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Home My WebLink About11442-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ..... .Z 3.6.~.8. 2. ...... Date ...S.e).~. e..m.b.e.r...~ .7., ................ 198.6.. THIS CERTIFIES that the building construct deck, add to kitchen & alteration Location of Property 105 Old Harbor R'oad New Suffolk,. N.Y. House No. Street Ham/et County Tax Map No. 1000 Section . .1. 3,. 7 ....... Block ...q 3. .......... Lot ...0. Q J ........... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated S ~ p g.exal~ ~ r..8. ~ ......... 19.8. ~. pursuant to which Building Permit No... 1 J .4.4.~ g ............ dated .0. c..~.o.b.e. ~...3.(3. ,. ..............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 ......... c q~.t.nug.~. Ac. 9 ¢.,..~¢0..~.Q. ¢~-.6. qb~..~. ~..6. e. r ~.~.%9r3..~.q.e..x.~.s. ~..~.ng..d.v.e.~.%i..rig ..... The certificate is issued to .... Virginia L. Wickham ................ .................. of the aforesaid building. Suffolk County Department of Health Approval ~ /A UNDERWRITERS CERTIFICATE NO .................. ?end ina Rev. 1/81 Building Inspector FO]~M NO~ TOWN O~ BuILDiNG TOWN SOUTH'OLD, N~ Y. BUILDIHG ~E~IT( (THIS PERMIT MUST BE KEPT ON THE PREmIsES COMPLETION OF THE WORK AuTHORIzED) UNTIL ~ULL N°. 111442 Z Dote Permission is hereby granted to: ~ ~./,.. · ........ x:~.~.....~..,x.i ............. i....i ................ Coul~ty TaXx Map No. 1000 'Section .'.,../(./..~,, ...... ,. BlOCk y..~.~',,~ ........ Building Ifispector. ........ Rev. :6/30/80 lot No. (..,J,O.-/- ........... and gpproved by the FORM NO. 6 TOWN OF SOUTHOLD Building Department, Town Hail Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Thia alBplication must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the foliowin[T; 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 o? 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 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, ,' 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 Date ..... , , · New Building/~.tJ¢. :l~.~.~.OJ~Oid or Pre-existing Building(X)., ........ ~/Vacant Land i ............ co. ,v 00o ...... . ........... . .1 ............. Subdivision ....... ~ ...................... Fi~ed Map No..,; ....... Lot No .............. Health Dept. Approval ........................ Labor Dept, Approval ...................... ,,. Unde~riters Approval . .¢ ............. Planning Boar royal ................ Request for Temporary Certificate ................. . .... Final Certificat~ . Fee Submitted $...O.~ .................... Construction on above described building and permi'(meets all app~cabl~_~codes and regu ations, Applicant ~ ~:..~ ...... '. ~ ............ . ..... Rev, 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF-ELECTRICITY :~-(T00343 ES JOHN STREET, NEW YORK, NEW yORK 1OO:~S ~ Date Application No. on file ~' T.,S ~E.'r~' ~.9, ~.9~ ~0~;~ N 77027 5 ordy the electrical equipment os described below and introduced by the applicant named on the above application rramber in the premises of Henry ~ichham, Private road off O1¢% Harbor Rd, Peoonio Bay & 0~(~~ Harbor Rd, New Suffolk,NoY in the following lacatlon; ~ Basement ~ Ist FI. [~ 2nd Fl. ~ Section Block Lot was examined ot~pt~l~ 15 t 1986 and found to be in compliance with th~ require nents o.( t/tis Board. FIXTURE 22 FIXTURES ~¢~t~ 22 14 ~2 -- DRYERS FURNACE MOTORS ~UTUBE APPLIANCE FEEDERS SERVICE DISCONNECT NO. OF S RANGES__ 1 10. ~ SPECIAL REC'PT R TIME CLOC~KS BELL UNIT HEATERS MULTI-OUTLET EXHAUST FANS DIMMERS A, WO OF NEUTRAL Goodale Electrical Cont. 7355Main Road Mattttuck,N.Y 11952 LIO# 783E This ~ertificate must not be altered in any manner; return to the office of the ~oard COPY F, OR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE GEI~ERAL MANAGER may be ide~tlfJed by their credentials. BE AL 'ERED INk, ANY MANNER. FIELD INSPECTION · FOUNDATION (1st) FOUNDATION (2nd) 2. COMMENTS ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CpDE FINAL ADDITIONAL COMMENTS: Regulatory ~fairs Bldgo 40~ SLR~f - Room 219 '" Stony Brook, New York 11794 (516) 751-7909 Cormmissioner September 17, 1981 Donald A. Denis P.O. Box 565 Aquebogue Square Aquebogue, New Yo~k 11931 For:Henry Wickham At: Old Harbor Road New Suffolk Town of Southold Suffolk County, New York Suffolk County Tax Map ~10000v 117-3-1 Construction of 14 ~ 1.f. wood deck onto easterly side of exipting house and 25' x 43' (approximately) one story addmtion on northerly side Dearsir: As a res~zlt of your inquiry concerning th~ above referenced oarcel~ this Department has conduct~d an on-site inspection° ~ have folmd f~he .x~x~xmxx (project) to be landward of 10' in elevation above sea level. Therefore, pursuant to Part 6~o1~ Official Compilation of Codes~ Rules and Regulations of the State of Iq~ York~ Section 661o4(b)~ no permit under .Article '25 (Tidal ~,L=tlands) of qbe Fnvi ~rorm~ntal Conservation Iaw is r~q~lgred. There is to be no placement of structures or material or change to topography below 10' in elevation ~n this parcel with- out additional application and prior approval. P~g. ional Permit Administrator FORM NO. 3 ~' TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ Date ................. , ..... PLEASE TAKE NOTICE that your application dated ................ ~'{:~!?....,~19 .~f.}.., for permit to construct ....... /%':L~.~ :'~ · .~. ~ ~ ...................................... at Location of Property ....... I. lO. ~. ~)l,~ /Jg~t~'i~O~-~,,. ~t¢~"~ }[/[' ~ ~U~OL~ House No. ' ................. County Tax Map No. 1000 Section ...... t. ['~¥... Block .. Lot Subdivision ................. Filed Map No ................. Lot No .................. is returned herewith and disapproved on the following grounds ....... )'{;9... ~.p~.q¥~ ~'. .... ..... ~[)~ ...... ~ ( C :~ ........ , ~ ......... ~'~' ' ~ ..... ~'"~" ................ ~ ........ Building Inspector $.%3 C~ 40 ~. ~ $ WM. i 0 t~ 0 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL,: 765-1802 Examined . .~....~. ....,19.~?. Approved ~ .O....~..~..(-~. .... , 19~../~. Permit No., ~/.¢ Disapproved' a~l~.~/- ~ i~t ............... ~ ~ .................. . .... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No //~. a. Tills 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 description of layout of property must be drawn on the diagram which ispart of this cation. c. The work covered by this application may uot be commenced before issuance of Building Pem~it. d. Upon apprc,'al 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 throughont the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan sh~l have been granted by the Building Inspector. APPLICATION 1S IfEREBY MADE to the Building Department for the issuance of a Building Pe~it 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 to comply with all applicable laws, ordinances, building code, housing code, and regulations, ~d admit authorized iuspectors ou premises and in buildings for necessa~ inspections. ...... '" ' .-sr.. Stat~ M~th~r appIicant is owner, l~ss~, agent, architect, engineer, g~neral contractor, electrician, plumber or bnild, ....... oe.e .......................................................................... (as on the tax roll or latest deed) If applicant is a corporation, siguature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's Licens: No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................................ House Number Street 1 County Tax Mat, No. 1000 Section ...~.l.t .......... Block ..3 .............. Lot...I ............. 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...~"S ~..~..~'~,.~ 71~. I .... t~,&~:l:P4'~ .~.,9,!.[,U~. ........................ b. Intended use and occupancy . I ~ '*~" ' '" NatureI of work (check whicl~ applicable): New Building., ......... Addition .......... Alteration . .~.. i .... Repair .............. Rembval .............. Dt. molition .............. Other Work .............. (Description) ' Estimated Cost (to be paid on filing this application) ;. If dwelling, number of dwelling!units .... { ............ Number of dwelling units on each floor ................ lfgarage, numberofcars ..~; ................................................................... h Ir busihess, connnercial or mixeit occupancy, specify h~tnre and extent of each type of use ..................... ~. Dimensions of existing structur{s, if any: Front ............... Rear .............. Depth ............... Height Number of Stories Dimensions of same structure with alterations or additions: Front ................. Rear .................. ' Iteight Number of Stories Depth .................................................................. ~. Dimensions of entire new construction:. Front ............... Rear ............... Depth ............... · ' Number of Stories Height ...................................................................... ). Size of lot: Front .......... i ............ Rear ............... · .......,,Depth .. ). Date 6f Purchase .......................... :.. Name of Former Owner ~.~"~i~.~. I. Zone or use district in which pr~mises are situated ..................................................... --! 2. Does proposed construction vJoiate any zoning law, ordinance or regnla~ion: ................................ ~. Will lot be regraded .= ........................... Will excess fill be removed from premises: Yes No · .Name of Owner of,li~emises~., ~.,~ iC~'~ll~Addres;s ~ll&~ll~l~. J~. Phone No."~.~,,t~}~.~.. Name of Architect .I,~.1~.~41~..~1,~ l'11},,~ . Address~U~lld~lf*~, . .~. Phone No. '~,~,,,~ .~,,~.~.~. Name of Contractor Address Phone No PLOT DIAGRAM [.ocate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from roperty lines. Give street and block,number or description according to deed, and show street names and indicate whether .terior or corner lot. ~' duly sworn, deposes and says that he is the applicant e is the ..... , ................................................................... : (Contractor, agent, corporate officer, etc.) f said owner or owners, and is duly authorized to perform or have performed th~ said work and to make and file this 3plication; that all statements contlained 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 b~fore me this ...............///~/~ / ~/~'Oa~f'~~ ......... 19~ ota~P~bhc, ~~. County '~~ ~ ~'~&~'(Signature of ~'~ ~ ~ ',~ ~r~ 30, I0~ ' ' ' ~2-428~9~0 - 8~lk ~u~ ...... / A~PP.G~_D AS '1 &$