HomeMy WebLinkAbout15441-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-17480
Date NOVEMBER 1, 1988
THIS CERTIFIES that the building
Location of Property 360 HARBOR
House No.
County Tax Map No. 1000 Section 027
Subdivision
ALTERATION
ORIENT, NEW YORK
Street Hamlet
Block 04 Lot 06
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 21~ 1988 pursuant to which
Building Permit No. 15441-Z dated OCTOBER 30~ 1988
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 ALTERATION TO ROOF AREA TO EXISTING ONE FAMILY DWELLING
The certificate is issued to YAN & FRANCOISE RIEGER
(owner, 5[~)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N040182 - OCTOBER 17~ 1988
Building Inspector
1~0~ NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
15441
Z
Permission is hereby granted to: ~ ~
at premises located at ...;~'~..~,~....,~~....~/. ......................................................................
County Tax Map No. 1000 Section ..... ,,0,.._~.,,~, ....... Block ...... ..O,..,Uf, ....... Lot No......~.....~,. ............
pursuant to application dated .... ...O...~.~.......~....t ............. , 19..~...,~,., and approved by the
Building Inspector.
fee
Building Inspector
Rev. 6/30/60
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted i~ 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~opertv 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: Additions $25.00
1. Certificate of occupancy New Dwelling,S25.0.0, Accessory ,~10.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50-. 00
3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00
4.Vacant Land C.O. $ 20.00 DeEember 11 1987
5.Updated C.O. $ 50.00 Date ..........................
New C on s t r uc t i on ...... Old or Pre-existing Building ............ Vacant Land .............
Harbor ~oad ' rient
Location of Property ................................... ~ ...............................
House No. Street I-lam/et
iran ;' ':'rancoise ~ieger
Owner or Owners of Property
County Tax Map No. ~000Section o2? Block . ~0b~/ 0~!
................. ; ........... Lot ...............
Subdivision ................................. Filed Map No ........... Lot No ..............
1544i ~ of Permit 1.0../86 Applicant Yan
Permit No " Date
Health Dept. Approval ?,!/A .Labor Dept. Approval
Underwriters Approval on ~.i[e .Planning Board Approval
of Ocupancy
Request for Temporary Certificate ..................... Final Certificate .....................
Fee Submitted $ .2..~...o.o. ......................
Construction on above described building and permit meets all applicable codes and regulations.
Rev. 10-10-7S
THE NEW YORK BOARD OF FIRE UNDERWRITERS
~ 0 ~50~0
BUREAU OF ELECTRICITY
~-- OCTO~J,~t~ I 7~ 19~E~5~ JOHN STREET, NEW YORK. NEW YORK 10038
. 5~279087/87 N
~pplication No. on file
o~y t~ ~t~ ~u~me~t m ~cd~ ~ a~ int~c~ by t~ ~t M~ ~ t~ ~ ~t~ numar ~ t~ ~m~s of
in the foffotclng Iocatb~n'~ ~ ~m~nt [] Ist FI.
~ 2nd FI. S~ectlon Block Lot
and found to be in compliance with the requirements of this l~mrd.
FIXTURES RANOES COOKING DICKS OVENS DISH WASHI~S EXHAUST FANS
S~RVIC~ ~SCX)HNE, CT S E Il ¥ I
OTI'Iill APPARATUS.'
NO. OF HI-LEG
C E
~:hi$ certificate must not be altered in any manner; return to the office of the Board if im:orrect. Inspectors may
FOR BUILDIHG DEPARTMENT. THIS COPY OF CERTIFICATE MUST ~HOT~BE ALTERED IN ANY MANNER.
TOWN OF $OUTItOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN IIALL
SOUTtIOLD, N.Y. 11971
December 7, 1987
TEL. 765-I 802
Mr. Yen Rieger
360 Harbor Rd.
Orient, New York
11957
To Whom This May Cohcern,
We are unable o complete your Certificate
of Occupancy because ,of the following reasons.
/~/ An application
is not on file. (ENCLOSED)
/2/ NO Underwriters Certificate on file.
/2/ The check is(~/not on file.)
/~/ No Health Dept. Approval on file.
/~/ No final inqpection has been made.
for Certificate of Occupancy
$25.00
Please contact our office
Thank you for your cooperation.
Building Permit # ] 5 4 4
Building Dept,
***/~/
on this matter.
I Z
No Plumber Solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
TOWN OF SOUTIIOLD
OFI"ICI! Of: BUILDING INSPECTOR
P.O. BOX 728
TOWN IlALL
SOUTIIOLD, N.Y. 11971
December 7, I987
TEL. 765-1802
Hr. Yen R~eger
360 Ilarbor Rtl.
Orient, New York
11957
Whom ThS~; May Cohcern,
We are unable %.o complete your Certificate
Occupancy bccnu~e· - s: } ,of the following reasons.
/~¥~ for Certificate of Occupancy
.i :; I~O[.._~ £ito. (-'~"'~"~YO S E D )
/'_X./ Uo Undcrwrit ~:r.; Certificate on file.
/ / No llealth I)ept. Approval on file.
].n.~[,cctzrn has been made.
