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Home My WebLink About12364-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N,Y, Certificate Of Occupancy No. Z12071 Date November 15 .8.3 THIS CERTIFIES that the building-.-.n.e.,w. .d.w.e..1.1.i.n..g ................................ Location of Property 1710 Tucker Lane Southold House Ale, Street Hamlet County Tax Map No. 1000 Section 059 .Block 04 .... Lot 005.1. ..... ;..; S ..... Greenfields at Southold .... 6313 1 Uoulvlslon ............................... l~uea Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·..M.a.y..1.1. ............ 19..8.3pursuant to which Building Permit No. 12364 Z dated ...... .J.u.n.e...~ ............... 19.8..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 ......... a private one-family dwelling. The certificate is issued to JUNE C. KIFFER ..................... ...................... of the aforesaid building. Suffolk County Department of Health Approval 13-S0-66, 10/4/83, Robt. A. Villa, UNDERWRITERS CERTIFICATE NO. N 612535 1P.E. Rev. 1/81 FOF~ NO. ~ TOWN OF cOUTHOLD BUILDING DEPARTMENT TO~'N HALl. SOUTHOLD, N. Y. BUILDING PERJv~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 12364 Z Permission is hereby granted to: ~ ~,. ~ ........... ~,~..z,,..,~,:....~i~, ......... ...... ~.~......~.~..~......./....,z.~.-. .................. et premises Iocoted et ....L..Z.dO. ......... ~.~&./~.~.....Z'~q.,~/~.~..... ~.~4z~.~. .... County Tax Map No. 1000 Section ....~..~ ....... Block ...~....~-. ......... Lot No. (~...~..~:~. ./. .... pursuant to application dated ...... ~...~..~..~....,.~. ........................ , 19..,~..~y, and approved by the Building Inspector· Fee $...,,J.../. .............. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD 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. 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 $5.00 / 2. Certificate of occupancy on pre-existing dwelling/ land use 3. Copy of certificate of occupancy $1.00 --Pre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 Date .......................... New Building ............. Old or Pre-existing Building .~. ......... Vacan~Land ............. Location CT rroperty ................................ House No. /]. , , ~ ~/ Street: / Hamlet: Owner or Owners of Prope// ~.....~'.~./:', ................................... County Tax Ma~.i~o. 1000 S~c~c~tion ./..~.(?.~.. ........ Block ...?. ::. ....... Lot...~.~. 'P..'/.. ..... Subdivision .~//./.~-.~?~..~.'.~.~.~:;~.~/.2. ........... Filed Map ~ ...... ' ....~Lot ~,,. >...C ........ Permit No. './[~...~.. ~.~.//... Date of Permit ~ .~'.~.~.. .... Applicant~._g,~.~.~..~..~:~..~.~>~'~.~/.q ~ .......... Health Dept. Approval ...: ..... ; .....'; ........ Labor Dept. Approval .... ~.'. ................. ' -- Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building ~Lp¢,~ meets all applicable 0odes and regulations. FIELD ~NSPECTION COMMENTS FOUNDATION FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ?DE FINAL ADDIT b COMMENTS:__ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~l{>~:~t; ~ ~Lg~ 85 JOHN STREET, NEW YORK, NEW ~ORK 10038 ~7~/83 wasexamitwdon fi,~ ~ ~ andfoundtobeincompliancewiththerequirementsofthisBoard. FIXTURE FIXTURES RANGES COOKING DECKS OVENS OUTLETS ~ECEPTACLES SWITCHES SYSTEMS NO. OF FRET EXHAUST FANS OTHER AP RATUS:, E R 'V I C NO. OF CC, COND 1 A.W.G NO OF HI-LEG OF CC COND AW.G OF HI-LEG NO OF NEUTRALS OF NEUTRAL 4 This certificate must eot be altered in any manner return to the off ce of the Board if inc~rr~r* - · P~,r--.. ~:~,. -- ~JZ',,,e COPY FOR aU LDIN~ n=~ ............. ¢ ~ .......... : ~e~e~*~~e~.~a',?~ ----,~ ,~,~,% ..... ..... ~n"v'c'~" 'nl~ ~ur; ur UEH I IHCATE MUST~O~ BE ALTER~D~ NA NY ........... MANNFR '~l= 7G5.'~802 BUILDING DEPT. INSPECTIONr ~'~FOUNDATION 1ST [ ] ROUGH *PLBG, FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL DATE INSpEcTO~ ~ INSPECTIO ~-~[] FOUNDATION ~.ST [~] .OUGH i~LB¢;i. ~ 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 Application No. /~d~Tg INSTRUCTIONS a. Tkis 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 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, 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 co,lc, and regulations, and to admit authorized inspectors on premises and in building for necessar~in~pections. , ///~- ~ / ,~/ ~ ///(Signature of applicant, o~ flame, if a corporation) (Mailing address of applicant) State whether applicant is o ncr, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder· /,.->-~,,.~,:~ c-- .~!~:)./:',.~:',A. .................................................................. Nan, e of owner of premises./.