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HomeMy WebLinkAbout16011-zFORM NO 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y Certificate Ol Occupancy No Z-16168 Date September 15, 1987 THIS CERTIFIES that the budding., .G .A.R.A.G.E..ADD. I .T.~.O.~... 150 Seaweed Drive Southold, New York Location of Property H~use 'No ...................................... Street Hamlet County Tax Map No. 1000 Section 088 .Block 02 .Lot 08 Subdivmton ......................... Fried Map No ...... Lot No ........... conforms substantially to the Application for Building Permit heretofore filed in tins office dated May 13, 1987 pursuant to winch Bmldmg Permit No 160ll Z dated . Ma.y 2.6.:. 1.987 ..... was issued, and conforms to all of the requirements oftheapphcableprovmonsofthelaw.~leoccupancy ~rwinchtinscertificateis~ssuedis ...... GARAGE ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR EDWARD & ELLEN WILLIAMS ~ecerBflcatemmsuedto ....... of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO. N/A N852150 Feb, 3, 1988 PLUMBERS CERTIFICATION DATED; N/A Building Inspector Rev 1/81 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) No- 16011 Z Permgss~on is hereby granted to: , ..e.~...~.(.~ ....... ~ ~~.. .~~......~...~..: ....~ .~..~3..t ............ ======================================================================== County Tax Map No I000 Section ..... .C~.~....~.. .... Block ....... .~.....~'... .... Lot No .......(~...~.. ..... purSuant to application dated ..... ~~ I~ ........... , 199].., and approved by the Building Inspector. Fee $...~.~....:..~. Rev 6/30/80 A FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions Th~s apphcation must be filled in typewmter OR Ink, and submitted m mmmmmmm to the Buildmg Inspec- tor with the followmg; 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 F~re Underwriters. 4. Commercial buddmgs, Industrial buddings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responmbte for the bulldmg. 5. Submit Planning Board approval of completed rote plan reqmrements where applicable. For existing braidings (prior to April 1957), Non-conforming uses, or buddings 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 bu ildings. 3. Date of any housing code or safety ~nspectmon of buildmgs or premmes, or other pertment inforrr~a- tmon required to prepare a certificate. C Fees. 1. Certificate of occupancy $5.00 2. Cert~hcate of occupancy on pre-existmg dwelhng $15. O0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O...__,___$5.00 5. Updatecl C.O. $15.00 Date ..................... NewCons t. ruct-~on,..t~.. %%~'~re-exlst,ng Bu,ld,ng ........... Vacant Land ............. Location of Property., J..~.~. ............ ~..~'~, .~.~r ~ fi (~. .~.O. u~a/oj House No Street Ham/et Owner or Owners of Property , County Tax Map No. 1000 Section ....... -..-. ..... Block ............... Lot ................ Subdwlslon ~'~-,~t~,~o ~ /~tZ~_5 .Fded Map No. .Lot No. 'r~)~J~// ~' of Permit '-'~../.' .~( .~?..App hcant .~. ~/.z.~.. ~.., ..~.././.,/-/,i~../~..~C ......... Permit No./.~.~,... Date . Health Dept. Approval .... --.~- -lg ............. Labor Dept. Approval .../~//Z~. ................ Undevwr,ters Approval ...... ,~. L .~, ............ Planning Board Approval . . ~J/./? .............. Request for Temporary Certifmate ............... F~nal Certihcate ..../~. ................. Fee Submitted $ ..................... Construction on above described bulldmg and permit meets all apphcab[e codes and regulations. Apphcant ...... ~ .................... Rev 10 10-78 OUNDATIO:; __ {1~~ OU~DATIO:; ( 2nd ) OUGH FRAME & ?LUMBING NSULATION PER N. STATE ENERGY CODE ADDITIONAL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000121 BUREAU OF ELECTRICITY ~-- 85 JOHN STREET, NEW YORK, NEW YORK 10038 o.,. February 3.1988 Appt,~.,,o.N...f,t~494976/S7 N ~Z150 THIS CE~IFIE5 THAT FIXTURE BXTURES RANGES OVENS EXHAUST FANS SYSTEMS NO OF FEET OTHER APPARATUS E V I C NO OF NEUTRALS Paul Burn~ 275 Tuwn H&rhor Lane Southold, N.Y., 11971 GEt4~dL~L MANAGE! Th~s cerflhcate must ~ot ~e catered m any manner, return to the office of the ~¢cl s{ incorrect tnspectocs may be ~denhfred by their credenho~s COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. HAP OF PF2©PE~TY W!LL!Ah/IS BAYVI ~V 'OF' ~,'T~L P ', N,¥ ;3~ LE -¢.,-1 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ]: INSULATION ( ] FRAMING REMARKS: [~] FINAL DATE 765-1802 BUILDING DEPT. INSPECTION [~FOUNDATION XST [ ] I' ] FOUNDATION 2ND [ ] FRAMING REMARKS: ROUGH PLBG. INSULATION FINAL DATE INSPEGTOR FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL. 765-1802 TOWN C,'- SOUTHOLD Examined 'NIY]~4~. ~ ,191'] l~ecezvecl ........... ,19. Disapproved a/c _%ox. Z3 /-% (Bmldmg Inspector) APPLICATION FOR BUILDING PERMIT Date ~ , 19. INSTRUCTIONS a Ttus application must be completely filled m by typewriter or in mk and submitted to the Building Inspector, w~tt sets of plans, accurate plot plan to scale. Fee according to schedule b Plot plan showing location of lot and of buridmgs on premises, relationship to adjoining premises or public stre or areas, and glvmg a detailed description of layout of property must be drawn on the d~agram winch ~s part of th~s api caUon. c The work covered by tkts apphcatmn may not be commenced before issuance of Building Permit d Upon approval of this apphcatmn, the Building Inspector will issued a Bufldmg Permit to the applicant Such pert shall be kept on the premises avariable for inspection throughout the work e No building shall be occupmd or used in wlx?le or in part for any purpose whatever untd a Certificate of Occupan shall have been granted by the Bmldmg Inspector .~ Ai~PLICATION IS HEREBY MADE to the Buri~ing Department for the issuance of a Building Permit pursuant to t Budding Zone Ordinance of the Town of Southold,~uffolk County, New York, and other applicable Laws, Ordmances Regulations, for the construction of bu. ridmgs, additions or alterations, or for removal or demolition, as hereto describ. The applicant agrees to comply with all apphcable laws, ordinances, bmldmg code, housing code, and regulations, and admit authorized inspectors on premises and m buridmg for necessary, ff~3~lnspectlons, c,~. ~ ~. ~5~ ' ~.. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or build. .... Name of owner of premises ~;:d-o-Lqr'c/ ~L ~//eg2 [.4.,];~///'~67c..~ ........... (as on the tax roll or latest deed) If applicant is a corporation, signature of duty authorized officer (Name and title of corporate officer) Builder's License No q~.~)--, Plumber's License No Electrician's License No Other Trade's License No Location of land on which proposed work wril be done House Number Street County Tax Map No 1000 Section Subdivision .~e ~, ~000 cx/ ~C F~_.S (Name) Hamlet Block ,~. . Lot. Fried Map No Lot 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 ~/~ ~ ~ Nature of work (check which applicable) New Bmldmg Repair ,. Removal ...... Demolition Estunated Cost ~./ .~Z~..,..-"- .......... If dwelhng, number of dwelling .units . .. If garage, number of cars . / Addition /,... Alteration ....... Other Work .... (Description) · .. Fee ...~."- ................. (to be paid on filing this application) Number of dwelling units on each floor ......... 6. If business, commercial or mixed occupancy, specify nature and extent of eaclx type of use ...... 7. D~menslonsofexlstlngstructures, lfany Front /5- , . Rear ../.3- ....... Depth Height .. . Number of Stones ~/ .... Dnnenslons of same structure with alterations or additions Front ~J'"i ' i'i'R;~r" i~c~i ' . ' Number of Stones .../..:~. ....... Depth ...... Height . 8. D~menslons of entire new construction Front [~>'. ' i 'Rear ./~..r ..... Depth Height .. . Number of Stones /.. 9. Size of lot Front /,~-D . . Rear . /~..~ ......... Depth~ .. /.SZ~ . 10. Date of Purchase .. ,Z.~.~ ......... Name of F~rmer Owner ~Se.,5~.;oz,',~' f)'C'rCX I 1 Zone or use dlstnct in which premises are situated ~ ..... 12 Does proposed construction violate any zoning law, ordinance or regulation' .. ',~?~91 ' ' i . . '.. i ......... 13. Will lot be regraded ............ Wfli excess fill be removed from premises. Yes / No 14. Name of Owner of premises . ~"~/ ~O. '.'/4 t '.~. ~z~.J. Address . ./5'~..~e . .,~.c~. ~ Phone No .'7~ ~...'- Name of Architect ..... Address ........... Phone No ........... Name of Contractor .~:/. ~.Z'/i'~'~..,~. 3 .... Address . ~...~Q.?'~'I-~. ·Phone No...~...'~."7~. ~ .... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back danenslons from property hnes. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot ~ ~ ~ ,9, - ~> STATE OF NEW YORK, S S COUNtrY OF.. . /, . ~ , · ....... (Name of individual signing contract) above named \, being duly sworn, deposes and says that he is the applicant (Contrac~or~orporate officer, etc ) ~f said owner or ownerS, and Is duly authorized to perform or have performed the said work and to make and file this ~ppbcation, that all statements contmned m this application are true to the best of his knowledge and belief, and that the work w~ll be performed in the manner set forth m the application filed therewith gworn to before me this .... /~ .r...dayof. ot Pubil0,. · County (S~gnature of applicant) APPROVED AS 76~-1~2 9 ~ rO ~ ~ ~R THE ~LLOWING iN~CTION~- FOR ~URE~J ,'ONCE IN$tJLA r~o~ ~UST ~T[ CON~r~~ & ENER~ r~ O~ CCN~uC~ON ~RS OCCUPANCY'OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY