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Home My WebLink About16627-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z16632 Date Feb. 3, 1988 THIS CERTIFIES that tbe building .... A..1 .t.e.r.a..t .ip.n...a .n.d..w. 9 p.d..s..t py.e. .............. · 480 Midwa Road Southold Location of Property .............. ¥ ............... House No.Street' ........................... Ifl~i~/o~ County Tax Map No. 1000 Section 090 .Block 02 .... Lot 05 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ....... ~ .o y.... ! .2 .,.. ! 9. .87 pursuant to which Building Permit No.. ! 6. .6.2.7. Z. ............. dated ...~ ?Y.'.. ! .6.(. ! 9. .87 ............ 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 ......... ..... R~ooy. at.~..w.i~ ~1 p.w.s.. ~.n.d..iO~,t.al 1..a..w. 99.d' .s..t 9y.e' ..ap..a.p.p.l.i.e.d...f.o.r.: ....... The certificate is issued to SUSAN RANSCRT ................ : .... k ................. of the aforesaid building. Suffolk County Department of Health Approval N /A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 TOWN O~ SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) '6627 z No ~ Dote ~" .... ~.~.~..../. ............... , ,,..~.~ Permission is hereby granted to: .~.~.~~.~....~.~...: ...... ..'~.. ~....LL~.~ ................................. ~....~......: .............. :...% ................ ~-~ .......... ~ ....................... .:~ at premises located at ...1~..~.~. ...... ~.....~.4~.., ........ ~......~....; ................... County Tox Map No. lO00 Section ...... .C~.C~.O ........ Block ..... .~..'~m ..... Lot No ...... .~.~. ......... pursuant to opplication dated ...~..~~....../...~.. ............... , 19..~..~.., ond approved 'by the Building Inspector. Fee $..~).. .................. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, N,Y, 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY BLDG. OEP'L TOWN OF SOUTHOLD Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate 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. Commemial 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty 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 buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 New Building ............. Old or Pre-existing Building ............ Vacant Land ....... : ..... 480 ' ' ' · d Location of Property M~dw,~y Roa Sou~hold House No, Street Ham/et Qwner or Owners of Property ....S.u.s. 0.q..R.a..~;%qh..~ ......................................... Cotlnty Tax Map No. 1000 Section . .QgD ........... Block .... 02 ......... Lot ....... Q~ ....... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. ;[,(~27. ~. Date of Permit ~L],/.l(}/'.~?AppllcantL.qv. ~rp.qr0~ p.t..~,j ~.t;.~. ,[.~c.,., .o,z.. ~)~4~e r Health Dept, Approval .. N/.A .................. Labor Dept. Approval ...i~/A .................. Un~lelwriters Approval..N'./.A. ................... Planning Board Approval .~/.A. ........... ' ....... Request for Temporary Certificate Final Certificate X ......... Fee Submitted $ ~.,g.-,Q 0 ....................... Construction on above described building a/Q~~e codes and regulations. Applicant ~.,,~.~.2 q]~ P,t. ................... :lU~vir.oame~t Ess~, Iac. for Owaer FOUNDATION (lst) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: Environment East, Inc. R. R. No. 3 3075 Indian Neck Lane Peconic, New York 11958 516-734-7474 ',% ~xamined../9....°r~L" .?.. '.~%...I..t°., lpproved /Q~..~.. 1.~. ., 19~..-/. Permit No./.Q~..'~.'/...'~. ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~°OUTHOLD, N.Y. 11971 TEL.: 765-1802 )isapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... Date .. INSTRUCTIONS a. This'application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sts of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buikiings on premises, relationship to a~ljoining premises or public streets r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. 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 p~rmit trail 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 tiall 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 luilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or '~egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. 'lie applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for necessary inspections. ·. ~.~v.~p.amo b~. ~', ~ ~.,..I nc... · Fo~..Ow~e.r ..... (Signature of applicant, or name, if a corporation) 3075 Indian ~%ck Lane · . Pe.ao mig. · · ~?~f. · .1t9~8 ...................... (Mailing address of applicant) Ctate whether applicant is owner, lessee, agent, ~chitect, en~neer, general contractor, electrician, plumber or builder. Contractor Xlame of owner of premises .... ~usaa .