The URL can be used to link to this page

Home My WebLink About14956-zTOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No, .. z2.4656 ........ Date ...... .~241. y..1.6.~ ................ ,19 .8.6. THIS CERTIFIES that the building ...... cleO}~..~c]0i.~.iQ~a ........................... Location of Property . B.O .[vlicldletD. n. Road,. ~;c. eenp.o.~:t; ,. Hew. 7P.]:1¢. ;[.1.9. 4 ~ ......... House No. Street Ham/et County Tax Map No. 1000 Section . 4.0. ........ Block ...5 ............ Lot .. ;3 .............. Subdivision. Yl,/c~. ~' 1 eat: £ ± e~.d ............. Filed Map No. 135~. .... Lot No... ~ .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ ~a.y..2.8..~ ..... , 19 . .8.6pursuant to which Building Permit No. 149567. dated .... .J.u.n.e...7 ~ ................ 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 ......... ....... ~.e..clx..a.d..d.L%o..n. ,~,q, ,e,x,i,s,~, .~.n9..o..n?.-.~.a~ .m.~.~...d.~.e).~. ,~.n.~. ................... The certificate isissued to .. games .a Cai:her±ne Chute ............... ?o¥,;d-, ~~ ............... of the aforesaid building. Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO ............................ .N./?. .................. Rev. 1/81 Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (TH1S PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 1 956 Z County Tax Map No. 1000 Section ...... ...(~.....~.~, ..... Block ....... i~..~.. ..... Lot No....-.~. ............... pursuant to applicotion doted ........................................ ~~ .~....~. , 19,~....~., ond oppro¥od 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 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. Finat approval of Health Dept. of water supplv 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 sifnilar 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 all property lines, streets, buildings and unusual natural or topographic featu res. 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. Fees: I. Certificate of occupancy $5.00 2. Certificate of ~)ccupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 $15.00 Date. ~..~/,~'~. .............. New Building ............. Old or Pre-existing Building .. ~. ....... Vacant Land ............. Location of Property ~.~....~.~.~Y/.~./~,F.~.~..~..,~4?~..~.~ .............. .~.~'.~..~..~..~'.-~..Lz', .x~'.,~. ....... /.~'.~...~.~.. House IVo, Street Ham/et Owner or Owners of Property ~'~.)Z7,,~'~5..~....~..-~'.~.¢'.,/?,~..~,.,..~.,~,~..~.~, .................... County Tax Map No. 1000 Section .... ~.~. ....... Block .... ~.. ........ Lot.. ,,~. ........... Subdivision ...... ?. ...................... Filed Map No. /.9.~'~'-~'...Lot No....~.. ........ Permit No./..~.~..~.~.,~.. Date of Permit ~..~/~..Applicant ~.)"~...~... Health Dept. Approval ...... ,~/'/~. ............. Labor Dept. Approval .... .x~.../~. ............... Underwriters Approval ........................ Planning Board Approval ................ Request for Temporary Certificate..../~.~. .............. Final Certificate . .0~'.,-g.. ..... .~....d?: ..... Fee Submitted $..~. -'..C{.~....(~./.'~..~.~ .~.. ....... Construction on above described building and p~mit meets all applicab~'~od~and regulations. R~v. 10-10-78 J~M£6 E~. "1 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 July 14, 1986 TEL. 765-1802 To Whom This May Concern, ~lease complete the enclosed application for Certificate of Occupancy and enclose a check for $5.00 (the fee for the CoO.)'and I will be able to ;complete the Certificate of Occupancy. Thank you so much for your cooperation in this matter. FIELD INSFECTION FOUNDATION (lst) FOUNDATION I2nd) ROUGH FRAME & FLUMBING 3. INSULATION PER N. STATE ENERGY CODE Ye FINAL COMMENTS ADDITIONAL COMMENTS: 76,5.1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING ~INAL REMARKS: DATE Y75G TOWN OF SOUTHOLD BUILDING DEPARTMENT ~ ,',' TOWN HALL 8OUTHOLD, N.Y. 11971 TEL: 765-1802 Examined . .~..A...l~(-~.'