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Home My WebLink About16523-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z188~9 Date FEBRUARY 28~ 1990 THIS CERTIFIES that the building. ALTERATION Location of Propert~ 925 ORCHARD STREET House No. Street County Tax Map No. 1000 Section 025 Block 002 Subdivision Filed Map No. ORIENT Hamlet Lot 018 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCT. 8, 1987 pursuant to which Building Permit No. 16523Z dated OCT. 13~ 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 ENCLOSE EXISTING OPEN PORCH AS APPLIED FOR. The certificate is issued to SHIRLEY B. CARLSSON (owner) ~ of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. H014183 FEB. 9~ 1990 PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 Building Inspector TOWN OF SDUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y, BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No_ 16523 Z Permission is hereby granted to: ................................................ · at prem,se, ,oco,ed o, ..~.~ ...... .0 &.~..~.......S~....~.,~.... ........... ~.~ ....................... County Tox Map No. 1000 Section ..... ..C~.,..c~.....~..--.. ...... Block ....... ..(~......:~.. ..... Lot No ...... 1...~.. ............. pursuant to appJicc~tion doted ..1~)..~.~:~,,.....~. ..................... , 19.~..~.., end approved by the Building Inspector. Fee $..~.:....../~... ...... Rev. 6/30/80 APPLICATION TOUN OF SOUTHOLD BUILDING D~PART:IE~IT TOUN HALL SOUTHOLD, NEU 765 -- I§OZ FOR CERTIFICATE OF OCCUPAN CONSTKUCTION " ...... OLD O~ PRE-EXISTING BUILDINg. VACANT LAND HOUSE NO. STREET ~AMLET O~ners of Propert~ ..... ~ .................. Filed Map ........ Loc .......... Approval .... - ........... ~oard Approval ..... Reques~ for Temporary Cer%ificace . .. Final Cer=ificare ..... FOP~ NO. TO~N OF SOLFEUOLD DUILD~/G D~FART~NT 765- 1802 m~TION FO! CERTIFICATE OF OCCUPANCY INSTRUCTIONS This applicatlnn must be E/led in Inspector with the fei!lowing; typewriter OR ink and submitted Co the Building , for ne~ buildings or ne~ usa: ]. Final su~ey of property ~i~h accurate location of all buildlnEs, property SCree~s~ and unusua~ naCucal or topographic Eea~ures. · ~. Final approval of H~lch Dept. o~ ~a~er supply and se~eraEe-dlsposal(S-9 3. Approval oE electribal installation ~rom ~oa~d of Fire Unde~iters. 4. S~ocn sta~eman~ fro~ pl~ber certlfyln~ ~ha~ solder used i~ system con~alus less' ~han 2/10 of IZ lead. 5. Co~erclal buildinE~ indus~rlal buildln~s, ~lLiple residences ond ~imilar.' buildings and installations, a certificate of code compliance icom the Architect or Engineer responsible Ear the building. 6. Submit Planning Boa~d Approval o~ completed si~e plan requirements. For existing buildlngs[(Prlor to April 9~ 1957] non-eoafomlng uses, or buildings and "pre-existing" lau~ uses: .. l. Accurate su~ey o~ ~roperty shoulng all property Iines, streets, building~ and unusual natural or ~opographic features. 2. a properly complete~ ~pplica~ion, a consent to inspect signed by the applicanC . If ~ CertiflcaCe ofiOccupamcy is denied, the Building Inspector shall mtate the reasons therefor im~iting co the appiiaaut. 3. Date of any housing~code or mafety inspection of bdildlngs or premlses, or other pertinent ' znfo~t~pn required co prepare a certificate. For Vacant Land Certificate of Occupancy: ~- ~ application for Vacant Imnd Certlfieate of Occupancy~shall be submitted, and a certified abstract of title ismued by a title company showing ~imgle a~d separate o~ership ~f/the entire lbt prior to April 9, 1957 shall also accompany thc application. ~ a Certificate of Oacupauay is denied, the Building ~hall mtate the reasons therefor in ~iting to the applicant. ~ES: ]. CERTIFICATE OF 0CC~CY - New ~elling $2~.00, Additioms to ~elllng Alteration to ~elllmg $25.00, Swiping Pool, $2~.00. Accessory building $25.00 Addition to Accessory. buildings, $25.00 - Businesses $~0.00. ~. Certificate of Occupancy on pre-existlug dwelling - $~00.00. ~. Copy of CertifiCate of Occup~mcy - $~.00 - over 5 years - 4. Vacant Land Cer:iflcate of Occupancy - $20.00 ~. Updated Certifi,:atm of Occupancy - $50.00 ~. Temporary Certificate of Occupancy -$15.0.0 Residential Co~erclal tO/14/~8 THE NEW YORK BOARD OF FIRE UNDERWRITERS PASE 1 ~).e~ss BUREAU OF E-~CTR~C,'rY 85 .JOHN STREET, FlEW YORK, NEW YORK 10038 D~te FEBRUARY 09,).990 ~pplicatlon~o. onfile 67208290/90 H 014183 THIS CERTIFIES THAT PER~IT N0. 1652~ o~y the el~t~al equipment ~ ~scdbed below and in t~duced by the appllca~t ~ed o~ the a~ve application number Jn the prem~es of ER'NEST CARL~ON, 925 ORCHARO $~-, ORIENT, N.Y. in thefotlowlng locatlon: ~ B~e~nent ~ Ist FI. ~ 2nd ~7. Section Bilk Lot ~sexamlnedou 3ANUARY 29,1990 andfoundlobelncompllancewiththerequ~rement~Qfth~sRoard. -- MEFEe 4W NO. OFp~C~.COND RANGES ~PECIAL EEC'PT R C AWG. OF CC, CON0 MULTI-OUTLET SYSTEMS NO. OF FEET EXHAUST FANS AMT. H P, DIMMERS AMT. WA!TS WIRING ONLY FOR SHALL SUN ROOM-1 ELEC. ROOM MEATERS:I-~ K.W, NO, OF NEUTRALS 925 ORCHARD ST. P.0.BOX 24 --'--'~'"' This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be ~ by th~ credentials. t TOWN OF SOUTIIOLD OI:FICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, 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. An application for Certificate of Occupancy is not on file. ~-'~<-~.