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Home My WebLink About13613-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building ....... .N.e.w..D..w.e.l.1. J:..rig ........................... Location of Property ...6. 7 .6.0 .......... .S.o.u.n..d. Aye.: ....... .~.a..t:~.i.~u..c.k ................ House No. Street Ham/et County Tax Map No. 1000 Section ...1. 2. .~ ...... Block ...0.{ .......... Lot .... 0. 0..8 .......... Subdivision...S.u.n..dP?.n...F.a.r.m.s....(.Iq.J:.n.o.r.)...Filed Map No..4.3.8. ....Lot No. 1 conforms substantially to the Application for Building Permit heretofore filed in this office dated · .D..eg.e..m~..e.r' .3. ........ 19 .8.4. pursuant to which Building Permit No ...... 1.3613g dated ..... .D.e. qe. .m.bp.r...5 ........... 19..8.4, 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 ......... .. r.-.-.~...~.e, vf. ?.r. ly.a.~.e..o..n?. ?.a..m.~.~y..p.w.e.~.~..~.n5 ...... The certificate is issued to STII~I*~.R, O-OSgPH & (owner, of the aforesaid building. Suffolk County Department of Health Approval 14-SO-I 77 UNDERWRITERS CERTIFICATE NO.. lq731008 Building Inspector Rev, 1/81 ~OB~ NO. ~ TOWN OF $OUTHOLD BUILDING D~PARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEP, MIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 13613 Z County Tax Map No. 1000 Section .../.....~'...../. ......... Block ........ ..~....~. ...... Lot No. O ~ pursuant ,o application dated ..... J~.~....l.,~ .............. , 19.~.~., and approved by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1~802 APPLICATION FOR CER'I'IF[CATE OF OCCUPANCY BLDG. DEPT. ,. , TOWN OF SOUTHOLD Instructions A. This application must be filled in typewriter OR ink, and submitted I ~ 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. 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 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 $15.00 3. Copy of certificate of occupancy $1.00 4.Vacan~c Land C.O. $5.00 Date .......................... New Building ...\/.~v.. ·~ .... Old or Pre-existing Building ............ Vacant~and ............. Location of Property//~ou~e ~.~.... ¢ .~.....~. · .~.%~... '.~'.~./...~S.tr.~....'.~..¢J'(~.. ............. H;/n/e't - .. Owner or Owners of Property .... .~//: .~?.' ...~. ?..P~:~[?lf.l.q 1~ ..... .~ ........ County Tax Map No. 1000 Section ./...'~.' ........ Block ...(~...~. ...... Lot .... ~...~. ...... Subdivision ................................. Filed Map No ........... Lot No .............. Permit NO. /.~ .L ~,. Date of Permit/?:,/F.~/C~pp'icant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporar~or~Certificate ..................... Final Certificate ....................... ~ Fee Submitted $ ./~.~.". ....................... Construction on above described building and permi' ,%..',L.~ ~ I ~0 Applicant .... er. 10-10-78 / meets all applicable codes and regu_lations. PLANNING BOARD MEMBERS Bennett Orlowski, Jr,, Chairman George Ritchie Latham, Jr. Richard G. Ward Mark S. McDonald Kenneth L, Edwards Telephone (516) 765-1938 TOWN ,-);' ¢:' ': .'" ' ~ SCOTT L. HARRIS Supervisor PLANNING BOARD OFFICE TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 June 24, 1993 Mary Lee Hasbrouck, Special Project Consultant Association For The Advancement Of Blind And Retarded, Inc. 164-09 Hillside Avenue Jamaica, NY 11432 RE: Request for site plan waiver for a vacation home at Premises of Joseph and Patricia Stiefer Route 48, Mattituck Zoning District: Low Density Residential (R-80) SCTM~ 1000-121-4-8.1 Dear Ms. Hasbrouck: The Planning Board has received your letter of June lB, 1993, requesting a site plan waiver for the above referenced property. Your request has been sent to the Building Department as site plan waivers are their responsibility. You will hear from the Building Department directly as to their decision. If the Planning Board can be of any assistance please contact this office. ce y, Richard G. Ward Chairman cc: Curtis Horton, Senior Building Inspector Gerard P. Goehringer, Chairman Zoning Board of Appeals THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ 85 JOHN STREET, NEW YORK, NEW yORK 10038 THIS CERTIFIES THAT only the electrical equiplnent as described below and introduced by tke applicant named on the abo~e application number in the premises of in the following location; ~] Basement [] 1st FI. [] 2nd Fl. Sectiott Block Lot was examined on ~]J~&~ ~ ~ ~ ~{'~ )~'~ and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES OVENS OUTLETS SWITCHES DRYERS FURNACE FLUOR~SCEN: VAPOR FUTURE APPLIANCE FEEOERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT OTHER APPARATUS: S E R PER ,e' OF CC, COND, V I C E NO, OF HI-LEG A, W. G. OF H~-LEG NO OF~EUTRAL$ OF NEUTRAL 4/0 This certificate must not be altered in any manner; return to the office of the Board if i~correct. COPYI GENEI~AL MANAGER may be identified by their TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date February 11, 1986 Building Permit No. %~o~%~Dc~ (please print) Plumber %~1~(~ ~ k~ ¢)~.