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HomeMy WebLinkAbout13254-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-16145 Date September 8, 1987 THIS CBRTIFIES that the buildkng .A..d .d'.zt. ~-gn...&. c. 9 n. .s .t r. .u .c .t . .n .e .w . .f g .u .n .d .a .t .i ? .n . .& . .c .e .l .1 .a .r... 915 Mill Creek Drive Southold, New York Location of Property//$$s~ k/o[ ......................... · ' ' 's't,:e~i .................. County Tax Map No. I000 Section . !.3.5 ........ Block ,..0.3 ........... Lot .... .0.3.7 .......... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated June 29, 1984 pursuant to which Building Permit No. 13254 z dated June 29, 1984 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 ......... ADDITION TO & CONSTRUCT NEW FOUNDATION & CELLAR, REMODEL EXISTING ONE FAMILY DWELLING The certificate is issued to ERNEST G. & DORIS B. ROBINSON ..................... ?o'4& k, '~'t¢}L~hlgX'x ................... of the aforesaid building· Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N.7 8 0 8 9 3 N/A PLUMBERS CERTIFICATION DATED: Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13254 Z Permission is hereby granted to: ..~.~.....~:....~...~..../~z ............ .... ..~~..~..~...~i ....... .~~ ..~~......~~....~..~.~....~.~ ................... at premises I~ated at ...... ~ ....... Z~.IL....C~.....~ ......... .......[.. ........ , ........ County Tax Map No. 1000 Section .../..~.~..~ ......... Block ,.~..~., .......... Lot No...,(~.,~..,.~,, ....... pursuant ,o a~lication da,~ .... ~'......~ ..................... '~.~ Gnd approv~ by the Building Inspector. ~ ~C~ ~/~ ~. ~ ~ [~ ~ Fee *.t~ .......... Building I~tor Rev. 6130/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m ~ 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.Finat 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pz~perty showing all propertv 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: Additions $25.00 1. Certificate of occupancy New Dwelling,S25.00, Accessory ,$]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50,. 00 3. Copy of certificate of occupancy $ 5 00, over 5 years $10.0~) 4.Vacant Land C.O. $ 20.00 ' ~/ , / ~ NewCOnstructiOn ...... Old or Pre-existing BuiJding .....~.....i ~/~2nd j '-'" ........ Location of Property ,~,/.,~....~?,I.I..<'L .~.?.*...¢e /~..~.~J{/ ,~ tJzT~/'~'~J//(~J ' / · .... .... .o. /YOU,eNO.~' ~.?~ .~' , Street ~_~,~.~.~t/~ tCatz#et Owner or Owners of Property . ~;.(~'f.~ · .(~ '..~'.'. ~(~. ('~¢( .... ¢¢l X~¢~ .......... County Tax Map No. 1000 Section / ~ ~ ........ Block ..... ¢. ~ Lot....~ ......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No/ ......... , Date of Permit ¢..Applicant .L (.~.-?.~..' .~ . ~.;. Health Dept. Approval ........................ Labor Dept. Approval ........................ Unde~riters Approval .~.~ .~ ......... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ~. ................... Fee Submitted $ ..... ~. ¢~-;.. .............. Construction on above described building an~mit meets all ~plic~codes and regulations. .................... Rev. lO-lO-7a Co .l lq5 BUREAU OF ELECTRICITY r JOHN STREET, NEW YORK, NEW YORK 10038 Robinson~ 915 Mill Creek Dr., Southold, FIXTURE OUTLETS SWITCHES FIXTURES 25 .50 ]3 23 DRYERS FUTURE APPLIANCE FEEDERS SERVICE DISCONNECT OTHER APPARATUS: lO. OF S R RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS oF ,,.~Eo F.~U,,A~S 2,/0 Hotors~.l-lH.P. Ernest G. Robinson ~~~ E-223 Diane Place Paramus, N.J. ) 07652 GENERAL MANAGER [his certificate must not be altered in any manner; return to the office of the Board if incorrect. Ins ecto¢ ' '' r~''~''t~''x~''e ,~1 . · p s may be )denhhed b the'r credentials · } BUI:~LDING DEPARTMENT. THIS C~PY OF CERTIFICATE MU~T J~OT SE ALTERED N ANY AiA~F~ FIELD INSPECt'ION~ COMMENTS · FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ~ODE FINAL ADDIT~ NAL COMMENTS: oO o~ ©. ~Z ,,--0 .. FORM NO. 5 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION (owner or authoriz, cd agenzkof owner) ~' (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance ......~...~...'.~......~Z...~......~... Other Applicable Laws, Ordinances'or Regulations ............................................ at premises hereinafter described in that .~.~..~.Z2.~.?'.~..~...~..~.~.x..(~ .~......../..~......L~..~...~....</.~....~-~.~,...