}. .... , 19~ (o Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERNHT VI C_ INSTRUCTIONS Received..5/ .... Date ........ 197 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 cog[e, housing code, and reamiations, and to admit authorized inspectors on premises and in building f°r necessary inspe~T~/,~ 4S ~~~ '~o_ r_!~;!t? ;'n~) .... .... - (maiZing address 9· applicant)/ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electffcian, plumber or builder. Name of owner of premises . . . .~ 0-~rm-Jl-~3.. ~,. ~ ........................................... (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 ...................... 1. Location of land on which proposed work will be done .................................................. umhe Street ................... . ..... County Tax Map No. 1000Section .~.D::.'-~. .... Block ..~ .... ~ ..... Lot.~'....~ ....... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . · C ............................ /2 . (1 ~ :;"~,~:~ b. Intended use and occupancy . .~. ·: .~./ .................... 3. Nature ofwork (check which applicable): New Building .......... 'Addition .......... Alteration .. ......... Repair ............ Removal .............. Demolition .............. Other Wor~..~. ,~ t~_ ,n ,q~ ,--~J ' (l~escription) 4. Estimated Cost ...~...~.'0..~. :.~. ?. ...................... Fee ~ (to be paid on filing this application) ~ units '-- Nu bet of dwelling units each floor 5. If dwelling, number of dwellin ............... m on . ..-': ............ If garage number of cars ~ ' 6. If business, commercial or mixled occupancy, spec~y natu[e and extent of each tyl~e ,of use ....' .'~....~....,~ ........ 7,. Dimensions of existing structures, if any: Front .:~ ID,~ ...... Rear .~/,~.,~. .... Depth ,~)~-~.. .... ..H, elght .,l~.4~. ....... Number of Stones.. 1. ....................................... . ........ ...... !D~tmenslons o~ same structure with alterations or fi. cl~tions: Front . ~ f~.~?_.a~. ...... Rear . ..~ .(t?. ~ ....... iDepth ,.,, . ~/?] ..~_.~g ..... !... Height ./. (~ .... /~., ........ Nun~er of.Stories. / ........ ....O ...., .... ' ~ 'id'; Ot,J'~t' ' · ~-0~ 8. ~Dnnen[~on's~n~i~ new construction: Front....~ 0.~...~ .... Rear ..~ {~o.-~.~- ..... Depth ...~.'/..~.n~: ~... 'Height .. ~.~.~.~. .... Number of Stories .... I"' .0~.. ........... ~'..~..~. ................... .~... 9. Size (~flot: Fror~.~ff~.~ .......... Rear .... ~. ~ ........ ^Dep,~h . '/"*)'r6~ i~ ...... ~ .... 10. Date of Purchase ... ~t/-]) .................. Nanle.otFom~wner l~.~ ........... 11. Zone or use district in ~ch premises are situated. ~..~Mi..k~ ........ [~-. ........... 12. Does proposed constru~on violate any zoning law ordinance or regulation: ... 13. Will l~t be regraded ... 1~4 ....................... Will excess fighetemove~mm premises: Yes (. N& 14. Nme of Owner of premi~2~ ~. ~Addres~~ ~ Phone $o.~.~r~ ~. Nme of ~chitect .... ~4 ................ Address . .~ ............ Phone No.. V'.. ........... Nme of Contractor . .~ ................. Address .... ~ .............. Phone No...( ~ .......... 15. Is thts property located~tthtnl;00 feet of a t5dal wetland? ~ Yes ..... No ~.. ~ If yes, Southold To~ TVustees Permtt may be requ5red. ' , PLOT DIAG~ Locate clemly ~d distinctly fll bufld~gs, whether existing or proposed, ~d. indicate fll set-back d~ensions from prope~ ~nes. Give street and block number or desc~ption accord~g to deed, ~d show street nines and indicate whether intelSor or corner lot. : S.S STATE OF NEW YORK, COUNTY OF .................. (Name of individual s: above named. Ining contract) being duly sworn, deposes and says that he is the applicant He is the. ................... ~ ...................................................... ? .............. j (Contractor, agent, corporate officer, etc.) 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 his knowledge and belief; and thht the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this Notary Public ............ : ......... County No. 4707878, ~I~Y~'7 (Signature of applicant)