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Home My WebLink About15225-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..~. 15527 December 22 Date ................................ ! 9 86 THIS CERTIFIES that the budd[ng AC CE S SORY . .. ....... . . Location of Property 3780 ORCHARD STREET ORIENT ....... Street Hamlet County Tax Map No. 1000 Section 027. .Block 3 .Lot 3.5 Subdivision..B}.A.U..J .05.A.I' S...A.C.R.E..S . Filed Map No.. 6373 Lot No .5 conforms substantmlly to the Applicahon for Building Permit heretofore tided in this office dated Sep. t. 3 86 15225.z 19... pursuant to which Building Permit No. dated s.efi, t. :..3 ..................... 19.8..6, was issued, and conforms to ail of the requirements of the applicable provmzons of the law. The occupancy for which this cemficate is issued is ......... Accessory garage. The ccrt]ficate is issucd to RICHARD G. DE VOE (owner, Yt~R~q['XeX~P~R of the aforesaid building. Suffolk County Department of Health Approval ...... N / A N/A UNDERWRITERS CERTIFICATE NO .................................................. Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERA~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15225 Z Perm,ssron ,$ hereby ~ ........... ...~?..,~...o...,..~R~... ~ ........ at premise, located at ...~...~?..'~..~. ...... ~.~.. ~..~..~~ .......... to opphcot,on dated . ....c~..~~~ ~ ~ .., 19.~(e, ond opproved by the pursuont Budding Inspector. Building Inspector Rev 6/30/80 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 typewmter OR ink, and submitted m~ 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 lines, streets, and unusual natural or topographic featu res. 2. Final approval of Health Dept. of water supply and sewerage dmposal-(S-9 form or equal). 3. Approval of electrmal ~nstallatlon from Board of Fire Underwriters. 4. Commercml buddmgs, Industrml buddmgs, Multiple Residences and similar buddings and installa- tions, a certificate of Code comphance from the Archttect or Engineer responsible for the buildmg. 5. Submit Planmng Board approval of completed site plan requirements where applicable. B. For existing buddings (prior to April 1957), Non-conforming uses, or buddmgs and "pre-exist~ng" land uses. 1. Accurate survey of property showing all property hnes, streets, buddmgs and unusual natural or topographm featu res. 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 buildings or premmes, or other pertinent mforma- t~on required to prepare a cert~fmate. C. Fees' 1. Certificate of occupancy $5.00 2. Certificate of occupancv on pre-existmg dwelling $15.0 0 3. Copy of certificate of occupancy $1 00 5.Updated C.O. $15.00 Date ..,.. ............ NewC°nstruct~°n..~ OIdorPre-exlstmg Building ~ ......... Vacant Land ............. Location of Property.¢.?~) .................. ~ ~ .~ .............. ~<~ Hou~ ~o, ~treet Ham/et Owner or Owners of Prope~y .................................................... Coun~Tax Map No. 1000Sect,on . .Q~ ...... Block...~ .......... kot.~..~.~ Health Dept Approval ~ App ................... Labor Dept. royal ...................... Unde~mters Approval ............... Plannmg Board Approval ..................... Request for Tempora~ Certificate .............. Final Certificate ~ ................ Fee Submitted $..~ O~ ConstrucVon on above descmbed buddmg ant] pe_rm~t~meets all apyble codes and regulations. Apphcant /~..~...¥. ....................... FIELD INSFECTION FOU~NDAT!ON (1st) COMMENTS FOUNDATION 2. (2nd) ROUGH FRAME & ?LUMBING INSULATION FERN. STATE ENERGY CODE Ym ADDITIONAL COMMENTS: 7GS-'~802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL,BG. [ ] FOUNDATION ZND [ ] INSULATION [ ] FRAMING REMARKS: [ ] FINAL DATIr INSPECTOR PAGE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ! 85 JOHN STREET. NEW YORK, NEW YORK 10038 JANUARY 26,1988 52623488/88 It 000893 ~te ~pplication ~o. on ~le THIS CE~IFIES THAT ~y t~ ~t~ ~ment M ~d~ ~ ~ int~ by t~ ~t ~M ~ ~ ~tM num~ M t~ ~mM of RICHARD DE VOE, 3780 ORCIIARD ST., ORIENT, N.Y. ~ ex*min~ ~ ondfound to be in core.lance with the r~ulrements of th~ ~rd. SWIT~ES RXTUKES RANGES OVENS DISH WASHIIIS EXHAUST FANS FURNACE MOTORS RJTW SIRVICl S E R I RICMARD DE VOE 3780 ORCHARD ST. ORIENT, NY. [1957 certificate must not be ahered in any manner; return to the office of the Board if P,r be identified the~' credentials. Disapproved a/c FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, NY 11971 TEL. 765-1802 (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19. o . Date ............ 