HomeMy WebLinkAbout16693-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z18005
Date MAY 5~ 1989
THIS CERTIFIES that the building
Location of Propert~ 255 SUMMER LANE
House No.
County Tax Map No. 1000 Section 078
Subdivision
ACCESSORY
Block 09
BAYSIDE TERRACE Filed Map No. 2034
SOUTHOLD
Street Hamlet
Lot 11
Lot No. 15
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DEC. 23, 1987 pursuant to which
Building Permit No. 16693Z dated DEC. 23, 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 BUILDING.
The certificate.is issued to
THOMAS & NANCY NUHFER
(owner, YJ~)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
N/A
Rev. 1/81
'Building Inspec{or ' ~
FO~.,M NO. ~
TOWN OF $OUTHOLD
BUILDING D£PARTMI=NT
TOWN HALL
SOUTHOLD, No Y.
BUILDING PER. MIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Permission is hereby granted to:
County Tox Map No. 1000 Section .... ..~....~..~. ....... Block ...... .,{~...~ ........ Lot No ...... !].. ...............
pursuant to application dated~~.~......~...~ ........ , 19.~..~., and approved by the
Building Inspector.
Building Inspector
Rev. 6/30/80
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NEW YORK
765 1802
11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Owner or Owners of
County Tax Map No.
Subdivision.~.~ ..-~I~ .....
Health
Planning
DATE .~-4~
~EW CONSTRUCTION .~ ..... OLD O~ P~E-EXISTINC ~UILDINC ...... VACANT LAND ........
Location of Property..~--~. ........ -~-~'~.%'-'f~--~-,. ~0; ......... .~..~.~ .........
HOUSE NO. STREET HAMLET
Property..~i~r~.~S ~.~.~G~ ~.~
~000 Se~io~ ~Z~.. ~o~ .O~ .... no~ ..~.~.
Dept. Approval ...~/~ ............ Underwriters Approval.~ ..........
Board Approval ..~/~ ...........
Request for Temporary Certificate ....... Final Certificate ~ ..............
Fee Submitted:
rev. 10/14/88
OUNDATIO.U ( 1 s t)
OUNDATION (2nd)
OUGH
FRAME &
?LUMBING
~NSULATION PER N. Y.
STATE ENERGY
CODE
FI~,AL
SUFFOLK COUNTY DEPARTMENT OF H~<H SERVICES
FOR AP~'ROVAL OF CONSTRUCTION ONLY
DATE. ItS REF. NO,
APPROVED
oo,/
(Q
AREA = 12,000 SQ. FT.
OR O 27 ACRE
CERTIFIED TO:
THOMAS NUHFER
NANCY NUHFER
The water supply & sewage disposal sys-
tems for lhis residence will conform to the
standards of the Suffolk County Depart-
ment o~ Health Services.
SU RVE Y OF
LOT 15
" MAP OF BAY$1DE TERRACE"
FILED MARCOni 11,1953 FILE N0.2034
AT BAYVIEW
TOWN OF SOUTHOLD
~LIC. N0.49668
P.O, BOX 909
MAIN ROAD 06SERVATPONS AND OR [ROil D.~TA OII?AiNEB [r~ OTHERS
SOUTHOLD~ N.Y, 11971
SUFFOLK COUNTY, N.Y.
lO00 - 078 ? 09 - II
SCALE I"= 50'
SEPT. 2 , 1987
...~J in accordance with the minimum
,~.~urds for title ~urvlyl as mtablbhed by
the L.I. A, L. $. and approved, and adopted
for such um by The ~ york ~ Land
Title Apociati~n.
87 684
'FORM NO, 1
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 765-1802
BOARD OF HEALTH ......
3 SETS OF PLANS .......
SURVEY ..........
CHECK ..........
SEPTIC FORM ............. :
NOTIFY
CALL ................
MAIL TO:
Disapproved a/c .....................................
(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 deta/led 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 Perrqit to the applicant. Such permit
shall be kept on the premises available for inspection throu,ghout the work.
e. No building shall be occupied or used in whole or m 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 Cbc 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 appt/cable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspection.. A .
(Signature of applicant, or name, I p
· ~.o....~p.~...~57.q.ce .f..~...oeq~.. Ao.< .o(./~ .~. 117.7/...
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Ocofue-~ f ~.a, . ...............................................................
Name of owner of premises .............................................
(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 B~ SUFFOLK COUNTY LICENSED
Builder's License No.../..'~..Z.~.~.Z .~.-,~¢. ........
Plumber's License No .... .~..~.L?. ...............
Electrician's License No. ~..~. 5[. !.'-..~----:...
Other Trade's License No ......................
1. Location of land on which proposed work will be done ..................................................
................................ .3..~. ~.~. ?g.4~.. ~ .~./Y..~f ......... ~ ~ .T...~o. ~ .................
House Number Street Hamlet
County Tax Map No. 1000 Section .................. Block .................. Lot .... ./.3~.. ...........
Subdivision..~..~. ?,~./.D.C.~...'~.6~..'~.. ~ .C.~. ............ Filed Map No.. ?~. J?.~...~. ..... Lot .. /..5~. .........
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy . .y.r.~.~.~../~.'.7~. .........................................................
b. Intended use and occupancy .../?.~.C?.-~'. ~..o?~..,~.~/.L,.~(.t?.~ ..........................................
................ :.. ~ ~...~ .~ ...... ~ .... ~.~lo.~ Ol,6~,V~ ~ '~
;, ~unoD ' .............. ' // /~ ~/~ ~ ~ ~~ ........... '~" ' ;"~'°qqn'4~°N
s[~l om olojoq o~ mo~S
~ ~ pu~ ~lI~q pu~ o~p~I~ou~ isl~ go lsaq o~ ol an~l ~a~ uogeolldd~ slHl ~ poul~luoo slu~m~l~ls ii~ ~ '.uog~olldd~
~ oI~J pu~ ~ ol pu~ ~o~ pl~s a~l po~oj~od oA~ ao ~=ojaod ol paz~oHlne &inp si p~ 's~ou~o =o ~ou~o pl~s &o
('o~o '~o ~l~odioo 'lu~ '~olo~iluoo)
............................ ............................................................. ~ si ~H
'lo[ ,tou.too .to .to.uolu!
uto&l suo.tsuom'!,p )[o~q4os II~ ol~v.lp,u! 'pu~ 'p~sodo.td ,to i~uDs.tx~ ~oti3Otl~ 's~m. pl,mq ii~ Al:~Vu!ls!p ptm XlS~lo o3~oo'I