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Home My WebLink About16173-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certi[icate O[ Occupancy No....ZT.l.6..9.9.6 ....... Date June 14, 1988 THIS CERTIFIES that the building .... .C.O.N..S .T.R.U.C..T..A. qp ..................... · 1405 Anchor Lane Southold, New York Locanon of Property h3tJs'o 'lV'o~ ....................... 'S't/e~[ ....................... h3r~/e:t County Tax Map No. 1000 Section 0 79 .Block 06 .Lot 6. 1 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated June 2 5, l 98 7 pursuant to which Building Permit No. 16 173 Z dated .... 3. .u 3 ?..6. ~..1.9.8..7 .......... was issued, and conforms to all o f the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ADDITION & DECk ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR ' ANTHONY & LINA FORO$ICH The certificate is issued to ..................... [ohJ/e'r, 'le)~'g~"TAq~i~f~ ..................... of the aforesaid building· Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. PENDING - May 23, 1988 N/A PLUMBERS CERTIFICATION DATED: nov. 1/81 Building Inspecffff FOn'M NO. ~ TOWH O~ BUILDING DEPARTMENT TOWN HALL SOUTHOLD, H. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 16173 z Permission is hereby grante~S to: /9 ,_~ , _ ..... g..~....~.:.~......~.m..~. ........... . et premises loc' ~ted at .../...~,..0...~.....~..~..~,...' .~I~.~...;.~ ..................... CaunW Tax Map No. ~000 Sec.o. ..... ~.2.,.~ ...... Brock ..... R..'J. ........ Lot No....~:..1 ............ pursuant to application dated ..... ,..~.~.....~. .................. , 19..~...'7.., and approved by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE 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 features. 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 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory.,~$ lO.00 Business $50.00. 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... New C on s t r u c t i on ...... Old or Pre-existing Bu ilding ............ Vacant Land ............. Location of Property . .~,~.~, ~,,' ................................./~,/I/'C~ /~ t~/~Je ...... ~..T~, ,~. ,~.1,~ ....... House No. Street Ham/et Owner or Owners of Property ...... .~..'~/,q/ Ll~l.~ .~...~..~.~/C/.~... ................................. County Tax Map No. 1000 Section ...Q,?.~. ....... Block ...O.~. ......... Lot.. ,~.'../ .......... Subdivision ..................... Filed'Map No ........... Lot No, ,~..6~ Permit No .... Date of Permit '. · Applicant 05~/'/ Health Dept Approval Labor Dept Approval ~, Underwriters Approval ........................ Planning Board Approval ..................... . Request for Temporary Certificate .............. Final Certificate ~,z Fee Submitted $ ............................. Construction on above described building and permit meets all aQ~cable codes a~nd regulations. Rev. 10-10-78 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING R£MARKS~, I<, ROUGH PLBG. INSULATION [~]/~INAL INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND [ FRAMING [ ROUGH PLBG. INSULATION FINAL DATE /~/~.~ ,INSPECTOR ~-~/~ 765-1802 BUILDING DEPT. INSPECTION [ F~OUNDATION 1ST [ ] FOUNDATION 2ND FRAMING ROUGH PLBG. INSULATION FINAL I NSPECTOR~~/ ~ UNDATION ( UNDATION (2nd) UGH FRAME & FLUMBING SULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR iLO. BOX 728 TOWN IIALL SOU I'IIOLD, N.Y. 11971 May 6, 1988 TEL. 765-1802 Anthony &Lina Forosich 1405 Anchor Lane Southold, New York 11971 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. /_~X An application is not on fil~. (ENCLOSED) /-_~/ :1o Underwriters Certificate on file. /_~/ The check -is(~>[~l%~/not on file.) /5/ No llenlth Dept. Approval on file. /.~/ :.:o final inspection has been made. for Certificate of Occupancy $25.00 Please contact: our office on this matter. Thank you for your cooperation. Buildinq Permit f~ t 6 1 7 3 Z Buildin~/ Dept. * * * I? NO Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) Approved ., 19~. 7. Permit No. ~ .~../.~...~..~. Disapproved a/c ..................................... BOARD OF HEALTH .,~ .... · ~U~ETyS ?~,/PLANS ,'.~/'/~ FORM NO. 1 CHECK '~';~'~' ~SO' ~ /OWN OF SOU/HOED .... BUILDING DEPARTMENT SEPTIC FORM ............. : TO~N HALL SOUTHOLD, N.Y. 11971 NOTIFY TEL.: 76S-~80~ C~U -'-"~ ~.- .... MAIL T0: (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date. ¢.47.°. f.~. ......... 19 ?.~. 