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Home My WebLink About15609-zFORM NO 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N Y. Certificate Of Occupancy Z-I5188 January 9, 1987 No ............. Date ............................ CARPORT ATTACHED TO EXISTING ONE FAMILY THIS CERTIFIES that the bmldmg ' DWELL I~G ] ............................ 770 Bray Avenue Lat~rel, N.Y. Location of Property . . .. ....................................... Mouse No Street ..... Hamlet' County Tax Map No. 1000 Section 126 Block 0 I .Lot 17 Subdivision... ~ ................ Filed Map No ..... Lot No ........... conforms substantially to the Application for Building Permit heretofore filed in tins office dated December 30, 1986 pursuant to winch Bmldmg Permit No I5609Z December 31, 1986 dated .................. , was issued, and conforms to all of the requirements of the applicable provm~ons of the law. The occupancy for winch tins certfficate is issued is ..... CARPORT ATTACHED TO The certificate is issued to .... of the aforesaid building N/A Suffolk County Department of Health Approval ...... UNDERWRITERS CERTIFICATE NO .. AN EXISTING ONE FAMILY DWELLING. GERARD P. GOEHRINGER ....... id eh t ' r xx ........... N/A PLUMBERS Rev 1/81 CERTIFICATION DATED N/A TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. No_ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15609 Z Dote...l'~...~.....~......~J. ........... , ~9.;~..~. Perrniss~on is hereby gr~nted to: ...G~....~...~......~.~..?~ ..~ ?.~....?..!..~ .............................................. .~.~......~,H..,...u.~,v...~, ~-~ ,. to ..~~.....~...~.¢~...~.......o~...~....,~,..__~. County Tax Map No 1000 Section ...Z. ~m...~. .... Block ...... ,,.¢~...~ ........ Lot No...l ..'1 ......... pursuant to application dated ~~.[~-~,....~, ..... , 19..~..~., and approved by the Budding Inspector. Fee $...~.... ............. 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 OF OCCUPANCY Instructions A Th~s 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 mstallauon from Board of Fire Underwriters. 4. Commercial buddings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responmble for the building. 5. Submit Planning Board approval of completed s~te plan requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses' 1. Accurate survey of p~'t~perty showing all properW 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 mforma- tlOn required to prepare a certlhcate. C. Fees: 1 Cert~ficate of occupancy $25.00 -- BUSINESS $50.00 2. Certificate of occupancy on pre-exmtmg dwelling $ 50.00 3. Copy of certfficate of occupancy $ 5.00, over 5 years $10./00 / 4.Vacant Land C.O. $ 20.00 c.o. 5o.oo 5.Updated NewConstruction ..... Old or Pre-ex~sting Building ........... Vacant Land ............. Locat,on of Property. 2.'/.72 ..................... /.~5.~; ,/¢~...~.L~/~. ............... House No 4 /~ S~eet Owner or Owners of Property . .~. :/~.~,~ ,~..~?~/-~/v~¢~: .'?.4~.',~. ............................. County Tax Map No. 1000 Section ... ~..~ Gl... (j · Block ..... ~ ....... Lot..~, ,,? ......... Subd,v,s,on .... ,~. ,~,~j~'/~ ............ F,led Map No ......... Lot No . ~..~,' ........ Permit N . .. Date of Permit Apphcant . ~ ....................... Health Dept· Approval ..................... Labor Dept. Approval ....................... Underwriters Approval Planning Board Approval . . Request for Temporary Certificate .................. Final Cert~fmate . ...~. .................. Fee Submitted $ ....................... Construction on above described budding and p~t-r~ts all ~p~ codes and regulations. Rev 10 10-78 ~/ R c. I oS(., C 0 % 15 Iq'[ OUNDATION (1st) OUNDATION (2nd) OUGH FRAME & PLUMBING NSULATION ?ER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. ,INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND £ ] INSULATION FRAMING [ ] FINAL REMARKS: FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N Y. 11971 TEL.: 765-1803 Examined I~reO~. '~ I Ap~ ~[-, !9~. Permit No Disapproved a/c .... , . (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Recexved ........... ,19. Date ....