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HomeMy WebLinkAbout16034-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No .. .~.15.87.8 Date ..... 3.u..n?..24.: .19.8..7 .. THIS CERTIFIES that the bmldmg . .deck...a,d.d~..fi.~.o.n.. ,~o..e.?_s.t xng..d.w.e.~.~in.?. , Location of Property , .. 76.5. ..... .C.e,d.a.r..Dr.i¥? ........ .~,a..~.~.~.tu.ck . House No Street Hamlet County Tax Map No. 1000 Section 10.6. .Block I 1 Lot Subd~vision. Matt%t.uqk., .D.ev. el..opi, n.q..Cq.Fted Map No 776.. . Lot No. .. ...32 .....& 33 conforms substantially to the Application for Building Pemut heretofore fried m this office dated ·...M~y..1.2, .1.9.~7 .. pursuant to wtuch Braiding Permit No. .1.6.0.3 4 .Z ......... dated . .. Ju, r~q~ .8,..1~.8.7 was issued, and conforms to all of the requirements of the applicable provisions of the law The occupancy for wluch tlus certificate is issued is ....... Deck addition to an exzsting one-family dwelling. The certificate is issued to of the aforesaid building Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO .. ROBERT & MARION SLATER N39801 PLUMBERS CERTIFICATION DATED: N/A ,r' l~[dddmg Inspector Rev 1/81 · OEM NO. ,a TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO- 16034 Z Permtss~on is hereby granted to: .~.~..~T~..5...~[.~ ...~...v. ...... ~.~~ ............. · ..~ ........... ~..~ .......... ~.%.,.....~.~.~.1... ot p~m,se~ ,oeo,ed o, ...a.~ ....... .~.~.~.......~~.~,,. ......................... County Tax Map No 1000 Section ..... t .~..~.- · · Block .... ,,~,,..~,,~ ........ Lot No ..... .C~..~, ...... ~u~o., ,o o~,,~,,o~ do,~ ... ~......~..~..~ ............. , ,~.~.. o,~ o~o~ ~ ~, Building Inspector, 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 OCCUPANCY Instructions Thru application must be filled ~n typewriter OR ink, and submitted m ~ to the Building Inspec- tot w~th the following, for new buildings or new use' 1. Final survey of property with accurate location of all buddings, property lines, streets, and unusual natural or topographic features. 2. Fma[ 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 Commercml buildings, Industrial buildings, Multiple Residences and similar buddings and installa- tions, a certificate of Code compliance from the Architect or Engineer responmble for the building. 5. Submit Planmng Board approval of completed site plan requirements where apphcable. Bo For existing buddings (prior to April 1957), Non-conforming uses, or buddings and "pre-existing" land uses. 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographm features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buddings. 3. Date of any houmng code or safety inspection of buddings or premmes, or other pertinent reforma- tion reqmred to prepare a certificate. C. Fees' 1. Certlflcate of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $10.00 2. Certificate of occupancy on pre-exmting dwelling $ 50,00 3. Copy of cert[flcate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O- $ 20.00 5.updated c.o. ~ 50.00 Date ..W.:J..~J ............... NewCons truc t,~on ...... Old or Pre-exmtmg Building ............ Vacant Land ............. Location of Property .. Hou~ No. Street ~amlet O~per o~ O~se~s of Property ................................................. co~ty ~ s~ ~o. ~ o0o s~o~,o~ Z~,.~. ..... ~o~ . ~ ~.~,.~ ..... uo~. ~ P. ~ ~ ~ .... Subd,v,sion ......................... F,led Map No .......... Lot No. ~ g.t ~ .... Health Dept Approval ................... Labor Dept Approval ....................... Underwriters Approval....~..~. ~ .~0. / ......... Planning Board Approval ..................... Request for Temporary Certificate ................ Final Certificate ...~.. ................. Fee Submitted $ ........................ Construction on above ~escnbad budding ancLperm~t meets ali, apphcab[e codes and regulations. ~,"~ '~%5 App Ica /~ . .. ~.~.~ ....................... Rev 10 10 78 OUNDATiO.U (1st) OUNDAT!ON (2nd) OUGH FRAME & PLUMBING NSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: TOWN OF SOUTIIOLD OFFICE OF BUILDING INSPECTOR P O, BOX 728 TOWN HALL SOUTIIOLD, 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/ Tile check ~s(outdated/not on file.) /~/ No Health Dept. Approval on file. /5/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit t~ ~_ _~ ~)_t ~ Z Building Dept. *~*/~/ No Plumber solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) Memorandum from .... BUILDING INSPECTOR'S OFFICE TOWN OF SOUTHOLD TOWN HALL, SOUTHOL~ N Y 11971 765-1802 May 12, 1987 Dear Mr. Slater: I am returning your application. Please sign ~t and have the sig- nature notarized and return it to us. When you return the applicatxon please mention that the rest of the paper work zs zn slot 25. Thank you. Secretary FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, NY 11971 TEL.: 765-1802 Examined x~.4~ 9.. ,19 ~"/ , 19g''/ Penmt No. } {~o&q..'~ (Building Inspector) A~PLICATION FOR BUILDING PERMIT BOARD OF HEALTH .o 3 SETS OF PLUS SURVEY . ..-~'~---'--, NOTIFY CALL MAIL TO: ........... ~ BLDG. " [ TOWN OF SOU~HOLD Date.~.k~. /e2.'