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HomeMy WebLinkAbout15598-zFORM NO 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy PLUMBERS CERTIFICATION DATED: THIS CERTIFIES that the bmldmg On.e.f.a..m./1.y...d? e.l. 1 ./.n.g... ................. Locatlon of Property ..R.p...W:..o.f.f ~.or.C.h ?.a.y. vie.~...R.d.. ......... .S.ou.?~.o.ld. ...... House No Street Hamlet County Tax Map No. 1000 Sechon O ? 7 ...... Block . .0. 3. ....... Lot .2. J ............. Subd~viszon .............. Fded Map No ....... Lot No .......... conforms substanha[ly to the Apphcat~on for Budding Permit heretofore filed in tlus office dated D e c. 23, 1986 pursuant to wtuch Bmldmg Permit No 15598 Z dated 9 e~q, 24., 1 ~ 8.6. .... was issued, and conforms to all of the requirements of the applicable provisions of the law The occupancy for wluch thts certfficate is issued is ... .. .O.qe..f.a.m. il.y dw.e.l.l.i.n.$, wzth co.v.e.red front porch. The certificate lS ~ssued to RICHARD WILLOTT ....... .......... of the aforesaid building Suffolk County Department of Health Approval . .8.6-SO. 7.1.94..O.c.t.: .2.,..19..8.7 ........... UNDERWRITERS CERT[F[CATE NO ........... .Pe.n.d..i.n.g. Oct. 5, 1987 O'Connor, Stephen I0/2/87 Building Inspector Rev 1/81 FORM NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NM 15598, Z Perrmsszon ~s hereby gronted to: .. ~,,,~2I~..,... L L .9..~1 ............. to ~ ° ~ ' ~ ' ......... ........... ........... ~t ~re~,,,s ,oco,e~ ot 2,,,.,.~,. ~....~.~...~.~ .~.....~~~ ................ County Tax Map No 1000 Section . .~.."(..~. Block ....... ..~....~, ...... Lot No....~m.~. ......... pursuont to opphcotion doted ...~1~..~J.~ .~.~. .......... , 19.~...~., ond approved by the Budding Inspector. Building Inspector Rev 6/30/80 OUNDATION ( ls t) OUNDATION ) OUGH FRAME FLUMBING NSULATION PER N. STATE ENERGY CODE FINAL Al DITIONA~ COMMENTS: FORM NO. 6 TOWN OF SOUTHOLD Bu ilding Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Th~s apphcat~on must be filled ~n typewmter OR ink, and submitted I~ to the Building Inspec- tor with the following, for new buddmgs or new use: 1. FmaJ survey of property w~th accurate location of all bullrings, property lines, streets, and unusual natural or topographic features. 2.F~nal approval of Health Dept of water supply and sewerage d~sposal-(S-9 form or equal)· 3.Approval of electrical mstallat~on from Board of Fire Underwriters. 4 Commercial buddings, Industrial bu~ldmgs, Multiple Remdences and similar buildings and installa- tions, a certificate of Code comphance from the Architect or Engmeer responmbte for the building 5.Submit Plannmg Board approval of completed site plan requirements where applicable. B For existmg buddmgs (pmor to Aprd 1957), Non-conforming uses, or buddings and "pre-existmg" land uses 1. Accurate survey of p~operty showmg all property lines, streets, buildings and unusual natural or topograph ~c featu res 2Sworn statement of owner or previous owner as to use, occupancy and condition of buddings. 3 Date of any housmg code or safety mspect~on of buildings or premises, or other pertinent ~nforma- t~on required to prepare a certificate. C. Fees' Add~tzons $25.00 1 Cert~flcate of occupancy New Dwellzng $25.00, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelhng $ 5 0.00 3. CopyofcertfflcateGfoccupanc¥ $ 5 00, over 5 years $]0 00 4.Vacant Land C.O. $ 20 00 5.Updated C.O. $ 50 00 Date .... /?~..~./?.../ ........... NewConstruction .... Old or Pre-existing Building ............ Vacant Land ............ Locat,on of Property . .'.~. ~...~ ...~..'...~.. ,~1/.'.~....../~... .... ~..~,.'[..[.~.,..~ .......... House No Street I-larnlet Owner or Owners of Property ...... '..?.~ .............................. County Tax Map No. 1000 Sect,on ....... .0..~... Block . .