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Home My WebLink About11416-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building ................................................ Location of Property .1.5. 0. ............. .B.a.y¥.~.e.r...~?.e.n..u.e ............. S.o..u.lz.h.o. ]:..d ...... House No. Street Ham/et County Tax Map No. 1000 Section . .qT.s ....... Block . .0.3. ........... Lot ...0..2.2 ........... Subdivision ..... ~ .......... -: .............. Filed Map No...X. ..... Lot No....X. ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ·.. 99.t.9 .b.e.r..8. ........ 19 .8.1. pursuant to which Building Permit No... 1 .q .4.1. 6..Z ........... dated ...Oc.t:.o. ber..8. .............. 19 1~.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 ......... The certificate is issued to ...... NANCY· .S.,. GR]~$[N.O. ................................ (owner, lo~,oe.~t~te~o~t). of the aforesaid building. Suffolk County Department of Health Approval ..... .n/.a. ................................. UNDERWRITERS CERTIFICATE NO ............. .n/.a. ................................. Building Inspector Rev. 1/81 TOWN OF BUILDIN~ DEP~RTMEN~ ' TOWN HALL SOUTH'O~D,' N~ Y. N? i141~ Z BUILDING PER~IT ; (THIS PERMIT MUST BE KEPT ON THE PP, EMIS~S uNTIL ~ULL COMPLETION OF THE WORK AUTHORIZED) Dote ..~c~ai~ .~.....~ .......... , ,9~f Per/nission is hereby granted to: · .......... ~~.. ~.~.~.~....~ ................ ~. ,o ..~....~..~~.~z:......~....~.~~......~.~.~ ............ ................ , ........... _~~ ....... , ........ ~.~_~...~....~~...~ ....................... at p~omise~ located at ..Z~[~... ...... ~.~7.~r~&~7.,~&a...f....~...~arg~&,~ Co.n ~x ao ~o. 10o0 s~ct,on ...~.~ ....... . ..... Block ,,..~.~ ........ kot ~o ......................... pars;ant {0 application dated ...G~[O.~.]...~;;....[....., i9.~, and bpproved by the Bu~MIng IOspector. ~ Rev. 6/30/80 : ' " FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Halt $outhoid, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and subr~tted in duphcate 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 fe3tures. 2. Final approval of Health Dept. of water supp y and sewerage dispose --(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings Industrial buldings, Multple Residences and similar buildings and installa- t OhS, 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 A;pril 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all prooerty lines, streets, buildings and ~nusual natural or topographic features. ' 2, Sworn s~atement 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. / - 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 Date.. New Building ............. Old or Pre-existing Building(Z} ......... =/Vacant Land ............. Location of Property .............. House No. $~ree~ ' Ham/et Owner or Owners of Property County Tax Map No 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No. ·.: ....... Lot No. ' .......... Permit No. 1[-. ...... Date of P~rm ............. App ,. ??. ' Health Dept. royal .... Labor Dept, Approval ...................... Underwriters Approval ,/')'L~. ~ ,~ ................ Planning Board Approval .................. Request for Temporary Certificate ' Final Certificate Fee Submitted S ............................. Construction on above described building arid perr~it'r~ee~s all appl,~cabl~odes and regulations. FORM NO, 6 TOWN OF $OUTHOLD Building Departmen~ . . Town Hall $outhold, N.Y. 11371 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and subn~itted in duplicate to the Building lnspec. tot 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 topograohlc features. 2. Final approval of Heaith Dept. of water supply and sewerage disposal--(S-9 form or equal). 3. Approval of electrical installation from Bobrd of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar ,buHding~ 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 requi{ements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildinas and "pre-existing" land uses: 1, Accurate survey of peoperty showing all prooerty 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 / /S 2. Certificate of occupancy on pre-existing dwe ting dr land use 3. Copy of certificate of occupancy $1.00 / 5.00 Rev, 10-10-78 New Building ............. Old or Pre-existing Building(,X) .. ......... ~ /Vacant Land -, ............ Street Ham/et Owner or Owners of Property .% ..................... County Tax Map No..lO00 Section . ,~]~. ,.~ .... Block ...~. ;~,.. Lot..~',~ .... Subdivision ................................. Filed Ma~'No ........... Lot No .............. Permit No ........... Date of Permit ........... ~pplicant ...................... ] ........... Health Dept. Approval ............. ~ .......... Labor Dept. Approval ...................... ~.. Unde~riters Approval ........................ Planning Board Approval .................. ~ . .~ Request for Temporary Cart f cate .... Final Certificat~ Fee ~ubm tted S - ~ ' ~-~ ~ Construction on above described building and per'ir'meets all aPp~eabl~o?s and regulations. