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Home My WebLink About10206-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No Zl1380 Date December 16 .............................................. 19.82.. THIS CERTIFIES that the bmlding ................................................ Location of Property 825 Bray Ave. & 75 Atbo Drive, Laurel County Tax Map No. 1000 Section 126 .Block 02 .Lot 007 Subdwlsion .............................. Filed Map No ......... Lot No .............. couforms substantially to the Application for Buildmg Permit heretofore filed in this office dated · . Nay. 9 ......... , 1979. pursuant to which Building Permit No...1.0.2.0.6. Z. ............. dated ..... Say. $0 ............ 19.7. 9., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ·..cons~.rucl:. metal .sgor.~ge. ~.ui$Oiag The certlf~cateis issued to . Frank J... Fli$.$ (owner, ............... of the aforesaid building. Suffolk County Department of Health Approval _N/.A ...................................... UNDERWRITERS CERTIFICATE NO ...N/g. .......................................... Rev 1/81 Building Inspector FOi~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUT~-IORIZED) N? 10206 Z Date ........................................................ , ........ Permission is hereby granted to: ....... Z.,..~ ............................ ~..~...~. .................. ~'~-'~ - ....... ~d~.~..c~z....~.:..~..: ............ ~ ,.,C~Zz~U ~ .(, ....... Z:f~ ~.....~.~(4~Zw.~ ~ ....... ~. ~ ~. ....................... pursuant to application dated ............. ~..~:....~.....~..~. .......................... 19.~.~.~.., and ap i rov~ by the Building Inspector. Fee · ..................... ~, ~, .~,,.~.~;.~;.;;. ......................... TOWN OF SOUT~OLD OFFICE OF BUILDING INSPECTOR · P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. ! 1971 TEL. 765-1802 _~ ~o~ ~ ~ -Applicant This ie to advise You that the on ~ ~ for'- - ~ a ~n=± ~nspect~on ~as~--~ his no~ been done. In order to complete thzs fi!e, it is necessary that a Certzf~cate of Occnpaacy be issued. Please fill out the enclosed form(s), return same to the above office with a check for $5.OO payaole to the Town of Southold. indicate to whom the Certzficate of Occupancy zs to be mailed, and arrange wzth this office for an inspection date. Thank you ~or your prompt attention. Very truly yours, Victor Lessard Adm~-nis ~r~ tor VL:ec Enclosures FORM NO. 6 TOWN OF SOUTHOLO Building Depar~men~ 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 w~th 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 topograohic 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 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 Aprd 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property llnes, 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $t.00 $5.00 Date ....... New Build~ng ........... Old or Pre-existing Building(X) ........ ~/Vacant Land ............ Location of Property ~0 House No. Srree[ Ham/et Owner or Owners of Property .~'qLq. ,t1~ .~ ....... ~ ..................................... County Tax Map No, 1000 Section . J ~(/¢~ ......... Block .... 0~ ........ Lot...O.0~ ........ Subdiwsion ........................... Filed Mae No .... 77 ..... Lot No~ . .~-. .......... Health Dept. Approval ........................ Labor Dept. Approval ......................... Underwriters Approval ........................ Planning Board Approval .................. ~ .. ~ Request for Temporary Certificate ..................... Final Certificate ........ - ......... - Fee Submitted $ ,~',C~,'(~,. . ..................... TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y, 11971 TEL. 765-1802 March 9, 1~87 RE: TO WHOM IT MAY CONCERN Frank J. Fliss 825 Bray Avenue and 75 Albo Drive Laurel, N.Y, TAX MAP NUMBER: 126-02-007 The solid fuel burning appliance was installed prior to the time that Southold required a permit and C.O. The appliance was installed in 1980. THOMAS FISHER Building Inspector TF:hdv Approved .%~6..~ .//..~.~) ...... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180~ /~o~-_~ ., 19~. Permit No.../.O...~.Q..~. ~ /o go 5- Application No. /0 ~0~ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Th~s application must be completely filled in by typewriter or 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 of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by th~s application may not be commenced before' issuance of Budding 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 inspechon 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 Southotd, 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 all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in bmldings for necessary inspections. ~ .... ..................... (Signaturej~Irapplicant, or name, if a corporation) .... ~Te~-~ ~/~5:~(Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. Name of owner of premises . ~.~. (L'lTh ~..~. :. ~.. ~'~ .~% .................................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. o. uvncr .... ~.r.~. n~,, ~: .¥-~ ~ i' :%.-5. ............. (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 .............................................. · 5 ..................... h ............ M 3/ ................ House Number Street Hamlet Cottnty Tax Map No. 1000Section ~.~. Block ~. 0 ~ Lot. ~O~ ......... Subdivision .................................... Filed p No .... ~%~ .... Lot (Name) 2. State existing use and occupancy of premises and ~tended use and occupancy of proposed construction: a. Existing use and occupancy..~mh ~ ~[...~.e.~.[3.~ ......................................... b. Intended use and occupancy ..~.'~.~.x~ ~Y...~.~.¢.~'~ ..*.~C<,) ~C/ ....... 3. Nature of work (check which a~plicable): New Building ...~. .... Addition /. ........ Alteration .... Repair .............. Removal .............. Demolition .............. Other Work...~.' O~.~.[.~..~e.~,.~ i' ~ ~/ d- i~:~Oc~=, (Description) 4. Estimated Cost. ~0~ ........ Fee ......... (to be paid on filing this application) 5. If dwelling, number of dwellingI units ............... Number of dwelling u, nits on each floor ................ If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, specify nat,u, re and extent of each type of use ............. , ........ 7. Dimensions of existing structur}s, if any: Front .... k.l.O ........ Rear .............. Depth ...~.k.} ......... Height ............... Number of Stories .. ~ ...................................................... Dimensions of same structure Oith alterations or additions: Front ...~..~. ..... Rear .................. Depth ................... ~... Height ...................... Number of Stories ...................... ' ' .q...IEI]~.~.'~..~... Rear ............... Depth ~'&'.. I,~D: ..... 8. Dimensions of entire new constructaon: Front ' ~ ' Heaght . ~..~. J~ ~ ~ ...... Number of Stones...I .......... c- ....t ................... .~ ................. 9. S~ze of lot: Front ...... /.O~i.,..~. ......... Rear ..... &...~: ?.~. ......... D{pth .I..O.b.: ~.: ........... 10. Date of Purchase ...... ~./.7.(0 ....~ .............. Name of Former Owner .~.~.0:..~.\.~>~..~r .~..~ % .~ ........ 11. Zone or use dastnct an whmh p~,emmes are situated ..................................................... 12. Does proposed construction viqlate any zoning law, ordinance or regulation: p,.O. .......................... 13. Will lot be regraded ....... ~ .O. ................. Will excess fill be removed from premises: Yes (N6') 14. Name of Owner of premises ,.~.r.o.~.~.~.-.~.I.L~$ ..... Address ~"~ob ~b~ .~Ot.~. ~ ~vE-~.Phone No. ~.q.~.. 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 bloc~ number or description according to deed, and show street names and indicate whether CoCr eC interior or corner lot. 40t rdO.5", 7~ ' t STATE OF NEW YORK, S.S COUNTY OF .................. ........ .................. (Name of indiyidual s:' :rang contract) above named. being duly sworn, deposes and says that he is the applicant (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dnly 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 therewith. Sworn to before me this~__~ i ;///?~ ~ .~.~ unty ,