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Home My WebLink About15294-zFORM NO. 4 TOWN OF SOUTNOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall 5outhold, N Y, Certificate Of Occupancy No E-]6078 Date ~ug~$.t..!?., !?~? ...... ONE FAMILY DWELLING WITH ATTACHED THIS CERTIFIES that the building ~A'R'A~I~' & WOO'D' 15gC'R5 ' ' : .......... Lo .... 895 Greenfield Lane Southold, New York cauon oi rroper[y .................................... House No Street Hamlet County Tax Map No. 1000 Section 0 6 3 .Block 0 ] .Lot 3 I Sub&vision ............... Filed Map No ........ Lot No .......... conforms substantmlly to the Apphcatton for Building Permit heretofore filed in this office dated September 9, 1986 pursuant to wbach Bmldmg Permit No. 15294 z dated S.e. ptemb, e.r .2. I ,. 1986 wasissued, and conformsto all of the requirements of the applicable provlmozls of the law The occupancy for wtuch fins certificate is issued is ...... ONE FAMILY DWELLING The certificate is issued to of the aforesaid building. Suffolk County Department of Health Approval 86 - S O- I 58 UNDERWRITERS CERTIFICATE NO . . N826486 WITH ATTACHED GARAGE & WOOD DECK AS APPLIED FOR CHARLES & DOROTHY LAUER ...... X ......... PLUMBERS CERTIFICATION DATED: July 6, 1987 Building Inspector I~OF,,M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDIHG PEI~,~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15294 Z Perrmss~on m ~...~ hereby gronted to _3.e..~.....~. ~.~..~ ............................ ...~....~....~...~.,. j..,..~.~.~ .. 'd ot prem,ses located at ..~.~.~......~..~l ..... ~.'~.....~ ........ County Tax Map No 1000 Sect,on pursuont to opphcotlon dated . Building Inspector. Fee $. ~ '../... Building Inspector Rev 6/30/80 FORM NO 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- I802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions Thru application must be filled in typewriter OR ink, and submitted m~ to the Budding Inspec- tor w~th the following; for new buddings or new use- 1. Final survey of property w~th accurate location of all buddings, property hnes, streets, and unusual natural or topograph lc featu res. 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 F~re Underwmters. 4. Commercial buddings, Industrml buddings, Multiple Remdences 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 p~Operty showing all property hnes, streets, buddings and unusual natural or topographtc 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. Addit ~ons $25.00 1. Cer~lficate of occupancy New Dwelling $25.00, Accessory ~$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelhng $ 5 0.0 0 3. Copy of cert~flcate of occupancy $ 5.O0, over 5 years $10.Q/O / 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .... j~. ¥./¥./.-- /o ........... NewConstructIon .... Old orPre-ex~stmgBudd~n§ ...~ ........ Vacant Land .. ... ........ Location of Property/$o.L ~N,o.~....~.. ...... ~.~.. ~..~..~....._~,,I.S~.rree/~?.~...Z(~, ,F'I,,~ ...... OwnerorOwnersofProperty..~_~./r~..~...~.0./~.. ~ T' ~.~r~..: ......... County Tax Mag No. 1000 Sect,on .... O/__m ~.~ .... Block .. ~ J. ........ Lot...~,/. .......... Subdlv,s,or~./?¢:~7 ,~..~ ./J ~..~J...~.~/-)~2/~1~ Flied Map No ........ Lot No.. ~...O .... Perm,t N o ~"~. ~.¢Z Date/ /.~ '°f .Perm~..' .~,~..Applicant...~-~,..~..~' ,~. ('. ~--/.,. Z (~'../-~Cfl:~.'