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Home My WebLink About16373-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17249 Date AUGUST 31, 1988 THIS CERTIFIES that the building. ADDITION Location of Property 1605 PINE TREE RD. House No. County Tax Map No. 1000 Section 098 Block 01 Subdivision Filed Map No. CUTCHOGUE~ N.Y. Street Hamlet Lot Lot No. 7.7 conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 21, 1987 pursuant to which Building Permit No. 16373-Z dated AUGUST 24~ 1987 was issued, and conforms to all of the requirements of the applicable previsions of the law. The occupancy for which this certificate is issued is GARAGE ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to LOUIS & BARBARA LaGRAND (owner,)~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N023192-JULY 25~ 1988 PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 FORM NO. 0 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) NO- 16~7~ z Date .......... ~ ....... ..~. Permission is hereby granted · · ,. ...~.~......~.~.u ............................... . _ .. ~...J.~.~,~,~..>.c~.......~.....~.. .................................................................. at premises I~ated at ..L~.~.~......~:.~.~.....~ ........ ~ .......... Coun~ Tox Map No. 1000 Secti~.9.~ ........ Bilk ....... .~..L ...... Lot No....~.,.~ ........... p, rsuant to application dat~ ...~.~..~1 ................ , 19.~.2., and opprov~ by the Building Inspector. Fee $..~'-~.:...~ Building Inspector Rev. 6/30/80 FORM NO. 6 ~-- TOWNOFSOUTHOLD I~ ' {~ [~ ~ ~ ~'~ Building Department ~ Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY~~ Instructions This application must be filled in typewriter OR ink, and submitted g ~ 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 topograpl~ic 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 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. Su bruit 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 pZ~perty showing all property lines, streets, buildings a~d 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: Additions $25.00 1. Certificate of occupancy New Dwelling,S25.00, Accessory ,,$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.vaoant ,and o.o. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewC°ns~;ruction ...... Old or Pre-existing BuiJding ............ Vacant Land ............. Location of Property .... [..L'.~..<::~. ............. ~ .~. ~ ........... .--~.'q:'.~r~'-~¢'~? ....... .~..~. ,~. S .~?. *?..~ .... House No. Street l-lam~et Owner or Owners of Property ..... b..~, .o.t..~...~. .................................. County Tax Map No. 1000 Section o~ ~ Block Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. t~'~ ~. Date of Permit . .~.~?.! .~.7.Applicant [.~. p..~!.%7.-~. Health Dept. Approval ...... .-'7. ................ Labor Dept. Approval ...... ~ ............ ... . Underwriters Approval '"- Planning Board Approval " Request for Temporary Certificate ..................... Final Certificate . ¢ d, ...................... Fee Subm rte ............................. Construction on above described building and permit meets ~-~cable codes and regulations. Applicant ..... ~ .....Ii (' .~..~.~ ......................... Rev. 10-10-78 .FIELD INSPECTION FOUNDAT 1st) FOUNDATION (2nd) ROUGH FRAME ~' PLUMBING INSULATION PER N. STATE ENERGY o FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FRAMING REMARKS: FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ J FOUNDATION 2ND [ ~ULATION [ ]FRAMING [,/JFINAL / 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ] ,NS/U~TIO. ]FRAMING [.~'~1 .AL ~ 7GS-180;B BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ;ZND [ ] INSULATION FRAMING FINAL REMARKS: ~,<~, ~)~- I DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [/~RAMING [ ] FINAL DATE INSPECTOR ~. THE NEW YORK BOARD OF FIRE UNDERWRITERS ~00077~ BUREAU OF E~ICITY 8 JOHN STREET. NEW YO~K. NEW YORK 10038 -- ,, ~UI,Y ~5~19~8~ .,8.., 53823288/88 N 02~192 THIS CE~IFIE$ T~T ~ ex.mi~ on ~d~nd to ~ in ~m~un~ with the r~ui~tnent, o~ thi~ ~. RxnJe~ PlXT',,~V~S OVIN$ FANS OOTLffT~ SWITCHI$ 5 4 5 S E I V I RIJLANI) ELE~/1/.B. RULANT) I~IATTITUCK, NY, 11952 LICi<NS~ NO, 2,42E , monna; r~turn to the office of the &uord }f i Ap prove'h~..u~....~. ~.., BOARD OF HEALTH TOWN OF SOUTHOLD CHECK ........ BUILDING DEPARTMENT SEPTIC FORM ............. TOWN HALL SOUTHOLD, N.Y. 11971 NOTIFY ~.4~- TEL.: 765-1802 CALL ............... MAIL TO: i¢.?. 19 .~.. Pemt No.t t;. ~?.a..