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Home My WebLink About12397-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCOJPANCY No Z17439 Date OCTOBER 20, 1988 THIS CERTIFIES that the building ADDITION Location of Propert~ 55 DOUGI~tS & 2570 KING ST. House No. Street County Tax Map No. 1000 Section 26 Block 03 Subdivision Filed Map No. ORIENT Hamlet I~t 006 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 27r 1983 pursuant to which Building Permit No. 12397Z dated JUNE 30~ 1983 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 CONSTRUCT UNHEATED PORCH ADDITION TO EXISTING DWELLING. The certificate is issued to RICHARD J. AND HELEN PASSANANT (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N714474 10/28/85 PLUMBERS CERTIFICATION DATED N/A N/A Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWel HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 12397 Z Permission is hereby granted to: ....... .~/,,~m......~....:..~m..,~ ...... ....... ~..~.~...c~..~z.~..~..~...: ...... ........ .~...~..~.....~....~:.....~,zz~7 ~o ......... Z .~......~.~ ..~...%~ff2~.~.-Z.......~.~.,z-/~,,~Z~......J .~/~.....~. ~.../.~...~.~../.../ ~....~ ~. ~.....~,~././~........~...~:. .......... ~.. '~,/.,~....z~ .~...~ at premises located a/~ ............................... ~ff ................................................. ........................................ ...... .......................... County Tax Map No. 1000 Section .....~.~f~/ ...... Block ....f~...~.. ........ Lot No....~--~.~. ........ pursuant ,o application dated ....... '~'~f~'~'""~"7" .............. , 19 .~.-~, and approved by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPAN Instructions A. This application must be filled in typewriter OR ink. and submitted m~ to the Building In~ec- tar 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. B. For existing buildings (prior to April 1957). Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topograFhic features. 2. Sworn s[~tement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of ~ny housing code or safety inspection of buildings or premises, or other pertinent informa- tion requu~ed to prepare a certificate. C, Fees: 1. Certificate of occupancy New DwelIin§,$25.00, Accessory.,,$10o00 Business $50°00 2. Certificate of occupancy on pre-existing dwelling $ 5 0,0 0 3. Copy of certificate of occupancv $ 5.'00, over 5 7ears 4.Vacant Land CoO. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... 6.Alteration $25.00 NewCons t~'uction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .~.1'.~..~.. y..0..o?.~..~/~...~.~./~?...~.~ ...... .~.~ I..~.~.~.. ........ /. ! .~.."~. .... House No, Street Ham/et County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No./..~..~...Z%. ~Date of Permit ~f~/.~...~ .Appl.ieant .~....~.~_~.~1. ~./~/. ~ ........... 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 mee3~__.p_plicable codes and regulations. Applicant ......................... THE NEW YORK BOARD OF FIRE UNDERWRITERS 1O00773 BUREAU OF ELECTRICITY I~'c~ 8~5 JOHN STREET, NEW YORK, NEW YORK 1OO$~ L~c-'tobez' 28 ~ 1985 ~62231/85 THIS DatecERTiFiES THAT Application No. only the electrical equipment ~ described below and introduced by t~ applicant narned on the able application number in the premises of Riohard P~ssant, in the follo~ing location; ~ Basemen~ ~ 1st Fl. ~ 2nd Ft. Outside Section Block Lot was examined on OCt~' 2~[ ~ 19~ and found to be in co~npliance with the requiren~ents of this Board. FIXTURE FIXTURES RANGES ~OOKINGDECKS OVENS DISH WASHERS EXHAUST FANS ~T ~P. TYpE EQUIP. J~2W 1~3W 3~3W 3~4W NO'O[E~COND OF~C. COND. NO OF HI-LEG NO OFNEUTRALS 1 10~ C~ ~' R~oe~o This certificate must not be altered in any m~nner; return to the office of the Board if ~ncorrect. /nspecto(s moy be identified by their credentials, F I~ELD ~'%NSPECTION 1. FOUNDATION ( 1 st) COMMENTS FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY FINAL ADDITIONAL. COMMENTS: BUILDING DEPT. INSPECTION [ ] FOUNDATION XST [ .] ROUGH FOUNDATION 2ND [ ] INSULATION FRAMING [~FINAL REMARKS: DATE FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined ~..~..,44.~. -5~dd . '~ Approved'~../~..~. .,.~ .... , l~Penn~it No. /~~ APPLICATION FOR BUILDING PERMIT Application No../.~..'5~. Z ./~... ...... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building 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 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 tins application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued 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 issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, 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 code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ..... ................... (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~ <A~ud ~0 ~ ~ ~ (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 .................. . ./~../'.~J..~ Electrician's License No _ Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. le,,:L '.',''t· {(o 'si O;r ....................... ir' 'ei ........... it'a n'l'e; ........................ County Tax Map No. 1000 Section .... d~.d. ......... Block ..... (..9.~.. .........Lot OO~ ....... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of pr~)posed construction: a. Existing use and occupancy .~..~. b. Intended use and occupancy 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .......... Demolition .............. Other Work ............... 4. Estimated Cost . ~ ~0~-3 d) j~. . ~ (Description) ........... / ......................... Fee.. ~ ........................... ~ /,~ (to be paid on filing this application) 5. If dwelling, number of dwelling,units .~' e~'~'Jc~ ............. mber of dwelling units on each floor ................ If garage, number of ears .... ~ ................................................................... 6. If business commercial or mixed occupancy, specify aat!~re/and extent or. each type of use .................. ~, 7. I)imensions of existing structures, ifany: Front ~..Co' .,. Rear~i*. Height /~./. .... Number of Stories . ...~..4.~. ................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Numberr of Stories ..................... 8. Dimensions of elatire new const/uction Front 3..G ...... Rear · ,p/ ~ ~q .............. _ ............... Height g' ..... I2umbar of Stories .. . .~. ......................... 9. Size oflot: Front .//?....'. J Rear /../~*i'~ ............ Depth/.~ 10. Date of Purchase ............................. Name of Former Owner ............................. 11. Zone or use district in which pr~mises are situated... ~.~/.~.:~.~ .......................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .~. ?. ............................ 13. Will lot be regraded ... ~ .i ................... Will excess f~ll be removed ~rtom premises Yes . .¢.o. 14. Name of Owner of premises ./~ cl ff.e..¥.~.~.*..~ ....... Address~..,'~./.,°4.~.d.°. ?..~..~g... Phone No .............. Name of Architect ~ Address , Name of Contractor '~.~.9.~f.~/'....-~...~..~..'*( .... Address j..~?.o, o .~.~.,~.~ ~.. Phone No. 3..~../. ?.?..~.4. PLOT DIAGRAM Locate clearly and distinctly all! 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 corner lot. STATE OF NE~OI?4IC,, -~ : (Name of individual sign!ng contract) above named. sworn, deposes and says that he is the applicant He is the ...................... i ........... ~ - '~x ""' ................................................... ;0r nt, corporate officer, etc.) of said owner or owners, and is dul~ author~6~rm or have performed the said work and to make and file this application; that all statements contained in this application am true to the best of his knowledge and belief; and that the work will be performed in the mannei set forth in the application filed therewith. Sworn to before me this I No u l~c, . ............. '. .... County //,~ No 5'2-$125850, Suflolfq Co..ul~t_y~/ [ Te m' Expires March SO,l~-~z7 ,,