~. -~ Lot. ?T.. l.. Subdwm~on .................. Fried Map No ........... Lot No ............. Permit No. ·. . Date of Permit ...... Apphcant .................................. Health Dept Approval ................. Labor Dept. Approval ........................ Underwmters Approval .................. Planning Board Approval .................... Request for Temporary Cetuhcate .............. F~nal Certificate ....................... Construction on above descmbed buddmg PP ~. .......... . .~...~.. ~..~. ....................... Rev 10 10 78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y 11971 TEL. 765-1802 CERTIFICATION Building l~rmit No. /~/~O~ 2 Owner (please print) Plumber (please print) I certif~ that the solder used in the water supply system contains less. than 2/10 of 1% lead. (pl~umber's signature) Sworn to before me this I day of /~ff_~ , Notary Public, , County Notary Public 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~FINAL REMARKS: / / 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [~INSULATION DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING REMARKS: FINAL DATE 765-'~802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [~ROUGH FOUNDATION 2ND [/.-]/FRAMING REMARKS: PLBG. INSULATION FINAL INSPECTOR ~,~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FINAL 765-1802 BUILDING DEPT. INSPECTION []FOUNDATION 1ST [ ]ROUGH PLBG. I' '1 FOUNDATION ZND [ ]INSULATION []FRAMING [ ]FINAL INSPECTOR Appr(~ve~ D~sapproved a/c FORM NO 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL ~°OUTHOLD, N.Y. 11971 TEL . 765-1802 , 19~ [P , 19~.~ Permit No I .~-~ 'tgZ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... , 1 9 · Date /~./2- ~.., 19/ a Tlus apphcatlon must be completely filled m by typewriter or in ink and submitted to the Budding Inspector, wltl sets of plans, accurate plot plan to scale. Fee according to schedule b. Plot plan showing location of lot and of buridmgs on premises, relationship to adjoining premises or public stm or areas, and giving a detaded description of layout of properW must be drawn on the diagram wtuch is part of this ap, caOon c. The work covered by tlus application may not be commenced before issuance of Budding Permit d. Up~nappr~va~fthisapphcati~n~theBudding~nspect~rw~issuedaBuddmgPermitt~theapphcant Suchpen shall be kept on the premises available for inspection throughout the work e. No bmldmg shall be occupied or used in whole or m part for any purpose whatever until a Certificate of Occupar shall have been granted by the Bmldlng Inspector APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Building Permat pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances Regulations, for the construction of bufldmgs, additions or alterations, or for removal or demohbon, as hereto describ The applicant agrees to comply, with all applicable laws, ordinances, budding code, housing code, and regulations, and admit authorized mspectors on premises and in budding for necessary msveCtlons .. (Signature of applicant, or name, if a corporation) ...... /. ................... (raa~l~_ng address of applzcan¢) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or build Nameofownerofpremlses /~*'~/'~'*~.~ ~t~7 (as on the tax roll or latest deed) If apphca.~t-rCh~>rlaofatlon,.~gnatur.~ o f.~y authonze. Cx)~,[icer (Name and title of corporate officer) 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 donJ/~ *' House Number Street ~.,,,.et ' County Tax Map No 1000Sechou %~ Block ~ ..... Lot 2 a. Existing use and occupancy b Intended use and occupancy Subd~viston Fried Map No. Lot (Name) State existing use and occupancy of premtses and intended use and occupancy of proposed construction 3. Nature of work (check which applicable) New Bmldmg . ~... Addition ......... Alteration .... Repmr Removal ...... Demohtmn .......... Other Work... ,~/~.