Loading...
HomeMy WebLinkAbout15236-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. zl5548 Date March 31, 1987 THIS CERTIFIES that the building ..... Ac. c..e.s.s.q r. y ................................ Location 1600 BAYSHORE ROAD GREENPORT of Property ............................................................... House No. Street Hamlet County Tax Map No. 1000 Section 53 . .Block 04 .Lot 31 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore f'fled in this office dated ..... .A.u.g ....I .9 .... ! .9.8.6.. pursuant to which Building Permit No...1.5. 2. .3.6.Z. ............ dated ...S.e. ? .t.... 5. .,..1.9. 8..6 .......... 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 ......... ..... .&c.?..~.~.o.r y...b3.~. ~..a 3.~.~: .................................................... PAUL M. & MAUREEN CLANCY The certificate is issued to ..................... /o~,n'e'r,'~'I~tt~'y~Y;) ...................... of the aforesaid building. Suffolk County Department of Health Approval ........... N./..A ............................ UNDERWRITERS CERTIFICATE NO .................. N./..A ............... PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 FO~t~g NO. It 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) 15236 Z Permission ts hereby granted to' ...... .J...~.~.....~....~..~ ..... ~ ............. · ..~~....~........~.:..V.., ..... u...~,..~: .... _, ot premises located c~, .. ~...LP. .......... [..~. ' ..... ~ .~-~.....~... ........ .~...~~ ..... pursuc~n, ,o opphc~mtlon doted k~4~,,,~v ../ ~, .. Building Insp~tor , 19<~. ~, and approved by the Fee $~.° .'/-~... Building Inspector Rev &/30/80 FORM NO. 6 TOWN OF SOUTHOLD BuildingTown Department Hall Southold,765-N'Y'180211971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A Thru application must be filled ~n typewriter OR ~nk, and submitted m mmmmmm to the Building Inspec- tor w~th the following; for new buildmgs or new use: 1. Final survey of property with accurate location of all buildmgs, property lines, streets, and unusual natural or topographm features, 2. Final approval of Health Dept of water supply and sewerage dmposal-(S-9 form or equal). 3, Approval of electrical installation from Board of F~re Underwmters. 4 Commercial buildings, Industrial buddmgs, Multiple Remdences and similar buildmgs and installa- tions, a certificate of Code comphance from the Architect or Engmeer responsible for the building. 5. Submit Planning Board approval of completed rote plan requirements where applicable, For existing buildings (prior to April 1957}, Non-conformmg uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~Coperty showing all property lines, streets, buildmgs and unusual natural or topographic features. 2. Sworn statement of owner or prewous owner as to use, occupancy and condition of buildmgs. 3. Date of any housmg code or safety mspection of buildings or premises, or other pertinent informa- tion required to prepare a certif~cate. Fees: 1. Certlflcate of occupancy New Dwelling $25.00, Accessory,SI0.00 Business $50.00 2. Cert~fmate of-occupancy on pre-existmg dwelhng $ 50.00 5.Updated C.O. $ 50.00 Date .... NewConstructzon ...... Old or Pre-exmtmg Building .... Vacant Land ............ Location of Property.. ?,, ,~,~?~.'?,~.. ,~, · .~, ?.'~.. ~ ............ ~~~' Owner or Owners of Prope~ ...... C... --.;..~~.. .~ ........ County Tax Map No. 1000 Section ............... Block .............. Lot ................ Subd~wmon ............................. Fded Map No .......... Lot No ............. Permit No./.,~,~...~.?,. Date of Permit .~/,~.JE{~..Appllcant .~.j...,Z.;. Health Dept Approval ..................... Labor Dept. Approval ....................... Underwriters Approval Plannmg Board Approval Request for Temporary Certificate ................... Final Certificate ....................... Fee Submitted $ .... ,/¢¥?, . .'~,. .............. Construction on above described bulldmg and p~ble codes and regulations. Applicant . . .(,.~,;/ . . ..z,~.~.,. ................ FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & FLUMBING INSULATION FERN. Y STATE ENERGY CODE FINAL ~DDITIO~AL COMMENTS: TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P,O, BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 To Whom ~hls May Concern, We are unable to complete your Certificate of Occupancy because of the following reasons. )An application for Certificate of Occupancy is not on file. )No Underwriters Certificate on file. /~The check is (*a~h~=~/not on file.) )No Health Department Approval on file. )No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit # .~ ~ ~, ~ ~ Z )No Plumber Solder Certificate on file. (all permits involving plumbing being issued after April 1, 1984) L APPROVED AS NOTED .'..,.;d?ANCY OR L~SE iS UNLAWFUL ~ ,~.,,,..o., "..