~ NO Underwriters Certificate on file. The check is(outdated/~gt on~.)~,O~3 /Z/ No Ilealth Dept. Approval on file. /Z/ No final ins.pection has been made. Please contact our office on Thank you for your cooperation. Dui]ding Permit t~ ~__ ~ .,~ ~ ..~ Z Building ***/Z/ No ( this matter. Dept. Plumber Solder Certificate on file. all permits involving plumbing being issued after April 1,1984 ) : icLD ±,,S .... FOUNDATION FOUNDATION 2. ROUGH FRAME & PLUMBING (1st) (2nd) INSULATION PER N. STATE ENERGY CODE FINAL ADDITION[L COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL.: 765-1802 Examined .rD..~../.~.., 19~. .']. Approved .O. ,e~....°~.....I.~/., 19~. ?. Permit No..[.~..~..~..~..~:7 Disapproved a/c ..................................... BOARD OF HEALTH 3 BETS OF PLANS SURVEY .......... CHECK gEPTIC NOTIFY CALL MAIL FORM ............. (Building Inspector) APPL,C^T,ON FO. BU,LD,NG PE.M,T Date~.~.,...~. · · ·/. INSTRUCTIONS a. Tiffs 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 co_de, and regulations, and to admit authorized inspectors on premises and in building for necessary in~e/jtigns// ~'~ /r ) ~ · (Signature of a~t~licant, or na~e, if a corporation) 5<.. ...... (Mailing address of applicant) State whether applicant is. owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......... ............................................................................. Name of owner of premises .. .( .~. .............................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of co¢orate officer) . ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... Plumber's License No ......................... Electr,c~an s L~cense No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ...................... .... er-, House Number Street Hamlet County Tax Map No. I000 Section ........ .~,..~.... Block ........ ~,~ ....... Lot ..... /. ~.. ......... Subdivision ............................... . ..... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... ..g..~t ...... ~.~/t ,~ ........ tq'~4~./ ....................... /-/ /r' r' ! b. Intended use and occupancy .................................................................... 3.' Nature of work (check which applicable): New Building ..... ' ..... Addition .......... Alteration .......... Removal Demolition Other Work Repair ......................................................... 4. Estimated Cost .......................... Fee ...................................... " (to be paid on filing this application) 5. If dwelling, number of dwellin~ units ....... / ....... Number of dwelling units on each floor ................ If garage number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .... ' .... ' ............. 7. Dimensions of existing structures, if any: Front ......... ~ ...... Rear .............. Depth ............... Number of Stories ' ' .... Height : ......... ' .................................................... Dimensions'of same structure ~v,th ~'~ . ................ Rear ' a~rerations or additions: Front .................. Depth ........... ,~,~ ..... Height ...................... Number of Stories ...................... Dimensions of entire new construction: Front ' Rear Depth Height ...' ............ Number of Stories ........................................................ . Size oflgt: Front .......... i. i:11¢i Rear..i.~ ................. Depth . 1 I. Zone or use district in which piemises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ... ~.O ...................... 13. Will lot be regraded ...... .,,~ .~ .............. ; .... Will excess fillber~removed from premises: Yes No Name of Architect ......... i. · ~. './4f .......... Address ................... Phone No ................ Name of Contractor ........ , .............. Address .... ; .............. Phone No ................ 15. Is this property locatedl within 300 feet of a tidal wetland? *Yes ..... No ..../~.. · If yes, Southold Town Trustees Permit maybe required. I PLOT DIAGRAM Locate clearly and distinctly alll 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. STATE OF NE~ YORK,., , , S,S COUNTY OF~ .... ...... f~;..~.Ad&..G..~..~~,...~tq. ¢~Q.~..~ .... being duly sworn, deposes and says that he is the applicant (Name of individual sigmng contract) above named. He is the ................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is ddly authorized to perform or have performed the said work and to m~e and file this application; that all statements contained h this application am true to the best of his knowledge and belief; and that the work w~l Be perfo~ed in the m~n~r set forth in the application filed therewith. Sworn to before me this ................... day o .......... Not~ary Public, ... County ................ x L~NDA J;F~,R~. v...,-~,: / ...... Notary Public, State of NeW YorkF2/ No. ~,822563, Suffolk Coun,ty/~ ~ Term Expires December 31, 19-M-~