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Home My WebLink About15755-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z- ~5648 Date April 16, 1987 THIS CERTIFIES that the building D E C K ADD I T I 0 N Location of Property 320 Pine Neck Road Southold, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 54 .Block 9 .Lot 12. 1 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Ma r c h I 2, 1 9 8 7 pursuant to which Building Permit No, 1 5 7 5 5 z dated Ma r c h 1 5, I 9 8 7 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for winch this certificate is issued is ......... DECK ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to ARTHUR & LINDA SAFALOW ..................... .................. of the aforesaid ,building. Suffolk County Department of Health Approval N /A UNDERWRITERS CERTIFICATE NO .................. PENDING - N/A PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 FOP~M NO. B TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y, BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 5755 Z Permission is hereby grq~: ................................. ............ .~. ~ II~ I at premises I~ated ot ....~..~ ....... ~..~.~...~.~ ........ ~~-...~ ........... County Tax Map No. 1000 Section .....Q~....~.~....~. ....... Block ...... .~...c~. ....... Lot No....k..~'...:..~ ......... pursuant to application dated ......~,.~..~..,./...,"~.,."~ - ................... , 19.~...~.,---- ond approved by the Building Inspector. Fee $. ~.....~......~.....'~. Building 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 A. This application must be filled in typewriter OR ink, and submitted -. ~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, 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. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, 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 site plan requirements where applicable. Bo For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pZ~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 buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C, Fees: 1. Certificate of occupancy New Dwelling. S25.00, Acc~ssory.;$10.00 Business $50.00 2. Certificate of-occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.'00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5. Updated C · 0. $ 50.00 Date .. ~%'¢[~ .% ~ ,..]~9. ~7 ....... NewCons~oruc %ion..X.... Old or Pre-existing BuiJding ............ Vacant Land ............. Location of Property 320 Pine..A.v, en.ue, Southold, N.Y. 11971 House No. Street Ham/et Owner or Owners of Property Arthur & Linda Safalow County Tax Map No. 1000 Section 54 Block 9 Lot. 12.1 Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Depto Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ 25, 00 Construction on above described building and permit meets all applicable codes and regulations. Applicant ~tl .J,. ~ef f~o~.n..A.g~.n.t..f. 9.r..A.r..t.h:qr...S.a.f.a.1..o.w.. Rev. 10-10-78 OUNDATION ( 1 s t OUNDATION (2nd OUGH FRAME & FLUMBING ~NSULATION PER N. Y. STATE ENERGY CODE FI:~AL . ADDITIONAL COMMENTS: TOWN OF S01JTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because,of the following reasons. C/ /is not on file. /~y~_, No Underwriters Certificate on fileo /5/ The check is(outdated/not on f~leo) /5/ No Health Dept. Approval on file. /5/ NO final inspection has been made° An appllcatlo for Certlflcat of Occupancy Please contact our office on this matter. Thank you for your cooperation. · .................................................... Building Dept. · **/Z/ No Plumber Solder Certificate on file. ( all permits involving plumbing being ' d zssue after April 1,1984 ) 76S.'180Z BUILDING DEPT, INSPECTION FOUNDATION 1ST [ ] ROUGH pLBG. FOUNDATION 2ND [ ] INSULATION []FRAMING [~FINAL · 3 SETS ov ...... FORM NO. I SURVEY TOWN OF 8OUTHOLD CBECK BUILDING DEPARTMENT SEBTI¢ VORM ............. TOWN HALL ~O~Z~ ~OUTHOLD, N.Y. 11971 ', TEL .: 765-1802 C~ ................ MAIL TO: isapproved a/c ................. ~ ~ / ,' ~ BI.DG, DEPT, .............................................. . .... (Building Inspector) APPLICATION FOR BUILDING PERMIT Datel~.a.r..c.hl .1..2 t ......... 19.8.7. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ts 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 areas, and giving a detailed description of layout of prgl%gtyf~l~t be drawn on the diagram which is part of this appli- tion. b ttdsa hc ..... ~v~o~l~)l~%me~'~5:~,~e,l~ issuance of Building Permit c. The work covered y ' pp ' ~t~ln,~;%o~ a ,~a~a,~, · d. Upon approval of this applicatiofldt!