HomeMy WebLinkAbout15705-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Z15304 Date Feb. 25. 1987
THIS CERTIFIES that the building ADDITION
Location of Pro~ertv 815 I-1ARBORVIEW AVE. I,{.ATTITUCK
- - h3d~e ~iol ....................... 's'~/e~i ' ...................... h~ie~
County Tax Map No. 1000 Section . .0.9.9 ........ Block . .3 ............. Lot ... JT...I ..........
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
.... F~I~,. I J,..1.9~.7 ..... pursuant to which Building Permit No...I.5.Tp.5.Z ..............
dated ...F.e.b:..2.5,..1.9.8.7 .............. 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 .........
.... pl~.K. 6.Dp.IT.I0~' ir0. ~:g~[ Sitar ~1~. Olql~. ¥61~;[1~7. PNI~T,IArlqP.. ..............................
The certificate is issued to CANDACE CORLI~TT
..................... /o¥,'e;,'t'ab~a~x~'~k .....................
of the aforesaid building.
Suffolk County Department of Health Approval N/A
UNDERWRITERS CERTIFICATE NO ...... ~/~-.
PLUNBERS CERTIFICATION DATED: N/A
..........
Building Inspector
Rev. 1/81
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
CTHIS pERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
~.~.~.,
No 15705 Z
Permission is hereby gra~ted to:
..... .~..~...-....~.~.. ....... ~~... ,~..,
.**..'~.~ ............... ~* ......... ~...~ ......................... . ~,~
to ..~ .~...... ,.~;~....~,,.~v~: ....... ....~=~..~ .......... 9......~.....~.
...... ........................ :. ................
at premises located at ..~..]..,~.......~.~.~...~U....L~.,..~.~...~.... .............
County Tox Mop No 1000 Section ...... .q~....~...~.. Block ....... ..~....~.. ..... Lot No ..... .~..']..:...~. .......
pursuant to application, dated ........ .'/..,~ .......
Budding Inspector.
Fee $.. .~.. ... ;. ...........
.., 19.~..'].., and approved by the
~.~........~..~;....: ......
Building Inspector
Rev. 6/30/80
A. Th~s application mus
tor w th the fo own,
1. Final survey of prl
natural or topogral
FORM NO. 6
TOWN OF SOUTHOLD
Build,ng Department
Town Hall
Southold, N.Y. 11971
765- 1802
I APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
: be filled m typewriter OR ink, and submitted m~ to the Budding Inspec-
I; for new buildings or new use:
~perty with accurate location of all buildings, property lines, streets, and unusual
,hlc features.
2. Final approval of ~ !ealth Dept. of water supply and sewerage disposal-(S-9 form or equal).
3. Approval of electri ~a[ ~ostallatlon from Board of Fire Underwriters.
4. Commercial buddllgs, 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 s te plan requirements where applicable.
B. For existing buddings (proof to Aprd 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1, Accurate survey o~ p~operty showing all property hoes, streets, buildings and unusual natural or
topographtc features.
2. Sworn statement of, owner or prewous owner as to use, occupancy and condition of buddings-
3. Date of any houmqg code or safety inspection of buddings or premises, or other pertinent mforma-
t~on required to prepare a certificate.
C. Fees: I ~ADDITIONS $25.00
1. Certlf[cateofoccu~ancy New Dwelling-$25.Q0, Accessory,St0.00 Business $50.00
2. Certificate of occupancy on pre-exmtmg dwelhng $ 50.00
3. Copy of cert~fmate bf occupancy $ 5.00, over 5 years $]0.00. ~.
4.Vacant Land ~.0. $ 20.0~ ~ / /~'~
5.Updated C.O., $ 50.00 Date ...... ?~.../. /.f..~.~. .........
NewC ohs truc t~ on..r Old or Pre-ex,st,rig Building .....! ...~... Vacant Land
Hou,~. No $~ree~ Hamle~
Owner or Owners of Property ~'~.,f~' ~. c~ ~ ~ ,4',.,~, .4~ ~
County Tax Map No. 1000 Section ....¢,, .C~ 9 ....... Block .... O-~ Lot .... ~1~.~ ~7.~
Subdw~mon ......... ~ .................... Filed Map No ........... Lot No ..............
