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Home My WebLink About15532-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall $outhold, N.Y. Certificate Of Occupancy No. Z 16660 Date February 19, 1988 THIS CERTIFIES that the building A 1 t e r a t i o n 2055 Anchor Lane Southold Location of Property ............................................................... House No. Street Hamlet County Tax Map No. 1000 Section . . . 9.7.9. ..... Block 04 .Lot 38 Subdivision..~.a.r.b.o.r. Lights Sec. I .Filed Map No. .LotNo. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... .~ py.....2 .6.,.. ! .9 .8.6. pursuant to which Building Permit No...1.5.5. 3. .2 .z ............. dated ...N.qv.....2.8. ,...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 ......... ...... ¢.o.n,y.e.r.t..e..x.i.s,t,i..ng attached garage to living quarters on an existing one fam'i'f~'h'~i~'i'n'jf ....................................... The certificate isissued to MICHAEL & ANNE HALL ..................... .................... of the aforesaid building. Suffolk County Department of Health Approval Iq/A UNDERWRITERS CERTIFICATE NO. bi003049 PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 FOF,~ NO. ~1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT fi'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 15532' Z Permission is hereby granted to: ......~~..~..:....~.~ .................... .~_~ ~.....~.:..'/.,......LL~ ~..~ ........... o, pre~,,s ,~o,ed at ~.~....~~...~" ......................................................... County Tax Map No. 1000 Section ...... ,.~....~...~. ...... Block ..... ..~.....~. ........ Lot No.....~....~ .............. pursuant to application doted ..~.~.....~..~. ............. , 19.~..~.., and approved by the Building 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 typewriter OR ink, and submitted ~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location 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 compliance 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 property 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- tion required to prepare a certificate. C. Fees: ~-~dd~ons~$?50D~5OOLS $25.00 ALTERATION $25.00 1. Ce~tificete of occupancy New Dwelling $25.00, Accessory ~$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelHng $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 . 4.Vacant Land C.O. $ 20.00 / /~..~. 5.Updated C.O. $ 50.00 Date ..C~ J.~ ............ New C o n s t r u c t i on ~. Old or Pre-existing Building ............ Vacant Land ............. Location of Property .~ .(?.~...,~. ........ /.~-~../~..d~../~....~...L..~../~..~'~. ........... . .~..'.~..~. ?~...~..~../~... House No. Street Hamlet Owner or Owners of Property . J~. g.~. ]'~--~.~'.2¢. .... . .~...~....~.....~./~..~.(-~. .... ...~...~??. ..... County Tax Map No. 1000 Section ..../~..? ....... Block...O..~. ........ Lot.. <.~ ~ ........ Subdivision.../-~JS~).f~....L../.G. !.~?.~....-~.. V?.7...Filed Map No.. Yd .g~-....Lot No. ~...~'~ ......... Permit No. 1~..~-3.~. .7..... Date of Permit .......... Applicant . ./~../.C./..f-~z/~...'~.'~..~.~v. ........... Health Dept. Approva{ ..../~.l..f~. ~ ........ ~. .... Labor Dept. Approva, ..~./.'~ .................. ~-- Final Certificate Request for Temporary Certificate ............................................ Fee Submitted $..~..~.:g. ~ .................... Construction on above described building and~..~)~ _permit meets a~le codes and regulations. Rev, THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY BS JOHN STREET, NEW YORK, NEW YORK 10038 ,:~UARY 25,1988 ~dppl~tionA/o.o. fil,, 5253838?/8"/ N 0030a. 9 PAG~ 1 THiS CERTIFIES ~HAT 14IC~A~L HALL~ 2055 ~NC~OR bANE, SOUTNOLD~ W exmm~n~ on dANUARY 0 ~, 1 ~8 8 ~nd~ound to be ~n compl;anee u, lth ~he requ;~me.t~ o~ t~ ~rd. RX'I~J~E I RXTURES IL&NGE$ COOiCINO DECKS OVENS MSH WASHERS F3(HAUST FAJ~IS OUTLETS rBlCE~TA~$ OUNDATION (1st) OUNDATION ( 2nd ) OUGH FRAME & ?LUMBING ~NSULATION PER N. STATE ENERGY CODE FINA/ ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: [ ] FINAL INSPECTOR ~~'~* [ ] FRAMING [ ] FINAL OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY Examined . .~.~.'-.~.