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Home My WebLink About14899-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z16552 Date December 31, 1987 THIS CERTIFIES that the building ...... A. cl .d.i.t.i.q .n..a.n.d.,..a. 1. t..e.r.a.t. ~ .op .............. Location of Property ..... ! 5.3.5...S.m.i.t.h...ap.a.d. .............. .e.e.c. 9.n.i.c. ............... - - House No. Street ~m/et County Tax Map No. 1000 Section .... 0.9..8 ..... Block 04 .Lot 15. I & 16. 1 , Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated M a y 1 4, 1 9 8 6 pursuant to which Building Permit No. 14 8 9 9 Z - dated .... M..a.y.. !6. .,.. 1.9. 8..8 .......... 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 ......... ,D.e, e, ,k..a,d, ,d ,i,t.i9 ,n' ,a.n,d,, ,a,l.t,e, ,r, .a.t,t, ,i ,c..f, 9 ,r. ,b.e,d, ,r p.o.m,, ,t,o..e,x. ,i,s.t.i,n, g..o,n,e,, ,f.a,m, ,i ,i ?.,, dwelling, HARRIET & MICHAEL GREENBERG The certificate is issued to ..................... [o~n'e'r, )~'~Y~R']~ ................... of the aforesaid building. Suffolk County Department of Hca]th Approval .... N../.A ............... UNDERWRITERS CERTIFICATE NO. P ~ n d in g 8 / 10 / 87 PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 ~0~v,~ NO. ~ 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) 14899 Z 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 m~ to the Building Inspec- tor with the following; for new buildin§s or new use: 1. Final survey of property with accurate location of alt 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-existir~g" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic featu r0s. 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: Additions $25.00 POOLS $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 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 .......................... NewtOns tpuc t~ on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . !~.~.5,".... ~. ~ [?.~....~.0.~.~. .................. ~[~ .............. House No. Street Nam/et Owner or Owners of Property .~.~e~ ........... ~ .... ~ .... a .............. O'l~ ,' ~ ..... County Tax Map No. 1000 Section .0 .~'~'.~ .... Block .O.~'.q.q ...... Lot. O,/~, .OO/ ..... Subdivision ................................. Filed Map No. ~%/ .Lot No. ~0. ff 3~ Permit No...~.~ ~ Date of Permit .~A ..... Applicant .... /~ ~. ~(~ ................. Health Dept. Approval ' . ..... Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ,,~. ..... FIELD I~SPECTION ~ DATE COMMENTS 1. FOUNDATION (1st) FOUNDATION (2nd) __ ROUGH FRAME & PLUMBING I 3. INSULATION PER N. Y. STATE ENERGY ADDITIONAL COMMENTS ' ' Wr' ?', 765-1802 BUILDING DEPT. INSPECTION DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [/. ]/~LATION FRAMING [/]' FINAL DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH pLBG. FOUNDATION 2ND [ ] ~I-SULATION / FRAMING [g,~ FINAL TOWN OF SOUTHOLD OFFICE OF BUILDING INsPECToR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 TO Whom This 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 (outdated/not on file.) ~ ~Cdd /5/ No Health Dept. Approval on file. /5/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. -~uilding Permit # .7' ~ ~ X ~ Z Building Dept. ***/5/ No Plumber Solder Certificate on file. all permits involving plumbing being issued after April 1,1984 ) FO~' NO. 1~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, lt. Y. BUILDING PE~'~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 15030 ~ = z/~ ,9.8[ Z Date ......... .~../-~ ~-T~ .................................. , ...... Permission is hereby granted to: ...~.~..~..G.~t.~ .................................. ...,I...4..~..~ ...... ~.~.~ ....... ~..~ .... ...~..~;~.Q.~u.c.,...~;..~ .......... ~.~..~...'~ to ........ ,,:~.~r..<~ ........... :.v..~....~..../.:.....¢Z.,.~....r-:,~.......~.~.~...:~:.....~ ....................... ........ .~..~.~. ................................. ::. ............................... i....~.~ .......................................................... n, premises located ot ....~...,~..5. S ............ .~..,~.~r~.~'..t...i....~-/~..~.. ............................................ ........................................................................................................ ,.~,/...~.(...L.~ ........................ County Tox Mop No. ,000 Section ...0....<~...~ ...... Block ..... .~...c~... ....... Lot No..~-~.L~.":,..(....~.~ ~' I pursuant tO application doted ...... .:~.~'/~...,..-.~......~. ................... , 19...