted work or as authorizing the impairment of any rights, title or interest in real or personal property held or vested in a person not a party to the permit. 13. The permittee is responsible for obtaining any other permils, ap- provals, lands, easements and rights-of*way which may be required for this project. 14. If granted under Article 36~ this permit is granted solely on the basis of the requirements of Article 36 of the Environmenta~ Conservation Law and Part 500 of $ NYCRR (Construction in Flood Hain Areas having Special Flood Hazards - Building Permits) and in no way signifies thal the project will be free from flooding. 15. By acceptance of this permit the permitlee agrees that the permit is contingent upon strict compliance with the special conditions on the reverse side. (SEE REVERSE SIDE) SPECIAL CONDITIONS ho~e or area i~enti£ie~ on ~/12/81 surve7 as :p~ me~o~, 18, ~e ~ o~ ,~ ~e~ ~oe~ ~o~ ~e~e~e ~e ~e~ee o~ ~e ~a~ ~7 be ~e~:~e~ ~7 o~e~ ~e~ ~e~e~ o~ ~o~ ~e~e~e~. ]-9. All local floodPlain ordin~ces must be adhered to. 20. NO FILL IS TO BE BROUGH~ TO SITE ~THOUT W~TTEN PE~SSION OF THIS OFFICE. DJL: cg c.c. LA~ ~ORCE~N~., U.S. A~y Corps of Engineers File Attached: Receipt NO. U 2351~ (25.00) ~ 2346 COMMENTS FIE~U I~SPECTION FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 INSTRUCTIONS (Building Inspector) APPLICATION FOR BUILDING PERMIT a. This application must be completely filled in by typewriter or in ink and submitted.2,..~-b;~_:,_uL~ to the Building Inspector, with 3 sets of plans, accurate pict 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 ~lascription 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 permil shall be kept on the premises ava/lable 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 Southotd, Suffolk County, New York, and other applicable Laws, Ordinances m Regulations, for the construction of building, 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 r,cgulations, and tc admit authorized inspectors on premises and in buildings for necessary inspections. // -. /' ..... (Signature of,gpplicant, or name, iJ~ a corporp, tion) ,, ' (Mailin~ address otea~plicant) I State wh.~et~is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........ . . ._i _;cc , , . 5 .z;i , ........ Nmne of owner of premise~...(~../[..-~ . ."~.. ~.' .......................................... ' ..... '"~' ~' ~ t~C' (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authori2~d officer. (Name and title of corporate officer) Builder's License No..1~. Plumber's License No ......................... Electrician's License No ........................ Other Trade's License No ...................... 1. Location oflandonwhichproposedworkwillbedone..~.~~.~.~..~ ........ ,~ . , . - C/ ~ ~ . ?~//- House NumbeM {3~ Street Hamlet /~ ..... .......... ...,;. ............ Lot .... ........... Subdivisione~.~~--?~..)* PiledMapNo..~.~.~:.a.. Lot ..~.X ........ (Name) ~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ....... ' ~;o~::.~.-,.~ ..... .: ............................... a. Existing use and occupancy · ',I.(} b. Intended use and occup~c9 .......................... ~. .............................. 3. Nature of work (check which applicable): New Building...Lz'......' Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Co .... (5~ (Description) · ? ..................... Fee .......................... , : ~, (to be paid on filing this application) 5. If dwelling number of dwelling: units .... ./. ......... Number of dwelling units on each flOOr If garaoe, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ................ 7. Dimensions of existing structurbs, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ......................................................... Dimensions of same structure with alterations or additions: Front ................. Rear ............... ' .... Depth ................... ... Height ...... .~ .............. Number of Stories ......... .t -¥,;_, ........ 8. Dimensions of entirt~ n.ew construction: Front . .~-47 ......... Rear . . .~%. ~ ........ Depth .-,g~... . 9. ~>ize of lot: Front .... .~.C?.,~",r...t, ...... ,.. Rear ....... .f.~.,~.. ......... Depth . .'~.~ .......... 10. Date 0fPurchase .......... s/. .~d~--7..,Z'. .........l~Igme of Fenner Owner ........... ' .................. 11. Zone or use district ih which prpmises are situated... ,~ .............................................. 12. Does proposed constructi?n/fvi,~.oJa,.l~any zoning law, ordinance or regulation: ...'./.kr~:.Q ....................... 13. Wi/1 lot be regraded ....I,,'./.~.,~ ....... ~. j..p,~.... Will exc, e~s fiji b~ r. llt~oved from premises: Yes 14. Name of Owner of pre.~..misds~,,/¥?~_~~ Address .",~,.'..~..~5~,~..../.. Phone N~. Name bf Architect .~P....f. ~.r'~/...~....~ Address ~w~l~~. Phone No?~. ,~. ~ rT ~.,,5'. Name of Contractor ......... ;'::T.-7. .......... Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly a/1 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 inter/or or corner lot. / · COUNTY OF, .~.2f~f/~'Z/'.Zk .. ' ] . _ ...... Y~" '/" Y'/' '/'?~' '--/'~'' '~ .:-. "~....~?)..J./. · ~.7. · · being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named· He is the ; -- ' "" ' "'*' '" '" ' '" ' '" ' "', , ~ontra~i~ent,'~-" ' ' ' ' "'"" ' ' ' ' ' '" '" '" '"" '"'" "corporate,officer, etc.) ' '" "''''"'" of said owner or owners, and is dufy' autho~z, ed t,~ .m*~orm or have performed the said work and to make and file this application; that all statements contained in this application are true to ihe best of his knowledge and belief; and that the work wffl be performed in the manne'r set forth in the application filed therewith. Sworn to before me this ~~~_ Public,, . ........ (Signature of applicant) <, . hoose) IL ............. S.,~J 05 tO :. - I00.0 ' ~~s w~-~c .... ~ .... ~ "' '~ ...... ~f :S~s ~oe '~ms, ~ s.-a~ o~ to ~. - too o , ~ ~ ~ ...... ~, ~, ~~~ .._ %~ -., . C SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFO . PT. OF SE ~ sUFFOLK COUNT~' ~T. OF "EALTH SERVICES -- ~FOR APPROVAL 0F A~OVED: OWN~ , OCCUPANCY OR USE IS UNLAWFUL ~iTliOlJT CE~T'IFICATE OF OCCUPANCY FEE. : 765-~802 ~9 AM TO 4 PM FOR TNE FOLLOWING JNSPECTIONS: 1. FOUNDATION _ TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C. O. ALL CONSTRUCTION SHALL MEFT THE REQUIREMENTS OF THE N ¥. STATE CONSTRUCTION & ENERC~¥ CODES. NOT RESPONSIBLE ,:'QR DESIGN OR CONSTRUCTION ERRORS. Un~ulhorized 8Iteration or 8dditlon to this document is a vlolat~on of ~ction 7209 of the Nev~ York S~at~ Education Coples of t%~s document not bearing ti~ englneer's inked 0 Unauthorized alferatlon or addition to this document is a violation of section 7209 of fhu New York State Education Copies of this document bearing f.t~ enginee/s inked seal or embossed seal shall not be considered valid copies. . ,Ir violation of section 1209 of Copies of thb 8ocumen~ not , , Unauthorized alteration or addition to this document is a viol.tion of section 7209 of the New Yo~ State Education Cop~es of fhls document not bearing tl~e engineer's inked seal or embossed seal s~ll no~' be cons;dared valid coples. F J