HomeMy WebLinkAbout16444-zFORM NO 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
$outhold, N Y
Certificate Of Occupancy
No Z16338 Date. Ocy.ober
TtllSCERTIFIhSthatthebmlding Addz~p~s
100 Park Avenue
Locahonof~operty House~o ''' ~t
27} I987
Mattxtuck
County Tax Map No 1000Sechon 123 ...Block . 07. ....... Lot . ,5...3. ....
Subdivision .Fried Map No .... Lot No .....
conforms substantially to the Application for Building Permit heretofore filed in this office dated
Aug. 10 ~ 1987 pursuant to which Braiding Permit No ...... ! ,6.4.44. z....
dated S e p t. 9, 1987 was issued, and conforms to all of the reqmrements
of the applicable prm~sions ot the law The occupancy for which this certificate is issued m ,.
Deck addition to exzstzng, o..ne fa. mi.ly dwel. l. ing... ............
The cerhficate is issued to . THOMAS AND PATRICIA CAREY
ioYn'dc ......
of the aforesaid braiding
Suffolk County Department of Health Approval
UNDERWRITERS CERTIFICATE NO
PLUMBERS CERTIFICATION DATED:
. . .N/A .....
.... N(.~ .......................
N/A
Building Inspector
Rev 1/81
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, No Y.
BUILDING FER~IT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Perm,ss,on is hereby grants,ed
~.~ .
.....J~..~.~..~2.~.~. ...............................................
.... .~.~ ........ ,~..~......~....~.~.~. ~ ........
at premises located at ..../.. ............ l~.ca~w~m....~ ,. ..... R_/..~.~.e~.~.~ ...........................
County Tax Map No 1000 Section./. ~,~ ....... Block ........ .(~...-). ...... Lot No....~.°...~..
pursuant to applicahon dated ...'~~A-L~.~.. /,..(~ ........ , 19.~.'"/,, and approved by the
Building Inspector.
Rev 6/30/80
FOUNDATION ( 1 st)
FOUNDATION ( 2nd )
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
CODE
ADDITIONAL COMMENTS:
7
CCI~O? C-RRORS
AONVdNO00 ~0
3JVOI~IIB30 1NOHiIM
1A:IMV'INrl .SI
TOWN OF SOUTIIOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN IIALL
SOUTIIOLD, N.Y. 11971
TEL 7~,5 IL0?
To Whom This May Concern,
We are unable to complete your Certificate
of Occupancy because of tho following reasons.
/_~ An application for Certificate of Occupancy
is not on file. ~
/--/ No Underwriters Certificate on file.
/--_~/ The check is(outdated~l ~
/Z/ No }loalth Dept. Approval on file.
/~/ No f~nal inspec[~on has been made.
Please contact our office on this matter.
Thank you for your cooperation.
Building Permit ~ / ~ ~ ~ Z
Building Dept.
***/~/ No Plumber Solder Certificate on
{ all permits involving plumbing being
issued after April 1,1984 )
Thank you for yt, ur
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765 - 1802
N FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitted m~ to the Building Inspec-
tor with the following; for new buddings or new use'
1. Final survey of property w~th accurate Iocatmn of all buddings, property lines, streets, and unusuat
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 ~nstallat~on from Board of Fire Underwmters.
4. Commercial buddings, Industma[ buddings, Multiple Residences and mmilar 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 buddings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of property showing all property hnes, streets, buildings 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 ~nspect~on of buddings or premmes, or other pertinent mforma-
t~on required to prepare a~
C. Fees: '_Additions ~
1 Cert~hcate of occupancy N'e~-D-~ellzng $25 (10, Accessory ,$10.00 Business $50.00
2. Certificate of occupancy on pre-existing 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 .19/.1.4./..87 ..............
NewConstruc f,~on ..... Old or Pre-exmtmg Budding ........... Vacant Land .........
Locat~on of Property I00 Park Avenue Hattituck
House No. Street le
Owner or Owners of Property Thomas & Patrici& Carey
County Tax Map No. 1000 Section ...~.2.3. ......... Block 07 Lot.. 5 %3
Subd~ws~on ..................... Fded Map No ..... Lot No ............
Permit No . .1.6.4.4..4... Date of Perm,t 9/09/8.TAppl,cant ?econ£c..D. eveloDmen.t Cord
Health Dept Approval .................... Labor Dept. Approval .......................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ................. Final Certificate . 10/14/87
Fee Submitted $.. 5.. ;0..0 ................
Construction on above described building and permit meets all apphcable codes and regulations.
Applicant .............................................
Rev 10 10 78
~-0. ZI~.~
765-1802
BUILDING DEPT,
INSPECTION
FOUNDATION ~.ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INS~ILATION
FRAMING [/~ FINAL
REMARKS:
DATE /~/~/~ 7
INSPECTOR ~/~ ~
/
THE NEW YORK BOARD OF FIRE UNDERWRITERS ~''
t 000663
BUREAU OF ELECTRICITY
~'- 85 JOHN STREET. NEW YORK, NEW YORK 10038
A~,t~;~.~$'r 03~ ]gSg 55~';3~88/88 N 025686
~t~ ~pplication No, on fil~
THIS CE~IFIES THAT
THOHAS CAR)~Y~ ~;ND OV PARK AVE,, MA~'T['rUCK, N.Y.
~ examifl~ on andJound to ~ in cotn~i~nce with the r~ai~ments oJ th~ ~.
RXTUI~ RXTUIES ~ COOKING D~CKS OVENS ~ WASI~IIS EXHAUST FANS
16 24 22 ~16
~ DISCONNE. CT S E R V i C
SH;)KF.
