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Home My WebLink About14999-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certi[icate O[ Occupancy No ........... Date Augus% 14 8..6 THIS CERTIFIES that the building Deck . 535· Lupton Pt. Rd. Mattit~ck ' Location of Property ............................................................... House No. Street Hamlet County Tax Map No. 1000 Section ~-~-5 ..... Block 11 ..... Lot 2 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... JUne. 6 ........... 19.86pursuant to which Building Permit No....1.4.9. ~.9.Z ............ dated ..... June. 2 P ............... 19.86, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued i~ ......... peck around an accessory inffround pool. The ce~ifJcate is issued to HENRY J. LOEFFLER (owner, ~e~ee-er.te~# of the aforesaid building. Suffolk County Department of Health Approval ....... ~../.A. ............................... UNDERWRITERS CERTIFICATE NO ............... N.. ,/~. ............................... Rev. 1/81 / Building Inspector I~B,M NO. 0 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) iN? 14999 Z hereb/granted to: ......... ..... o, premises located at ...~.~...~...w~.'~....~.,...~...'¢~....~...~..;......~...~..; ...... ....~.~~ ......... County Tax Map No. 1000 Section ....... J.[..~. ....... Block ....... 1.1 ........... Lot No ...... ~ ............ pursuant ,o application dated ......... ...~..~....(~. ................... , 19.~.~., and approved by the Building Inspector. Building Inspector Rew 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hell BLDG. DEPT. Southold, N.Y. 11971 TOWN OF SOUTHOLD 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted I~ 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 featu res. 2. Final approval of Health Dept. of ~vater 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 p;Coperty 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: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 5.Updated C.O. $15.00 Date ..~ .......... _._~ New C on s ~ r u c ~ i o n ...... O Id or Pre-existing gu [iding ............ Vacant ~and ............. Location of Property. ~¢ ~... ¢.~.¢ ~. ~..~..~.~.,.?..~ ~.~[ .~ .C/~ ....... House No, Street Hamlet Owner or Owners of Property ,..~.~...~...~~ ~ ................ ..... .......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. ~'?.~.~, ~ Date of Permit ~..~,~.~..~.~..~.Applicant · ~-..~. ,~L?, ~, .~.~...~ .~, .~..~?..~.~.,' .j~., Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ · Planning Board Approval ~,.. .................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ 0% ~) ~) Construction on above described building and permit me~t~/~t-ap, Fficabl~q~d~ and regulations. FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE Ye NAL ~ ~o., ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined . Approved · Disapproved a/c ..................................... Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date 5-5 19.8.6. INSTRUCTIONS a. Tkis 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 grmlted 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, ~nd regulations, and to admit auth°rizedinspect°rs°npremisesandinbuildingf°rnecessarypz~ ~( ~/7~ "' 'S~fn]'~r'e~$~r~lida~j ;~-ff~rm'e', ifa co p ' ) .... ,..515. Ru-.n ..oa Zo.. ................. l~attituck, N.Y. qd952 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner Name of owner of premises . .Ii!e.n. ?y..O.': . .L.o.e. 2...i'.1.ex .................................................... (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.° ................................................. ...5.3.5. y.o!-' .,. !!957. ....................................... House Num bet Street Hamlet County Tax Map No. 1000 Section ..... /.lk9 ......... 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 ...r.e.q.i.d. .e .n. ¢. 5.. $ .l ...................................................... residential b. Intended use and occupancy .................................................................... 3. Nature of work (check which applicable): New Building .......... Addition . Repair .............. Removal .............. Demolition ........ ........ Alteration ........... ·.. Other Work..~.~.9.~. .: ....... (Description) 4 Estimated Cost ' Fee (to be p~id on filing this application) 5. If dwelling, number of dwelling units ............... Numbe~ o f dwelling units!on each fioor ................ If garage number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type~ of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear ........ ~ ...... Depth ............... Height Number of Stories ith alt ddi{i Dimensions of same structure w erations or a ons: Front ............. .... Rear .................. Depth ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front · .5.0. £.t;, Rear ............... ; ...... Depth . ~.~..~.~ ....... Height ............... Number of Stories ............................. ! ........................... 9. Size of lot: Front . .3.0.9..t.~. ............ Rear..~.5..l?.~.: ............. Depth . .5.7.~. J?.~... ............ 10. Date of Purchase ...'1.c~5. . Name of Former Owner i , 1 1. Zone or use district in which premises are situated., re. s Sd.e. rtl: ±al. 12. Does proposed construction violate any zoning law, ordinance or regulation: . 13. Will lot be regraded .. 3! 0 .... ~ ................... Will excess till be removed !from premises: ~ No 14. Name of Owner of premises .Ap. pl..ig.a.n.~' ......... ' Address ................ i. · · Phone No .............. "" Name of Architect ........................... Address ................ i. · · Phone No ................ Name of Contractor ................ : ......... Address ................ !. . Phone No ........... 15. Is this property located withint.00"feet of a tidal wetland? * Yes ..... No .~.~.~' · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. ~n&cate 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 OF NEB{ C'nlTNT¥ nP ~ulzo±r S.S ........ .H.~O.~y' .4... ~.o.o. ~..~.Z.o.~· .................... 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.)! 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 ofins~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 6th .day of Jun~ 19 86 ..... " ............................. : ....... ' "' Notary Public, ....~.g.~.~.q3~ .k ..................... County - ./ ,~07o~ = /