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Home My WebLink About11348-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. Certificate Of Occupancy No ..... z.T.l.s.7, q4. ..... Date April 29, 1987 THIS CERTIFIES that the building . .R.ep .a ~ .r..~..A.1 .t .e .r..f.o.u.n.d .a.t .~ 9?. ?.f..o .x.~ .s .t .5 .ng . .d .w .e .~ .~ ~.ng. Location of Property 2015 Bay Avenue East Marion, New York h3~s'~ 'Iv'o: ....................... 'S't/e3i ............................ Horn/et County Tax Map No. 1000 Section ...0.3 ! ....... Block . J .7 ............ Lot....2 ............. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated August 26, 1981 pursuant to which Building Permit No. 11368z dated August 27, 1981 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 ......... REPAIR & ALTER FOUNDATION OF EXISTING DWELLING AS APPLIED FOR PEGGY HELLER & ANNE WYDEN The certificate is issued to ..................... [o~,n'o),'LX~7o~tStYt~'X:X ................... of the aforesaid building. Suffolk County Department of Health Approval Iq/A UNDERWRITERS CERTIFICATE NO. . . N /A tq/A PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 TOWN OF S~TtiOLD BUILDING DE~PART~EN~ TOWN HALL SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON TH,~ PREMISES COMPLETION OF THE WORK AUTHORIZED) No. ~34s z UNTIL FULL Building I~sPector. FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF O~CCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted in duplicate to the Buiiding 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-IS-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 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 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 $1.00 $5.0O Date ,~ .~-.7..t,~?, ......... New Building . ..~. ......... Old or pr_re-existing Building ............ Vacant_Land ............. Location of Property. ...... ................... House No. ~ ..... ~ . , S~reet Ham/et Owner or Owners of Property ..... ~.. ~. ~--/~;.'~ ......................... County Tax Map No. 1000 Section ...~{ ....... Block .... ?.~ ....... Lot.. Subdivision ........... ";'7.~'. ................. Filed Map No ..... ~ .... L~o .............. Permit No ........... Date of Permit .......... Applicant ........ .... ..... ~ .Labor Dept. Approval ........ Health Dept. Approval ....................... U nde~riters Approval ~ . ..................... ....-7 ................... Planning Board Approval Request for Temporary Certificate ..................... Final Certificate~ ..................... Fee Submitted $ ............................. Construction on above described building~,,~rmit meets alJ~licable codes and regulations. Apphca ................... Rev. 10-10-78 FOUNDATION (1st) FOUNDATION k. (2nd)' ROUGH FRAME & PLUMBIHG INSULATION PER N. STATE ENERGY CgDE ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1802 Examined/.~.~/.? .: .2-.'~.. ~'~ . , ........... Approvea ..... 7 ..........1~. Permit No ~¢F~ .................................. ; ~ ..... ~...~ ,. (Bnilding Inspector) ).PPLIC~T1ON FOH BUll. DING PEBM!T Application No .............. INSTRUCTIONS a. This application must be completely filled in 'by typewriter or in ink and submitted in triplicate to the Buildi Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according te schedule. b. Plot plan showing Iocation of lot and of buildings on premises, relationship to adjoining premises or public stre~ or areas, and giwng a detailed description of layout of property must be drawn on the dia~am which is part of this ap~ 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 pern shall be kept on the premises available for inspection throughout the work. e. No building shalI be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan shall have been granted by the Bui/ding Inspector. APPLICATION IS HEREBY blADE to the Building Department for the issuance of a Building Permit pnrsuant to t Building Zone Ordinance of the Town of Southold, Snffolk County, New York, and other applicable Laws, Ordinances Regulations, for the cons/ruction of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and buildings for necessary ' pections. (~ignature of a~l~ant, or name, if a cor~ .. ........... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build, Nmne of owner of premises . ~ .... l.Z, .... , ............................................ (as on the tax roll or latest deed) If applicant is a corp.orrfljion, signature of duly authorized officer. Builder's License No .......................... Plumber's License No ......................... ELctnclan s L~cense No ..... ,.<'. ........~.. ....... Other Trade s License No..': . . .'~k~:.~,-cz:7 ....... Location of land on which proposed work will be done ................................................ ..... .............. .......................... House Number Street Hamlet County Tax Map No. t000 Section . .~F.....O, .~7/. .... Block ...~.~. .... .Z..7. ..... ~ot ?.~. 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 ............ "3' ~ "~-- .... Z""W ........... T .......... b, Intended use and occupancy . ~. &ff.. ~/~Z~. '~~ ~ .......... .4 L Nature of work (check whict, applicablel New Building .......... Addition .......... Alteration .......... Repair ........... Removal ............. Dumohtmn .............. Other Work ............... r~ ~ (Description) ' Estimated Cost ............................................. ¢ ........... (to be paid on filing this application) ;. If dxvelling, number of dweiling units .. ~ Number o f dwelling units on each floor. If garage, number of cars ........................................................................ i. If business, commercial or mixed occupa acy, specify hatnre and extent of each type of use ..................... ~. Dimensions of existing structures, if any Front ............... Rear .............. Depth . .~..O .......... lleight .... {.~ ........ Number o!~ eries ....... /. ................................................ Dimensions of same structure with alter,, tions or additions: Front ................. Rear .................. Depth ...................... HeigI I ...................... Number of Stories ...................... I. Dimensions of entire new coostruction:h. ont ............... Rear ............... Depth ............... Height ............... Nnmbcr of S :eries ..................................................... t. Size of lot: Front ........ ~.ff ........... Rear ....... '~'-'.'~. ..... ' ....... Depth ....ff~. ................ Date o'f Purchase ............................. Name of Former Owner .................. , .......... Zone or use district in which prennses ar ~ s~tuated ................................... ' .................. Does proposed construction violate any: offing law, ordinance or regulation: . ~.~-.~.. j ....................... V/ill lot be regraded .......................... ... Will excess fill be renfoved from premises: Yes No Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect ........................... Address ................... Phone No ................ Name of Contractor ........................ Address ................... Phone No. ~ ~ff. 7~..-~.&'..,~.. PLOT DIAG RAM s, whether existing or proposed, and, indicate all set-back dimensions fi'om )r description according to deed, and show street names and indicate whether I. 1. L Locate clearly and distinctly all build roperty lines. Give street and block number terior or corner lot. r^TE OF N~V~..,Off~ ~,~., s.s ................................................. being duly,sworn, deposes and says that ke is the applicant (Name of indMdual signing cent 'act) )Ore 'llamed. e is the ......................................................................................... f said owner or owners, and is duly autho )plication; that all statements contained in · ork will be performed in the manner set for worn. to beforec:~7 ~m~s ...... · .,..".". ..... dayof .... otary Public JUDITH T. TERRY Notary Pubfic~ $~te Of New York No, 52-034g~6~ Suffolk Commiss[o~ Exl~ffes Contractor, agent, corporate officer, etc.) ized to perform or have performed tile said work and to lnake and file this this application are true to the best of his knowledge and belief; and that the hi the application filed t~;erewJth. ......... ,, ~- ~ (Signature of applicant) FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..~.l.qg~5 ......... Date ...... &p..r' .~.1..1.9. .................. 19.82.. THIS CERTIFIES that the. building ................................................ Location of Property . .2. O..1 35 ........... .B.a.y...A?.o.n. ?.e ................ .g.a2~.~. [i~.~.r.~o..n ..... House No. Street Hamlet County Tax Map No. 1000 Section . .qb .1 ....... Block .... '! ? ......... Lot ...0.0. ~ ........... Subdivision ..... ~ ......................... Filed M~ip No...X. ..... Lot No. X · conforms substantially to the Application for Building Permit heretofore flied in this office dated .3,q~U~,t..8~. 19 ~.1 pursuant to which Building Permit No. 11 ~1~48 ~ dated .... g.U/~:"W~t~'...:~ ,~.' . ........... 19 '~:'f., 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 privato one-f atollX dwellingS. The certificate is issued to Reno (Jendron (owner, of the aforesaid building. Suffolk County Department of Health Approval ..... !~/.r. ................................. UNDERWRITERS CERTIFICATE NO. n/r Building Inspector Rev. 1/81 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Halt Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and subr~itted in duplicate to the Building Inspec- tor with the following; for new buildings or new use: I. 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 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 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: I, 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 Date.. New Building ............ Old or Pre-existing Building(Z) :~(. ....... =/Vacant Land 'i ............ Hou~ No, -- Street [ Ham/et Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. [~ 3ff~X~ Date ofPermit ?J~:/¢/.Applicant .... .O~.~; ................. R~( pt App Health Dept. Approval ........................ Labor De . roval ......................... Unde~riters Approval ..... ~/¢. ............... Planning Board Approval .................. ~ .., Request for Temporary Certificate ..................... Final Certificate ........ - ......... - Fee Submitted $ ............................. Construction on above described building and permit'meets all appl~cable~codes and regulations. Applicant. .................... .. :'.. ,.v.,o.,o_,. /oq¢5