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Home My WebLink About15600-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building D e c k Locatlon of Property 3780 Orchard Street Orient fiDuse'No ............. '~t/e~t ..................... I21~rnle~ County Tax Map No 1000 Section 0 2 7 ...Block 3 ..... Lot ...3.. 5 ........... Sub&vmon .Se.a.u.j.o.I.a.i.s..A.c.r..es ....... Filed Map No .6.373 Lot No .5 ........... conforms substantially to the Apphcahon for Building Permit heretofore filed ~n flus office dated .. !.2/2.2./86 ....... , pursuant to wluch Buddlng Permit No. . I5.69.0.Z. ....... dated .I.2./. 2 .4 / 86 ........ was issued, and conforms to all of the requirements of the applicable provmlons of the law The occupancy for wluch trus certificate is issued is ...... Deck..addi, t. zp.n. t9 e.xi..s.~ing.pn.e..f.am, zly dw.e.l.li, qg: .................. The certificate is issued to . of the aforesaid building. RICHARD DE VOE (o wrier, i~F,e~ ~]~'7,)X Suffolk County Department of Health Approval .... N L .A ............................ UNDERWRITERS CERTIFICATE NO .... N./.A .......................... PLUMBERS CERTI'FICATION DATED: N/A Rev 1/81 FOF,,~ NO. · TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No 15600, Z Permission is hereby granted to' .................. ...~..'?..~..~ ....... ..m..~...~.~.d....%.'f~... .... ..~.~..~:.~.: ...... ~.~.~>z..7 ...... ~. ..... ........................ at prem,ses located at -..~.~. -~....'~. ....... ..~..~~... ~-~....' ..... ..~~'~... .................... County Tax Map No 1000 Section ...(~.....~tr,.'l. ...... Block ...... ..~....~ ..... Lot No ..... ..~.; ,.~. ..... pursuant to opplicahon dot~-~.....'~..'~..., I9~ h, and approved by the Building Inspector. Fee $.....~...Y..~.. ' Building Inspector Rev 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Budding Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY FEB 2 - 1987 A. Thru apphcatlon must be filled in typewmter OR ink, and submitted m ~ to the Budding Inspec- tor with the following; for new buddings or new use 1. Final survey of property with accurate location of all buildings, property hnes, streets, and unusual natural or topographic features 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equaJ). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commerma[ buddings, Industrial buddings, Multiple Residences and mmilar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planmng 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 p~operty showing all property lines, streets, buildings and unusual natural or topograph lc featu res. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of bu tidings. 3. Date of any housing code or safety inspection of buildings or prem~sas, or other pertinent Informa- tion required to prepare a certificate. C. Fees: 1. Certfficate of occupancy New Dwelling $25.00, Accessory ,$t0.00 Business $50.00 2. Certificate of occupancy on pre-ex~stmg dwelling $ 50.00 3. Copy of certffmate of occupancy $ 5.00, over 5 years $1.0.00 4.Vacant Land ~.0. $ 20.00 //.3 / 5. Updated C.O. $ 50.00 Date .... .( ..~7 .............. NewConstpuctlon ....... Old or Pre-ex~st~ng Budding .~. ......... Vacant Land ............. House No Street Hamlet Owner or Owners of Property .. ~ !~ .~.'4,~ .~..b.~..(0.~ .................................... County Tax Map No. 1000 Sect,on 0~7 Block .3... Lot Subd,v,mon ~r~.o.~.'~.O?4zjl .5'. /~..~..~5 ........ Fried 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 . ..~. .................. OD Fee Submitted $...~.~ ...................... Construction on above descmbed building and permit ryets all apphcable codes and regulations. Applicant. ~.. ~,..~.''. ......................... 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION FRAMING REMARKS: DATE [ ] ROUGH PLBG. 2ND [ ] INSULATION [ ] FINAL INSPECTOR OUNDATION ~lst) OUNDATI ON ( 2nd ) OUGH FRAME & ?LUMBING ~$SULATION PER N. Y. STATE ENERGY CODE FI~AL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL £OUTHOLD, N.Y. 11971 TEL.: 765-1802 , 19~k Permit No J ~otY'~ ~ Received .......... ,19. Disapproved a/c (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS oT 19:- Date / ....... a Tlus application must be'completely filled m by typewriter or in ink and submitted to the Building Inspector, wltl sets of plans, accurate plot plan fo scale. Fee according to schedule b Plot plan showing location of lot and of bufldmgs on premises, relationship to adjoining premises or pubhc stre or areas, and giving a detaled description of layout of property must be drawn on the diagram wi'uch is part of ttus api catmn