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Home My WebLink About12567-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Zq59q8 Date October 40 .8.5 THIS CERTIFIES that the building garage addition. Location of Property 3520 North Sea Dr. Orient hi~ds'~ hio; ....................... 's't/e;i ....................... hi~iol County Tax Map No. 1000 Section ~ 5 ,Block ~q .Lot 2 Subdivision Green Acres ,Filed Map No. 35~0 .Lot No. ~ 8. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... .A.u.g.u.s..t..2.6. ..... , 198..3. pursuant to which Building Permit No. q 2567Z dated ..... S..e?.~.e.m..b.e.r..~. .......... 19~.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 ......... The certificate is issued to D. LORE ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval ....... N/A UNDERWRITERS CERTIFICATE NO ................................................. . Building Inspector Rev. 1/81 PO~.~ NO. 2 TOWN OF $OUTHOLD BUILDING D~PARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 12567 Z Permission is hereby granted o: ~ , /~.~ .... ~:...~. ........................................................ ,o ....t.~:~~.....~....~..~.~,.....~.~.~...~.......~ .... at premises located at ...~;;~.~....~....~...~..~...c.~....~..~/~.L.;~..)......~~.. ............. County Tax Map No. 1000 Sectijp~-.....~.../...-~~. ...... Block ........ .J ............. Lot No....~ ............... pursuant ,o application dated ..~.q..~..~.........~.~....~q ......... ..., 19'~...~., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southo;d, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 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 req0irements where applicable· B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survev of p["operty showing all property lines, streets, buildings and unusuat natural or topographic 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 $15.00 4.Vacant Land C.O. $5.00 I ) Date ..... .~..I..(~....~..~.. ..... New Building . . . Old or Pre-existing Building ............ Vacant Land ............. Location of Property .~).{~:'~'. ~..~.~ ~.....~..~. tq~ ..... O..e~'.o. ~. ..... ~...~.~.~..~. b?..~· ... House No. Street Ham/et Owner or Owners of Property ~) ~.,..L..~). ~-,.~ County Tax Map No. 1000 Section ~) Block Lot ~ Subd,v,s,on .~../~.~.~.73.. ~L~.I~. ~.. ,9...eJ.E../J.l. Filed Map No..~..'~...Lot No. ~J.~.. '" ' '~'c~ · . ......... ateo Pe ........ ,,..~ ..~ ..nt ....; ...... f ........... Health Dept. Approval ........................ Labor Dept. Approval ...................... .. UnderWriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............ ,:..y. ,.,.. ........ Construction on above described building and per'ts al~piicable codes a~d regulations. pp .... ........... Rev. 10.10.70 ECTION IDATE tl COMMENTS ~ (2nd) mt LUMBING t mi PER N. Y. ~ { ENERGY E ,,-mC FIELD INSPEC 1. FOUNDATION FOUNDATION 2. ROUGH FRAME 3. INSULATION STATE C,ODE 4. FINAL ADDITIONAL COMMENTS: I:~14 YORK STATE DEPAP. T,MENT OF E~VIP~t~.~NTAL CONSEIt. VATION Regulatory Affairs Unit ..~ Bldg. 40, SUgY--Room Stony ..,..--t516) 751-7900 A review has been made of your proposal tot New York State Department of Environmental Conservation has found the ~ parcel ~/ project to be: .,, Greater titan 300' from inventoried tidal wetlands. .. Landward of a substantial man-made structure greater than 100' in length constructed prior'"'to"September 20, 19~7. ... Landward of 10~ contour elevation above mean sea level on a gradual, nat- ural slope. .. Landward of topo~raphical crest of bluff, cliff or dune in ex.ss of I0 feet in elevation above mean sea level. ,. Therefore, no permit under Article 25 (Tidal Wetlandsof the Environmental Conservation Law) is required at this time since the ~urrent proposal is beyond State mandated J'~rlsdiction pursuant to this act. Ho~ever, any additional work or modifications ~o the project may require a per, tit. It is your responsibility to notify this office, in writing, if such additional work of modifications are contemplated. Very truly yours, ~ Daniel J. Lark~n Regional SuperVisor of Regulatory Affairs DJL:RNT:cz OCCU?ANCY OR USF. IS U~,~LAWFUL ~'~ii;~,~'i CERTIFICATE OF OCCU~CY AP?RO¥'~D AS NOTED 'NOTIFY BUILDING DEPARTMENT AT 765-t802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNdATiON - ~0 ~EQUIRED FO~ P~URED CONCRETE 2. ROUG'~ - FRAMING ~ PLU,~BING 3 ~NcU 4. F~'~ CQ~STRU~iON ~{UST ~: ~ ~t~n~E FOR C O ALL C?'~-~''CT~ON SHALL ~EET THE RF~':~ENTS OF T~ N.Y. STATE CONSTRUCTION I ENERGY CO~S. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 19~.~.. No.~.' .~..~..~.. ~.~. Approved ......~ .... , Permit Disapproved a/c ..................................... Application No... ]..~:. · .