The URL can be used to link to this page

Home My WebLink About16253-zFORM NO, 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z 16137 Date .8.e.p.~.:..4.,. 1987 THIS CERTIFIES that the building ...... .Afl. d..~ .~ .~.o.n. ................................ Location of Property 4 I 15 Soundview Ave. Southold House IVo. Street Hamlet County Tax Map No. 1000 Section ...6 .8 ........ Block ....0 .] .......... Lot . P./.q J .5 .......... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated May 28, 1987 .. pursuant to which Building Permit No. 16253g dated Ju 1 y 20, 1987 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 ......... Deck addition to existin~ dwelling as applied for. The certificate is issued to MICHAEL & RITA HAGERMAN (ownor, of the aforesaid building. St~ffolk County Department of Health Approval N /A UNDERWRITERS CERTIFICATE NO. N / A PLUMBERS CERTIFICATION DATED: N/A ............ Rev. 1/81 FOB~ NO. fJ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, No Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL ,,COMPLETION OF THE WORK AUTHORIZED) No_ 16253 z Permission is hereby granted to:, ~ ~ / ~.~....~~~ ................... ~.. ' .... ~ ,~?e~..~.~......~...~...~ ................... . ~o ...~~......~....~ :./.~....~~..~~ ............ at premises located a~C'/t ........ ' ~ ~'--~-- ~ ~~~...~..~.~/4~.....~'....,.~...~,...~.-~- County Tox Map No. 1000 Section ....... ~.. ........ Block ...................... pursuant to application dated ...~ .~.. ................................... , 19.~....~, and approved by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y, 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m~ 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 disposal-(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 property 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 buiMings. 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: Additions $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50-. 00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.updated C.O. $ 50.00 Date .~-~.'..~..../~./ ......... NewCons t~uc tion ...... Old or Pre-existing Building ............ %/acant Land ............. Location of Property ... ,L~ J./, ~) ............... ,~,~ PropertyH°UseN°' ...... ~/~i./'~.~.---'t,~/~,l,q,~c,~.,~Street ........ .... Nam/et Owner or Owners of County Tax Map No. 1000 Section ...5.~,,.. ''~"''""" Bock . .47. ,/ ......... Lot.,[.. ,~, ,~,, ..... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. ('.~'.,].~.'-~.~Date of Permit .......... Applicant ........... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. Applicant ,,. Rev. 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 ~'r 3, ~'~? TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. / /:~// An application for Certificate of Occupancy is not On file. /5~~ No Underwriters Certificate on file. /_~ The check is(outdated/.~ot on file.)~- /5/ No Health Dept. Approval on file. /5/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit ~ ~_ ~ __2 ~ ~_ Z Building Dept. ***/5/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) Occupancy or use is unlawful without a of Occupancy. Clear up this matter as soon so that leEal action does not have to be taken. Thank you for your prompt attention. Certificate as possible UNDATION {1st} UNDATION (2nd) UGH FRAME & PLUMBING SULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: .T FLJLT~ BOARD OF HEALTH ...... 3 SETS OF PLANS ....... 'FORM NO. I SURVEY ......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL NOTIFY SOUTHOLD, N.Y. 11971 TEL.: 765-1B0~ CALL / Examined · · ?/'...,~. · ....... , 19 .~.? Approved .............. y .1;~2. , 19 .~7. Permit No../.~..~..ff. ~...~-~ Disapproved a/c ..................................... MAIL TO: 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 permil 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 uhtil a Certificate of Occupan% 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 applicabl~ Laws, Ordinances m Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described The applicant agrees to comply with ail applicable laws, ordinances, building code, housing code, and regulations, and tc admit authorized inspectors on premises and in building for necessary inspe~s. ~ ,-/]--7~ // (Signature of applicant, ration) (Mailing address of applicant) State ~vhether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . ~ .. .;..~ · · ' ........... (as on the tax roll or lateit deed~J If applicant is a corporation, signature of duly authorized officer. (Name and title of co, orate officer) . ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY Builder's License No .......................... LICENSED Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done: ................................................. ...q..//,sT ......... ,_qc, d /7. rcm.. House Number Street Hamlet County Tax Map No. 1000 Section ...~).(9.~.; ........ Block .... CD. [ .......... Lot .../~-~ ......... ' Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and inteDded use and occupancy of proposed constroction: Ii a Exist ng t se and occupancy .......... ..~.: ........ . .~....~.~ ........ ~ ...................... b. Intended use and occupancy .................................................................... · Nature of work (check which applicOble): New Building .......... Addition · · · .~. · · · · · Alteration ...., ...... Repair .............. Removal ' .............. Demolition ........... J.. Other Work.. If dwelling, number of dwelling unit~ If garage, number of cars ........ ,. ~)escription) · .................... Fee...................................... (to be paid on filing this application) .............. Number of dweIling units on each floor ................ If business, commercial or mixed occupancy, specify nature and extent of each type of use ................. . .... Dimensions of existing structures, ifiany: Front ............... Rear .............. Depth ............... Height ............... Number ~f Stories ........................................................ Dimensions of same structure with a!terations or additions: Front ................. Rear .................. Depth ...................... I~eight ......... . ............. Number of Stories ............ ~. ........ Dimensions of entire new constructipn: Front .~././. .......... Rear . .~.~1. '~-../&' .....Depth . ../70...~ ./. ,~f.t... Height ............... Number ~of Stories ........................................................ Size oflot: Front .............. i ........ Rear ...................... Depth ...................... Date of Purchase .............. I ............... Name of Former Owner ............................. Zone or use district in which premises are situated ..................................................... I. Does proposed construction violate ~ny zoning law, ordinance or regulation: ................................ .' Will lot be regraded ............ i ................ Will excess fill be removed from premises: ,Yes No · Name of Owner of premises ...... i .............. Address ................... Phone No ................ Name of Architect ............. i .............. Address ................... Phone No ................ Name of Contractor ............ !:. ............. Address .... : .............. Phone No ................ ,. Is this property located within 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold Town Trusteas Permit maybe required. PLO~F DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back d/mensions from ~perty lines. Give street and block nun ber or description according to deed, and show street names and indicate whether ~erior or corner lot. 'ATE OF NEW YOP~Kn/~ · ' (Name of individu~ract) ....... being duly sworn, deposes and says that he is the applicant ove named· i e,_ is the ......................... j.. ~ ....................................... ~ .(Contractor, agdnt, corporate officer, etc.) said owner or owners, and is duly adthorized to perform or have performed the said work and to make and file this plication; that ali statements contained in this application are true to the best of his knowledge and belief; and that the >rk will be performed in the manner set forth in the application filed therewith. .'om to before nmChis ~/.~.~ ........ ~.*-] .......... day of ............ , 19~. P tarymublic, . ..... ~..~'..:'~..~..~.~... County ~..~...~..~.~~ HELEN Y,. lIE VOE ....... l .... I~. 4707878~ ~ff01 ~ [ / / (Signature of apphcant)