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HomeMy WebLinkAbout16622-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Date January 20, 1988 THIS CERTIFIES that the building ALTERATION & RENOVATION Location of Property 760 Madison Street Greenport, New York House No. Street Ham/et County Tax Map No. 1000 Section 40 ,Block 5 .Lot 23 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated November......................12, 1987 pnrsuant to which Btfilding Permit No. 16622 z dated.................N ov emb e r 12, .... 198. 7 .... .. 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 ......... ALTER & RENOVATE EXISTING ONE FAMILY DWELLING AS INDICATED The certificate is issued to DOUGLAS & SUSAN NOBLE ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval ......... .N ./.A. ............................. UNDERWRITERS CERTIFICATE NO ................. .N/.A. ............................. PLUMBERS CERTIFICATIOI~ DATED: N/A Building Inspector Rev. 1/81 ~0~ NO. ~ TO~N O~ $O~T~OL~ BUILDING DEPARTMENT TOWN HALl.. $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) / __ Permission is hereby granted to: ..ar..,....~~.......G~ ....................... ,~~ ........ .~..:~..:...t.z..~..~..I ......... at premises located at ...~..~......~...~....~ttt~.....~......L%.~.~.0~....__ -- .a.. ~-~ ................. County Tax Map No. I000 Section ....... (~..~....o. ...... Block ...... .~..~. ....... Lot No.....~....~...~ ........ pursuant to application dated ...~.~...~....-~... .............. , 19.~..~.., and approved by the Building Inspector. Fee $...~....:..~ ..... Building Inspector Rev. 6/30/80 FORM NO. 6 Building Department . ~J._~,~E~PI~ .~, ~1~.~1_~1~. ,~_[Jl~l O L D 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 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. Certificete 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 ..~?.c>r'% NewC°nstruc~ion ...... Old or Pre-existing BuiJding ............ Vacant Land ............. Location of Property . .~..~..~?. .................... ~ ~'x a,,~C'o ~-~ .~.'.~... .... .~..l?. House No. Street Yam/et Owner or Owners of Property . ~...~? .%~.~. ~..~. ?...~...~...~...~'~.....~??.L°.. ! .~-.. .................... County Tax Map No. 1000 Section .. ~ .¥~. ........ Block ....~.~.. ....... Lot.. ~. ?~'..~. ....... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. I.~..~..~..~..~. Date of Permit .1! t ! .~.}.~.~..Applicant...~..~..c~.C~....~. .... ~-.~..~.'-..~. ....... Health Dept. Approval ........................ Labor Dept. Approvai ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Subm itted $ .~.~.~. ?.~ ..................... Construction on above described building a ts cable co s and regulations. Applicant ............ ~ ........................... R~v. ~o-~0-7s ~ ~'-~' ?'iELD iNS?ECT!ON IIDATE I! FO. UNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & .FLUMBING INSULATION FER N. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: TOW'N OF SOUTtlOLD OFFICE OF BUILDING INSPECTOR ILO. BOX 728 TOWN [{ALL SOUTIIOLD, N,Y. 1197I January 15, 1988 TEL. , 65-1 George W. Koch Mt. Beulah Ave. Southold, N.Y. 11971 To Whom This May Concern, We are unable to complete your Certificate of Occupancy becau[~e .of the followin9 reasons. -_x/ I~.1 I.-_I 1~I An application for Certificate of Occupancy is not on file. ENCLOSED NO Underwriters Certificate on file. '['hc~ check i'.;(~g~not ©I1 file.) $25.00 No IIealth Dept. Approval on file. No final inspection has been made. Pier, se contact our office on this matter. Thank you for your cooperation. lh~ilding PermJ. t It I 6 6 2 2 Z Duildi~:g Dept. ~k/}]/ Ho Plumber solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION / FRAMING [/FINAL REMARKS: DATE_///3//~ Z ~..,,. 0 o BOARD OF HEALTH · :~" '~'~¢" 3 SETS OF PLANS ~.-~.. ,, , ,~,:~; ,, ?~m~;, 'FORM NO. 1 SURVEY ....-....-~,. ~. ~,~Z~ ~¢~e,,,~ BUILDING DEPARTMENT S~C ~0~ .... TOWN HALL 8OUTHOLD, N.Y. 11971 TEL.: 765-1802 CA~ .... ~- · · pproved ~ ~.~ .].~., 19 ~.~ Permit No..I. 9.~.~.~ ~sapproved a/c .....''~ ' ................ ........ ' (Building Inspector) APPLICATION FOR BUILDING PERMIT // z .......... 