~.. ·. ~ .... (Building Inspector) APPLICATION 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 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 what. ever 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, buil~jing code, housing co, lc, and regulations, and to admit authorized inspectors on premises and in building for necessary insp/(~.tj,~s. . ,,~ ~ ,,, ' - ..... .... /(~n'ature of applicant, o[~/d~e~, ifa o porat' ) .. (Mailing address of apl~,tcant) State whether applicant is owner, lessee,~, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..... .--.~. ,~....~. ?...~.'..~.~. ................................................... (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 ......................... Electrician's License No.. z~JtT.__________________~ .~.. ........ Other Trade's License No ....... ~ ............. 1. Location of land on which proposed work will be d ~'...~..~=~9. .. ?.~.~ .... .o.~../e.~. ~./. :.~T... .... c¢~.~.~. ~./ .... ../~..~.~..,.~:.. ................ ~..~.,//~.~' .z::.7 ..................... House Number Street Hamlet County Tax Map No. 1000 Section ..... .t~../'.-5.~-. ....... Block ....... /. .......... Lot Subdivision , ~ .(~..~,./..~-~./~....7~.. Filed Map No,¢~-. . '.~..~.~...O ..... Lot.. [~ .-<. ........ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed constr~tction: a. Existing use and occupancy ........ ~.G~6 ......................................................... ...... .'_ __ .......... b. Intended use and occupancy 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ....... ..~. Repair .............. RemOval .............. Demolition .............. Other Work..~,r~..~.~..~... i ~. ~..~...~;~¢ ' (Description) 4. Estimated Cost ............ ~f...w O ~ Fee ;~"j ......... (to be paid on filing this application) 5 If dwelling ' ' ' ~-- Number of dwelling units on each floor ..~.. · , number of dwelhngiumts ............... . ........... If garage, number of cars ... ~ .... ' ............................................................. 6. If business, commercial or mixed occupancy, specify n.a~ture and extent of each t2/pe of use ....~-rr; ............... 7. Dimensions of existing structures, if any Front 4. ~ Rear d' ~ r~,,,h 3 -~ Height .... 7.~. ......... Num. ber of Stories .... ./.7..-~. ............................................... Dimensions of same structure with alterations or additions: Front .. f. 7. ........... Rear ....~.~. ............ Depth ...................... .Height .... '~.o. ......... Numbez of Stories //×,~ 8. Dimensions of entire new construction: Front .... /.q .-- ..... '.. /~ Rear ............... Depth ............ Height .... ./.~. ........ Number of Stories ..... / .................................................. 9. Sizeoflot: Front ... ,If?.... i ........... Rear ...... /../· .~. ............ Depth . .?.q..o. ............... 10. Date of Purchase .......... ~ .................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated.../~.~'~., c ............................................ 12. Doesproposedconstructionvio!ate?~lyzoninglaw, ordinance or regulation: ..gJ..~ .......................... 13. Will lot be regraded ........ ~../.~. O .............. Will excess fill be removed from premises: Yes ~_?~.'~ 14. Name of Owner of premises . ~>,. 4-P..~.~ ......... Address Phone No. Name of Architect ......... ~ ................. Address ................... Phone No ................ Name of Contractor ........ ~ ................. Address ................... Phone No ................ 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 inumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK,. ............ ~.~...".~. '. ')J..~.~.~ ~ T~..~. ~..r~...~... being duly'sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. ~/ i (Contracto ,~gent,~p rate fficer, e . of said own'er or owners, and is duly authorized to perfo~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 ofliis 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 NOTARY pUBLI¢, State of N~w Yot~ · : qualified i'n Suffolk County L~ .......... ~ ' Commission Eipiros Maroft ,~11~ lS;)i./ cant) -- - SUFFOLK CO. HEALTH DEPT APPROVAL 'BI P%'FRHEAD, ~ Y L-~ ~'~ C ~,S K,:-.P ~FO~ ~ ~LTB D~T~T disposal and r~te: ru~pl~ for this location ]ave Chief of Ocneral F_u$imeertm$ Se~vioos ~RODER[CK VAN T~,P.C~ ~ - LICENSED LAND SURVEYORS GREEN~RT NEW YORK STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEFT, OF HEALTH SERVICES. (S) APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY DATE: , : ' ..... H. S. REF. NO.: ~'~ ~O--~O APPROVED-.' SUFFOLK CO. TAX MAP DESIGNA7 ION: DIST. SECT. BLOCK PCL. OWNERS ADDRESS: LO~E OAtc~2'AL.E, hi.h: It~ DEED: L. TEST H~E ~AMP SEAL