The URL can be used to link to this page

Home My WebLink About15192-zFORM NO. 4 TOWN OF SOUTHOL~ BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17181 Date AUGUST 10~ 1988 THIS CERTIFIES that the bulldin~ ONE FAMILY DWELLING Location of Property 625 NORTH OAKWOOD ROAD LAUREL~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Sectmon 127 Block 7 Lot 15.1 Subdivision Filed Map No. Lot No. conforms substantmally to the Application for Building Permit heretofore filed in this office dated AUGUST 22, 1986 pursuant to which Building Permit No. 15t92-Z dated AUGUST 25, 1986 was mssued, and conforms to all of the requirements of the applicable provmsions of the law. The occupancy for whmch thls certificate ls Issued lS ONE FAMILY DWELLING WIT~ ATTACHED GARAGE & ATTACHED DECK The certlfmcate ms issued to DIANE CHRISTIE (owner, ~L~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 86-SO-66-AUGUST 9~ 1988 UNDERWRITERS CERTIFICATE NO. N-021368 JULY 12r 1988 PLUMBERS CERTIFICATION DATED APRIL 6r 1988 Bu~ldln9 Inspector Rev. 1/81 FOR~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDIHG PERMIT N°. 15192 Z Date ....~~q.~...~..........~...~. ............... Perm~sslon ~s hereby granted to' .............. ~...r,~..- .~-r~.. .... ~...~....~.~... ~ ................ .~...~ ......... ..u......H..:.....,~.~.~ .......... at prem,ses located at .....~....~.....~........~...~.....~~......../~....~........~... '.~ ............. County Tax' Map No 1000 Sect,on ./."'~.-~..... Block ..... ..'] ............ Lot No ?/~....I.~":. I. pursuant to apphcat~on dated . ~'. ~ .......... 197~..~., and approved by the Budding Inspector Fee $~'~0~ ,. /' Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 BLDG. DEPT~ TOW,N OF,S0UI~OLD APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled ~n typewriter OR ink, and submitted -. Imam.mm to the Building Inspec- tor with the following; for new buddings or new use: 1. Final survey of property with accurate location of all buildings, property hnes, streets, and unusual natural or topographic featu res. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal), 3. Approval of electrical ~nstaliation from Board of Fire Underwriters. 4. Commercml buildings, Industrial buildings, MultipLe Residences and slmBar 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 (p.or to April 1957), Non-conforming uses, or buildings and "pre-ex~sting" land uses: 1. Accurate survey of p~operty showing all property hnes, streets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buddings. 3. Date of any housing code or safety Inspection of buddings or premises, or other pertinent mforma- t~on required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certlflcate of occupancy New Dwelling $25.00, Accessory ,$]0.00 Bus~ness $50.00 2. Certificate of occupancv on pre-exist~ng dwelhng $ 50.00 3 Copy of certlfmate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ...................... NewConstruction ..... Old or Pre-exmting Building ........... Vacant Land ............ Locat,on of Property , ¢.c¢.~..~ J¥o4-t~ Of~ ~co ood ~O&b d~.x.'~/_. Hout~o No. , Street Earn/et County Tax Map No. 1000 Sect,on ...... /.~...~ .... Block .... ~ ...... Lot.../.?. / ......... Subdlwmon ................. Filed Map No ......... Lot No ............ Perm,t No. [.~./~...~. Date of Permit ........ Apphcant .... (~ ......... ~ ........... Health Dept. Approval ....................... Labor Dept. Approval ........................ Underwriters Approval .................... PIanmng Board Approval ...................... Request for Temporary Certificate .............. Final Cert*ficate ....................... Fee Submitted $ .................... Construction on above described budding and permit meets all applicable codes and regulations Apphcant...~¢~.....Jrt:, C..~1~..