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HomeMy WebLinkAbout13308-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Towl~ Hall Southold, N.Y. Certificate Of Occupancy No. Z15376 Date Marc.h 18, 19,87 THIS CERTIFIES that the building .... .C.e. 1. 1..ay ..................................... 300 SIXTH STREET Location of Property ................................... L AU RE L House No. Street Hamlet County Tax Map No. 1000 Section . .1.2.6. ....... Block ...... [ ........ Lot 9 Subdivision .~.g.O....%[J.T.H.I.L..L..S.E..C :..I. ....... Filed Map No..8.6.1 ..... Lot No. 37 conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... .J.u.l.y...1.6.,.. ! .9.8.4. . .. pursuant to which Building Permit No... 1.3. .3.0.8.Z. ............ dated .J.u.l.y...3.0.,.. ! .9.8.4. ............. 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 ......... Construct full cellar under existing one family dwelling. The certificate is issued to Marie & Helmut Mandl ..................... ?oYn'e'r, ...................... of the aforesaid building. Suffolk County Department of Health Approval ....... .N/.~ ............................... UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED: N/A Builff~fig Inspector 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? 13308 Z County Tax Map No. 1000 Section ...J....~.......~. ........ Block ........... ~ ......... Lot No ....... ..~ ............... ,o ..... ......................... , ill'id oppfoved by the Building Inspector, Rev. 6/30/80 FOnM NO. $ TOWN OF $OUTHOLD P. O, Building Departmont Town Hell Southold, N.Y. 11971 765- APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled 'n typewriter OR ink, and submitted ~a ~ to the Building In,pea- tar with the following {or new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unu~al 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 'nstallat[on from Board of Fire Underwriters. 4. Commercial braiding, Industrial buildings, Multiple Residences and similar buildings and in~talla- tlons, a certificate of Coda compliance from tho 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)0 Non-conforming uses, or buildings and "pre-ex st land uses: 1. Accurate survey of property 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 certificato, C. Fees: . ' 1. Certificate of occupancy flew O~ellzn~,;,$25.00, Acce.~3ory ,.$10.00 Buszne~: $$0.00 2. Certificate of occupancy on pre-existing dwo,lling $ 50.00 3. Copy of certificate of occupancy $ 5.00~ over 5 year8 $I0.00 4.Vacant Land C.O. $ 20.00 5.Uodatod C,.O. $ 50.00 Date .......................... 6. ~lteratlon $25.00 NewCons tr'uc t, ion ...... Old or Pre-existing Building ............ Vacant Land ............. Loaa, o, of Prop ,ty .... ..... ........................ , House No. / /ri'cot Ham/et Owner or Owners of Property .... ./ .................................. -~'~-~'/ Bio ' . ;'-,'.~ .' .~'..?.~. ~. Lot. County Tax Map No. 1000 Section ............... cl,, ......................... Subdivision ~~, :.'.~.. ......... Flied Map No. ~'.4;. / ...... Lot No... ~. 2. ....... / , . · ' n .............. ' Permit No. ~.~.~.~.~.~. DateofPerm~t.. ....... ~.,,.Apph,a t .................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Planning Board Approval Underwriters Approval · Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. b ' and er It meets all ap hcablo codes and regulations Construction on a ova described budding' ~---~.. J/~ ,~2_m e,? ~i:a~ m3~' '' '. Applicant . ,/..,,....,-,-., ,~..,4,; .~,¥~, ,=.-~ .................. FIEL~ INS~ECTION 1. COMMENTS ~o0 r % ~Loo r F 0 U_.N D A_..T I ON (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE Ye FINAL ADDITIONAL COMMENTS: 76S-1802 BUILDING' DEPT,, INSPECTION [ UNDATIoN ZST [. ] RouGH PLBG. FOUNDATION 2ND [ ] INSULATION' ' [ ] FRAMING REMARKS: DATE FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved . .~...., 19~.~.. Permit No..J .~..~...~.~..'~.. Disapproved a/c ...................................... TOW~ Application No .................. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tins 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 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 12remises and in building for necessary inspel~.ions. (Signature ofd(pplicant, or ~frne, if a' corporation) ... (Mailing address of applicant)-J¢~ State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. Name of owner of premises ........ ~. lm~.~4~ ~ .~ar. ie...~.aa.d./. ................................ (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...~.D/... ~,./.~.. ~.Tt~.~) 1. Location of land on which proposed work will be done .................................................. ..... ................... .......... .... ............. House Number Street ~0~ ~ ~ Hamlet County Tax Map No. 1000 Section ....... ~.~.G ..... Block ........ ~ ......... Lot .... .~ ............. S~di~i~io,.G¢.'.J.,.T~.~.(Name)Se~-~"O'CS { ..... FiledMapNo..~... Lot. ~.~ ......... 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 .~'~.~.'. - ~/... ~,~;~ ' , : ~1~' ...................... ork ~f cars 6. If business, commercial or mixeld occupancy, specify nature and extent of each type of use .... ..... 7 Dimensions of e isting stru tur~s if a y Font R Depth x c , n : r ' ~ ' ear : ....... Height Number of Stories Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth : Height Number of Stories 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ......................................................... 9. Size of lot: Front .......... i ........... Rea]: ...................... Depth ...................... 10 Date of Purchase ,' Name of Former Owner 11. Zone or use district in which pr~mises are situated.. ................................................... 13.12' WillD°es proposed construction vie!ate any zoning law, ordinance or regularion:lot be regraded ~.0. ............... .... i ...................... Will excess fill be removed from premises: Name of Architect ' Address ..... Phone No ................ Name of Contractor ........ i ................. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and, indicate all set-back dimensions from property 1/nes. Give street and block number or description according to deed, and show street names and indicate whether interior or Corner lot. I o 765-1802 9 AM TO 4 PM FOP, TH~ FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED ~ FOr~ POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING ~ '2- 3, INStI' ~'rtON 4, FIb,'^l - C©~'STRLICTION MUST BF : ..... ~ q~'c FOR C,O, ALI- CO~q'~p'~C-r ON StIALI- MEET THE pv,~' :~'r~b!T$ OF THc N.Y. cnU~,Tv n[2~-~2~f~./~$e-~ 'S.S CC' q ~ ', RE. P0b.$1R. - FOK . · - ~'~.~./~ ./. ~. · .~ .................... being duly sworn, deposes ~d says that he is the applicant .(Name of ind~dual signing contract) above named. (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly authorized to perform or have perfo~ed the said work and to m~e ~d file this application; that dl statements contained ~ this application are true to the best of his knowledge and belief; and that the work will be perfomed in the m~ne~ set forth in the application filed therewith. Sworn to before me this ounty . ..... ,: New Building .......... Addition .......... Alteration .......... , . ............. Demolition .............. Other Work6'~LL~. :i .~..~..0 (~.~. (Description) ~ ......................... Fee .... · ........................ I (to be paid on filing this application) O of dwelli~giunits ............... Number of dwelling un, its on each floor ................ 'd :/