c The work covered by tins application may not be commenced before issuance of Budding Permit d Upon approval of this application, the Building Inspector will issued a Bmldmg Permit to the applicant Such pen shall be kept on the premises available for inspection throughout the work. e. No budding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupm shall have been granted by the Budding Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Bmldlng Permit pursuant to Bmldlng Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance; Regulations, for the constructlqn of bmldmgs, additions or alterations, or for removal or demolition, as hereto describ The applicant agrees to comply w~th all apphcable laws, ordinances, budding code, housing code, and regulations, and admit authorized inspectors on premises and m building _for gecejsary. 13s ec222Bg13~ (Signature of applicant, or name, if a corporation) ............. (mazlzng address of applzcant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build -* 6utcb. & .. ............. Name of owner of pre,roses ~1~. ~t~. ~.~ d.0~.~ ......... (as on the tax roll or latest deed) If applicant is a corporation, mghature of duly authorized officer (Name and t,tle of corporate officer) Builder's License No O, co ~ ~.~.. Plumber's License No Electrician's License No .. Other Trade's License No Location of land on which proposed work will be done ..... 32r 57- O. t ttouse Number Street Hamlet County Tax Map No 1000 Sect,on 0~-'~ Block 3 Lot ~P 3. ~ Subd,v,s,on ~O~O~tS ~e~ FfledMapNo ~323 Lot ~ (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction a Ex,stmguseandoccupancy O/'I~r...- Fpt3tlO~/ btoEd-4-.tm}o .......... b Intended use and occupancy 3. Nature of work (check which apphcable) New Building t: ..... Addition ....... Alteration . Repa~.. Removal ........... Demohtion .......... Other Work..~).~.~/~ ..... (Description) 4. Estimated Cost $~. ('~..: .OD. ........... Fee ............................. (to be prod on f'flmg this application) 5. If dwelhng, number of dwelhng units . 0~J.~. ........ Number of dwelling umts on each floor .............. If garage, number of cars . .~fl~ .......................................... 6 If business, commercial or m~xed occupancy, specify r~ature and extent of each type of use · t Depth . ~/ ......... 7. Dimensions oftex~stmg structures, ffany. Front. ~g ....... Rear &L~. .......... ' ........ t '" Height ~..~ ......... Number of Stones Dimensions oi same structure with alterations or/~d,d~tlon's' F'ron['' i .~'~. Depth .3. ~. .......... Height .. g2.~' ......... Number of Stones ....&: ............... 8. Dimensions of entire new construction Front Height ...... ,..~, N~m~ ber of Stones .................................... 9. Slzeoflot Front .(~'.O. t~O .. . Rear..~.~-SV ......... DAepth ..30~ .............. 10. Date of Purchase . . ] (/g~5-- ...~ .... ~ . Name of Former Owner ~at~.~./-4~ .~[q/0~ ...... 11 Zone or ase district in which premises are situated ~x[5 d~Z4. F~t4-. .................... 12. Does proposed construc~lpn violate any zomnglaw, ordinance or regulatlon .t~o ...................... 13 Will lot be regraded ./',10 ..... WflI excess 14. Name of Owner of premises ~xt~l~'l)~dO.'t&. . Address .3']g~.0t~*t{~ K.~ .5.T. Phone No g/o/~/ta4~ ... Name of Architect 5Ptt~¢. ...... Address .......... Phone No .......... Name of Contractor . ~tX~E- .............. Address ............ Phone No. 15. Is this property located withinl00 feet of a tidal wetland? * Yes ..... No ~-~<f.. · If yes, Southold Town Trustees Permit may be requmred. PLOT DIAGRAM Locate clearly and distinctly all buddings, whether existing or proposed, and, andlcate all set-back dunens~ons fro property hnes G~ve street and block number or description according to deed, and show street names and indicate wheth mtenor or corner lot. STATE OF NEW YORK, S.S COUNTY OF ............. K I~{/~ I,~l~ ~O~x.. ..... being duly sworn, deposes and says that he is the apphca (Name of individual signing contract) above named He is the 0tJ~q~'' -f ~)Og.~>~.~ .................... (Contractor, agent, corporate officer, etc ) of smd owner or owners, and is duly authorized to perform or have performed the said work and to make and file tt application, that all statements contained m th~s application are true to the best of his knowledge and belief, and that tl work wdl be performed in the manner set forth m the apphcation filed therewith. Sworn to before me this .. ~,~ ~a~ day of..b.~'(ZFcWI6 .~. 19 ~:~ N017i~ PUSl. l~, ~lt8 o~ New York 4707878, Suffolk County,, ~ ~res Ma'ch 30, !9 o / (Signature of apphcm