The URL can be used to link to this page

Home My WebLink About12125-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z.11R15 ~t b. 19.83. No ................. Date Se em er 12 THIS CERTIFIES that the building -..-.ri.e?...dy.e.~.~..t.n.g. ............ Location of Ptoperty 700 Tepee Trail Southold ~ ~/o~ ........................................................ Street Hamlet County Tax Map No. 1000 Section 087 ;Block 02 .Lot 025 ...... ~ .~ Subdi 'ion Nun..nakoma Waters pN 546 8 vls ............................. Filed Ma o ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated J..a.n.u.a.r.y 6 19 83 pursuant to which Bttilding Permit No. 121 '2.5 Z . dated ....J.a.n.u..a .r~t..2.4. ............. 19 .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 ......... a p_rivate one-family dwelling. The certificate is issued to WINDS WAY BUILDING CORP. ro~er,'f~¥~:~' ..... of the aforesaid building. suffolk County Departmeat of ~e~th Ap~to~a .~.~. ~ .S .0.-.~. 5. .~ ~. g/. e..~ ./?.~. :. ?.b.t. :. ~: V i ~ i a, P. ~.. UNDERWRITERS CERTIFICATE NO ........ .N.6. 0. ~ .~.7.2. ................................. Building Inspector Rev. 1/81 FO~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 12125 Z Date ..... ~ .............. , Permission is hereby granted to: ../~. ,~.~..~.~..~../~...~..... ~...~.~ ...... .z~.~......~...~~Z. ~... ...... ~..~. .~ ..~.~ ...... ,o ......... ~.~.~...~ ....... ~~....~~-. ........................ at pr*m~e~ I~at~d o .......................................................... ...... Coun~ Tax Map No, lO00 Section ...... ~Z ..... Bilk ...~,~ ......... Lot No...~dJZ ....... pursuant to application dat~ ..~.~.,..~~ .......... , 19[~and~ approv~ by the Building Inspector. ~* $.~.q~Z.. .......... / Budding I~ector Rev. 6/30/80 ELD INS~ECT I~ON COMMENTS FOUNDATION (1st) FOUNDATION ( 2nd ) ROUGH FRAME & PLUMBING INSULATION PER N. Yo STATE ENERGY CODE FINflL ADDITIONAL COMMEN~S: FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY instructions 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 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 Undervvr.'iters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architec~ o¢ 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: 1. Accurate survey of peoperty 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 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 land use ~/8-/$5.00 3. Copy of certificate of occupancy $1.00 Date....~.~.~..; .~. ,,. ! .~.?..~.,.. New Building .... ~ .... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ......................... .~ ............... Owner or Owners of Property .... .~..t.,~.5. ............. (/ . .: ............... County Tax Map No. 1000 Section . .~ ..... Block ..... ;;; ....... Lot ........ J ....... Subdivision...~..~..v~.~..~,..~ ~....~..~iled Map ,o. '~' ~ .~..~'....Lot No .... .~. ........ Permit No. !.~. ¢/Z..~ZDate of Permit"~9~. ~ .Z.t.~pplicant....~. [/~..,...~...~......~F.~.~. ~. Health Dept. Approval !2--~0 ~ ~"'-~ .Labor Dept. Approval .~. ~0 .~, C"~-J '~, ni App Underwriters Approval .Plan ng Board royal ....... Request for Temporary Certificate ..................... Final Certificate ........ ~ .......... Fee Submitted $ ~ -~ " Construction on above described building and permit meets all applicable codes and regulations. Applicant. , . .~..,fi..,~..~, . , . .~... ,~.~. ,..~, .~$ ~ .(~... , ~ . :,1~ ....... ,4, THE NEW YORK BOARD OF FiRE UNDERWRITERS BUREAU OF ELECTRI(I~.IT~ J'~ly ~5~, [~3 85 JOHN STREET, NEW YORK, NE~, ~0RK 1OO3~ THIS CERTIFIES THAT only the e~etrical equipment ~ described below and introduced by t~ applicant ~n ed on the able application number in tlze premises of in the following location; ~ Basement ~ 1st FI. ~ Xnd Fl. ; Section Block Lot wosexomlnedon ~1~ 7 ~ ~ and fou.d to be [n com~llahce w~th the requirements of thts Board. 33 ,~ ?~ 33 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DIECONNECT S E R ~ ~ V I · OTHER APPARATUS: C 1 ~land Elect. Co. P. O. Bc~ 143 M~,tit~ck~ N.Yo, 11952 not be altered in any manner; return to the office of the Board GENERAl, MAN, ASER may be their credentials. NEW YORK STATE DEPARTMENT OF EI~VXRoR-M~NT~ CONSERVATION Building 40, SUNY--Room 219 Stony Brook, NY 11794 (516) 751-7900 AMENDMENT TO PEP/{IT EXTENSION OPEXPIRATION DATE Permit No. Your recent request to extend the ~bSve permit has been reviewed pursuant to 6ICfCRR, Part 621. It has been determined that there has not been a material chaa~e in environmental conditions, relevant technology or applicable law or regul- ations since the issuance of the existingpermtt, therefore, the expiration date is extanded to '~47 3i; 1,~_% · This letter is an amT%dment to the~o~iEinal permit and as such, shall be attached thereto, andla copy posted at'~e Job Site. All other terms and conditions remain as written in the original permit. Very trul~ yours, Daniel J..Larkin .Regional P~mit Administrator DJL:cz TOWN OF SOUTHOLD BUILDING DEPART~EN¥ TOWN CLERK'S OFFICE ~UTHOLD, N. Y. Ex, mined ~ ~....