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Home My WebLink About15667-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y Certi[icate O[ Occupancy No .z.-.I. 5.9.33 .... Date ... July 8, 1987 THIS CERTIFIES that the buridmg N U R S E RY B U I L D I N G 6960 Sound Avenue Mattituck, New York Locat,on of Property ill,use tVo .................................... Street Ham/et County Tax Map No 1000 Sect,on . . 1.2. 1 .... Block . .0.5 ..... Lot..P./. o...1 ........ Subd,vm~on ..................... Fried Map No ........ Lot No ............. conforms substantially to the Application for Burid,ng Permit heretofore filed ,n th,s office dated February 2, 1987 pursuant to winch Budd,ng Permit No 15667 z dated. Feb... ruary. . . 6, ....I 987. . .. was ,ssued, and conforms to all of the reqmrements of the apphcabte prov,mons of the law The occupancy for winch tlns cert,ficate is issued is . NURSERY BUILDING AS The cert,flcate ~s issued to GE R..AR? & APPLIED FOR BARBARA GOEHRINGER · ' ' (o--er,'~'~Wn l~s~[~ .............. N/A of the ~ aforesmd bufld,ng. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO N/A PLUMBERS CERTIFICATION DATED: N/A Buridxng Inspector Rev 1/81 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) 15667' Z County Tax Map No 1000 Section ...... /..~'~-/ . Block ...... ..~.,.~'. ....... Lot No .......... pursuant 'o application doted ....~.~c~......'~.. ............. , 19~..~.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Buildtng Department Town Hall Southold, N.Y. 11971 765 - 1802 , APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This apphcat~on mu~t be fdled ~n t,/pewmter OR ink, and submitted i~ to the Building Inspec- tor with the following, for new buildings or new use: 1. Final survey of pr~operty w~th accurate location of all buildings, property lines, streets, and unusual natural or topographic 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 Underwriters. 4. Commercml bu~ld~ngs, Industrial buddings, Mu~t~p{e Residences and similar buildings and installa- tions, a cert~fmat~ of Code comphance from the Architect or Engineer responsible for the budding. 5. Submit Planmng Board approval of completed rote plan requirements where applicable. B. For existing budd~n'gs (prior to Aprd 1957), Non-conforming uses, or buildings and "pre-existing" land uses' 1. Accurate survey of p~operty showing all property hnes, streets, buddings 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 houmng code or safety inspection of buddings or premises, or other pertinent informa- t~on required to prepare a cert~fmate. C. Fees Additions $25.00 1. Cert,flcate of occupancy New Dwelling $25.00, Accessory ,$10.00 Buszness $50.00 2 Certificate of occupancy on pre-existing dwe~hng $ 50.0 0 3. Copy of certlficate of occupancy $ 5.00, over 5 years $]0.00/ 4.Vacant Land C.O. $ 20.00 5.Updated C.O- $ 50.00 Date ..... '" ' ""'.~.~.~.~..Z/ ......... NewConst, ruc%zon Old or Pre exmt~ng Building . Va(Jant~aod . Owner or Owners of Property . .~.~/~..~.... ~4~.~.¢~'.~'~.~.~.t~.~v~....~, .............. County Tax Map No. 1000 Section ........... Block .. ~. ......................... S ubdlvision..-~.~.~.~.-¢'./~ ~~ ....... Filed M apNo . ~ ....... Lot No ........... Perm,t No. /~.¢Z 'Date of Permit ~ZApphcant . . ~ ........... ' .......... Health Dept. Approval ...................... Labor Dept. App~val ........................ Underwriters Approval ...................... P1anmng Board Approval ...................... Request for Temporary Certificate ................. Final Cert~hcate ...................... Fee Submitted $ .'~. .................... Construction on above described building and perrr~tt-m~ets all applicable codes and regulations, Ap~. ; .................... Rev 10 10 78 ~ OUNDAT!ON ( ls t) OUNDATIOI~ (2nd) OUGH FRAME & PLUMBING ~;SULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N Y. 11971 TEL.: 765-1802 Examined .~.~...Qx~-~*m'-%~ ~. , 19 ~, 7 Approved ~ Jk.xx~w~..~ ..