Loading...
HomeMy WebLinkAbout12846-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..~J.2.~l$ ......... Date January 26 19 84 THIS CERTIFIES th t*l h 'la' --garage reconstruction -.a..ne vUl._lng ................................................ Location of Property .,..Sfi..5 ................ .B.e.a.qh. V 9p.d...~ 9.a.d. ........ .C.u.~. c..hp.~u..e ..... t~ouse No. Street Hamlet County Tax Map No. 1000 Section , . .1.1. 6. ...... Block .... 0. q ......... Lot ,..0.2. 2. ........... Subdivision....X ........ . ................... Filed Map No. , .X ...... Lot No....X .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated · .J.a..~ .u.a.E y...2.4 ......... 19 .~ 5. pursuant to which Building Permit No... ~. 2. .8.~.6...Z ........... dated .... 4 .a.n.u.a.~. y..2.4. ............198..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 ......... ...~.. ?.?..~.~?.~. ?.~?.0.. 9.~.?. ~..<?.y., !.d?.~..~ ?.h.~. ~. !. ~ar a.~e. The certificate isissued to PAUL SUTER & HIS WIFE ..................... ? d'd,r~e*r, 'l¢~sd~" t;~,~/ ..................... of the aforesaid building. Suffolk County Department of Health Approval ..... N.. / .A .................................. UNDERWRITERS CERTIFICATE NO .......... ~ e..n.d.~n.g ........ Rev. 1/81 Building Inspector FOR~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, hi. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 12~46 z Permission is hereby granted, to: ...~L~. ~'"':'~ ....... ; ........ '~"i .......................... ..~.~~...~..:~..~.....~.L..~..~/. ~t promi~ .......... ............................. .-....-.- .--.......-..] ............ ~ ~ ~,~~,~ ~ ............ Coun~ Tax Map No. 1000 Sectiqn ...... ~.~.~ ......... Bilk ........~. ........... Lot No...~.~ ....... pursuant ,o application da,~ ...~~,.~.~-- ................... , 19~.~., and approv~ by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 'I'OWN OF SOU'i"HOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instruction, s A. This cpplication must be fiiled in typewriter OR ink, arid submitted in duplicate to the Buildin§ Inspec- tor with the [oltowing; for n~}w bi d ~fls or new use: 1, Final su~ey of prope~t'? with accurate location of a)l buildings, property lines, streets, and unu~al r;atural or topographic foaaJms. 2. Final approval of Health Dap1. of water supply and sewerage disposal-(S*9 form or equal). 3. Approval of electrical in~ailation from Board of Fire Unde~riters. 4. Commercial buildings, Industrial buddings, Multiple Residences and similar buildings and h~statla- ~ions, a ~;erdfica~e o~ Code compliance from the Architect or Engineer responsible for th6 building, 5. Submit Planning Br)a~ d approval of completed site plan reqnirements where applicable. B. For existing buildings (prior to AprFI 1957), Non-conforming u~s, or buildings and "pre-existing" 1. Accurate cJ~ey of peoperty showing all property lines, streets, buildings and unu~al o~turat or topographic featu res. 2. Sworn statement of owner or previous owner as to u~, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premiss, or other pertinent informa- tion required to prepare a certificate. 1. Certificate of occupancy $5.00 / 2. Oertific@t~ of occupancy on pr[:.~-exis'lin§ dwelling/ lend 3, Co~w of certificate of occupancy $ use-.-P:,e-Ex[?~t, 5. ng C.O. ~;15,00 Vacartt; land C.O. :I; 5,00 ............ I'~,~v i~.Mulnq ............. OM or ~re~ex st n~ ~uildM~ ............ Vacant kand ............. P,'ou~ No, Street Hamlet Subdivision ................................. Filed Map No ........... Lot No .............. P,,rmit No ........... Date Of Permit .......... Applica,,. ~,. ~., Underwriters Approval ........................ Pla~ming Board Approval .... ~].1~ .............. Request for Temporary Cert~f cate ................... Final Certificate .................. FeeSubm~tted$. b(OO Construction on above described building and p~it~meets all applicable codes and regulatior~r;. Applicant ..... .'¢¢A~1...~414~-¢ · ~ · ~-~J-6}. · .' ...................... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 :.q Approved ~.(L~.. ~J~-0-~..