The URL can be used to link to this page

Home My WebLink About10673-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupnncy No.Z.! 1..3.6.3. .......... Date ......... J.a.n..u.a.r.y...1.0 .............198..3. THIS CERTIFIES that the building .a.d. .d .i.t.i. qn. ...................................... Location of Property 345 Northfield Lane Southold House No. $O'eet Ham/et County Tax Map No. 1000 Section 071 .Block 01 .Lot 023 Subdivision X .Filed Map No. X .Lot No. X conforms substantially to the Application for Building Permit heretofore filed in this office dated ·..-~ p r ;i.], .30 ......... , i 9~ 0. pursuant to which Building Permit No.. J.0.6. 7. .3..Z. ........... dated ..... lg$ y.. 13 ................ 19~.O., 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 deck addition to existing dwelling. The certificate is issued to HERMAN BORGELT ..................... '4 4 j ...................... of the aforesaid building. ~. Suffolk County Department of Health Approval ...n/.a. .................................... UNDERWRITERS CERTIFICATE NO. n / a Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificnte Of Occupnncy No. g&l.363 .......... Date December 16 19 82 THIS CERTIFIES that the building ................................................ Location of Property ~s~ ~o.5' No~thf/,~lql. L. Rrl~ ,. Southo ld ' County Tax Map No. 1000 Section ...71 ....... Block . .1. ............ Lot.. 23; Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application fOr Building Permit ~ofore ~ed in this office dated .... &pr.il.. 30 ........ ,19~80. pursuant to wlz~ch Building Permit No. ' J-l~673Z ............. dated ... ~la¥..1,3 ................. 1980., 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 ......... .... ¢ono~;lruc.t .~ec~ .a~td. it~io~ .~o. e~ist&~,g ,~twollin~ ....................... The certificate is issued to ... Hel~man..B®rgel ........................................ (owner, levee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ... bl/A ................................... UNDERWRITERS CERTIFICATE NO .................................................. R~. 1/81 Building Inspector TO~WN 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 AUTHORIZED) Permission is hereby granted to: ....... ....... 4.:.~..cc:.z,.~...c....,....~..:..~.: ............. ,o ...~,.~./.~.~.~.z~.c-z..CZ:. 42~.~ ~,~....~.../.../...z.~.z~J....../...O......~.~/.~./..~.z..~ .:. ~.,. z.z ./.~.~..~¢~ ............ ..~.~.zc: .............. .~/z~. r~. ~...../.~.':~f~9.~-:.-~:7.Z ...... at premises located at ..~....~.:.C~..~...,...~..~.~/..~.-~-Z~T/~~''''.'~'~/~'~: .................. ..................................................................................... .~..~../.-zfr../~Z,~...-=.Z~.: , ... pursuant to application dated .,~..,..~..~. ............ , 1 ,, and approved by the Building Inspector. Fee $../...~.,.,,,..~.... .... Building Inspector FORM NO. 6 TOWN OF $OUTHOLD Building Department 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 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 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 buddings (prior to April 1957), Non-conforming uses, or buildings and "pre-exisdng" land uses: 1. Accurate survey of peoperty 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 buddings 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 or land use 3. Copy of certificate of occupancy $1.00 $5.00 New Building ............. Old or Pre-existing Building(X). Z.. - =/Vacant Land ............ ,- , ............. Location of Property..,~. ¢;,-...~.~/~'~ ,~.{ ~'~_~.¢. .... ~, A ~.E % ~.~) House No. Street ~ Owner or Owners of Property ..EA¢'..~.~'~/~.,~.~.-.~. ~¢'.,~,,,~,(,..E~/~/'~/~,,~,,¢J~..~,,~,,~7'.,.. County Tax Map No. 1000 Section ..... 7/~, ...... Block' ....... .~ ....... Lot ...... ?,.-~ ..... Subdiwsion ........ ~. ........................ Filed Map No ........... Lot No .............. Permit No, ffJ~,~..7. ~,,, Date of Permit ....... pplicant ...... ~,,~-~',~f/, ....... Health Dept. Approval ........................ Labor Dept. Approval ...................... ,.. Underwriters Approval ........................ Planning Board Approval .................. ~ .,, Request for Temporary Certificate ..................... Final Certificate ........ - ......... - · Fee Submitted $ ....... .~.; . .O..~.! ............ Rev. 10-10-7e Construction on above described building and permit'meets all app~cable~co.des and regulations. TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 This is to advzse you that the job under Building Permit No. 7~(~p~ issued to ~jL ~o~ ~c~ ~ o~ ~-/~o "for "?