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Home My WebLink About12724-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. Certificate Of Occupancy No,. ,,Z,1,5.6.8..6 ........ Date April 24 , 1987 THIS CERTIFIES that the building ....A.d.d.i.t..ig.n.s' .................................. Location of Property 55405 County Rd. #48 (North Rd.) Greenport County Tax Map No. 1000 Section 044 . .Block 0 1 .Lot 0 1 l Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... 0. c. .t .. . . 2. 4. ,..1.283 pursuant to which Building Permit No...1.2.7..2.4.Z ............. dated ...N.o.y :..2. ,...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 ......... ..... .T.w.q..a.d.d.i.t..ip.n.s...tp..e.a..s .t..s.i..d.c..qr...d.w.e. 1..1 .i.n.~ ~..e.n.l.a..r g.e..r. 99.m' .&...a.d.d...e.l.o.s e t. The certificate is issued to HE-NRY PETERSON ..................... ?oYn'dr, i idr&k .................... of the aforesaid building. Suffolk County Department of Health Approval ....... ~ ./.A ................................ UNDERWRITERS CERTIFICATE NO. N 6 8 3 8 5 9 PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 FO~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 12724 Z Permission is hereby granted to: ............ ~..~.:.....~,.=,-,.~ ............... ........... ~~..~ .............. ............ &.~.,~.. ~.~..-.. ~,~ ...... . ,o ....... ~.~~......~.....~.~.~ ~z~.....~....~...~~ ~.....~~9.. :..~.~....~..~..~...~~ .............. ~,~,~,,,,~,~,, ...................... ~ .......... :.....~ ........ ~&...~~ ............ ~.~~ ~..... ~& ~ a~... ~., ~. ~.....d~:..~J. ..................................................................................................... ~~~..~... Co~,~ ;~x M~ No. ~000 S,¢,o, ...~.~.... S~a ..~./ ........... ko~ No....~Z/. .......... Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall $outhold, N.Y. 11971 765- 1802 Instructions A. This application must be filled in typewriter OR ink, and submitted m ~ 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 supp[v and sewerage dlsposal-(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 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 Dwelllng.$25.OO, 'Accessory ,.$10.00 ~usiueas $50.00 2. Certificate of ..occupancy on pre-existing dwelling $ $ o. 00 3. Copyofcertiflcateofoccupancy $ 5.'00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 $ 50 O0 Date..March 19, 19~7 5 .U~dated C,.O. 6. ~%lterat~on $25.00 New C on s t r u c t, fL on ...... Old or Pre-existing Building ...~...~ ....... Vacant Land ............. Location of Property ................................. - ............................. House No, Srreet Ham/er IIen rv Pea, er s o~ Owner or Owners of Property " P44 01 O] 1 County Tax Map No. 1000 Section ............... Block ............... Lot ............... Subdivision Filed Map No Lot No Permit No ........... Date of Permit, ........ ~.,. cant ............................... Health Dept. Approval .N'.o.~. To vir~], ...... LaborDept. Approval '~o~-~ re uire~. Underwriters Approval. ?;'~..~.: ,r.c?..~! :. :~'5, Planning Board Approval .~,e,~. re uired Request for Temporary Certificate ..................... Final Certificate ,,. ** ................ Fee Submktad $ 25. OO Construction on above described building and permit mea~ all applicable codes and regulations. 31?/? 1000121 BUREAU OF ~ ' ' ~ kl 85 JOHN 5TR~T, N~W YORK. N~W YORK 1OO~8 THIS OERTIPIES THAT only ~)le elect~ca[ equipment ~ described b~lo~ and introduced by the applicant ~d on the above appllea~ion ijumber i~ the premises of Henry Peterson, 68 North Road, Southold, N.Y. in thefollowin~locatlonl ~ B,svm,,nt ~ Is, FL ~ ~n~ FI. o6tside Section Block Lot was examined on March 18 t 19 8 5 and f hind to be in compllanc, with th~ requlremants of lites Board. KINO DECKS ,OTHER APPARATUS! i' Paul Burns Town Harbor Lane~ ': Sou~hold, N.Yi, 11971 , ' not be altered in any ma~{ner; return to the office of the Board f ncorrect, ,identd~ed ' I~y their credentials. 1 FIE~D INSPECTION FOUNDATION FOUNDATION 2. ROUGH FRAME & PLUMBING (1st) (2nd) INSULATION PER N. Y STATE ENERGY ?DE FINAL )ATE COMMENTS ) m ADDITIONAL COMMENTS: , ,.~ C. W. POWELL BUILDER & CONTRACTOR Robinson Road Greenport, N. Y. Phone 477.0995 C. W. POWELL BUILDEB & CONTBACTOR Robinson Road Gteenport, N. Y. Phone 477-0995 u.~_r~l-r" C/~A'A,,'L. J'P,~C~ 7"0 76S-1802 BUILDING DEPT. INSPECTION FOUNDATION FOUNDATION ROUGH! PLBG. 2ND [ ] INSULATION FRAMING FORM TOV~N OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ............ Approved ............. Disapproved a/c ................................... ..~T..~. .................................................. (Building Inspector) APPLICATION i:OP, BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter od in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of Jot and of buildings on premises, relationship to adjoining premises or public streets o, areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval bf this application, the Building Inspector will issue 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 ~he 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 buildings for necessary inspections. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~ilder ~{e~ry Nome of owner of premises ...... : ........ ~ .................................................................................................................................... applicant is a corporate, signature of duly authorized officer. (Name end title of corporate officer) Builder's License No ......... ~..8. ....................................... Plumber's License No...~.e.....b..~...:];...i..c:.9.~.~.9.~ ............. Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of land o~W,~.h proposed work will be done. Map No.: ........................................ Lot No ......................... Street and Numb~'~ ~8.~.~?..u..~..~y.~.~.~.e.~.~.~.8.~L~.e.~r..~b~B~`.~..~.~1~.~ 8.~.~,Ltf,.~.~.l.f].,...~., ~., .............................. ~ '-~- .~._~ ~-~q' Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ..... .R...e.~.i..~.l..~..e.~ ...................................................................................................... b. Intended use and occupancy ]Riesirlemee x¢-/~ ~ , .. 11. 14. Nature of work (check whichj applicable): New Building .................. Addition ......X.. .......... Alteration ................. Repair .................. Removalj Demolition .................... Other Work i ,~J ~ (Description) ooo... ! 5 Estimated Cost ...................................................... Fee .......................................................................................... (to be paid on filing this application) If dwelling, number of dwelli'ng units ...?.~.~ .................. Number of dwelling units on each floor ............................ If garage, number of cars ..... ; ........................................................................................................................................ If business, commercial or :mixed occupancy, specify nature and extent of each type of use ............................ Dimensions of existing structu'res, Jf any: Front 4~ ~ Rear ..~3. ......................... Depth ' Height !5 ~ NumBer of Stories Dimensions of same structur~ with alterations or additions: Front 4~ Rear Depth 40 t Height ....1..5..~. ................... Number of Stories Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Numberl of Stories ..................................................................................................................... ' 1~4~ Size q~ lot: Front §0t I Rear §0~ Depth Dat~ of Purchase ................. i ...................................... Name of Former Owner ........................................................ Zone or use district in which premises are situated ...~.e...s..:i:~..e..~...~../...a:.l: ........................................................................ Does proposed construction vi,o ate any zoning law, ordinance or regulation: ........................................................ Will lot be regraded' ~;e ' .............. ~ ............. Will excess fill be removed from premises: ( ) ,~Yes (X) No · ]leery ~'e~so~ .qo~±,ho].~]~ ~'"'~l~one No 765 5302' Name of Owner of premises ........... , ........................................ Address ....................................................... Name of Architect ..............., ............................................... Address ................................ Phone No ....................... C. ~i .~.~we].l , Greeu~)er~. N., __ 477 0995 Name of Contractor ........... ; .............................................. Address ................................ P~'6'n= No ....................... PLOT DIAGRAM Locate c property line~ whether interi early and distinctly alt buildings, whether existing or proposed and indicate all set-back dimensions from · Give street and block number or description according to deed, and show street names and ind cate >r or corner lot. :>. 'T'o 59uk heu E STATE OF NEW Y(;~RK// .~.,y ~ ~ ~ OF ,;i ....... :......~.~.Z..I.:.~ ................................... being (Name of individual sig~ing contract:) above named. : duly sworn, deposes and says that he is the applicam He is the ' j (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dul,'y authorized to perform or have performed the said work crud to m<~ke and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the wo'rk will be performed in the manner set forth in the application filed therewith. Sworn,,~ ~--/~t° b~for~ me this ........ ...... Notary Public~_s~.., :,~~-County ............. ~... ~....l_.Ov~ ............................. , ~' JUDITH T, TERRY ~ (Signature of applicant) Notary Public, State of New York No. 52-0344963 Suffolk Codnty,/f~ Commission Expires March