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Home My WebLink About13300-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z~3889 Date October ~ 85 THIS CERTIFIES that the building .. addition. Location of Property ~'175 Waterview Dr. Southold County Tax Map No. 1000 Section ....... ~....Block .......... ? ....Lot ~ 5 . Subdivision ........ X ...Filed Map No. X .Lot No. X conforms substantially to the Application for Building Permit heretofore filed in this office dated ....5..u..1. 3~. 3.']. ......... ,19 .~.~ pursuant to which Building Permit No ....... ! .3.3.0.0.~. ........ dated .... .A.u. g .u.~3.. 3 .............. 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 ......... .. g.d.~$.~_.o.n.. ~.o..ex..:t~..rig..d.w.e ~.:L.~.n. g: .......................................... Ttxe certificate is issued to ........ ~.K.. ~r,..8~. ~..~QE. ¢.% .WQ.~..~.Q .R? .................. (owne~ of the aforesaid building. Suffolk County Department of Health Approval ................ ~l/g. ...................... UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 TOWN OF $C~U'rHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13300 Z Permission is hereby granted to: ..... ...~.~ ~~.~..~,...~.~.~ ..... .z.z~ ...... ~.~z~~.....~., ..... .~..~.~..~ ...... ~..~ ................. ,o pursuant to application doted ....... J.~..~...~......~../.. ................. , 19 .... c~nd approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall f,,'~uthold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions in duplicate c- A. This application must be filled in typewriter OR ink, and submitted . ,,V,, i:eo~zhe 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, ~ndustrial buildings, Multiple Residences and similar buildings and insta{la- 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 p~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 preDate a certificate. C. Fees: 1. Certificate of occupancy $5.00 ~, Certificate of occupancy on pre-existing dwelling $1 ~[~0 0 2. 3. Copy of certificate of occupancy $1.00 .......... ~-~, 4.Vacant Land C.O. $5.00 ' Date .......................... New Buildidg .... ..... I '. U.' 'Old or-~re-ex~st~g' ' ~' Building ............ Vacant Land ............. Location of Property ]! ~,~....~..~.T.~" ,~7~J-~/~...J~)~{. ,~.~. ...... ~..~.~.~.0..~. (~...~.: ~/~ /'.(.~.~. House No. "~ Street Hamlet Owner or Owners of Property ~.~/.)~./.~ ' ~c~ /~,; ~ .,. ...... J ............. ,. ........... CountyTax Map No. 1000Section . {~?~/' Block .~..~, Lot. Subdivision ................................. Filed Map No ......... i .Lot No .............. Permit No. 1 ~ {).Q~.. Date of Permit ?/-~!/. ?'~/., .Applicant ............ ~. ................... Health Dept. Approval ........................ Labor Dept. Approval ........................ U nderwriters Approval .t~...~..~. ,~.. ?,~. ,L~. ~ ...... P lan ning Board App royal ..................... Request for Temporary Certificate ..................... Final Certificate ........ .~.. .......... Fee Submitted ............................ Construction on above described building and permit meets all applicable codes and regulations. App,can ......................... Rev. 10-10-78 ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ 85 JOHN 5TREI~T, NEW YORK, NEW YORK 1003~ ~,~ angn~2~, ~e~ ~,,~..oa~o.o~.~ as~/~ N656544 THIS CERTIFIES THAT I~aak Wohlfo~, 1175 Waterview Drip, in the/ollowin~ location; ~ Basement ~ 1st ~. ~ 2nd FI. Section Block Lot was exami~d on ~'~ ~0 ~ ~ and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS SYSTEMS DIMMERS NO. OF FEET E R V I C E OTHER APPARATUS: NO. OF CC COND A.W G NO, OF HI-LEG A W.G. NO. OF NEUTRALS A.W, G. PER ,~ OF CC, COND OF HI-LEG OF NEUTRAL 1175 ~ate~v~ew Vrive S~utl~old, N.Y. 11971 This certificate must not be altered in any manner; return to the office of the Board if incorrect. InspectoJ~s may be identified by their credentialS. FIELD INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY qgDE 4 o ADDITIONAL COMMENTS: FINAL Examined/~./~..J .... , Approved/~. · .~/~ ........... Disapproved a/~ ...... ~.'~i~.- .... ~.. 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEl-,: 765-1803 19 . 1~...~. Permit No. (.~.~.~..(~. · . . (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. 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, ond 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 i.~__e~.~. ~ (Signature ° f ap~i~r/n~; i~ a c°rl2-~ati°n) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general' contractor, electrician, plumber or builder. Nmne of owner of premises .~.~.. ~..NJ..( .~.'.+...~. ~..~ .C. ~.....~!..Q .~..L..~..~..~. i .~. · ......................... (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 be d6ne .................................................. .... [[ .......... .............. . :r. .................. House Number Street Hamlet County Tax Map No. 1000 Section .... ~..-2..~. ....... Block ..... O..~. ......... Lot...O.. ( ~ .......... 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 ................................................... . ................ b. Intended use and occupancy ............ .~.~. j.~.e~ ................................................ 3. Nature of work (check which applicable): New Building ' Addition .......... Alteration ....~...... Repair .............. RemOval .............. Demolition .............. Other Work ............... ~....~....~.~. ~ ~.. ~t~. (Description) 4. Estimated Cost ....... (~. .............. Fee . i ~" (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 . 6. If business, commercial or mixe!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 ..... t ................................................... Dimensions of same structure with alterations or additions: Front Rear Depth i Height Number of Stories 8. Dimensions of entire new constrUction: Front ............... Rear ............... Depth ............... . Height ............... Number of Stories... I .................................................... 9. Sizeoflot: Front .......... ! ....... , .... Rear ...................... De~th . 10. Date of Purchase .. lO.~.~g'.'. ~ · ' ..................... · ..o..o.../1~..~8.O.X .....Name of Former Owner .. ~.q~..~q ~.e.~. .............. 11 Zone or editi ti whihp~ ' ituated · us s r c n c remlses are s ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot beregraded.........................i .... 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 ai! buildings, whether existing or proposed, and. indicate ail 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. ,4 STATI~ OF NEWflftO RK,~ cou ¥ OF ......... ( 'n'g'c'o'n't;ic'ti .......... being duly sworn, deposes and says that he is the applicant above nanled. He is the (Contractor, agent, corporate officer, etc.) 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 contoined 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 b~fore me this Not ary Publ~~..~Y~.. :~ ......... // ~.. ,*,,:o~-,.,.,,~o..., . ture'ofapPliCant) PlP~ I00o O0 ~OoOO I~ VIE,, Ix/ DF/'/Y~ MAP OF PROPERTY TOWN Of ..... ~0~ .... su~o~K cou,~Y, N. Y. RICHARD WILHELM L.S. GONSULTANT$ CENTER MORICHES & pATCHOGUE NEW YORK 1~78.ot20