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Home My WebLink About11895-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z.~ 53@2 .......... Date . .t. p?.i. 1...~ ~ ...................... 198.5.. THIS CERTIFIES that the building . Location of Property .... 3 6.0.. N o ~.t.h. I~ ~-.~. ~ y. ~.v.e., H a t t i t u c k House No. Street ......... County Tax Map No. 1000 Section ... ~. 2, .2 ...... Block 03 .Lot 03 5 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·...i.u.a ... J .6 ..........,19 .8.2. pursuant to which Building Permit No. 1 q 8 95 Z dated ..... &epi;,..a .............. 19132., 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 ......... ... S.~lar..coll~.ction..r. o or~ .add~,~i~a..t.Q, .exi.~ .t,i.n.g, dwe 11 .i.n.g ............... The certificate is issued to RICHARD A, LUHRS ..................... .................. of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. P e n d in ~ 3 / 2 8 / 8 Rev. 1/81 Building Inspector : TOWN OF ~O~T~OI~D i' BUILDING D~P.~RTMENT TOWN HALL SOUTHOLD,, N~ Y. ~ BUILDING pERMIT (THIS PERMIT MUST BE KEPT ON THE PP, E/~ISES UNTIL ~ULL CQMPL:ETION OF THE WORK AUTHORIZED) Permission is hereby granted to: pursuont to ~pplic~tion doto .~.2 ........... ~...:: ...... 19:~nd opprovod by the ~ ~ In~ct~r Rev, 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY TOWN OF SOU'tHO,.D 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: I. Final survey of property with accurate location of all buildings, property lines, sti'eets, 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 p:Coperty 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 $ ].5.00 3. Copy of certificate of occupancy $1.00 Date ........................ New Building ..~. .... .~/~-j,~.~. Old_or ,Pre-.existing Buildlipg_ ~ Vacant Land ................ Location of Property ~.,..~;C¢~q . ~.'~.d( · ./~.Z'/../../.~. ~4-~....~.. 7'" .............. House No. v Street ' ' Ham/et Owner or Owners of Property . .,~2.4f/~. ~..~'.~....~..~.,~..~..r-._( ................................ County Tax Map No. 1000 Section ,/:Z ~-~ Block ~ Lot~....'-~.. Subdivision ................................. Filed Map No ........... Lot No .............. Permit No./.z)..~...~..~..ZDate of Permit-~..~..¢.'~...Applicant .~..?~Z"~..,~..~/,~. ~...~.: ?ff. ......... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit r~ee't~ll applicable codes and regulations. Applicant ........ .~..~.../.~ ............... ,e,.,o.,o.,s -- &/ew Yori~ ~ -...,..._.,.....¢,,.. . ,,. ' ~e.a I~: $'0'=1°' : JUN 2 0.1995' FIELD INSFEC%ION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING COMMENTS INSULATION FER N. STATE ENERGY ~ODE FINAL ADDITIONAL COMMENTS Approved ..~.~...~...~.. FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHQLD, N.Y. 11971 TEL.: 765-1802 ., lC .~.~.~'Permit No..{.//.~...ff..~ APPLICATION FOR BUILDING PERMIT INST RUCTIONS a. This application must be completely filled iu by typewriter or in ink and ~submitted in triplicate to the Buildi 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, relatim~ship to adjoining premises or public sire* or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part o~'this cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon apprc,'al of this application, the Building Inspector will issue a Building Permit to the applicant. Suci~ pern shall be kept on the premises available for inspection throughout the work. e. No buildJng shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan shall bare been granted by the Building Inspector. APPLICATION 1S HEREBY MADE to the Building Department for th~ issuance ora Building Permit pursuant to t Building Zone Ordinance of the Town ~f Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, 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 regulations, and admit auth°rizea inspect°rs mi prenliscs and in buildings f°r necessary inspe~,~/~Z/,~,/ - ...;.../..,.,~..~,.,,:,._....i../.,......... (Signature of applicant, or name, if a corporation} .e,..