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Home My WebLink About15027-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z14709 Date July 25 86 .................................................. 19... THIS CERTIFIES that the building ........ .A.c.c.e..s.s.o.r.y...b.uilding ' n rt 1135 Core Creek Lane, Southold, New York 11971 Locatlo of Prope y [l~Js~ ~/oi .... Y .................. Street Ham/et County Tax Map No. 1000 Section . .0.7.8. ....... Block 04 ..... Lot 020 . Subdivision..M./.q..Cg.r.e.y' .C.r.e.e..k..E.s.%. 9.t.e.s...Filed Map No. 4.9.2.3. .... Lot No....2.5 ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ·.. ~.u.n.e...2.6., .........,19 .8.6. pursuant to which Building Permit No. 15027 Z dated .... .J.u.x!.e...2.6., ............... 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 .e.s.s.o..ry..b.u. S ......................................... The certificate is issued to .... ~.~.c]..r.e,w,, ?... ,G. ~,l.l.~,g .hg.r' ................................ (owner, of the aforesaid building. Suffolk County Department of Health Approval ........... N. [.A. ........................... UNDERWRITERS CERTIFICATE NO ................... N. [.A. ........................... Building Inspector Rev. 1/81 Z~Omw NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOL. D, N. Y. BUILDinG PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. ~5027 Z Date ...... .(.~. ~.J .~:.. ................................... , Permission is hereby granted to: ....... ,o ....... ...Q.Q~.~..~"Z......~,.~.¢.~'~.:~ _~ ..~.......q-~z. zr-~.l.b(~ ......................... County Tax Map No. 1000 Section .~...~..~ ........ Block ....0....~'.. ......... Lot No... '~...~,~) ......... ~ur~ont to opp,ca,on dot~ ....',~O..~..~.......Z ........................ , ~ .~...., and a~pro¥~ by t,e Building Inspector. Building Inspector Rev. 6/30/80 TOWr~ OF SOU APPLICATION FOR CERTIFICATE OF OCCUPANCY FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southo~d, N.Y. 11971 765- 1802 Instructions 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 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~3perty 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 $1 5.0 0 3. Copy of certificate of occupancy $1.00 5.Updated C.O. $15.00 Date .............. NewConstruction ...... O~d or Pre-existing Building ~ Vacant Land Location of Property ~,~ ~'~' ~C) S.~~ .~...~?.~.~.~...~,~ ....... Owner or Owners of P~H:;~2~°" ~ ~. ~.¢.'.~ ~t~.~ .................... County Tax Map No. 1000 Section ............... Block ............ Lot .......... Su bd ,vision ~.'~¢~ .~ ;~ .... Filed Map No. ~.~...Lot No. Hoalth De~t. Approval ........................ kabor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ................ Final Certificate V' ............ Fee Submitted $ ............................. Construction on above described buiJd~rr~ t mee~/ap/~lica~e'~s and regulations. ....................... Rev, 10-10-78 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS. ~ ~~ FIELD F 0 U__N D A_T I 0_? -- (___~ ~_t_), FOUNDATION (P-nd) oi-~ ROUGH FRAME & ,, '--- PLUMBING 3. ' INSULATION PER N. Y ..... STATE ENEBGY .......... ¢q~ODE .... ~ m ADDITIONAL COMMENTS TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTItOLD, N.Y. ' NOTICE OF DISAPPROVAL · .~.~3..~'T..C'-~.~-r~..~. ~ ~ ~.~;..(.-~ ~ .. ~:~e/o ~-D., ~. ~..~...13.~ l PLEASE TAKE NOTICE that your application dated ...... ~... for p~it to ~.~ .~ ~ ~ .,~.~... ~.~~. ...... at Location O'iProperty ~ ;{.t .~... ~ . ~~. ~oose mo. ~treet Hamlet CountyTax Map No. 1000 Section .. ~... Block . ~.~.' ..... ~t Subdivi~o ed Map No ........... Lot No .................. is returned herewith and disapproved on the following grounds ............................... ..../3,....?.,..r~..~. ~,~4... ~.~: t .c~. ~ ~. c~..T~.. ~,7~ .o..~.-~,, ........... . ...~c~.~ 1.0~.. 0~...~.~~... ~. .............. .... t ~.. ~.~ .... ~.,~.. ~.g.~ .Q~ ........... ~. L~ ~T.~.O.~ . Building Inspector RV 1/80 · ~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-180:2 ^pproved&U.C.Z ..... l g.ee i No.l.' O.Z Disapproved a/c . ,~_~__~w.... ..... .,~ ........... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... ,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 permiO 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 ~ 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 a,-,qicant agrees to comply with all applicable laws, ordinances, building code, h~sia~ code, and regulations, and to admit~thorized inspectors on premises and in building for necessa~ctio/~s. /~ f, ,, ............ (Sign_,ature of appl~c~fnt, or name,~f~ corporation) · .B~ ~. ~q ~..C~.-wk..~ .~.., ........... · ....... i~±ling address o1~ appl±cant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. Name of owner of premises .~..~.,..~s~.....~..~..k..C3~..~.[.~.,4.. C~ 0~\ \c~ (~-v~-~.. ......... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Build.er's License No ........ .~./..B .............. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ....................... 1. Location of land on which proposed work will be done ......... /~. !~A].ff'..(~./~. ~.~,~ .................. ~ I .~ .~. C..~% .6.~r..~:.x...C~:~ ......... ~o...~.~.., .k~ ....................................... House Number Street Hamlet County Tax Map No. 1000 Section ...'.~..~ .......... Block ....... .~. ......... Lot .... ~-~.Q).. · ..... ". .... Subdivision~.o~.~.~J~..~..~.~. ......... Filed Map No..~r.~.~3 ...... Lot...~.~. ........ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . .\.~. 9.~.~. . .~..~. ..... .~..&.'~ ........................................... b. Intended use and occupancy .................................................. 3. Nature ~l~licable): New Building . ,.q .bt:--.?... 'Addition .......... Alteration ;.. .... ,.. :. Repair,..~ i¢,val .............. Demolition .............. Other Work ....... ..... ..... E lll ' i'l (Desc ptmn) i:~t ........................ Fee ...................................... 4. stimate.d~ ~ i;L'5-- j ~ lA (to be paid on filing this application) 5. Ifdwrellifl-~f~we(ltt Funits. .. ~.~. . Number ofdwelling units on each floor ...... 6. If business, commercial or mix'ed occupancy, specify nature and extent ofeach type ofuse. .................... 7. Dimensions of existing structures, if any: Front ...... .-x ....... Rear . ~ Depth.. -- Height ............... Nu,mber of Stories ....................................................... Dimensions of same structure with alterations or additions: Front ................. Rear ........ ~ ........ Depth ...................... Height ....... .. ~, ............. Number of Stories ........... t ......... ...... Rear /0 r ....~ .......... 8. Dimensions o~e~ntire new construction: Front.../~). ~ ii ................ Depth Height .... 2r.'. ........ Number of Stories ..... ; ..... ' .......................................... 9. Slzegflot: Front ......... i ............ Rear ................... :.. Depth ...................... 10.. Date~f Purchase ......... 3 ................ ~x.. Name of Fomter Owl~er ................ 1 1. Zone or use district in which premises are situated; ..... 'Z~o..~. ~ .................................... 12. Does proposed construction v.~plate any zomng law, ordinance or regulatmn: .... //J: .......................... 13. Will lot be regraded ...... .t~q ................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premise~ ~-~km:~-~ ~.L.~.~...~.. Address ~ [~.~..C~..~.q-~. ~f~h~Phone No."J (*.~"7 .E~.~.~. 1... Name of Architect . , t~ ................ Address .......... Phone No .... 15. Is ~:h±s oronore,, ~ w~th~nl200 feet of a thdal wetland? * Yes ..... No .~. :ustees Permit may be required. : ~ PLOT DIAGRAM ~ [ bufld~gs, whether existing or proposed, ~d. indicate fll set-back d~ens]ons from number or description accord~g to deed, ~d show street names and indicate whether ST^ O NE ¥OR} , i o COUNTY OF..~.~...~ .a ...... i (Name of individuaI'~signing contract) above named. duly sworn, deposes and says that he is the applicant He ig the .' ................... ~ ...................................................... ~ .............. .. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dgly 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 tkht the work will be performed in the man~er set forth in the application filed therewith. Sworn to before me this .... .................... ............. , l q... ~ot~ry Public, State :of N0w~ ~$11~ ................ ~o. ~m~0.01~ '~ ~ ~ (Signature of applicant) Quallfie~ in Suffolk O0ulmlss[0n Expires ~arch 30, 1~