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Home My WebLink About15120-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy N_ Z16819 Date . April 26, 1988 THIS CERTIFIES that the building A d d i t i o n s Location of Property 3315 Wells Avenue Southold House No, Street Hamlet County Tax Map No. ] 000 Section . .0. 7. .0 ....... Block .. 04, .Lot . 0 8 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore flied in this office dated July 21, 1986 ................. . .... pursuant to which Building Permit No. 1.5. .1.2.0.z.. - dated...July .... ,.......,..,.,22' '1986 ..... .. 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 ......... Construct a deck and dormer to an existing one family dwelllng. The certificate is issued to A. ROKE ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval ..... N./A. ..,. ............................... UNDERWRITERS CERTIFICATE NO ............ N786692 1 /6/87 PLUMBRRS CERTIFICATION DATED: N/A Rev. 1/81 TO~VN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. ~UILDING PERJ~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 151~0 Z Permission is hereby gronted to: .... ............. ~.-.,.~..~..~.~ ..................................................... , . ...,.'~.~.~.....~.~ .......... to .~...~_..~-~.*******--******--**--******* ot p~i~e~ ~te~ ~t ..,~.~...a ........ ~.~...~~ ....... ~~ ............. County Tax Mop No. 1000 Section ..... ..~,..-~...-~. ...... Block ..... .l~)...~ ........ Lot No.....C~...~ ............ pursuant to application doted ..... ...~..~......'~...' .................... , 19..~..~.., and approved by the Building Inspector. 'guilding Inspector Rev. 6/30/80 FIELD INS[~ECTION FOUNDATION (1st) FOUNDATION (2nd) PLUMBING CODE FINAL ADDITIONAL COMMENTS: o ~ FORM NO. 6 TOWN OF $OUTHOLD 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. B. 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 features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safeW inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25,00 POOLS $25.00 ALTERATION $25.00 ]. Certificate of occupancy New Dwelling. S25.00, Accessory ~,$;0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0 3. Copy of certificate of occupancy $ 5.00, over 5 years $~0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 ?ate.. /tC,..~..~. ......... New C OhS truct i on ...... Old or Pre-exi~ting Building ............ Vacant Land ............. Location of Property ............... l-lou~e No. ............................... Street lta~nle't Owner or Owners of Property ....~..".. ~.P..'.~..C. , ......................................... County Tax Map No. 1000 Section .... ~?.?..O ...... Block ..... .~....~. ..... Lot ...... .~. ?. ...... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No.../.J.'?..~.~ Date of Permit...~./.7. ~./.~LApplicant .. ~. .'. ~.~//~'/- ' ...... ~ ~./. ' ?~./J.,~ ........... ,/~ ~'., 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~ meets all aDolicable~odJ~s and regulations. Applicant ....... ; ........... THE NEW YORK BOARD OF FIRE UNDERWRITERS 1001381 BUREAU OF ELECTRICITY I~- eB JOHN BTREET, NEW YORK, NEW YORK 10038 ~'ate Ju.rraary 6~ 19J~7 448914/86 THIS CERTIFIES THAT only the electrica~ equipment ~ ~scribed be~ and i~troduc~ by the applicant ~med on the a~e appl~ation number in the premises of ~rt ~ke, Wells Awing> O~l~n A~n~, Sout~ld, N,Y, in the fottowlng tocatio.; ~ Basement ~ Ist FI. ~ 2nd Fl. Section Bt~k Lot , . I)e~n~r 22, 1986 ~as examtnea on arid found to be in compliance n'ith the requirements qf tbls Board. 10 ;~0 10 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDER! TIME CLOCKS UNIT HEATERS MULTI.OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: ]~' ~,F.C.Io ~'-,~1~31~ Detector $ E NO. O~ERCC~,COND A, WG OF CC, COND C NO, OF HI-LEG jAWG OF HI-LEG NO OF NEUTRALS AWG, OF NEU?RA[ Jodlr Pt~ull] o Pat Lane l,{attituck~ N.Y. 11952 Ltc. #2300E GENERAl. MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect, inspectors may be identified by their ~RTMENT, THIS COPY OF CERTIF CATE MUSTNOT BE ALTERED IN ANY MANNER 7GS-1802 BUILDING DEPT. INSPECTION FOUNDATION ZST [] ROUGH PLBG. FOUNDATION 2ND []INSULATION FRAMING []FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING , REMARKS: DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] ~NSULATION / FRAMING [,~] FINAL DATE 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL,: 765-180~' Approved ., 19~.h. Permit No. l .