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Home My WebLink About15185-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N ¥. Certificate Of Occupancy No Z14875 Date September 15, 19 86 THIS CERTIFIES that the bmldmg .... d.e.c .k.a.d .d.~.t.~.q .n .................... Location of Property ...2. 75..P .ars.qn.s...B.l.v..d ...... EAst Ma.r~.pn ,.. N. Y: ...... House IVo Street Hamlet County Tax Map No. 1000 SectIon 37 .Block 2 .Lot 3 Subdivision ........................ Filed Map No ..... Lot No ............ conforms substantially to the Apphcahon for Buil&ng Permit heretofore filed in flus office dated ~.u.~.u.s ~..q ~ ........ 15~85z · 19 86 pursuant to wluch Brai&ns Permit No .................... dated . fi..u.~ u.s ~.. ! .% ............ 1986., was issued, and conforms to all of the requirements of the applicable prowmons of the law The occupancy for which this certificate is issued is ......... ... de.c..k..a.dd.$.t~.o.n. ,t9. e.x. zs.tzn.~..on.e., fa. mm.l~..d.w.e.l.l.z.n~ ..................... The certificate is issued to Robert C. & Sally Haupt (owner, ~e~ ~ X of the aforesaid building Suffolk County Department of Health Approval N / A UNDERWRITERS CERTIFICATE NO ...... 1;81 FO]2.~ NO. B TOW'N OF SOUT*HOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERJ~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLE'rlON OF THE WORK AUTHORIZED) N9 151 5 County Tax Map No 1000 Sechon pursuant to apphcahon dated Burial~ Inspector. Fee $. ..~ ..... ............~.. , 19.'~.~, end approved by the Rev 6/30/80 FORM NO, 6 TOWN OF SOUTHOLD Bu ilding Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Th~s apphcation must be filled in typewriter OR ~nk, and submitted m Imemmma 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 topographm features. 2. F~nal 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. Commercml buildings, Industrial buddings, Multiple Remdences and similar buddings and installa- tions, a certificate of Code comphance from the Architect or Engineer responsible for the building, 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buddings (prior to April 1957), Non-conforming uses, or buddings and "pre-exmting' land uses: 1. Accurate survey of pzOperty showing all property lines, streets, buildings and unusual natural or topo graph ic featu res. 2. Sworn statement of owner or previous owner as to use, occupancy and condmon 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-ex,sting dwelhng $15. O0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 ~./ /.~,.~ 5. Updated C.O. $15.00 Date .... /./. .............. NewCons truct~_on ...... Old or Pre-existing Budding ............ Vacant Land ............. Locatmn of ProperW ~ ~% ~)~5 ~ ~.~ ~ ~ ~. , Hou~ No, St~ Hamlet . ......... , . .. . .. CounW Tax Map No. 1000 Section ...............Block ............... Lot .............. Permit No. lm.~ Date of Permit X/(~J~¢...Appl,cant .%~.a~. ~,.?4~.~.en ........ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ................... Request for Tempora~ Certificate .................. F mai Certificate ....................... Fee Submitted $ ~'' ~ Re. 10 1Q-78 co V 7,S FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING 3. INSULATION PER N. STATE ENERGY Ye CODE FINAL ADDITIONAL COMMENTS: 765-180~ BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: [ ] FOUNDATION XST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION [ ] FINAL DATE ~ , NSP£CTOR :-' ~ ~:~*/~ Examined ~ Approved~ Disapproved a/c FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL 765-1802 ~F~SO_UTHOLD Received ........... ,19.. (Bmld~ng Inspecto~ APPLICATION FOR BUILDING PERIVtlT INSTRUCTIONS a. Ttus apphcatlon must be completely filled m by typewriter or ~n mk and submitted to the Buddmg Inspector, wltl~ sets of plans, accurate plot plan to scale Fee according to schedule b. Plot plan showing location of lot and of buddings on premises, relationsh~p to adjoining premises or pubhc street or areas, and g~vmg a detmled descnptmn of layout of property must be drawn on the diagram wluch is part of tlus appli cation. c The work covered by ttus apphcabon may not be commenced before issuance of Budding Permtt d. Upon approval of tins apphcatlon, the Building Inspector will issued a Budding Permit to the apphcant Such perml shall be kept on the premises available for mspechon throughout the work e. No budding shall be occupied or used m whole or In part for any purpose whatever until a Cerhficate of Occupanc: shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Bmldmg Permit pursuant to th. Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable laws, Ordinances o Regulations, for the construction of buddings, additions or alterahons, or for removal or demohhon, as hereto described The apphcant agrees to comply w~th all apphcable laws, ordinances, budding code, housing code, and regulations, and t, admit authorized inspectors on premises and in building for necessary mspec~ns; _ [ . (Signature of applicant, or name, if a corporation) //.7Z¢ .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or bmlder. ..................... t ........................ AS llo-reO .......... Nameofownerofprem[ses ~O~Ft~ ¢' ~ . . .~,~~.~'.'_ ____~ _ __ ~ ...... (as on the taxr~~=;~~t ~ AT If apphcant ~s a co~omnon, s~gn~ture ofdu]g autho~z~d officen 7&~1~ 9 AM TO 4 ~ ~ THE . . ~LOW~NG I~S: ~UN~N ~ ~R ~ED CO~E~ 2 ~UGH ~AMING & ~UMBING a, · . F~AL C~STRUC~ MUST ~ COMmiE FOR C.O ALL ~N~RUC~N ~L MEET T~ ~QU~s ~ ~ N.Y ~A~ CONS~u~oN & ~D~ NOT ~S~LE ~R ~IGN OR CqNS~ON ERRORs. (Name and Utle 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 · ..... House Number Street County Tax Map No 1000 Secnon ~.7, -.27..- 3 .. Block .. Filed Map No. Hamlet ...... Lo~ ~ 21.7.[- ,C¢f¢,,,.2_ Lot .... State ex~shng use and occupancy of premises and ~ntended use and occupancy of proposed constructmn b. Intended occupancy P~ ~ ~' ' '-- 3. Nature of work (check which apphcable) New Budding .... Addition. .'/ . Alteration Repair ..... Removal ......... Demolition ........ Other Work. g, ¢~,~ ~ (Description) 4. Estimated Cost . {/ ·~g7/9 ............. Fee .......................... (to be paid on filing this application) 5. If dwelhng, number of dwelhng 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 type of use ~ . · t ! ...... 't ..... 7. Dimenslonso. f.e.xIstlngstructures, lfany Front...~...' .6'~, ... Rear .~../-/. .... Depth '~ff .... /, · Height ~' ......... Number of Stones . .O/4~e ....... Dlmensmns of same structure with alterations or additions Front .,:~-~,'... ii. i'. i.. 't{;~r .~'~.'{ 'i.. ii i'.. Depth . .~e' /'~.. ~ ...... Number of Stones . .......... Helght t .......... ' 8. "'~lmenslons of entire new construction Front.....ggt.. ... Rear ./.~. .......... Depth IL~-~. ...... .. · Height ~" Number of Stones 9. Size of lot Front . tt~.~.~ ...... Rear [..g) ........... Depth ~.~'o 7.$ 10. DateofVurchase . tq;Y[/'/- ........... Name of Former Owner~nr,4Ol*J~ '"- 11 Zone or use district in which premises are situated .................... 12. Does proposed construction violate any zoning law, ordinance or regulation ...A/. ~. ........... 13 Will lot be regraded ....... ?.~.-. ........... Will excess fill be remove.,d from premises. Yes N 14 Name of Owner of premises ~*g~f~.t C', .~'/4~/(/'- . Address ,l~o×/t~t.~-..fl4n.,¥~,y{Phone No Name of Architect . . .'- ......... Address .............. 'Phone No ........ Name of Contractor ....... .'7 .......... Address ........... Phone No ............ 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... *If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly all buddmgs, whether existing or proposed, and indicate all set-back dtmenslons fro property hnes. Give street and block number or descnptlon according to deed, and show street names and indicate wheth mtenor or corner lot. STATE OF NEW ,YORK,.~ ,~ S S COUNTY OF. c ........ . ' , ............... being duly sworn, deposes and says that he is the apphca TName';of ~ndivldual signing contract) above named.' '~ He is the ' ' "~" ~ ' (Contractor, agent, corporate officer, etc.) of smd owner m' owl)ers, and is duly authomzed to perform or have performed the said work and to make and file tl application, that ail statements contained m this application are true to the best of h~s knowledge and belief, and that t work will be performed in the manner set forth m the application filed therewith Sworn to before me this Notary Public, .. dayof . ~Z~ ........... 197-.~. , ........ 1': .............. County . .~t94~ ~ NL470,,~7~ SulMl~d: 7 (Signature of apphca,