~...., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ................ ,19... Approved ................ , 19... Permit No ............ Disapproved a/c ..................................... Received ........... ,19... APPLICATION FOR BUILDING PERI~/IlT 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 until a 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, anal regulations, and to admit authorized inspectors on premises and in building for necessary inspe,~ions. ,~ t'~ J . (Signature of applica~,,dr name, if a corporation) ./. ¥. :i ! (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premise&.~..¢]~.~.. ~f .% .~.c!..~4_~.. ~ .~./.~...~.....~...O..O..Y'..~ ..... (as on the tb~J loll or latest deed) If applicant is a corporation, signature of duly authorized officer. Builder's License No...~i'?(..~. ................. Plumber's License No ......................... Electrician's License No.. ~. ~ .~..~.~ ........... 1. Location of land on which proposed work will be done] ................................................. .............................. .................. House Number Street Hamlet County Tax Map No. 1000 Section . .0..~..~.~..O..O. ...... Block . .~..~.; .O..0 ......... Lot ..... .O../.~: .O.Q ./.'.. Subdivision ..................................... Filed Map No .... .~..~.~.~/. ....Lot...~..0..?~..~...c~.. (Name) 2. State existing use and occupancy of premises and intended use dud occupancy of proposed construction: occupancy .'...O./~..P). .......... ; '" ....-: i .................... a. Existing use and b. Intended use and occupancy . .~..c....~. ......... .4~K.....e~D~.....'vT.. 3.Nature of work (check which,applicable): New Building. , .,........ Addition..,....... Alteration .,~ ........ Repair Rem'ova .............. Demolition .............. Other Work ............... ~ ~ ~ ,~ ~'~ ~ (Description) 4. Estimated Cost ...... ~ .... ~ ~'~ ~ ................ Fe ~ . r ~'~; ~ ~ ?, ~, ~h ,-. tto be paid on filing this application) 5, If fl~m~, number,of dwelhfig'umts ............... Number of dwelling units on each floor ................ If garage number of c~s ~ 7 6. If business, commercial or mixed ~ccupancy, specifv natur~ and extent of each ty~e2f use~ ........ ~ ...... ~ .... 7. Dimensions of existing structures .if any Front.. ~ ~.'fl ....... Re~., ~G. ~ ...... Depth , .~.~, might . .............. of .................... , ..................... D~aensions of same structure with alterations or additions: Front .... ~g ~ .... Rear ... ~ ~. ~ '3 v .... Depth ..... ~.~ ,.~.' .......... ~ Height ..................... Number of Stories .. / ~ 8. Dig~ensiqns of enti~e~ew construction Front,.. f:~ ~... Rear, ,.~f ..... Depth ,, Height .' .... ~ .... Number of Stories .... ~ ...................................... 9. Siz~ofl0t Front ~' Rear ]~o, O ~ De~ .. ~'~'~ ...... 10. Dateofrurc~ase ..~q.~'./.q~5 ........ ~meofFo~a~-~ ~/~ ~Tw~/~ ' ' ' ' ' ' '''' 5 ~ ~' ' 11. Zone or use d~strlct xn winch premases are situated .... ~. t ~ ~ 12. Does propop~ construction violat~ any zoning law, ordinance or regulation: ..~ ........................... 13. Will lot ~xegra~d ............. : ....... '.. . ,~i~,excess fill be removed from premises' Yes , No ~ ~; , "'~" ' oo~ · · 14. Nmne o(~wn~f preml~e~ ~/~... ~[~s ~,~(~.l~ ~Phone No, ~ N~ne ' . ~t ~ ~ .......... ~' ' ' of Architect Address ~.~ ~ N~e of Contractor ' ~ Address ' Phone No ~5. ~s th~s property ~ocated w~th~n 300 feet of a t~da~ wet,and? *Yes ..... No ..... · ~f yes, Southo~d Town T~usCees Permit maybe required. PLOT DIAG~M Locate cle~ly ~d distinctly ~l bflild~gs, whether existing or proposed, and~ indicate ~l set-back d~ensions from property ~nes. Give street ~d block nu tuber or description according to deed, ~d show street n~es and indicate whether interior or corner lot. 3TATE OF NEW YORK, 2OUNTY OF ................. s.S ............................... I .................. being duly sworn, deposes and says that he is the applicant (Name of individual signin~ contract) ~bove named, i te is the , ' (Contractor, agent, corporate officer, etc.) ,f said owner or owners, and is duly ~uthorized 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 knowledge and belief; and that the ~ork will be performed in the manner s~t forth in the application filed therewith. ,worn to before me this , .......... ·..~. ~. ·; ..... day Of ..... ~ .......... , 1994 iotaryPublic, .... ~...~.'..i.g~...