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Home My WebLink About15626-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z]5204 Date . 3. a..n.u.a.r.y. 14,o 1987 THIS CERTIFIES that the bmldmg . . .W. oo.d.b, urnzng, s.t. qyf~ ................. Location of Property 50 Cleaves Polnt Read East Marion County Tax Map No. i1000 Section 0 38 .Block 0 2 .Lot 3 1 Subdlvlszon ..... ; .............. Fried Map No ....... Lot No ............ conforms substantially to the Application for Buridlng Permit heretofore filed in tins office dated · .J.. ap....7. ~..I 9.8..7 .., pursuant to winch Braiding Permit No .... 1 5 § g.6.z, ......... dated .... J..a n.... !,4. ,.. I. 9. .8 .7 ...... was issued, and conforms to all of the reqmrements of the applicable provisions of the law The occupancy for winch tins certfficate is issued is ...... · . y.o. gp. .STO. V.E.. ..................................... The certificate is issued to MARGITTA WAHRENBURG .............. .............. of the aforesaid bmldmg Suffolk County Department of Health Approval N /A UNDERWRITERS CERTIFICATE NO ........... N. {.A .......................... PLUMBERS CERTIFICATION DATED: N/A .... '~fl~lng Inspector ' Rev 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, lq. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 15626 Z Permission is hereby granted to: ..~...'~..~...~.~...~.:~:.....I.L~..~.~. ot premises Ioceted et ............................................... .-. ..................................... County Tax Map No 1000 Section ..... ..(~...~.~ ....... Block ...... .,~....~T.. ........ Lot No. ..~...J ....... ...~t~.~...L ~ ........ , 19.~'/., and approved by the pursuant to application dated Budding Inspector. Building Inspector Rev 6/30/80 OU~4DATION (1st) OUNDATION (2nd) OUGH FRAME & PLUMBING I~SULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIO~AL COMME~TS: FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION I' ] FRAMING [ ] FINAL REMARKS ? DATE///~//~/~! INSPECTO~ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 . APPLICATION FOR CERTIFICATE OF OCCUPANCY JAN i 319~ Instructions A. This application must be filled in typewriter OR ~nk, and submitted I m to the Building Inspec- tor w~th the following; for new buildings or new use: 1. Final survey of p~operty w~th accurate location of all buddings, 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. Approvat of electrical installatmn from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings Multiple Remdences and sim,lar buildings and install~ t~ons, a cert,ficate of Code compliance from the Architect or Engineer responmble for the budding, 5. Submit Planning Bloard approval of completed site plan requirements where applicable. B. For existing buildings (prior to Aprd 1957), Non-conforming uses, or buildings and "pre-existing" land uses' 1. Accurate survey qf 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 buddings. 3. Date of any houm~g code or safety respect,on of buildings or premises, or other pertinent mforma- tlon required to prepare a certificate. C, Fees: 1. Cert~ficate of occupancy $25.00 -- BUSINESS $50.00 2. Cert~hcate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certlftcate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 ~ 5.Updated C.O. $ 50.00 Date . .~.~.~. 1~.~ l'J.~ .~. ........ NewConstruc%zon ...... Old orPre-exlstmg Building ...~/. ........ Vacant Land ............. Hou~ No. Stree~ Nam/et co~ty,~ u~ ~o. ~000 s~io~ . D G.~ ...... ~o~k ~. .......... co~ ...5 .~ ......... s~b~,~,~,o~ .~&~¢.~..~C. ~ ...... m~o~ u~ ~o 2¢2~.~... ~ot ~o.. ~.~ ......... Permit No .......... Date of Permit ......... Applicant . ,.,...~ ~.~ ........................ ¢... Health Dept. Approval ........................ Labor Dept Approval ...................... Underwmters Approval ....................... Planmng Board Approval ...................... Request for Temporary Certificate ................... Final Cert~hcate ....................... Fee Submitted $ ............................. STOVE REPORT rsu~edorAppl,¢amlsName_ MARC,,ITTA C,. WAHREN~,IIRG ~n~sNeme ~Y H_ RFFVEIAGFN~Y INC. ~PE OF STOVE ~ad~nt ~ C~rculet~ ~ ~et~ USED FOR ~ P~ ~t Is there a smoke detector ~n ~me ~m as stove' ~es ~o -~o~,cvNo A5 04 ~.J 26 A heat No ~ _FOLLOWING MUST BE COMPLETED ONLY IF UNIT IS INSTALLED BY OWNER REMARKS Rear ol um,I lO w~l~/8" --" :qes /~zO-/- ~ Botlom of urn! tO floor t~-'~ .~' snches Fron~ of urn: t0 fron~ edge o~ f~r protecimon /~ ~' _,nches Yes [.~-Ko f~,3~Z2 Ptd mU S,A ~sapproved a/c FORM NO. 1 TOWN OF SOUTHOLO BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: 765-1803 , 19~7 Penmt No [ ~o...