Loading...
HomeMy WebLinkAbout11364-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-12082 Date: 11/25/83 · ~{IS C~TIFIES that the building ADDITION Location of Property: 670 RICHMOND RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map NO. 473889 Section 51 Block 6 Lot 10.1 Subdivision Filed Map No. __ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated pursuant to which Building Permit No. 11364-Z dated SEPTEMBER 9, 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 A SCREENED PATIO ADDITION The certificate is issued to WILLIAM H MULLEN (OWlqER) of the aforesaid building. S~-FFOLK COU/FrY DEPARTMENT OF ~RALTHAPPROVAL ELRt-rRIC~%L C~aTIFICATE NO. PLUMBERS CERTIFICATION D~£~ Rev. 1/81 N/A N/A N/A //riz/ Sig ure FOEM NO. 2 BUILDING 'DEP~R*MEN~ TOWN )HAL~ BUIL~NG P, EP~iT. (THIS PE~IT MUST BE KEPT ON ~H,[ PREMISES UNTIL COMPL~ION OF THE WORK AUTHORIZED} Per~nissior{ is hereby granted to: Date JLL 19....?/./ a.;" ~ ~'~,rem.se~ located at · ...... ~ ......... , ........................................... , ........................ :.;.....; ...... .; ....... ....... ; ~ · ............ ~ ................ ~ ................ ?~ ...................................... CouoW To~ Map No. 1000 'Sectio~ ~...~ ? BIO . . ;...L. 0t No '.~ i, ne ;~ ann cat on dated . ~*~ ~/ ~ '~, and ~pprovO by the Building laSpector. Inspector ? Rev. 6/30/~80 L FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y, Certificate Of Occupancy No. Z12082 Date . November 25 ................................................. 19.8.3. THIS CERTIFIES that the building --screen ~.a.~..i.e. Location of Property 670 Richmond Road Southold I~S'e ~01 ........................................................ Street Hamlet County Tax Map No. 1000 Section .. 9.5.1. ...... Block ...0.6 ........... Lot . .0.0.9.-~ 0..1.0 .... i. '.~- Subdivision .... X ...... Filed Map No. X .Lot No. X conforms substantially to the Application for Building Permit heretofore filed in this office dated .... A.u.g.u.s.t...3.1 ........19.8..lpursuant to which Building Permit No....1.1.3..6.4..Z. .......... dated ..... S..ep.t.e.m..b.e.r..9. ..........19.8..1, 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 screened patio addition. The certificate is issued to EDWARD L. HOFEMAN (owner,-fc'~ee' o~t~n'O of the aforesaid building. Suffolk County Department of Health Approval .... .N./.A. .................................. UNDERWRITERS CERTIFICATE NO N./A . Rev. 1/81 ,~uilding Inspector FORM NO, 6 TOWN OF SOUTHOLD Buiidlng Depar~men~ Town Hall 8outhold, N.Y, 1 i@71 APPLICATION FOR C~RTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and subn"fitted in duplicate, to the Bu ding In.;pec-. tot wi~h [he following; for new buildings or new use: 1. Final survey of proper~¥ with accurate location of all buildings, property lines, streets, and unusual ' natural or tonograoh c fa:lures. 2. Final approval of Health Dept. of water supply and sewerage disposa -(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial bu Idings, Mull pie Residences and similar buildl.ng.~ and instal!a. lions, 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 April 1957}, Non.conforming uses, or buildings and "pre-existing" land uses: 1. Accurate ~rvey of peoperty showing all property lines, ~treets, 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 ar safety inspection of buildings or prernises~ 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 tand use 85.00 3. Copy of certificate of occupancy $1.00 Date .. OctQ]o. er 11, 1983 New Building Old Pre existing Sui~ding(X) X Vacant ............. or - · / Land Location of Property ..... .Rich~c~l. R,o~Q],. ~qu~bP~.. ~¢~ .~9~..~7~ ..... .. ~ .. ......... Hou~ No, Street Ham/er Owner or Owners of Property ~d~a=~ ~ 9lock .... · .................. F~d Ma~ ~o. ,. ~ ..... Lo~ No( P it No " erin ..... Da.e of P ~ -~ :.... Health Dept Approval ........................ Labor Dept. Approval ...................... Underwriters Approval ........................ P~anning Board Approva~ .................. Request for Temporary Cerdfica~e ' ' ..................... Final Certificate . ~ ..... - ......... Fee Submitted S ~..5, QQ Construction on above described bu i[ding a%¢~rm'j f mee~s all app~cabl~o~ and regu laHons. ~,, ~o ,o ~ Rudolph ~[.//Bruer, Attorney for FIELD INSPECTION COMMENTS FOUNDATION (lst) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY FINAL ADD~ITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1802 ^pprovea .... f/ ...... , Permit No ..... Disapproved a/c ....... :'. ............................ ~ ~/ (Bu)diti~nspe~tor) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No./../-~,q ~ ....... Date ................ , 1 a. This application must be completely filled ill 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 to schednle. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stre~ or areas, and giving a detailed description of layout of property must be drawn oil the diagram which is part of this apl: cation. c. The work covered by this application may not be commenced before issuance of Building Pemfit. d. Upon apprc'.'al of this application, the Building Inspector will issue a Building Permit to the applicant. Suc~p.ern shall be kept on the premises available for inspection tl'.roughm~t the work. e. No building shall be occupied or used in whole or in part for any pnrpose whatever until a Certificate of Occupan s!'.all have been granted by the Building Inspector. APPLICATION 1S HEREBY MADE to the Building Department fol' the issuance of a Building Permit pnrsuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees t.~ comply with ail applicable laws, ordinances, bui~ng code, housing code, and regulations, and a dlnit authorized inspectors on premises and in buildings for necessary~ .... ;(_' ~ ~-' ~L' '' '~' .......... (Signature of applican'[, or name, t~ation) .../~'~-'.. 3 .>. ,'.... ,.C'~..,v....~/Z,:z~.."¢m~....~ "_~M.. (Mailing address of applicant) /,t,~/,)t,~ State whether applicant is owner, lessee, agent, architect, engiueer, general contractor, electrician, plumber or build, .... .~..~.~,...~4..,~-.... C~...,~..~, .: ,~. ~ ............................................................. Nmne of owner of premises . ~7~..~.,~-.~.~. .../--~.. /"~. ,~..,,~: .... .,'~..~. ................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly anthorized officer. (Naure and title of corporate officer) Builder's License No... ,~..~...7. ............... Plmnber's License No ......................... 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 ~.67/.7.T .~../.~.). ..... Subdivision ..................................... Filed Map No ............... Lot .............. (Name) State existing use and occupancy of premises and intended use and oecnpancy of proposed construction: a. Existing use and occupancy/4"/~,"~'. ~-?~" ~' 2~&~/d~)~..~.~ ........................ ·...ff.~./. ~'.,i~ ............. b. Intended use and occupancy ............... <~.~..~ff..c~_~..' ..........................