~ ~c~ is ~ompleted and a final inspection has/-~ has not/~ been done. In order to complete thms file, it is necessary that a Certificate of Occupancy be issued. Please fxll out the enclosed form(s), return same to the above office with a check for $5.00 payable to the Town of Southold. Please indicate to whom the Certificate of Occupancy is to be mailed, and arrange with thms offzce for an inspection date. Thank you for your prompt attention. Very truly yours, Victor Lessard Administrator VL:ec Enclosures FOU~fDAT !ON { ~ st ) FOIR~DATION 2. ROUGH FRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY COpE ADDITIONAL COMMENTS: FINAL OCCIJPkNC¥ OR' USE IS UNLAWFUL V~I'[~IJT CER11FIf, kTE OF OCCIJPkNCY ._~-~II~)VED ilLS I~101 NOTIFY BUILDING DEPARTMENT AT 765-'1802 0 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2, ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C:.'O. ,ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION' & ENERGY CODES. NOT RESPONSIBLE I~OR D~ OR CONSTRUCTION ERROR5. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 .... ....' ........... ............. : .... : ......... ...._ (Bfiild~ng Inspector) INSTRUCTIONS a. This 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 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 ~nspection 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 Regulahons, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all apphcable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. ....... XL...,: .,:e..r... ~...../L....~...-L. ~ .............. (Signature of applicant, or name, if a corporation) ..... ~ ~.....x..s.-.~. ~.~.~.~.~. i~.,...~:. (Mailing addres~of applicant) /. I q ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............... ................................................................... Name of owner of premises ...~. e:...1.~ ~...kJ~, . .~.. ..... ~...?..t~..~p...~..I ............................. (as on the tax roll or latest deed) If applicant is a corporat~n, s~gnaty~re of duly authorized officer. (Name and htle of corporate officer) / / Builder's License mo.-~..~. 2.7 .... ~/..J~. ~ .~..~/~/~,Z? Plumber's License No .......... / ............ Electrician's License No ........ /.. ............ Other Trade's License No ..... .) . ............ Location of land on which proposed work will be done ................................................. . .~. . .~ . . .x. ~ ~ :~,./: /. .r.~ .~ . ~ .~. . - ...... : .5.'~ ~ : ?~ ~ .~:',>. ................................... House Number Street Hamlet County Tax Map No. 1000 Section ..... .~..~.. ?l... Block ......... ! ....! .... Lot 2~' ~)~-~ Subdivision .................................. Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . ~96~'~ ......... .~..,~A'~.../.~...~.......~...~.~. :~..~-..&r .?..-~...<.~ ................... b. Intended use and occupancy . .~:7~.. ?.4~...~..~: ....... &~.~. !'.'77-ff..~. ..... ~. ~...~ ./. )'.~..~9.~~. ........ 3. Nature of work (check which applicable): New Building .......... Addition .......... Alterat,,i~q .......... Repair .............. Rem6val .............. Demolition .............. Other Work .¢..g/~..~-.~.-, ...... 4. Estimated Cost . ~. ~ .................. Fee .. ~ .................................. (to be paid on filing this application) 5. If dwe!ling, number of dwelling units ............... Number of dwelling units on each floor ................ 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, if any: Front ............... Rear .............. Depth ............... Height ............... Nuniber of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ................... ~.. Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ................ 'Rear ............... Depth ............... Height ............... Nun~ber of Stories ........................................................ 9. Size of lot: Front .......... ; ........... Rear ...................... Depth ...................... 10. Date of Purchase .......... ; .................. Name of Former Owner ............................. i 1. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ....... ~..~ ........ ~ .... ,; ....Will excqss fill be removelt from premises: Yes No 14. Nmne of Owner of premises/~/,cg/?',~ ./~... ~. ~.%~:[,-T. Address ,f/~¢.~ .~2~,/r~E.~i>L,~L~. ;. Phone No. ~;~h~. '.20.~ ~.. Name Of Architect ......... Address ................... Phone No ........ : ....... Name of Contractor tt'///~..~ ~.' ]~.',~]t~] ~]] ] ]] ii]Address .~.q~ t~.~ .~. ~.~.. Phone No.~ .~..-rS.~.~.. Locate clearly and distinctly all property lines. Give street and block interior or corner lot. PLOT DIXGRAM buildings, whether existing or proposed, and~ indicate all set-back dimensions from number or description according to deed, and show street names and indicate whether STATE OF NEW YORK, COUNTY OF. being duly sworn, deposes and says that he is the applicant He is the .............................. ..~ ........ : ....................................... : ...... ~;¢m~porate officer, etc.) of said owner or owners, and is du~y authorize, d to perform or have performed the said work and to make and ~file this application; that all statements contained in th~s 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 bsfore me this .................. ~ ..... day of ...... .,/¥ .} ........... 19 Not yPublicd :!7. ......... :.-- ounty ~ I/~'] P~O'~RY PUe:LII~, State of NeW Y*rk b' ! N_o, ~5~50, S~fo k Co~ i Term E~p~res March 30, I I