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HomeMy WebLinkAbout15359-zTOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Occupnncy Z-15245 Date February 4, 1987 THIS CERTIFIES that the building ...6PP.r.~.! 9.u. .~.9..~.x.r.S..~ 5.~.q' 9.~.~..~. b.~.z.h¥, p.W.E.~..L.IN G Location of Property ...59.0. . .F.A.Iq.~I.~?..R.O..A.D... NEW SUFFOLK, NEW YORK House No. ' ..... 'S't/e31 ....................... ~t~t~[oi County Tax Map No. 1000 Section I 17 .Block 06 .Lot 02 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...................... .. pursuant to which Building Permit No. I 5359 z Septeraber 29, 1986 ...................... October 6, 1986 dated .............................. 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 DWELLING. The certificate is issued to ....CLIFFORD TYLER ................. .................... of the aforesaid building. Suffolk County Department of Health Approval Iq /A UNDERWRITERS CERTIFICATE NO. Iq 788880 PLUMBERS CERTIFICATION DATED: Iq/A Rev. 1/81 · 0~ NO. ~ TOWN OF SOUTHOLD ~LilLDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDI~IG PER}AlT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPL~:TION OF THE WORK AUTHORIZED) N°. 15359 Z Permission is hereby gronted to: to ...... ~ ............ -~-.-......~¢~. ........ at premises located at ...~2.~......~....~ .............. ~ ...... .,.~r~../,~.. County Tax Map No. 1000 Section ...... L/....~.. ........ Block ...... (J~....~¢ ...... Lot No ...... ~ ............ pursuant to application dated ...~'~.~~......~..~....., 19..'~..:~, and approved by the Building Inspector. Fee $.~.~.....'.~... Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.¥. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This 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 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 the 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 p~3perty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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: _..1, Certificate of occupancy. $25.00 -- BUSINESS $50.00 2. Certificate of occupancy on pre-existingT~welling $ 50-. 00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10/.00/ 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .... ~/~ ,y.~z,..~.(.(~.~ NewC°nstruction ..... Old or Pre-existing Building ............ Vacant Land ........... Location of Property ................................................................... House No. Street /'/am/et Owner or Owners of Property ,. ~[,..~...~).~ ..... .~..~....~.~..---~--%~.. ...................... County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. , Date of Permit .......... cant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval V/ ...... '.Planning Boar royal ................. ................. d App ..... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ .C~ ,~, .' O3 Construction on above described building a~'~pe~rnit meets .albappli~able codes and regulations. Applicant .......................... Rev. 10-10-78 HORTON CONSTRUCTION CO. INC. CONTRACTORS & BUILDERS P.O. BOX 1442 MATTITUCK, N.Y. 11952 PHONE (516) 298-5531 TOWN OF $OUTHOLD 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~ ~~ ~ /5/ No Underwriters Certificate on file. /2/ The check is(outdated/not on file.) /5/ 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. Building Permit # ~ ~' 3 ~- ~ Z CLIFFORD TYLER Building Dept, ***/_~ No Plumber solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000663 BUREAU OF ELECTRICITY ~]~]. 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the el~tricaJ equipment ~ ~scribed belo~ and int~uced by tim applicant ~med on the above application number in the premises of Cli~:'ford Tyler~ F~nnin~ R~,, New Suffolk, N.Y, in the followlng location; ~ Basement ~ tnt Fh ~ 2nd ~7. Section Block Lot t~sexaminedon ~]~LL~ ~7 andf°undt°beinc°ntpllat~ceu~iththereqttirementsQfthisll°ard' FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT 2 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCI~S UNIT HEATERS MULTI.OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT S E R V I C AW, G, OF OTHER APPARATUS: Glenn Bradley Box 602 11948 lic. ~1227 GENERAL MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BU)LDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NO3' BE ALTERED IN ANY MANNER. 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~__~,~---~ ~/~e~..