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Home My WebLink About12285-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z~3850 Date September 12 19 85 addition. THIS CERTIFIES that the buildfl~g ................................................ 7610 Flatt Rd, Orient Location of Property/~$~ h/'o ........................................ ~ ................ · Street Hamlet 27 1 10 County Tax Map No, I000 Section ............ Block ............... Lot ................. X X X Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore flied in this office dated April 11 1983 12285Z ......................... pursuant to which Building Permit No ...................... dated .. April 26 83 .......................... 19..., 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 ......... Addition to existing structure. JOSEPH & EDWINA HATAIER The certificate is issued to ..................... [o'~n'e),~k~j~f{J ..................... of the aforesaid building. Suffolk County Department of Health Approval ......................................... UNDERWRITERS CERTIFICATE NO ..................... ¢ / h Building Inspector Rev. 1/81 BUILDING DEp~RtJ~IENT TOWN HALI~ SOUTHO[D, N4 Y.~ ~HIS PE~IT MUST BE KEPT 0~ THE~P~E~IS~' UNTIL FULL C~PL~ION OF THE WORK AUiHORIZ~) N? 1228~ Z Permission is hereby granted to: /~ ~, r) . . ;.i~. ......... ...; ............. at premises JocQted at ..../.~.~..~,e .......... ~....~.~.,~.~ ........ .r '~--~-~=~ ....~ · ................ ~ ........ ,.~,.4..... ~.~ .:...,.., ~. ............ , ............................ County Tax ~op No ~000 Sect o, . ~.. ~ock :.. ~./....:...,ff Lot Uo.'....~.ZO ......... ; . . ' / , /./ , ,,, }i 19 ~nd a roved b the pursuant to apphcahon dated ... ~.. .................... ~ .....~., · PP Y Buil~dlng InSpector. Fee $.. ,Z,..~,, .............. ...... Building, nsl:mCto~ Rev~ 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y, 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions BLDG, DEPT. TOWN OF SOUTHOLD This application must be filled in typewriter OR ink, and submitted ~ ~1~ 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-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 instella- 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 appl~icable. 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 topograph ic 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 $15.00 3, Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 .~r~'~,~, Hou~ No, Ham/et Street ~ o, o,.ro. ty ...5 S. ............ CounW *ax Map No. 1000 Soction . .~. ...... Block . .~..1 ......... lot .... O. t.G ...... Subdivision ................................ .~ __ Filed Map No ........... LotN~o .............. Permit No. ).~. ,Q...~...7~. Date of Permit ¢/?...~/~.+..Applicant .... .~..', .d.°~. ,~.q.,.~F?', ....... ' ..... Health Dept. Approval .../~,~¢.~...d.'.%..~:..~..~,~..L .--~ .Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .... i .~.. .............. o% ..... Fee Submitted $ . o .~ ..... . . .~...t~. ..... Construction on above described building and permit meets all applicable codes and regulations. App,eant ..... .... ....................... Rev. 10-10-78 FIELD INSFEC'~ON COMMENTS .... .__~=~ FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ~,ODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 :,-u-,...........-....0~u~ldinglnspector) .... APPLICA~TION FOR BUILDING PERMIT 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 sc;de. Fee according to schedule. b. Plot plan showing location Of lot and of buildings on premises, relationship to a~ijoining 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 this 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, N6w York, and other applicable Laws, Ordinances or Resmlations, 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 in.~ ~ (Sl~14aturorof aplSlicant, 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 .... h//~...~...A{...~"...~..~.../~'./..~'./?...~?.....~.~..~. ~../.~-~ ....................... (as on ~he 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. "'" S~ Plumber'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 ..... (~lt~.~. ...... Block .... .O../ ........... Lot..~../'.~.. ........... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... .~.~9~..,~....~..~...c~. .............................................. b. Intended use and occupancy ,~'/,~2~ S/err~ ~ ~ Repair ............ Removal '. ............. Demolition .~...'"---~... ...... Other Work ............. 4, Estimated Cost ............... ,. ..................... Fee .-~.~ ................................. I (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars 6. if business, commercial or mixed occupancy, specify nature and extent of each t×pe, of use ..................... 7. Dimensions of existing structures, i~ any Front , ./~ Rear . ./g' . Deoth o~ ,4,/ Height .../.?./.~.~{ ..... Number,: of Stofies "' ?i' i iii ..... i.i.iiiii.iiii...~...iiiiiii'i'i .... Dimensions of same structure with alterations or additions' Front . ~2~.." Rear .~. ~. ' ' ' ' i ' ' . / / . Depth .... 2 ./. .............. Height ....... 3.. ~. ............ Number of Stones . / 8. Dimensions of entire new construction Front ....... .c~...t ..... Rear ...... ff./. ...... Depth ... ?. ~.. ...... Height . . .fl: ./. . /2inmber of Stories ...... /. ......................................... 9. Size of lot Front /~?(/,cv o i, Rear /?. ~.-?f . D~n~h' ' ' 10. Date of Purchase ( .f.?~. ...... Name of Former Owner . 11. Zone or use district in which premises are situated ..... .~.(".-~...~. ?~74¢f.( ..... iii, 12. Does proposed construction violat{ any zoning law, ordinance or regulation: ..... .f~.~. ................... 13. Will lot be regraded .... .... ~.t~.} ............ : ....Will exe.ess~fill be removed from pre~nises; L' Yes ~o 14. Name of O~,ner ofpremases ,d.,./~d..Z~,~Z~.~. ...... Address ./j.6./..~..~.~..,~./~.-.~ff.. Phone No..~. ~.~....3..o'~'~...~.~.. Name of Architect t/ Address ~ t , Phone No. Name cfC nt crc t~ Addre */ Phon No O ra r ........... ~ ............... SS ................... e ................ 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 acec~ng to deed, and show street names and indicate whether interior or corner lot. : COUNTY OF~ne;~~.. .. ~ ' .................................................. being guly (Name of individual si~ng contract) above named. sworn, deposes and says that he is the applicant He is the ...................... ! ................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworu to before me this . r~otary Publi¢.~,<'~'..~. ,z~... ~ ?. c-~, .~'~.~nty d -- ,, , Nota~ Publll, lt~t. of New yeti{ ~ ..... ./~77~. · ./ ...... /,1 ....... \ 7 .............. , . . ~/~ ~// ' (Signature of applicant) (~mmission Expires March ~0,.