[,a , 19 ~ "1 Penmt No Disapproved a/c (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH 3 SETS OF PLANS SURVEY ~,~ CHECK SEPTIC FORM NOTIFY CALL MAIL TO: FElt 2 - 1987 Date . INSTRUCTIONS a This apphcat~on must be completely filled m by typewriter or mmk and submitted to the Bmldmg Inspector, with 3 sets of plans, accurate plot plan to sgale. Fee according to schedule. b. Plot plan showing locatxon of lot and of bmldmgs on premises, relationship to adjmmng premises or public streets or areas, and glvmg a detmled desc~lphon of layout of property must be drawn on the diagram which is part of this apph- cation. c The work covered by tlus application may not be commenced before ~ssuance of Budding Permit d. Upon approval of th~s application, the Bmldmg Inspector will issued a Buddmg Permit to the apphcant Such permit shall be kept on the premises available for mspectlon throughout the work. e No bmldmg shall be occupied or used ~n whole or in part for any purpose whatever until a Cemficate of Occupancy shall have been granted by the Bmld~ng Inspector APPLICATION IS HEREBY MADE to the Butl&ng Department for the issuance of a Bmldmg Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances or Regulahons, for the construction 9f buildings, additions or alterations, or for removal or demolition, as here~n described The applicant agrees to comply with all apphcable laws, ordinances, buxldmg.cqcle, housings, ode, and regulatmns, and to admit authorized inspectors on premises and m bmldmg for necessary lnspechggF / '-ff ,./~/ ~ · . .......... ' , (Signature of applicant, or p~me, ~f~a corporation) (Mallmg address of apphcant) State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ............ ....................................... Name of owner of premises ~".~/fT-t/.~. ~.. ~.~~ ,,~.. W'~ff .............. (as(o,W~he tax roil or latest deed) If apphcant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builder's License No Plumber's License No Electrician's License No Other Trade's License No Locatmn of land on which proposed wo/3~ will be done House Number Street County Tax Map No 1000 Section Subdivision /~p~,f,l',L' ~ /~.,~ . (N am e ) Hamlet Block SLot / Filed Map No . . Lot ./..~ ...... 2 State existing use and occupancy of premises and intended use and occupancy of proposed construction a Existing use and occupancy b. Intended use and occupancy 3. Nature of work (check which applicable) New Budding /x(.. . Addition .... Alteration Repair . .. Removal .......... Demolition Other Work ..... ~ 3~.~ (Description) 4. Estimated Cost ............... Fee .............................. I " (to be paid on filing this application) i .~.~./:/.~... . Number of dwelling units on each floor .......... 5. If dwelhng, number of dwelhng units .. If garage, number of cars 6 If business, commercial or mixed occupancy, specify nature and extent of each type of use ............ 7. Dimensions of existing struqtures, if any Front ........ Rear ....... Depth .......... Height ........ Number of Stones .............................. DLrnenmons of same structure with alterations or additions Front ......... Rear ....... Depth .............. Height ...... , ....... Number?f Stones .............. Dimensions ofentlre new construction Front~.,-- d.o~ ...... Rear ../.dY. ........ Depth ../~. f ........ Height ./{~: ~/. ..... Number of Stones /ff'-/-- ................................ Size of lot Front . . ..~. ,7---.x ....... Rear.../~..,~.. ........ Depth .~ ~ ............. Date of Purchase /. ~/.-¢//?'. ~. ......... Name of Former Owner Zone or use district in which/premlsesT/are situated ~ ~'x~fi-~. ................................. Does proposed construction violate any zoning law, ordinance or regulation' . ./l/~. ................ Will lot be regraded · Name of Owner of premises ............ Address ............. Phone No ............. Name of Architect ........... Address ............. Phone No ............ Name of Contractor . .: ......... Address ............ Phone No ........... 10. I1 12 13. 14. 15. Is thzs property located within 300 feet of a tidal wetland? *Yes ..... *If yes, Southold Town,Trustees Permit maybe required. I PLO~ DIAGKAM Locate clearly and distinctly all buddings, whether exmtmg or proposed, and indicate all set-back d~menslons fro property hnes. Give street and block number or descnptlon according to deed, and show street names and indicate wheth. interior or corner lot. K STATE OF NEW YOR , COUNTY OF · s.s (Name of individual signing contract) above named · being duly sworn, deposes and says that he Is the apphcm He is the . ~_~C}: . ZgZ~9~ ~. ...... (Contractor, agent, corporate officer, etc ) ~ ~ ,q - of emd awnor~r c':.'n2~, ~d is duly authorized to perform or have perfo~ed the sad work and to m~e ~d file th applicatmn, that all statements contamed m thru apphcatmn are irue to the best of his ~owledge and behef; and that work wdl be perfomed ~n the m~ner set forth m the apphcatmn filed therewith. Sworn to before me thru .... ...... ..... ~0IARY PHBUC State 0f ~ Y~ ~ (Signature of apphcan No 52 4524771 ~uahfle~ ~n Suffolk Comm~mon Expires Nov 30.