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HomeMy WebLinkAbout11287-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...Z.1.3.3.1..4 ......... Date April 2 ]9 85 THIS CERTIFIES that the building ....P. qq.1.. (&...F.e.n. qe. ) ............................ Location of Property .4.7.5 ................ C..1 .e.a.r.v. ~_ .e.w..A. y .e.. .............. S..o.u.t.h.o..1.d.... House NO. Street Hamlet County Tax Map No. 1000 Section . . .qT.0 ...... Block .... 9.8 ......... got ...0.3.7 ........... Subdivision.. ,F.o, ir.v/.~W. ~.~z21~ ............. Filed Map No..3.3.8..8., .Lot No..1.5 ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .J.u.l.~( ..... 1. 7 ..... , 19 .8.1. pursuant to which Building Permit No. 11287 Z dated ...... .J.u. ]..y .......... .29 ..... 19 .8.1., was issued, and conforms to all o f the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... .I.n. qr. 9.u.n.d' .P9.o. 1..w/ Fence The certificate is issued to DePETRIS, WAYNE & KATHLEEN ..................... ?o¥/& ...................... of the aforesaid building. Suffolk County Department of Health Approval .......... I~I,/A. ............................ UNDERWRITERS CERTIFICATE NO ................. N 684766 Rev. 1/81 Buildlng Inspector FOZ.~ ~0. ~ TOWN OF $OUTH~L TOWN HALL SOUTHOLD, N. Y, ~O N. 1'1287 Z Permission is hereby granted to: BUILDING, P, ERA4!T! ~iS~ (THIS PERMIT MUST BE KEPT ON THE PRE~ ~S UNTIL F~ULL COMPLETION OF THE WORK AUTHORIZED) Dote .....1 ..... · "~" ................. , ]9. ................ , ................................................... ..., ......................... ~...,~..,....,~ ....... ~ ............ .............. ,,~ ~, ~'"'~-':~ .................... ~ -~.~.. _ , ...~ ....... .~Zz6(.O.../_.2. ..... ~,pW T:x Mop No. 1000 Section ..~ ..... Black ? ....... ~:mt No..~.Z ........ pu{s~ont to application dated ..... ~?'"'"~'7 ....... ...:...;~...... :~Z end approv~ by the ~u~[ ln~ Inspector. / ~of I [ ~ 3 ~' ' Building Ink.tot FORM NO~ 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. 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. Fina~ approva~ of Hea~th 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 buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. §. 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 p~t~perty 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- t~on required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 $15.00 ~,~ate ...................... New Building ............. Old or Pre-existing~uilding ............ Vacant Land ............. Location of Property ........... ~.;~ ./,~./...~. Y.~.. / (?. ~'.)... House No, Street I Hamlet Owner or Owners of Property .~.~.'~..../~..'(-..~'2~7.?-.%¢~...~-~. .~..~.~. ............. County Tax Map No. 1000 Section ...¢-~.7..O ....... Block ... ?...~. ....... Lot..O...~.'l ........ Subdivision ................................. Filed Map No ........... Lot No .............. I [ ~-~r~z:~ it .~,\52.0/17~,I Applicant Permit No ........... Date of Perm .................................... Health Dept. Approval . . .~0~ ................. Labor Dept. Approval ........................ Underwriters Approval..~...~..~.~..q.~. ........... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .. ~ ................... Fee Submitted $ ~ ......................... / ,,'3 Construction on above described building and ,~rj~i, meets aJi/p~c,~_ ,~c~es and regulations. k~-'~ '7V'~ Applicant...~...~.~., . . .~..~/~ ............... 2.o qqq / Rev, 10-10-78 FIELD INSPECTION ~ 1. FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ~ODE COMMENTS FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.', 765-1802 D~sapproved a/c . . . i~ ....... ' ' ' ~~ ~*1 (~ ~ ~PLICATION FOR BUILD1NG PERMIT Application No..~O~. / ....... INSTRUCTIONS a. Tlus application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buddi Inspector, w~th 3 sots of plans, accurate plot plan to scale. Fee according to schedule. b. Plot Flan showing location of lot and of bmldmgs on premises, relationship to adjoining premises or public stre,' or areas, and gwlng a delalled description of layout of property must be drawn ou the diagram which is part of this apt:. cation. c. The work covered by this ppplication may not be commenced before issuance of Building Permit. d. Upon apprc.'al of this application, the Building Inspector will issue a Building Penmt to the applicant. Such pern shall be kept on the premises avalhlble for inspection throughout the work. e. No btuldmg shall be occupied or used in whole or m part for any purpose whatever until a Certificate of Occupan shall have been granted by the Building Inspector. APPLICATION IS IIEREBY MADE to the Building Department for the issuance ora Building Permit pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances R~gulatmns, for the construction of buildings, additions or alterations, or for removal or demolitioq, as herein describe Tl.e apphcant agrees to comply with all applicable laws, ordinances, buklding code, housing code/arid regulations, and admit authorized inspectors on prennscs and in buildings for necessary i~r~ections / J / / ................... ,/'.%51<..: ............. (Sig~}~ture of applicant, or name, if a corporation) State whether applicant ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build (as on the tax roll or latest deed) If applicant ~s a corporation, s~gnature of duly authorized officer, (Name and hdc of corporate officer) Builder's License No ....... ~ ................... Plmnber's Licens0 No ...... ~ ............. Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .... ~ .[.~3.~.. ~ .~ .............. Itouse Number Street Hamlet County Tax/vlap No. 1000 Section ..Q .~...Q .......... Block ....o..?. .......... Lot...~5. ~..~. ........ Subdivision .~5~ ...................... Filed Map No .~ ~. ~7~ .... Lot...~.~ ........ (Name) 2. State existing use and occupancy of premises and intended usc and occupancy of proposed construction: b. Intended use and occupancy 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Remloval~ .............. Demolition .... ~ ......... Other Work. ~?.~-,~..c~ ..... . (Description) lY. stmmted Cost ........................................................... ~ ........... (to be paid on filing this application) ;. If d~velling, number of dwelling units .. I Number of dwelling units on each floor If garage, number of cars . , .................................................................. i. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... t. Dimensions of existing structures, if any: Front ..... Rear .............. Depth .............. tleight Nu~)ber of Stories' Dimensions of same structure With alterations or additions: Front ................. Rear ................ Depth ...................... Iteight ...................... Number of Stories .................... ~. Dimensions of entire new const,ruction' Front ............... Rear ............... Depth ............. Height ............... Number of Stories ...................................................... /. Slzeoflot:Front .../...o7~. .............. Rear .... .t...c? ............. Depth ... ?. ............. ). Date of Purchase .... ~. ! ~ ............... Name of Former Owner ...~--~5'¢v¢.-._ ........... I. Zone or use district in whid-h premises are situated ..................... y. T ........... !. Does proposed construct on v o ate any zoning law, ordinance or regulation: .... ~. Will lot be regraded ........ ' .................... Will excess fill be removed from premises: ?¢ ff-.~Yes ~, tNo ~. Na~ ~e of Owner of prom s,'s . Address . Ph e .~..~.' ./.. ....................................... on No ...... Name of Architect ......... . .................. Address ...... ' .... · ......... Phone No ................ Name of Contractor Address Phone No PLOT DIAGRAM Locate clearly and distinctly ali ou'Idings, whether ex/sting or proposed, and, indicate all set-back dimensions from roperty lines. Give street and blockI number or description ac~_c_ording to deed, and show street names and indicate whether terior or corner l_ot. TATE OF NE~Y"~Rb;,Z. '(}~,~'o'~i'~'~1 siglling contract) ''' )ove named. being duly sworn, deposes and says that he is the applicant (Contractor, agent, corporate officer, etc.) f said owner or owners, m~d is duly authorized to perform or have pet;formed the said wink and to make and file this ~plication; that all statements con[ained 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 h~ the application filed therewith. worn to before me this ....... day o . ....... , 1 . .Public, . ........ ' .... County C/ [10{~R{No. 52-8125850,PUBLI0~ StatSSuff01kOf N0Wt?,ou~j~''~'-YIN'fl ........ ~/'' '''~/ ...... iSignature of applic:~nt) iTerm Expires March 30, 19,, ,'~, FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 TEL,: 765-1802 Examined ................ , 19... Approved ................. 19... Permit No ............ Disapproved a/c ' Applicabon No ................ (Building Inspector) APPLICATION FOR BUILDING PERMIT _Z' ' a. This application mtyt be completely filled in by [ypewriter or in ink ~d submitted in t~plicate to the Buildi Inspector, with 3 sets of pl:~s, accurate plot plan to scale. Fee according tc scl~dul . b~ Plot plan ~howin~ ~on or lot and of bmldings on premises, r~lat~stfi[ to adjoining premises or public stre~ or ar~as, and giving a d~tmle~ description of layout of property must be d~wn on the diagram which is part of this cation. ~ / c. The work covered by th~ application nfay not be con~nenced befof issuance of Building Pc~it. d U )on apprc al of tlnshs aaI~)hcation thc Building. Insp~ctor~ will. ..... ~is ~e a Building Penmt to ~ethe ap¢licant. Suc ~ pen e. No budding shall be oCCUlted o~ osed m whole or in pa~ for afiy purp¢~hataver m~cate of Occupan ~PLICATION IS IIEREBY M~DE to the Building Depa ~ issu~i~ Pe~Jt pursua~ Budding Zone O~dmance of the To?~ of Southold, Suffolk C y~b~s~inan~ Reg.dations, for th} construction of ~"~ddings, additions or al or removal ~2i 3n, ~ herein descr The apphcant agrees to comply with al~applicable laws, ord :e, housi: e, and admit authorized inspectors on p~emiscs at~d in buildings for (Mailing ration) State whether applicant is owne~, lessee, agenl itect, or bmld ........ ~..x.3..~.~ ..... .~ ,~,~,ne of o,~ner of,,~o,n,,es. ~.~ .h.%~ .... ' ~ ~..~.~ ~'.b. ................... . ............. .... '('a~'the tax roll or latest deed) If applicant Is a corporat:on, signature authorized officeXr~ (Name and o,f corpo Builder's License No .... er) '~ Plumber's License. No ...................... Electrician's License N, . ...... Other Trad~'s ............... Looat, n of,a,,d o,' ;,osed work will be done.."~., k...~ .'~..~m~. ~ .... .~. .................. ........ .......................... ............................. House Number Street --k.~,Hamlet _ (Name) ........ ....... State exis ing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .. . b. Intended use and occupancy .~..~-) L Nature of work (check whicl, applicable): New Building .......... Addition ........ Alteration .......... , P, epair .............. Removal .............. Demolition ............ Other Work .~ .~. c.>o .. (to be paid on filing this application) ;. If dwelling, number of dwellina units .............. Number of dwelling units on each floor ...... If garage, number of cars .... ! .................................................................. i. If business, commercial or mixed occupancy, specify hature and extent of each type of use ................... I. Dimensions of existing sta~ctur~s, if any: Front ............... Rear .............. Depth ............. lleight ............... Nulhber of Stolies ...................................................... Dimensions of same structure with alterations or additions: Front ................. Rear ............... Depth ................... ~.. Height ...................... Number of Stories .................... /. Dimensions of entire new construction: Front ............... Rear ............... Depth ............. tteight ............... Nmi~ber of Stories ...................................................... ). Sizeoflot: Front .......... : ............ Rear ............... ' ....... Depth .................... ). Date o'fPurchase .......... ~ .................. Name of Former Owner ............................ I. Zone or use district in which pr~mises are situated ................................... ". ................ 2. Does proposed construction vidlate any zoning law, ordinance or regulation: ........ ~ ...................... t. Will lot be regraded ........... Will excess fill be removed from premises' Yes_, .~_No , ' ..... 1. Name of Owner of premises . .. .................. Addr,~ss ................... Phone No. ..: .......... Name of Archit,)'ct ......... ; .............. :.. Address ................... Phone No ................ Name of Contractor ........ ~ ................. Address ........... ; ....... Phone No ................ PLOT DIAG RAM Locate clearly and distinctly all buildings, whether existing or proposed, and.indicate ali 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 NE¥~r'~OR,19',.~,/I , :e e OUN'rY .... '°'° (Name ~'f indMdual sighting contract) being duly sworn, deposes and says that he is the applicant e is the ..................... . ................................................. ~agent, ~orpg~ate officer, etc.) f said owner or owners, and is duty 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 he performed in the manner set forth hi the applic';ation filed tl:erewith. worn to before me this , :- '' · " ......... , ~0. 52-8,,17850, ~uf[olk ul~__---fi~ ,, (Signature of applicant) "