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Home My WebLink About16037-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N Y. Certificate Of Occupancy No Z15838 Date June lO, 1987 THIS CERTIFIES that the budding A d d x t i o n 200 FRED STREET NEW SUFFOLK Location of Property H us No' Street Ham/et County Tax Map No. 1000 Section l .17, . . Block 04 .... Lot . 2. ! ......... Subdivision ....................... Filed Map No ........ Lot No ............. conforms substantially to the Apphcat~on for Building Permit heretofore filed in this office dated Ma y 13, 1987 pursuant to wNch Bmldmg Permit No. 16037 Z dated .. J u.n e 9 ,.. ! 9. 8.7 ...... was issued, and conforms to all of the requirements of the apphcable provlmons of the law The occupancy for which this certificate m issued m ... ,Co.nst. r. uct a..d.ec.k. 9.d.dz. ti.o.n.to..an .ex.i. st.z.n.g .?n.e f.a..m.z.l.y..d.w.el.l.z.n.g..... The certlflcate iSlSsued to FRANK J. $TRAKOSCH ..... ?o¥.'dr.Xta,v~t~.t~.,~xxx ........ of the aforesaid bmldmg. Suffolk County Department of Health Approval ... N/A ...................... UNDERWRITERS CERTIFICATE NO N/A PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev 1181 I~ORB~ NO. · 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) 16037 z Permission is hereby granted to: .......... ' ~o.-~.,Z~'-~---"~ ' ' ~ ~"~'""'"'~,L,3 ....... ~'a:"'_"~' ............................ ~""~7~' .......... at premises located at ....~.-?-°..--.~'.)~. ....... ~7 ........... .~.......~.......~ek~ ............... County Tox Map No. I000 Sect,on .... ~. !.'~.. .......... Block ....... .~...~ ....... Lot No......'~-..! ............. pursuant ,o application dated ...~.~ .~....~.. ............... 19.~. 1.., and approved by the Building Inspector. Building Inspector Rev 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N Y. 11971 765- 1802 TON ,~ .......... APPLICATION FOR 6ERTIFIOATE OF OOOUPANOY instructions A. This application must be filled in Wpewmter OR ink, and submitted I a to the Building Inspec- tor w~th the followmg; for new buddmgs or new use' 1. Fmal survey of property with accurate location of all buddings, property lines, streets, and unusual natural or topographic featu res. 2. F~nal approval of Health Dept. of water supply and sewerage dmposal-(S-9 form or equal). 3. Approval of electmcal ~nstallat[on from Board of F~re Underwmters. 4. Commercml buildings, Industrial bufldtngs, Multiple Residences and mmilar buddings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed rote plan requirements where applicable. B. For existing buddings (pmor to April 1957), Non-conforming uses, or buildings and "pre-~,xlsting" land uses: 1. Accurate survey of property showmg all property lines, streets, bullrings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buddings. 3. Date of any housing code or safety mspectlon of buddmgs or premmes, or other pertinent informa- tion required to prepare a cert~fmate. C. Fees: 1. Certlficate of occupancy $25 O0 -- BUSINESS $50.00 ACCESSORY $10.00 2. Certificate of occupancy on pre-existmg dwelling $ 50.00 3. Copy of certiflcate of occupancy $ 5.00, over 5 years $10,00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ........................ NewConstruction ...... Old or Pre-exlstmg Building ~' Vacant Land LocaUon of Property Owner or Owners of Property .... V..~',~, ? ,~.., J... %,-6. ~, ~, t~. p ?_.~, ,.1. ....................... County Tax Map No. 1000 Section ... ( .I. ,~, ...... Block .... .O..~ ....... Lot .....-/-- t Subdtwmon .......................... Fded Map No ........... Lot No ............ Permit No ........... Date of Permit ....... Apphcant ................................ Health Dept Approval .................. Labor Dept. Approval ........................ Underwmters Approval ............. Planning Board Approval ..................... Request for Temporary Certlhcate .............. Final Certificate ..................... Fee Submitted S ....................... Construction on above descmbed buddmg and permit meets aJJ applicable codes and re~laDons. Applicant .... , .~A C..J~- .~ ........ ,~ ,,~. ~ ,o,~? ~..~ ...... OUNDATIO:~ ( ~ st ) OUNDATION (2nd) OUGH FRAME & FLUMBING NSULATIO~ FERN. Y. STATE ENERGY CODE ADDITIO~IAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION FRAMING REMARKS: [ ] ROUGH PLBG. ZND [ ~NSULATION [4 FINAL DATE INSPECTOR Examined .~f,b, tt~,.