Permit No ........... Date of Permit .......... Apphcant .................................
Health Dept. Approval .,., .................... Labor Dept, Approval ........................
Underwriters Approval ...................... Planmng Board Approval ......................
Request for Temporary Celtiflcate ................ Final Certificate .......................
Fee Submitted $ ,
Construction on above described building and permit meets all applicable?~des and regulations.
Rev 10 10-78
OUNDATION ( ls t)
OUNDATtON (2nd)
OUGH FRAME &
PLUMBING
I~SULATION PER N. Y.
STATE ENERGY
CODE
FINAL
......... ADDITIONAL COMMENTS:
7GS-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION tST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
FRAMING ~L
REMARKS:
DATE INSPECTOR
7GS.'180~
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [ ] INSULATION
FRAMING, [ ] FINAL
REMARKS:
DA'T~
, /
%"/o-/
/ ..~'-. !
/ "-/'?
/ I
/ / /
/
,.-'~ / /
'..'.. /
/ ~-~ /
USE IS bi, LAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCy
/
"'.-/... /
/ ...."-.
/
HAP OF PEOPEr)..TY
CAIqDACE COI2LETT
A'I'
I'dATT ITUCI~.
".~LJ¥]I;I'-/It'~IC~i CF P£2OI-'[I~I'IES OF TN[: OLD HILl. IqA,',,,'EI, J ¢0" '\'""'~'-~ J'~
'~,u~F, co, PAP ~-~0'z99 ) ' .."C~-......
~.OT I I,.~qLLY ~ I-~r~BOU_.W~k"~Z AVE.
, ' '~ - i ~.,_AS_<:L ---"~ -
.,~.. ~_ / ./ ~/~'
~X - ~ ~ Y~ ..~ ~ ~ ~¢~ ~v~
.. ' .... ~'~ LIC LAND ~O~V~O~¢
Examined .~-xo-~ ~4T
Approved ~-q~~ .~
D~sapproved a/c ..
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
~OUTHOLO, N.Y. 11971
TEL.. 765-1802
,19~7
, 1957 Permit No ~ ~'7o,'~ .'~
APPLICATION FOR BUILDING PERMIT
Becezved ........... ,19.
Date 2~///~. ,19.~
INSTRUCTIONS
a Ti'ns appllcatmn must be, completely filled m by typewriter or ~n ink and submltted to the Budding Inspector, w~t~
sets of plans, accurate plot plan lo scale Fee according to schedule
b Plot plan showing locat19n of lot and of buddings on premtses, relatmnsh]p to adjoining premtses or pubhc stre
or areas, and g~vmg a detatled descnphon of layout of property must be drawn on the dmgmm which is part of this ap,
catmn.
c The work covered by this application may not be commenced before msuance of Bufl&ng Permit
d. Upon approval of this apphcatmn, the Bmld~ng Inspector will ~ssued a Budding Permit to the apphcant. Such pen
shall be kept on the premises available for mspechon throughout the work·
e No bufldmg shall be occpp~ed or used ~n whole or m part for any purpose whatever until a Cemficate of Occupm
shall have been granted by the Bmld~ng Inspector
APPLICATION IS HEREBY MADE to the Budding Department for the ~ssuance of a Bmld~ng Permit pursuant to ~
Bmld~ng Zone Ordinance of the,Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances
Regulatmns, for the constructm~ of buildings, additions or alteratmns, or for removal or demolmon, as hereto descnb~
The apphcant agrees to comply, w~th all apphcable laws, ordinances, budding code, housing code, and regulatmns, and
ad,-mt authorized inspectors oa p~emtses~ and ut bmldmg for necc~ary..~n.~j)e~ons.~ c*~.T .~X~. ~ e_.~ x.__~ t222::;t~-~(~rJ~r~
(S~gnature of apphcant, or name, ~f a corporatmn)
I, (raa~_l~_ng address of applicant/
State whether apphcant ~s owner, lessee, agent, architect, engineer, general contractor, electncmn, plumber or build,
Name of owner of premises ~ . ~- (~.~... ~'-rY~. . .... .. (as on the tax roll or latest deed)
If apphcant m a corporahon, s~g~ature of duly authorized officer
· ' ' (Name and t~tle of cO[Porate o}fic~r)
Budder's L~cense No
Plumber's L~cense No
Electrician's L~cense No
Other Trade's Lmense No
Locatton of land on which proposed work wdl be done
House Number Street
County Tax Map No I000 Sectmn
Block
Hamlet
.-,-~ .... Lot CP. / 7., eot2)/.
