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Home My WebLink About15849-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building ....... .a.d.d.J:~. i..o.n..~..o..cl.w.? .I.l.i.n.g.: ................ Location of Property ..... 4. 7.0 .............. H..i.c.k.o.r.y..S.~r..e?.t. ..........S.o.u.~..h.o.l.d. ...... house NO. Street Ham/et County Tax Map No. 1000 Section ..... .5.4 ..... Block 6 .Lot 9 Subdivision ............. 2( ................. Filed Map No. X .Lot No. X conforms substantially to the Application for Building Permit heretofore filed in this office dated March 31, 1987 15849Z ...................... pursuant to which Building Permit No ...................... Apri,1 3, 1987 dated ............................ 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 ......... Addition ~o existing dwelling. MR. & MRS. SPICER The certificate is issued to ........................................................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N8 19 07 2 PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- t802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted mt~m,.,~m 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 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: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $10.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.'00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .... ~..,~.t4~/.~..-7... New C on s t r uc b i on.,, }q, Old or Pre-existing Building ............ Vacant Land ............. Street Southold Location of Property ...... 47. 0 ........... .H.i.c.k.o..ry ....................................... Hous~ ilo. Street Ham/et MR. & MRS. SPICER Owner or Owners of Property ............................................................ 54 6 9 County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. PermitNo. 15849ZoateofPermit 4/3/87.Applicant Mr. & Mrs. spicer Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ............. X. ......... 25.00 Io9 Fee Submitted $ ......... Construction on above described building and permit meets all applicable codes and regulations. 0'0'~-~::1~*~5 George N. Terry app.cant .................................................... Rev. 10-10-78 THE 1000091 July 10, THI~ CERTIFIES THAT NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY BB JOHN STREET, NEW YORK NEW YORK 10038 only the electrical equipment as d~scrlbed below and introduced by the applicant named on the above application number in the premises of John R. Spicer, 470 Hickory Road, Southol~ N.Y. u~s examined on and found to be in compliance v'it h the r~qulremeat s of th s Board. FIXTURE OUTleTS SWITCHES DRYERS FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS SYSTEMS NO. OF FEET E OTHER APPARATUS: 1 Smoke Detectoz' S E R C [~c,e j A.w.o. No o~ ~.~a A.w. o NO Of N~U~t,~S Peter Bogovic N. Bayview Rd. $outhold, N.Y .11971 Lio #137E This certificate must not be altered in any manner; return to the office of the Board if incorrect. GENERAL MANAGER may be identified by their COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IH ANY MANNER. OUNDBTION OUNDATION (2nd) OUGH FRAME & ?LUMBING LUSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: Z 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. REMARKS: FOUNDATION 2ND [ ] IN/SULATION FRAMING [~ FINAL DATE INSPECTO~ 765-1802 BUILDING DEPT. INSPECTION / FOUNDATION ~,ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL DATE /-//,~//~ ? / / INSPECTOR~ 765-1802 BUILDING DEPT. INSPECTION' FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [~FRAMING []FINAL E ..... INSPECTOR 3U~VF~Y FOR JOHN R. ~, ANi"JE SPICER AT SOUTHOLD Td','.'.'.l 0[: 30UTHOLD SEPT, 2'1~ 1970 $~Ct,.,'R!T'£ TITLE ~ dOHi'l R, .~.1 ,.~tl¢.lE O0 ij :? JOHN R. ~ ANNE SPICER AT SOUTHOLD 'Fd','.?'~ OF" $OUTHOLD ..S!.IFF',:;..h: ,6Z~.'~:!',~, ?i Y. ,'~i2'~L~' · ;'~z ~0~ SEPT. 2'411870 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined , .(~...~. ..... 15~.q.. Approved .Q~-~..~xlt A .~ ..... 19'$..~. Permit No. ].