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 co04, housing code~ and regulations, and to admit authorized inspectors on premises and in building for necessary insp~ (Signature of applicant, or name, if a corporation) .... :%.f-' (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................ ~.o~.z'.&*. c. ?.o.,~. . .................................................................. Name of owner of premises . .~.. e~ .~..../..V/P.~.~.ff ........................................................ (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 CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .... t,,~e~ .1.7..t~. ........... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... l. Location of land on which proposed work will be done: ..................... . ........................... ..7(.a .................. ........... House Number Street Hamlet County Tax Map No. 1000 Section . .d>..~..O..o. ....... Block ~9~4' O © Lot O,,~ ~,9 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 .... ' .?~. ~.r. 4rrZ...~.~.$. ~.~.4r~.c~' ......................................... b. Intended use and occupancy .... .~..4 .,~.z.& ........................................................ 3. Nature of work (check which applicable): New Building ' Addition i ......... Alteration ...cji..~. ~... pai ' Re r .............. Removal .............. Demolition ......... ~ .... Other Work .......... . ..... (Descrip~tion) 4. Estimated Cost ...... O O Fee · (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... l ......... Number of dwelling uhits on each floor ..... ./ .......... /. , If garage, number of cars ......................................... ; ............................. 6. If business, commercial or mixed occupancy, specify nature and extent of each fype of use '-" 7. Dimensions of existing structures, if any: Front....~'. 9...7. .' ..... Rear ...~'.q, ........ &' 'Depth.· .......... .-,'~.~'...~,' ....... '; ..... Height ...].~.~ ......... Number of Stories ....... ~ .................. [ ............................. Dimensions of same structure with alterations or aql,ditions: Front . .~..~.. De th ,.~'7 G, He1'* /.~. .............. Dimensions of entire new construction: Front ....... .~..' ..... Rear ..... wr- ........ Depth ... r~. .......... Height ............... Number of Stories .................... , ............................. 9. Size of lot: Front .... q~..l.P.' ............ Rear ..... ~.f~.: .~.~..' .......i Depth ...I.'~Z.°.'°~' ...... 11. Zone or use district in which premises are situated .... ~.. ~'~.t.~g~?.J.~,.~. ...... i ............................. 12. Does proposed construction violate §ny zoning law, ordinance or regulation: ..i~t9 .......................... 13. Will lot be regraded .......... ~9/. O. .............. Will excess,fill be removed from premises: ,---Yes - No 14. Name of Owner of premises"~v~c,..~, e,~-.~. ....... Address ~:ff../l~4~. ~. t.*?...~.. .... Phone No. ~.Z~..': .-~..~./.~... Name ' ~ .. ~'~. ~--~..; ... of Architect .......................... Address .......... ~ .. Phone No... ~ .......... Name of Contractor . .O~£ .o... ~.~..~.~. ........... Address .~'.~..~: ~.q .. Phone No. ~.~,;ff. 7.~...~. '/.... 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No ...--J~-.. *If yes, Southold Town Trustees Permit mag be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all 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. STATE OF NEW YORK, ,.~ ,~ ~ COUNTY OF..-~~ a.a ~ ........ ~.'g~.. ~'~ .~. .... '. '. '.' ...................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) i above named. ~ l(-,,~'. ~. ~ ,',., - ~t'~ He is the ........... ~r~ ~ , ' · (Contractor, agent, corporate o~{,~1~}, e~ i .... ~ , 'of said owner or owners and is duly authorized to perform or have perfo~4~ thel~sald~wO}k'~nd to nihke and file this application; that all statements contained m this application, are true to the~e~l~o£,llis Imowledgo,and belief and that the work will be performed in the manner set forth in the application filed there~,~t ¢~' ~,, ,., ,,-'i ;,' *",\ ! ~ 4 ! ~ ,. Sworn to before me this ' ;.~:,',~¢a-;:4 .... ~,~,~:, ~*<. ;,,~:, .............. /..C~. ....... day of..'~... ~ .............. , 19 ~.? No~ 4844751 Clulil~ied in 8uffot ~2'~ty County ~ (Signature of applicant)