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Home My WebLink About15775-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z17027 Date June 24, 1988 THIS CERTIFIES that the building Ad d i t i on Location of Property 255 Lakeside Drive Southold h3Osb 74oi ....................... 's't/e3i ....................... h3A/oi County Tax Map No. I000 Section . . .0.9..0 ...... Block ...0.3. .......... Lot 0 I I · 000 Subdivision.. Cedar Beach Park . . .Filed Map No. 90 .LotNo. 62 conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .M.a.r..e ,h..9. ,...I .9.8. 7. . pnrsuant to which Building Permit No... [ .5 .7 .7.5. Z. ............ dated March 16', 1987 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 ......... Deck, above ground pool & gazebo added to an existing on'e family dwelling. The certificate is issued to C. AROL AND ALBERT PROFY of the aforesaid building· Suffolk County Department of Health Approval ...... .N/.A. ................................ UNDERWRITERS CERTIFICATE NO. N829121 Aug. 25, 1987 PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 FOR~ NO, 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NE 15775' Z / Permission is hereby granted(~~to.'_ ~-- '~ ~'~~.. ~T~.. ............ ~: ................ ; ......... ~ ...... ?'"i ...... ....... ~~... ~....~.~. ~. ~o~~..~.~.&.~..~.~..~..~.~~ · ~% , . ~, ~r,m,,, '~*,ed *, ..;.~.~.~ .................. ~.-..-~.~.-..~ ...... J pursuant to application dated ...... ~.~%...~.. ................... , 19.~.~.;.,""-- and 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 CC( 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. 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 buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion requ ired to prepare a certificate. C. Fees: Addit±ons $25.00 1. Certificate of occupancy New DwelLing,$25.Q0, Accessory ,.$]0.00 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 i 5.Updated C.O. $ 50.00 Date .......... ~....~.' ......... Newc OhS truc t ion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property 4~'~'?.:.5. . /?.~. t ................... /. // House No. Street Hamlet Owner or Owners of Property . ~./~ County Tax Map No. 1000 Section O ~'~, d.O Block dP ~, o O Lot. Health Dept. A~prov~l ........................ kabor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....~ ................. Fee Submitted $ ............................. Construction on above described building a,Te~:~/m,~ets a~le cod~ations.~ App,,cant . .. . >' '>-" "'": 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. /Z/ An application for Certificate of Occupancy is not on file. No Underwriters Certificate on file. /5/ Tile check is(outdated/not on file.) /~/ No Health Dept. Approual on file. /5/ No final inspection has been made. Please contact our office on Thank you for your cooperation. Building Permit t~ I ~-- 7 ~ ~__~--Z Building Dept. ***/Z/ No Plumber Sotdor Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) this matter. OUNDATION (1st) OUNDATIO:; (2nd) OUGH FRAME & FLUMBING ~NSULATION PER N. Y. STATE ENERGY CODE ' ADDITIONAL i THE NEW YORK BOARD OF FIRE RWRITERS 1165013 ~' BUREAU OF ELEcTR CITY 'j , : ' · kh , ' ~: ~ El5 JOHN STREET, NEW YORK, NEW YORK 10038 ' , the electrical ~ipme~t ~ ~scrlbed belo~ .nd introduced by the applicant ~med on the above applicetlon number D~;: & Mrs. A,' Profy,~255 Lakeside Drive,: SoBth°ld~, ; ~ ~, thefollowinglocat~on~ ~ Basement ~ Ist Ft. ~ 2nd 'l~ attic ~ .t~h, 4 FURNACE MOTORS OVENS DISH WASHERS EXHAUST FANS DIMMERS : SYSTRI~,S NO. OF FEET SERVICE DISCONNECT OTHER.,APPA~TUS: ':, u ~ · ELEC. ROOM HEATERS: ~, 1.5kw. , ,LIGHTING: 4~ L lzte' '~75 Cedar Pt. Dr. E. :,~ ~'~,,r* Southold, N.Y. 11971,: ~ic 48 ' ' MANAGER This ce~ificate must not b~ altered in any monner~ return to the office of the Board if incorrect· Inspectors m~y be identified by their credentials. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ]/~SULATION / FRAMING [l,/J FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG' FOUNDATION ;ZND [ ] INSULATION FRAMING r~FINAL DATE ~/~//f/ 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. /5/ An application for Certificate of Occupancy is not on file. .~_/ NO Underwriters Certificate on file. /5/ The check is(outdated/not on file.) /~/ No Health Dept. Approval on file. /Z/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit Building Dept. *~/~/ No Plumber Solder certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) BOARD OF HEALTH . 3 SETS OF~PLANS ....... FORM NO. I SURV'EY .......... - / t TOWN OF SOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM ............. TOWN HALL NOTIFY SOUTHOLD, N.Y. 11971 p.G~.-r. TEL.: 765-180:~ CALL ......... MAIL TO: Disapproved a/c [~} I~R - ~ 195] (Building Inspector). APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets 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 Or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by tiffs application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessa ' spections. (Signature of appli~a'nt, tiffed/me, 'if ~ corporation) · ~..,5Z'.,5..: .~/..?..,g. ~ .s :.27. ~./)..¢..,5..,: .,. ~'.o..?,.'('..,?.4 .z:,, (Mailing address of applicant) /[/,~. //c/7/ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .1~ .~. .~. .IZ-: ~ .~. . . ?. . .~,1~.~.. .0.. ~. . . .~,lz,~ ~,, l~". ,y ................................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (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 ...................... 1. Location of land on which proposed work will be done .................................................. · ,~ ~.s.-...Z.~ .,f_-.s. (¢~...~.~.: .5.~ :..,...$.~..o..T.~..o..c.b' .,...,,f.: f...../../.q..7./. ...................... House Number Street Hmnlet County Tax Map No. 1000 Section ...~. ~.~P.'..O..~. ..... Block . .~..~.,..O..~. ...... Lot...~../. ! .'..(_9..0,.0. .... Subdivision·. ~.~../,~./9../~...~...~./9.~. Ii....~o~.~. ~. ......Filed Map No..c~ .O. .......... Lot ...~...P-: ........ (Name) 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 . .~ .~-X/..D.~./~..~. ~- .... .IA/../..~./-/.....~. 3. Nature of work (check which applicable): New Building .......... Addition ........ '.. Alteration ....... Repair .............. Removat .............. Demolition ............. Other Work'. .............. .. ,~ , (Description) ?.¥po. ' 4. Estimated Cost ..... : ~.~ .................... Fee ...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars ....... i ................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... Height [/~ ~. [ Numbe~ of Stories I ' Dimensions of same Cm~t~r~x~{t~alterations or additigns: Front ................. Rear .................. Depth ...................... iHeigkt ...................... Number of St,ories ....................... -8. Dimensi~ns~fentirenewc~nstru~ti~n:Fr~nt...6~.E.~..~4..~..~e~./~..~U~(~.~/Depth~ ............... Height . .~.'8>. t ......... NumbeI of Stories ... Z...-'7 ................................................ 10. Date of Purchase . . ~. [. /. 7.1.8>.~. . ................ Name of Former Owner .5~;.,9(O~-5. ?..,~ff~q. 4~..~..O*2..2~.. 1 1. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................. ". .......... 13. Wnl lot be regraded ... A .O .... .......... Will excess fill be removed from premises: ~ No Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .......................... Address .... : .............. Phone No ................ 15. Is this property located within 300 feet of a tidal wetland? *Yes .k~... No ..... *If yes, Southold Town Trustlees Permit may_ be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, an& indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether I~ Pltlblic, State o~ ~ew York T~rm ~pires OctOber 31, 1 ...... being duly sworn, deposes and says that he is the applicant County PO,Ok