.,. Health Dept Approval.' '/--"~'/~' '/~7'- .... Labor Dept. Approval ...................... Underwriters Approval .................. Planmng Board Approval ...................... Request for Temporary Certificate ................. Final Certificate ................... Fee Submitted $ .................... Construction on above described buddmg and/~m~t meets all apphca~s ar~ ulat~ons Rev 10-10 78 c0% FIELD T~NSi~ESTION ~DATE COMMENTS FOUNDATION -- //~ ~F FOUNDATION ~) /~ >Z~ ~/~ ~'~(~ ~ ... ~ ~.~ ~ : ~-~~ FLUMBING INSULATION ~ER N. Y. STATE ENERGY CODE 2. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber's signatu~ Sworn to before m~e thzs x9 C~ Notary Public, ~/~/~ County // Notary Public THE NEW YORK BOARD OF FIRE UNDERWRITERS 1001071 BUREAU OF ELECTRICITY k~- 8.5 JOHN STREET, NEW YORK NEW YORK I0038 ..,. .~ugus'r. 12,1987 ~,,,,,,,,-.,,,,.,',,,,,,,;,,.~.60sgs/87 N 826486 THIS OERTIFIES THAT =xt.~ ~ ) RXTU~ES RANGES C~K NG DECKS~VENS m~SH WASHERS ~EXHAUST FANS Smoke Detector-1 G & S Elec. Box 215 Southold, N.Y., 11971 lic.~578-E 11 This cerr, f~cate must not be aJtered ,n any manner, return to the off,ce of the ~oard ,( ,ncorrect Inspectors may be ,denhfmd by thesr credenhals. TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P,O. BOX 728 TOWN HALL SOUTHOLD, N.Y 11971 CERTIFICATE OF OCCUPANCY Date ..... ~%U$1;. ~l,.. ,19.8~.. This CERTIFIES that the Lot ......... ~ ............................. Location of Property 895 .G~¢D~ .$~D~-~h SO~hOl~..~.~ ...... House # Street Hamlet County Tax Map #, Section ..... ~$ ....... Block ..... ~ .......... Lot .... 3~ ...... Subdivision ............................ Fzled Map # .......... Lot # ........... conforms substantially to the applicable provisions of the Zoning Code of the Town of Southold. The premises are located in the A-Residential Aqricultural zoned District and may be used for such uses as are presently authorized by the Zonzng Code in such district subject to, however, all of the requirements of the Zoning Code. The certificate is issued to Jera~.~ ~-~ ;~v. an~an . (owner, x~4~ R R xg~fx ~ i Rr~sR~ ~ of the aforesaid lot. . . . ............. Building Inspector Rev 1/85 A FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions Thru apphcatlon must be fille~d in typewriter OR ~nk, and submitted m m.--~--, to the Budding Inspec- tor w~th the following; for new buddings or new use: 1. Fina~ survey of property with accurate location of all buddings, 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 electrical installation from Board of F~re Underwmters. 4. Commercial buddings, Industmal buddings, Multiple Remdences and s~'nilar buddings and installa- tions, a cert,flcate of Code comphance from the Architect or Engineer responsible for the budding. 5. Submit Planning Board approval of completed site plan requirements where apphcable. B. For exmtmg buddings (prior to April 1957), Non-conforming uses, or buildings and "pre-exist~ng" land uses' 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographm features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buddings. 3. Date of any housing coda or safety inspection of buddings or premises, or other pertinent mforma- t~on required to prepare a cert~fmate. C. Fees' 1 Certd~cate of occupancy $5.00 2. Certificate of occupancy on pre-exmtmg dwelling $15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 Date New Budding ............ Old or Pre-exmtmg Budding .......... Vacant Land . ~ .... too p ty . ~.~..~. .......... ~.~, ......... '~ ~'~(~ .¢~. ..... {~.' ........... House No. %j~e ~*'¢~ I , Street Ham/et Owner or Owners of Property .r~v'' . O (..).~/y-~/.(~..~. ................................. County Tax Map No. 1000 Section ~_..