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Home My WebLink About16657-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUP~NCY No Z-17574 Date DECEMBER 7~ 1988 THIS CERTIFIES that the building ADDITION Location of Property 530 HIPPODROME DR.&435 ROGERS RD. House No. Street County Tax Map No. 1000 Section 066 Block 02 Subdivision Filed Map No. SOUTHOLD, N.Y. Hamlet Lot 33 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 1, 1987 pursuant to which Building Permit No. 16657-Z dated DECEMBER 1, 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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to FREDERICK & CATHERINE STEIN (owner, Y~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-014066- MAY 26~ 1988 PLUMBERS CERTIFICATION DATED NOVEMBER 28, 1988-GEORGE GIUNTA Rev. 1/81 Building Inspector FOu~' NO. J~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: / ~ , ~.~.~!,...~....%....u..v..&.o... ........ ~ ........................................................ " ~ (r-'~ .... ,~ ~ County Tox Map No. 1000 Section ....... .(~..~...~. ...... Block ...... ...{~......~.. ..... Lot No ..... ..~.....~ .......... pursuont to opplicotion doted ~~?:~.....} ................ , lO.~...~., ond opproved by the Building Inspector. Fee $..,.~.~....;.~ 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-iS-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-con{orming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pzoperty 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 $25.00 1. Certificateofoccupancy New Dwelling,S25 bO, Accessory,,$i0.O0 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $([~0.00 5.Updated C.O. $ 50.00 Date . .f. . . NewCons truc tion ...... Old or Pre-existing Building ............ Vacant Land ............. Hou No.w .' . Strest County Tax Map No. 1000 Section ..... ~..~. ..... Block .... ~ ....... Lot . . .~..~. ....... Subdivision ................................. Filed Map No ........... Lot No .............. Health Dept. Approval ...................... Labor Dept. Approval .......... Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ...................... Fee Submitted $ ....................... ,~,,x.. Construction on above descmbed buddmg an~f'p'ermit meets all aQplicab(e,codes a~ Applican .. . ........... Rev. I0-10-7S TO'~'N OF SOUTLIOLD OFVICE OF BUILDING INSPECTOR P.O. BOX 728 q'OW N 1 IA L L SOU I'IIOLD, N.Y. 11971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occuf~ancy because .of the following reasons. /_-/ An application for Certificate of Occupancy is not on fil~.. ,/'~/ :lo Underwriters Certificate on file. '/~/ The check is(out0, ated/not on file.) /~/ b'o ,'Iealth Depto Approval on file. /~/ No final inspection has beeu made. Plea:m contact our office on this matter. Thank you for your cooperation]' ~.~,~ po~t ti.I. _ti_ _6_ ,5 2, z Buildin~ Plumber ( all permits involving plumbing being after April 1,1984 ) TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 72g TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. / Owner'~>~}'~/~ /~, (please print) Plumber ~4~O~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sw~o~ to before me this ~ day of ~ ~1., Notary Public, ~1~3~ County 1. FOUNDATION FOUNDATION ROUGH FRAME ~ PLUMBING INSULATION PER N~. STATE ENERGY CODE FINAL ~DDITIONA'L COMMENTS: DRIVE 106.0' 0 7 I .---::'.BLOCK AS SHO'~ ON ' No;'1472 765-1802 BUILDING DEPT. INSPECTION FOUNDATION ~.ST [ J~OUG# PLBG. / FOUNDATION 2ND [,~ INSULATION FRAMING [ ] FINAL 765-1.802 BUILDING DEPT. INSPECTION REMARKS: DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ;ZND [ ] INSULATION [ ] FRAMING REMARKS: [~INAL DATE INSPECTOR ~ ~~~ 7GS-~,802 BUILDING DEPT. INSPECTION FOUNDATION ~,ST t- ] ROUGH PLBG. [~YFOUNDATION '2ND [ ] INsuLATIoN FRAMING ,r ] FINAL 765-~.802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST i.:RAOUNDATION ZND MING ,r. ] FINAL REMARKS: ROUGH PLBG, INSULATION DATE BOARD OF HEALTH ...... 3 SETS OF PLANS ....... 'FORM NO, 1 SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL NOTIFY SOUTHOLD, N,Y. 11971 TEL.:76~1802 CALL ................ MAIL TO: Apprr~ved~L:u~. J .... , 19.8.7. Permit No..}.(P. ~..~.2 .