19 INSTRUCTIONS a Tills application must be completely filled m by typewriter or mmk and submitted to the Building Inspector, w~th 3 sets of plans, accurate plot plan to scale Fee according to schedule b. Plot plan showing location of lot and of buildings on premises, relahonsh~p to ad.lomlng premises or pubhc streets or areas, and giving a detmled descnphon of layout of property must be drawn on the diagram which ~s part of this applt- canon. e. The work covered by this apphcatlon may not be commenced before ~ssuance of Building Permit d. Upon approval of this apphcatmn, the Building Inspector w~I1 tssued a Building Penmt to the apphcant. Such permit shall be kept on the premises available for inspection throughout the work· e. No buildmg shall be occupied or used ~n whole or ~n part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Bmldlng Inspector. APPLICATION IS HEREBY MADE to the Bmldmg Department for the issuance of a Bmldmg Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk Cotmty, New York, and other applicable Laws, Ordinances or Regulahons, for the constructmn of buddings, add~taons or alteratmns, or for removal or demohtaon, as hereto described. The apphcant agrees to comply w~th all apphcable laws, ordinances, bmldmg code, housing code, and regulataons, and to admit authorized inspectors on premises and m bmlding for necessary msp~tlpn~..~_..~, (Signature of apphcant, or name, ff a corporatmn) g. ......... (Malhng address of applicant) State whether apphcant ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · ......................... Name of owner of premises . (as on the tax roil or latest deed) If apphcant m a corporation, s~gnature of duly authorized officer (Name and title of corporate officer) Builder's L~cense No. Plumber's Lmense No Electrician's L~cense No Other Trade's L~cense No ... Location of land on which proposed work will be done .... House Number Street County Tax Map No 1000 Section Oc~'7 (Name) Hamlet loek.. 3. .... t. ot.. 3,.._7- ...... Flied Map No ~. ~ ?3. .... Lot... State ex~st~ng use and occupancy of premmes and intended use and occupancy of proposed construcnon a Ex~sUnguseandoccupancy ONE [2'-t~ ILX/.. ~.WFI,,I,/.,~..~- ....... b Intended use and occupancy ~/~ ~ F_- ................... 3. Nature of work (check which applicable) New Budding .. ~ Add,lion .. A/teration . .. Repmr .. Removal ....... Demolition ......... Other Work.. ee~ (Description) 4 Estimated Cost .~,.,,,~,j.'4. Clht~ .~. ................. F ,7'Q'~./'.. ~ ....... (to be prod on filing this appl,catlon) 5. If dwelI,ng, number of dwelling units ......... Number of dwelling units on each floor ........ If garage, number o f cars .. {30.~.. ...................................... 6. If business, commercial or mixed occupancy, specify natu, re and extent of each type of use .............. 7. Dimensions of existing structures, if any Front .... ~' .... Rear .~g ....... Depth ~1(/ ...... Height .,2~ '. ..... Number of Stones . .~. ~2 Dnmensions of same structure with alteratlons or addltions Fro~i '' ir2.~.~.'ii.ii'ii'l{;jr".~;.."i'iil, i Depth 2~j .......... Height ........ Number pf Stones. .~. ............... 8. Dimensions of entire new construction Front /G' . . . Rear .../.&. ....... Depth .. oq.~.' . .... Height . . .lT. ...... ~_ . Number of Stones ....~. ,. .... , ................. ; .......... 9. Size of lot Front .. !o~(~. ~ ~.O. ....... Rear. ~, .~..5- ....... Depth . ~../.~ .... ,- ....... 10. Date of Purchase .[I/.gS'. ........ Name of Former Owner .C..//dgq~rj~'~0/o£ ........ 11 Zone or use district in which premises are situated ...................................... 12 Does proposed constructlqn violate any zoning law, ordinance or regulation .Al/2 ........................ 13. WflI lot be regraded AIO Will excess fill be removed from premmes Yes ~ 14 Name of Owner of pren~l}~S' ' ~l~-~ ~[i~. ~)~. (/~-~' i i Address . .~780. O.P~ta~.5~ Phone No. /~r~~. ~. Name of Architect .. B.~.t4.q.r. .......... Address ............... Phone No ............. Name of Contractor ....S.a.t'l.[. ............. Address .............. Phone No ........... 15. Is this property located withzn 300 feet of a tidal wetland? *Yes ..... No ..~.. *If yes~ Southold Town Trustees Permit maybe required. PLO*F DIAGRAM Locate clearly and distinctly all buddings, whether existing or proposed, and indicate all set-back dtmenslons fron property hnes Give street and block number or description according to deed, and show street names and indicate whethe interior or coruer lot. STATE OF NEW YORK, S S COUNTY OF ....... · ~JO t'l/~.~P0 hie¢- ............ being duly sworn, deposes and says that he is the apphcan (Name of lnd~vidual signing contract) above named. He is the .(~¢~.g~ ~t, llD ~.~7.~b~... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file th/ application, that ail statements contained m this apphcatmn are true to the best of his knowledge and belief, and that th work wdI be performed in the manner set forth m the application filed therewith. Sworn to before me this .... ~. /t~.. ~ dayof . ~ ....... 19.J7.~. Notary Public, ........... ~ ~.-..~. . County (Signature of apphcan