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Home My WebLink About10865-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. Certificate O[ Occupancy No. ZII865 Date August 24 ., 19 .8.3. THIS CEF, TIFIES that the building ... g.a.r.a.g.e..a..d.d.~.t..~g.n ........................... Location of Property . . .5.0.0 ................. .F.a. r3..n.~p,g .Bp.a.d. ........ .~.e.~q..S.u.f.f.o..1.k... House No. Street Ham/et County Tax Map No. 1000 Section .... I.I. 7 ..... Block ..... 6. ......... Lot ........ .2 ........ Subdivision ........... x .................. Fried Map No ..... ~...Lot No ........ ~ ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ·.. September. 16 .... ,19 80. pursuant to which Building Permit No .... -r 0@.65~, ........... dated . . .S..ep.t.e.m.b..e.r..I..8 ........ 19.8.0. , 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 ......... ....G.ar.a. qe..a.d.d..i.ti.qn., g.n.t. 9' .a..o.n..e..f.a.m..i.ly..d..w.e.!l..i .n~.. .......................... The certificate is issued to ............... .C.L.I.~..F.Q.Rp..T..Y.L.E.R., .&..WI..~.~ ................ (owner, mc ........... , of the aforesaid building. Suffolk County Department of Health Approval ................. N./..R ...................... UNDERWRITERS CERTIFICATE NO .................... .NS.I.I. 0. 7..8 ...................... Building Inspector Rev. 1/81 TOWN BUILDING ~i TOWN'HALL SOUTHOLiD, BUILDING; P~ERMI~ (THIS PERMIT MUST BE KEPT ON THE PR~t~S S. UNTIL ~ULL COMPLETION OF THE WORK AUTHORIZED:)i Permission is hereby granted to: ADD GARA~GE ONTO A ONE PAULY 500 PANNING ROAD ~ at 'premises located at ~ · ................. ; ..............} ............................................................. 1-1 7 aunty Tax Ma No 1000 Sect on .................... · : ~ep~embe~' pursuant to apphcaton dated ........................................ Building Inspector. 15.00 Fee $ ........................ 6 ~,,,_ 2 ,.~ .............. ~ Lot ,,~u ......................... .;..., 19...8.~., and approved by the ;Inspector t FORM NO. 6 TOWN OF SOUTHOLD Bu i~d~ng" ueparzmen~ Town Halt Southo~d, ~. r. 1 l~l ~ APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and subr~itted in duplicate to the Building Inspec- tor wl~h the following; for new buddings or new use: 1. Final sun, e,/ of property with accurate location of all buildings, property lines, streets, and unusual natural or tooograohic features. 2. Fma~ approval of Heaith DeD~. of water supply and sewerage disposa --(S-9 form or equal}. 3.Approval of electrical installation from Board of Fire Unde~riters. 4. Commercial bui~ings, Industrial buHdinas, Multiple Residences and slmHar bu dnas and installa- tions, a cortff~ca,e of Code compHancs fr~m the Architect or Engineer responsible ~r the building. 5.Subm~[ Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to ~pril 1957}, Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate ~pzey of peoperty showing all property lines, ~reets, 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 safew inspection of buildings or premises, or other pertinent informa- tion required to prepare a ce~iflcate. C. Fees: 1, Ce~fficate of occupancy $5.00 2. Ceruficate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of cemflca~e of occupancy $1.00 NewBuifding .¢~'~/,,. OlOorPre-ox,stingBuiMmg(%) ~oc,,,o~ o,~,o~,,,~...:'~(~ ............. b~x~r~,',~../~A, . /LL.4'... ~ / '.~'~ ~' , ~ ~T ~' Hamlet Owner or Owners of Property ..... Subdivision ...... ~ ......................... Flied Map N~ .......... Lot Na .......... App App Health Dept. royal ..... ~ ............. Labor Dept. royal .......... ..... ....... ~.. Und~,riters Approval k~ ~5 ........................ Planning Board Approval ..... Request for Temporary Certificate ...................... Final Cerdficat~ ., ~ ....... Fee Submitted S . · ~ .... ~-/ :~ r ~.~ .., ,o,;¢;~~. .~,,;,,,;,~ ?~. ~' '~ r/~' '7'"- '~'~" ................ TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 April 24, 1984 Clifford Tyler 500 Fanning Road New Suffolk, N.Y. Dear Mr. Tyler: I am writing to you about the Certificate of Occupancy for the garage addition. If you will please send us the $5.00 fee we will send you the Certificate of Occupancy. This C.O. was mssued August 24~ 1983 and has been in our file waiting for the payment of the fee. Yours truly~ Building Department THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRIqlTY~ 85 JOHN STREET, NEW YORK, NEw fORK 10038 in the/allowing locathm; ~ Basement P~ 1st FI. ~ 2nd FI. (~a~ Section Bh,ck Lot ~ ~,,,i,~a on $ ~b..;~; j> 23 ~ 198J. and found to be in compliance with the requieements of this Board. FIXTURE FIXTURES RANGES OVENS EXHAUST FANS OUTLETS RECEPTACLE~ SWITCHES DRYERS SYSTEMS NO OF FEET E OTHER APPARATUS. E R I C AWG AWG NO 3 AWG OF NEUTRAL 5 BUILDING THIS ~1 IN ANY MANNER. _, I: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined ...... qX/f.