The URL can be used to link to this page

Home My WebLink About12601-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. ZI6305 Date Oct,ober 19, 1987 THIS CERTIFIES that the building A d d i t i o n Location of Property 425 Calves Neck Road Southold House No. Street Hamlet County Tax Map No. 1000 Section 063 . .Block 07 .Lot 29. 1 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... .A.u.g:. 3 1983 pursuant to which Building Permit No. 12601 z dated ..... $.e.p.t.....1.3. ~..I .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 ......... Construct addition to existing dwellling. (sun room) The certificate is issued to DR. MAX MILLER ..................... ...................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO .............. .~ 8 3 5 8 0 6 PLUMBERS CERTIFICATION DATED: N/A ........... Building Inspector Rev. 1/81 FOE~d[ NO. :B TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 12601 Z Permission is hereby granted to: ...... Z~..~.~.L4~.~:cZ ~.~. ............ ..... ~.~ ............... .~ ........... ~ ............... ~/1~ ~o .......... ~~ ~ .....~.~ ~.z~ ~ ~ ........ ,Z..~ ...... ..... ~ ................. ~,~......~.~....~,..~z~ ............................ ~ ........................... ~,~,,~,,,,~,,~ ~, ....... ~ ........ ~.~.~..~.....~.~....~.~-- ......................... ........................................................................................................... ~.~-/~..~ .~.~. County Tax Map No. 1000 Section ..~.1~..-,~... ........ Block ..~...~.. .......... Lot No...~.,~..~..:..../.... ~..4~,~ --' ~ 19~ approv~ the pu~uant to app[ic~ion dated .~ .............................., and by Building Inspector. Fee $ ...................... Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N,Y, 11971 765- 1802 I ] IL':.: \k'_~~ L~ ./_ L:-~II II I))~' ...................... ~llll B ]')G. DEPT. TOWN OF SOUZHOLD APPLICATION FOR G~RTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ml~=====~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 unumal natural or topographic features. 2, Final approval of Health Dapt. 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 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.O0, Accessory ,~10.00 Business $50.00 2, Certificate of occupancy on pre-existing dweINng $ 50, OO 3, Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 s0.0o O te .... 7 5. U~dated C..O. 6. ~%lteratmon $25.00 New Cons truct ion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ..~..~........~_~..4.,;,. ~..~.~.' .,, ~.~:~, .~.~ .................... , -.~,., .c:~?., .'~..<~.., ....... House No. Street Ham/et Owner or Owners of Property , ,~,*~- .... · ,~, · · ,~, .... ,~, ~,~ .......................... County Tax Map No, 1000 Section ...~..-~. ....... Block .... .7 ......... Lot.. 2, ff.. 1 ...... Subdivision ................................. Filed Map No ........... Lot No .............. Health Dept. Approval ........................ Labor Dept, Approval Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ....... .~, .~.~..~ f~:~ ......... Construction on above described building and de~s and regulations. pa, applica e co .': :'. F I~E L D '{NSFECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING COMMENTS INSULATION PER N. Y. STATE ENERGY ~ODE FINAL ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR ILO. BOX 728 TOWN HALL SOUTHOLD, N.Y. ! 1971 TEL. 765-1802 This is to advise you that the job under building permit no. 12601Z ia~ued to M Miller on _~1~/8~__~ for Addition ....... is completed and ~ final in~peetlo,, has ( ) has not ( ~")"been done. rn order to complete this file, it' is necessary thmt a C,~rtlficate of Occupaucy be issued. Please fill out the enclosed form, return same to the above office with a check for $25.00 parable to the Town of Southold. Please indicate [o Whom the Certlflente of Occupancy is to be mailed, and arrange with this office for an inspection date Occupancy or use ia unlawful without n Certificate of Occupancy. Please. help ,~ to clear up thi~ matter so that legal action does not have to be taken. 'thank you for your prompt attention. Very truly _y~, Victor Lessard l'Ixecut ire Admln{strn~or FL:gar encl. HE~ YORK STATE DEPART~iE~!T OF EF!VIRONr!E~!TAL CO~!SERVATIO~ Regulatory AffMrs Unit Building 40, SUNY Stony Brook, NY 11794 ~0 PERi, IT ,,~,ECESSARY - TIDAL ~ETLA~DS ACT Henry G. Uilltams Commissioner x rm 'll '' Re: Dear Location: mr, A review has been made of your proposal to: It has been determined that no permit is necessary under Article 25 (Tidal ~etlands). However, any additional work or modifications to the project may require a permit. It is you~ responsibility to notify this office in writing if such additional work or modifications are contemplated. Assuming you have obtained any other applicable permits, you may proceed with your project. Very truly yours, / Reginal Permit Administrator gJL:R~!T:ll TITLE MO. · 0/$ IZ7, t~ fl. '.3 ,';' o MAP OF PROPERTY AT (s'u££,/A' Po. ,/./. SURVEYED~ FOR O',~,/.C GL, ARANTEED TO ~,~v' "'~';, 7~.,/,~ ]..~.r u)...a~c(~ Ce. New York State Lcenied PROFESSIONAL LANO SURVEYOR 189 Seors Road, west lehp,L I,N Y 76S-1802 BUILDING DEPt. [ ] FOUNDATION xsT [ ] ROUGH PLBG- [ ] FRAMING REMARKS: THE NEW YORK BOARD OF FjR~ UNDERWRITERS BUREAU OE ELECTRI~IT~ 85 JOHN STREET NEW YORK, NEW yoRK 1003~ THIS CERTIFIES THAT ' in the followlng location; [] Basement ~ Ist FI. FIXTURE FIXTURES OUTLETS SWITCHES Lot DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEOERS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS OTHER APPARATUS: S E R ~ i · Goodale Electrical Cont. NO, OF HI-LEd A W'G, NO OF NEUTRAl A. W G, OF HI-LEG OF N~UTRAL not;be altered ~n an' BUILDING return to of credentials. ANY MANNER~ FORM NO. 1 TOWN OF SOUTHQLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 TEL.: 765-1802 .... 