~ .......................... Rev 10-10 78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P O BOX 728 TOWN HA. LL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. /%.~./(~r~ ~ Owner b/~A3~ ~/d ~;~ (please print) Plumber ~/ ~ ~J~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. umber's signature) Sworn to before me this ---- Notary Puk Notary Public, ~/~.~ County ~AR~S ~. S~AC~( Oualdied in Suffolk Commmsion I~lre. ~C'. ~~~ :'IELD ihSlmb..O~ FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: ~--'~( ~ ~ \"~//~ BUILDING DEPT. NSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. /~/, ~ [ ] FOUNDATION 2ND [ ] INSULATION FRAMING DATE ~/~,/~,~ ,NSPECTO._~~,~/ REMARKS: THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ! ,J~]',¥ ]~, :J 9'~ ES JOHN STREET. NEW YORK, N~)~38-'----~----- ~ I'~ ~te ~pplication ~o. on file THI~ G~I~I~ THAT DYA~ C~I~'~"[~;, NO~T~ 0~(~ ~O~J), POLE ~ ~,~{j~l,+ N~Y. ~ exami~ on ond~ound to be in cot~lpliun~ with the ~qut~tnents of th~ B~rd. RXTURES RANGIS COO~ING DECKS OVENS DISH WASNIRS EXHAUST FANS S~RYlCl DISCONNECT S E R V I C E =. o~ ~UTULS ?. / (;. w. o. (~g NEUTRAL JODY PUMILLO P~T 1,,RNF., / M~TT'[T{]CK, NY, 11.952 h CgNSg NO. 2300F; B~II~IIIU~ MANA~BI 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 FOIl BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST HOT BE ALTERED IN ANY MANI4ER. /, SU:'FOLK CO HEAL?H DEPT APPRO H S NO STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DIS[ SYSTEMS FOR THIS RESIDENCE CONFORM TO THE STANDARDS OF SUFFOLK COUNTY DEPT OF HE SERVIEES FOR APPPOVAL CONSTRUCTION ONLY ~1 DATE~ / ~ DIST SECT BLOCK OWNERS ADDRESS TEST HOLE I STAMP Approve~J~,g.-a~(-) ' , 19~g Disapproved a/c FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL £OUTHOLD, N Y, 11971 TEL.. 765-1803 Permit No/&.'! ~.~"~ Received .......... ,~9 (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ., 19. INSTRUCTIONS a Ttus application must be completely filled m by typewriter or in ink and submitted to the Buddmg Inspector, with 3 sets of plans, accurate plot plan to scale Fee according to schedule b. Plot plan showing location of lot and of buddings on premises, relationship to adjoining premises or pubhc streets or areas, and giving a detmled description of layout of property must be drawn on the diagram which is part of tins appb- cation. c The work covered by tins application may not be commenced before issuance of Budding Permit d. Upon approval of this apphcatlon, the Building Inspector will issued a Budding Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No bmldmg 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 Bmldmg Inspector. APPLICATION IS HEREBY MADE to the Budding 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 apphcable Laws, Ordinances or Regulations, for the construction of buddings, additions or alterations, or for removal or demolition, as herem described. The applicant agrees to comply with all apphcable laws, ordinances, budding code, housing code, and regulations, and to admit authorized mspectors on premises and m bmldmg for necessary inspections (Signature of applicant, or name, if a corporabon) ........... F. ................... ........... ........... (mailing adflress of applicant) State whether applicant Is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................. Nameofownerofpremmes ~ d, .d~'2D~-~ ..................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer 2 (Name and title of corporate officer) Bullder'sLlcenseNo /{Or J'~UOI/t~/(~ ~'~ ]~i5 PlumbeFs hcense No Electrician's Llcense No J' Other Trade's License No Location of land on which proposed work will be done .. Itouse Number Street County Tax Map No 1000 Section / .~k 7 Block . Hamlet .. 7 .. Lot /'/°. [.~.', I Subdiwsion . . 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 }/)~]~lQ'r~ ................ b lntended use and occupancy . OP[~'~ /~PJJ'Jl./~. 3. Nature of work (check which apphcable) New Bufldxng . ~' Addition Alteratmn Repmr ...... Removal ........... Demoht~on ......... Other Work .......... (Descnptmn) 4 Estmaated Cost 4~ ~ :~ t~.~. 0... Fee (to be paid on filing this apphcatmn) 5 If dwellmg, number of dwelhng umts .......... Number of dwelhng umts on each floor... If garage, number of cars 6. If business, commercml or m~xed occupancy, specify nature and extent of each type of use ................ 7. D~mensmns of ex,sting structures, ff any Front ...... Rear ........... Depth Hmght ........ Number of Stones Dmaensmns of same structure with alterations or addmons' Front .......... Rear ............... Depth ...... Hmght .......... Number of Stones ....... 8. Dmaens~ons of entire new constrnctmn Front ..... Rear .......... Depth .. Height ...... Number of Stones ..................... 9. S~ze of lot Front ..... Rear ............ Depth ......... 10. Date of Purchase ......... Name of Former Owner . 1 1. Zone or use d~stnct m which premmes are mtuated ...................... 12 Does proposed construction wolate any zomng law, ordinance or regulation ..... 13. Will lot be regraded ............ Will excess fill be removed from premises Yes N t4. Name of Owner of premises ................ Address ................. Phone No Name of Architect ..... Address .......... Phone No .. Name of Contractor ............. Address ........... Phone No ...... 15. Is this property located wzthinl00 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 ex,sting or proposed, and. ~ndicate all set-back danensmns rrm property hnes G~ve street and block number or description according to deed, and show street names and mdmate whetht ~ntenor or corner lot. STATE OF NEW YOg.t~ o i~' COUNTY OF . ..,~ffz~'~'ll% S.S .. __t4 . (Name of ~n&v~duaI slgmng contract) above named. · being duty sworn, deposes and says that he ~s the apphcm SHe is the .. ~2b~, .~.. ~.. I ......................... (Contractor, agent, corporate officer, etc ) of said owner or owners, and m duly authorized to perform or have performed the said work and to make and file tb application, that all statements contained m thru apphcat~on are true to the best of his knowledge and behef, and that tl work will be performed m the manner set forth in the apphcatlon filed therewith. Sworn to before me this ..... .7--.2-..t~ . day of .~?.~o~.'T7 ...... 19<~..~-~ Notary Public, . .... ~"~...F=~ ~..~'- County ............. ........ (S~gnature of apphcar _1 ~3 0 ', //~ ,/ ,! ~Tb,TEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DIS~)SAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO DEPT OF HEALTH SERVICES (si , , APPLICANT SUFFOLK COUNTY DEPT OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY DATE .............. H S REF NO APPROVED ......... suFFOLK CO TAX MAP DESIGNATION DIST SECT BLOCK PCL OWNERS ADDRESS [,e ~,Oy 582 DEED L ~ .... -~'~ibL,~' "i' I T~FSOIL -LOA~ 5AI~ r-. Y LO~,~, STAMP LICEN~D LAND ~RVEYOR~ GREE~RT NEW _BILEAK. FAST T 2-4 YO I OCCUPANCY OR'' I 'r USE IS UNLAW, FUL ,, ,.' :WITHOUT CERTIFICATE' OF OCCUPANCY' ER usED iN'WATER sOLD : '""~TEM CANNOT _e:UPpLy ,~r= - ,='-LEAD. ~cEED 2/fO or ~ PLUMBER CERTIFICATION ON LEAD cONTENT BEFORE CERTIFICATE OF OCCUPANCY APPROVED AS NOTED ' r NOTt~ BUILDING OEPARTM~T 765-1~2 9 AM TO ~ 'PM ~R THE FOLLOWING IN~PEC~ONS: FOR ~UR~D CONCRETE ~ ROUGH 'FRAMING & PLUMBING 3. INSULAFIO~I ~, FINAL CON.RUCTION MUST BE COMPLETE EOR C.O ALL CONSTRUC~ON ~L THE REQUI~MENTS ~ ~E N,Y ~AT~ CONSTRU~ON & ~ER~ ~D~. NOT ~S~NS~LE ~IGN Oa C~;~NS~U~ON ~RO~S, ,I . .. ... ,. . . .,.,~:~..,.. ¥, - ' "' ' ' I'gLL, ~ '?'~ ~ ~ ',. · ' ,, . tZX~¢~ ~ " ' " " - 'x~ ," [ ' " t' ,,-' , "" ' ' " ! ~ ,' - , . t . , . ¢o . , , , . : , . ' I , k~ FL . ,. ~ 5 ECO D OC)~ PL.4L[. o ~U:, ? ' " , ~,r4V o