/q~ -2 19 INSTRUCTIONS a. Ttus application must be completely filled in by typewnter or in ink and submitted to the Building Inspector, wztb sets of plans, accurate plot plan to scale Fee according to schedule b Plot plan showing location of lot and of buddings on premises, relationship to adjoining premises or pubhc sire, br areas, and givmg a detailed descnptmn of layout of property must be drawn on the diagram which is part of this apl~ caatlon. c The work covered by tlns application may not be commenced before issuance of Budding Permit d Upon approval of this application, the Bulldmg Inspector will issued a Building Permit to the apphcant. Such per~ shall be kept on the premises avadable for inspection throusmut the work e. No budding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan shall have been granted by the Building Inspector· APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bmldlng Pennlt pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordmances Regulations, for the construction of buddings, additions or alterations, or for removal or demohtlon, as herein descnb, The applicant agrees to comply with ali applicable laws, ordinances, buddmg code, housing code, and regulatlons, and admit authorized inspectors on premlses and in bulldmg for necessary mspec.~..~/.~~... (Signature of applicant, or name, if a corporation) .~HP~'~ ~. O~. c>P-~--My.. /,, 2. ~ /. ......... (Malhng address of applicant) State whether apphcant l~WO_wne~r lessee, agent, architect, engineer, general contractor, electrician, plumber or build, Name of owner of premises ,'~(~-- .~- ,~/),~-~VA.) {.,c) O'"~../~7",',~.~ (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 ..... Electrlclan's License No .......... Other Trade's License No Location of land on which proposed work will be done House Number Street County Tax Map No 1000 Section /g)~ · ~ Subdivision . . (Name) Fd ............. Handet Block . q ./[.~ .~? .. Lot .0. O~. ,.~,h~:EO. ..... FfledMapNo . .. Lot '-~ff-~.~.~ · .. State exlstnlg use and occupancy of premises and intended use and occupancy of proposed construction a Exlstmg use and °ccupancy /~7/~"'q '~4'(~'/~ ~'~/~9~>, ..... '~~'._ b Intended use and occupancy ~-~ ~-,~ 2P~J/~ L · Nature of work (check which apphcable) New Bmldlng Repmr ...... Removal ......... Demoht~on Estimated Cost ~'/,30 C) If dwelhng, number of dwelhng umts . Ad&t~on Alteration ........ tX,,,Other Work.. 7-7~.~,~.... (Descnptmn) -. .. Fee ..... . .... .. ... .... .. ' (to be prod on fihng ttus apphcat~on) ....... Number of dwelhng umts on each floor ..... If garage, number of cars ........................................ ,. If business, commercml or m~xed occupancy, specify nature and extent of each type of use ........... Dm~ensmnsofexistlngstructures, ffany Front ~to Z Rear .,J ..... Depth ~. Hmght ..... ~1 .....Number of Stones / ........... Dmlens~ons of same structure with alterations or additions Front .. Rear ..... Depth ............ Hmght . Number of Stones .............. ,. Dimensmns of entire new constr,uctmn' Front / 7 ! ~ ' Rear . ./. 7.' a. :'.... Depth ./. Z: ~. ~'. .... Height ........... Number of Stones .................................. S~ze of lot Front . d.~.o.~ ....... Rear .. ,Z. o.o. ? ..... '. Depth /0.?,.).: ............. Date of Purchase ~g~O5 r-../,~. O ........ Name of Former Owner~. 7',/FqMK.~.~. ........... Zone or use dmtnct m which premmes are s~tuated _~ltP~r,~4.t-. ................... Does proposed constructmn violate any zomng law, ordinance or regulation' M.O ...................... Will lot be regraded .. ~ <3 . . ........ Will excess fill be removed froi~l.prem~ses .Yes Name of Owner of prem~ses/~.~'~F.*/~OA!o'O:-,Fz,~f~'~. Address2.J~z~.~.d.~..P.z-~.-.alO-~...i~.9-T."'P~one No.o//.(o. ~.5.9. Name of Architect ................ Address ............ Phone No .............. Name of Contractor ... ,.5.~ ~-.~. ........... Address ................ Phone No .............. ,. Is this property located w~thin 300 feet of a tidal wetland? *Yes ..... No ~... *If yes, Southold Town Trustees Permit ma~ be required. PLOT DIAGRAM Locate clearly and d~stmctly all bmldmgs, whether existing or proposed, and intimate all set-back dlmens~ons from aperty hnes Give street and block number or description according to deed, and show street names and ~nd~cate whether enor or corner lot /~/9~Z~ t~O/0 ? 'C i,o /--~.,z.t o,O.. ,l-o7-' ATE OF NEW YORK, ~--~t-~ · ' (Name of md~ual s~gmng.c~nt;:ct}~.~J ..... being duly sworn, deposes and says that he ~s the apphcant ove named ~s the .... ~.~ (Contractor, agent, co,orate officer, etc ) smd owner or ownem, ~d m duly authorized to perform or have performed the smd work and to m~e and file tlus ahcat~on, that all statements contmned m thru apphcat~on are true to the best of h~s knowledge and behef, and that the ~rk will be perfo~ed ~n the m~ner set forth m the apphcatton filed therewtth. om to before me th~s ..... /~r~ .... dayor .... ~ .... ,19~ taw Pubhc, . .~~ ...... ~~~ ~'' (S,~a}u~e'~ f :Opl;c~nt, V~'I W AV~'. N 52'0Z'00 ' 3! LOT ~ ~o oo 5~ S.§2~o?'O0"~ LOT 34 LOTS MAP Ot 'MA T TI TUCK DEVELOPING FIL£D MAY I, 19R$ ] ~IL~ MATTI~ TOWN OF ~U~O~ $UPFOLK ~, N.Y. CO., EMPIRE OF AMERICA COMMONWEALTH LAND TITLE INSURANCE CO N~RT ~ ~ MARION W/N/FRED SL A donack associates ~13 west main street riverhead, new york 11901 (516) 369-1717 (212) 746-3020 July 26, 1983 Job N2 85-313 I000- 106-11-08 Scale :1" =30'