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Home My WebLink About16589-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17576 Date DECEMBER 8, 1988 THIS CERTIFIES that the buildinq ADDITION Location of Propert~ 1345 WILLOW TERRACE House No. Street County Tax Map No. 1000 Section 826 Block 02 Subdivision Filed Map No. ORIENT Hamlet Lot 29 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCT. 29, 1987 ..pursuant to which Building Permit No. 16589Z dated NOV. 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 GARAGE ADDITION TO AN EXISTING ONE FAMILY DWELLING. The certificate is issued to MOGENS THOMSEN (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N044634 NOV. 9~ 1988 PLUMBERS CERTIFICATION DATED N/A · Building Inspector Rev. 1/81 FOBM NO. ~ TOWN OP $OUTHOLD 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_ 16587 7. Permission is hereby granted to: .c~.~,....~.:~,. ....... ~!.~.~.~ ................... ,~.~....~..~.....~................o.~.~..~.o....~....~ ....... ~ ~~w:...~~ ~, ~.~~.~ ~ ............................... :.....~.....' .................. ~t pr~mise~ l~at~d ~t ..I..~.~......~ ........ ~~..a.....~.~ ......................... pursuont to opp,co,on doted .... .~.....~....~ ...... 9..~ ............ , 19.~.."/.., ond opproved by the Building Inspector, Fee $..~)..... :....../... ..... Building Inspector Rev. 6/30/80 L ~ow. oF'~ou . ,~ APPLICATION FOR CERTIFICATE OF OCCUPANCY FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y. 11971 765- 1802 gal Instructions A. This application must be filled in typewriter OR ink, and submitted mlmmmma~ to the Building inspec- tor with the following; for new buildings or new use: 1. Final survey of property with acc[Irate location of all buildings, property lines, streets, and unusual natural or topographic features. 2.Final approval of Health Dept. of water supply and sewerage disposat-(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 app~icaMe. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre. existing" land uses: 1. Accurate survey of p~perty showing all property ~ines, 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: Addit£ons $25,00 POOLS $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50 · 00 3. Copy of certificate of occupancy $ 5.00, ove~ $ yea~s $]0.00 4.Vacant Land C.O. $ 20.00 5.UpdaLed C.O. $ 50.00 Date NewCons f, ruc t~ on ...... Old or Pre-existing Building ............ Vacant Land ............. Looat~on of P,operty. i.%V.f. ~.Z.~.~.~. ~ .7.~¢..~. '.AC:. ¢..P, ~.~.~M~ ...................... House No. Street Ham/et Owner or Owners of Property .................................................... zg County T~x Map No. 1000 Section ............... Block ~ Lot Subdivision..WCe~¢.*...~.?.~.6¢. ¢~ ...... Filed Map No, . ,~.~¢.~, .Lot NO, Permit ........... Date of Permit .. .¢~..Applicant .~ ~¢~ .......................... Health Dept. Approval ................ ' ........ Labor Dept. Approval Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. Rev, 10 10-78 (2 o z/7s~?-~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY T~-qc~ ! 85 JOHN STREET, NEW YORK, NEW YORK 10038 Dat~ Application No. on fil~ THIS ~y t~ e~tHc~ ~u~ment ~ ~ri~ ~ a~ int~ by t~ ~t ~m~ on the a~ ~t~ numar in t~ p~m~s o~ TNis any mannar; ~urn to th~l~N~l~C~lo~rdF~,i~cc~.ect. Inspectors may ba idantlf:~b¥ thaif credentials, COPY FO~ BUILDIHG DEPARTMENT. THIS COPY OF CERTIFICATE__MUST~NOT. --BE -.-.---------~ALTERED IN AHY MAHNER. ..... · U~La~ ~ UL ~--LE V ..; ~ z_.AL1E 765-1802 BUILDING DEPT. INSPECTION FOUNDATION ZST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ~NAL DATE INSPECTOR 765-1802 BUILDING D£PT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION FRAMING REM, ARK~Sf~' DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] ~SULATION / FRAMING [~"~ FINAL DATE FIELD FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FI'idA/ ADDITIONAL DLDG. D~:';- ?. BOARD OF HEALTH ...... 3 SETS OF PLANS, ~ TOWN Of: SOUTMOLD CHECK ~]:~- -~'~ 5 .... BUILDING DEPARTMENT SEPTIC FORM .../~.~ .... TOWN HALL NOTIFY SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .10..*~¥~,~. ~.., 19 .~.]. Approved .A)~ ..~.., 19~). Permit NoJ.{~.~-.~.~..~.. CALL ................ MAlL TO: ~0, ~ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERIVIiT Date ................... 