&. :., ~ (Maitin~, address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build Nmne of owner of prcu,ises,. ~/~4~./~...l~.. ~i~. ............................................. (as on the tax roil or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's cense ..... ........ Plumber's Licens~ No...."-~. .................... Electrician's License No.' . .ZZT .................. Other Trade's Licei~se No. %":. ................ ~ ~ 0 ~ , 1. ' - ' Location of land on which proposed work will be don~~~ .... ~ .Z~ ~../~. House Number Street Hamlet County Tax Map No. !000 Section ........... Block ..... ~. ,~ ....... Lot.. 0 ,~.~. Subdivision ................................... Filed Map No .... ........... Lot .............. (Name) 2. State existiug use and occupancy./__°f premises and intended us~ and occnpancy of proposed construction: a. Existina use and occunanc'~ ff~/~ ~ ' .. Intended us~ ~d occupanc7 : ........ ~ ....... ................ 1. Nature of work (check wbict,, applicable): New BuL!ding .......... Addition .......... Alteration ......... Repair .............. Removal .............. Demolition .............. Other Work .............. '~~ ~. ~. i oo__ ~ ~;.~ ~ (Description) Estimated Cost ' Fee (to be paid on filing this application) ;. If dwelling, number of dwelling un/ts .......... Number of dwelling units on each floor .w ............. If garage, number of cars ~ ..................................................................... L If business, commercial or mixed occupancy, spec~y fiature and extent of each type of use . .~ ................ t. Dimensions of existing structures, if any: Float. 2 .~ ........ Rear .3.~ .......... Depth .~ .......... igtt ~.~ N~ Z/~/ ~ He ~ ............ m~ber of Stories .................................................. Dimensions'of same structure with alterations or additions: Front . ~.~ ............. Rear .~ ............ '. Depth ...................... Height ...................... Number of Stories .................... I. Dimensions of entire new construction: Front .;,)~ ......... R~ar..~ ........... Der~ :~ ......... Height .~ ............ Nmnber of Stories ............... ' /. Size oflot: Front .~ ..... .... '.. .... Rear..~.A~ .......... Depth ..d~ . ). Date drPurchaso, .~. r.~21 .............. ~Name otFom~er Owner ~~. :~ff~fi ~:2~. 1. Zone or usu district in which premises are situated. ~ .' ........................... ?. ............... L Does proposed construction violate any zoning law, ordinance or regulation: ~ .......................... t. ~'ill Iot be__Tgi aed ne" ' ........"'" .....win ex,ss,fill be removed from premises: & L Na ~e of Ox 'n.r of pre nisus .~dCb.&~Q~ &~0ff~ Address ff~gff~ ~ ~Z~Phone No~-~ N~ Name of Architect .~ff~.. .......... ~:. ~:..( ·Address. 2.Pho, Y ffY:......... Name of Contractor .ffZ~ ..................... Address ............ Phone N; .... :':::~. 2~ PLOT DIAGRAM Locate clearly and distinctly all ou'klings, whether existing or proposed, and. indicate all set-back dimensions fron roperty lines. Give street and block mnnber or description according to deed, and show street names and indicate whethe .tehor m corner lot. rATE OF NEW YORK, ou v ?.... S.S ~//d~.,~h/J.~ ,~.'/-.~F. . being duly sworn, deposes and says that heAs the apphc~.nt (Nanie of indMdual signing contract) >ope named is the .. ~~ ......... '.. ~: ........................... , ....... ............. ;.. ~ ~ (Contractor, agent, corporate officer, e"c.) . ' ~ ''~ ......... f said bwner or own'~, and is duly authodzed to perform or have performed tli,: said work and to m~e and file ~is ~phcatmn, flint all sJ, atcmcnts contamea m tlns apphcatm~ are true to the best of his knowledge and belief; and that the · ork will be perform&d in the manner sat forth h~ the application filed therewith. worn to before me this . .. ~.~ ~,~" . ....... ,...~;~¢.-~::;./..~.;~ .................. ~.."". '..'...',}' ~~,~'~' . ." ' '.' ]. ~ .'. (Signature of applieant: