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Home My WebLink About16327-zFORM NO. 4 TO~VN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector lown Hall Southold, N.Y. Certificate Of Occupancy No. Z17043 Date July 1, 1988 THIS CERTIFIES that the building ...A..1 ?.e.r..a .t.i.qn. ................................. Location of Property ...2.1.9..9.0..R..a..c.k.e.C.~. Court (pvt. Rd.) Orient House No. ' ....................................... Street ~l~t~/e~ County Tax Map No. 1000 Section . . .0.1.7. ...... Block . . .0.6 ........... Lot . . .9...1 ............ Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Aug. 7, 1987 pursuant to which Building Permit No. 16327Z dated . .A.u.g. :..I.2. ,. i .I .9.8. 7. ............ was issued, and conforms to an of the requirements of tbe applicable provisions of the law. The occupancy for which this certificate is issued is ......... .... Co.nv.e r.t..e>;i,s.t, in. g..a.t.t..a.c.h.e.d., g.a.r.a.g.e..t.o...1.i.v. 5:..ri.g. area. The certificate is issued to JILL MUIR (owner, ~a~[c~7,eY~Irr~Jl[X of the aforesaid building. Suffolk County Department of Health Approval ....N./.A. ................................... UNDERWRITERS CERTIFICATE NO. N017455 June 17, 1988 PLUMBERS CERTIFICATION DATED: N/A ........ Building Inspector Rev, 1/81 FORM NO. ~ TOWN OF $OUTHOID BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLI:-rlON OF THE WORK AUTHORIZED) NE 16527 Z Date Permission is hereby granted to: °~ ~.1 ....... . ....~.~.~.......~.:..'r/..,,..L Li/.~?...'/. ............... , ,o ot premises ~ocated at ..~....L.~..'/. ....... '.~.~,~.......~..C. gv......~.J.....~t,~.. ........... County Tax Map No. I000 Section ..... ,(~.,i,,,~ ......... Block ....... .~..,,~,. ...... Lot No ..... ,.~."...~ ............ tO application doted ......~ ~.~...] ............ , IgOr..., and approv~ by the pu~uant Building Inspector. ~--~), ~ Fee $ ........................ Rev'. ~/30/$0 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY ,, BLDG. DEFt', TOWN OF SOUTHOI.~. ,,, InstruCtions This application must be filled in typewriter OR ink, and submitted ~ 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 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 prepare a certificate. C, Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling.$25..Q0, Accessory%S10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50~. 00 3. Copy of certificate of occupancy $ 5~00~, o~er-5 years $10,00~ 4.Vacant Land C.O. $ 20.00 5.Upd&ted C.O. $ 50.00 Date .... 5../.2Z8..8 ............... NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .2..~.9.9.0..R..a.c.~.e.~..~..C.o.~.~.~.. {?.~.~.~.a.~..e..1~.o..a~.).,...O.~.~e.~.;. ~:¥., ........ House No. Street /'/am/et Owner or Owners of Property ....... ~ ~,~.~..N. ,u.~,r. .......................................... County Tax Map No. 1000 Section ...0. ,17 ......... Block . 06 Lot 9.1 Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. , ~.~-~.27,2J. Date of Permit . ,8/.~.2. ,/.8.?,Applicant .... J..~, ,1,~..~,~, ~,r .................... Health Dept Approval Labor Dept Approval Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ....... r ............. Final Certificate ....................... Fee Submitted $..2.5.,0.0. ...................... Construction on above described building and permit r~ !l~a~pl~7,d~s and regulations. Applicant ...... ~.~~ .~ .~. ~ ..................... THE NEW YORK BOARD OF FIRE UNDERWRITERS ~r, ~ '1 t. 9~U 2 BUREAU OF ELECTRICITY ~-- 85 JOHN STREET, NEW YORK. NEW YORK 10038 JUN.~ ~7,19~ 5~2964~8/~8 N 0~745~ ~e ~ppllca~i~ No. on file THIS CE~IFIES THAT o~y t~ ~t~ ~uipme~ ~ ~ ~w a~ lnt~ by t~ ap~t ~ ~ the ~ ~t~ numar in t~ p~m~ of ~ examin~ on andflound to be in compllan~ with the ~ui~ments of this B~rd. RXTUR~ RXTURES RANGES OVENS EXHAUST FANS SERVICE DlSCONNL~T S E R V I C A. W.G. NO. O~ HI-LEG OF CC. CO~O. I~3I,EC. ROOM ~HOKE DETECFOR: --I ILO.BOX 1768 SOUTflOl,D, NY, tl. 971 ~ ~ This ce~f~a~ m~f ~t ~ ai~r~ in any manner; ~urn to ~ afire of t~ ~ard if incorre~. Ins~rs ~y ~ i~ntifi~ ~ t~ir ~. UNDATION ( ~ s t) UNDATION (2nd) !~ UGH FRAME & FLUMBING SULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ]/~SULATION FRAMING [ ,~FINAL 765-~802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND I*~FRAMING REMARKS: ROUGH PLBG. INSULATION FINAL DATE INSPECTOR ~~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ]/R/OUGH PLBG. / FOUNDATION 2ND [~ INSULATION []FRAMING []FINAL REMARKS: ~ ~/~-~ 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT ~EP'b~C TOWN HALL NOTIFY SOUTHOLD, N.Y. 1J971 TEL.: 765-180~' CALL ne~ MAIL Exami .~.T../..~.-, 19~, ?. Approv~ ./t~...~. !..~'.., 19~'..~i Permit No./.~..~'~' ~ .~ Disapproved a~c ................. '. ;'. ). ............ · .~,-) ,, .$ ,d,~..~4,~..{~.~ ..r~..~..-' .......... : . .. (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH 3 SETS OF PLANS '~Y''' SURVEY %" ~0RH ............. : Date . .~V.C~-..V$.17...9l.., 19~. INSTRUCTION? Tkis application must be completdly 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 kave 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 premises and in building for necessary inspections. C,X, ~ Q~ ..' ''' i~i'g~r'~l~mant:'~ ~'~~;; name, ifa c;;~;[a'ti~) .... fdCN'r, N,Y., (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......... . .......................................................................... Name of owner of premises .... ~..'.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) ALL CON, TRACTOR'S MUST BE SUFFOLK COUNTY LI.CENSED Builder s License No .... number's License No ......................... e'AS-r Electrician's License No ....................... Other Trade's License No ...................... C~'~),4~,fq' ~) · 9.ff T.,. N:Y .................................. House Number Street Hamlet ' ' ' County Tax Map No. 1000 Section ...~.l.q: 9.°. ........ Block ....(~..~...o..~. ....... Lot...~?.~:?.~.1 ......... 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 ............................................................ ( ppli ) ' 3. Nature of work check which a cable: New Building .......... Addition .......... Alteration ...~ .... Repair .............. Removal .............. Dexnolition .............. Other Work ............... (Description) 4. Estimated Cost ........ ~ · · ? ..................... Fee ..... , ........................... · (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 .... i ........... ~ ..................................... . .................. 6. If business, commercial or mix6d occupancy, specify nature and extent of each type ofhse ~: ~.'.' ?~.'./.. i ......... 7. Dimensions of existing structu~es ifany:F~ont...~,~P.~ ; ' Rear ,.~. t .. ~-Depth ~! Hmght ............... Number of Stories ...... ~ ............................................... Dimensions'of same structure With alteratio,ns or additions: Front ...~,%-'P~ ........ Rear .. ~/Y~ ......... Dep, th ..... ~--:'/1~: ......... i... Height . ..................... Number of Stories ...................... DimensiOns t~tl~t~tire new cons{ruction F~r0nt ..... ". ..... . ..... Rear ............... Depth ............... Height ............. Number of StOries ' ' S~ze of lot: Front ...1.~.0.,~.,.i.., .... '....... Rear ?i,l~.~.,~.~ .t.... ....... Depth 1. I~-{*, .e}:~ !: .47./.&.~...g'.~?... Date of Purchase ....... ~./tflF.].~'.O ............. Name of Former Owner I~/~'..~ ,~.l~k~Kl~,,..'U... A~99~.. Zone or use district in which premises are situated ............................. Does proposed conatruction vi61~t~.e any zoning law ordinance or regulation: ... ~fOtt.~. Kh/.~k(.hJ ............... Will lot be regra'dbd ........ ~tlk~ ....... i .......... Will excess fill be rem.oved from premises: Yes No N~me of Owner o~ premises . .-'~.1~ .~ ./~y.1~.{k ...... Address ~.~{ .~]t ~ .O.&Jg~Trpl~/. Phone No.,.~ T..'q..~ g.~].... Name of Architect ......... , .......... ........ Address ................... Phone No ................ ......... hone 15. IS this property locatedI within 300 feet ;f a tidal we~lamn~l.~{es~'~ .... No~ .... · If yes, Southold Town Trhstees Permit maybe required. . i PLOT DIAGRAM Locate clearly and distinctly al~l buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and bloc]: number or description according to deed, and show street names and indicate whether interior or corner lot. ~11. 12. 13. 14. STATE OF NEW YORK_. ,~ ,,~ ~ COUNTY OF ~-~,1~.~,,..k.~. , ". "~. '', ' (Name of individual mg~ng contract) above named. .;. . . being duly sworn, deposes and says that~ae is the applicant ~ (C~ntr~actor.? ~gent, corporate officer, etc.) ~, and is d~ly authorized 'fo peff6r~h or have ~d;f~nned'the said ~ork and to m~ and file this application; that ail statements contained ~ this application are true to the best of his knowledge and belief; and that the wOrkswomWilltd bef6rebO>perf°~edme thisin the m~n~r~ se~. forth m~ the application flied, therewith~ ~ ~ 7. ............... .~ ...... day of..~ .... :. ~xxr.-~ ...... 19.. .... ..... ~l~ ~BUC State o~ ~w. . _ ~7~78'(q, Suflolk Coun~ ' .~ ' - ~ ~ ~ (Signature of applicant) ' I '1 F~' &'-g' ~ , ~Y' V, ~',L.. NOTIFY E~JILDING E)~p~,RTMENT AT '~ 76~1~2 9 AM TO A ~ F~R TH~ ~ FOLLOWING INSPEC~ON~: FOUNDA'rtO~ TWO ~GUIRED OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFlJCATE OF OCCUPANCY nl FO SHED'K p 0 f", - N T A,,'W O ~' leo TY P CA L SEC T/O N SCALE. '