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Home My WebLink About16181-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z16569 Date January 7, 1988 THIS CERTIFIES that the building .... .A.d.d..i .t.i.qn. ................. LncatinnnfPrnn t 600 Bay Avenue East Marion ........... =er.y ..................................... House No. Street ..................... h~t~io~ County Tax Map No. 1000 Section ....0.3. 1. ..... Block 0 8 ..... Lot 10 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... 3. u..n .e..2. 9.,..1.9. 8..7.. pursuant to which Building Permit No. 1618 I z ~ - dated ...J.u.l.y...7.,.. ! ,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 ......... Addition to an existing one family dwelling. The certificate is issued to PHILIP & MARIE KOCH ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval N /A UNDERWRITERS CERTIFICATE NO ........ .P.en.d..~.ng slip I/4/88 ...... PLUMBERS CERTIFICATION DATED: N/A ..~uil. di~ng[~spector Rev. 1/81 FOB, M NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDIHG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO_ 16181 Z County Tax Map No. 1000 Section ....... O..'~..J ..... Block ....... .~...~ ....... Lot No....L~.. ............... pursuant to application doted ........ ..,~~..~..~ .................. , 19.~..~.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 BLOG. DEFT. TOWN OF SOUi'HOLD APPLICATION FOR CERTIFICATE OF OCCUPANCY FORM NO. 6 TOWN OF SOUTNOLD Building Department Town Hall Southotd, N.Y. 11971 765 - ] 802 instructions A. This application must be filled in typewriter OR ink, and submitted .... ~ to the Building In~pec~ tor witb 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 featu res. 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 tile 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:.0g POOLS $25.00 l. Certificate of occupancy New ])welling $25.00, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancv $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... New C e n s t t~ u c t i on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ................................................................... House No. Street Nam/et Owner or Owners of Property ............................................................ County Tax Map No. 7000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... 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. Applicant .~.~...~..d~ ................... 3 TOWN OF $OUTttOLD OFFICE 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. ~c~e~z~ /--/ No Underwriters Certificate on file. /~/~The check is(outdated/not on file.) /~/ No Health Dept, Approval on file. /5/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. ~uilding Permit # _ /~ ~ / ~ / Z Building Dept, ***/Z/ No Plumber Solder Certificate on file.. ( all permits involving plumbing being issued after April 1,1984 ) TOWN OF SOUTHOLD OFFICE 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. ~c~ /_--~ No Underwriters Certificate on file. /_~ The check is (outdated/not on file.) /_-/ No Health Dept. Approval on file. /--/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. ~uilding Permit # _/'~ /, ? ! z Building Dept. ***/Z/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) UNDATION ( 1 s t) UNDATION (2nd) UGH FRAM &~/ ?LUMBING SULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ] ~OUNDATION 2ND [ ] INSULATION / FRAMING [ ] FINAL REMARKS: DATE INSPECTO~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] I~OUGH PLBG. FOUNDATION 2ND [~ INSULATION [ ] FRAMING [ ] FINAL REMARKS: ~/~*~,~ DATE BUILDING DEPT. INSPECTION FOUNDATION 1ST [ I ROUGH PLBG. FOUNDATION 2ND [ ] IN/SULATiON FRAMING ~'FINAL ... DATE:~! i ~'? 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. / FOUNDATION 2ND [~/INSULATION FRAMING REMARKS: FINAL DATE INSPECTOR ~/~~ ~/~ TO N SO T,O D . .,:.. ·~' . TOWN HALL TOW~'.~ OF SOUT~'~OLD $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved . .~ ~..~.., 19~. 7. Permit No. [ .~./..~. J..~. · . .Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ~./~.~J~'..~J/~... 3 SETS OF PLANS .. SURVEY ...... CHECK . .... SEPTIC FORH · NOT~ "[7?- CALL ............... HAIL TO: Date ................... 19... INSTRUCTIONS a. Tkis 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 Iftspector. 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 code, and regulations, and to 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 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 corporate officer) . ALL CONTRACTOR'S MUST BE SUFFOLK COUI~ITY LICEI~ISED Builder's License No.. ~ ............... Electrician's License No. ~ ............. Other Trade's License No ...................... Location of land on which proposed work will be done] ................................................. .... .......... ..... ........... ................... House Number-- Street Hamlet County Tax Map No. 1000 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 ..... ?. N..,.. ~. ~.~../~.. ?.. ~ .~. (.~.~q.¢..~5...~V...C/4..~.~,.e.3..~. './ff.&..f~ ........... b. Intended use and occupancy .~..f.O. &c~..~..6.~.G~..~.~*.P)~t . .7.A r.'[v/5...~..t$/~ e~.d~e.~,.e~ v ........... 3. Nature of work (check which applicable): New Building Addition.: 2'~ ..... Alteration .......... Repair .............. Remorai .............. Demolition .......... :~:'' 4. Estimated Cost. * .................... Fee ...................................... ' (to be paid on filing this application) 5. If dwelling, number of dwelling units ....~. (( .~. ...... Number of dwelling units on each floor...~TZ.....' ........ If garage, number of cars .. rT.~ .......................................... .......................... 6. If business, commercial or mixed o~cupancy, specify ~ ~" · nature and extent of each type of use . ..: ..... ~ ........ 7. Dimensions of existing stmctures, ifany: Front .... .~Sff.rd?Ir' Rear Height . ~./. d;. ~.r ........Numbe~ of Stories ... ~.~...~. ..... :.. '. i ..................... ' .................. Dknensions of same structure with alterations or additions: Front ................. Rear ................... Deptli ...................... Height ...................... Number of Stories ...................... 8. D m con ru · /F ~ . x enslon~ of entire new st ctlon. Front ............... Rear ............... Depth ............... Height ~.(..O.t.r . Number of Stories ..... ~..~./~.... 2 .................... 9. Size of lot. Front .... z,. · r ..... ' ......... -__ Rear ..: ....... .~..' ..... v..,.. Depth ...................... ....d¢.>¢~.: .... '/~'..~.~. ......... Nmhe of Former Owner . .~.~, .d.~..~f.~.d.. ~.~.6'..~. ....... 10. Date of Purchase 1 1. Zone or use district in which premilses are si' 'tuated ............................... ........................ 12. Does proposed construction violat6 any zoning law, ordifiance or regulation: ................................ 13. Will lot be regraded ....<~P. .............. , .'..'.. Will ~xcess fill be removed from premises: Yes No 14. Nanle of Owner of premises .~.dl~?. ~.o..c:..~..... ;. Address~'~..z~,~/~,/g.~.~.me. :obPhone No..~..~. 2: .~..aT~,2'.. 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 Trustees Permit maybe required. PLO~F DIAGRA~ Locate clearly and distinctly all 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 aqd indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ~ ....... S.$ .................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) ~bove named. He is the ........................ i ........................ i ........................................ (Contractor, agent, corporate officer, etc.) vf said owner or owners, ai~,~ d is duly authorized to perform or have performed the said work and to make and file this application; that all statemehts contained in this application are true to the best of his knowledge and belief; and that the ~ork will be performed in the manner set forth in the application filed therewith. gworn to before me this ........... '. ~:~.6]~'~/2 . '~)..J J~. t"/J ........ day of. i .~ .... : .... '., 19 ~...? : .. .7,. .. u uo. ,' ..... .....j,. ....... .............. . No,.4707~7~ ~.ll.o[l~ .~nt~q '~' ~ ' (Signature of applicant)