The URL can be used to link to this page

Home My WebLink About15187-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y Certificate Of Occupancy No..Z. 1.4860.. Date Sept. 9 19 86 THIS CERTIFIES that the buridmg . Al. te.r.a, ti. qn. ................................. Location of Property 430 Grove Road Southold House No Street Hamlet County Tax Map No 1000 Section 5.1 Block . 6. ....... Lot .ltl. ....... Subdlwsmn ...... Fried Map No .... Lot No ............. conforms substantmlly to the Apphcatton for Burid~ng Permit heretofore fried ~n ttus office dated .... /~.gu.~t. 18. .... 19 .86 pursuant to wtuch Bmld~ng Permit No. 1.5.1.8.7. Z. ............... dated .... A.u. gu.s.t..18. ............. 19 .8.6., was ~ssued, and conforms to all of the reqmrements of the apphcable provm~ons of the law The occupancy for wbach tins certfficate m ~ssued m ......... · . A. lte. rationq-en.c, lo. se .p. or.c.h. . ........................... The certfficate m ~ssued to . .Ma. ri.an. T... &/.o.r .F. ra.n.c.i.s..J.: .D.±r.s. ch. erl. ................... (owner~ of the aforesmd building. Suffolk County Department of Health Approval .. .N./..A ........................ UNDERWRITERS CERTIFICATE NO ........... N../.A ......................... Rev 1/81 FORM NO 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z14861 Date . .S.e.P~. :.9. ............... 198~. THIS CERTIFIES that the building ...... Ac.c .essgr. y' ,b.u..il..dz.n.g. ................ Location of Property 430 Grove Road Southold House No Street Ham/et County Tax Map No 1000 Section . .51. ..... Block 6 Lot 19 Subdivision ...................... F~ed Map No ...... Lot No ............. conforms substantially to the Apphcatton for Building Permit heretofore filed m this office dated .... .A .u g .u .s .t . .1.8 ....... , 19..86pursuant to wluch Bmldmg Permit No 15187Z dated August 18 19 86 ....................... , was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which flus certfficate is issued is ....... .. Ac.ces.so.r7 shed in rear yard. The certificate is issued to M.a.r.i.a.n .T. b/o.r ?ranci. s J..Dir.s.cherl ..................... (ownar, t~t~t~ of the aforesaid building. Suffolk County Department of Health Approval ..... .Iq/A. ....................... UNDERWRITERS CERTIFICATE NO ........ .N/A. ....................... Rev 1/81 ~O~,~[ NO. ~1 TO~VN OF SOUTNOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERA4IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 15187 Perrmsslon ~s hereby granted to' ....... ~.~.~.~....~. ..~..~.. z/..~...2.../~ ~ ~-... at premises I=ated at ..... ~.~.~..~~ ............................................... ............................... ~..~. ..................................... ~...~'~::::::::::::::::::::::::::::::::::: co~.~ ~ ~ ~o ,o0o ~ec,,o~ ~/....~ ~,=~ ..... 5 ........... ~o, ~o .... Z..~ . pursuant to application dated Building Inspector Building Inspector Rev 6]30./80 FORM NO. 6 TOWN OF SOUTHOLD Budding Department Town Hall ~ $outhold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 5°. Instructions A. This application must be hlled in typewriter OR ink, and subm;tted m ~mama~a to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate Iocatmn 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 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 buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p=operty 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 housing code or safety inspection of buildings or premises, or other pertinent informa- tmn requtred to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Cert~flcate of occupancy on pre-ex~sting dwelling $15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Lamct C.O. $5.00 5. Upda~_ecl C.O. $15.00 Date ..................... NewConmtructzon ...... Old or Pre-exmting Budding ~. ........ Vacant Land ............. Locat,on of ProperW .¢~ ~...~.f.~. ~,.. ~ ff~/ .... ~ e. Z~ e~ ~ ..... Hou~ No. ~reet , Ham/et County Tax Map No. 1000 Section .............. Block ............. Lot ............ Subdiv~mon ............................... Fded Map No .......... Lot No .............. Permit No. Date of Permit mant ' Health Dept. Approval ........................ Labor Dept. Approval ....................... . Underwriters Approval ........................ Planning Board Approval ..................... . Request for Temporary Cert~fmate ..................... Final Certificate ., ~. ................... Fee Subrnitted $..~.,.. ~"~/,-)....V/.~..~0 .'~. ....... Construction on above descmbed budding and permit meets all applicable codes and regulations. Applicant ."~d. ~,.. ~.'~./....~ .................. Rev 10 10 78 -30 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 m ~ to the Building Inspec- tor w~th the following; for new buildings or new use: 1. Final survey of property with 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-iS-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 responmble 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 property showing all property lines, streets, buddings 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 housing code or safety inspection of buildings or premises, or other pertinent informa- non required to prepare a certificate. C. Fees: $. Ceruflcate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 , 5.Updated C.O. $15.00 Date .. ~... ..-' ......... NewCons tructzon ...... Old or Pre-exlsting Building /.. ......... Vacant Land ............. Houca No. Street , Hamlet Owner or Owners of Property .~...~..,.,~. ,/.~...'~...2,...Y~.....~.~..~..'.~-~.<.J...'~'..'.~.4 .~..~...~...'~./~'/ County Tax Map No. 1000 Section .....-~../. ....... Block ...... ~. ....... Lot..~.~. .......... Subd~wsion ................................ Filed Map No .......... Lot No .............. Permit No .... Date of Permit . .cant · Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporaw Certificate ..................... Final Cert~hcate ,, / ................... Fee Submitted $ .... ~ .... , ........ Construction on above described building and permit meets all apphcable codes and regulations. Rev, 10 10 78 .5o 9,2f USE IS UNLAWFUL WiTHOIII' CE~IIFIC^IE OF OCCUPANCY :iELD IhS~m~..O~ FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & FLUMBING INSULATION FERN. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: l Mc.G LJ i I;~E CLAUDE ~ INA OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE ~u~r"~llt'~ed FIELD INSPECTION FOU__NDA_.TIO__N --- ~s t ) FOUNDATION COMMEN ~ ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: - i~4ame o! lnalVl(:lUal slgnlng contract) above named. He is the ........... (-.4) c)t'-o.- [-C c'-e~-f~ - Contractor, agent, .......... ( corporate oflqccr, etc.) of' said owner or owners, and is duly author/zed to perform or have performed the said work and to make and file application; that all statements contained in this applicatmn are true to the best of his knowledge and belief; and that th~ work will be performed in the manner set forth in the appheation filed therewith. Sworn to before me this FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-18013 .... Approved ' ./¢ ..,l¢ 'Pe m,tNo Disapproved a/c ........................... Application No ............ (Budding Inspector) APPLICATION FOR BUILDING PERMIT Date . .~.u .cji..t..1.8t ........ 1' INSTRUCTIONS a. This application must be completely filled m by typewriter or in ink and submitted to the Building Inspector, v 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 s or ge. as, and giving a detailed descnphon of layout of property must be drown on the diagram which is part of flus cat/elL c. The work covered by tlus application may not be commenced before issuance of Building Permit. d. Upon approval of thru apphcation, the Building Inspector will issued a Budding Permit to the applicant. Such p shaft be kept on the premises available for mspechon throughout the work. ¢. No burring shall be occupied or used m whole or in part for any purpose whatever until a Certificate of Occu~ slmll have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Braiding Department for the issuance of a Building Permit pursuant t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinanc Regulatmns, for the construction of buildings, additions or alterations, or for removal or demolition, as hereto desc, The apphcant agrees to comply with all apphcable laws, ordinances, budding code, housing code, and regulations, m admit authorized respecters on premises and m building for necessary inspections (g0gn0.ture of.3pplicaat, Or name, If a core,ration) 450 ~rove (Maihng address of apphcant) State whether applicant ,s owner, lessee, agent, arclutect, engineer, general contractor, electrician, plumber or but; Owner ......................................... ;'i .... ............. Name of owner of premises Francis J. and Marian T. ' rscheT'~/Jm,//~F" t Z"/[Y,~F -'~,. ....................,~: ~, ~,rr4 h_t,~:~,7~dt ~"~' ' ,:t, ' ~ .... applicant is a corporation, s,gnature of duly author, zed officer. If ffOYIF¢ F. JJILBING DEPA~T~'r r ........... 