PJ¢~n~;e contact our office
Th;tnk you for yot]r cooperation.
BuJ.]d]ng Per,nit t~ I 5 4 4
Bu.iJd]r~g Dept.
on this matter.
1 Z
No Plumber Solder Certificate on file.
( all per'mit:; involving plumbing being
J..~;sued alter April 1,1984 )
'ONNDATION (~st)
'OUNDATION (2nd)
PLUMBING
iNSULATION PER N. Y.
STATE ENERGY
CODE
ADDITIONAL COMMENTS:
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
REMARKS:
FOUNDATION 2ND [ ] IN/SULATION
FRAMING [~,/]' FINAL
DATE /~/~/~ 7 INSPECTOR ~ ~/~
7G5-180;~
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [ ] INSULATION
[ ] FRAMING [ ] FINAL
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [ ] INSULATION
[ ] FRAMING [
] FINAL
765-1802
BUILDING DEPT.
INSPECTION
]FOUNDATION 1ST [ ] ROUGH PLBG.
] FOUNDATION ZND [ ] IN/SULATION
] FRAMING [/~ FINAL
DATE . '~ INSPECTOR
×amined .0.%~.q?-:5~...~o..., 19 .~.~.
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N,Y. 11971
TEL.: 765-1803
,pproved .o?:..~....o,~.....~.q., 19 .~. Permit No./.~.q.q./. ~
~isapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. This application must be completely filled in by typewriter or ill 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-
~tion.
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
~all 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 9 Certificate of Occupancy
~all 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
eliding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
egulations, fro' the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
lie applicant agrees to comply with all applicable laws, ordinances, build~ag lode, housing 99deb4itntd regulations, and to
Jmit auth°rizedinspect°rs°npremisesandin building f°rnecesi~iT.i~:~.ic' ]~.~...~ .~..~..:( .~.... .......
(Signatu/ ,~/~applicantj~55~y~ame, if g(corporation)
.tate wliethe, applicant is owner, lessee, agent, architect, engi;t;i/, 'ie'n;!~;~oiI~l~;~efllSc~t;~c~i~l~[l{&~ 5o; ~1115t~;.
.......................... ..........................................................
..,ff.... ............................................
(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....~7. O....~..~....~.~..~.W-"..&.°. ,6-3~-~' ('~
Phnn her's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
Location of land on which proposed work will be done ..................................................
llouse Nmnber Street Hamlet
County Tax Map No. 1000 Section .... .2.7 .......... Block .... ~. ............ Lot... ~ .............
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 ........ ~.d..~(..fi-fie .............................................
b. Intended use and occupancy ........... ~ .... ~ .... ~ ........................
3. Nature of work (check which applicable): New Building .......... Addition..~ ....... . Alteration ~ . ........
Rep/dr ' Removal Demolition [ Other Work
' (Description)
4. Estimated Cost ................................... Fee ........... . ...... ~ .....................
(to be Ipaid 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 bu ' commercial or mixed o. ccupancy specify nat d exte t of each tY~e of use
· slnes$~ , ute an n
7. Dimensions of existing structures, lfany:Front .... ./Ti~. . . Rear .. ff.'c~. ....... .Depth . .~:~.
' .~.// Number of Stories 2 ....... ~ ........
Hmght ...................................... ~ ....... i .............
Dimensions of same ~structure with alterations or additi~ofis: Front .... ~..~. ........ Rear .... .~'.'~..~.. i i .....
Depth ....... ,..~.~' ........... Height ...... :2~..~. ......... Number o~ Stories .......... /. .........
8. Dimensions of entire new construction: Front ............... Rear ....... i ....... Depth .............
Height ............... Numberer Stories ........................... i ....... [ ......... '. ·
9 Size of lot: Front ~' .i~' Rear ~.Q i Depth ~...~
0 Date of Purchase Name of Former Owner i '
1 Zone or use district in ....
winch premises are situated .
2. Does proposed construction violate any zoning law, ordinance or regulation: ... ~ ..........................
3. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No
4. Name of Owner of premises .................... Address .............. i ....Phone No .................
Name of Architect ........................... Address .............. i ....Phone No ................
Name of Contractor Address .' Phone No '
,5. Is this property located withinl.00 feet of a tidal wetland? *,'Yes ...~.. No .....
· if yes, Southold Town Trustees Permit may be required. ,
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. ifidicate all 'set-back dimensions from
roperty lines. Give street and block number or description according to deed, and sh6w street names
atefior or corner lot.
'rATE OF NEW YORK,
OUNTY OF ......... S.S
and indi?te whether
worn to before, me this
~ /'~ . '~. 1~..
..................... day of ............. , .
mrm ~ree ~m~r 31, 1~~
i
(Signitture of applicant)
XfA/Q ~ ~.. ( .~"~..~..~. being duly sworn, deposes and si s that he is the applicant
(Name of individual signing contract)
9ove named·
e is the ............................................................ r ......... . ..................
(Contractor, agent, corporate officer, etcD
f said owner or owners, and is duly authorized to perform or have performedthe Jsald' ' work and to make and file' th~s'
)plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the
ork will be p~rformed in tho manner set forth in the application filed therewith. .