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Home My WebLink About12596-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.. Zqq 98.5. ........ Date .... Dctobe~-6 .................. 19 '83 THIS CERTIFIES that the building . gI)DXTZON ..................................... '( ' h/o~54 ' Location of Property ,4~e~ .5. P.:~she;mlazas..t3ea ct~_.l~zl.. ..... Cu/ae~_o~ue ............ · ,~'treet Hamlet County Tax Map No.'1000 Section ..... ?.!q...Block ....... .~ .......Lot .... 5.~ ....... :..: Subdivision..~.e.o..o.n.i?..~..a?..p..r.o~.. .......... Filed Map No..7.~.6. .... Lot No....!O. ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .8.ep.~..e.m?.e.z/..~ ..... 19.8.~. pursuant to which Building Permit No..~1.2..~9.G.g. ............. dated ...... gept ember..q~ ....... 19~33., 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 deck addition Go an existing one £amily dwelling The certificate is issued to RO53~[P GOELLER (owner, lessee or tenantJ of the aforesaid building. ~/x Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO. lXl/A Building Inspector Rev. 1/81 FOBlg[ NO. ~ TOWH OF SOUTHOLD BUILDING DEPARTMEHT TOWN HALL SOUTHOLD, bi. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 12596 Z Permission is hereby granted ~ , ~ County Tax Map No. lO00 Section ........ .~..~.~ ......... Block ......... ~ ........... Lot No....~,.-'~...~ ........... pursuant to application dated ....... ~ ......... ..., 19.~..~,, and approved by the Building Inspector. Fee $..~...~...: ....'~... ....... Building Inspector Rev. 6/30/80 FIELD INSPECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING COMMENTS INSULATION PER N. STATE ENERGY qOBE FINAL ADDITIONAL COMMENTS: FORM NO. 6 TOWN OF SOUTHOLD 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 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 instalta- tions, a certificate of Code compliance from the Architect o~ 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 peoperty showing all property lines, streets, buildings and unusua[ 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 qr land use $/5"/$5.00 3. Copy of certificate of occupancy $1.00 Date .~/~..X/~..'./ ./"~. ~,./~'..~...~.. New Building ............. Old or Prg-exic.~ng Buildin. g ............ V~dant Land ............. Location of Property . ,/.':/~..~.. c,~.4,/,~ .,<.,;,...~..~.? ................. ~'.~..~...~.~..,~...(-~/. ... .~.~. ~.'?..Y~ House No, Street Ham/et Owner or Owners of Property .............. , .......................................... County Tax Map No. 1000 Section ..... [ 1 / ....... B~ock ....... / ....... Lot... 3.. ....... Subdivision./.~4'¢.~,~ ~.'.~.../~./4.¢....~..~.¢..~.,....Filed Map NO...'7..~.~...Lot No, . ..Z/. ,O. ....... Permit No. ~. ~..~:~. ¢...~Date of Permit' ~¢~/~.~..~.Applicant, , .~ ,~z::2~/4f.4, .~i~ ............. Health Dept. Approval ........................ Labor Dept, Approval ........................ Underwriters Approval ........ ~ ....... Planning Board Approval ..... H.,~ ............. Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ .... . .'~. :..~. ~ ................ Construction on above described building and perrp~t meets a,[I applicable codes and regulations. Applicant...~.../~ .~'-'-'~4~.y~z-~. 4~'~.¢). ....... ~ Rev. 10-10-78 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION PERMIT NO, i0-83-ii06 PERMIT UNDER THE ENVIRONMENTAL CONSERVATION LAW [ ARTICLE 15, (Protection of Water) [] ARTICLE 25, (Tidal Wetlands) ARTICLE 24, (Freshwater Wetlands) [] ARTICLE 36, (Construction in Flood Hazard Areas) PERMIT ISSUED TO Robert Goeller ADDRESS OF PERMiTTEE Haywaters Road, Nassau Point, NY LOCATION OF PROJECT (Section of stream, tidal wetland, clam, build,rig)South ~-ide of Ha3rV~aters 585' west of Landing Road~ Cutchogue Harbor~ Nassau Point Road approximately DESCRIPTION OF PROJECT Constz~ct a i2'xlS' wood deck plus 2'x12' steps attached to existing dwelling an~ greater than 1CO' landward oI' mean high water. Ail activities as per suppl plan received August 30, 1983 COMMUNITY NAME (City, Town~ Village) COUNTY Suffolk 1. The permittee shall file in the office of the appropriate Regional promptly in writing of the completion of the work. 2. The permitted work shall be subject to inspection by an authorized order the work suspended if the public interest so requires. cepted expressly, by the execution of the application, the full legal respon- sibility for all damages, d~rect or indirect, of whatever nature, and by whom- 4. Any matertal dredged in the prosecution of the work herein permitted bed oi the waterway or flood plain or deep holes that may have a tendency to 5. Any material to be deposffed or dumped under this permit, rather in at the locality shown on the drawing hereto attached, and, if so prescribed thereon, w~lhin or behind a good and substantial bulkhead or bulkheads, such 6. There shall be no unreasonable mterference wdh navigation by the 7. That if future operations by the State of New York require an alteration in