19.. IN STRUCTION S 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 stme 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 perm 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 Occupant 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 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 admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or 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 .......................................................................... (as on the tax roll or latest deed) If applica/~i~/~ corporatio¢,,signature of duly authorized officer· .... .......... (Name and title of corporate officer) ALL CONTRACTOR'S 1RUSI BE SUFF~ COUNTY LICENSED Builder's License No .... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on which proposed work will be done ................................................ House N'um ber Street Hamlet County Tax Map No. 1000 Section .................. Block .................. Lot ........... Subdivision ~[/~ [~ .~.~ ~ Filed Map No.. ~.? ...... Lot 7~ ........... (Name) 2.State ernst' in=- use and occupancy of premises and~ ~, intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................... b. Intended use and occupancy ................. -~ ................ .............................. 3. Nature of work (check which applicable): New Building ' Addition ..... Alteration Removal Demolition Other Work Repair .............................................. ' ............ ~s ~ '- (Descriplion) 4 Estimated Cost .... ~~r-~.~j/j-,~O,t~ ........ Fee .................................. " (to be paid on filing this application) 5. If dwelling, number of dwelling units .......... ..... Number of dwelling units on each floor....~-7 ........... If garage, number of cars ..... i ..... ;77..~<..c~ .... .- ................................................ 6. If business, commercial or mixedI occupancy, specify nature and extent of each type'of use ...'...7.: .' ............ 7. Dimensions of existing structures, if any: Front ..... .o~.~ ...... Rear ..... ~ .D. ..... Depth ....-~.~. ......... Height .... &.?...~. ...... Number of Stones ...... './.../.4 .... Dimensions of same structure with alterations or additions: Front i i '. ?'.' ~. i i i i i i i ....l{~Jr' 111121 Depth .¢'7~~p . .................. ..................... Height.. :2 c> ..... Number of St{}~i;s / './.o.._ . . Dimensions of entire new construction: Front .. ?...d? ~. ..... Rear .... .P..~. ....... Depth . .~...d .... Hmght ...... O..cD ...... Number of Stones ............ ?'& .......................................... 9. Siz~ of lot: Front ....... /.DY:..~.. ........ Rear. ....... ./.'/. ~ ... Depth .. ./.q.3 ............ : 10 Date of Purchase J Name of Former Owner 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... . ./Sz/..~ ...................... 13. Will lot be regraded ....... ~ ,~, ................ Will excess fill be removed from premises: _ Y~s ~'~qo Name of Architect .......... : ................. Address ................... Phone No ................ Name of Contractor ........................... Address .... : .............. Phone No ................ 15. Is this property located w±th±n 300 feet of a t±dal wetland? ~¥es ..... bio ..X... *If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly a~d distinctly ~ll!buildings, whether existing or proposed, and. indicate ail set-back dimensions from property Hnes. Give street and block humber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ................. i ................................................. being duly sworn, deposes and says that tie is the applicant (Name of individual signing contract) above named. He is the ......................................................................................... (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 this application; that all statements conthined in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ............... ~. ........ day of ...................... 19'~.../~.. I~tarv Public ~ ~ , 1tlt.118 ~. ~£ VOE Y '. ~10~t~atlO. St~ ~ (Signature of applicant)~ No. 4707878. Suflot Term Expires Mi~rch 30, Z SCALE- 40" I" r_;1: MON1UMEN F O: P/PE ~'.[C_:'~ 5UI,A/IE'YOF,~5 - ..-.;,rgE. E.t, Jl. PO,~.T, IM,Y, I