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Home My WebLink About16546-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy l~o. Z16320 Date October 21, 1987 THIS CERTIFIES that the building Ad d i t i o n Location of P~operty 670 Seawood Drive Southold House No. Street Hem/et County Tax Map No. 1000 Section 79 ..... Block 8 .Lot. I 1 Subdivision.. Seawood Acres . . .Filed Map No. 2575 .LotNoo l0 ... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... O.q.t... .2.0. ~. .1.9.8. .7. , pursuant to which Building Permit No. 16546Z dated .0..c .t.... 2. ! 2.. 1.9. .8 .7 ............ 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 ......... ...... C o~.s.C~tuc.t..a.c.o.v.e ¥.e.d..c)¢.c.k.~..a.t.t.a.c..h.e.d..t, 9' .t.h.e...h.o.u.s..e.. ................. The certificate is issued to ROBERT E. & JOHANNA J. BOERGESSON (owner, ,/~t~ ~ X X X of the aforesaid building. Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO. N/A N/A PLUFiBERS CERT][F][CATYOIq DATED: Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z16321 Date October 21, 1987 THIS CERTIFIES that the building ...A..c .c.e.s.s. ? .r.i.e.s. ................................ Location of Pro ert 670 Seaweed Drive Southold P YHouse .......................................................... No. Street l~r~/o~ County Tax Map No. 1000 Section ...7.9 ........ Block .... .8 .......... Lot 11 Subdivision Seaweed Acres .Filed Map No. . 2. .5.7.5. . .Lot No. l0 conforms substantially to the Application for Building Permit heretofore filed in this office dated Oct. 20, 1987 pursuant to which Building Permit No. 16546Z dated ...O.c.t.:..2. I.:..,...,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 ......... ........ t.~.o...m.e.t.a..t..a.~.~..e.s.s.o?..y. >.~. ~ .t.~.i.~. ~..s ...................................... The certificate is issued to . ROBERT E. & JOHANNA J. BOERGE$SON .................... ~dd,,,'o;, ~4o~;~ ×~cx ................. of the aforesaid building. Suffolk County Department of Health Approval ......... ~./.A. ............................. UNDERWRITERS CERTIFICATE NO ................. tq/A PLI/MBERS CERTIFICATIOI~ DATED: Building Inspector Rev. 1/81 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) N~16546 Z Permission is hereby granted to: ...4~.a..~..~...~..~ to .................... ~..~~...~.....~ ......... ~... ................................... .............. g~~...~..~ ....................................................... ............... .......... ............................. .5 ............ : ......... ~o=~,= ~ ~o. ,0oo ~,~,,o, ......... z.~.... ,,~ ...a.~ ........ ~,,o ........ /./. ...... Building Inspector. Fee ............. Rev. 6/30/80 FORM NO. 6 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 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 featu res. 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: Additions $25.00 1. CeFtificate of occupancy New Dwelling $25.0.0, Accessory,S10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0-. 0 0 3. Copv of certif[cate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5. Updated C.O. $ 50.00 Date. .~ ~..2... NewCOnstpuctionX .... Old or P~re-existing Building ............ Vacant Land ............. Location of Property ..~. ~..~~ ~.~ House 'No. ' ' Street ..... Ham/e't Owner or Owners of Property ............................ County Tax Map No. lOOOSection ..7.,~. ....... BIock...~l~ ....... Lot..~..( .......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No./. ~ ~..~.~ Date of Permit/~'./~.//.~.Applicant Hea~th Dept Approval "-'-" Labor Dept Approval " Underwriters Approval , .j~.,. A ............... Planning Board Approval ..... ~ ............ Request for Tem,p~o}rary Certificate ..................... Final Certificate .~ff~..... ............... Fee Submitted f..~. ........................ Construction on above described building a?d~l~%mit meets a~ppl~able codes and regulations. App 'Jcan t ~,~ ~ ,~1.~ · ,~, ,/.~ ................. R.~. lO-lO-78 BOARD OF HEALTR ...... 3 SETS~'~,OFPLANS o- ...... TOWN OF SOUTHOLD CHECK ] ]~ BUILDING DEPARTMENT SEPTIC FORM ............. TOWN HALL NOTIFY $OUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined .~,~.. A. ~.. ..... 19 ~..7 Approved d'~., .~Z. · ..... , 1~. ~. Permit No,..~.~. ,~., .~.~ ~ Disapproved a/c ..................................... CAL~ . MC:g°.¢.A .... MAIL TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .rd..°r.,..~.? ........ , 19~ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 streel or areas, and giving, a detailed description of layout of property must be drawn on the diagram which is part of this appl 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 peTM 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 Occupanc shall liave been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to ti Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations; or for removal or demolition, as herein describe~ The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t admit authorized inspectors on premises and in building for necessary, jasp~tions. (Signature of applicant,~dr name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde Name of owner of premises . ./~o. ff'~''I . .~.'..~F.. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. Plumber's License No ......................... Electrician's License No....~%. .................. Other Trade's License No ...................... 1. Location of land on which proposed work will be done. (Name and title of corporate officer) - ALL CONTRACTOR'S MU UFFOLK COUNT ~(~'~:~V - ~u,der's Lice.se ~o .................... ~lk~f -~ . ~ ' ..~.Z, ....... ~,t~.e. ¢~ x~ ...... ~9~'.q~(.~..~ ............................ Honse ~um bet Street Hamlet County Tax Map No. 1000 Section ..... ~5 ......... Block ..... ~ .......... Lot .... cc ............ l~*~ ~ ~*~ S~ . ......... s.uai~i~io~..S ................................. Firedamp No. ~5~ ......... ~ot. /~ .... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...~.q~... ~ ~c~ ....... j ......... ' ....... b. ... ............... - .......... 3. Nature of work (check which applicable): New Building S"'' Addition Alteration Repair ......... ...../Reraoval .............. Demolition .............. Other Work 4. Estimated Cost . . 7... ~-..fi'. ~..~.~//, 2' .................... Fee . .~... 7~..T~.. ~.........(Description). (to be paid on filing this application) 5. If dwelling, number of dwelling units t Number of dwelling units on each floor If garage, number of cars .... .................................................................... 6. If business, Commercial 9r m~x~d occupancy, specify natui'e and extent of each type of use. .................... 7. Dimensions of~emstmg ~tructures, if any: Front ,x, 57,~.... ...... Rear . .$'T.5'7. ........ Depth .. 7./ .......... Height Number of Stories /.'. ' ' Dimensions'of same structu, re ~vi[h alterations or additions: Front ................. Rear .................. Depth ~ Height Number of Stories Dimensions of entire new construction: Front . .,~. .... ' ..... Rear ,. ~ ......... Depth . .~;';';';';';';';';'~. .......... He~gb t .......... Nora her of .qtorJ~,q / .......................................... 9. Sizeoflot: Front ...,/~cp..: ............ Rear ..... /.o..o...~. .......... Decth . .4J'~,~.. / 10. ,Date of Purchase /ff.~.?. Name of Former Owner . ~t.~....~.,O4-~,'Z. ............. 11. Zone or use district in which plremises are situated .................................................... 12. Does proposed construction viOlate any zoning law, ordinance or regulation: .,./,/~. ......................... '. 13. Will lot be regraded . ./~..o.. I .................... Will excess fill be removed from premises: Yes 14. Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect ' Address Phone No Name of Contractor ....... ; .................. Address .... ; .............. Phone No ................ 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No ~... *If yes, Southold Town T~ustees Permit maybe re0uired, PLOT DIAGRAM Locate clearly and distinctly 011 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. "8. STATE OF NEW YORK, S.S ..... COUNTY OF ................ ,. ........................... ~ ...................... being duly sworn, deposes and says that he is the applicant (Name of individual slgning contract) above named. He is the .................... i ..................................................................... (Contractor, agent, corporate officer, etc.) of said owneLor owners, and is duly authorized to perform or have performed the said work and to make and file thim application; that all statements c6ntained in this application are true to the best of his knowledge and belief; and that th~ work will be performed in the manner set forth in the application filed therewith. Sworn to: before me this .. County ~ ' HELEN K, DE ¥OE '" NOTARY ~LIflLIC, State ot I~ew York ~ (Signature of applicant No. 470~$71t Suffolk County~ , Term Exp res Melch 30, ~9 a' ~J *