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Home My WebLink About13561-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Zq 3562 Date June 26 85 THIS CERTIFIES that the buildLug garage addition. Location of Property., .2.0.0. .......... G.r..a.m.d.A..v.e.m,u.e. House No. Street .... County Tax Map No. 1000 Section q 39 .Block ~- ...... Lot 9 o Subdivision....G?.~..d..~..~.~. $~.h.~.~. ........... Filed Map No....~7.7....Lot No...!9. ?.~. conforms substantially to the Application for Building Pemait heretofore filed in this office dated .................... ,19 . pursuant to which Building Petmait No ..................... dated No~ember 20 19~.~ , 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 ......... .... .~.~?.~.~e...~45..5.o.~...~.o..e.~..~.s~.~. a .o?..-.c.~.m..~.~..~..w.e.Z.z.~..n~.. ................... The certificate is issued to EDWARD & ALTI-IEA SIDOR {owno6~ of the aforesaid building. Suffolk County Department of Health Approval .............. .l~/.k. ........................ N/A UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev, 1181 lrO~M NO. ~ , TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N-° 13561 Z Permission is hereby granted to: ,~......~/.....,.~...:... ....~..~ ......... .~.:...~..~..~..~..~.. .v. ................ ~ ;.;..~ ......... .....; ...................... ~...~:.~....: ........ ~~.[~ .............. .... ~...~.~..~~.,...~....~...~......,¢. ...... ~.~..~ .............. at premises located at ............................................................................................................................ County Tax Map No. 1000 Section ..... L..~..~ ........ Block ......... ~ ......... Lot No ..... .~..:../. ........... pursuant to application dated (~O.~ ~ 19.~.~., and approved by the Building Inspector. Fee $ ...................... Building Inspector Rev. 6/,30/80 FORM NO. 6 TOWN OF $OUTHOLD 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. 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. Commercia[ 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 pZ~operty 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 $ [ 5,00 3. Copy of certificate of occupancy $1.00 Date ........... New Building .../~ ........ Old or Pre-existing Building ............ Vacant Land ............. Location of Property ~.~..~).... House No. Street Hamlet Owner or Owners of Property .~'.Z?.O?.~. ,~.O..9~..Z~.47-,/?, .'~../~....S.~.,~ ~ ..................... County Tax Map No. 1000 Section .,, ,/.3.~. ....... Block ..... ~ ........ Lot .... .~: .~. ........ Subdivision .~f,~,~..J~,.~'~.f~/.... z~.~..~¢/..~.~7'~...~. .... Filed Map No. ~.?.~...;..Lot No. ~,~'.~.~..o. ,: .~z../ Permit No. [.~.5./,oJ.~. . I/~¢10~-~' . ~)¢-C~ .~.,/~.....~.4'~O .~ Date of Permit .......... Applicant ............................ Health Dept. Approval ........................ Labor Dept, Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $..~.'..~...~..~. J~..~:~..~. ......... Construction on above described building and permit,,,m~,et~ all~c~ble codes and regulations. (~,0, d~_ I~c~ Applicant.. ~ ........ ~ ......................... F1ELM IM£4'ECT%ON COMMENTE , , FOUNDRTION ( ~ FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1802 Disapproved a/c ..................................... ¥OWN OF SOUINOLI~ Received ........... ,~9... (Building Inspector) APPLICATION FOR BUILDIi~IG PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildhags on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by tltis application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herei~ described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ,4 ' (Signafure of applicant, or name, if a corporation) . .%.P... ..... (Mailing address of applicant) ///~Y& State whether applicant is owner, lessee, agent, architect; engineer, general contractor, electrician, plumber or builder. .......... O. ........................... ............................................... Name of owner of premises . .~.~...~.~...