~.2~..q.~ h. Disapproved a/c ..................................... (Building Inspector) Received...~./?.].. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS 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 ~ 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, b)~ilding code, housing code, and regulations, and to admitauthorizedinspectorsonpremisesemdinbuildingfornecess~ ~,~...~....~.... (Mailing address of applican[) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · ................................................................ Name of owner of premises . .~.../57~...~..~'..~...~/J(_,lg.~ ................................................. (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..l. ~ .~. ~.~...~/~. .......... Plumber's License No.~.~...~..tld~.WO.V? ........ Electrician's License No. ~OMI. C~.('. Other Trade's License No ...................... q 7~ 1. Location of land on which proposed work will be done....~t../.c.~..°.~.[..~'~d..ff.~Y.~..~.~/.4..~..q,. ........................... , r-,. lc. e x ?. ,,v.. .4. ................... ,.X. q. . .l,. ? .Id.. .. ltouse Number Street Hamlet County Tax Map No. 1000 Section ...~...Y ......... Block ...~.. ' Lot..~ ............... 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 ....~..5../..~..~..~..(--.L~ ................. ~.' ................................. b. Intended use and occupancy . ~ ~ ~ ~' ~-- ~ i ~ .............. '. '3. Nature ofwoti~ (check which applicable): New Building ..... ' ..... Addition .. ,, ..... ~.. Al/~ration ....... '... Repair ........ · ....... Removal ............. Demolition ...... -, .....~.. Other Work; .............. ,' (Description) 4. Estimated Cost...~...~..O..~?: .~.9.O. ...................... Fee .,~..O..: .O. ,.,~. [ ........................... · (to be prod on filing this application) 5. If dwelling, number of dwelling units. .. ..... ....... Number of dwellingunit~ on each floor.. .......... . .. If garage number of cars 6. If business, commercial or mixed occupancy, specify n~ture and extent of each typ'e of use . ~ , 7. Dunens~ons of existing structures, ff any: Front. ~. 7 ........... Rear . ~.'~ .......... Depth ~.~' ............ ' Height .. ].~..: ....... Number of Stories ... ~t ............... : ........ ; .............. e ........... Dimensions of same structure with alterations or additions Front ~q's~ t ... ! Rear ,,].~ . Depth..~.~. ................ He,ght ... ~ ................. Number,of ~tories .... /.. ..... ., ......... 8. Dimensions_of. entire new construction Front . ,~1"~..~ .... ~ .... Rear . ~3..~. ,~ ......... Depth .~.,.~..~ ........ Height ./..~..r .......... Number of Stories ..... ~/ ................... ] ................ 10. Date of Purchase ..... . .-:w.... ,~ Name~f Former Owner ; ~ . .. 11. Zone or use district in which premises are situated. [~-~$:~:/~.~. j ;~ 1 .... 'il i i i i i ............ :i ..... 12. Does proposed construction violate any zoning law, ordinance or regulation: ~.~ ..... iiiiiiiiiiiiiiii. 13. Will lot be regraded .~/O.... ........ ~. .......... Will excess fill be removed, from premises: Yes 14. Name of Owner ofpremises~ e~,t, et[_ Address~,~C~o~ .~, .~.~r.~ Phone No 7...g~.- 5. ?Z amc of Architect .......... Address ~ ' '~;~.~ ·. t. ~'~ Ph,,~o PLOT DIAGRAM Locate clearly and distinctly all 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. OF NEW YORK, S.S OF ~bove named. He is the... ......... being duly sworn deposes and says that he is the applicant (Contractor, agent, corporate officer, etc. of said owner or owners, and is duly authorized to perform or have performed the ~md .work afidt9 ~nake and file th~s application; that all statements contained in this application are true to the best of h~S. 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 ...... · .~-~.~..., 19~2 ~ Notary Pubiic,...~ .~.:. ~.. ~. ~..g-~,... Count~_~eg~ .~'.'~-~-'[~ .............. NOT~R¥ ~t I£~0,g~t~l~ o~ ~'8 ....... ~7(~;gnature of appli~,ant) No, 47071t78, Suffol[ Term Expires M~ch 30,19-.~,,,~