~., 19~-~- FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL °~OUTHOLD, N.Y. 11971 TEL.: 765-180:3 Approved ~. ~'~.....~..~., 19.~.~. Permit No. 1..~'7.~."..~.~..~a. NOV 261986 'ii: G Received ........... ,19... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work, e. No building shall be occupied or used in whole or in part for any purpose whatever untied Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building 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 applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. "/ .-v f) '" t ~ikhkidr'~l~lidahk,"'"' "'*'~; hk;ne~ ki a .......... corporation) .... State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. Name of owner of premises ./f~../.~. f.7~. · ./~. ·.~. .... .~.~......./~. · .~. ~ ..................................... (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 ......... \ ............... \ Electrician's License No ........ .~\[ ',,, Other Trade's License No ......... 'k ........... 1. Location of land on which proposed work will be done .................................................. ..... .... ......... ................... House Number Street Hamlet County Tax Map No. I000 Section ..... . .~..~..C~ ...... Block .... .(~...~. ........ Lot .... ~..~. ........... Subdivision. 2~ . .~.. · . .Z-../..g.~..&.ow..~....' Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of prbmises and intended use and occupancy of proposed construction: a. Existing use and occupancy ./..~.~..k/. .... .~..~7-.._~. ............................................ b. Intended use and occupancy ~<c,,f~( i3.. Nature of work (check which applicable): New Building .......... Addition ... ....... Alteratio ........ Repair .............. Removal .............. Demolition .......... i.. Other Work ............... 4. Estimated Cost ............................... Fee ...................................... (to be p~aid on filing this application) 5. If dwelling, number of dwelling units...O ............ 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 typ~ of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear . ~ Depth Height ............... Number of Stories ............................. . ........................... Dimensions of same structure with alterations or additions: Front : Rear Depth Height Number of ~tories 8 Dimensions of entire new construction: Front Rear ' Depth Height Number of Stories 9. Size of lot: Front . ~C~: (~.O. ............... Rear G~,o..O ............... Depth .... ,/,.5~ ............. 10. Date ofPurehase . .~.-~4~... ~v .~. . .. Name of Former Owner . .:.~..6/?..~...~? .................. 11. Zone or use district in which premises are situated. 12. Does proposed constructinn violate any zoning law, ordinance or regulation: : 13. Will lot be regraded ............................ Will excess fill be removedi from premises: Yes No fp 14. Name of Owner o remises .................... Address ................ i. ·. Phone No ............ Name of Architect Address ' Phone No : Name of Contractor Address ~ Phone No ' 15. Is this property located withinli00 feet of a tidal wetland? * Yes ..... No ~.. · If yes, Southold Town Trustees PermiS~~ be required. DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and~ indicate ail set-back dimensions from property lines. Give street and block number or description according to deed, and showi street names and indicate whether interior or corner lot. STATE OF NEW YORK, ~OUNTY OF ....... S.S ....... ~//}.C.~ .... ./~JT..~.~. ............. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) ~ above named. He is the .............................................................. . ........................... (Contractor, agent, corporate officer, etc.) i yf--s~dd, owner or-reNnets, and is duly authorized to perform or have performed the said work and to make and file this ~pplication; that all statements contained in this application are true to the best of his nowledge and belief; and that 'the ~vork will be performed in the manner set forth in the application filed therewith. Sworn to before me this ........................ day of .... .. .. .... , .. ~otary Public, ................................ County N~I~IY rlls[Ic, stm ~ ~ ~ ~ff~ (Signature of applicant) T~ ~ ~h ~, ~