~.LS.../f//..O[~lock ............. Lot ............... Subd,v,s,o~(?.~*/4 ~Y~.~4,[~/ F,,edMapNo 'otNo Permit No ......... Date of Permit ........ Apphcant .............................. Health Dept Approval ................ Labor Dept. Approval ....................... Underwriters Approval ....................... Planmng Board Approval ..................... Request for Temporary Certlhcate .............. F~nal Certificate ...................... Fee Submitted $ . .~.~O ~ ............. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [,~NAL REMARKS: DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING RrMARKS: ~~/~:~,~.~ DATE INSPECTO~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~ REMARKS: ~/~~/~ ~ ''TE .~/~/~o°'/~ INSPECTOR _'~6~ ,~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION ZST [ ] ROUGH PLBG. FOUNDATION ZND [ ~ IN~~SULATION FRAMING [ ] FINAL DATE ,. 0 INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [] ROUGH PLBG. [~FOUNDATION ZND []INSULATION FRAMING []FINAL DATE INSPECT~ 7GS-'f 802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [' ]/ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [~FRAMING [ ] FINAL 7GS. XS02 BUILDING DEPT. INSPECTION [~~UNDATION XST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ] FINAL / DATE .~_~~ INSPECT~ 7GS-180~ BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING [ ] FINAL b_i I III. Ill IJl I II II . SUFF{ THE WA' SYSTEM.~ CONFOR SUFFOL~ SERVI( CONSTFtt DATE ~ H. S F, EF APPROVE SUFFO DIST i ' 'OWN£~5 DEED. ~ I Examlned~ ,~.r.~ '~' ~ Approved c2~-~ . Disapproved a/c £;~V~£/~¥~#i~0~ORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y 11971 TEL , 765-1803 , (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... ,19. Date .¢~/~ . , 19°. a. This application must be completely filled m by typewriter or m ink and submitted to the Budding Inspector, wit 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 public sty or areas, and giving a detmled descnphon of layout of property must be drawn on the diagram which is part of this ap cation. c. The work covered by fins application may not be commenced before issuance of Bufldmg Permit d Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant Such per shall be kept on the premises available for mspechon throughout the work e. No budding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupa shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Bmldtng Department for the issuance of a Building Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance Regulahons, for the eonstruchon of buddings, additions or alterations, or for removal or demolition, as hereto descnl The apphcant agrees to comply with all applicable laws, ordinances, budding code, housmg,-qode,,23nd regulations, am admit authorized inspectors on premises and m budding for necessary/~lctlons .... (Signature of applicant, or name, if a corporation) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or buff, Nameofownerofpremlses 4.f.2,~zt'lj,'- (~¢J~r'l/~.~{. ~ ~ ~r ..... (as on the tax roll or latest deed) If applicant Is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builder's License No Plumber's License No Electnman's License No Other Trade's License No Location of land on which proposed work wflI be done House Number Street County Tax Map No 1000 Section (~,Z~ Block / Subd,v,s]on ' e/d ~~OI~. F,led Map No (Name) Hamlet · Lot Lot ~' 0 2 State existing use and occupancy of premises and intended use and occupancy of proposed construction a Existing use and occupancy ........... b Intended use and occupancy '---/~ t"m;t ~'J/t~fl2 7/~/~ ~r4 ............... 