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Home My WebLink About12371-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. ZI6403 Date November 13, 1987 THIS CERTIFIES th tl Addition at ~e building ................................................ Location of Property ...1.1.0...B.ey.e.r..1.y. Road Southold House No. ' ............. 'S't/e~i ....................... County Tax Map No. 1000 Section 05 2 .Block 0 2 . .Lot 0 16 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated April 9, 1983 . pursuant to which Building Permit No. 123.71z dated .... 4u..n.e..7. a..1.9.8. 3. ........... 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 ......... Deck over an existing roofed over porch. The certificate is issued to BARBARA AND FRED BRUCH (owner,~]t~b~[~X of the aforesaid building. Suffolk County Department of Health Approval .. N / A UNDERWRITERS CERTIFICATE NO. Pending I 1/9/87 PLUMBERS CERTIFICATION DATED: N/A B uil~[fig Inspector Rev. 1/81 FO~ NOo ~B TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? ~237! Z Permission is hereby granted to: ...... ~.~.....~....~~...~.,~. ..... ...... _~. ~/~. ~.~. . . . . . .-. . ~ .: ~. . . . . . zz.~ z~. ,o ....~.o...~...~..~....~ ....... ~.~,~::....,~...~.x..z...~./.z.~.~....z~.~ .~. ../.....~/-~c.,.~z:.. ....... .,~.~. .............. ~..,~.,~.~.c~.. .............................................. a, p,em lses ,=,ed o, . . ~'Za ........ Z~O. ,. ~. .: ........ ~.U. ~. . . .,~-"~.'~ ............................ ......................................................................................................................- Co-nt~ To× Mop No. lO00 Se~t~o~ ..~.~...~ ........ m~k ...~ .......... to* So...~ ............ Building Inspector Rev. 6/30/$0 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions JUL - 7 :; This application must be filled in typewriter OR ink, and submitted =, ~ 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 featu res. 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. 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 featu res. 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 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 New Building . .~, .......... Old or Pre-existing Building $15.00 Date ...J.u.t.y..7.,...1.9.8.7. ......... ............ Vacant Land ............. location of Property ,110 ~everly Rqad Southold House No. ~ Street Hamlet Owner or Owners of Property . ?.~, .e~9.a.~.a~.a...B.r.u. qh. ................................ County Tax Map No. 1000 Section .... 052 Block 02 Lot... 16 Subdivision ................................. Filed Map No ........... Lot No .............. Permit No...1.5.4.8..7...ZDate of Permit . 1..~ :-.1.2. r .8.6Applicant ...R.o.n..M..o.r.i.z.z..o..B.u.i..1.d.e.~ ¢. ,I.n.c. ;.. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ....... Final Certificate .X. Fee Submitted $ .~..5: .0.q ..................... cable ~,0des and regulations. Applicant . .~.../. ...................... FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted ,~ ~ 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. §. 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 property showing all property lines, streets, buildings and unusual natural or topogra[~hic features. 2. Sworn st;,tement 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 New DweLLing.S25.00, A¢¢essory.,.$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.Oo $ 20.00 5.Upd.~ted C.O. $ 50.00 Date .~..U~...~.'.C~..~,,~../,../Y.~./. ..... 6.Alteration %/ $25.00 New C on s t r u c t i on..~.... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .. ~./..0. /"~eU~//,~/J ,~O~Z(-7~ . .~..~).~.,L'?/7. h .~?l~.... House No. Street Hamlet Owner or Owners of Property ........................... County Tax Map No. 1000 Section .....O~...~.. ..... Block ...~...c~. ........ Lot.../..~..z~ ........ Subdivision ................................. Filed Map No .......... Lot No ............. Date of Permit App,ica,t PermitNo~. ,~.'7, ! ...................................... '.Z. Health Dept. Approval ........................ Labor Dept. Approval ...................... Underwriters Approval ........................ Planning Board Approval .................... Request for Temporary Certificate .................. Final Certificate .............. 5- oo Fee Submitted $. ~....o..