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Home My WebLink About12588-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-15314 , Date Mardh 2, 1987 THIS CERTIFIES that the building ...A.d.d..i?.i.o.n...t.o...a .t.t.a.c..h ?.d..g..a.r.a.g.e. L ti ~" ~ 7130 Indian Neck Lane, Pec6nic, N Y oca on oi rroperW .................................................... '.. '.. House No. Street ' ' ~'r~/e~ County Tax Map No. 1000 Section .... .0 .8.6 ..... Block . .0.7. ........... Lot 008 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated August 24, 1983 . pursuant to which Building Permit No. 12588 z dated......September..................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 ......... Four foot Addition to an attached existing garage attached to one · ' · F'a'm tly' 'dwei'l'~n g'. .......................................................... The certificate is issued to .... NINA S. FISCHER ................. ?o¥&~,~~cx .................... of the aforesaid building. Suffolk County Department of Health Approval iq /A UNDERWRITERS CERTIFICATE NO. N /A N/A PLUMBERS CERTIFICATION DATED: Building Inspector Rev, 1/81 FO~ NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ~? 1~588 Z Permission is hereby granted to: ......~..~..~. ...... ~..~...~. ............... ...~~...~~.~ ......................... ...~.~.%...~...:~...: ................... .............. ........ .~.~..~....~ ................ ....~....~ ........... ¼. .......... ~.~., ....... ..~~...~ ......... · ! at'~...~.J' 0L.-,,",fJ '~c,~ ¢~;;....~.~..h...~,g.~......~.~| Vv ' ~' County Tax Mop No. 1000 Section ......-~....ff.,,w. ........ Block ........ ..I ........... Lot No......'~....=..~ ........ pursuant to application dated .~t/,,~...~..........~.~. ............... , 19-.~..~:~, and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD E, uilding Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY FEB 3 -198( Instructions 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 unumal natural or topographic features. 2. Final approval of Health Dept. of water supply and seweragedisposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences amd 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: I. Accurate s~rvey of pz:operty 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 ])welling,$25.00, Acces,~ory ,,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0 3. Copy of certiflcate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 ./ 7 .7 $ 50. O0 Date· .~'.~..'~..~.! ........... 5. uodated C.O. 6. Alteration $25.00 New C on s t r u c t, i on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .............. . ........... : · . legume No. Street Hamlet Owner or Owners of Property ... , .. ' ..... ' ............................ County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Health Dept. Approval ....................... Labor Dept. Approval ...................... Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submittad $ .~,~ ......................... Construction on above described building and permit meets all applicable codes and regulations. Applicant. ~/~.',~/¢'Z'.~· ............................. Rev. 10-10-78 £ FIELD INSFECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & FLUMBING INSULATION PER N. STATE ENERGY qODE Yo COMMENTS FINAL ADDITIONAL COMMENTs: TOWN OF SOUTIIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 This is to advine you that the jpb under building permit no. 12588Z issued to - Nina Fzscher on 9/t2/83 for Additio~ is completed and ( X ") been done. In order to complete this file. it is necessary that a Certificate of Occupancy be issued, please fill out the enclosed form. return same to the above office with a check for $25.00payable to tile Town of Southo[d. Please indicate to Whom the Certificate of Occupancy ia to be mailed, and arrange with this office for an inspection date Occupancy or use is unlawfu1 without a Certificate of Otc,panty. Please. help ns to clear up thin matter eo that legal action does not have to be taken. Thank you for yonr prompt attention. Very truly you~, Victor Leseard Executive Administrator VI,: ga r encl. 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 typewriter OR ink, and submitted ~m Immmmmm 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 featu res. 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p;O~perty showing all property lines, Streets, buildings and unusual natural or topographic featu res. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of bu ildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: l. Certificate of occupancy New Dwell±n§ $25.Q0, Accessory.,$10.00 Bus£ness $50.00 2. Certificate of-occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ................................................................... House No. Street Ham/et Owner or Owners of Property ........................................................... County Tax Map No. 1000 Section ............... Block ............... Lot ............... Subdivision ................................. Filed Map No ........... Lot No ............. Permit No JD,5~ ~ ~_2~-_ Date of Permit Applicant Health Dept. Approval ........................ Labor Dept. Approval ...................... . Underwriters Approval ........................ Planning Board Approval ..................... Request for Temporary Certificate ..................... Final Certificate ...................... Fee Submitted $ ............................. Construction on above described building I gul,~jons. Apphcant /,/i.,E~. (~/...~'~'~'%%... ~. ~ ............ Rev. 10-10-78 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ~IAL FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved .~.~... L.~., 19~. Permit No. !..~.~.~..1~.~ Disapproved a/c ..................................... Received .......... ,19... (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 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 6ther applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or ,dteratzons, :or ,,for removal or demohtion, as hereto described. The applicant agrees to comply with all applicable laws, ordinances, bdild~ng code,-nbusing code, and regulations, and to admit authorized inspectors on premises and in building for necessary insnections (Signature of applique, or name, ifa corporation) ............ (Mailing address of appli~fit) 5tare whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises.. ~%9 .'.. ~/..~..'(.~...~. · .~. ......................................... (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 ....... . .~'...~4 ..... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done....~.. ~.~.. ,~.6. &..~9.4~t4 ~--...d~.~07~.-<~ .7'r.. ~.~.o ...... ....................................................................... x... ...... tlouse Nmnber Street Hamlet County Tax Map No. 1000 Section .... .~...~. ....... Block ..... '~' 7' ....... Lot. ~.~.Z. .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy .~ .... ~..~ O..C~[ .c&~.~.~.%...~.C~.c~ .%.,.. Nature of work (check which applicable): New Building .......... Addition . .~.. ..... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... ~ (Description) 4. Estimated Cost .... .~..~e.~.~ ........................ Fee . .~..~.: .~.. ,.~'-.. ......................... : ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor~ ................ lfgarage, number of cars <9~.~ ............. ~;. ".. ..; . .~ ~, . . . 6. If bus,ness comme~'cial or mixed occupancy, specffy,n,a, ture,~.nd ,elttent of each ,type of use ... ~,....~ .... ~, .... 7. D~mens~or~,of existing structures, if any: Front ...... t..~'~.. ~ .~.:. Rear .J.'2..~;/.... r. : '~ Deptl{ .~qJ~..../~. .... Height ~../ Number of Stories../ Dlmensto~s~ of_.sa~e structure w~th alterations or additions Front/..2--. .......... Rear /~.. . Depth..~,-~ ~. ............ i'" Height .~../.. t. ,_~. ~. .......... Numbe, r of ~i;ri;s ./ ....... 8. Dimensions of entire new construction: Fro/nt/..~.' Hmg t ...... , .......... Number of Stone~ ...... ..,.. ~, .... 9. Size of lot: Front . j(.~.. ~, .~./.~. ........ Rear. ~./~.~.':/. Fr./. D, cpth . .t~. ~./../t~'. ....... 10. Date of Purchase .......... i ................... Name of Former Owner . .~./,/,~--~d.~.~. ............. 11. Zone or use district in which premises are situated ...... ~ ............................... ~ .............. 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will 10t be regraded ./~... ~.. ,~ ...... ,,.,,;.., ...... Will excess fill b,e removed from premises: Yes No 14. Name of Owner of premises ./.tiq. ~...Z~A,..a:,. [2~7'/,,~.e~.to~,. Address ~..C~t~.~. ..........Phone No.."f..4 ~.. fo.~.~7... Name of Architect ...,~ ..... i ................... Address .................. Phone No ................ Name~of Contractor ~.~.,/~a.~... '~... Address ~..~J~..~,~i~P.~.. 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 number or description according to deed, and show street names and indicate whether interior or corner lot. STATEOFNE~Y~RK! / ~_/ ,oo COUNTY OF.. ~.. i~'~ · ..v~ -,,~' · ~-.t'.~.*..~,,~-..-..~ .................... being duly sworn, deposes and says that he is the applicant ' (Name of//ndividual signing contract) above named. ~" He is ~he ......... . ................................................................... (Contractor, agent, corporate officer, etc.) of said owner or o~vners, and is du!y 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 therewi~th. Sworn to before me this ........... ~.c..~oC'/~ ..... dayo! .... ~. ~',~., ........ 19~.~,~ no~nv ~.~, ~t ~ tl~o~f ~ C/..f (Signature of applicant) ~, $2.8125850! Suffolk T~ I;~i~es March ~),