70B-1802 9 AM TO 4 P~,~' ':"'~ (Nm'ne and htle of corporate officer) FOLLOWING INSP{~CTION' FaR ~ED CO~' BuddcFs License No ........ 2 ~OUGH ~AM~NG ~ - ,* Ptumbcr's hc~se No ........... 4. ~AC ~NST~C~ '~ ~U~I ~ COMmiE ~R ( ~ ~ ~ ~QU~M~S O~ ~ ~ ~ ~ Othc~ Tmdc's hccn~ ~o ..................... 5~A~ CON~O~ ~ ~ ]. ~catmn of land on wMch proposed work wdl be done. ~Tgv~~~Y{,,.~}~$.~ ....... ... 430 ...... q~e ~4 ..... Sou~old House N~ber Street Hamlc~ County Tax Map No. 1000 Sec[mn .... 5~ ........... Block 6 Lot .... Subdw~Slon ' N ........ ........................ Fried Map o ....... Lot ..... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed constructmn. one fam~ ly dwelling a. Existing use and occupancy ...................................................... b, Intended use and occupancy o.n.e. ~..e~o:..~y .dv?.l.l.i.n.g. wi.ti}, eric. loser porch and shed (DescHptioi 4. Estmantc d Cost .................... Fee $75.0 (to be paid on ffltng th,s applicanon) 5. If dwelling, number of dwelbng unats ............ Nutnber of dwelhng umts on each floor ............. If garage, number of cars ............................................................... 6. If business, commercial or mined occupancy, specify nature and extent of each type of use .................. 7. Dtmensmns of existing structures, if any: Front ............... Rear ............. Depth .......... Height ............... Number of Stones ................................................ Dimensions of same structure with alterations or addihons Front .............. Rear ............... Depth ..................... Height ................. Number of Storie~ 21' 6" ~. Dunens~ons of ennre new construchon Front., .11..0' Rear ,11..0' . . Depth ....... Height ............... Number of Stones . .o.n.e. ....... S..I~.:. 9.'..6."..X..6.' ...................... ). Size of lot' Front .................... Rear ................. Depth ............... 3. Date of Purchase ...Decembex: .4,..1~79t ......... Name of Former Owner ~, .nn..% .H..qql. b. rc.c~.e. ...... 1. Zone or use district tn which premises are muated...I~.sAd, en?.i.a.1, ............................. 2. Does proposed construction vmlate any zomng law, ordtnance or regulahon: ........................ L .Wall lot be regraded .................... ,.., Wall excess fill be ren~ov~d from premises: Yes Mr. and ~rs. D~rscn 430 r e a ~,.Name of Owner of prom,sea ............... e/~dre~ .~out~, f~ .~1~7.]. Phone No. 7.fiS-.5~4.9.fi. Name of Architect ......................... Address ................. Phone No Name of Contractor ....................... Address .................. Phone No ........... PLOT DIAGRAM Locate clearly and distinctly all budd:ngs, whether ex,sting or proposed, and. indicate ail set-back dunens~ons fr -operty lines. G~ve street and bIock number or description according to deed, and show street names and indicate whet terior or coruet lot. SEE AT?ACHED SURVEY 'ATE OF NEW YORK, S.S )UNTY OF..SUFFOLK ........ ~r~an T. Dirscherl .......................................... being duly sworn, deposes and says that he :s the apphca (Name of ind~wdual s~gntng contract) ave named. is the ...O~¢n...?. ........... (Contractor, agent, corporate officer, ere ) sa~d owner or owners, and ~s duly authorized to perform or have performed the sa~d work and to tnake and file phcatlon; that all statements contaxned in th~s appheattnn a~e true to the b~st of h~s ?mowiedge and behef; and that ,rk will be performed in the manner set forth m the appl:catton fried therewittt. 'om to before tne this 18th ~, r~C August ,086 i~ ~ m~t~ ~a~eq (Signature of apphcal