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Home My WebLink About15938-zFORM NO 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y Certificate Of Occupancy No.Z16600 .... Date. ~u~f.y.2.1,.1988 THIS CERTIFIES that the bull&ng Alter. at ion ..................... Location of Property 1 3 7 5 .B u .ng afl_ o..~. L a n e M a I: t z t u c k House ivo ' ' ' 'S'tr'ebt ....... hamlo} County Tax Map NO 1000 Section 123 , Block 3 ..... Lot . ! .8 .......... Subd~ws~on .......... Fried Map No ..... Lot No ........ conforms substantially to the Apphcahon for Budding Permit heretofore filed in tins office dated Aprzl 16, 1987 .......... I pursuant to winch Budding Permit No ] 5.93.8. Z. ......... dated .A.p,r i 1. 27, . ,.I .9.8.7.... was issued, and conforms to all of the reqmrements of the apphcable provisions of the law The occupancy for winch tins certificate is ~ssued is .... Re?.r. am.e .anti ',.rep. lace..an e.xl. ft.lng, rpo. f..a.s.a, ppli. ed..fo.r.: .......... The certificate is issued,to . JOAN SAUNDERS ..... ?owneL~r~Pr,lt~Xf~k ..... of the aforesaid budding Suffolk County Department of Health Approval .Iq ./.A ................... UNDERWRITERS CERTIFICATE NO Iq84 8635 12 / 3 1 / 87 PLUMBERS CERTIFICATION DATED: N/A / Bmtdl~ 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) N9 15938 Z Permiss:on is hereby gronted to' ~.~..x....L~.~.~ .............................................. .... ~.~.....~.:~.:....u.~> ,.._ ..,.~.....~ ;).,,.., ~.~ · z ,' ot ~,,e, ,ocoted ot..~..~:.~...~~....~.~ ...... ~.~. County Tax Mop No. 1000 Section_.....J ..~.~:) ...... Block ...... ..(~..~ ...... Lot No .....J..~ ............ pursuant to opplicotion doted ...~.....~..J~ .................... , 19.~'~.., and approved by the Building Inspector. Fee ................. ...... Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 TOWN APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Th~s apphcat~on mdst be filled in typewmter OR ~nk, and submitted I ~ to the Buddmg Inspec- tor with the followmg; for new buddmgs or new use' 1. F~nal survey of property w~th accurate location of ail buddings, property lines, streets, and unusual natural or topographic features. 2. Fmal approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical mstallat~on from Board of F~re Underwmters. 4. Commercial buddmgs, Industrml buddmgs, Multiple Residences and similar buildings and installa- tions, a cert~ficat~ of Code comphance from the Architect or Engineer responmble for the buildmg. 5. Submit Planmng Board approval of completed rote plan requirements where applicable. B For existing buddmgs (prior to April 1957), Non-conforming uses, or buddmgs and "pre-existing" land uses. 1. Accurate survey of property showing all property hnes, streets, buddings and unusual natural or topograph m featu res. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buddings. 3. Date of any houmng code or safety mspectlon of buildings or premises, or other pertment mforma- t~on required to prepare a certfftcate. C. Fees: 1. Certtficateofoccdpancy $25.00 -- BUSINESS $50.00 ACCESSORY $]0.00 2. Certificate of occupancy on pre-ex~stmg dweihng $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 5.Updated C.O. $ 50.00 Date ~- ;..~ ~ ? . .~ % ........... NewConstpuctzon '.. . Old or Pre-ex~stmg Budding ............ Vacant ~and ............. ................... ~ ..... ~;;~;~ ...... Owner or Owners of ~ro~e~ ........................................... co~tv r~ u~p ~o. ~o0o s~t,o~ . ~ ......... ~o~k ...~. .........cot... [.g ......... SubdlvlSlOn ......... ~ ................... Fried Map No .......... Lot No .............. ' Permit No .... Date of Permit Apphcant . ¥. .%, .. ~!~.~.~; ............ Health Dept Approval .............. Labor Dept. Approval ........................ Unde~mters Approval . ~ .............. Plannmg ~oard Approval ...................... Request for Temporary Cert~fmate ................ F~nal Certificate ~.. s~,tt.~ s. P-~-,'.~ .............. Construction on above de'~cmbed budd~n; a~ p~m~t meetst~il applicable ~odes and regulations. , Apphc~nt .~,'~..~.~J~-~'. .............. TOWN OF SOUTIIOLD OFFICE OF BUILDING INSPECTOR P O. BOX 728 TOWN IIALL SOUTIIOLD, N.Y. 11971 TEL 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because of tho foltow~ng reasons. /_--/~'~ AnI application for Certificate isi not on file. /? /_~ /-/ /-_/ of Occupancy No, Underwriters Certifi~le. No, tlealth Dept. Approval on file. No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit t~ / ~-~ 3 ~___ Z Building Dept. ***/~/ ~o Plumber Solder Certificate on file. all permits involving plumbing being issued after April 1,1984 ) ~0o[3._~. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT Center Street CliEf Saunders.Bum~mlow Izne,Mattituck N~w %D~k ~s e~a,.,.~ on December 17 %987 ..d founa t,, t,. :. ~o,.p:,.., e ,,,,~ t~. ~,p.