~a~ach~ ....................................................... (as on the tax roll or latest deed) applicant is a corportltion, signaturc of duly authol i/cd ofl loot. ................................ .... (Name and title of corporate officer) Builder's License No.. J~(~. HZ. ............... Plumber's License No ......................... Electrician's License No ....................... Olher Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ......... ¢80. M&dway..Road ..................... So~thOl.d ................................... House Number Street Hamlet County Tax Map No. 1000 Section ....9.0 ............ Block ...... 2 ........... Lot .... J .............. Subdivision .... ~ ................................. Filed Map No ............... Lot ............... (Name) State existing use and occupancy of prenfises and intended use and occupancy of p'roposed construction: a. Existing use and occupancy ...0t~e. 3]amil.y..Dwed. l~_~. ........................................... b. lntendeduseandoc.cupancy One Fatai.ly Dwelling with'new wiudows and wood sto. v.e.: 3. Nature ofwork.(check which applicable): New Building .......... Addition .......... Alteration n IR, ...... Repair Ren~ovai ' Other Wor,k ........................... Demolition ........................ , ,*,k~Desc~iPtion) 4 Estimated Cost .~. ~.~).. Fee (to be paid on filing this application) · ~ ' -~ N mber of dwelling units o ch floor 5. If dwelling, number of dwelling units ..... ........ u n ea ........ 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 structures, if any: Front. ........... ;... Rear a .... ... ., .De ....... D~menslons of same structure with alteration i : ............. Dimensions of entire new cons ruction, l~ront ......... e ....... Height ............ Number of Stories ..... ' ......f... ' ....... .... ..... ~ ............... 9 Size of lot: Front I ' Rear Depth 10. Date of Purchase . I Nam. e of Former Owner ............... · ' hp~* ' ' Resxdenttal ' 11. Zone or use district ~n wh~c cremes are situated ............................................ property lines. Give street and blocl interior or comer lot. Does proposed con?truction violate any zoning law, ordinance or regulation: ........ 5Jo ......... ~ Will 10t b ' fill b ' No' e regraded i 1¢0 .......... Wdl excess ............. e removed from premises: Yes Name of Owner of premises $,l~a a Il. ~a r~ $ ~b~ .... Address L~ 0. ~a, c]~tt~.. [tcl ,... Phone No,7.~,-. ~- ~3,~ ....... Name of Architect ......... ] ....... ; .......... Address qq~.t.h, ql..d ~..~J¥..1.1.9.. }~one No .... Environment ~a...s).,..I. nc.~,t,t~,~ 3075 Indian 5JeC~hY~r~y.3.L~7,7~7.4..-' Name of Contractor ........................... ~ ............................ ~ etonic, ~Y 119~ PLOT DIAGRAM Locate clearly and distinctly ~l buildings, whether existing or proposed, and, indicate all set-back dimensions from : number or description according to deed, and show street names and indicate whether ;TATE OF NEW YORK, , S.S ~.OUNTY OF ................. ................................................ being duly sworn, deposes and says that he is the applicant (Name of individuai sigOing contract) bovc named. le is the ..................... i ........................................................... ! ~gent, corporate officer, etc.) ,f said owner or owners, and is duly authorizeWT6-perform or have performed the said work and to make and fi ~l~this- pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that tho ~ork will be performed in ,the manni*r set forth in the application filed therewith. .worn to before me this totary Public, ...... g~. .-. · Ho. 4707878, Suffolk Ceunq~c$, . (Signature of applicant) Term Expires ~s[ch 30,19,-~ 3. Nature of work .(check which applicable): New Building ..... ' ..... Addition .......... Alteration . ~ ..... l{epaii'~. ............. Removal .............. Demolition .............. Other Wor~. ,..~ ......... ' ~tDescr/ption) 4. Estimated Cost ...................................... Fee .................................... ~ (to be paid on filing this application) 5. If dwelling, nmnber of dwelling units .... J, .......... 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. Dhnensions of existing structures, if any.,: Front ........... ;..: Rear ~ ....... .~... ,Depth ............. Height ............... Number of Stories ~. \. (.... ~ ...o/X,~ .... ~.... ~ .... , ?). ......... Dime isions of same structure with alterations'~0klil~ons Fr~'/,~...0 o k) ~ t~ l~ear~~ . '" 8. Dnnensmnsofentrenewco,struchon' W,,nt ' '~ea;..~.....C. ..... De th . . Height ........... Nmnber of Stories ............. -- --¢ ............................................ 9. Size of lot: Front ...................... Rear ...................... Depth .................... lO. Date of Purchase ......... Name nf F~rmer · ' 'hp ' ' d R 11. Zoneoruset strct nwhc remsesares~tmte 12. Does proposed constructkm violate any ZOlti~lg law, ordinance or regulation: ........ No .................... 13. Will lot be regraded ................ I~To .......... Will excess fill be removed from premises: Yes 14. Name of Owner of premises 31.~.a a o. ~,~ O ~ ~h .... Addressh,~ O. ]'~.~, d. ~.~t~. I~.d ..... Phoue No.7.6..q,': ~ 0~3~.' ..... Name of Architect ........................... Address S. ? .u.~.~.q ~ .d,..3'.T .y..1].9.. }]tone No ............ -.. Name of C'nntractor ';' ~wi r' ~nrrlt:~ n (, J::~ ,~t, .I. 9(.~..Address }~075 Igdian .N.e.e.~h~Yr~o. PLOT DIAGRAM Locate clearly anti distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions fm property lines. Give street and block.number or description according to deed, and show street names and indicate wheth, interior or corner lot. ;TATE OF NEW YORK, S.S ;OUNTY OF .................. ................................................ being duly sworn, deposes and says that he is the a'~'l~ticar (Name of individual signing contract) bore named. le is the ..................................... .~ .................................................. ior;gent, corporate etc.) officer, f said owner or owners, and is duly authorizeiFF6~perfor~n or have performed the said work and to make and fi el~'th: 0plication; that all statements contained in this application are true to the best of his knowledge and belief; and that th /ork will be performed in the manner set forth in the application filed therewith. worn to before me this /2 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ,pproved /Q .Iv'M'A~.....~.. 1.~.., 19~..~. Permit No./.~..&'.?.'~· · )isapproved a/c ...................... , ............... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... Date .. )}~. Yq ?.h.,~,z,. 2,, .... 1¢'.7. INSTRUCTIONS pletely filled in by typewriter or in ink and submitted to the Buikling Inspector, with 3 lc. Fee according to schedule. a. This application must be cpm ,ts of plans, accurate plot plan to sc: b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets r areas, and giving a detailed description of layout of properly must be drawn on the diagram which is part of this appli- trion. c. The work covered by this appiication may not 6e commenced before issuance of Buildiug Permit. . d. Upon approval of this application, the Building Inspector will issned a Building Permit to the applicant· Such permit tall 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 mil have been granted by the BulldOg Inspector. APPLICATION iS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or .egulations, for the construction ot~ buildings, additions or alterations, or for removal or demolition, as herein described. lie applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for necessary inspections. .. ~:~.rW. 7. r ;~.~¥~(~ b~;. f.,,.,, s ~.,..Inc... · ~,"oz'..Owan.v ..... (Signature of applicant, or name, it' a corporation) 3075 India'~ ,%ak Lane · . i'c.a,,~ ~.] i.c... ¥I~r. · .319~4~l ...................... (Mailing address of applicant) ;late whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~lame of owner of premises .... ,~u~$ aB. .}2ar~.s.q h 1; .................................... , ................... : (as on the tax tell or latest deed) f applicant is a corporation, signatul e of duly autho~ ~zcd ~dll, %1 (Name and title of corporate officer) Builder's License No..,~,~,(> ,!EL ............... Plumber's License No ....... i .................. Electrician's License No ...................... O her Trade's License No .... ~ .................. Location of land on which proposed work will be done .................................................. ......... 4,~0. H,~dwa.y..Road ..................... Sau.,th ~l.d. .................................. ._ llouse Number , Street Ilamlet ~'~ County Tax Map No. 1000 Sect:on ....9.0 ............ Block ...... 2 ........... Lot .... J .............. Subdivision ...............,.. ..... Filed Map No. Lot i(Name) State existing use and, occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy i · .0fao. 14'.am fL.1..'J: .Due],~iA;; ........................................... i b. lntendeduseandoc.cupaney!....One t~'amily..... Dwel]inF, with new windows ~.~qd woo~l stove:.. 21' ,f E X I,STI ~ G .SuN k :Ai~lloVED ...... ,_~. OCCUPANCY OR 7~5-1~2 9 A~ TO 4 FoLL~N6 INS~ONS: ~.,....o. ~o.~u,~oUSE IS UN~WFUL ~ POURED CON~ETE ICATE ~UGH FRAMING & ~UMBING ~.,...~.,o,~ wiTHOUT CERTIF 4 FINAL GON~UCTION MU~ .,,o,,.,, ~. c.o. 0F OCCUPANCY ALL CoNSTRUC~N SH~L ME~ T~ ~QUIR~ENTS ~ ~NN.Y 'STA~ ~ ~ CON~I H~C~ON ER~RS, VAT 0 ~1 'T £bN PO g,C~q 5TOWE PiPE ~'~.T~,~L_ VA"FI 21' 6uN POP,,C V\ ELEVAT'IO\'q, ,, , , '/:2. 3uN Po P~Q¼ F_.LE VAT'I ON ~) -1 ....... JJ ............... [ F-LOOFL L EL