~.. Disapproved a/c ..................................... ................................ (Building Inspector) APPLICATION FOR BUILDING PERMIT DateZ~..tT.~.od/er.. /$7' 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 La~vs, 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, ~ar~d re~gulatigns, and to admit author/zed inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) (M~'iling address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. Name of owner of premises.../~..../*..~..~.F.~....~.'.~.~...'~....~2.C.~.~./. .~. ............................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duty at}thorized officer. (Nam~ and title of corporate officer) , ALL CONTRACTOR'S MUST BE SUFFO)~K COUNTY LICENSED Builder's License No../(.~..O'[~-..~:~..-.,~/. ~. ...... Plumber'sLicenseNo..~..~.~o~.A~...~c,~~ ~ ~ Other Trade's License No. ~..e.....¢../Z~ ¢~' :,... .... ..... : ............. County Tax Map No, 1000 Section ~ .~.~ J ....... Block ..... ~. ~ ........ Lot .... ~ ........... Subdivision ..................................... Filed Map No ............... Lot ............... (N a m e ) 2. State existing use and occupancy of premises and intended use and occugancy of proposed construction: 3. Nature of work (check which applicable): New Building ........Ad&tlon' ' ' 'i' .................. Alteration Repair .............. Removal .............. Demolition ........... i... Other Work ............... . j (Descrip~tion) 4. Estimated Cost.. .~.~..°.'..~.9 ..................... Fee~ .......... ! ............................ (to be Ipaid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars ...~ ~-~ ........................ ; .......... ~ ............................ 6. If business, commercial or m~xed occupancy, specify nature and extent of each type of use 7. D~men~ons of ex~stmg structures ~f any. Front... ~$ ......... Rear . .~... ....... Depth ~'~v~fl~gV.. Height . . ~ .......... Number of Stories .... ~a.~ .................... ~ ............................ D~ensions'of same structure with alterations or additions: Front ............ ~ ..... Rear .................. Depth ....... . ............... Height ...................... Number o~ Stories ...................... - 8. Dimensions of entire new construction: Front ... [~ .... ' ..... Rear ..... ~ ....... Depth . .~.~ .......... Z Height . . .~ .......... Number of Stories. ..... ~.e ....., ............ d' ~Depth .. d.O.~ ............... 9. Size of lot: Front ..... 7 ................ Rear ...... Z~ ............. ~ ............................ 10. Date of Purchase ............................. Name of Fonner Owner J 11. Zone or use district in which premises are situated ................. 12. Does proposed construction violate any zoning law, ordinance or regulation: . ~ .~; ~ ~ 13. Will lot be regraded ....... ~ .... .~.._..., ....... Will exq.~sj!I1 be rem27~d from premises: Yes No 14. N~e of Owner of prem~ses~ ~o Address o,'~, ~ ~ PhoneNo ~-~ N~e of Architect ~X,7~. ,~r~/'. ............ Addre~ ~.~,~, ~,~t~. Phone No ~ ¢~- Name of Contractor ~ ~, ......... Address ~.~.~4~mhon~ No~ ~¢~/Jg 15. Is thfs property located within 300 feet of a tidal wetland? *Y~s ..... No ..... *I~ yes, 8outhold Tom Trustees Permft maybe requfred. PLOT DIAGKAM Locate cle~ly ~d distinctly ~1 bufld~gs, whether.existing or proposed, a~d,i~dicate ~1 set-back d~ensions from property Hnes. Give street and block number or description according t6. deed, ~d~ho~ street nines and indicate whether interior or corner lot. STATE OF NEW YOP~, COUNT_Y OF_ . ,--rz~. 4~4,d.,~.-,~/.,"~q. ....oz . . ........... (Name of individual signing contract) He is the .. ~ ................................ (Contractor, agent, corporate officer, etc.) of said owner or ownem, ~d is duly authorized to perform or have performed the mid work and to m~e ~d file this application; that all statements contained ~ this application are true to the best ofh s knowledge and belief; and that the work w~l be performed in the m~ner set forth ~ the application filed therewith. Sworn to before me this ..... ............. ..... Qualified in Suffolk Coun~ _ ~ Commission Expires Juno 30, 19~ G I ..q /