~ ................... , ~ ........~ ~p~.c~,o~ ~o.~ ............... ~o~~.~ ................ . ~. ~ uo....~~ ......... 'sepproved o/c ............. :z:;x'~2 ....... x: ...... :...._~ ........................................ ...................................... L~ ........ ~:2 ......................... J......: ............ ................. ~~~ .............. ~B~ding Insp~tor) ~ate ..... .....~ .......................... INSTRU~IONS a. This application must be completely filled in by typewriter oe in ink and submitted in triplicate 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 ofproperty must be drawn on the diagram which is port of this application. 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 issue 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 port for any purpose whatever until o 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 Lows, 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and ir) buildings for necessary inspections. .... ............... .................. ...................... (Signature of/applicant, or r~me, f a;corporotion) .... ./.~.~. ................ ../.~. ........... ~....~ ....... /..~..~.....~ ................ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................... ...................... Name of owner of premises ......~../.~.~/.~..~.....~..~./../.~/~.z..~.......~..~.~../ ........ ~....~'.~.~...~..~...~..~?...'~.. ............................... appli~rp~e, signature o_f (~aly outhorized~l~ficer. If (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No. ' ~'* Electrician's License No ................................. ~... .... Other Trade's License No ............................................... ,~ j3t ~ C'~/j~/~-o~-//I//~-z~ J , 1. Location of land on which proposed work will be done. ~ap No.: .~.~ ................. ~ .......... ~i' Lot No ........ ~ ............ {Street and Number,~;.~.....~..~c~.~....,.~JYA.,t..J ................................................... ~.¢.'.~/Z..j.4....o.!.~.> .............................. Municipality 2.State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ................................................................................................................................ b. Intended use and occupancy ........ ~..~, .~..~ !:~.....~..?...L,-.~./.~. ~ ................................................................... 3. Nature of work (check which applicable): New Building'. ...... Addition .................. Alteration 'i .............. Repair .................. Removal ................... Demolitior, .................... Other Work ..................................... . ............... ~ (Description) ':' (to be paid on filing this application); 5. If dwelling, number of dwelling units ........ ~ .~...'.Lg. ........... Number of dwelling units on each floor .......... i ................. 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 structures, Jf any: Front ............................ Rear ................................ Depth Height ........................ Number of Stories ................................................................................................................ Dimensions of same structure with alterations or additions: Front ....................................Rear .......... , ................. 8. DimensionsDepth ................................ of entire new construction:Height ............................ Front ~(~Number of Stories ................................ '(~ I-leight ..... ~...-). ....... Number; of Stories ...~, .......................................................................................... i .................. 9. Size of lot: Front . .. ~ ................ Rear ....................................... Depth ................................ 11. Zone or use district in which :premises are situated ................................................................................... i .................. 12. Does proposed construction violate any zoning law, ordinance or regulation: Will lot be rearaded g/~--~. Will excess fil be removed, from premises: .( ) Yes (/-'~No Name of Architect : ............... . .............................................. Address ................................ .Phone No...., .................. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimgnsions 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 (~"~1<~.! ,,.J ' ' {~'3/~,,~. O~(~l be ng deposes and soys that he is applicam (Name of individual si~ning contract) above named. ' (Contractor, agent, corporate officer, etc.) i of said owner or owners, and is doly authorized to perform or have performed the said work and to m~lke and file this application; that' ali staternents contained in this application are true to the best of his knowledge an, belief; and ti,ar the Work will be performed in the manner set forth in the application filed therewith. Swo'ro to before me this / 5,0 Notary Pu~b c, . ..............