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HomeMy WebLinkAbout12612-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...Z-15248 Date ....F.e.b.r.u..a.r.y..4.2. 1987 THIS CERTIFIES that the building ADDITION TO ACCESSORY BUILDING 600 King Street Orient, New York Location of Property ........................................... House NO. Street ............... County Tax Map No. 1000 Section 026 .Block 02 ..... Lot 036 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ....................... pursuant to which Building Permit No. 126 ! 2 z September 8, 1983 ...................... dated.......................September 16, 1983 ...... , wasissued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ADDITION TO ACCESSORY BUILDING MICHAEL & CATHERINE BOGDEN The certificate is issued to .......................... ................................. (owner,/~.mYeJt li,~l{~ X X X of the aforesaid building. Suffolk County Department of Health Approval N /A UNDERWRITERS CERTIFICATE NO. N / A N/A PLUMBERS CERTIFICATION DATED: Rev. 1/81 ~OElt~ NO. ~ '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) 12612 Z Permission is hereby granted to: ..... ........... ................. ,o...~.~ .... ~ ~.~ ~ ~ .......~ ...... ~ at premises located at ..... (~..~-)~ .......... .~.~.~....~ ......... ~~.: ...... County Tax Map No, 1000 Section .,,...(~.,.~....~, ....... Block ..... .,~..~ ..... Lot No.....,(~.....~.....~. ...... pursuant ,o application dated ..... .~~~....~. ....... , 19..~3.., and approved by the Building Inspector. Fee $..J.....;. .............. Btlllcling Inspector Rev. 6/30/80 The New York Board of Fire underwriters is in the process of issuing a certificate o~ compliance for the etectrical inst¢~at~on as covered in an apptication noted below. rtificate will providCdCail of the and certilied to be in comp National Electrical Code as o! that date, (Application Number) (Inspector) /~.~(Rev. 01/96) ~ FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall $outhold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY FEB 3 - 1981 Instructions A. This application must be filled in typewriter OR ink, and submitted ... ~ to the Building Inspec- tar with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unu~al 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 Residelnces and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer respon.s!ble for the building. 5. Submit Planning Board approval of completed site plan requirements where apphcable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate ~urve¥ of p~operty 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 New Dwelllng,$25,00. Acee.~.sory ,,$10.00 BusJ. ne,~s $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00. over 5 >,ears /~10.00 4.Vacant Land C.O, $ 20.00 c.g. , o.oo ate ...... · ~lteration $25.00 NewCons truction Old or Pre-existing Building Vacant Land Location of Property ....... ~.... ~'-~'.... ........ ~. ' /louse No. Street O.nerorO.nerso, P,operty .... County Tax Map No. 1000 Section .... ~ ........ Block ............... Lot ..... ~-,~.. ...... Subdivision ................................. Filed Map No ........... Lot No ............. Permit No. . Date of Permit Applicant ..... Health Dept. Approval ........................ Labor Dept. Approval ....................... Underwriters Approval Planning Board Approval .......... Request for Temporary Certificate ..................... Final Certificate ...................... Fee Submitted $...,,/.d~. ~,, ................. Construction on above described building and permit meets all apPlicable codes and regulations. n~v. 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN }/ALL SOUTHOLD, N.Y, ! 1971 TEL. 765-1802 'l'hJs is to advise you that the job under building parfait no. ~126~2~ issued to Michael Boqden on --3./1~/_8~____ for _~3~c_~essory is completed and a fi. hal ~n.,pection has '~----~'has not ( X ) been done. rD 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 w~th a cheek for $1D.O0 payable to tile Town of $outhqld. Please indicate to Whom tile Certificate of. Occupancy__La_ to be mailed, and arrange wlth t ~l~s office for an inspee~on date Occupancy or use in unlawful without a Certificate of Occupancy. Plnase. help u~ to clear up thls~ matter so that legal action does not have to be taken. Thank ye, for your prompt attention. Victor Lessard Executive t~dm[uistrator VL:gar enc]. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O, BOX 728 TOWN IIALL SOUTHOLD, N,¥. ! 