~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber's signature) Sworn to before me this //z~,~ day of 19 £& Notary Public, 5~ F~u =~ County Notary Public FIE[~D I~SPECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY ~ODE FINAL ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~oOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved . .~.., 19~~ Permit No ) ~0 };~::~- Disapproved a/c ..................................... TOWN 0F, SOUTHOLD Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ................ , 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 be? 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 coSl)e,/lqous~g code, and regulations, and to admit authorized inspectors on premises and in building for necessary, in~/~// ~-" -~~ (Signature of appligant, or name, if a corporation) :[,... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (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.~ ~ ~)°f land on which~propos~work~ ~ ~wfll be done ...................... House Number Street Hamlet County Tax Map No. 1000 Section . ./~../..~./. .......... Block ... ~).¢ .......... Lot....~.~.. ........... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and oc.cu, pancy, of proposed construction: a. Existing use and occupancy . . . ~...~.cr..vr~. · .~ ..... ' ........... i.' ...... [....~ .......................... b. Intended use and occupancy ...~..~....h~.~. .................................. 3. Nature of work (cheek which ' ' t,4/. Addition ..... Alteration apphcable): New Building . . .' .................... RepaJr~ .................. Demolition .............. Other Work ............. ' i (Description) 4. Estim~tted Cost . ./....~.t~. ~, ~..~.O. ........................ Fee .... C: *" (to be paid on filing this application) 5. If dwel/ing, number of dwelling i~units ............... Number of dwelling units on each floor If garage, number of cars ..... ................................................................... 6, If bustness, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing stmcturos, if any: Front ............... Rear .............. Depth ............... HeightI ............... Number of Stories ........................................................ I)imensions of same structure with alterations or additions: Front ................. Rear .................. I epth ...................... Height ...................... Number of Stories ......... .8. I auens~ons of entire new constmctmn. Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9 Size of lot Front Rear Depth 10. Date of Purchase ............................ Name of Former Owner ............................. 11. Zone or use district in which pr ,~mises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ........................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ................... Address ................... Phone No ................ Name of Architect .......................... Address ................... Phone No ................ Name of Contractor ........................ Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blockinumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE oF NEW YORK, ' S.S COUNTY OF ................. ............................ ~ .................... being duly sworn, deposes and says that he is the applicant (Name of individual sig~ng contract) above named. ~ He is the J ~ ~ i (Contractor, agent, corporate officer, etc.) of said owner or owners, and is d~ly authorized to perform or have performed the said work and to make and file this application; that all statements conialned in this application are true to the best of his knowledge and belief; and that the work will be performed in the mann,er set forth in the application filed therewith. Sworn to before me this ! ... :. ' ' ... :- Notary Public, . .... ~ .0~... 0 .... County ~ . , .:.;- ,.. ..... i '[erm Ex~lre~ ~&r 30 19 ~$ ,00/