~ e} Approved 7~ . Disapproved a/c FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, NY 11971 TEL 765-1802 · , 19 7. SUHVEY .... CHECK .......... SEPTIC FORM ............. : NOTIFY HAIL TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a Tlus application must be completely filled m by typewriter or m ink and submitted to the Building Inspector, w~tl sets of plans, accurate plot plan to scale Fee according to schedule b Plot plan showmg location of lot and of buildings on premises, relattonshlp to adjmmng premises or pubhc stre or areas, and givmg a detmled descnptmn of layout of property must be drawn on the diagram which m paff of th~s ap~ carton. c. The work covered by t~s apphcat~on may not be commenced before msuance of Bu~dmg Permit d. Upon approval of tins apphcahon, the Buddxng Inspector wdl ~ssued a Building Pe~t to the apphcant Such pen shall be kept on the premises avadable for mspectton throu~out the work e. No building shall be occupied or used ~n whole or ~n p~t for any purpose whatever until a Certtficate of Occupm shall have been granted by the Braiding Inspector. ~PLICATION IS HEREBY MADE to the Building Dep~tment for the issuance of a Bmld~ng Pem~t pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, ~d other apphcable Laws, Ordm~ce~ Regulanons, for the constmchon of bmldmgs, additions or alterat~ons, or for removal or demohhon, as here~n descfib The apphcant agrees to comply w~th all apphcable laws, ordinances, building code, housing code, and regulations, and admit authorized ~nspectom on premises and m building for necessa~ ~echons ~ ~ I t ( . . .... (Sz=nature of apph~ant, or name, zf a corporatzon) State whether applicant zs owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build ' '~ [' ~ If \ C~.L"%e % .... .-~-.¢-~.-~.. ~: ....... x ................................. Name of owner of ,remlses %:\ ~, ~, !%-...Q.. 5."~)).q .~ .~., ".q !,.'. ........... (as on the tax roll or latest deed) If applicant ~s a corporatmn, signature of duly authorized officer. 2 (Name and title of corporate officer) ALL CONTRACTOR'S MUS~ BE SUFFOLK ,COUNTY LICENSED Builder's License No. .c,~ ( ~. ~... .('.~. ~ ~ ~ ~ -~ I< t' Plumber's License No. .. Electrician's License No Other Trade's License No Location of land on which proposed work will be done i ..... ttouse Number Street County Tax Map No I000 Sectmn ~ [.~.. Sub&vision (Name) .... Ha le; Block ('3 ~.~ Lot T_ [ Filed Map No Lot .. State existing use and occupancy of premises and Intended use and occupancy of proposed construction a EMsUng use and occupancy { ~ ~, , /~ c, ~.- .< b. Intended use and occupancy .... ~ . c~ffe~ ................... Nature of work (check which applicable) New Building Repar ..... Removal Estimated Cost .. ~ ,,1.0. Ox9 . . If dwelling, number of dwelling units If garage, number of cars . If business, commercial or mixed occupancy, specify nature and extent of each type of use ....... Dimensions of existing structures, if any Front. Rear ....... Depth ..... Height ...... Number of Stones .................... Dm~enmons of same structure with alterations or additions Front ..... Rear .... Depth ............ Height .... ~. .. Number of Stones . . Dunenmons of entire new construction Front ..T t3. Rear .'.~ . .ti . I .. . Depth .. 3 ('. t. . Height . . .g..l~. ..... Number of Stones ............................ .... Addition ~.~.. A.It erat~on ... ...... Demolition / ....... Other '~ ork .... qDescr~?tlon) /" (to be paid on filing this apphcatJon) .... Number of dwelling units on each floor .. - Size of lot Front ....... Rear ................ Depth ............... Date of Purchase ........ Name of Former Owner ................... Zone or use distract in which premises are situated ...................................... Does proposed construction violate any zoning taw, ordinance or regulation .......................... Wall lot be regraded ............. Will excess fiI1 be removed from premises' Xes No Name of Owner of premises ............. Address ............... Phone No .............. Name of Architect .................... Address .............. Phone No ............... Name of Contractor ............... Address ............... Phone No ......... Is thzs property located w~thzn 300 feet of a tzdal wetland? *Yes ..... No ..... *If yes, Southold Town Trustees Permit maybe requzred. PLOT DIAGRAM Locate clearly and distinctly all bmldmgs, whether exlshng or proposed, and indicate all set-back dunenslons from ~perty lines Give street and block number or description according to deed, and show street names and indicate whether enor or corner lot ATE OF NEW YORK, S.S )UNTY OF (Name of indwldual signing contract) ove named being duly sworn, deposes and says that he is the applicant is the ............................................................................. (Contractor, agent, corporate officer, etc.) smd owncr or owncrs, and is duly authorized to perform or have performed the smd work and to make and file flus ohcat~on, that all statements contmned m ttus application are true to the best of hm knowledge and belief, and that the ,rk wdl be performed in the manner set forth m the application filed therewith. orn to before me this x.~ (S~gnature of applicant)