~ d~ ~ (Description) 4. Estimated Cost ..... ~ dot -- Fee ~ ~' ~t O (to be prod on filing thas application) 5. If dwelling, number of dwellmg umts....~'Jv~.... .. Number of dwelhng umts on each floor ............. If garage, number of cars 6. If bus~ness, commercml or mixed occupancy, specify nature and extent of each type of use .............. 7. D~mensmnsofex~stmgstru~tures, ffany Front ........ Rear ............ Depth ............ Height ........ Number of Stones Dunens~ons of same structure w~th alterations or add~tmns' Front .......... Rear .............. Depth ........... He~,ht .... . .t .,, ~ .. . Number of S.t~nes .......... r~. ~ ..... 8. Dunensmns of e. rlhre new cbnstruchon Front . . .t./~... ~... Rear ....~'~ fl. ..... Depth ~7~..~. ...... Height . fi`O".' ..... Number of Stones . ,~ ...................... · ' * t ...... ~'l' ' Size of lot Front /,~. ......... Rear .~,,,x~. ....... Depth . ./.2.~.) ...... Date of Purchase .... .-'-- ............ Name of Former Owner .............. Zone or use &strict ~n which premises are s~tuated ..................... Does proposed construction wolate any zomng law, ordinance or regulatmn' . ..................... ,,~ Will lot be regraded . ~ . . ., .... Wfll.~xcess fill be removed from premises . Yes Nmme of Owner of premises/~20~.tl~'~ t ffdd~ ~/t~.q~ddre~s~.a¥.).adi'..~l~lf'~l~,tltt~.. Phone No..~2,t ~/./2~ Name of Architect .... ai .... t..-.., .... ,~ ...... Address ............. ,.. i.. Pkone No ..... i ;'27.2 .... Name of Contractor fx/.ia*//?~. ~.t,Z*5 ~ .. Address~t.~ .~/t~..t~., ~,~.~. Phone No..~.~ ..'(~... Zs chz$ property located w~-th±n~.00 leer of a c±dal wetland? * ¥e$ ..... 1to ..... · ¥t5 yes, SouChold Town Trustees Perm±~ may be requ±red. PLOT DIAGRAM 9 10 11 12 13. 14 15. Locate clearly and d~stmctly all buddings, whether exastmg or proposed, and, indicate all set-back dnnensmns frc property hnes. G~ve street and block number or descnptmn accordmg to deed, and show street names and mdmate whetb interior or corner lot. STATE OF NE'v¥ Y,O'I~, o~ / COUNZY ..... ~~ ' ~ ~[... being d~ly swo~, deposes ~d says that he is the appllCa (N~me of lnd~dual Sl~ng contract) above named ~ ~ He ~s the . . ~ ~~ .............. (Contractor, agent, corporate officer, otc ) of smd owner or owners, and ~s duly authorized to perform or have performed the smd work and to make and file tJ apphcat~on, that all statements contmned m th~s applicahon are true to the best of h~s knowledge and behef; and that t work will be performed ~n the manner set forth in the apphcahon filed therewith Sworn to before me th~s ..c~q~..r-~ ...... dayof ~ .. ,19.o~ I~ot~w Publle~ ~ ~ t1~ ~ £/, (Signature of applica ~Io a-0_~, Sul~llt ~ ': : ~E[~ I ~ ~ ,~,~ ~,.~ SUFFOLK CO. HEALll-IH. S. No.DEPT'I~'-~--'--'--'--'--'--'~O'~,'~APPROVAL ,~ STATEMENT , ............ ~ ~ ~ ~ /~L ~ ~ ~ ~ ~ ~ SUFFOLK ~U ~ ~ H~ ~ ~F~K C~TY ~. , , ~ ~ : ~ ~._.. ...... ~._ ~__~ . LY~LI~LY SERVICES -- FOR APPrOvAL ' ~ . ~ ..... ~-.~-- ~- . .L ....... ~__~. i t ~ ; '~ N.~25~. , t~.~1 ~ ~~ ..... ",~ ,., } ~ ~ ~ ~ ~ ~ ~FFOLK CO. TAX ~ ...... ~ , ~ " · ~ ~ ~<A~ ~ ~ ~ ~N~5~EL~ATiON ~EFU~T~ MEAN i { ~ . ..................... ~M, , ; ~C~r' '' ~ ~ k ,/,' , [--~",'- ~VEL. 12 ...... -,id WiLLL21I ¢ ...................... E~e~ { LICE~D LAND S~V[Y~S ...... u-, ~ ......... ~ ~ GREEN~RT ~W ! Fr. lEr.~ ;SE~ k ~. V&~; ,&l' 47' ) 1~' I~IGHT OF Yv'AV MAP ,C;~O 77 3 2; ,i D£ ,,'FA; '%? ~"*' '= '.ZO', F AT / , ~ ~o' ~l~ or wAY, ~'...~' O. '~. ~ L~M, ': ~,D~EC ~,~2Gl R~,.ECf,~ ~ :)", '.~ ' , !~~ ..... / If ~op~er tubing Is use4 for water distributing Iystem; piping shall be of lype~ K~or L onl~ $OLD£R USED IN WATER SUPPLY SYSTEM CANNOT £XCEED 2/10 of I% LEAD. PLUMBER CERTIFICATION ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY OCCUPANCY OR USE IS UNLAWFUL '~ WITHOUT CERTIFICATE OF OCCUPANCY -¸1 o!