Subd~ws~on
State exmhng use and occupa
a Existing use and occupancl
b. Intended use and occupancy
Fded Map No Lot
(Name)
acy of premises and ~ntended use and occupancy of proposed construction
' 3 Nature of work (check which applicable) New Bmldlng
..... Addition.. ~ .... Alteration ..
Rep ...... Removal ........ Demolition ......... Other Work.. ~.E~.~&-...
,mr ~ [ ~ --~ (Description)
4 Estm~atedCost . .. f.~, ?Y .............. Fee . ! ......................
(to be prod on filing this application)
5 If dwelhng, number of dwelling units .......... Number of dwelhng units on each floor .........
If garage, number of cars .........................................................
6. If business, commercial or mixed occupancy, spemfy nature and extent of each type of se .....
7. Dm~enmons of exmtlng structures, if any Front .... ,~J ..... Rear .... ,r':.. .... l~;pit~ ii i~i/. i/.
Dunenslons o[same structure with alterations or add~..Bons Front . ~.~> ....... Rear ...~ .........
Depth . ~:. . . i. . . Height . t ~.: ........ Number of Stories . ./. ...........
8 Dnuens]ons of entire new construction Front ........... Rear ............ Depth .........
Height ..... Number of Stones ................................
9 SizeefIot Front .~ .. ., Rear ........... D~epth_d .... :,r,'_' '' :' '
1 1 Zone or use district in which premises are situated ~ ..............................
1 2. Does proposed constructlo~ violate any zoning law, ordinance or regulation ~. c~ ....................
13 Will lot be regraded ..... ~ ~. ........ Will excess fill be removed from premises Yes I'
14 Name of Owner of premlse~ Oq*.a/~¢+~ OP~°-~f'Address -e'/'4%'St-~/-~-~'?"~"Ph°neN°'
.......... Address .. . Phone No
Name of Architect .... I' '
Name of Contractor ............ Address ............. Phone No ....~.. ......
I5. Is this property loca~ted withinl00 feet of a tidal wetland? * Yes ..... No . ..
· If yes, Southold Town Trustees Permzt may be required.
i PLOT DIAGRAM
Locate clearly and distinctly all buddings, whether existing or proposed, and~ mdlcate all set-back dunenslons fro
property hnes Give street and block number or description according to deed, and show street names and ]nd]cate whett
interior or comer lot.
STATE OF NEW YORK,
COU1W~Y/OF '~'..~,~:t- ~7, S.S
........ I .......... being duly sworn, deposes and says thalbhe is the apph~
(Name of mdw~dupl s~mg contract)
above named
He ~s the ' ' I (Contractor, agent, corporate officer, etc)
of smd owner or ownem, ~d,~s duly authored to perform or have peffo~ed the smd work and to m~e and file
apphcatmn, that all statement? contained m thru apphcatlon are tree to the best of his knowledge and behef, and that
work will be perfo~ed ~n the m~ner set forth m the apphcatmn filed therewith.
Sworn to before me th~s
..
FRED W ~AELIN,~R
NOTARY PUBLIC, S~ of New Yor~
No 7135315, Gqal~md m Suffolk ~ (S~gnature of apphc
Corem ~res 8/31/8P
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
,/
ALt CON~TRUCTIO~ ~A~L
~N O~ CG~TN~ION