3 Nature of work (check which applicable) New Budding w-- Addition ....... Alteration ....... Repmr ...... Removal ........ Demolition ........ Other Work .......... (Description) 4 Estimated Cost ~. · t ¢'~-- -: · .t~.6j ~ .... Fee ...................... (to be paid on filmy this application) 5. If dwelling, number of dwethng 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 . '-~ ............ 7. Dnmenmons of existing structures, if any: Front .... Rear ......... Depth ........ Height ..... Number of Stones .......................... Dunenmons of same structure with alterations or additions Front .......... Rear ........ Depth ........ Height ..... ,... Number of Slones ..... 8. D~menmons ofentlre new construction Front ~.~? Q.~- .'~.~) Rear . ~' .B.J..(~.~.~j] Depth . .7~ .~ '1~ ','t' ' · Height ./..& ' .... Number of Stones . .. oLq ~ ................................. 9 Slzeoflot Front.. ¢'.~..~',12 .... Rear..?:/9,(~ ......... Depth .l"~,~..~...I.(*.w.~T~ .. 10 Date o f Purchase ........... Ne,me o f Eormer Owner -J~ ~.~.Ct-.. 9t7.* ~ t ~z ~ ..... 11 Zone or use district in which premises are intuited. ,~e~, 0/~. ~. [ ..... / ................... 12. Does propose~d construc.tlpn violate any zoning law, ordinance or regulation. /}tO ...................... 13. Wall lot be regraded Dtc~ ...... ~ ....... Wfli excess f'fll be r~mo¥~l~f, ro~n premises' Yes 14. Name of Owner ofpremlsesQ.~C*.a~'/~. ]~, /,x~.~.~ Addres~...>~¢a ~.-~..~..~.-Phone No. ~'{~ [,c~o~. ~.. Name of Architect ........ Address ........ Phone No.. Name of Contractor . ...~...c~q.~- .......... Address ............... Phone No ......... 15. Is thzs property located withinl00 feet of a t~dal wetland? * Yes ..... No · If yes, Southold Town Trustees Perrazt may be required. PLOT DIAGRAM Locate clearly and distinctly all buddings, whether exlstmg or proposed, and. indicate all set-back dnnenmons from property lines Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. TATE OF NEW~Y'ORK, o o (Name of lndlvldual mgmng 6ontract) hove named. being duly sworn, deposes and says that he is the applicant is the ......... ~.' ............................................... (Contractor, agent, corporate officer, etc ) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file ttus ~phcatmn, tlxat all statements contained m this apphcation are true to the best of h~s knowledge and behef, and that the ork will be performed in the manner set forth m the application filed therewith. ~orn to before me this ....... dayof. ~ I~lfll~, ~ ~ ~t ~ ~ (Signature of applicant) · ~ ~i~ ~31,tm ~ SUFFOLK CO. HEALTH DEPT. APPROVAL H.S NO. 86'~0'i58 DEPARTMENT. T) IE WATER SU~Y A~ SEWAGE DI~AL THE S~AGE ~S~SAL AND W. ~ .":.';". Y F~CILITIES FOF TH ~ ~E~ FOR THIS RBIDIEE WILL L~ATION HAVE SEEN INSPE~ ~t'ir;~S DEPARTMENT Ah ~UND TO BE SATISFAC~RY./~ ~O THE ~ t ) , ~FF~K COUNTY ~PT. OF HEALTH ~ ~ ~ SERVICES - FOR APPROVAL OF '-; / CONSTR~T ~N ONLY A~OVED: - ~: L. P. LICENSED LA~ SUR~S GREE~RT NEW Y~K S4,1FFO4..K CO. HEALTH D~P'I'. ~OVAI H.S. NO. ~ / ~ ROv AL ..... ~4AP OF P~OPE'~TY z ~NT~J~ ~EFE~ m ~ SEA LEVEl_. ...... SUFFOLK CO. HEALTH D~J~r. Ar'"~;OVAL H.S. NO. : ~ ,. ,, - ' ~FF~K CO~TY ~. ~ ~ALTH o CON1DU[~5 rZE'Fi:~ TO ~gA.M SEA LE~'EL. GUA~Ah, ?fS~:D TO LIC~AND $URVEY~S GREE~RT NEW YORK AT 9.AM TO"4 PM FOR THE 3.r,INSULATI01'~ AL coNSTRUCTiON MusT" ALL CUm= - oFTHE N,Y II SOLOE~ US~O SUPPLY SYSTEM CANNOt ~gl~D one 47 ~)400 ~ M~i~,l~ad r Phone 477 '~ '~n Road ~ G REENPORT~,N.Y~ 11~ ' Main Road