~.q.·., 19~.~. Permit No./..~..~.q.~..~. Disapproved~a/c ..................................... Application No .................. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date.. (/'.2..~. ......... , 19 .~..f 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 Regulati6ns, 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. ................ ..................................................................... Nameofownerofpremises . .//ff..~..Z .~...d&9-,~-~.'.dq). · ~ ......... ti~)'J~S'~IO~'~D ........... ....... IT(as on the tax roll ogat~l] ~[1~ If applicant ia a corporation, .signature of duly authorized officer. DATE: ~B.P. 'FEE' ~ BY: ~-~-'-' ~, '~-- EPARTMENT AT ...... . .~..././~.4..~../~..~ ....... ~ .... tqr",TlFY BUILDING D ~ -.- (Name and title of corporate office~) ~5'-i802 9 AM TO ~t PM FOR IHt Builder's License No .......... /?./. ............ FOIL©W}NG iNSPECTIONS: Plumber's License No ...... ~, .~.4.4 .'~.. · ........... Electrician's License No .... l~Ut~d ............. 1, FOUNDATION "TWO REQUIRED FOR POURED CONCRETZ 2, ROUGH - FRAMINm 3 ....... 4, FINAL" C BE C~,Mo~ Other Trade's License No .................. ALL ct;m 1. Location of land on which proposed work w,ll be done ....... ~'d*C '¢~. COsI*I *! J~TI.QD · · ' ...... ~:Z. ..... · ..&~ ¢ ..... ~7~P~ .... 1 ........... em~.e~.~eu~.,x.c ................ House Number ' Street U Hamlet County Tax Map No. 1000 Section ...... I~ ~ .......... Block . . ~. ............. Lot '~ Subdivision . ~ ................................... 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 ...... ~J~ ..................................................... Repair ............ Removal ............ 4. Estimated Cost ....... ~../~ ............. 5. If dwelling, number of dwellingi units ........... If garage number of cars Nature of work (check which applicable): New Building .......... Addition .... .~.... Alteration .......... · Demolition ............... Other Work ............... , ,.~ _ (Description) Fee ... . (to be paid on filing this application) · Nub f d ' ' ch fl m er o welhng umts on ea opt ................ 6. If business, commercial or mix{d occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ................... I... Height ...................... Number O, fzStOries .............. 8. Dimensions of entire new construction: Front ..... ~,~. ...... Rear .... ~.-r ......... Depth .. i.~.' ~ ii ..... ' 'ght ' ' He~ ............ u er of Stones ....... ......................... ,.~ ............ 9. Size of lot: Front ...... ..~.-.~':. ........... Rear ............. Depth ................ 10. Date of Purchase .......... ~ .................. Name of Former Owner ............................. 1 I. Zone or use district in which pr~mises are situated ..................................................... 12. Does proposed construction viola/eany zoning law, ordinance or regulation: ............ ~.~ ............... 13. Will lot be regraded ........ ...~. .............. / ~. Will excess fill be removed from premises: Yes 14. Name of Owner of premises .~4'g~.,r'~'~.~...?.~.~-~dress ................... PhoneNo.' Name of Architect ../'~'~ ' '-- ~'i ..... 3~7);~' ' ' ~ .... Address i'" i~t~. '~ ....Phone No .......... Name of Contractorx./_~ ~/.'4/../'.2~/./-. .~ffJ,..~.. Address ~¢/ ...:.. Phone No../~.~.' .~.~fi. d. ~ .~.. PLOT DIAGRAM Locate clearly and distinctly all 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 NEWYORI~ ti ,~ ~ '~ ~ .°Y. '. '. '. '. '. '. '. ......... (Name of individual sighing contract) above named. ; being duly sworn, deposes and says that he is the applicant (Cont~c~or, agent, corporate officer, otc ) 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 conthined in this application are true to the best of his knowledge and belief; and that the work will be performed in the manndr set forth in the application filed therewith. Sworn to before me this .................... day o . .............. , . Notary Public, . .... .... County NOTARY~UIILIC, State o'f New York ' ' '~ ' ' (Signature of applicant) · No. 52 8125850, Suffolk Couq~ ~/