~].,~. .... County ~/~ ~ ~1~~~ ...... ,, ....f ....... '-'~(~'~--(Signatureofapplicant) FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL gOUTHOLD, N.Y. 11971 TEL.: 765-1603 Examined ..: ,~..~../~.., 19~(~ Approved.. ~-~.. ~.~..., 19 .~. · Permit No..../t..~...~..? Disapproved a/c__f__~ ......... ~ .... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... ,19... Date ................. 19 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 until a 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 Bnilding 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 co~[e,,~4a~ regulations, and to admit authorized inspectors on premises and in building for necessary ~n _s~_~ns. .................. (Signature of applicant, or name, if a corporation) (mailin~a~d~ess of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or Name of owner of premises .~/.c[~?.[.. ,. ~ ./d.~.~.t~. r...(~ge...~4.../ ........ : ............. (as on the ta'k roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Electrician's License No. ~'~- ~'-- Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................................... House Number Street Hamlet County Tax Map No. 1000 Section ... ~¢g .~ ....... Block .... ~, ~.q ....... Lot..Q~,~.Q( ......... Subdivision ..................................... Filed Map No... ¢7~/ ........ Lot. ~. ~& ..... (Name) 2. State existing use and occupancy o~.. ~ intended use and occupancy of proposed construction: . a. Existing use and occupancy ... ~ ..... ~ .... ~..~~ .................... b. Intended use and occupancy ..... ~~ .~.~. ~/~P. fP4Tck4 ........................... ' ~ Nature of ~whmh apphcable): New Building .......... Ad~..~__ ....., Alteration ...'. . 4. Estimated Cost.·~.~.~'.~.7~.~..~ .......................... Fee .y~..~..O.. ~ ................ , ...... (to be paid on filing this application) 5. If dwelling, number of dwelling units .... .-: .......... Number of dwelling unit~ on each floor . . 7. ........... If garage, number of cars ......... -7 .................................. i ........................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .. ;': ...... , ..~ j ....... 7. Dimensions of existing structures, if any: Front...~.~..~.t ........ Rear . ~..(o, .~.~i ...... Depth Height ............... Number of Stories ]. ~ $zza~It.~t ................................ Dimensions of same structure with alterations or additions Front 56,$* Rear ~ ~0 ~, ~" ....... Depth .... .3.-&.. ,.3. ............. Height ........ ~. ............. Number of Stories .... /~ ........ :. . 8. Dimensions of entire new construction Front ~..O. ~ .o ' .. Rear ...~'.~.'i ...... Depth ...o~.~tt~ ~~ .... Height o~¢~..~ Number of Stories ~ (q.~'.¢.). . . ' 10. Date of Purchase ...... /?.o~/~ .].~ ............ .~Name of.F. ormer Owner ~qtg~q/..?7~,v./.A. 11. Zone or use district in which premises are sitt ated... [4..e.s!~.qT~.t~lv. ..... ' / 12. Does proposed construction violate any zoning law, ordinance or regulation"" ' '.~.~[ ............. 13. Will lot be regraded ... A/to ..... , ............... Will excess fill be remov~ed from premises: Ye~ _ No Name of Architect Name of Contractor .......................... Address ...............- t ~... Phone No .... ,, ........... 15. Is this property located withinl.00 feet of a tidal wetland? * Yes ..... No ~.... · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly a/1 buildings, whether existing or proposed, and. indicate all set-back dimensions from lines. Give street and block number or ~descril?t. ion according to deed, and show street names and indicat~e whether STATE OF NEW YORK, S.S COUNTY OF ................. : ................................................. being duly sworn, deposes and says that he ~s the applicant (Name of individual signing contract) above named. He is the .............. (Contractor, agent, corporate officer, etc.)! of said owner or owners, and is duly authorized to perform or have performed the s~id work and to make and file this application; that all statements contained in this application are true to the best of his[knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before m~e this ................ l;..., da, of.i ..... ........ ~t~,~ ~ (Signature of applicant) LO7 ~8 MAP OF LO TS ~0 ~ 32 LoT 5O donack i a,' sociales t 7~5-1802 9 AM TO 4 PM ~ ~FOLLOWING ~NSPECTIONS: ~, FOUNDATION - TWO REQUIRED Z ~(~;~ - m~"~'-~,cT~°~ Mus* BE (',~m r-FF FOR C. O. ALL COtq?rR~JCTION SHALL ~EET THE REO~ilR~ENTS OF THE STATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FO~