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Home My WebLink About15666-zFORM NO 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Budding Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Date ~p~....~9,..[987 .......... THIS CERTIFIES that the budding Locatlon of Property 3160 Orchard House No County Tax Map No, 1000 Section 2.7. Addzt~on Street Orzent Street Hamlet Block 3 .Lot 3. 1 Subdivision ........ ....... Filed Map No ..... Lot No ........... conforms substantially to the Apphcatlon for Building Permit heretofore filed in tins office dated · .. D. e.e.... 8. :..19. 8. 6.. pursuant to wluch Bmldmg Permit No . 156. 6 .6 .Z ........... dated . ...F e.b...6 ,. I 9. .87. was issued, and conforms to all of the reqmrements of the apphcable provisions of the law The occupancy for winch tins certfficate is ~ssued is .... Construct an addztxon to existing one family dwelling. The certificate is issued to FREDRICA WACHSBERGER .......... ........... of the aforesaid building. Suffolk County Department of Health Approval .N/.A. .................. UNDERWRITERS CERTIFICATE NO .. . N822544 7 / 27 / 87 PLUMBERS CERTIFICATION BATED: Mzke Jacobi 9/4/87 Budding Inspector Rev 1/81 TOV~N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ ~5666, Z Perrmssion is hereby granted to: ..~ ~.~.~...~.~...~.~...~.;/ ................ .... ~,~,,,,~,~,...~.L.~ ............ ~~...~ ........ ~.~ ............... County Tax Map No t000 Section . ...C~....~...-~. ....... Block ...... .~.....~. ..... Lot No.....~....:..1 ........... pursuant to (3ppllcotion dated .... ...~..~......~-~......, 19.~...~, and approved by the IL} Building inspector. Fee $..~.... ............... BuilSIng 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 This apphcat[on must be filled in typewriter OR ink, and submitted ~ to the Building Inspec- tor w~th the following; for new buildings or new use. 1. Final survey of property w~th accurate locat;on of all buddings, property lines, streets, and unusual natural or topograph ~c featu res. 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 F~re Underwmters. 4. Commercml buildings, lndustmal bu~ld~ngs, Multiple Residences and mmdar buddings and installa- tions, a cert~fmate of Code comphance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed rote plan requirements where apphcable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses. 1. Accurate survey of 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 bu ddings. 3. Date of any housing code or safety inspection of buddings or premises, or other pertinent mforma- t~on required to prepare a cert~hcate. C. Fees. Addztions $25.00 1. Cert~ficate of occupancy New Dwelling $25.Q0, Accessory ,$t0.00 Business $50.00 2. Certificate of occupancy on pre-ex~st~ng dwelhng $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 ),ears $t0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ......................... NewConstruction ..... Old orPre-ex~st,ngBuddmg ....~....~ .Vacant Land ............. Locet,onofProper .... ............................ ' House No. ~. , ~ / feet Ham/et Owner or Owners of Property .. County Tax Map No 1000 Sect,on Subd~wmon ......................... Fded Map No ......... Lot No ............. Health Dept. Approval ................... Labor Dept. Approval ........................ Underwriters Approval ....................... Piannmg Board Approval ...................... Request for Temporary Certificate .................. Final Certificate ................... Fee Submitted $ .......................... Construction on above described bu,tdlng an~ perAIt ~ets all ~pphcable c~ and regul~lons. ~ Apphcant ' .~......~.......~./'~../.?..'~../.~... , .~. TO~VN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N Y. 11971 TEL. 765-1802 CERTIFICATION Date Bulldin~ Permit No. {~-~ ~-- Owner ~-~ ~ ~__~~ (please prznt). {please prln~) I certify that the solder used in the water supply system contains less ~han 2/10 of 1% lead. Sworn to before me this ~~t~0~ ' ~ day of ~ ~ 470n?a,~ 19~ Notary Publzc Notary Public, ~ County OUNDATION ( 1 st) OUNDATION ( 2nd ) OUGH FRAME & ?LUMBING NSULATION PER N. Y. STATE ENERGY CODE FINAL ! ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ~- ] ROUGH PLBG. FOUNDATION 2ND [ ] IN~SULATION FRAMING [~FINAL REMARKS: DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION FRAMING REMARKS: ROUGH PLBG. 2ND [,~SULATION [ ] FINAL DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [~OUGH PLBG. FOUNDATION 2ND [ ] INSULATION [~]'~RAM I NG [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [~ROUGH PLBG. [ ] FOUNDATION [ ] FRAMING REMARKS: ~//~t ] FINAL DATE INSPECTOR TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. /_~/ An application for Certificate of Occupancy is not on file. /Z/- NO Underwriters Certificate on file. /~/ The check ~s(outdated/~ot~~)~OO /Z/ No Health Dept. Approval on file. /~/ NO final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit $ % ~_ ~ ~ Q Z Building Dept. ~**/~/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,19~4 ) ~ O G C ''~ ~ !ii-' TOWN OF SOUTHOLD ..... - TOWH CLERK'S OFFICE ~r ~ ' . ' I SOUTHOLD, N. Y. D~sapproved a/c ....................................................................................... Applicahon No ............................ APPLICATION FOR BUILDING PERMIT Da,e ....Z~ ....................... ~9 ~.... INSTRUCTIONS o Th~s apphcahon must be :ompletely filled In by typewriter or in ink and submitted in trmphcate to the Build,- Inspector, with 3 sets of plans, aCcurate plot plan to scale. Fee according to schedule b Plot plan showing Iocahon: of lot and of buddings on premmes, relationship t,o. adjoimng premises or pubhc streets, areas, and giving a detailed descriphon of layout ofproperty must be drawn on the diagram which ~s part of thins appl carlo c The work covered by this lapphcotion may not be commenced before ~ssuance of Building Permit d Upon approval of this application, the Building Inspector wdl ~ssue a Budding Permit to the apphcant. Such perm shall be kept on the premises available for inspection throughout the work. e No buildmg shall be occupied or used in whole or in port for any purpose whatever until a Certificate of Occupan, shaJJ hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Buildmg Department for the issuance of a BuJIdmg Permit pursuant to tF Bu~[dmg Zone Ordinance of the,Town of Soutbotd, Suffolk County, New York, and other applicable Laws, Ordznances, Regulahons, for the construchonl of buildings, additions or alteratmons, or for removal or demolition, os herein describe. The apphcont agrees to comply With oil applicable laws, ordmances, building code, housmg code, and regulations, and; admit outhonzed Inspectors on premises and in buildings for necessary inspections. (Signature of app tcant, or nome, mfa corporation) .F... .................. (Address of'applicant) State whether applicant is owner, lessee, agent, architect, eng,neer, ~____~ml contractor'S, )dectncmn, plumber or buHde Nome of owner of premises .~.~/..~: ...... .~.~-~'~.z...~,~c~z~. ........ If apphcant. ~s a corpo~teJ~ signature of duly authorized officer. ,C .d ................ (Name end title of 'corporate officer) ~'BuHder's L,cense No...1~.h.(~.[.%..:..~.1 ........................ -,,~' '~' PLumber's Licens~ No .......... .~- /,h/ ~ I -I, -141: ~, Electr,c,an's L,cense No ...... i.l..~....i~. ................. .d.c..~...E~']'~ P'< other Trade's L~cense No... ............................................. Location of land on wh,ch proposed work will be done. Map No ~.F?,,5 ............. Lot No .{. ............. Street and Number ...~.t.~.~......~.~.~-~).....~T. ........... O~.t-z~...y ~.~.~ T~ Municipality State ex,sting use and occupancy of premises and intended use and occupancy of proposed construchon o Exisit,ng use and occupancy ..... ,~,,,.,,~,,,/,.,k,~4.Z~ .................................. ~ -A~ ~l?- o~- 3.1 3. Nature of work (check which apphcable) Repmr . Removal 4 Estimated Cost ...... 5 6 7 8 If dwelhng, number of dwe hng units . If garage, number of cars! New Budding Demohhon Fee ,. t on ................. Alteration ....... · Other Work ............ (to be paid on filing this apphcahon) Number of dwelhng units on each floor ....... If business, commercial ',or mixed occupancy, specify nature crud extent of each type of use ............ / .... Dimensions of ex,st,ngstructures, lf any. Front ~.t~..t. ............. Rear ...~.~...I. ................... Depth ~..~/. ........ He,ght .~.~..k ...... Number of Stones . . ].~---~.~ ..... D~mens~ons of same structure with alterations or addmons Front . ~..~ .................... Rear ~7 ........ Depth D~mens~ons of entire newl construction Front Hmght Size of lot Front .... j~-~ ..~.0 ..... · Number of Storms .L~ ................ 'Z-'~ ' ......... Rear .. ~51. .............. Depth Rear gg' ~'.~ ............... Depth ..5/3(":' ..z~ .... 9 10 Date of Purchase .'~.~ ..'~ ,~ [~'~'~ .... Nome of Former Owner ...."~"~-4~J~...~...~...¢~ ............ 11 Zone or use &strict ~n wh?ch premises are s~tuated . [~0°. ......................................................... 12 Does proposed constructlo'n wolate any zoning law, ordinance or regulation .~..0. ........................ 13 W,II lot be regraded pL~ ~- . ....... W, II excess fill be removed from prem,ses: (~"'Yes ( ) No 14 Name of Owner of prem,ses'~'t./.~f~,,~'~~.... .......... Address~../.~.0..~..~'.~ ./~.(~t~hon~ No.~,.Z...~..=.~.?.~), Name of Architect . ' ' ".. . . .... Address ................................ Phone No ................... Nome of Contractor ~ ~(~--~J ... Address ................................ Phone No ............ PLOT DIAGRAM Locate clearly and dmhnctly alt buddings, whether existing or proposed, and re&cate all set-back &mens~ons fro property hnes awe street and block number or descr~phon according to deed, and show street names and re&ca whether ~ntenor or corner lot ce_2 o 2 Wl) 0= o'o par oo= oo 3160 STATE OF NEW YORK, lS S COUNTY OF ... .... 01~ ..L..k).: .~\~.L~-~... · · bmng duly sworn, deposes and says that he is the apphca' (Name of ~nd~wdual s~gnmg contract) above named He is the .. C~:~ ~I~..j~..L ........................................................................................ (Contractor, agent, corporate officer, ere ) of smd owner or owners, and is duly authorized to perform or have performed the said work and to make and fi this apphcat~on, that oil statements contained ~n th~s apphcahon are true to the best of h~s knowledge and behef, o~ that the work wdl be performed in the manner set forth m the apphcahon fded therewith Sworn ta before me th~s (Signature of applicant) RO 4707878. S~ffo~i~ County...,,, ~ le~ [.xp~res Msrch 30,19 z/