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Home My WebLink About12681-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. zi5379 Date March 18, 1987 THIS CERTIFIES that the building A d d i t i o n Location of Property 8200 Main Road East Marion ' County Tax Map No. 1000 Section . .3. ! ........ Block 7 ....... Lot 1 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · 0 c t. 12 ~ 1983 pursuant to which Building Permit No. 1268 1 Z dated Oct. 12, 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 addition to existin~ dwelling. The certificate i~ issued to JAMES & JOAN ROGERS ..................... ?o¥.'& 'l~'gT.t~7;t) ...................... of the aforesaid building. Suffolk County Department of Health Approval ...... N/A UNDERWRITERS CERTIFICATE NO .............. ~7,9 5 3~.2 ........................... PLUMBERS CERTIFICATION DATED: N/A ~Building Inspector Rev. 1/81 FOlt~ NO. ~ TOWN OF ~OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CTHIS PEWIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted ~o: ~ ..... ~.....:~.~;~.~ ...................... ..$ ........ ~......m...~......~.~...., ............................ ~o ...~.~......~.~, .~......~~....~..~~.~ ....... at premises located at ...~....~......?.. ....... ..~......~.....,. ......... ~.~'-'-~..~...-~.~ .................... County Tax Map No. 1000 Section ...... ..~..]. ........... Block ........ ~ ........... Lot No ......~ ............... p~rsuant to application dated ........................................................ , 19 ........ , ~nd approved by the Building Inspector. B'~ilding 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 OCCUPANCY instructions A. This application must be filled in Wpewriter OR ink, and submitted ~a~ 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 d{sposal-{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 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 New Dwelling,$25.00, Accessory ,~10.00 Business $50,00 2, Certificate of occupancy on pre-existing dwelling $ 5 0, aa 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Uodated C.O. $ 50.00 Date .......................... 6. Alteration $25.00 New C OhS tr'uc f, ion ..... ,~ Old or Pre-existing Building ............ Vacant Land ............. Location of Property ... ~ · · ~ · ~ ............ ~'.~'~" ............. House No. Street Ham/et Owner or Owners of Property...~'.'.~..~,~..~,~ · · Coun,yTaxMap,o.,00OSec,,on ......... 'et .... ¢. ...... i Subdivision Filed Map No Lot No .. Health Dept. Approval ........................ Labor Dept. Approval ....................... Underwriters Approval ........................ Planning Board Approval ..................... Request for Temporary Certificate Final Certificate . I:ee Submitted $ ............................. d p ppli ans. Construction on above described building an ermit meets all a cable codes and regulati Applicant ..... ,~ ~'~-.4 ./, .~.z ~ ~, ............... / ~ :[ooo?o~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY ~- 85 JOHN STREET, NEW YORK, NEW yORK 10038 aa~e At~l~It 1, 1984 ApplicatlonNo. onfile T..s CERT,.,EST.AT N 653892 only the electrical equipment as described below and introduced by the applicant narned on the above application number in tke preotises of gan~,~ Rog~rs, 7520 Main Rd., East Marion, in the following location; [] Basement [] 1st Fl. was exa,nlnedon J~y 19, FIXTURE FIXTURES OUTLETS SWITCHES 4 4 4 4 DRYERS FURNACE [] 2nd FI, ~:~0~'~ Section Block Lot and found to be in compliance with the requirements of this Board. RANGES OVENS EXHAUST FANS FUTURE APPLIANCE FEEDERS TIME CLOCKS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT OTHER APPARATUS: S E NO OFPERCC~COND. R V I C E A W G. NO. OF Hi-LEG ~ A.W. G NO OF NEUTRALS A. W G, OF CC, COND, OF HI-LEG OF NEUTRAL Sal Prato 1¥1ggim4 11044 LIc. 10~9 E This certificate must not be altered in any manner; return to the office of the Board if inco(rect Inspectors may be BUILDING DEF , THIS ~ I ANY MANNER, FIELD INSPECTION FOUNDATION (1st) FOUNDATION ( 2nd ) ROUGH FRAME PLUMBING INSULATION PER N. STATE ENERGY QODE FINAL ADDITIONAL COMMENTS: Examined .C~ .~..'~-.. Approved .~..I.~.. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 ., 19~..~. ., 192~. Permit No./..~..b.'~.l .:~-... Application No .................. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .... }.o. 1 .t..-~. ....... , 195.~. 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 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 code, and regu.lations, 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 .................... /. ........................................................ '/" (as on (t~e' ~a~' ;011 or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..... /7~..o..~ ............... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section ..... ~.../ .......... Block .... .~. ........... 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 ........ ~.fi..~..~...~....1~.. ~ ............................................ b. Intended use and occupancy .......... ./( / / 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Remgval .............. Demolition .............. Other Work ............... : ~ (Description) 4. Estimated Cost. flfl. f~.,.../.5~'64.<).,.q.0 .................. Fee (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 type of use 7. Dimensions of existing structurqs, if any Front ............... Rear .............. Depth ............... ~ Height Number of Stories Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ' Height Number of Stories 8. Dimensions of entire new construction: Front ..... /.~./, ..... Rear ...... /.~./ ..... Depth ../.7/ ......... ][{eight ~. ! Number of Stories 9. Size of lot: Front .......... I ........... Rear.... ................. . Depth ...................... 10 Date of Purchase Name of Former Owner 11. Zone or use district in which prgmises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ........ 4 ................... Will excess fill be removed from premises: Yes No 14 Name of Owner of premises Address Phone No Name of Architect ......... i ................. Address ................... Phone No ................ Name of Contractor ........ I ................. Address ................... Phone No ................ Locate ,clearly and distinctly al property lifted. Give street and blocl number or description according to deed, and sE interior or corner lot. ~~~~'-~ , PLOT DIAGRAM buildings, whether existing or proposed, and. indicate all set-back dimensions from ow street names and indicate whether / ./2/ STATE OF NE~f~RK, .~ !'~ S .....c..-- ,,,~-.~e o'f'i~liv}ci~2~2n~~ ......... being duly sworn, deposes and says that he is the applicant above named. He is the ............. ~ .......................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dully authorized to perform or have performed the said work and to make and file this application; that all statements conthined in this application are true to the best of his knowledge and belie~; anti that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ute of applicant) TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. ! 1971 TEL. 765-1802 This is to advise you that the job under building parfait no, 12681Z issued to James Rogers on ..~./1__%~._8~3.._ for Addition ia co~ple'~ed and a final {n~pectlon ha~* ( ) h~s not ( ~")' 'been done. Fn order Co complete this file, it is necessary that a Certlf{cate of Occupancy be ~8ued. Please fill out the enclosed form, return same to the above office wi~h a check for $2'5.00 payable to the Town of $outhold. Please indicate to Whom the Certificate of Occnpancy is to be mailed, and arrange with this office for an inspection date Occupancy or use is unlawful without a Certificate of Occupancy. Please. help us LO clear up this. matter so that legal action does not have to be taken. Thank you for your prompt attention. Victor Lessard Executive Administrator VL:gar encl . 0 o ~ FA~T MAF4 ~ Of'4