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Home My WebLink About15859-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17168 Date AUGUST 5, 1988 THIS CERTIFIES that the buildin~ ONE FAMILY DWELLING Location of Propert~ 196 WILLOW TERRACE LANE ORIENT House No. Street Hamlet County Tax Map No. 1000 Section 026 Block 82 Lot 08 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 31, 1987 pursuant to which Building Permit No. 15859Z dated APRIL 4~ 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 CONSTRUCT ONE FAMILY DWELLING DESTROYED BY FIRE. The certificate is issued to DAVID L. & SUSAN So FRENCH (owner,)~QL~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED pENDING SLIP 7/15/88 ROY C. TAPLIN 7/20/88 Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. N_o BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15859 Z Date .............................. Permission is hereby gronted to: ~...:~,..~...5~ .................................................... __ .......... ...... ;~"-r -;-';'"-=' ........... ' .......... ~ ....... ~ --~-~-~..~ ¢-~.._~ ~ .................... ........ ~' .................. ;'~;"'":'"':'~,,. ~~-~ W'~ ..................................................... ~ ..... ~'" County Tax Mop No. 1000 Section ..... .,(~,,,.,,.~:,...~.. .... Block ...... .,~,.,.,~., ..... Lot No....,,l~,,,,,~, ............ pursuant to application dated ...~~....~....~ .............. , 19..~...~.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. $ TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A, This application must be filled in typewriter OR ink, and submitted m ~ to the Buildin tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of, all ~uildings, property lines, streets, and unusual natural ortopographicfeatures. .25~'W'~-~ ,~--<' ~O~_-y-,~.~ , 2. Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form or 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 p~operty showing all property lines, streets, buildings and unusual natural or topographic featu res. 2.Sworn statement of owner or previous owner as to use, occDpancy and condition of bu ildings. 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 POOLS $25 . 00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$ ]O.O0 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0,00, c.o. 0.0o 5.Upda~.ed C.O. $ 50.00 Date ......................... New C ohs truc ~: i on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .............................. ~.~.r.~.,.~-.../-//./.. :... House No. ' ...... OwnerorOwnersofProperty .~..,~..¥./; .... ~.. ..... .~'.'.M..~../~.~..~.~..,..~.. ./?.'.,~.~...~. ..... Hamlet County Tax Map No. 1000 Section ............... Block .............. Lot ................ Subdivision.....~.~..~. ?.-7 ............ 2''/ .... Filed Map No..~.~..,~..~-. Lot No //(/~/c/~ - Perm t No /-~;~'~'-~Z Date f~ . ~/~/,,~-~ /'/,~_Z/~_ L/'~, ~.' '-~ ......... Health Dept. Approval' '~'~: '~ '//~'~' .~-. '~'~.~.~..' .~///~/'?" ..... Labor Dept. Approval..~?..~...'~.~.~...~.~.Zi-'/; ... UnderwritersApprova ....../. ' ....... Planning Board Approva, .~.~.'./~.'.~..~.~..~.~...~.~. .... Request for Temporary Certificate...//~..~. ............... Fna Cert ficate .~.~..~.' .... ............. Fee Submitted $~...~.~...~:~).. ................... / building and per~et~ co~s and~ regulations. Construction on above described Applican t . .J/~..~//..~~. ........................ Rev. 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 CERTIFICATION TEL. 765-! 802 Date Building Permit No. /~ Owner ~,'~ ~- PZ~ (please print) Plumber ~O~ ~ ~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. ber's signature) Sworn to before me this ~..day of 19 ~ · Notary Public, County ~ Notary Public ANN R, Ot. STAD NOTARY PUBLIC, St~t0 ~ N~ No. 47642~7 Qualified in Suffolk 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND[ ] INSULATION 7G5-'~802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ~~FINAL ~ REMARKS: - DATE ,,, ,~//~/~/ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL DATE OUNDATION I 2nd) OUGH FRAME VI PLUMBING iNSULATION PER N. STATE ENERGY CODE · ADDITIONA'L COMMENTS: C -J. THE NEW YORK BOARD OF FIRE UNDERWRITERS ;.000*708 BUREAU OF ELECTRICITY ~- 85 JOHN STREET, NEW YORK. NEW YORK 10038 J~(,JS, 03,~98:~ 5:}467987/l~7 N 0254317 Dat~ Applicstion No. on THIS CERTIFIES THAT on/y t/~ e/set.ca/~quipmmzt as d~cr/bed b~low and introduced by the applicon t n~n~./on the .bore application number in the premises of VILLOI,{' 'Iq'IRRAC~i~ 5,. ()R]'~:NT, in ,he followin, loca~cv ~, ~gtent ~ I,t FI. ~ 2nd FI. ,gectlon Block Lot was examined on and found to be in compliance with the require~nents of this Board. RXTUll FIXTURES IIAN~IS OVENS DISH WASHIRS EXHAUST FANS OUTtlTS SWITCHES 29 36 22 29 DRYERS FURNACE MOTORS ~ CLOCKS MU~Tt. MJT~T DIMMERS NO M NIT S~RVlC~ DISCONNECT S E R v I C E MOTO~S:l-0.75 SMOK~ DKTEC'rO~:-t ]. 