~e,,~.,~ W ,~,,. ~o~d RXTURE ECEPTACU~S SWtTCHE$ RXTURES RANGES COOKING DECKS OVENS DISH WASHERS Lot SERVICE D~SCONNECT NO OF ~ OTHER APPARATUS S E R V NO O E COND OF ~C COND NO O~ HI LEG A W G OF HI LEG E ~o~ij rumil !o Pat Lane ~ttit~ck,New %~rk 11952 ~AI. MANA, G~ This cerhflcate taus! not be altered m any manner, return to the office of the Board ~f incorrect Inspectors may be *denhfled by their credenhals OUNDATION (1st) OUNDATION (2nd) OUGH FRAME & PLUMBING NSULATION PER N. Y. STATE ENERGY CODE Fi~AL ADDITIONAL COMME?ITS: .A tr" 0 BOARD OF HEALTH - 3 SETS OF P~LANS ....... FORM NO 1 SURVEY .......... ~' TOWN OF SOUTHOLD CHECK .......... BUILDINGDEPARIMENI SEPTIC FOHM ............. /OWN HALL F, OUTHOLD, N,Y. 11971 NOTIFY YJl ~ TEL.: 765-1803 CALL A~, ..... MAIL TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS TOWN OF $OUTHOLD Date a Ttus application must be completely filled m by typewriter or in ink and submitted to the Building Inspector, wit sets of plans, accurate plot plan to scale Fee according to schedule b. Plot plan showing location of lot and of braidings on premises, relationship to adjolmng premises or pubhc str, or areas, and g~vmg a detailed description of layout of property must be drawn on the diagram whmh is part of ttus ap cation c. The work covered by th/s application may not be commenced before ~ssuance of Building Permit d Upon approval of this apphcatzon, the Build~ng Inspector will issued a Bufldmg Permit to the apphcant. Such pet shall be kept on the premmes available for mspechon throughout the work. e. No building shall be occ~upzed or used ~n whole or in part for any purpose whatever until a Certificate of Occupa shall have been granted by the Bmldmg Inspector· APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Bmldmg Permit pursuant to Building Zone Ordinance of th~ Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance Regulations, for the construction of bmldmgs, additions or alterations, or for removal or demohtzon, as hereto descnl: The applicant agrees to comply with all apphcable laws, ordinances, budding code, housing code, and regulatxons, and admit authorized inspectors on ~remlses and m building for necessa~[znspechons · (S~gnature of applicant, or name, if a corporanon) (Mailing address of apphcant) State whether apphcant Is owner, lessee, agent, architect, engineer, general contractor, electncmn, plumber or built ofprem,ses ~ %~kxJ~.-~,.j. '--~-';~N~i,._)ii '' ii' '' ii.'' Name of owner ' (as on ;h)e' tax roll or iatest decca)' If.~ant m a cc~ra~o f ;uly authorized officer ~nd htle of corporate o ficer) ' ALL CONTRACTOR'S MUST-BE~UFFOLK COUNTY LICENSED Builder's License No . ~.o~t~.tJ( [-~-~---, Plumber's License No .. Electnman's License No ,. Other Trade's Lmense No Location of land on which proposed work will be done lIouse Number re County Tax Map No 1000 Sechon [o~-~ Hamlet Block ~ .. Lot Subdwts~on Fried Map No Lot .. (Name) State existing use and occupancy of premises qnd ]ntendre~ use and occupancy of proposed construction a. Existing use and occupancy ~q ~ ~' . ~C(( I~ . . b Intended use and occupancy ..... ~ ~ .................. " ..... Nature of work (check whlcll applicable) New Budding Repair .. . Removal ....... Demolition Estimated Cost Addition . . Alteration ~ ..... Other Work . (Descnphon) ' (to be paid on filing this application) ·. Number of dwelhng units on each floor .......... If dwelling, number of dwelling units . If garage, number of cars ...... If bumn~ss,~ ~t~cg~frr~uBal or mixed occupancy, specify nature and extent of each type of use .. Dlmenstoh[pt~e,.~B_tgag structures, if any Front .... Rear ....... Depth . .. Height ~ ~.. Number of Stones . . Dunenmon~ of s' qth alterations or addlt~ons Front .......... Rear .... Depth ........ Height ..... Number of Stones ............. Dlmenslo~ of entlm new copstruction Front . . Rear ........... Depth ............ Height ........ Number of Stones .... 9. Size of lot Front ....... Rear ............. Depth ................. 10 Date of Purchase ............ Name of Former Owner . 11 Zone or use dlstrlct in which premises are situated ..................... 12 Does proposed constructio~l violate any zomng law, ordinance or regulatlon .................... 13. Will lot be regraded .l~ ~) ............ Will excess fill be removed from premmes Yes N 14. Name of Owner of premises .... Address ...... Phone No .......... Name of Architect . , . I ..... ~ ..... Address ............ Phone No .. . NameofContractor 1~...~/ C6.'~°~(... Address ~'~.~ .bPhoneNo 15. Is this property local.ed within 300 feet of a tidal wetland? *Yes . f'~. No ..... *If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly, all buddmgs, whether existing or proposed, and. indicate all set-back dnnenslons fro~ property hnes Give street and block number or description according to deed, and show street names and indicate wheth~ interior or corner lot. STATE OF NEW YORK, S S COUNTYr-OF .... · .. ~ . · bemg duly sworn, deposes and says that he is the apphca, (Narrte ofind~ id allmgmno contract) above named ~..~.. He is the . . .~..V/ ........ O. . .C.~o. (Contractor, agent, corporate officer, etc.) of said owner or owners, and l~ duly authorized to perform or have performed the said work and to make and file tl apphcatmn, that all statements contained m this application are true to the best ofhm knowledge and belief, and that tl work will be performed in the manner set forth m the application filed therewith Sworn to before me this Notary Public, . .~.~~,.... ....... r~o~ Publl=, S~t~ of ~l~w ¥~,~ ~ (Stgnature of apphcax No. 4822563. Suffo k County,~ Term F-.xpire~ December 31, 19,.,,