~ ..... County ~ ........................................................ ; .................... P.O. BOX 728 SOUYHOLD, NY 11971 FORM NO. 10 T0~.~N OF SOUTHOLD BUILDING DEPART~HENT (516) 765-1802 TOWN HALL MAIN ROAD SOUTHOLD, NY ~PPLICATION FOR DEVELOPMENT PERMIT Instructions: The application to the Building Inspector includes (each ~n dUplicate) 1. Form No. l0 filled out in ink or typewritten, 2. Sur- vey of premises with elevations above mean sea level, 3. Drawings of pro~ posed work. The application must give complete information to show that the proposed can comply to the Local Law No. 1-1980, Chapter 46 of the Code of the Town of Southold known as "Flood.Dsz~age Prevention Law" of the Town of Southold. The applicant must submit approvals that any other agency requires. General Standards as required in Section 46-17 of the law to minimize flood ~amage: A. Anchoring of structures, including tanks and mobile homes B. Use of construction material and methods C. ~ Design and location of utilities D. Subdivision proposal with drainage, public utilities design ~nd base flood elevations Specific Standards as required in Section 46-18: A. Residential construction B. Non-residential constru6tlon C. Mobile homes The applicant must submit plans and specifications as well as any other information requested by the Building Inspector to substantiate the facts that the structure has or will have the lowest floor, including basement/ cellar, elevated above the base flood elevation or; if pe~-~uitted by the Federal Regulation, that: 1. such structure is flood proofed in such manner that below the base flood level the structure is water tight with walls substantially and impermeable to the passage of water, 2. that structural components are capable to resisting hydrostatic and hydrodynamic loads and effects of buoyancy, 3. applicant must sub~it certification by a registered professional engineer or archlte~t that the standards set forth in Section 46-18B (1) (2) (3) of the So~thold Code are satisfied. C~o~stal HiMh Hazz~rd a~ea (V Zone) ~6-19. Applicant shall submit plans, specifications including--the required ertmf~catmons and such other in- formation as the Building Inspector may requii*e in that ~he provisions of 46-19 are complied with. Mobile homes are prohibited. The lowest portion of the structural me~bers of the lowest Floor cannot be lower than the base flood elevation with all space below open except breakaway walls. .S..and dunes. If sand dunes exist on the premises ~nd the apblicant pro- poses to--~lter same, plans and specification must be shown ~n detailed nature of any alteration submitted. B_uildin.~ Permit. A Building Permit is also required for any structure. Both a Development and a Building Permit must be issued before any work can start in a special flood hazzard zone. A,~ritten disapprovsl~or a~ permit must b'e issued within ten (10) worki~g days. During const~uction, the inspector shall be notified in time so he may make the required inspections. Upon completion, the required certification fo the final elevations and work m.ust be submitted before the approval to use or occupy can be approved. 4/80 (Fill out the form on the back of this sheet) Application Received Disapproval Issued 19 FORM NO. 10 APPLICATION FOR DEVELOPMENT PERMIT' In the Town of Southold 1. Type of Development Proposed: New St'ructur'e' (including storage tanks~ Addition and/or:iAlterati°nE~ Flood. Proof Below'. Base Flood Elevation Other (spebi£y) ~ '-'' '- '' 2. Elevation Data iJn relation to above mean sea level of: .. '- '(a) Lowest floo~ elevation, including basement -feet inches (b) In a V Zone,! bottom of lowest structural merabez~. . f'Set 3. FIRM--Flood I?s~:rance Rate . ~- ~ - ~. Location of P~op.,er~y: -. Co~ty Tax Map Nb., District, 1000, Section ~ Block ~ Lot(s) x) 6. ~vmission to bs~ g~nted: ~0wner as above'New Owner '' I ~Unde~ Cont~ac~ (Lessee( ~Contracto~ . .. Approval from ot~er(s) before Pez~it is issued: DEC~_3_~ /.~5 &--,lot ~ 9 w D ~ WETLANDS (Town Board), ~ne[L_l,, ~ew uwner ~-l,i .. Undb~'~=Oontract--~.. I__~, Lessee--I., i , . ed in tl~is appli6ation are .true to the best o~ my knowledge ~d belief and that the work will be perfumed in the mannerset forth in the application file~ therewith.~-- -- ~ :., COUNTY 0F~~ SS ~~~~ . - /' ' Signat~'~' ' Applic~t s mailing if not given ab6ve: h/80 SUFFOLK CO. HEALTH DEPT, APPROVAL.' YORK ~gs~e%ed by this de~rtment ~d fo~d / THE W~ND SEWAGE OtSPOSAL cONFoRM TO SUFFOLK CO. DEPT. OF ~IC-ANT SUFFOLK COUNTy SE~RVfC£S -- FOR CONSTRU~tON ONLY DATE: AP~OVED: DEPT. OF ~'V A T, 1 :O,N 765 T~n~9 A~,( T~ 4 P~. FOR THE ' ~ATE CONST~Ib'~' ~ ENERGY' If copper tubing is used for water distributing system; piping shall be of types K or L only II r I L-'L F__ V A T"/O ~°