HomeMy WebLinkAbout10600-zFORM NO, 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No...Z125.12 ........
Date ... June 5 ...
.............................. 1984
THIS CERTIFIES that the building . .qq~ .ny.e.r.s..ig.n. ..................................
Location of Property ...1.2.9. 5. ............ .R.o.b.i..n.s.o.n...L.a.n.e. ............. .P,e.c.o.n..i.c .......
House No. Street Hamlet
County Tax Map No. 1000 Section . . .0.9.8. ...... Block 05 .Lot 2,3 , 4
Subdivision ...... X. ........................ Fried Map No.. X .Lot No. X
conforms substantially to the Application for Building Permit heretofore fried in this office dated
...... p.e. q9 .m.b.e.r...6 .... 198. .0. pursuant to which Building Permit No...1.0. ~ 9.0, .Z. ...........
dated .... M..a..r.c.h.. 2. .6 ...............198.0.., 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 . .t.1) .e ....
conversion of existing guest quarters to living unit for caretaker.
The certificate is issued to CHARLES BOCKLET & CONNIE LOU BOCKLET
(owner, le~e~o~ ~artO
of the aforesaid building.
Suffolk County Department of Health Approval ..... N/.~ ..................................
UNDERWRITERS CERTIFICATE NO ............. ~. {1.8.~[1, O .5 ............................
Building Inspector
Rev. 1/81
FO~ NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, hi. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
CQMPLETION OF THE WORK AUTHORIZED)
N? 10600 Z
Permission is hereby granted to;___
.... ~z,,..~-,~ ~ ./.-.. ...............
...z~.z~ ~...~.~....~,..~.~.~: .............
.... .t~,~--C¢~,~./..~..~..4~......~.....: ..............................
~o ...~.~.~z--.....~..~. ,z..-z.~.. ~.......~.~ ~......p.~z~r~.~........~ .............
~:,z..z~.~.....~.~.z.,.......~zc...~~_.~.-..: ...... ~....~¢....x.~.,~.....:/r/~
at premises located at ....... ...... y,
..... ~../...c.......C~.~.r~....~...c,.:c~..~:.. ............................................................................
!
pursuant to application dated ~.~,,~.C~r~.,~r:~.t-~'~:~./~......~....., 19...~...., and approved by the
Building inspector.
~ee *..Z.~--...~ .....
Building Inspector
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 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.
For existing buddings (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
topograph ~c 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 or land use $5.00
3, Copy of certificate of occupancy $1,00
New Buildm§ ............. Old or Pre-existing Building .... ~i".. Vacant Land .............
Location of Property ..................... .......
St~et
House No, , .~ ~ H~m/et
Owner or Owners of Property . · · ~, · .~ff .~- - · ~'~.ff~ & ..... ~'. C-~'~
Couatv Tax ~ap ~o. 1000 Sact~on ....~ .~ .~ .... e~ock ..... ............... '~..
Subdivismn ............................. Fded Map No ........... Lot No ..............
Permit No. ?.~..~. P. 0.. Date of Permit . Applicant ................
~ , o/-'/'~o--/~, De rov
Health Dept, Approval . ~..~.~, . -~ .~.* ............ Labor pt. App al ........................
Underwriters Approval..t~. , ' .(/~, .~..~.l. ~..'~:T..Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate ......... , ..............
5..,.¢
Fee Submitted $ .......................
Construction on above described build'~,~et~r~ll~c~s~d regolations.
e .......
THE NEW YORK BO.~ARD OF FI;RE UNDERWRITERS
BUREAU ~ ELECTRIOIT%;
(~ 85 JOHN STREET, NEW YORK, NEW ~ORK 1003e
THIS CERTIFIES THAT N 4 8 ~ ~. O 5
only the e~ctrical equipment as described belo~ and introduced by tim applicant named on the able application number in tae premises of
in thefollowing locat~on; ~ Basement ~. 1st FI. ~ 2nd FI. Section Block Lot
was exa,nlned o~ ~y 2~ , ~9~0 and found to be in compliance with the requirements of this Board.