C~:'O.~w~ NO. O; H6t~O Of ~.. ~.~ I~0. O~ NEUleAI
BOX 602
NY,
I,I('~;NSE NO. 122'i Per
This certificate must not be altered in any manner; return to the office of the Board if incorrect, Inspectors may be identified by their credentials.
COPY FOR BUILDIHG DEPARTMENT. THIS COPY OF CERTIFICATE MUST HOT BE ALTERED IH ANY MANNER.
Disapproved a/c
FORM NO 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.. 765-1802
,19 '7
,19g2 PermltNo ]
(Building Inspector)
BOARD OF HEALTH . -
SURVEY ..........
CHECK ..........
SEPTIC FORM ............. :
NOTIFY
CALL ~ ~.~.'.~ I ~ ........
MAIL TO:
f AI! 101987
APPLICATION FOR BUILDING PERMIT
Date ~ ./~. ., 19
IN STRUCTIONS
a. This application must be completely filled m by typewriter or in ink and submitted to the Building Inspector, wl
~ets of plans, accurate plot plan to scale Fee according to schedule·
b Plot plan showmg location of lot and of buildings on premises, relationship to adjommg premises or pubhc st,
or areas, and giving a detmled description of layout of property must be drawn on the diagram which is part of this a
cation.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this apphcation, the Building Inspector will issued a Budding Permit to the apphcant Such pe
~all be kept on the premises available for mspechon throughout the work
e. No braiding shall b% occupied or used m whole or m part for any purpose whatever until a Certificate of Occup
shall have been granted by the Building Inspector
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant tc
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordmanc.
Regulatlons, for the construction of buddings, additions or alterations, or for removal or demohtaon, as hereto descri
The applicant agrees to comply with all apphcable laws, ordinances, budding code, housing code, and regulations, an,
admit authorized ~nspectors on premises and m budding for necessary inspections.
(Signature of applicant, or name, if a corporation)
(Marling address ofapphcant) ~i~L/'~
State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or bull,
Name of owner of premises '~' ~
(as on the tax roll
If~apphcant. Is tNcgr-Kor~ of duly authorized officer
(Name and title of corporate officer)
ALL CONTRACTOR'S MUST_BE SUFFOL~K COUNTY LICENSED
Budder's License No . I ~J~ :~...*/t_2
Plumber's License No
Electrician's License No
Other Trade's License No ....
10o
I Locat,on of land on wluch proposed work wdl be done
House Number Street
County Tax Map No I000 Section ] ~[ ~
·. Block
Hamlet
Subdivision .... Filed Map No . Lot (Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction
a. Ex,sting use and occupancy %, O~ ~.~ ~~~ ....
b. Intended use and occupancy
3. Nature of work (checkwhlch applicable). New Budding . . . Addition ...... Alteration ......
Repmr ........... Removal .......... Demolition ........... Other Work .........
.~..~. ~ (Descnp~mn
4. Estimated Cost .: ............... Fee ....................
(to be paid on fihng this application)
5. If dwelling, number o~gf-d~elhng units ....... Number of dwelling units on each floor
If garage, numbe,~c ,ars-- ~'~ .......................................
6. If business, co, t~rcml or m~xed occupancy, specify nature and extent of each type of use ................
7. Dimensions of ex~stmg structures, if any Front ....... Rear ........... Depth ..........
Height ......... Number of Stones .............................
D~rnenmons of san~ ~tructure with alterations or additions Front ....... Rear ......
Depth .... ~ .~ ...... .-~igl;t,t ~, ........... Number of Stones ..........
~- $. Dimensions of entire new construc~11o~'~i~'~nt/~.~.~.~..'- ~.O~../~Rear ........... Depth ..........
Height ...~, ~ ....... of Stomes ...................................... Rear ./~' , ~7 Depth . .~4~. I.~C~..
9. Size of lot Front . },,...]..Number
10 Date of Purchase ................... Name of Former Owner ............
1 1 Zone or use dlstnct ~n which premises are situated .......
1 2 Does proposed construction violate any zoning law, ordinance or regulation: .. .(~o?. .............
13. Will lot be regraded .~'.o. ............ Will excess hll be removed from premmes: Yes
14 Name of Owner of premises ............. Address ............ Phone No ..........
Name of Architect . .'~I?1 ~ .g . ..~... Address}~/~}c-' t'J//lt, fl~ Phone No.-~°~.
Name of Contractor ~.~;.tl,.~.l.(.. ~_~..~.t~:~ll,41.lA~ Address .--~.~.'; i~id.' .Y-i .~'~.'. ii Phone Noi~..~.
blo
15. Is this property located within 300 feet of a tzdal wetland? *Yes .....
*If yes, Southold Town Trustees Permit maybe required.
PLO~F DIAGRA~
Locate clearly and distinctly all braidings, whether existing or proposed, and, indicate all set-back d~menmons fro
property hnes Give street and block number or descnphon according to deed, and show street names and ~ndlcate wheth
interior or corner lot.
STATE OF NEW YORK, S S
COUNTY OF .......
(Name of ~nd~wdual signing contract)
above named
being duly sworn, deposes and says that he is the apphcar
He is the
(Contractor, agent, corporate officer, otc )
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file th
application, that all statements contained m this application are true to the best of his knowledge and belief, and that th
work w~ll be performed in the manner set forth m the application filed therewith.
Sworn to before me this
......
Notary Public .......
.. Count. y~ ....................
(Signature of apphcan