1971 TEL. 765-180~ 'rhJs is co advise you that. the Job under bu[ldlng permit no, ~ issued to Michael BocTden on .9/1~_83___ for _~.sory is completed a final ~nspectiOn ha~, ( ) has not ( X ') been done. and in order to complete this file, it' is necessary that a (;ertJficatc of Occupancy be issued. Please fill out the enclosed form~ return same to the above office w~th a check for $10.00 payable to the Town of Southold. Please indicate to Whom the Certificate of Occupancy ia to be mai[ed, and arrange with this office for an inspection (late Occupancy or rise is unlaw£ul without a Certificate of Occ,pnncy. Please. help ,, ~o clear up ~hia; matter ac ths~ Je~nl action does not bays to be taken. Thank you far year prompt attention. Very truly _y~, Victor Lessard Executive Adm[nistrator VL:gar encl . FIELD INSPECTION FOUNDATION (1st) COMMENTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY QODE FINAL ADDITIONAL COMMENTs: [ ] FOUNDATION 1ST'"[ ~] ROUGH *PI~BG. [ ] FOUNDATION 2ND [ ] INsULATi [ ] FI~.MING ' [ ~ FINAL REMARKS: DATE ~"')l ' ') '~ L~ INspECTOR ,\~ FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined...5.&~...'~..h..., 19~.~ Approved.....~.. ~. ,~- .~,., 19~, ,~, Permit No..1.' .~.(~ .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 other applicable Laws, Ordinances or Re ulations 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 building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of 9pplicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................... ............................... Name of owner o f premises . .'~...~.-..~.~..... ~.'/.F~/~/.~. ~ / .... .~ ~...,~ .................... (as on the tax roll or latest creed) 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 ...................... 1. Location of land on which proposed work will be done .................................................. ' ~'~' '~' ............. "' '~'/' ~e'e '~'~°~' ' ' ' ' ' ' '~' '/Z'/' '~' '~/' '~' ..................... t~ouse Number i .... Hamlet " County Tax Map No. 1000 Section ..... (,~. o~.~. ..... Block .... ..~. ~ ....... Lot....(,~ ~...~. ........ Subdivision ..................................... Filed Map N~> ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ... ~.~1 ........................................................... ................................... b. Intended use and occupancy 3. Nature of work (check which a plicable): New Building .......... Addition... · .¢~.... · Alteration .......... Repair .............. Rem. >val .............. Demolition .............. Other Work ............... , (Description) 4. Estimated Cost ¢/r~lc^o.c~.~'I ......................... Fee ...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling iunits ..... I ......... Number of dwelling units on each floor....--7 ........... If garage, number of cars . . .-rrx.. . ................................................................. . . 6. If business, commercial or mixed occupancy, specify nature and extent of each ty~pe ~f use .~.._....~. 7. Dimensions of existing structurgs,, if any: Front. ,/0. t. (~.? ..... Rear . . ./. ~...6..~ .... l~epm . ii ~ id'. .-~......[ ~/~ ..... Height . 7. ............ Number of Stones .... ./ ................. ,} .................. ;.._. ............ Dimensions of same structure with alterations o~additions' Front ~. ........... Rear ... '.~.~..t.. / ! , . .-t-- ..... Depth ...6~. ............. ;.. Height . ~...~,- .............. Number of Stories .... [ ............... 8. Dimensions of entire new construction: Front .... : .... , ..... Rear ..... : ......... Depth . ~ ........ Height ~ Number of Stories 9. Size of lot: Front .......... i ........... Rear ...................... Depth ...................... 10. Date of Purchase .... ].q~..~. .................. Name of Former Owner ~.~.¢,~'...~. [O-~ .......... 11. gone 6r use district in which pr~mises are situated...C~ ~ d ~b:,.~o~- ..................................... 12. Do~s proposed construction violate any zoning law, ordinance or regulation: ~ ........... ~ ............ 13. Will lot be regraded ....~. i ........ aWill, excess fill be removed from premises. Yes 14. Name of O~vner of premises ~ ! .~r~..~..~'. ?..~..~..r!~.~.~dPd~ess ... 6~.o0...~.'~.5..P..... Phone No..~3~.~ .-. Name of Architect ......... i ................. Address ....... .~.rT..~.. ..... Phone No ................ Name of Contractor ........ ~ ................. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, anti. indicate all set-back dimensions from jro lines. Give street and block'number or description according to deed, and show street names and indicate whether r corner lot. STATE OF NE~V~ YORK,, e e ...~6h4~4-. :l .~,~...'. g:..~.o. ~4~ ................ being duly sworn, deposes and says that he is the applicant I (Name of individual signing contract) above named. He is the .... 'e, CxT. ......... ,: i' (Contractor, agent, corporate officer, etc.) of said owner or owners 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 ~n the manner set forth in the application filed therewith. Sworn to before me this ~.,e.~.~ .day o ~ .~c'.. ., 19 ~OI~ARY PUBUC, State o* Ne~'tYor!~ ' No. 4641336, Suffolk C~un y O~rlrnission Expires ~arct~ ~0, ".i NO, IF~, ~t i~D NG DEPARTMENT AT 755-1802 9 AM TO 4 PM FOR THE 1. FOUNr4'TION - ~0 REQUIRED FOo p~URED CONCRETE /'1.1'¢ 10'6"