4/0 SAi,VA'i'ORF~ C. PRAT() Roil. BOX 208 GRK~NPORT~ NY, ~I] 99(i b{CKNSE NC'. ~1049~'1 Th{~ c~m{fi~o~ m~ .or in monMr; rMurn ~o th~ oHh:~ oi ~ Boord ii Ptr. may be identified by their credentials. BLDG, DEPT. TOWN OF SOUTHOLD H.66 05 O0 ~,- J, (D: I P...OM PIPE FORM NO. 1 TOWN OF SOUTHOLD ~UILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ., 19~. 7. ., 1~.'~. Permit No..).~'77..~.~. SURVEY . . · CHECK ' O~RM ..... SEPTIC NOTIFY CALL ................ MAIL TO: Disapproved a/c ..................................... (Building Inspector) . 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 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 inspections. ....... (Signature of applicant, or name, if a corporation) (~ailing address of applicant) State whether applicanta is_owner, lessee, agent, architect, engineer,' general contractor, electrician, plumber or builder. Name of owner of premises .... ~.{~.~...L,.~J...C~-[..: (as on the tax roll or latest deed) If. ...... applicant....is ~.c .o.. ~.r[°rati°n I si~0re .~..~. . ~ .~L .~..~ of duly "¢' . .~..V~.... authorized.~....°fficer' (Name md title of corporate officer) ALL CONTRA(~TOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License~ No. 7.. ~ ..... ~ .....Ti....T...T Plumber's License No ......................... /~z-~~ Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be d~>ne~ ....... ~.~TTt. ~.. ~, .................... ........... ¢..cO0.., ....... ' ........ .'r,.. b. :',/ .............. House Number Street Hamlet County Tax Map No. 1000 Section ...... ~-/~. ........ 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 ...... ~~J~ .~'7~.~C~. ~ .~. ~r~.. use and occupancy ....... ~~'.~l~-.~{K}*~."~..~. ................. b. Intended 3. Nature of work (check which applicable): New Building Addition Alteration Repair .............. Removal .............. Demolition ............. Other Work ............... / A' (Description) 4. Estimated Cost.. g~/ff.~. ~. .................... · ...... Fee.....C7~....~,.0...7..~. ................ ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units . ./~r~. .... · · · Number of dwelling units on each floor ................ If garage, number of cars ............. ..--. .............................. [ ......................... . 6. If business, commercj,~.[ (~r sll[xe0, occupancy, specify nature and extent of each ty~eiof use ............. t ........ 7. Dimensions ofexisti~ifany: Front .... ~..~ ...... Rear ...,~. ~,~.).: ..... Depth....~.0 ......... Height ............... Number of Stories ..... "'[4 ........ ~r~ .... ~' '- * ~ ............... .~., t~'' .......... Dimensions2f s~ne structure with alterations or additi~)~ls~': Front .~,...'~ .i... Rear.. ~g~,e ............ Depth .... ~.~) ............... Height ..... J ....,,, .......... Number of Stories .......... ....., ........ 8. Dm enmons of entire new construchon Front ..... ~,~.... ..... Rear .... ~, ..... Depth .. ~ t~ ......... ~ O.~aeight ............... ,Nun~r~,)o f St orion t .......... ! ........ ze of lot: Front ~~ (~..r.).. ~ [~... Rear ...... ~.~,'~ ............ D ',pth ..... [.(.~, .-~. .......... te of Purchase .':. ........................... 2;game of,.Fmuuer..Owner .. i .......................... 1 1. Zone or use district in which premises are situated .... K~{iO. 3JT, lfl .. :. i ......................... ~ 2. Does proposed construction violate any zoning law, ordinance or regulation: ............................... 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No fp . 14. Name of Owner o remises .................... Address .................. ,..PhoneNo ................ Name of Architect ........................... Address ................ ;.. Phone No ................ Name of Contractor Address : ' Phone No 15. Is this property located within 300 feet of a tidal wetland? *Yesl ..... No ..... · If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. ind! Cate all set-back dimensions from )roperty lines. Give street and block number Or description according to deed, and show street names and indicate whetl~er nterior or corner lot. ~TATE OF NEW YORIZ)~ R ~ ~OUNTY OF ......./ff._l...[' ' ~ .t .... ~F'-i% _~1/~ i ' (Name of ~d~~on~t) ~ [ C~ ., Z 277. ....... ............... .. ...... (Contractor, agent, corporate officer, etc.) said owner or ownem, ~d is duly authorized to perfom or have performed the sai work and to m~e and ~e this. [pplication; that all statements contained ~ this applicaQon are true to the best of his knowledge and belief; and that the york will be perfo~ed'in the m~ner set forth ~ the application filed therewith. ;worn to before me this ~ ' ~ NOTARY PUBLIC,~tate of New York * !~ ~' No 4707878 SuflokCeunty~:~ ~' ~ ' ?erm'Exo r~s MArch ~ 19...,~ / 1 h ,b~'/~'TIoK uMBER CERTI,FICATIO PL , -:BEFORE' ,ON, LEAD cONTENT CERTIFICATE OF OCCUPANC)t: r i WATER OCCUPANCY OR ~ ~usE IS UNLAWFUL q sL -f