Loading...
HomeMy WebLinkAbout15799-zTOWN 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- ~.5799 Z Date Permission is hereby granted to: ..... ~....~.........~..~. ... .... .. ................... . . ~~......~.,~..,../..:..t~../. ....... .c;~..~....~.,,......~.......~....~....~~....~...~.~ ...................................... at premises located at ..os'~.~,.'~.,....~,,,%d¢.~..',..,~,,~..,-~..;.....,'~~~-~,~.. County Tax Map No. I000 Section .... ..C~..~...~. ....... Block ....... ..~...~. ........ Lot No .....,~.:...~... ......... pursuant to application doted ........ ~.(~1,~....~.....~..~ ..........., 19.~..~..., and approved by the Building Inspector. Fee $...~..:..~. Rev. 6/30/80 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z16591 Date January 19, ]988 THIS CERTIFIES that the building ... A..1.t.e.r..a .t.i.qn. ................................. Location of Property 250 Paradise Point Rd. Southold House No. Street Hamlet County Tax Map No. 1000 Section ..... 0. 9. .3 .... Block 0 1 .Lot 5.2 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore ~ed in this office dated ..... .M.a.r.c.h...I.8.,.. ! .9.8.7 pursuant to which Building Permit No. J.5.7.9. 9..z .............. dated M............................arch 28, 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 ......... · A! t..e.r..a.t..t.~.c.h.e..d..g.a..r .~.g.e., .~ ?.t.q .~..t y.t.~. ~..qy.a..~.t.e.r.s.:..a.s., .~ p.p.! t. ?.d..f.o..~..o.~...~... one family dwelling. The certificate is issued to R. DOUGLAS & SUSAN BLIVEN of the aforesaid building. Suffolk County Department of Health Approval ............ ~/..A ........................... UNDERWRITERS CERTIFICATE NO ............... ~q844998 I 1/30/87 PLUMBERS CERTIFICATION DATED: John E. Walters Plumbing & Heating 1/19/88 Building Inspector Rev. 1/81 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1502 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 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.Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conformihg Us~s, or buildings and "pre-existing" lend uses: 1. Accurate survey of property 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: Additions $25.00 1. Certificate of occupancy New Dwelling $25.0.0, Accessory;S10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 --/ 5 .Updated C.O. $ 50.00 Date .,///.~./~. ..... ?~., ............. NewConstl~uction ...... Old or Pre-existing Building ............ Vacant Land ............. ti Loca on of Property ................................................................ House No. Street Ham/et Owner or Owners of Property ... o?3 l 5-2_ County Tax Map No. 1000 Section ............... Block . o Lot - Subdivision ................................. Filed Map No ........... Lot No .............. PermitNo .......... jl~.~-?~¢ Date of Permit .3/~?.//~.~7.Applicant ....~./.e.?.% ..................... /~ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meats all applicable codes and regulations. Rev. 10-10-78 1000378 THE NEW YORK BOARD OF FIRE UNDERWRITERS kh BUREAU OF ELECTRICITY ~-- Nov'e~er 30, ],98-85/ JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT o~t~a~ f~utpm~nt ~ ~scrlb~d ~lo~ ~ interlaced b~ the 9p~llcant ~med on the a~e a~.llcatlon number in the premlses of ~g~u ~ven, rara~e ~o~nt ~. ~ ~eaar ~each Rd. & N. Bay V~w in thefollowl.g location; ~ B~ement ~ Ist FI. ~ 2nd FI. Section Bilk Lot ~s examined on N~ember 6, 1987 aRd found to be in complionce with the req~ire.tents ~f this Board FIXTURE OUTLETS 3 I~ECEPTACLES SWITCHES DRYERS FURNACE MOTORS FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS 3 FUTURE APPLIANCE FEEDERS TIMECJ. OCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: 1-G.F.C.I. $ E R NO OF CC COND~I PER ~' A, WG OF CC. COND V I C E NO OF HI-LEG NO OF NEUTRAl AWG. OF NEUTRAL Steve's E~ectric Inc. P.O. Box 1268 So~thold, N.Y. 11971 lic.~3494-E GENERAL MANAGE~ 11 This certificate must not be altered in any manner; return to the office of the Board if incorrect, inspectors may b~ identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE M~ST NOTBE ALTERED IN ANY MANNER. TOWN OF Sou'rltOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL 8OUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. /~ 7 ~ ._~_ Owner ~ (please print) Plumber ~o~3 (ple%se ,print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber's signature) Sworn to before me this 19¢~ , Notary Public, OUNDATION ( 1 s t) OUNDATION {2nd) OUGH FRAME & PLUMBING iNSULATION PER N. Y. STATE ENERGY CODE - ADDITIONAL COMMENTS: TOWN OF SOUTIIOLD OFFICE OF BUILDING INSPECTOR ILO. BOX 728 TOWN IIALL SOUTIlOLD, N.Y. 11971 EL. 76~-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because ,of the following reasons. /~/ An application for Certificate of Occupancy is not on file. ~~ /~/ No Underwriters Certificate on file. ~/ The check is(outdated/not au files) ~ /~/ No Healt~ Dept. Approval on file. /~/ No final inspection has been made. Please contact our office on this matter. cooperation. Thank you for your Building Permit tl Building Dept. ***/~/ No Plumber solder Certificate on file. ( all permits involving plumbing be~n~ issued after April 1,1984 ) Occupancy or [lse is IIl][;lldf [11 Wi£hOUt of OCCUDa~]cy. Clear up illin matter so that legal action does not have [o Thank you for your prompt at tent ion. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [i~]~SU~TION [~FRAMING [ ] FINAL REMARKS: DATE` ~,,~//'~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING ~]~AL REMARKS: DATE INSPECTOR Examined..~...o./~...~.?..., 19~.~/.. Approved . .~ · .~.~. ·., 19~.?. Permit No.l..~'~.."].~.c/.~... Disapproved a/c ..................................... BOARD OF HEALTH 3 SETS OF PLANS J 'FORM NO. I SURVEY J TOWN OFSOUTHOLD CHECK~ ~?'~O*OO BUILDING DEPARTMENT SEPTIC FORM TOWN HALL NOTIFY $OUTHOLD, N.Y. 11971 TEL.: 765-1802 CALL MAIL TO: I~-~ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ..... : ............ 19 a. This 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 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 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 necessary inspection, s. .... . ././! ./,K~...~. ................... (Signature of applicant, or name, if a corporation) .... ..... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....... ..................................... Name of owner of premises ../~.../??.~j/./q..3'..%..~.~. 7~'...~. '..../4,5 ./'.~ .C..? ................................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) . ./ Builder's License No.. t?. (~,! i~., ~,..;7 ................ Plumber's License No .... .~..o.~....~.....t~..~./..~?: .~,q Electrician's License No.. ~5'.'~.~..~..~..g' .... .~./~.c~-fc- Other Trade's License No ...................... 1. Location of land on which proposed work will be done] ................................................. House Number Street Hamlet County Tax Map No. I000 Section ...q.~/. ~ .......... Block .. ( ............... Lot,. 77 .&. ............ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... .~./, ?~...f~.'...~.%':?.'. '.~. · · ·C4.~.~; -//.' .'5) .................................. b. Intended use and occupancy . --f.".,2 ~. ' 3. Nature, of work (check which applicable): New Building ' Addition t: ......... Alteration .'.~.. . .... Repair ........... Removal , Demolition ' Other Work ......... · (Description) 4. Estimated Cost .................................. ~ ............................. ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... ]. ... Number of dwelling u~its on each floor ................ 6. If business, commercial or mixed occupancy, specify nature and extent of each t!ype of use ............ 7. Dm~enslons of existing structures, if any: Front .......... Rear ............ ~ ...... Height /.c/' Number of Stories I ' Dimensions'of same structure with al~terations'or additions: Front , ~"~/~". .,.... Rear .~...,~.. '--8. Dimensions of entire new construction: Front .......... ' ..... Rear ...... ~ ........ Depth ............... Height Number of Stories 10. Date of Purchase . /.~/..(~. xr .... ~ ~ ,- 1 1. Zone or use district in which prem/ises are situated ...................... i ............................. 12. Does proposed construction violate any zoning law~ ordinance or regulation: .,,?f.~ ........................... 1 3. Will lot be regraded .,e~. ?. ................ ,,. ,... Will excess fill be removed from,p~r,e~, jse~: Yes , No Name of Architect ................. ' . Address : . Phone No. Name of Contractor (3 ~.~ Address /,2z.5 ~,~.,,t./~,, .PhoneNo. 15. Is this property located within 300 feet of a tidal wetland? *~es ..... No ..... *If yes, Southold Town Trustees Permit maybe required. . PLO~r DIAGRAM ' ~ . Locate clearly and distinctly all buildings, whether existing or proposed, and~ ~nd~cate all set-back dimensions from property lines. Give street and block number or description according to deed, and shlow street names and indicate whether interior or corner lot. STATE OF NEW~__ ~ _~_~Y~ORK. S S COUNTY 0 ~.~4~<~-/.. ' ~ .......... (.~n~;.o.f.i~~o~.~.c.~..... . . . . ) being duly sworn, de ~oses and says that he is the applicant above named. He is the .. . ~z (Contractor, agent, corporate officer, etc ) ~'4~,'V', ~ ~ ~t.~,~ .~ of said owner or owners, and is duly authorized to perform or have performed thei said work and to/fi-eke 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 be performed in the manner set forth in the application filed therewith. Sworn to before me this ................ · /?. ~'~..~.' .day of ........... .?,~...'~..~.., 19 Y..~ $otary~ic, .... .~ . .~,.~~<.. .......... County . / LOR~A ~. ~OH~RDT ...... ~ Nota~ Public, 8rate o~ New York No. 52-8882150 Qualified tn Su~oH~ County C0mml~010n Expire, ~...~]/t (Signature of applicant)