~f.?...,19..~ Approved . .~//~...., 19 ?.O. Permit No..~.~. ?..~. · .~. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No.. ~..O.~..~.-~5...~'~. 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 this application may not be commenced before issuance of Building Pen]nit. d. Upon approval of this application, the Btulding Inspector will msue a Building Pem~it 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 all applicable laws, ordinances~lding c?~de, housing/~cod~e, and regulations, and to admit authorized mspectors on premises and in buildings for nece ec(~ 0) (Signatur~e. o f applicant,.or name,~corporation) (M~ linage' address of applicant) State whetS}er applj~ant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...... ,(~..:.~..: Name of owner of premises ~. ~4~ ~{o~..5' . ~.{.L .~.(... t.y.i~..~. .............................. .... ~' ' ~ .... (as on ttie 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.'~.. ~c'e2~ .C~....~. [~C.-- ~_~O , Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section .................. Block .................. Lot ................... Subdivision .................................... Filed Map No ............... Lot .............. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... t. ~ ~ ~ cO ~ ~ (/~K3 .~ b. Intended use and occupancy .................................................................. 3.~ Na'tut; of work (check which a~plicable): New Building .......... Addition...~'.... Alteration .. Repair ..... ~ ....... RemOval .............. Demolition ........... (.. ~ther Work ....... .~.: :..~.. /~/~' ' ~-- (Descr?tion) (to be paid on filing this application) 5. If dwelling, number of dwellingJunits ............... Number of dwelling units on each floor ................ If garage, number of cars .... i .... I. · ' ..................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of~existing structurds, if any: Front ............... Rear .............. Depth ............... Height' ./. ~ ........... Number of Stories ....... ( ................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ................... i.. Height ...................... Number of Stories ............ 8. Dimensions of entire new constrUction: Front.. (.2-..'7./.42. ..... Rear..[ .2n.T.(-e ....... ~dp'ti~ i .Z'..~'.'. ~iii ..... Height (.'5 t '- O Number of Stories 9. Size of lot: Front . .x'ZTE2.... i ........... Rear .... /.4Y~. .............. Depth . .~-.~?. ............... 10. [)ate of Purchase .......... i .................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ....... [ .....~. ..................................... 12. Does proposed construction vio!ate any zoning law, ordinance or regulation: ..................... ~ ..... 13. Will lot be regraded ...j~) p.. ~.. .......... ~ ...... Will excess fill be removed from premises: ( ~'es_,.,,' No 14. Name of Owner of premises II{v{ .~lr~..Q [i~..I7.1.<<Address ................... Phone No. '?.~..J~'~.~..d?~..~.~c~.. Name of Architect ' Address Phone No Name of Contractor ......... . ................. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly alli buildings, whether existing or proposed, and, indicate all set-back dimensions from prope~nty lines. Give street and block inumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ~ - S COUIVrY OF...~.q..~./~..z;..k-./. 7'... ..... . .¢. : . .& . . (Name of individual signing contract) above named. He is the ...................... ; ................................................................... (Contractor, agent, corporate officer, etc.) of s~d owner or owners, ~d is duly authorized to perform or have perfomed the said work and to m~e and file this application; that all statements contained ~ this application are true to the best of his ~owledge and belief; and that the work will be perfomed in the m~neT set forth in the application filed therewith. Sworn to before me this / . ...... ~'' 'A ........ day ofl. , ,?/t; ................... , quahl~ed ~n Su,~ Cou~W ~ (Signature of applicant)