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 March 11, 1983 To Whom It May Concern: Please be advised that the Town of Southold has no record of a Certificate of Occupancy for property located at 1000-078-03-022, currently owned by Nancy S. Grissino, ether than C.O. Zl1452 for new cellar and alteration to an existing one-family dwelling, and C.0. Zl1453 for an accessory structure. The original dwelling apparently pre-exists our Zoning Ordinance. Sincerely, Curtis W. Horton Building Inspector CWH:ec FIELD INS?EC~ON~ FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY FINAL O~,L (' 0 ADDITIONAL COMMENTS: vtLS~-f~ ........ ~ -- ~ ~Z_/ - FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765'1803 Application No ............... 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 to schedule. 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 descriptiou of layout of property must be drawn on the diagram which is part of this apF 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 buildiug shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan shall have been granted by the Building Inspector. APPLICATION 1S HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to t Building Zone Ordinance of the Town ~)f Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, fbr the construction of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply with ail applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) · ........ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build (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.../.~.~.. ' ........... Plumber's License No..~ ................. Electrician's License No.' . ~ ................ Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................................ .... :"//.. t'..~.o .............. ~.,4fa,~..'r~ .~...~.e~.- ........... .---¢~e ~ .,¢+.~ ............. , ........ House Number Street County Tax Map No. 1000 Section .... I~. ~.~. ........ Block .... .~..). Subdivision ..................................... Filed Map No. (Name) Hamlet ,-. ......... Lot ................ .............. Lot .............. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... /~ .~:.~. L ~2~:,~. T'/../~. ............................................. b. Inteuded use and occupancy ......... &,~. t>.~..~. .~.~.,r..~....~..-C¢(q ~..~.~. ................. ............ 3. Nature of work (check which applicable): New Building /-'/ Addition Alteration . Repair .............. Removal .............. Demolition .............. Other Work ............... ~ /(.~. ~ (Description) Estimated Cost ......... .~. t~'. ~. ....................... Fee ................... ~. ........... .' (to be paid on filing this application) ;. If dwelling, number of dwelling units ............... Nmnber of dwelling units on each floor ................ If garage, number of cars ........................................................................ i. If business, commercial or mixed occupancy, specify hoture and extent of each type of use ..................... ~. Dimensions of existing structures, if any: Front ..... .' ......... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Stories ...................... ~. Dimensions of entire new construction: Front ..... /.f... ...... Rear .... t:. ~ ....... Depth . .t~-,- .......... Height ...... t..~. ...... Numb~er of Stories .... /. ............ ., ............. ............ v .......... Size of lot: Front ....fy...~C-~,.,.4L~.'i.;. .......Rear..../.-% ¢'.-. ~ .......... Depth ,~.41d.2_~.~'..~..~/.~:.'~."if.. Date (if Purchase ..... ~./4 [7/. ~.'~'. .............. N~me of Former Owner /~e~¢~..7-.../:.¢?.-5..T.,¢/~.. ....... Zone or use district in which premises are situated .,~. &,~t.P. &.4/.72z~.~ ...... Does proposed construction violate any zoning law, ordiaance or regulation: . i/~2~. Will lot be regraded ... ~.tT....' ................. Will excess fill be removed from premises: Yes Nd,ne of Ox ncr of prem~ses~/~.,q~.tg.'~:(~.t.441t~.~... Address ~t4.g/Va-T~,at,,4/t'~,, ...... Phone No ~.~. $-~ ~ ~ Name of Architect ...* ........................ Address-- ................... Phone No ................ N:m~e of Contractor ~ . Address ................... Phone No ................ ). 1. 3. I. PLOT DIAG R,~M Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from roperty hnes. Give street and block number or description according to deed, and show street names and indicate whether terior or corner lot. 'fATE OF NEW YORK. , outcry OF...~.U.~. ;r..&&.r.... s.s .... ' .¢.1.C.T.~.g.... g r. i. ~.. (.N..0 .................. being duly sworn, depo,~es and says that he is the applic,*nt (Name of individual signing contract) )ore named. e is the (Contractor, agent, corporate officer, etc.) f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this )plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the 'ork will be performed in the manner set forth in the application filed therewith. worn to before me this ....................... day of ...................... · ~o. ~2.~2.~m ..... '.. ~.~..~~ ........ Qualified In Sufiolk Coun~ gommission ~pires March 30, 19~ (Signature of applic~t) OF I:ICClJ~A~C¥ oi ,~4x 4° /2/47 , BUIED~NG DE~RT~F~ CODES, NOT RESPONSIBLE DESIGN OR CONSTRUCT ON ERROR~