~.~x~/~ (state character of violation) ' in violation of ..... ~... ~/' ...... ~e.~'......(~.:.Z.~.~...Z.....~. ~ (State section or paragraph of applicable law, ardinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy ~he conditions above mentioned forthwith on or before the ~ day of .......................... ....~ ...................... , 19.......~ The premises to which this ORDER TO REMEDY VIOLATION refers ore situated at ~./~..~.../~,',~X.~'.Z.~..~.......'~...~...~.;..~-J?/.~.~.,../~.....County of Suffolk, New York. Failure to remedy the conditions aforesaid and to comply with the applicable provisions of may constitute an offense punishable by fine or imprisonment or both. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION lIST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING [~AL DATE. BUIWINe 'DEFT. INSPECTION [ ] FOUNDATION XST ~X~ ROUGH PLBG. [ ] FOUNDATION ZND ~ INSULATION [ ] FRAMING,,, [ ] FINAL REMARKS:~'~ DATE .... '~/.9~/~> / INSPECTOR ~/~?, /.,, ,_. I 'FORM NO. 1 TOWN OF SOUTHOLD · BUILDING DEPARTMENT TOWN HALL - ,,. $OUTHOLD, N.Y. 11971 TEL.: 765-180:3 ?..., 92¢ (Building Inspector) APPLICATION FOR BUILDING 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 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. e. 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 heroin 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 inspecflipns. ~ ~ ...... .............. (Signature of applicant, or name, if a corporation) .......... i 'aili g ad~ress 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 of land on which proposed work will ha d~,_.~_.: ................ House Number Street County Tax Map No. 1000 Section ..... ~/.~ .-~. ...... Block ..... .d~..~. ........ Lot .... .~...~..? ......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy....t~-~-.... ~. ~ ............ i ...................... b. Intended use and o~upancy... ~...'~.. ~. ~ .~..~..'~. ~. 3. Nature of work (check ' ' ' winch apphcable): New Building ..... ' .....Addition .....>~ .... Alteration .......... Repair .............. Rem6val .... .~ ....... Demolition Other Work... ' : (Description) 4. Estimated Cost ................ Fee .... ~ '~' (to be paid on filing this application) 5. If dwelling, number of dwelling ~nits ..... /. ......... Number o f dwelling units on each floor ...... /. ......... If garage, number of cars .. ~.O~--~... . ......... 6. If business, commercial or mixed occupancy, specify nat_u, re and, extent of each type of use . .~ ............ 7. Dimensions of existing structure:~, if any Front .4..8~. ....... Rear .. ~..~. ....... Depth ... v-~.~.~ ...... Height . ..~q. ~ .... Number of Stories ...... .2-r. ................................................ Dimensions of sam6 structure with alterations or additions: Front ................. Rear .................. Depth Height Number of Stories 8. Dimensions of entire new construction: Front ..... .~,~ ....... Rear .... .~.. fi, .......Depth .... .~..'q.-'. ....... Height ~- ............... Num'ber of Stories 2-. 9. Size of. lot: Front ...... ~9~../, ........... Rear ...... Z~ .o~. ........... Depth ... ~/.~..,q? .............. 10. Date of Purchase ........... i .................. Name of Former Owner ............................. 1 I. Zone or use district in which pr{mises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........ .~.O. ..................... 13. Will lot be regraded ........ ,1~. ............... Will excess fill he.removed from Eremises: Yes No Name of Architect i Address Phone No Name of Contractor . ~ · . Address .......... Phone No PLOT DIAGRAM Locate clearly and distinctly all ibuildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block fiumber or description according to deed, and show street names and indicate whether interi~r~or ~orner lot ' b ing duly depo es and ays that he is the applican~ (Name of in d'lvl'd ual sign'fig~ cent rac t) above named, He is the ....................... [ .................................................................. ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dulyi authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner ~et forth ~n the application filed therewith. Sworn to before me this NOTARY PUBLIC, State 0I New V0r~ ................. NO. 4707878, ,gt~ffo~k l~m E~l~r0S March 30, 19.~$[ (Signature of. applicant) Z