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 diagran~ which is part of this appli- cation· c. The work covered by ti'ds 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,Jra/~ding code,_khousing code, and regulations, and to admit authorized inspectors on premises and in building for necessary ?sP~ ~ ~ .... ~ .~K....p...~<o...~:.*.~.~'. ~. .......... (S/~nature of aplph~ar~f, .:..'J..-, , (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . j~A/7'/'~D./t/.~/ ~ ,~/'.//,/./~ .~.~.~,~$:JC/~/ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... ,~r..tl~-flE~ 7-,2 Plumber's License No ......................... Electrician's License No ....................... Otlier Trade's License No ...................... 1. Location of land on which proposed work will be donel . . .h(~.~.~..u~.<.. ~./.~...h(./.'-~....zy.--q~ .7'f?/~.¢i~.'' ........... ........ ., . . &u. .r.,"f. e ....................................... House Number Street Hamlet County Tax MapSo. i000Section ...7~ ............ Block...~. .............. Lot....~.~/ ............ ' Subdivision ,/J/~'~'~'~'~ ~/~tr~r ~'--q~rT~Y Filed Map No. '~,fl~r~ Lot /.5- (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... .o./~..~. ......................................................... O /V o,01 b. Intended use and occupancy .......................................... - ............... 3. Nature of'work (check which applicable): New Building ..... ' ..... Addition .~ .... Alteration ... i ....... Repair .............. Removal .............. Demolition ........... Other Work ............. ~.. ~ ~,~ (Description)i 4. Estimated Cost ....~P,.~..~.~.: .~.~ ....................... Fee .......... . ......................... · (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................. If garage, number of cars ........................................................ '7 ............... 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 ............... Height ............... Number of Stories ........................................................ Dimensions'of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Siories ...................... 8. Dimensions of entire new construction: Front .......... . ..... Rear ......... ~ ..... Depth ............... Height ............... Number of Stories ............................. ; .......................... 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 10. Date of Purchase . ~ ........................... Name of Former Owner ............................. 1 1. Zone or use district in which premises are situated .......................... 21.. ......................... 22. Does proposed construction violate any zoning law, ordinance or regulation: ..... , .......................... t 3. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No 14. Nmne of Owne; of premises 3tf. r~.~t .Q 4,.~..-/~.~,~c/.¢~. Address .,.~.q~. ,~.~(c~g.. fW,.. Phone No. Name of Architect ........................... Address ................ :.. Phone No ................ Name of Contractor ..... V/ff. ~. tr% .~.~..~! ~ ~-.,9 .... Address .... : ........... :.. Phone No ................ 15. Is this property located within 300 feet of a tidal wetland? eyes . .... No ..... vqf yes, Southold Town Trustees Permit maybe recruited. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from ~roperty lines. Give street and block number or description according to deed, and show street names and indicate whether _nterior or corner lot. ;TATE OF NEW YORK, S.S ~OUI~Y OF ........ ~ ...... .... .~..~:[.&7.~/[ ~q .~....~-..~..\7~..o..~. ). ?':%............ being duly sworn, deposes and says that he is the applicant (Name d) f individual signing contract) bove named. ':'¢'~ ......... ~i~.: ..:. 1els the .............................................. w ................ ~ ?p .....~' .................... (Contractor, agent, corporate officer, etc.)~;,, ~ ~ ,f said owner or Owners, and is duly authorized to perform or have performed the,skia t [ake and: file this pplication; that all statements 'contained 'in this applickti'on.'a~e trhe to the best of gis lmowledge and belief; and' that the york will be performed in t.he manner set forth in the application filed therewith. }worn to before me' this .o~..~'-. ........... day of..~-< ............ , 19 Jotary Public,...._ ......... ~.'~~ ....... Count ~ . UNDAJ. ~0~ (Signature of applicant) N~ Pu~lo, 8~ of N~ mrm exmr~ ~m~r 31, 19