the position of the structure or work herein authorized, or if, in the opinion TOWN Southold IFIA COMMUNITY NO. ] .DAM NO. ~E~ ~oE: P I ;~1 ~0 N ~T~ ].j' GENERAL CONDITIONS 8. That the State of New York shah ~n no case be habie for any damage 9. That if the display of lights and signals on any work hereby authorized ~s not otherwis~ provided for by law, such lights and signals as may be pre- scribed by the United States Coast Guard shall be installed and maintamed by and at the expense of the owner, 10. All work carried out under this permit shall be performed m accor- 11. If granted under Articles 24 or 25, the Department reserves the right be just and equitable. If upon the expiration or revocation of this permit, the modification of the wetland hereby authorized has not been completed, the applicant shall, w~thout expense to the State, and to such extent and in such site to ~ts former condition. No claim shall be made against the State of New 12. Thi~ permit shall not be construed as conveymg to the applicant any r~ght to trespass upon the lands or interfere with the riparian rights of others to perform the permitted work or as authorizing the impairment of any rights, title or interest in real or personal property held or vested in a person not a party to the permit. 13. The permittee is responsible for obtaming any other permits, ap- provals, lands, easements and rights-of-way which may be required for this project. 14. if granted under Article 36, this permit is granted solely on the bas~s of the requirements of Article 36 of the Environmental Conservation Law and Part 500 of 6 NYCRR (Construction in Flood Plain Areas having Special Flood Hazards - Buffding Perrntts) and in no way signifies that the project will be free from floodipg. 15. By acceptance of this permit the permittee agrees that the permit 95-20-4 (9/75) SEE REVERSE SIDE) SPECIAL CONDITIONS See additional conditions A-J PERMIT ISSUe DATe IPERMIT ADJ~INISTRATOP~ . .~ ~- ..~ ~,/ Y'" ,~6DD~.eSS cc: USACE ~ Stony Brook FORM NO. 1 TOWN OF SOUTHOLD. BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL,: 765-1803 Examined... '~.~....[.d[.., 19 .~.~' Approved ...~ .~.. ~..~.., 19~.~.. Permit No.). .~. $~..C~ .~:.:/¢. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received .......... ,19... 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 ail applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspecj~r~s. ' C// ...... (Signature o'f ~pplicant, or na~ne', if a~6rporation) ... ? ...... (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 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....I-..'; ..... ~ ....... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be d~one.~ tTz--.~~'~//.-~ . .~.A~.~~ ...... .......... ................ ....... ................. llouse Number Street Hamlet County Tax Map No. 1000 Section .... ~ .... ;].).) ......Block .... ...... ~ ....... Lot ..... ~.~ .......... Subdivision .~0.,~¢../~.~.a~)~ ............. Filed Map No...t)~. ..... Lot .... /~ ....... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy.../.. ~4.~ Z~... :.~:~ ~: .................................. b. Intended use and occupancy .... ~. ~ ~/~ ~... ~ ~.. ~.~ ........................ 3. Natur? of work (check which a~plicable): New Building .......... Addition..~.~..~.. Alteration .......... Repair .............. Removal .............. Demolition Other Work ~ ,ff~O,5~ ~1/ ~.. ~'~ (Description) 4. Estimated Cost ....... ./. ............................. 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 stntctures, 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 consiruction: Front ......... ', ..... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. 'Size of lot: Front .......... i ............ Rear ...................... Depth ...................... I0. Date of Purchase .......... : ................... Name of Former Owner ............................. 1 1 Zone o di i t in whi h p~* mi it d ' . r use str c c e ses are 8 uate .................................... ..... ....... 12. Do'es proposed construction vi61ate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ..: .................. 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 {~l~ock number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NE~,~-'~K /~ IS S ' .... · {~-~/'..~'~-~..~/~,b~x~w-~-~.. being duly sworn, deposes and says that he is the applicant (Na~fl'e of individual signingXcontr~ct) ,~bove named, l ~ (~ (Contractor,)ge~ corporate off~cer, etc.) ~f s, aid~owner or ~wners, ~d is dul~ ~d t~or~or have perfo~ed the said work and to m~e and file this appdca~ion; that an statements contalne~this application are true [o the best of his ~nowledge and belief; and ~hat the work will be performed in the m~ne? set ~rt~e application filed therewith. Sworn to before me this N~m~blic ......... ~ .... &~~ County f ~~ ~~ .............. ~¢'~;~1~, ~eSg~ V,~ ' / / ff (Signature of applicant) NO. 52 8125850, SUffolk CON~ ~19n~qn e,,u~ ~) ~ . y~r~ Fxoir~s March 9~. 19~