1 . .Pe mit Disapproved a/c ;-: ..............................~ ~.~.~.. k (Building Inspector) APPLICATION FOR BUILDING PERMIT Received.-~...,19... INSTRUCTIONS ' a. This 'application must be completely filled in by typewritir 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 adjoini~ig premises or public streets or areas, and giving a detailed description of layout of property must be d~awn on the diagram which is part of this appli- cation. c. The work covered by tlfis application may not be commenced be~'ore~issuance of Building Permit. d. Upon approval of this application, the Building Inspector~.q~i~sg'edla Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throu~e w0J~k. ~ e. No building shall be occupied or used in whole or sgi'i~;Srt ~or any p~rpose whafbver until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Bmldi:xi. ~ .,~rtrc, ent £~r ti~ye, issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Sn,~'* ~t~ County, N}w ~t ork, and other applicable Laws~ Ordinances or Regulations, for the construction of buildings, additions or altera .on , or,lo, removal or demolition, as herein described. The applicant agrees to comply with all applicable laws. ordinances, b~il,q~ngcode, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary ~spec~i~r~/ ' ,,, ~ ....... ... :.': .Z~..~.~..~.: ~...~.. ............ (Sig~'ai~e~ 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. ....... ~,~..~. ~..r~..~. .... .~. ~ .~..r?. ~ .~r.o..~. ....................... , .............................. Name of owner of premises .... y~../~.,..../~...~:~.......~ff.. (¢.~..d~..~.. ....................................... (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 ....................... Other Trade's License No ...................... t. Location ofland on which proposed work will be d ~ ~-~/~S ~fl/t~'~,/(' ~,~O ' one ............. : ..................................... 4Z6 . Itouse Number Street Hamlet : County Tax Map No. 1000 Section .... ~.~.~ , ........ Block .... ~ ....... ..... Lot.. ~.t . .~;.~, J... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occu0ancy of proposed construction: a. Existing use and occupancy ........ t...~.~.t/.q~qd. :~..¥. .... ~.9~..~(~C., t,~.G .............................. b. Intended use and occupancy ........................... ~..l'/'~i~Ixt] ...... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Rem'oval .............. Demolition .............. Other Work ............... (Oesc ption) 4. Estimated Cost t ~.~..<>~ Fee : (to be paid on filing this application) 5. If dwelling, number of dwellin~ units ............... Number of dwelling units on each floor ................ If garfige, number of cars .... i .................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ................... 7. Dimensions of existing structurbs, ifany: Front... ~..~ ....... Rear 2..~.. . . Depth...~.~.~.? ..... Height ............... Number of Stories ...... ~ ............................................... Dimensions of same stru~cture With alterations or additions: Front ... ~..."7 ...... Rear .~;~ Depth ~ ~., .~.[. i .Height ...................... Nu'n~ber of St;~i~s .... iii...!'iiiiiiiiii 8. Dimensions of entire new construction: Front .... t..7... ...... Rear ..... I..'~ ..... Depth ... ~ ... Height ............... Number of Stories ........................................................ 9. Size of lot: Front ..... ~o C). i ............ Rear ...................... Depth ...................... 10. Date of Purchase ............................. Name of Former Owner ............................. 11. Zone or use district in which p~emises are situated ..................................................... 12. Does proposed c0nstruction vidlate any zoning law, ordinance or regulation: ............................ 13. Will lot be regraded '. ....... i .................... Will excess fill be removed from premises: Yes ,QNo) 14. Name of Owner of premises .. i .................. Address ................... Phone No ................ ~ Name of Architect ......... .i .......~t~i~'~ ' ' Address ................... Phone No ................ ' .7.Z. .. Name of Contractor %.o.~.~ . ,. Address .B.q¥.9(~.(.. ~.~,~,t~Pc~Ffione No.. ~.~.~.o.7.~. PLOT DIAGRAM Locate clearly and distinctly ali 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. STATE OF NEW,'~RI(,,, t~,,~ S S COUNTY..-'n,O . ~fi~ X/ . , O~. C~a~iv~lghi~~i~be~ng~~. ~ -,-~ duly sworn, deposes and says that he is the applic~t above named. ofHe is the said ...... ~ '"~ :':' ' "::" .....~~~ ~~ent, c;rporate officer, etc.) .... o~ner or owners, ~d is du}y~r~~orm or have perfo~ed the said work and to m~e and file this application'; that all statements cont'aihed M t~is application are true to the best of his ~owledge and belief; ahd that the word w~l be perfomed in the m~ner set forth in the application filed therewith. Sworn to before me this ..... ~. .......... day of ......... '., 19~. Notary Public ........ ~...~.~County 6/ _~mN ~tt~ ...... ~ .................................... ~ ~,t, ~ ~ow V~re~. (Signature of applicant)