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Home My WebLink About13588-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Z.I.~ ] 6p... Date .... J..a.n.u.a.v.y. 22 1985 THIS CERTIFIES that the building . Deck addition Location of Property 1225 Ninth St. Gre. enport ~- House Ho. Street Hamlet County Tax Map No. 1000 Section .q4...~ ........ Block . .0.3. ........... Lot ....... 0.2. .~ ....... Subdivision..qr.. ~.e.n.p. 9 .v.~. .Qr.. ~y.~.n.g. ?.a.v?.....Filed Map No. 3.6. .9 ..... Lot No.. 4 conforms substantially to the Application for Building Permit heretofore filed in this office dated · ...J. q3, y..2.3. .......... 19~.~.. pursuant to which Building Permit No. 1. .3.5.8.8. Z. .............. dated ..... N. qv. :..2.~. ............... 19~.4. ., 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 ......... .... D.~ ¢ t~..acCO ~.t.~,OO, .t.q, ~ w.e. 1. $ .i.n~ .. ............................................. The certificate is issued to Joann Schellenbach & Alida Rojas {owner, Iq~ ~r~tr~ X X ' of the aforesaid building. Suffolk County Department of Health Approval ........... .N./. ~. ........................... UNDERWRITERS CERTIFICATE NO ................... .iq./. g. ........................... Rev, 1/81 Building Inspector l~l~t~ NO. ~ TOWN OF SOUTHOLD BUILDING DEI~AI~TMEHT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 13588 Z Permission is hereby granted to: .. ...... ............ ,o.~a~/z~.....~ ~.''...~~~~//~ ............ ..... ~. ............. ~~..~~~.....~:.. ~, ~,~,,, ~,~ ,, ..~~.....~ ........... ~: .................................................. ......................................................................................................~~~~~.~:.~..~.~. .... Building Inspector. Rev. 6/30/80 FORNt NC). 6 TOWN OF SOUTHOLD Building Department Town Hall ,%uthold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitte~to the Building Inspec- tor with the following; for new buildings or new use: I, 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 or Engineer responsible for the building. 5. Submit P[anning 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 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. Fees: 1o Certificate of occupancy $5.00 / 2. Certificate of occupancy on pre-existing dwelling/ ~and use 3. Copy of certificate of occupancv $1.00 --Pre-Existing C.O. $15.00 Vacant land C,O. $ 5.00 Date ..... Z ............... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ..... / 2~ ~/ 5'~ ~ .~..~ ./~....~?~,~.J House No. Steer ..... ~amNt Owner or Owners of Property ...................................................... Subdivision ................................. Filed Map No ........... Lot No .............. Permit Uo./.:~ ~...--~-Date of Permit ,/./T?.~'.'..~'Y. Applicant ............ ~ ..................... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ..... Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ............ i .......... Fee Submitted $ ..... .j~ .0 .q ..... ~ .[.~../.d Construction on above descr bed bui ding and permiV~;ieets all appi~cab)e co~ s~d reg[dations. // ,..,o.,o.,, F-I ELD ~INSFECTION DATE COMMENT~S FOUNDATION (1st) FOUNDATION ( 2nd ) o ROUGH FRAME & FLUMBING 3. ... INSULATION FERN. Y. STATE ENERGY ADDITIONAL COMMENTS: FO~M NO~ 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ · o .r~e~,-~...&d,~n~.~. ........ ~,~ for permit to construct..-~ ~,,~,~.-.~.~.O'-,~ ........ ~ ......................... at ~o~.ono~o~t~,;~Z~;~'. ..... ~,~ .... ~.' .......... ¢~~-~ . Stroot ~ ~ Hamlot County Tax Map No I000 Section . ~.~ .... Block ...~ ....... Lot . ~.~ ..... Subdivisi~~t~.~Filed Map No. --- Lot No .... ~ ........... is returned herewith and disapproved on the following grounds ~~. ~[~X. ~ .... ~'~" '~'~'' :~'~'' ~' ~7"- '~' · ' RV 1/80 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N,Y. 11971 TEL.: 765-1802 z: Approved ................... 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 buildings 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 this 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 herein 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. . (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general' contractor, electrician, plumber or builder. ' ...........' ....... . ........ Narrie of owner of premises ' ' (as on tt~e tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. Plumber's License No. · Electrician's License No ...... . .F~'~., ...... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ..... .... .................. House Number Street Hamlet County Tax Map No. 1000 Section Block ~ Lot..~ Z~ .... Subdivision..~t~-~.qq~'...P¢~I.~5 · ?~'. ...... 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 ..................................................................... b. [~t~ded ~se and occupancy .................................................................. ,/ 3. Nature of work (check which applicable): New Building ..... ' ..... Addition .. I/f.. ..... Alteration .......... Repair .............. Rem6val .............. Demolition .............. Other Work ............... 4. Estimated Cost ........................ Fee ...................................... '~' (to be paid on filing this application) 5. If dwelhng, number of dwelhngiunits ............... Number of dwelling units on each floor ................ If garage number of cars 6. If business commercial or mixed occupancy specify nature and extent of each type of use .... .~ ...... structures, ..... ....... ... ........ Depth ... ~ ........ 7. L tteight ............... Number of Stories ...... [t./~.,. ..................................... * ....... I)unenslons of same structure with alterations or additions. Front ..... .O,.? ......... Rear ...o~..p~....~. ....... Depth ....oqo..~-~. ~q ....... ~.. Height ..... t.~,. ................ Number of Stories .................... 8. Dimensions of entire new construction. Front .... ~ I t~ ........ Rear .... ~ ....... Depth '-:...~. ~'Height ............... Number of Stories ...................................... .~ ................. 9. Size of lot: Front ...... .~. } ........... Rear ...... .%..~. ............. Depth ,[Ob ................. 10. ])ate of Purchase .... ,,T~.~):.. g~ ............... N~me of Former Owner ..... ~. I~,g~6~m,. ............ 11. Zo r use district in which remises are situated ~.$~ ~ ~ ~ l nco p, .....]~.. p~....~t. ..................................... 12. Does proposed construction vio'l~t,~,any zoning law, ordinance or regulation: ............................... 13. Will lot be regraded ........ ,:,'.,',.'.~ 'AZ'..'.N'u' ............. ,.~.,;&. Will excess fillN~. ,..*'~..be removed,.?..~, from premises:~:.~,,, q..'lYes~ 14. Nmne of Owner of premises . .~,~ .,u,A-~..q~t4q. ]lqo.~5... Address .... ,. ....Phone No. ~. .0¢?¥... Name of Architect ......... ............. Address ................... Phone No ................ N f C ,.C~..[6: ~l. ql~ly-4q .Cr~c.~T Phe N ameo ontractor.. .... ... .. . .. ....Address ... . .. on o .............. PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW~.qzYORK,~..0~ .IRE. i ~.~ S COUNTY OF. · . i: .,. ~)..~.~ .D~0Q-~....':1.:..[~.l.VT. i q~ ..... .. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the .................... : ..... ............................ of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements con~ained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before m:~ this J ........ . .c~. ~.c~¥ ......... day all.. ~.~.~.O...[~ ............ 19 .~.~ Notary public,(~& ~ ~~~ NOTARY PtlBUC, Stero ~1 New York [ fi0, 52,4524771 (Signature' of applicant) Qualified in Suffolk County CoramJusilon Expires MarCh 30~. 198,~ ~_, .t