.xm.~ .x~u.~s .A,~s ovms
OUTLETS
EXHAUST FANS
DRYERS
SYSTEMS
OTHER APPARATUS-
1 t~ Detector
C E
A w g NO OFNEUT~ALS
OF HI-LEG
AWG
OF NEUTRAL
2
Avenue
Iq~Y. 11935
This certificate must not be altered in any
copy '~OR
to the office of the Board if '
Tills COPY, OF
GENERAL MANAGER
Per
may be by their crede~ha/s
FOUNDATION
(~a~)
FOUNDATION
2.
ROUGH FRAME &
PLDTgBING
INSULATION PER N.Y.
STATE ENERGY
CODE
FINAL
I~AST
~]0 Peter R. Stou~enbu~$h
lnliian Neck Lana
, pCeomc, New York 11955
~16-734-7474
/' .~"¢ ' ', Ocr. Z
Ti+lc Nc;,. I01 - ~ -'7C~zf7
FOBM
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
N'OTICE OF DISAPPROVAL
.--~....~.~z..w..~..~..,.
..... . .h....~zT...: .......................
!
PLEASE TAKE NOTICE that your application dated .,J~..~.~.ff~.~....~..........., 19..~...
· ~ ~ll~c ·
for permit to construct ................................... ?...at the premises located at ....................................
l.~.~z...~.~.~.~..~,~ ............. ~ ~,~- ~ ~
$~ /~o¢~ ~Z Block ~.~ Lot .~.. .....
................................... 0~ .. is
returned herewith and disapproved on the follow~ng grounds~~...~.~.~.~...~... . ....... .
/
~/zz~...~...~z~9.L~....~.~.~ ~,.T..~.~.~ ...........................
............ i=f~..=,L ........................................................................... : .......... /.....1 .......... ; ..................
Buffdin~ Inspector
HENRY E. RAYNOR. ,Ir.. Chairman
FREDERICK E GORDON (~)
JAMES WALL
BENNETT ORLO~SKL
GEORGE EITCHIE LATHAM.
P ~D
T(~D~
Southold, N.Y. 11971
January 17, 1980
TELEPHONE
765-19S8
Mr. Peter Stoutenburgh
Indian Neck Lane
Cutchogue, New York 11935
Re: Charles Bocklet #2654
Dear Mr. Stoutenburgh:
The following action was taken by the Southold Town'Planning
Board at a regular meeting held January 7, 1980.
RESOLVED to approve the site plan of Charles and Conuie Lou
Bocklet, map dated June 4, 1979, pursuant to Section 100-30 of
Article III of the Code of the Town of Southold, for second
dwelling/residence on single parcle of land.
Yours truly,
Copy to Board of Appeals
Building Inspector
Muriel Tolman, Secretary
Southold Town Planning Board
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
12 July 1982
Mr. Charles Bocklet
1295 Robinson Lane
Peconic, NY
Dear Mr. Bocklet~
I am writing you in reference to the barn conversion into living
quarters. It has been found that many changes have been made up~
stairs and new plans must be submitted. Also, upstairs windows do
not conform.
I am returning your check for your Certificate of Occupancy and re-
mind you that use o this building without a Certificate of Occupancy
is a violation.
Hoping you will take the necessary steps to correct this matter, I
remain.
Sincerely yours,
Victor Lessard
Building Administrator
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
/
TEL.:
765-1803
Examined ,( ,~..d. ......... , 19 t~
Disapprowd. a/c.~l~.'.~~ ........ ~.::'.' ~ /
L (Building InspeCtor)
Application No../~. ~/~.(~.~. .......
APPLICATION FOR BUILDING PERMIT
Date :-.-~.. f. ...... ,19 7..~'
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 Buildmg 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 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 herem described.
The applicant agrees to comply with all applicable laws, ordinances/,A.~ing code, hot~i~glcode,~nd regulations, and to
adnrit authorized inspectors on premises and in buildings for nece~ary lnsr~ections. ~ ! I // / , ]
, .......
(Signature of a~lSlicant, or nam__e, ~f a ~6rporation)
·/.~..L~..../.-t.~.-~.~./.,.~ .... ,..~.,~* ..... ! .... ...
