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Home My WebLink About13056-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z13085 Date Dec 27 ................................. ' ................ , 19.84.. THIS CERTIFIES that the building ....... .N.e.w...D .w.e.1.1..i.n.g. .......................... Location of Property 205 Grange Rd. Ext: Southo 1.d - House iVo. Street Hamlet County Tax Map No. 1000 Section . .. 0. 7.5 ...... Block . . .0..4 .......... Lot .. 01 i S.~.a~,,lql~. South Harbor Homes ....... ......... n ............................... F~ed Map No.4096 .Lot No..1.1 ........... conforms substantially to the Application for Building Permit heretofore fried in this office dated March 16 19 .84. pursuant to which Building Permit No. 13056Z dated .... .ARr. Sr.1 ........ 1.9. ........ 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 ......... New Private One Family Dwelling The certificate is issued to KEVIN KNOBLOCH (owner,-¢es~e or-ter~n~) of the aforesaid building. Suffolk County Department of Health Approval .......... .1.3:-.S.O. 7.2.2.8. ..................... Pending UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev, 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT fi'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13056 Z Permission is hereby granted to'.. , ~ . , ~ ~ ..... ....... ............... /alo ~ o 0t ,ocate, ...~...:°~"g~ ,~.....~....4......~.~~ .. .,emises at ................ ~..~. ...................................... County Tox Map No. 1000 Section ..... ...<~....~.....~... .... Block ........ ~ .......... Lot No ........ I..[ ............. pursuant tO application dated ....... .~...C~.....~.......J....~. ................... , 10..~..~, and approved by the Building Inspector. Buirding Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $0UTHOLD Building Department Town Hall $~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY ~' stru~tl, A. This aPP cat or~ mustb, e f~!¢,e~ in ~Ypewr , 'u~ ..IK, and su. bmitte~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 disposel-(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 peoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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 / 3. Copy of certificate of occupancy $1.00 land use --Pre-Existing C.O. $15,00 Vacant land C.O. $ 5.00 Date . .]2,e.c.e.$,b.e~, ~. ,1 ,..1.9¢A... New Building . .. ~.S. ...... -t~ldo¢Pre-exisfing-Bt~Hding-_~.-;'.-.'~:',-,-.-¥~cafl~£e~===~== ..... - Location of Property....2,0.~.......Grange...............Rd' ~xt.. ..................................... House No. Street Ham/et Xevin J. Xnobloch Owner or Owners of Property ............................................................ County Tax Map No. 1000 Section 75 Block 4 Lot. 11 ~ - · ' ~Oq~ 11 Subdivision .. ' ...... en ~.'~x~e~k'd~taO(' ~ ~,a Map No. . .Lot No. Permit No ........... Date of Permit .......... Apphca · · · Health Dept. Approval ............. Labor Dept. royal ........................ d'App Underwriters Approval ............ Planning Boar roval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $. ~.~. ........................ Construction on above described building and permit meets all applicable codes and regulations, C, Applicant~/ ................................... Rev, 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY F- o~. G~ ~o.. ~T.~T..~W YO....~, ~o.~ ,~0~ THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number ir~ the premises of in the following Ioc~tio~; ~ Basement ~ 1st FI. ~ 2nd Fl. Section Block Lot was examined on ]~. ~f~ ,~ ~ and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLE~ SWITCHES FLUORESCENT DRYERS SYSTEMS NO. OF FEET E R V I C E 4 4 Bo~ ' m~ This certificate must not be altered in any manner~ returnable] ~to the office of the Board if incorrect. Insoectors ma be Jdentifi ,, ~j ~.: ~ -~,~,,~ u~PARTMENT. THIS COPY, OF CERTIFICAT~U~T NOT BE ALTERED 7G5-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION RAMING REMARKS: ZND [ ] INSULATION [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND ~ INSULATION FRAMING REMARKS ..~,~ [ ] FINAL DATE INSPECTOR U, ~,/-. ;' FIELD I,lo~ EC~I N~. FOU:IDATION (lot) FOUNDAT£ON 2. [2nd) COMMENTS ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: ~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved . .~/~..[.~...., 19~.~ . Permit No. Disapproved a/c ..................................... Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .. ~arck. 16, ...... 1984. 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 Occupahcy 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 necessa~_~i~sp.ecti~v/~ . / /~ · .............................. (Signatt(~e of applicant, or name, if a corporation) .. ~. 9.1.Q5...S 9.u.n.d..v.i.e.w...Aye.,. S. 9 .u,.g. h. 9 .1.d. .N. Y. . .1.1. 9 7 (Mailing address of applicant) State Whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... 0.-~.e.r. and General Contractor ................... Name of owner of premises ...R.e.n.e.. .... ................ (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..~-~[~..2~. ~ .~'.., ~ ....... Electrician's License No. ~ .~[.. ?..' .......... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. 2 05 Grange Rd. So utho ld House Number Street Hamlet County Tax Map No. 1000 Section ......... .7~ ....... Block .... .4 ............. Lot... 1. 1. .............. Subdivision ..................................... Filed Map No ...... .~ .5[ ..... Lot .... I.I .......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy New house is being built for one family use 3. Nature of work (check which applicable): New Building ....X.' ..... 'Addition .......... Alteration .......... Repair .............. RemoVal .............. Demolition ............ Other Work ............... : (Description) 4 Estimated Cost .5 ~, 000 i, Fee ,: *', (to be paid on filing this application) 5. If dwelling, number of dwelling ~units ............... Number of dwelling units on each floor ................ If garage number of cars one 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structure~, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure w~th alterations or additions: Front ................. Rear .................. ~ Height Number of Stories Depth .................... i .............................................. 8. Dimensions of entire new constrbction: Front ..... 46 Rear 46 .. . Depth .~.2. Height .. ?.6. .......... Numlber of Sto.ries . .2. ............................. 9. Size oflot: Front .... .2.0.0...., ........... Rear .... ~/'''i ..... ii'i" Depth ..... !~ ............. I 0. Date of Purchase ...A.PF.°.. 1...J.9.8..4 .............. Name or Former Owner ... )t.e.n..e..~.e..n.CL?.O.n. ........... 11. Zone or use district in which prdmises are situated ........ l:Le.s:Ldeng ±al ................................ 12. Does proposed construction violhte any zoning law, ordinance or regulation: ,..~9 ........................... 13. Will lot be regraded ..... 3~e s.; ................... Will excess fill be removed from premises: No 14. Name of Owner of premises .. 'i ................. Address ................... Phone No ................ Name of Architect .. ~ ............ Address ........ , .......... Phone No ......... Name ofContr~ctor . ..K.e.v..i.n.j.K.n. 9.b?-.°.?.h ...... Address .so. undv0).e.w. Av.e. Phone No. '~6~'5~ Locate clearly and distinctly all property lines. Give street and block interior or corner lot. As on Survey PLOT DIAGRAM buildings, whether existing or proposed, and, indicate all set-back dimensions from number or description according to deed, and show street names and indicate whether STATE OF' NEW YORK, COUNTY OF. fi..~.~..~. [ [% ...... S.S ...... . . ......... . ....... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. Heisthe , ' (Contractor , agent , corporate officer, ere . ) of said owner or owners, and is duiy authorized to perform or have performed the said work and to make and file this applicatioff; 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 mannor set forth in the application filed therewith. Sworn to before me this ............ ./~ !.~. ...... day oif._z.../.~..a.t...~.. ......... 19 .~..?/ SHIRLEY FITZGERALD '.~.~/.~rh ........................ Notary Public, State of Now York (Signature of applicant) No, 24-01F 4706845 Qualified n K ngp County Cornm ssion expi[e8 March 30, faeilltiee For thl~ ic~atlo~ ~mve Been ~ in~ected by t~is d{partment ~d fo~d ' Se~icea 'C ~, ,T.'.0