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HomeMy WebLinkAbout15474-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17358 Date SEPTEMBER 27r 1988 THIS CERTIFIES that the building. Location of Property 355 KING STREET House No. County Tax Map No. 1000 Section 026 Subdivision ADDITION ORIENT~ NEW YORK Street Hamlet Block 1 Lot 27 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NO%q~BER 6~ 1986 pursuant to which Building Permit No. 15474-Z dated NOVEMBER 8~ 1986 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 EXISTING ONE FAMILY D~T.INGAS APPLIED FOR The certificate is issued to EDWARD H. & DALE J. KING (owner, ~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTHAPPROVAL N/A UNDERWRITERS CERTIFICATE NO. N829105 - AUGUST 25~ 1987 PLUMBERS CERTIFICATION DATED N/A Inspector Rev. 1/81 l~O~m' NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERA~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 15474 Z Permission is hereby granted to: ~. .~. ~/,~ . ..... ~.~....~..~....~ ..................... ...~~ ...... .~.:.~, ........ ~..,..~..~7 .............. ,, ,o .~..~...~....~~..o.....~..~..~....~:..i.~ ...... ............... ............................................. , County Tax Map No. 1000 Section ..... ..~....~....(Iq. ..... Block ...... ...~;~....L ....... Lot No.....~...~:--.~. ......... pursuant to application dated ....~..~......~. ................ , Jg.~..~.., and approved by the Building Inspector. 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 OCCUPI Instructions m n~. DEPT _ BLDG, D A. Th[s apphcation roust be filled in typewriter OR ink, and submitted =~ to the Bui[ding Inspec- tor w~th the fo[Iowmg; for new buildings or new use: 1. Final sUrvey of property w~th accurate location of all buddings, 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 buildmgs, Industrial buildmgs, Multiple Remdences and similar buildings and installa- tions, a certificate of Code comphance from the Architect or Engmeer responmble for the buildmg. 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-existmg" land uses: 1. Accurate survey of property showing all property lines, streets, buildmgs and unusual natural or topographtc features. 2.Sworn statement of owner or prewous owner as to use, occupancy and condition of buildings. 3. Date of any housmg code or safety mspect~on of buddings or premises, or other pertment reforma- tion required to prepare a cert~fmate. C. Fees: Additions $25.OO POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.G0, Accessory ~$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certlflcate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 '~'/~ /~' ~ /~.O. /~.~, 5.Updated C.O. $ 50.00 Date ................. NewConstruct ~on. ~.... Old or Pre-exmtmg Bufldmg ............ Vacant Land ............. Location of Property ................... , ,, ).~.t ................. House tVo. Street ~lamlet Owner or Owners of Prope~'y... .............. ...........-. ..................... . County Tax Map No. lOOOSection (~)~q(~ Block ... /~. .... Lot ..'~Z ..... Permit No. . Date of Permit ./.I .... (P...App hcant .. i~.~, ......... .c7. ............ Health Dept Approval . . ~/..~ ....... Labor Dept royal .... ~//.~./~ ............. .............. App Underwriters Approval.~. ?.~.c~ ./.O. ( .... .... ... Planning Board Approval ................. . .. . Request for Temporary Certificate .................... Final Certificate ...¥c:..~. ................ ,ee Subro,tted ..... Constructmn on above described building and permit meets all ap~.[mable codes and regulations. Apphcant ................... j~ ............................... Rev 10-10-78 ~ 8 DRYERS FURNACE MOTORS FUTURE &PPUANCE PEEDERS RANGES OVENS EXHAUST FANS TIME CLOCKS UNIT HEATERS DIMMERS SY$iTEM$ NO OF PEET SERVICE DISCONNECT OTHER APPARATUS S E R V I C E PO Box 28~ Laurel New York 1194~ ~, G~AL ~ Per -?', ~,~ Thts ¢e~d~cate musf not be a}~red m any manner, return to the off~ce of the ~ord }f incorrect Inspectors may be ~denttfted ~1 ~e~r credentials COPY FOR BUILDING DEPARTMENT THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY ~NNER 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~FiNAL REMARKS: 7GS-~80~ BUILDING DEPT. INSPECTION ~~NDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS × / TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR. P.O. tJOX 728 TOWN ttALL SOU IIIOLD, N.Y. 11971 To Whom This Hay Concern, TEL. 765-1 We are unable to complete your Certlflcate of Occupancy because of the following red, sons. /~// An ,~ppllcation for Certificate of Occupancy _/is not on file.C~~ .'Io Under:;riters Certificate on. file. i e check /~/ lin lloalth Dept. Approval on file. /~/ No final in[,pocLion baa been made. this matter. Please contacL our office on Thank you for your cooperation.~ Bu', ldinq Permit BU 1 ldi,~'l Dept. ***/~/ No Plumber Solder Certzficate on file. ( all permits involving plumbing being issued after April 1,1984 ) OUNDATION (1st) OUNDATION (2nd) OUGH FRAME & ?LUMBING NSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined. i:.~.~..~'.., 19 .~.~. Approved .~~...~.., 197.G. Permit No..] .::..~.~{7.~t. ·~. Disapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 issue 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, NewYork, 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 buildings for necessary inspections. (Signature of applicant/or name, if a corporation) (Marling address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................................................................... Name of owner of premises..~....~Q..~.rq.J..~....q. ~Q./)f. ¢..'~.../~. ,. ¢.~ ........................................ (as on the ttx roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No... O~..~..~'. ................. Plumber's License No ......................... Electrician's License No.. ~?..~..~..~.. .......... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. .................. ................................ .¢>. .e/. ¢?. , ................... House Number Hamlet County Tax Map No. 1000 Section . ~. (o.0..0 ........ Block . I~./.O. .O. .......... Lot. O .~. ~.O..O. ~ ...... 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. ~. e .~i~ .//.~../~.rrt .~ .~..~. ................................................. b. Intended use and occupancy .~q'r..~.~ ./.~.. ~..~J~..: ./.~. ............ ,,~.,~..~. ~'...:. '. ......................... 3. Nature of work (check which applicable): New Building .......... Addition .. ~-~ ..... ,~lteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... Ge/', ~ ' .t[~ (Description) 4. Estimated Cost .. ?~. ~e?.~.O.. '. ........................... 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 ............................................ ............................ 6. If business, commercial or mixed occupancy, specify nature .and extent of each t~pe 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 Stories ...................... 8. Dimensions of entire new construction: Front .... /~ ......... Rear ... ,/~.: ~. ...... Depth . .~...7' .......... 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 ..................................................... 12. Does proposed constructio~l violate any zoning law, ordinance or regulation: .... ~.©. ..................... ..,_,. removed from Yes g .... ............. .... .~ .... excess oe premises: j ~nuj Name of Architect ......................... -.. Address .................. Phone No ................ Name of Contractor .Cb~r~ .'~x~-.. ......... ..... Phone No. ..... PLOT DIAGRAM 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 and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF... S.S ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ......................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this .............. ..~. ....... day of....~.~ .... ,19..~. Not. Public, Coun '1 I%," ~J4T¢.~ Pd 'z- ~L]' OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE ·- nCCUPANCY o.^w..¥ ¢4¢ EEVIGED