~.~... F~.../~.~)...~.~: .;~/~, ..~..~'~....~.~..~..~ ............................. (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 .................................................. ............ .,e:,?. .,v.o. ........ . ....... . ............. House Number Street ¢ Hamlet County Tax Map No. t000 Section ./.'.'~.~..~.. Block ....... .~ ......... Lot Subdivision..~/Q~./~/~/~/...~. ;?/~-~.~. ~.' ~f.' .~.~. ........ Filed Map No. ~.~ ? ......... Lot ~..,~. ~ .o. ~.~/.... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...),~..(41./..~z(/-./../]~... ~JA~... ~'7~...~./'~. ~/z'~. ............................... b. Intended use and occupancy ...~'~ff~ .~..~,~7.-. ................................ 3. Nature of work (check which apphcable): New Building .......... ddition ...... Alteration . .[ ........ Repair .............. kemovai ............ Demolition ........... ... Other Work .............. .]~. ~.,/ / od (Description) 4. Estimated Cost .......................... ~...~. Fee .......... 1 ............................ (to 'be ~paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor ..."77'. .... If garage number of cars 6 Ifb 1 o d Jfy:na f htyPe fu · usiness, commercia r mixe occupancy, spec ture and extent o eac o se ............... 7 ' ' fe ' ' ' y F ~./ R ~.,~. / pth Dimensions o xlstmgstructures, lfan rent ....... ear . .~ . De . ........ ,~ Height ~,,¢.... Number of Stories . .~(~-,J~A4/4-~.6 C, qj...~q~*~J~,, J) ......................... Dimensions of same structure with alterations or additions: Front . 51[~.. ~.~,,. ~ ..... Rear . ~..~ ............ Depth , ~,~/ .................. Height ..... ; ~ ............... Number o4 Stories .../. ............... 8. Dimensions of entire new construction Front /6 ...... Rear. f.~ ., . Depth a2~ ........ ~ Height . ./.-~: ......... Number of Stories .... / ....................... ! .............. , ............ 9. Size of lot: Front ,.,/~.~. .............. Rear .... J.,~..O. ............ !Depth ./,~2.~.. ,~ ........... 10. Date of Purchase .... /.~2~./2. .................. Name of Former Owner i.-).~¢F.. 11. Zone or use district in which premises are situated ............... ! ........ 12. Does proposed co~'gtruction violate any zoning law, ordinance or regulation: ...~.0 ..... iii. 13. Will lot be regraded .. 4lJ.~ ...................... Will excess fill be remov4d from premises: Yes 14. Name of Owner of premises ~..D.B*O.t~,~;r/44'~. ?../~fAddress ./~z~.7~./Z',~/~. ~ .... Phone No. ~7~ :-.~gd. .... Name of Architect ' .'777.. Address i Phone No Name of Contractor ~,fZ2. Z~..~i.~IA,Z~.~.~.. Address . ~C~.7.C/i~.~ .... Phone No. SJ.~/. 7,.,~o~ ~/... PLOT DIAGRAM Locate clearly and ~istinctly all buildings, whether existing or proposed, and, red,cate all set-back dimensions from property lines. Give street and block number or description according to deed, and shdw street names and indicate whether : interior or corner lot. STATE OF NEW YORK, __COU~Y OF~ No. 47dkli ~, TMm ENwW Mer~h ~0, ~ g..~) (Signature Of applicant) work will be performed in the manner set forth in the application filed therewith. Sworn to beforeme this ........ ....... ,,A'~ .~. a;-.: .... .,,,,~'q..'~."r ............ county <--5 .. ~P~I~.~~ ................. S.S (Name of individual signing contract) ,- -,. , .. i " above named. He is the " "', (Contractor, agent , corporate officer, etd · ) ',' of said owner or owners, and is duly authorized to perform or have performed thei said work and to make and file this'! · application; th,at all statements contained in this application are true to the best ofliis knowledge and belief; and that the FEE'~-~ RY: _ ~:~L., ..... ~ NOTIF~ ..... '~ m'NG DEPA~TMKNT A~ ~ 76~ 1~C~ o AM TO 4 PM FOR TF'r FO[ I r¥~,,k,q I k,SPFCTIONS: [,~, ,, 1. FOIJN~ATI~N - TWO REOUIRED FOR P~"J~cO CONCRET~ 2. ROUGH - FRAMING & PLUMBING 4. FiNAl CQN'SqRUr'TION MUST BE C~*~m cr'r FOR C O. ALL CONSTRUCmlON SHALL MEET THE REO~ UqEMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. - /$0,09