~..~.&.o...~., Disapproved a/c ..................................... (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 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.~,,... ----'/1 ,a ,m /2 .... ..... (~'l~n~fftur~ of applica .n~, or name, if a_cor, pora~ion) ... (Mailing address of applicant) / ~ State whether applicant is_owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. (as on the tax roll or latest deed) If applicant is a coxporation, signature of dulg, auth~ri~d officer. (N~me and title of corporate officer) . /' Builder's License No ..... ,/. .... Plumber's LicenseNo ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done....~//~.....~..~...~..~..~...../~.Z~. ................ ..... ~.~ ~.l.-C. . ..... ~. .¢ ~ t5. . . ,~. ge ................ So.~. . .:-.~. .o. .~.~. ..... ~ House Number Street Hamlet County Tax Map No. 1000 Section .... 7..~. .......... Block ..... ~. ........... Lot . . . .~.. ............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: 3. Naturo of work (check which applicable): New Building ....... Addition Alteration . Repair ~ ............ .............. Removal .............. Demolition .............. Other Work ............... ~ ~ ~ ,i (Description) 4. Estimated Cost ...... ~.~O/ ~o ~o O F ' (to be paid on filing this application) 5. Ifdwe!ling, number of dweiling.units ............... 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 type of use ..................... 7. Dimensions of existing stmcturds, if any: Front ............... Rear ............ Depth Height ............... Nun]ber of Stories ........................................................ Dhnensions'of same structure w~th alterations or additions: Front Rear Depth ' Height Number of Stories Dimensions of entire new construction: Front . Rear Depth Heightl ................ Number of Stories ........................................................ Size oi~lot Frt~nt ' · .............. Rear ...................... Depth ...................... Date of Purchase i Name of Former Owner 11. · ' ' ' ~ · · Zone or use d~stnct in whmh premises are s~tuated ...... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...................... ; ......... 13. ,W, ill lot be,,regraded ....... ~ .o.~. ',2' ............ Will excess fill b~e re_moved from premises: Yes No 14. nameofuwnerofpremises .,~.O~ ...Address ~l.~.f..JY....~.~(-,~..'~q~l~neNo ...... Name of Architect ' Address ~-~ -- 15, Is this property located ~rithin 300 feet of a tidal wetland? *Yes ..... No . [... ' · If yes, Southold Town Tru!stees Permit maybe required. PLOT DIAGRAM .,.- Locate clearly and distinctly alii buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block pumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ~.S COUNTY OF .............. ~,.. , . ...... · ~' 'g~,~f ~'J.~' ~'" ~':./~" ~.~. ~ .......... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ........................................... , ................................. i (Contractor, agent, corpora~te 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 a lication re · · . , PP . ~,~ true to the best ofhi~ knowledge and belief;and that the work will be performed m the manne~ set forth in the application filer therewith. Sworn to before me this Notary Pubhc,' .. ~...d~'°.~.,. . Ne. 4707878, Suffe~ {erm F. xp{~s March 30. oCCU? NCY OR USE tS UN~WFUL WI'I'HOUT CER'i'TFt~'TE oF OCCu? NC¥ SED ltv WATER ExcEEU ~*~' 0 APPROVED AS NOTED DATE: '7/.z~.?/~(, B.P ~' / ~TI~ ~I~IN60EPAW~ AT 7~1~2 9 AM TO 4 ~ ~ ~E FZ~WIN6 INSETS: FOR ~OURED ~E 2 ROUGH FRAMING & ~UMBING 3. INSU~rlON 4, FINAL ~N~RUCT~ MUST ~ COMmiE FOR C.O. ALL CONS~UC~ON ~L ~ T~ REQUI~M~S ~ ~E C~, NOT ~E ~R m~GN OR E~N~ON ~ORS,