~ & ~ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Recexved ........... ,19.. a Tlus application must be completely filled in by Wpewnter or ~n ink and submitted to the Building Inspector, with ts of plans, accurate plot plan to scale Fee according to schedule b Plot plan showing location of lot and of buddings on premises, relahonstup to adjoining premises or public street ~ areas, and gwmg a detailed description of layout of property must be drawn on the diagram which is part of this appl ~tlon c The work covered by this application may not be commenced before issuance of Budding Pernut. d Upon approval of this application, the Building Inspector will issued a Budding Permit to the applicant. Such perm~ all be kept on the premises available for inspection throughout the work e. No budding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupanc lalI have been granted by the Budding Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Braiding Permit pursuant to th ml&ng Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o egulations, for the construction 'of buddings, additions or alterations, or for removal or demobtlon, as herein describe, lie applicant agrees to comply with all applicable laws, ordinances, bufldmg code, ,housing code, and regulatmns, and hint authorized inspectors on premises and m budding for necessary inspections 1./ ,-~ (S~gnature of applicant, or name, ~f a corporation) tale whether applicant is owner, lessee, agent, architect, engineer, general contractor, electricmn, plumber or budder ,amc of owner of pre,roses ~[ I~.~ ~, ~A~B~ (as on thc tax roll or latest deed) t apphcaut ts a corporahon, signature ofduly authorized ofl'lccI (Name and title of corporate offic~r) Builder's License No. Plumber's License No ..... Electrician s License No .. . Other Trade's License No Location of land on which proposed work will be done I louse Number Street ( ounty Tax Map No. 1000 Sectmn ~ ~ .... Hamlet Block ~' Lot '2~1 Sub&vision ........ (Name) Fded Map No Lot State existing use and occupancy of prenuses and intended use and occupancy of proposed constrtlchon a Existing use and occupancy b Intended use and occupancy Nature of work (check which applicable): New Braiding . . ...... R~moval ..... Repair . Estmaated Cost . . .~[P.~ ............ .. Ad&t~on Demohtion 4 5 If dwelling, number of dwelling units ..... If garage, number of cars ............................... 6 If business, commeroal or mixed occupancy, specify nature and extent of each type of use .... 7 Dlmenmons of existing structures, if any' Front ...... Rear ........ Depth Height . . Number of Stones .......... Dmaensions of same structure w,th alterations or additions Front ....... Rear .. Depth ......... Height .... Number of Stones ............... 8. Dmlenslons of entxre new construction Front ........ Rear .......... Depth .......... Height ........ Number of Stones ......................... 9 S~ze of lot Front . . .... Rear ............ Depth ............. 0 Date of Purchase ..... [ Name of Former Owner I Zone or use dmtnct in which,premises are situated ....................... 2 Does proposed construction violate any zoning law, ordinance or regulation ........... 3 Will lot be regraded ..... ! . Will excess fill be removed from premises Yes 4 Nmne of Owner ofprem:ses ............ Address . .. Phone No .. Name of Architect L .......... Addless ...... Phone No .... Nmne of Contractor . '.. I. .......... Ad&ess ...... Phone No *..... ...... Alteration ......... ·. . Other Work (Description) Fee ............... (to be paid on filing th,s application) · Number of dwelling units on each floor .... 5. Is th~s property located with~nl00 feet of a t~dal wetland? ~ if yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly~ all buildings, whether existing or proposed, and indicate all set-back dnnensmns frou roperty lines G,ve street and block number or description according to deed, and show street names and in&cate whethe atenor or coruer lot. TATE OF NEW YORK, S S OUNTY OF (Name of m&wdual mgmng contract) bore named be,ng duly sworn, deposes and says that he Is the apphca~ ,e is the ..................... o., . (Contractor, agent, corporate officer, etc ) fl[~ ~ $ ~:; ~[ f said owner or owners, and m duly authorized to perform or have performed the smd work and to make and file thi ~)phcation, that all statements contained m thru apphcatton are true to the best of h~s knowledge and behef; and that th ork will be performed m the m~ner set for~ m the application filed therewith worn to before me th~s ........ ~ .... dayof ..~ ......... 19~7 ot~mubhc, ... ~ ' ~ ~ ... County.3/ ~