~ /5/ No Underwriters Certificate on fileo /~/ The check is(outdate~no~ on file.) /~/ No Health Dept. Approval on file. /Z/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit # ! ~- 3 J- ~ Z Building Dept. ***/_~ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) FOUNDATION (lstl FOUNDATION (2nd) ROUGH FRAME & FLUMBING INSULATION FER N. STATE ENERGY CODE Ye ADDITIONAL COMMENTS: 7GS-XSOZ BUILDING DEPT, INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION []FRAMING []FINAL REMARKS, ~ /~ ..... ~/.~..~-:~.. ",~~ DATE, /,~/// INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: [ ] FOUNDATION ~ST [] ROUGH PLBG. [] FOUNDATION 2ND []INSULATION []FINAL , ~ DATE ,INSPECTOR / FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL £OUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved~5..c-~....o'~.....~...., 19'.~.~ Permit No../.~:.~. ~ Disapproved a/c ........................ i ........ ~ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... ,19... -~P 3/~3 a. This 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 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, 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 necessa, r¥ inspections. (Signature of applicant, or name, if a corporation) .?.:~:...¥..~.x. ............................ . . · .CA~&~..'7r2. .................. i" i~ ........ (mailing address of a~p ic ) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........... %e ~ .e.<.4 ...... .c..o..~.~ ~ ~. ............................ Name of owner of premises ....~-~..~.\.[.'~..~.9 .~'..~..... ~..'~.~.l. · '/--'~'(~ ........................................ (as on the tax roll or latest deed) If aprRlic}~nt is a corl~oration, signature of duly authorized officer. (Nam¥~nd 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 .................................................. · .,~ya.0 ...................... ~a,.~.c>...~ .~... .......... ~.c..-~.... ~.o. ¢:~e .~ ............. House Number Street Hamlet County Tax Map No. 1000 Section .... ]'/' 7 ......... Block .... ~.4 .......... Lot... {~..~... .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and inteng[ed use and occupancy of proposed construction: a. Existing use and occupancy..~.\.~.. ~O~.~. .... .~.~..p%~..~..~q3... ~...C%)..~.!i.~(..~..~/ ...................... b. Intended us~ and occupancy .......... ~.~.~.. ¢.fTX..~.~/.. ~ ................................ . I · ' 3. Nature of work (check which applicable): New Building .......... Addition . 1~. ...... Alteration . .i ...... Repair Removal Demolition ' Other Work (Description) , 4. Estimated Cost.. t ...................... Fee ......... i ........................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ number of cars ' If garage 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear ....... i ....... Depth ............... Height Number of Stories Dimensions of same structure with alterations or additions: Front ....... ~ Rear Depth ...................... Height ...................... Number ofiStories ...................... 8. Dimensions of entire new construction: Front ........... Rear I Depth Height Number of Stories 9. Size of lot: Front ...................... Rear ...................... iDepth ...................... 10 D t of P ch Name~)fFo~m.e Own · a e ur ese ............................. r er ., ............................ 11 Zoneo dist i ti whichpr mi esituat d ..~..~'~.~:~,.~k,-~o_.~ · ruse rc n e sesar e ... . 12. Does proposed construction violate any zoning law, ordinance or regulation: .... i ........................ 1 3. Will lot be regraded ............................ Will excess fill be removed from premises: Yes 14. Name of Owner of premises .................... Address ............... i .... Phone No ................ Name of Architect .................... Address ............... Ii .... Ph one No ................ Name of Contractor ~.~..~....c-o'~4~;~'- ..... . Address . .(~./3.XT~\"9.,-M...~M..! .... Phone No..~...~.F..'q . .~.o..~.. 15. Is this property located withint.00 feet of a tidal wetland? * ~es ..... No . .~.. · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. inOicate 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, S.S ......... (Nan~e ;'f i~'~vi~al sijning c'~'n~;~c'ti .......... being duly sworn, depo?s and says that he is the applicant above named. He is the ........ c>~' .~.--~./" ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the stlid work and to make and file this application; that all statements contained in this application are true to the best of his iknowledge 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 o~..~ .O. & ......... 19 .~o Notary Public, ~.. ~.'. .... 4.. ~..3~-~.. .... Count . · .........