(Mailing addre~ of applicant)
State whether applicant is o>vner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
..................................
.............. :2 ......... /-'z,,..
Name of owner of premises ....... /./. ]~.1~ .....~e. t..~t.~.-A~,~.~ .... .~.. ~ ....;..: .......................
(as on the 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 ..... .~..I. ~. ...............
Plumber's License No.. t.c)'...~. ~,~.~-. ~..~r~..~.
Electrician's License No ......................
Other Trade's License No ......................
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 ...............
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .... ~. ~~...~.. ~. ~'.~.~.~ .... ~..~ ~, .*.~...~ .......
b. Intended use and occupancy..>~' ~. ~..C~ ~+.~...~..
3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .'~ ......
Repair .............. Rem~oval .............. Demolition .............. Other Work .............
i ~ ~ (Description)
I
............ Fee.. ~.-~. ..............................
4. Estimated Cost ...... .-*. ........
; (to be paid on filing this application)
5. If dwelling, number of dwelling units .......... /'.Q.. 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. Dimefisions of, exis0ng structures, if any: Front ...... ~-~ .rD .....Rear~ ..~.,...5..O..t~ · Depth ....~..(~. ........
Height .... ~ .fy ...... Number of Stories ......... ~ .... ~ .... ~ ?_~..t.t..~...~. ...................
Dimensions ofl~n(~ structure With alterations or additions: Front .... .~..O ......... Rear ....
Depth ................... i... Height ....... ~.~ ........... Number of Stories... ~ . [,~....'?~ .~..~../..o.~
8. Dimensions of entire new construction: Front .......... ~... Rear ............... Depth ...............
Height ............... Number of Stories .......... ~.Z:~..~>..~ ~: .................................
9. Sizeoflot: Front ...... .t~ ......... Rear,3.~.'.O..~... ~. Depth ...'~...,..c>. .............
1 1. Zone or use district in which piemises are situated ..... J~,k..~r. &~.c!.-e,.~,,~ & ..................... t .........
'12. Does proposed construction vi41ate any zomng law, or&nance or regulation: ...~:.t~j..,~,c.$-.-q. ....................
13. Will 16t be regraded ....... .~.. ..... .,~...:..,..,~.. Will excess fill be. remov~ ,f~rom premises: -. , Yes _ No
Name of Architect .......... i..,.,,,t ................Address . ~, ............. .~. ~rhone No ..... .,. ~ .......
Name of Contractor . ~"~.-q.~..i. '~ o.~,~,'~.~.~(o~Address ... ~.o.~.~o..~.~-Phone No...~. ~. 1~.."~ ~'. i~,
PLOT DIAGRAM
l,ocate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from
property l~nes. Give street and bloclc number or description according to deed, and show street names and indicate whether
interior or corner lot.
........................... ~ ..................... being duly sworn, deposes ~d says that he is the applicant
(Name .... ~ '
of mdlwdual slgmng contract)
above named.
Heisthe ........... 3 ............... ~..~ .................................................
~ ' ~ ~C~tr~ctor,~nt, corporate officer, etc.)
of s~d o~ner or owners, ~d ~s d~ly author~orm or hav~ perfomed the smd work and to m~e and file ~s
app~cafiofi,;~ thht ~11 statements co~t~ned ~ this application are true to the best of his knowledge and belief and that the
work will be'perfo~ed in the m~ner set forth ~ the application filed therewith.
Sworn to before me this ~ , ~ . .
No. 52-03~963 Suffolk Coun~o~
Corem sslon r~p*r~s March 80,
iI
ji
iI
NOTI~ BUILDIN~
'765-1802 9 AM TO 4 PM
FOLLOWING INSPECTIONS:
LI. FOUNDATION "TWO
FOR POURED CONC~E
~. ROUGH - FRAM]~ &
5. INSU~T~ON
~. FINAL - CONSTRU~ION
BE CO~pLETE FOR C.O.
'ALL CONSTRUCTION S~A~ ~e~'
THE REQUIRE&AENTS OF TH~
STATE CONSTRU~ION &
CODES. NOT RESPONS]B~
DESIGN OR CONSTRU~I~
/0