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Home My WebLink About14951-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...Zi. ~.3.8.2. ........ Date May 6, 1986 19... THIS CERTIFIES that the building Deck Location of Property ........ .65.0...C.o.x..I~..o .c.k..R..o.a.d. ............ 1~. a..~.~.~.~u..c.k ............ House No. Street Hamlet County Tax Map No. 1000 Section .1..1.3 ........ Block 014 .Lot 008 Subdivision .... .l:t.e.r.~.~.a~.~...H.a.r.b.o..r ......... Filed Map No. 6853 .Lot No. 8 conforms substantially to the Application for Building Permit heretofore filed in this office dated .. ~P.~TiJ-,..25 ........ , l 9,8, ,6 pursuant to which Building Permit No. 14951Z dated ~. p.r.i.i...2.5 ................... 19.8.6., 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.~..~.~.~.~.~..~.. ?...<~.qk., .~.d~.~. ~.o~ .~..o..~.x. ~..~.q~.~., .o?...~.%m)..~.y..ay. ?.~.z??: ........ The certificate is issued to WILLIAM F. AND ARLEEN AMATO. ..................... /o¥,,'~;, ~:tb~ir/r) ...................... of the aforesaid building. Suffolk County Department of Health Approval .... .N./.~. .................................. UNDERWRITERS CERTIFICATE NO ............ ?./..~ .................................. Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CI'H1S PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: · . ~., .....~..~..~.....~.~ ............................................. ~ et premises Iocoted et ............................................................................................................................ County Tox Map No. 1000 Section ...... /.Z.~.~ ........ Block ...... ..0..../..~.. ..... Lot No ........ ..~)....~. ........ pursuont to application dated ....... ~.....I...(,/ ................... , 19..~....~.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 765-1802 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ]FRAMING [ ]FINAL REMARKS. .... ~,~ DATE INSPECTOR F1EL~ INdirECTION FOUNDATION (.1st) COMi~ENTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted m~ 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing ali property lines, streets, buildings and unusua~ natura~ 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: 1. Certificate of occupancv $5.00 2. Certificate of occupancy on pre-existing dwelling $15.0 0 3. Copy of certificate of occupancy $1.00 ~p ~/o //<~ ,~,~, · .~, · 4.Vac~ant Land C.O. $5.00 ~. ...... 5. Updated C.O. $15.00 Date .... New Building ............. Old or Pre-existing Building ..... .,.~.,.. ~ca~t Lind .ii .......... Location of Property .. ~. q'.~. ,'. .~./~.~...~. ~ House No. . Street Owner or Owners of Property....~..~ .~.//~../.~..~. ~./.'/...~.~.. i'.~...~ .'~'.~.......~.~..~..~...~'."~.~.... Subdivision.../~,~,~,/,~. ,'~-~/.., ../~./"~...~% .~:.~..Filed Map No, ~, .~,~.~f.Lot No ...... .~. ..... Permit No ........... Date of Permit ......... ';Applicant.. ,~,/~/ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit r~eets all applicable ~o~_des and regulation, s. .... ........ Rev. 10-10-78 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Sou/hold, N,Y, 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR' ink, and submitted ~a ~ to the Building Inspec- tor with the following; for new buildings or now use: 1. Final survey of property with accurate location of ail 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 P~anning Board approva~ of completed site plan requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p[~perty 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- ,lion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 $15.00 5 .Updated C.O. ......... Old or Pre-existing Building Location of Property...~..~.'~.. ..... C.~'~../~.. ¢..C~. .... ~.~. ........ Hou.~ No. , Street Owner or Owners of ProperW .~,.~..~..~....(~'b..~....~. Vacant Land ............. Ham/at County Tax Map No. 1000 Section .... J../..3. ...... Block ..... ./.~/ ....... Lot .... .~..~ ....... Subdivision. ~, "~"~' 'to', ,~.~r-,...~, ,(;~,,, , ,r-'~L'"~',, ........ Filed Map NO. ~.~, 6,~,...Lot No, . .',~ .......... Permit No. /.':~.~.1..~.. Date of Permit .~l~r)..~..Applicant..~..~..~'~/...... ~..~. ?. ........ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ..... , ................. Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $, , ,~, .~. :, ..,~. ................. Construction on above described building and per[nit me,ets all applicable codes and regulations. 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 ', TEL.: 765-1802 Examined..~(~..~..~..., 19~.~°. Approved .Q~. ~g , 19~.~. Permit No ............ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BLDG. D¢~:,~ TOWN OF SOUTHOLD,, , , Received ........... ,19... Date .................. , 19... 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 ~f 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 ~t 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 agree8 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 in.n,~speff?ons.//~~ /...~.'C..~ .~:~ :-~ . nature of applicant, or name, if a corporation) ' ' ......... ("'~l'ail~ i~ add~- ~ees; ;¢'~plicant~'/'~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........ , , (as on the tax roll or latest deed) If applicant is a corporation, sign ture of duly authorized officer. .................... .................. (Name and title of corporate office, r) - Other Trade s License No ..... :./.7.. .......... ~/1. Location of land on which proposed work will be done .................................................. .................o ' . .................................... House Number Street Hamlet County Tax Map No. 1000 Section .//..~. .......... Block ...... .~..../7..~. .....Lot .... . .~..d~...~.'. Subdivision .... ~*./.~.~.'-T..~...~Z/.~d.~.~4.~ ~'' FiledMapSo....~?~.¢'.'7.-?.... Lot .... ~ ........ ~ ~f (Name) '/2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... /~57.~.d./.~ .~.~.'~f~.~:...~....~.',?.~.~2dz~....~..~.~../:.~. .............. / b. Intended use and occupancy ........... .~F~...'7 ........................... /. ................. / ~3. Nature of work (check which applicable): New Building .......... Addition. Repair .............. Removal .............. Demolition .......... i ........ Alteration ~}.,~_~ .~. !... Other Work .... ~/.~..~... ~ (Description) ' 4. Estimated Cost ...................................... Fee .......... , ............................. ,/ ~ (to be paid on filing this applicatiop) ~5. If dwelling number of dwellingunits . . ., ..... .xd//~. . Number of dwellingunitson each floor. . . .~. ./4 .. If garage, number of cars .......... .~..J~. ............................. ! ................ l ........... 6~. If business, commercial or mixed occupancy, specify nature and extent of each type of use ...... ~. ~.r~ .......... 7. Dimensions of existing structures, if any: Front ......... ?/, .... Rear ...'17'..'~.,. g, ~. .... Depth...~, .~.~. ?. f .... Height . Number of Stories ....... ~.. ~.~ ................ I .................... Dimensions'of same structure with alterations or additions: Front .o5'..4:. ~/i,~ Rear Depth Height Number of iStories -~-8. Dimensions of ~3~re new construction: Front .... 2;~-~. t... ....Rear ...2.2, (. i ....... Depth ../.~../. ....... Height ..... ~.. ........ Nunfiber of Stories .................. / ......... i ............... ./ ............ ~ Size of lot Front ..... ~.~.,a ............. Rear .... ?a~..9~. . Denth ,~e4~..~.. 4/2. Does proposed construction violate a~y 3~ojaing law, ordiffance or regulatmn: .... ../.v ~&5. ............. .... ~¥3. Will lot be regraded ......... /7: .~. ~4~,.., .......... 3V),l.I excess fill be renl~ved~o!l~m'e~m~s;/, Yes Name of Architect ......... ~ . Address ........... i .. Phone No .... · ........... Name of Contractor ........ ' ' ¢' ....... Address ' .~ . ' '" ' Phone No. ) .-7-~..~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. % STATE O F NEW YJD R~,._~--_ /// ~ cou ¥ ........ ~..[. 't//(.~.~.~... ?.?i....~..~..~.~ .~..: ........ being duly (Name of individual signing contract) above nmned. 22 3 sworn, depqses and says that he is the applicant (Contractor, ~gtnt, corporat& offiee~r, e't&.)! of said 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 contained in this application are true to the best of hil knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ' ~ d~ , . (Sig~aatur~ o,figP~licant) -- 72.t/ ., HAWKINS· WEBB, JAEGER, ASSOCIATES p.tj. SURVEYING & ENGINEERI~'IG PROPER~ O~ ' SCALE .---~" ~ FILED MAP NO. CONSTRUCTION, DATES FDN.~'~O'~ UND. CONST,~'~ P'INAL ~.'~