(~ .~ ..~..~'.5 ~...~:..?':>:"~(i; ............................................. (as on the tax roll or latest deed) If applicant is a cor. p, oration, signature of duty authoriz~d?fficer. ..................."7~-' ; ' ~' " ;/ .......K}':: ............ (Na?'/e'and title of corporate o'fficer) Builder's License No .... ..q':?. ................. /2. Plumber' 's L~cense No .... .~.. L{ .~.. ~.'.. Electrician's License No ..... .~..... ~ ~ Other Trade's License No ...................... 1. Locatlonotlanaonwmcnproposedworkwillbedone~?~c:~,~/-~-~-~' ~- ~'a-~.,V ,~.::~ ~/ , ~/._/ ~, House Number Street Hhmlet County Tax M o. 1000 Section .{ 2- : .................. ................... (ok:: ,.~: / ' Sub&ws]on..;...:. ........ · :'. .................. 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 ~'~ '<: ~'' "~' b. Intended use and occupancy .... y ........ : ..................................................... 3. Nature of work (check which applicable): New Building t/ Addition Alteration Repair .............. Removal .............. Demolition ........ Other Work. 4. Est~ated Cost (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 ~d extent of each type of use . ."~ ................. 7 Dimensions of existing structures, if any: Front ~ Rear Depth Height ............... Number of Stories ........................................................ Dimensions ofs~e stmct~e w~ ~terafions or additions: Front ................. Rear .................. Depth HeiSt ...................... Number 0f Sto~es ...................... 8. Dimensions of entire new construction: Front . .~. HeiSt /z"wr N ~b fSt ie / 9. Size of lot: Front . .,~ar x,, , . ~ep[~5~,._5;~. '. ................ 10. Date of Purchase .............................. ~ame of Fo~er Owner .,F.,. Z '~5qq%+5 ................ 11. Zone or use district in which pr~mises are situated ..................................................... 12. Does proposed construction viohte any zoning law, ordinance or re~lation: ~4'2 ............................ 13. Will lot be regraded ~. '.. ~ ~ .:~ ...... ,.. .......... Will e~qes~fill be re~gv~from premises: . Yes N~' Name of Architect ............................. Address :~)~5 Phone No. ¥~ ¢}4~... ..................... r' ............................ Phone No. "- PLOT DIAGRAM Locate clearly and distinctly all~ buildings, whether existing or proposed, and, indicate ail set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether STATE OF NE~(~-'~RK; , /,~ S S cou ¥oF ,' .. ;~.1.¼,~-: ~. ~. ~..--~. ,:.: .--'. :fy-: ](:. ~: .............. being duly sworn, deposes and says tha'ffne~ is the applicant (Name of individual signing contract) / above named. is the ~ ?evl4 i i (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 ~-knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. ~ Sworn to before me this ........... of..... .. N~~ totk C ou,0~y/ k ',.._.z \ ~, ~, x r ", <"t ~'z ,'..5 U I7.',¥ E".¢' E .~ · c. .... - - nu~: z~,~98s'"rowk~ OF - '? .... ',,, DO'F,IANU E ,r.~fSg I0 E. ZTO. COO X. 4o, 499 5.~. J'!,.]h,!E C. /t'-cc~ > ~0oo.5,)-~_5 ~//' \?~0/x~'2 ~' SUFFOLK CO. HEALTHH S. NoDEPT' APPROVAL ~-~'~ kiAP OF' pr'~o~--~T , ~ '2' ~,' SUI~VEY'ED FOIZ -' ¢~ ~'~ ........ THE WATER SUPPLY AND SEWAGE DIS~SAL *~ ~ ~ SYSTEMS FOR THIS RESIDENCE WILL k~~ /- ........ (S) APPLICANT , . ~L¢~ ~ SERVICES -- FOR APPROVAL OF ¢ MAOSAPE~A PA~, ~-- _ . .-. ~ ~.~ ~ ~ / ~,- -. - - '- , .~Z:x.AL E 50, ./ ! i LQTNOo.[LEFk*~iil)"IdAPOFSOU'FtI,DLD~,~+X,~cE,,FI~E~N [ d:. RO R ...... ..~.~ W, Zc?~,Z~kq i:'A Lr.. OM ~EAN L:~& LEVEL. glCENS~DLANDSUR~Y~RS HOUSING AND OOi';;~/[UNTY RENEWAL S~AM,P OF ~PPROVAL ' ® I 11 *4 A :® NEW YORK STATE DIVISION OF HOUSING AND COMMUNITy RENEWAL N¥0052 :,, / / '/ 2 t'r N8 YORK STATE DIVISION OF HOUSff,IG )~ND COMMUNITY RENEWAL STA~,'~P, OF APPROVAL ~ ODEL OR CO~,~'PONENT : NEW YORK STATE DIVISION OF HOUSING AND COMMUNITY RENEWAL SIAI",u OF APPROVAL FO A f ODEL OR CO:'POI~IENT NYUO52 COMM[SSION'ER / LF¢ ~o o~ SHIEET L I/ This ]s a reproducton of the N.Y.S. s~[mp o ~pprova or Model ............. A c~,mplete set of ?=p ore [ [prints ere on file a[ Contempri Homes $ with N.Y.' Dlvlsioro of HoudnE, iI · ...I,,,,, OF APF O6"",L FC ,' OuEL OR CO, I ur,,_ ,~ '~ u u q 9 ........ J ........................... le~¥ ............. ?~' A~P~ ,J X= U APPXOVAL ELFCy~ I~k ~L~U o ~ This ~s e reproduction of the N.Y.S. stamp of approval /or NEW YORK STATE DIViSiON OF HOUSIHG AND COMMUNITY RENEWAL A o IA,. l-- OF APPROVAL ~....,f FO; ,~ r ODEL OR CO;'PONE' T ~~ Dlvsl ' Pi . App,oval NO. , H,~,u c.. II~ copper fublng is used for water distributing system; p~iping shall be of types K or L only