~Btmdfi~g I@%rl~{~p~i~t%~z B~ui.~lc~g Permit to the applicant. Such permit all be kept on the premises available for, ht%~ltiob~r~tt~tlt~%0 ~1 e. No building shall be occupied or ~%~. w~y~ qr,~l.n l~'~]l~{'~dl~%eax~l~atever until a Certificate of Occupancy all have been granted by the Building Inspeq[Of~ %t'%~ [-~ ~;~.1% a APPLICATIO .N. IS HEREBY MADE to~ ~BD~I~I~-~II~'~r the issuance ufa Build!ns Pcrm,t pursu.ant to the Aiding Zone Ordinance of the Town of Sg4~aolll%~fl~25~ht~,"~New York, and other appl!,ca, ble Law. s, O. rd .mane.eft egulations, for the construction of build~g]~adRilh/h~6? alterations, or for removal or demout~on, as nere~n uescnoea. ne applicant agrees to comply with all app'fidable laws, ordinances, building code, housing code, and regulations, and to Imit authorized inspectors on premises and in building for necessary inspections. Paul J. Heffernan (agent for Art (Signature of applicant, or name, if a corporation) Safalow.) Rt. ~ 48, Southold, N.Y. 11971 (Mailing address of applicant) rate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Agent for S.afalow ameofownerofpremises ..... A.~:.t.h.u..r .&. Lin.da Sa~.a. lqw .......................... (as on the tax roll or latest deed) , ' applicant is a corporation, signature o f duly authorized officer. ~.} z ~_-~ ~ 7 ;~ I 7 (Name and title of corporate officer) , ' < ~' ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED ,-,~ 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~ .................. b~-;%¥~:'i~,Oh'~'f~OC~ffY;~'~, '~E~{~Y' ........ O~ COf~ ~JC t ~O~: ~'Street House Number County Tax Map No. 1000 Section 54 Block 9 ' Lot. 12.1 Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . 9~.~P.q .~99.~ .~ .OP. ~;~.~q. P~g~. .9Dg. ~Q. ~. .q(. 9 ....... b. Intended use and occupancy ~.~¢. 9~. above ....................... : ........ Nature of work (check which applicable): New Building ..... ' ..... Addition .... i ...... Alteration .......... ' her Workextsting deck ' Removal Demolition Ot Repair ....................................................... ~ (Description) Estimated Cost · ..~..Q-~....' '- Fee ~50.'00 ~ (to be paid on filing this application) If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars ............................................. i .......................... If business commercial or mixed occupancy, specify nature and extent of each type[of use Dimensions of existing structures, if any' Front Rear ~ Depth Height ............... Num. ber of Stories ...... : ...................... ~.~' ! .......... R Dimensions of same structure with alterations or additions: Front ......... [ .. ear ............... Depth l .q ' Height 0-z-[" Number of Stories Dimensions of entire new construction: Front ' Rear ' Depth lteight Number of Stories Si flot Front 1~ .59. Rear ~.~.0. 7..~ ' Depth J, 23 48 Date of Purchase 19.89 ....... Name of Former Owner ~a..rg.~r.~'¢..C... Zone or usc district in which premises are situated, R.e. sident.ial. .. . Does proposed construction violate any zoning law, ordinance or regulation: ..... , ........................ r~9 ·. Will er~c~ss..fill be. relllove~t from nremises: - Yes No Will lot be regraded ...... X~' ~'~f~lb~ ...... -~ 9caJ. ver~: ~r.~yossfit:' ,, 248 7722 Name of Owner of premises ................ ,aaaress ............... t-none ~o ............... Name of Architect - Address ' Phone No Name of Contractor Address ' Phone No Is this property located within 300 feet of a tidal wetland.* ~YesI ..-... No nO.. ~If yes, Southold Town Trustees Permit maybe required. . PLO'r DIAG RAM ; Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from petty lines. Give street and block number or description according to deed, and show istreet names and indicat~ whether ~u'ior or corner lot. ;%TE OF NEW YORK, UNTN OF · ~ ~'~ ' ('Name of irkdividual signing contra_ct), is the (Contractor, agent, corporate officer, etc.)! said owner or owners, and is duly authorized to perform or have performed the ~fl(~olLki~,nd to make and file this .. &cat~on; that all statements contained in this application~are, true to the best of Ms!knoWledge and behef; and that the rk will be performed in the manner set forth in the application,filed therewith. - om to before me this. ..... /..c~...~. ........ day 0 f '.~ . · .c-?/~-~d-.-~.. tary Public, ...... ~ .......... Nota~ Pubflo, State of New