~/., 197 a Tins application must be completely filled m by typewrtter or in mk and submitted to the Building Inspector, witl sets of plans, accurate plot plan to scale Fee accor&ng to schedule b. Plot plan showing location of lot and of bmldmgs on premises, relationsinp to adjoining premises or pubhc stre or areas, and glvmg a detailed d~scnptlon of layout of property must be drawn on the diagram winch is part of this apr cation. c. The work covered by tlus application may not be commenced before issuance of Bufldmg Penmt. d Upon approval of tins apphcatlon, the Bmldmg Inspector will issued a Bmldmg Permit to the apphcant Such petx shall be kept on the premises available for mspectlon throughout the work. e. No buildmg shall be occupied or used m whole or m part for any purpose whatever until a Certificate of Occupa~ shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Bufldmg Department for the issuance of a Budding Permit pursuant to Budding Zone Ordmance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of bmldmgs, addittons or alterations, or for removal or demolltaon, as hereto describ. The apphcant agrees to comply wxth ail apphcable laws, ordinances, bmldme caxle, hou/~m~,code, and regulatnons, and admit authorized inspectors on premises and m bmldmg for necessary ins. pe ~ctmo~./.fi . ~//' i~lg~;tdr'e ;f app- 1]d~, o~ name', if ..... d-/..z.=/. ................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor', electrician, plumber or build Name of owner of premises . 7~ .... (../as on the tax roll or latest deed) If apphcant is a corporation, siggature of duly authorized officer (Name and title of corporate officer) Builder's License No .... Plumber's License No .. . Electrician's License No Other Trade's License No 1 Location of land on which proposed work will be done .............. House Number StrUt Hamlet County Tax Map No I000 Sectmn 4/~ ~' Block / Lot Subd~wston /~.~(~' . Filed No ....... rot 77 ....... (Nm~) "' 2 State ex~stmg use and occupancy of premises and intended use and occupancy of proposed constmctmn a Existing use and occupancy ............... ., , &:,),, " , ..: .............. b. inrenc~ed use and occup,n;cy - ,//~/~:/~Z~'~.,~.~g.. ~,7~..'. ........... 3. Nature of work (check which applicable) New Budding .. .... Addition ........ Alteratmn .~.. Repmr .... ~. Removal ....... Demolmon .......... Other Work.. ~ ~ ~l~ (Description) 4. Estmaated Cost /~. f) .................. Fee ....................... (to be prod on f'fl~ng this application) 5. If dwelling, number of dwelhng units ............ Number of dwelhng units on each floor ........... If garage, number of cars , ~..~..~,.,z~ ~,.~/,~ ~. ,· ..................................... 6. If business, commercial or rmxea~'occupancy, specify nature and extent of each type of use ................. 7. Dxmens~onsofexlstingstructures, ifany Front ~Z-~,9~ ...... Rear . ..~.~. ..... Depth ~<7, ...... Height ../d ~. ...... Number of Stones ..../?.'~- ........ , ......................... ' Danenslons of same structure with alteratmns or additions Front . 7~.~. ...... Rear .. ~. ....... · Depth . .Z/~ ........ Hezght ,,~.'~ ....... Number of Stones . ,/./~ ........... 8. Dtmenmons of entire new construction Front /~..' . ...... Rear . ./~' / ....... Depth f..-? ..... r of Stones. / Height ..... iNumb ............................. 9. Sizeoflot Front--__~SD ........... ~ Rear ./.~?. ............. __~r.-Den*h ...,,.___...., .......... 10 Date of Purchase ../~4"~..i ......... Name of Former Owner J.~/~-e ~T.~-~o~e'~r44'~. 11 Zone or use district In which' premises are situated 1 2. Does proposed construction violate any zoning law, ordinance or regulation' .,4K'.~ ................. 13. Will lot be regraded I' p'~ ...... Will excess fill be removed from premises Yes 14 Name of Owner of premmes x r,~ .. Address ............. Phone No Name of Architect ......... Address ............... Phone No Name of Contractor ..................... Address ................ Phone No ........ 15. Is th~s property loca,ted withznl00 feet of a tidal wetland? * Yes ..... No~... · If yes, Southold Town Trustees Permit may be requzred. PLOT DIAGRAM Locate clearly and distinctly all bmldmgs, whether existing or proposed, and. indicate all set-back dimensions frc property hnes Gave street and block number or description according to deed, and show street names and indicate whetl' interior or coruer lot /£ STATE OF NEW YORK, S S couNTY OF ... c' ~/z4':ev ?~' (~¥~.,~¢~-~--z_/ ...... being duly sworn, deposes and says that he ~s the appllc~ (Name of ~nd~wdual~gnmg contract) above named· He m the ~' . .. (Contractor, agent, corporate officer, etc.) of sam owner or owne~, ~d ~s duly authorized to perfom or have performed the sa~d work and to m~e and file apphcatmn, that ~1 statements contained m thru apphcatmn are true to the best ofhm ~owledge and behef, and that work will be perfo~ed ~n the m~ner set for~ ~n the apphcat~on filed therewith Sworn to before me th~s .............. of. cemg ..., Not~ Pubhc ~W~KI ~A~Y ~UBLIC Sbte of Nm Y~ No 52 45247?] (Signature of apphc~ Qu~hhed ,. S~ofk Coun~ ~, Comm~on ~p~res Ne~ 30, ~ ~9 ~e s~ t +.. -.<.% ~0 'tNT-DATA FOR APPRO~d_ TO CONSTRUCT SURVEY FOR GERARD P GOEHR/NGER LOT NO 29, "GEO£GE / TUTHILL, SECT /" AT LAUREL TOWN OF SOUTHOfD SUFFOLK COUNTY, NEW YORK DEC 2~, / DATE AUG ,~ 15 SCALE I' -' 20' NO, GUARANTEED TO