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HomeMy WebLinkAbout15380-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Date October,. 14, .., ............................... 19 86 THIS CERTIFIES that the building ........ ?.qc..e.s.s. qr. ¥..b.u.i..1 .d.i.n.g..J_p..r..e.aF..y..a.r.d... Location of Property .................................. .Sout.hold, N.Y. 1170 Park Place ~ . .......................... House No. Street Ham/et County Tax Map No. 1000 Section 087 .... Block 01 ,Lot 14 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated 0c t ob. er 1 19 .86. pursuant to which Building Permit No. 15380Z October 8~ 86 dated ............................ 19 .... was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... .~..~.q~.s.s..o.r.y...~.uA~.~.$.nF..~.n.. r.e.a.r.. 7.a.r.d. .......................................... Charles & ~inifred Wittmer The certificate is issued to ........................................................... (owner, &~eo>o~ ~o~x of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO .................................................. Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z16986 Date October 16, 19.8.6. enclosed breezeway THIS CERTIFIES that the building ................................................ 1170 Park Flace ~ Southold Location of Property/~d ~ Ho ........................ ~r'e~t' ................. ' ..... s , H~mlet County Tax Map No. 1000 Section . .0.8. 7. ....... Block 01 .Lot 1 ~ Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in tiffs office dated ..................... 1986 pursuant to which Building Permit No. 15380 Z October 1 , , ........................ October 8, 86 dated ............................ 19..., 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 ......... enclosed breezeway to existing one family dwelling. The certificate is issued to ...... Charles & Winifred Wittmer ............... ?o¥,'e;, ¥d*idxk' d&ix ..................... of the aforesaid building. Suffolk County Department of Health Approval .......... N/A UNDERWRITERS CERTIFICATE NO. 5///1 d'Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTM£NT TOWN HALL $OUTHOLD, N. Y. BUILDiHG PERi'iT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. ~5380 Z Permission is hereby granted to: ~ ~v..~...~...,?..~ ................. · .~. ,.o.. : !~.~..v..t .. ~,~,,~,,,,~,,~, ..... L~.~..~.....~....~C~.~ ......... ~~~ ............ County Tax Map No. 1000 Section .... ..¢~,...'~..,']'. ....... Block ........ ..~A,] ........ Lot No ....... !..~ ............. pursuant to application doted ..... (;~...~..~...~ ................... , 19..'~..~.., and approved by the Building Inspector, Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR iok, and submitted in duplicate to the Bu{Idin§ 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, IndustriaI 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 peopert¥ showing all property 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 [lousing code or safety ins~oection of buildings or premises, or other pert[nent informa- tion required to prepare a certificate· Fees: 1. Certificate of occupancy 2. Certificate of occupancy on pre-existing dwelling/tanduse --Pr'e-Ex±stJnpJ C.O. $15.00 3. Copy of certificate of occupancy $1.00 Vacant Zand C.O. $ 5.00 New ~3uilding ............. Old p( Pre-existing B~ilding ............ Vacant Land ............. LocaUon of Property .............. , ..... ~,... · .~ ~ ...... ;', · · -, ....... Hous~ No. J Street Ham/er / , , . .... / ./~ ....... cou., ,00o ...... ,,o,, ...... I ........ ,o, .... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant, . . ~..~.t.¢, b. ~..~, · .~ .............. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ,~ .................... Fee Subrnitted $..~.,.~'. ................... Conslruct*on on above de~ribed building and,p~rmit m~ets all appticable¢c,~des ap.d regulations. ¢,~ ~os l ¢ e Iq~7 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY InstrUctions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building [nspec- 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 featu res. 2. Fine[ approval of Health Dept. of water supply and sewerage dispos~l--(S-9 form or equal). 3, Approval of electrical installation from Board of Fire Under~Nriters. 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 peoperty showing all property lines, streets, buildings and unusual natural or topograph ic 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 $5.00 / 2. Certificate of occupancy on pre-existing dwelling/ land 3. Copy of certificate of occupancy $1.00 use--Pre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 °ate .... Fl® ........ '... New Building ............. OId~ Pre-existing ~ng ............ Vacant Land ............. Location of Property .......... .~.-) ..~.. ~.~ . .,..~z.....~. , .... ~ .... ~.. ¥/,,~/.e[, CountyTaxMap,o. lO00Sec,,on ...... B'ock ...... 1 ........ Lo, ..... :/ ....... Subdivision ................................. Filed Map No ...... ~ .... Lot No .............. Perm it N o. ~.5~,~.0..~.. Date of Permit .......... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate t/~ .................... Fee Submitted $..~.~. · .~? .................... Construction on above described building and,,~it me_ets all applicable cg(J~s Md regulations. Rev. 10-10-78 FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: ~0 0 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 %pproved .O...~...a~....~..., 19ff.¢. Permit No./~..'.~..~..O. ·~. Application No .................. )isapproved a/c ..................................... ..... · ,~ff ~ (~ (Building Inspector) ~ ~ ~'.d.t-~ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date Oct.ober 1 19 86 a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 *ts 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 .r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. c. Tho 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 hall be kept on the premises available for inspection throughout the work. ¢. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy hall 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 :uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable laws, Ordinances or '~egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. 'he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for necessary inspections. __ (Signature of applicant, or name, if a corporation) Colonial Village · . . So~tholcl,..New..York .119 (Mailing address of applicant) Rate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner ~ameofownerofpremises Wit%mer, Charles and Winifred (as on the tax roll or latest deed) f applicant is a corporation, signature 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 ...................... Location of land on which proposed work will be done .................................................. /17~ Park Place ~r~-~r Southold House Number Street Hamlet County Tax Map No. 1000 Section ..... 0.8. 7. ......... Block 01 Lot 14 Subdivision ' Filed Map No Lot (Name) · State existing use and occupancy of premises and intended use and occupancy &proposed construction: a. Existing use and occupancy One family dwelling b Intended use and occupancy .... ~ Repair ............. , R~mov~l ..... ,,,,, Do~gll., ~,;, ~, ~,, ~ ~s ~ ~ ~.~; .~ *enclose breezeway (DescHptlon) ' Est~atedCost ~ 20 O, O ~ .. ........ .. .. . . ....... ...... Fee... ........................... (to be ~aid on filing this application) } Number of dwelling units on each floor If dwe~g, number of dwelling units .......................... Ifg~age, number ofc~s.. -- . .... . ' If busMess, commercial or mixed occupancy, specty nature and extent of each ty~e of use ...~ ................ D~en~ons of existing structures if any: Front Sea ay Rear ' Depth HeiSt ............... Number of Stories .... l. $~o.<y ................ ~ ............................ D~ensions of same structure with alterations or additions: Front .. ~ .~..~OY~ Rear .................. Dep~ ...................... Height ...................... Number o~Sto~es D~ensions of entire new construction: Front..nf.a. ' . ..... Rear ..... ~ Depth HeiSt Number of Stories Sizeoflot: Front Rear., Date ofP~chase . .q?~P..~ ~..1~ ............ N0~ o rmer Own r '..' ............ Zone or use district in which premises are situated..$5 ~3.q5~3.~ ............. Does proposed construction violate any zoning law, ordinance or regulation: .. ~ .......................... .W~ lot be regraded ............................ Will excess fill be removed from premises: Yes No N~e of Owner of premises . Chicle s. ~ tt~.~<. Address 9P.~O~A~ . V~.~ ~gPPhone No. ~ 5 ~ 7~.~ ~ ~ ..... N~e of ~chitect Address ' Phone No N~e of Contractor .......................... Address ............... } ....Plione No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from )perry lines. Give street and block number or description according to deed, and show street names and indicate whether crier or comer lot. SEE ATTACHED SURVEY ~TE OF NEW YORK. 3wrv ....... s.s Charles Wittmer being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) ye named. Owner s the ........................................................................................ (Contractor, agent, corporate officer, etc.)l aid owner or owners, and is duly authorized to perform or have performed the s,id work and to make and file this ication; that all statements contained in this application are true to the best of hisiknowledge and belief; and that the k will be performed in the manner set forth in the application filed therewith. m to before me this O,ct,ober 198. .6 ...... 1 $~: ............ day of ..................... u3' Public ........... Suf.fiq 2~.k.,. Z ' Y ~...~ ...... Count ~ ~ARY DIANA flOTARY PUBLIC, State of ~eW No. 52-4655242, Suffolk Cou~ y Commission ~pires March 30, 19'~/ (Signature of applicant)