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Home My WebLink About16658-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17575 Date DECEMBER 7, 1988 THIS CERTIFIES that the building Location of Property 295 HIPPODROME DR. House No. County Tax Map No. 1000 Section 66 Subdivision ACCESSORY SOUTHOLD, NEW YORK Street Hamlet Block 2 Lot 33 Filed Map No. 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. i6658-Z dated DECEP~BER It 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 ACCESSORY GARAGE AS APPLIED FOR The certificate is issued to FREDERICK H. & CATHERINE STEIN (owner, lessee or tenant) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N014066-MAY 26, 1988 PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 FORM NO. O TOW'~ OF Sou'r~OLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N 1665 Z County Tax Map No. 1000 Section ....(~.~...[R ......... etock ..... ~ ........ Lot No ...... ~ .......... pursuant to application dat~ ~.~.~....J ................ , 19.~.g., and approv~ by the Building Inspector. Fee ....................... B ultclfng 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 1/771 Instructions A. 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 disposel--(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~coperty 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 buiJdings 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 00, Accessory~,,$10.00 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 o.oo 5.Updated C.O. $ 50.00 Date ..... -7~.../.. ..... /. . NewC°nstruc%i°n ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property '~ ?5-- ...j~,.j'.~.?..~&sj~jr~ r~: .~/.~_..~.,.~.. ...................... ...... House No. Street Owner or Owners of Propert CounW Tax Map No. 10O0Section .. ....~..~.. . ...,.. Block . ~_z Lot .3 .~.... Subdivision..; ........................ , ...... Filed Map No. , ......... Lot No ........ .... Permit No./.~..-~..~..-~Oate 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 buiJding an.~.permit me.ets ail ap~gticable codes a(~d ~m,lat~ns. Applicant .~. ~ ~. /./'~ ~ Rev. 10-1o-7a FO~I~BATION FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 106.0 '" '"" ...... MAP"" bF .... LoT I BLOC~ 7 ,,,, ..., s sHoWN on ^ ,bl;k' C'~ ESTATES 765-~.802 BUILDING DEPT. INSPECTION FOUNDATION 15T [ ] ROUGH PLBG. FOUNDATION AND [ ] ~SULATION / FRAMING [~ FINAL DATE INSPECTOR 76S-1802 BUILDING DEPT. INSPECTION ~FOUNDATION 1ST ~ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING FINAL 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL,: 765-1802 Examined .'~.~ .I ...... 19~ ?. Approved~.~w~-,~-..I ..... 19 .~.~. Permit No.)..~.k..~...~.. BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... CHECK .......... SEPTIC FORM ............. : NOTIFY CALL ................ MAIL TO: (Building Inspector) 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 permit shail 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 code, housing cods, an0 regular, ions, and to ....... ~forn c ssa ins ections admit authorized inspectors on premises and m bmldm~ e e ry p . (Signature of applicant, or name, if a corporation) (Mail~g address of applicant) State whether applicant is o.~ les~/agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises../...~.~... ~.../~.~..~'.. · · .~.l~...~. · .~..d~.~.'(7'/.~ .............................. (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.../.3'.,..d'..~..~..-t~'..-~. ......... Plumber's License No ..... .~...~..~.." .-.'~. · ........ Electrician's License No..../,~-. ~...~..E.. ....... 1. Location of land on whic~ proposed work will be done[ ....... / ...... i ................................... .... . ................ House Num bc~ ~ Str0et Hamlet ~ County Tax Map No. 1000 Section '~'~'9 ..... Block ..... Z~ ......... Lot ..... 1) ............ Subdivision ..................................... Filed Map No ............... Lot ............... (Nmne) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: . a. Existing use ann occupancy .m~..~t¢.. ~~ ............................. ., ......... b. Intended use and occupancy .~.Z. Z~.. ~r~.. ,~O~.~.. ~,f. ~Z~r ....... 3. Nature of work (check which applicable): New Building ' .. Addition.. ,~. ..... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost ..... · ...................... Fee ...................................... [ *' (to be paid on filing this application) If dwelling, number of dwelling ~nits. · .t~.~.~' ....... Number of dwelling units on each floor ................ 5. If garage, number of cars ........................................................................ 6. If business, commercial or mixe0 occupancy, specify nat,ure and extent of each type of use ......... '..: .......~.. 7. Dimensions of existing structur6s, if any: Front...'~-: ........ Rear . .4t.~.: ....... Depth~.~.'~..~j,,..~. Height .../. ~'. f. . Number o f Stories . ZT~..e.. ....... ~'.. D/mensions of same structure with alterations or additions: Front ............ Rear ...'~..~'. .......... ,iT'. ~,: ' ight / ~/: ~.,~ Depth ................ :.. He .................. Number of Stories ...... e ........... ' ... ~,...7'.... ..... Rear ... ,2.7. ........ Depth .............. Dimensions of entire new. constrUction: Front Height ~. ~,~ o,~ ;/Id, .~.~;,~t. . Number of Stories ...... t~. ~,.~. ............................................ 9. Size of lot: Fron~'.'t.~ .'?... 2'.~. ........... Rear ..... ~..~. .............. Depth .... /..o.g' .............. 10 Date of Purchase ' Name of Former Owner 1 1. Zone or use district in which premises are situated ......................... , ........................... 12. Does proposed construction viOlate any zoning law, ordinance or regulation: . .z~a ~...,,~'~.a ~ ,h ............... 13. Will lot be regraded ..... ~. o,.~ ..... ., ........... Will excess fill Ipe rerO.ov, ed. from premises: Yes No 14. Name ~f ~wner ~f prem~es~/~. £/.~. ~. .`~.a(~f~. ~t`.n . . ~ Address ~>~:x. ff.ff~ . ~..°. .... .,.,.PhoneNo..,~.~.-.o.~.;z.~.. Name of Architect .,~A~.~,~..~.~../ ............... Address .~o. ~*g,. b .~.~.,6~i~.~ed'~/~, Phone No..t( ~4~.-. O.Z.,{'.~.... Name of Contractor ~/~/.'.'.~.r ,J~-~v., · Address,.(o.f'ae/,;~/v¢ ~. ~..~. ~'hone No. ,f7.~/.-/.4~ ,~ .... 15. Is this property located iwithin 300 feet of a tidal wetland? *Yes ..... No ..... · If yes, Southold Town TrUstees Permit maybe 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 blockinumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YO~.~ ff/f/~ COUNTY OF. ..... ~.,~.~/a7 .~.-.../Z.e~.~..wy .,~.' ............ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. / / . Heis the ...... C .q?...~.~.~..~. ~..~Y7 ................................................. i (Contractor, agent, corporate officer, etc.) of said owner or owners, and i¢ du'ly authorized to perform or have performed the said work and to make and file this application; that ail statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this .................. day olf ...... 19 ~.~ Nota~ry Public ..... County I'16T/~¥ POSLl~stl(of New York ......... . . N0.4815023 (Signature.of applicant) ' I Qualified in Su,,ff01k ~ounty ...,. ' Commission Expires Juno 30, 192(.X 0 0