~ OCCUPANCY ~ .O(~S~ ~UC r~ON S~LL m[,/, ~f~ OH CC ~STEU~ON ERRORS. TE Guaranteed to Southold Sawng$ Bank Securdy Dtle & Guaranty Ca Paul8 Maurean Clancy PA T T SECCAFICO PROFESSIONAl rAND SURVEYOR 109 tOOP DRIVE SAYVILLE, NY 11782 (51G)567-4775 NY~ l-lC NO 049287 D,~TE 1/22/88 SCALE 1"--20 Approved Disapproved a/c FORM NO 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL EOUTHOLD, N.Y. 11971 TEL.. 765-1803 , 19~G Permit No (Bulldzng Inspector) APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a This application must be completely filled m by typewriter or in ink and submztted to the Building Inspector, w~tl sets of plans, accurate plot plan to scale. Fee according to schedule· b. Plot plan showing location of lot and of bmldmgs on premises, relationship to adjoining premises or pubhc sim. or areas, and giving a detmled description of layout of property must be drawn on the diagram which is part of this cation. c The work covered by tins apphcatzon may not be commenced before zssuance of Budding Permit. d Upon approval of this application, the Building Inspector will issued a Budding Permit to the apphcant Such perr shall be kept on the premises available for mspectlon throughout the work e. No buildmg shall be occupied or used m whole or in part for any purpose whatever until a Certificate of Occupan shall have been granted by the Budding Inspector APPLICATION IS HEREBY MADE to the Bufldmg Department for the issuance of a Bmldmg Permit pursuant to Bmldmg Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buddings, additions or alterations, or for removal or demolition, as hereto descnb, The apphcant agrees to comply with all applicable laws, ordinances, buildmg code, housing code, and regulations, and admat authorized inspectors on premzses and m bmldmg for necessary~ ~ ~ ,,."-' ~' -(b'tk, r~ture of applicant, or name, ~f ~c~ ' ,,*,,.- ,,o'.z>. . .... ......................... State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or build, Same of owner of prem,ses P~" /~/, ~.. ~q'~ ./~' ~,~----~1/. (as on the tax roll or latest deed) If apphcant ~s a corporation, signature of duly authorized officer (Name and title of corporate officer) Builder's License No Plumber's L~cense No Electnman's License No .. Other Trade's License No. Locanon of land on which proposed work will be done House Number Street County Tax Map No 1000 Section Hamlet Block.. ~/... Lot. 2 Subdlvis~on ..... Filed Map No ... Lot (Name) State ex~shng use and occupancy of premises and intended use and occupancy of proposed construction a Existing use and occupancy ~.~'..~/~T/~/. ~t~-~V.~. .......... b Intended use and occupancy 3. Nature of work (check which applicable) New Budding .... Addition . .. Alteratio~ . . . Repmr ... Removal .... Demolition . .. Other Work . ~ o (Description) 4, Estimated Cost ~ ~9~ ' ~/) Fee ~e ~6...~, g~' ~/ (to be paid on filing this application) 5, If dwelling, number of dwelhng umts Number of dwelhng umts on each floor ........ If garage number of cars --- 6 If business, commerclalormlxedoccupancy, specffy na~ure and extent of each.type of use .. . 7 Dimensions of exlstmg structures, if any. Front. ~' ~. . . Rear ~.~'. ~..... Depth . . Height ~ ~ ..... Number of Stones. / .................................. Dnnenslons of same structure with alterations or additions Front .......... Rear ........... Depth ........ Height .... Number of Stones ....... 8. Dlmenslonso£e, ntlrenewconstructlon'Front /~'~ .. Rear /.{'..~ ..... Depth Height .~'O . . Number of Stones / 9. Sizeoflot. Fr;nt' ...~.,~,O .~,~. Rear.. ~.,~.' 'i.' i'ii 10 Date of Purchase .~. '7..( ~.- ~..~. . . .~ame o~f. FormerD!vnei . .~.., 4~..~',~r~ ...... 11 Zone or use dlstnct in which premises are situated.. ~ .~ .~$..'~..g~/~/.~'. ....................... 12. Does proposed construction violate any zoning law, ordinance or regulation 13. Will lot be regraded ..... ~b~ .~.,. - ..... Will excess fill be removed from premises: Yes No 14 NameofOwnerofpremlses/~./.~. g"~. "~.... Address .~./~..~ ........ Phone No. .~?>. Name of Architect ~' Address . Phone No. Name of Contractor .. . .'7. ........ Address .......... Phone No ....... *Yes ..... No ~'. 15. Is thzs property located wzthinl00 feet of a tidal wetland? * If yes, Southold Town Trustees Permit may be required. PlOT DIAGRAM Locate clearly and distinctly all bufldmgs, whether existing or proposed, and. indicate all set-back dnnenslons from property hnes. Give street and block number or descnptlon according to deed, and show street names and mdicate whether interior or comer lot. STATE OF NEW YORK, S.S COUNTY OF ........ (Name of individual signmg contract) above named being duly sworn, deposes and says that he is the applicant He is the ....... (Contractor, agent, corporate officer, etc.) ~ owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application, that all statements contamed m this application are true to the best of his knowledge and behef; and that the work wdl be performed in the manner set forth m the application filed therewith. Sworn to before me this ......... / 7 .... day of....~----~.. Notary Pubhc, .~..~- ~a<..~ . County(~~..