~.. Disapproved a/~ ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. T~s ap~licati~n must be c~mp~ete~y fi~ed in by typewriter ~r in ink and submitted t~ the Building Inspect~r~ 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 this 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 de~'fi~n, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housingfcod~a/, and regulations, and to admit authorized inspectors on premises and in building for necessary inspection~ ~.~ (Signature of applicant, or name, if a corporation) . .'~..~..,. :,.,...(.~.~. ~ .~.. ~,~..,,.: .-i.: :.?.'!., .......... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......................... ?.. ........................................... Name of owner of premises k ? .°. ! +..~/..~,../l"fi'..%,, ,~q?,~. . .~'.~. 4.t'~'..~.'~. ·~. ...................................... (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 Builder's License No..L"~..~.-/?...~. ! ............. Plumber's License No. "g'~ C ~. Electrician's License No. LICENSED Other Trade's License No ...................... Location of land on which proposed work ~ill be done .................................................. ............. .......... ,., .......... .c?., ................. House Number Street Hamlet County Tax Map No. 1000 Section ..... 7~.. ........ Block .... ./ ............. Lot .... 7.'..~. .......... i Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupanc~ of premises and intend~.~se and occupancy of proposed construction: a. Existing use and occupancy ....... ~.....'~.. '.'r..~...I.~..~'%.. ......................................... b. Intended use and occupancy ,sz~,,~ ,.., ar~,~.~f,,,,, , ,,~..., .... ' ' ~ Alt 3. Nature of work (check which at~phcable): New Building ..... ' ..... Addition .......... eration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... ~ (Descrigtion) 4. Estimated Cost ................ 2 ............... Fee ...................................... I * (to be paid on filing this application) 5. If dwelling, number of dwellingiunits ...... ~ ........ Number of dwelling units on each floor... I ............ If garage number of cars ' 6. If business, commercial or mixe'd occupancy, specify nature and extent of each type of use ...' .'r- ..... ~ . . . 7. D~menmons of~ex~st~ng structurOs, ff any: Front....qr.'>.'. 9.: .... Rear .4t5'~. ~ ..... Depth *-~ -r~ *. Hmght . .. t .~.'.?..~ ..... Number of Stones ...... i J .... ~. ! ............ '. ~. .... ',', ....... ' .... "h ' ~.~"~ ~ .~. ~" '~ ~. Dimensions'of same structure w~t alteratmns or additions: Front ................. Rear ............... Depth. ~'~"~' ~ ....... i' · Height . I .q..~. '~ ........ ~, ............ Number of Stories ~ Dimensions of, entire new construction: Front ... (,<;"~ t..... Rear ...~..~..-~..~ ..... Depth .'~. ~.-ff, .~. ....... Ite~ght ... ! .~....'. ..... Number of 8~tories .... .... ~ .... Si eoflot:Front .... ...... Rear ...... 10 Date of Purchase ,' Name of Former Owner 11 Z disti tin hihp' ' ' d · one or use r c w c remlses are situate .................................................... 12. Does proposed constructton wqlate any zoning law, ordinance or regulation: ....~. t.. ......................... 13. Will lot be regraded ........ ~' .o .................. Wall er~cess fill be removed from premises: Yes 14. Name of Owner of premises [,~ ? ! }. k& .~1..t~. ?..~. .... Address ~.~.o. ~ .I'..~,~...~...~..~..,.. Phone No."t.~. ~f...~.q. ?.~ .... Name of Architect ........ i~;i~.' ~.' i i i i i i''' Address .................... Phone No ................ Name of Contractor ... ~.., ... Address ~.TM. .~!! ~..~Y.~.~ ~'?.... Phone No."l.~. .~': .'~..~."/.~... 15. Is this property locatedlwithin 300 feet of a tidal wetland? *Yes ..... No ..~... · ][f yes, Southold Town Trgstees Permit may_ be required. i PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and. 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 interior or corner lot. STATE OF NE'v~ORK, z ~ .... COUNTY OF i ........... .~. 3 .e'.~/.~.4 . .~J:~...'{.~'. ?'~'..~. ................. being duly sworn, d~poses and says that he is the applicant (Name of individual signing contract) above named. He is the ......................................................................................... I (Contractor, agent, corporate officer, etc.) of said owner or owners';.and is dilly authorized to p~rform br have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will b~ performed in the mannbr set forth in the application filed therewith. Sworn to before me this . .. da .,'7' ...... Notary mu~blic, . ...... ~ .... ~,-,~,~. ..... ~ ~County .................... Term Expires Ootober 1~1, lg..~.~