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HomeMy WebLinkAbout13116-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z15354 Date March 17~ 1987 .. THiS CERTIFIES that the building ..... .A.c.c.e.s..s .o.r.y. ................................ Location^~ ..... +. 6500 NEW SUFFOLK Ave. NEW SUFFOLK County Tax Map No. 1000 Section I 17 . .Block 4 .Lot 35 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Ma.M 4, 1984 ....................... pursuant to which Building Permit No. ! .3 .l.l.6. z. .............. dated ....M.a.y.. J .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 ......... .............. .A. qq .e.s.s.qr.y..s.t.q.r.ag.e. shed. The certificate is issued to JOttI, l A. BEHR, JR, (owner, of the aforesaid building. Suffolk County Department of Health Approval ........ I~ [ A ............................... UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 FOB~ NO. ~ TOV/N OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT frillS PER~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13116 Z Permission is hereby granted~0: ~ ~....~ .......... ..~.~...~..~..t~!~.;.~..: ...... ._. .............. ~ , County Tax Map No. I000 Section ....... !..!....~ ........ Block .......... .~. ........ Lot No ......~L ~..~ ......... pursuant ,o application doted ........... ..~.....~....L~.'' ...................... , 19.~..~..,'' and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Deportment Town Ho1! Southold, N.Y. 11971 76.5- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY / Instructions A. _This application m.ust bo filled in typewriter OR Ink, and submitted ta ~ to the Buildln~j Inspec- '[or with tho following; for new buildings or new uso: 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 equali. 3. Approval of electrical installation from Board of Ftre Underwr'ters. °n 4. Commercial bu,ld ks, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compllanco from tho Architect or Engineer responsible for the buUdin0, 5, Submit Piannlng Board approvat of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings end "pre-existing" land uses: 1. Accurate survey of p:operty showing all property tlnes, streets, bulidlngs end unusuat 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 Inspectior~ of buildings or premises, or other pertinent inl'orma- tier required to prepare a certificate. C. Fees: . , ' ' 1. Certificate ot occupancy flew Duell[n,%.$2:~.00. Acce.~:~o~y ~$10.00 Uua[ne~,~ 2, Certificate 6f occupancy on pre-existing dw~Uing S 50.00 3. Copy of certiflcate of occupancv $ 5.00, ove~ 5 yea~a ~10.00 5.Uodated C,O, ~ 50.00 Date ....... 6. Alteration ~25.00 NewCOns truetion ...... Old or Pre-existing Building ............ V~cant tend ............. o, ................ ..... HOuse No, /~ Street Hamlet Owners of Property ' .'.*. · Owner or ., ...... ,...' ....... ' ..... '' ............................ County Tax Map No. 1000 Section ........... 0... Block ............... Lot ................ Subdlv'sion Flied Map No Lot No Permit No ........... Date of Perm!~ ~"V~../'.~/~. ~,/..Applicant .................................. ~ Labor Dept Approval ~ Health Dept Approval · ~- ' Board Approval ~ Underwriters Approval ........................ Planning ...................... Request for Temporary Certificate ..................... Final Certlflcato... ~ ............ Fee Sobm tted S.y. .................. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 '['OWN IIALL SOUTtlOLD, N.Y. 11971 TEL. 765-1802 This is to advise you that the job under building permit no. ~ issued to John Behr Jr , on __5/iOZB~ .... for ~cc~ssorg is completed and a fiaal inspection has ( ) has not ( ~-been done. [. order to complete this file, it is necessary that ;i Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a check for $10.OOpayablc to the Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with this office for an inspection date Occupancy or use is unlawfnl without a Certificate of Occupancy. Pletlse help us to clear up tb~s matter ~o that legal action does not have to be taken. Thank you for yo~r prompt attention. Very truly Victor Lessard Executive Administrator VL: ga r encl . FIELD I~S'P E~T ION COMMENTS FOUIIDATION {1st) FOUNDATIOU ( 2nd ) ROUGH FRAME & PLUMBING INSULATION FER N. Y. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: TOWN OF $OUTIIOLD OFFICE OF BUILDING INSPECTOR ILO. BOX 728 TOWN IIALL SOUTIIOLD, N.Y, 11971 TEL. 765-1802 This is to advi,~e yon that the job under building permit no, ~ issued to John Behr_Jr en ._._5/iOL~A___ for . .,A~sq~l is completed o fin~]l {n~;pectlon has ( ) has not ( x) been (lone. and In order to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form, retern same to the above office with a cheek for $10.OOpayable to the Towu of Sou(hold. Please indicate to Whom thc Certificate of Occupancy is to be mailed, and ~rrange with this office for an inspection date Occupancy or nsc in unlawful without n Certificate of Occupnncy. Please help its to clear tip th~s matter ao that actJ. on does not have to be taken. Thank you for your prompt attention. Very truly y~, Victor Leesard Executive Administrator VL:gar encl. 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 8,OUTHOLD, N.Y. 11971 TEL.: 765-1802 , Approved .... ~ ~ ~.., 19~. Pe~it No. J.'~) .[~%. · ............................................. h .... APPLICATION FOR BU LD NG PER~IT Date ................... 19... 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, 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 co~e, housing code, and regulat'~?s, and to admit authorized inspectors on premises and in building for necessary inspe~ctio~, d .... ~i' ~;~n~ ' ! :~~a~io'~) .... ( 'g~;~atu~ of ~ pp ' , ' (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ............. ~..'...~..< .~.....~..~. .................................... ' '~'C)5-~t*-~ (as on the tax roll or latest dee~: ~ - 'L3 N~. .... If applicant is a corporation, signature of duly authorized officer. DATE: ~ ko~_~ B.P. :& I._~!J._[,._°cz (Name and title of corporate officer) Builder's License No ..... %. ............... Plumber's ~icense No ........ ~k~ ........ /'" NOTIFY BLtlLDING I)EPARTMFNT A 765-1802 9 AM TO .x PM FOR T[ ': FOLLOWr~G I. FOUNr)A-'!'?h! - T\A/O REC~'iRED FOR I¥',!JV r~ CONCRL--T': 2. ROLIq'H ;-RAM!N~ ~ pI!'Mr~IF'G 4. F[NA~ BE ALL COh?"r~ Jr"~ EON THE RE©! UeVMi-NTc, .~',I" 7'~-'' N Y. 1. Location of land on which proposed work will be done .................. STATE..G@N5 ¢'RUC.'TI'9?q' '~o · .~ .,.~..O.(2:) ................I, Wf, M,.A ~ .'-.-'~.x.."~x~?t'% .~..,..~..I~31~.N~:~ON£TRLtd-H.O~ 'ERRORS.' House Number Street Hamlet County Tax Map No. 1000 Section .... ]. [..~. ........ 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 ..................................................................... b. Intended use and occupancy ........ ' .~.~Z).~.Q~.P'~'. ............................................ 3. Nature of work (check which apl~lioa, ble): New Building ..... ' ..... Addition .......... Alteration Repair .............. Rem6val': ............. Demolition .............. Other Work ..~.\~3.)-A..~.. 4. Estimated Cost ......... ' ...................... Fee . . .'. ~ ............................ (to be paid on filing this application) 5. If dwelling, number of dwelling pnits ............... Number of dwelling units on each floor ................ If garage, number of cars ' 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 with alterations or additions: Front ................. Rear .................. Depth ..................... '.. Height ...................... Number of, Stories ........... j .......... 8. Dimensions of entire new constrhction: Front .... [Q.../ ..... Rear ... [ .O. ......... Depth .~ ............. Height Number of Stories 9. Sizeoflot: Front .. ~ ........i ........... Rear ...................... Depth ...................... 10. Date of Purchase ........... i .................. Name of Former Owner ............................. 1 1. Zone or use district in which pr~mises are situated ..... ~ .' ......................................... 12. Does proposed construction viol~te any zoning law ordinance or regulation: ............................ 13. Will lot be regraded ........ .,. .......... ......... Will eXcess fill be removed from premises: Yes 14. Name of Owner of premises ./~4D..~..(~.~,~.. Address ~\.k~..[~.... Phone No. '-/~.~(7.6'.~.. ~.~. .... Name of Architect .' 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 Tnes. Give street and block:lumber or description according to deed, and show street names and indicate whether corner lot. ,.g~o~ ,o'n ~ STATE OF NEW YORK, S.S couIqry OF ................. ...... ~ ..................... .................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. 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 contained 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 before me this day ................... of Notary Public, . ..... ~.~.-.~.9.Z..~..~.... County ~ ~ .~..~ NOT~¥ PUBEIC,iSlate 01 New ¥0r~ (Signature of applicant) [' No 4/078/8