% .................... Construction on above described building an~meets~-~licable codes and regulations. Rev. 10-10-78 INFORMATION FOR BUILD, lNG DEPARTMENT WE ARE 1N THE PROCESS OF ISSUING A CERTIFICATE OF COMPLIANCE FOR THE ELECTRICAL INSTALLATION AS COVERED IN AN APPLICATION FILED WITH OUR DISTRICT OFFICE. ~ ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS APPLICATION NO, ~ IN SPEI~TOR FIELD INSPBCTI~ COMMENTS FOUNDATION (Ist) FOUNDA~TiON .... (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C~DE FINAL ADDITIONAL COMMENTS: ! '." / / / / / / $ -1 .' OX, FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Disapproved a/c ........ - ......... ~. ................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled-in 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, relationship to adjoining premises or public stte~ or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this apl: 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 porn 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 Occupan 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 t Building Zone Ordinance of the Town of 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 describ( The applicant agrees to comply with all applicable laws, ordinances, building code, ho~.~ing code, and regulations, and ~dmit ~uthorized inspectors on premises and iu buildh'~gs for nece~inspel~tions. .,~ . . (Signature of apphcant, or name, n.a corporahon~ ~(~l'ail~ ~;e's; ;~'applic-' ~ ~i) ...... , .... (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 .......................... Plumber's License No ......................... Electriclan'sLicense No ....................... Other Trade's License No ...................... 1. Location ,of land on which proposed work will be done ..................... ~ ........... ,,..,-7. ......... House Number Street/ ' llamlet County Tax Map No. 1000 Section ............... Block ............ Lot ............. Subdivision ....... ~( ............................. Filed Ivlap No .... x~. .......... Lot .... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy ............................ Repair .............. Rembvai .... ' .......... Demolition ............ E:;timated Cost · · · .~ ...... Ii ......................... Fee . · i', (to be paid on Filing this application) If dwelling, number of dwellingi0nits .... .~. ........ Number of dwelling units on each floor ................ number of cars ; If garage, · ·. · ~ .............................................................. If business, commercial or mixe!d occupancy, specify natuj'e and extent of ca_ch tyt)e of use ....... .... Dimensions of existing structureS, if any: Front... ~.,~0. ........ Rear ..-~.q~. ........ Depth i' .~..' i'~. i i i.. Height ............... Number of Stories .../. ]'Z,..'~. · · ............................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Number of Stories Depth .................. .. Height................. ..... ''"''"'''""''" Dimensions of. entire new construction: Front. ~..~fi;fr ....... Rear...S.fif.t ....... . Depth ./.2./. ....... ~. Nu*he of Stories Hight /0 Size of lot: Front ..: ........ Rear Depth Date of Purchase ~. ~ Name of Former Owner pie'mises are situated Zone or use district in which Does proposed construction vi61~te, any zoning law, ordinance or regnlation: ................................ 'Il e~t~e fill~be, re ov~d~r ' Will lot be regraded ....... . ................... Wt ss m om premmes: Yes No Name of Owner of premises ~l~(d~.~.. ......... Addres~'J~/.d~/(~'/.~...,. ,~... Phone No ................ ' ' . . . . ........... ~ .....Address . .~..~..~,~ ...... ,....,.. Phone No ................ !' PLOT DIAGRAM Locate clearly and distinctly ali i buildings, whether existing or proposed, and, indicate all set-back dimensions from :operty hncs. Give street and block number or description according to deed, and show street names and indicate whether ;terior or corner lot. ' '(Name of indiw'dual signihg cont~t~ - hove named· ' ' ~' (Con ent, corporate officer, etc.) f said owner or owners, and is duly au-ffthorize~T6 perform or have performed file sa. id work and to make and file this 9plieation; that all statements con'tained in this application are true to th'e best of his knowledge and belief; and that the 'ork will be performed in the man~r set forth in the application filed therewith. worn to before me this i ' ~o~~_ .),.? -"- f~Sfi~Vure of applicant) ~rm ~,oires March 30. 1~ ' . il¸ APPROVED AS NOTED ~ NOTIFY BUILDING DEPOneNT AT 7&5-]802 g AM ~O/P~ FO~ THE FOLLOWING INS~ ECTIONS: 1. FOUNDATION ~ TWO REQUIRED 3, INSULATION ALL CONSTRUCTION SHALL ~EET THE REQUIREMENTS OF THE N.Y. STATE ~ONSTRUCTION & ENERGY ~O~ES, NOT RESPONSIBLE FOR