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Home My WebLink About15045-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold~ N.Y. Certificate Of Occupancy No ...... Z..1.5.8. Q .7 .A.... Date ......... .M.a.y...2.8.,..1..9.8.7. ......... THIS CERTIFIES that tbe building ...b.r.e..e.z.e.w.a.y..&..~j .a,r.a. qe...a.d.d.i..t.i.o.n...t.o..d.w..e.]_.l.i..ncj. Location of Property .... .3.6.1. Q ........... B..r.i.d.5{e...L.a.n.e. ................ C.u..t.c.h. qg.u.e' ... House No. Street Ham/et County Tax Map No. 1000 Section ..... .8.4 ..... Block ........ 5. ...... Lot 11 Subdivision .... Igra.o,~: .Ag.r.e.s. .............. Filed Map No...5. 8..7.2..Lot No....1.5. ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated June 20, 1986 15045Z ...................... pursuant to which Building Permit No ...................... June 28, 1986 dated ............................. 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 ......... A breezeway and garage addition to an existing one-family dwelling. Th~ certificate is issued to ..................... to'~n'e;~j~ ..................... of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... N771440 UNDERWRITERS CERTIFICATE NO .................................................. N/A PLUMBERS CERTIFICATION DATED: ~' BrOiling Inspector Rev. 1/81 · 0~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERi, IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~.~ 15045 Z Permission is hereby gronted to: ,o .~~...~...~.......~....~...g~.....~....~. .......... .... ~ .... ...~~.~.~~ ~..¥~.~ ......... o' premises Iocoted at ...~.~.~...0......~...~...~.....~..~.;.....~....~d~,,~ County Tax Map No. 1000 Section .... ..~.....~...~. ........ Block .... ...C~.,.,?,. ........ Lot No ...... .~l ................ pursuant to application dated ..... ...~..~..,...,~......~.. ................. , 19.~.~..,, and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hail Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m emmmm~a 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 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. C. Fees: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.'00, over 5 years $]0.00 o.o. o.oo 5.updated C.O $ 50.00 Date, NewCons truction~. .... Old or Pre-existing Building ............ Vacant Land ............. Locat, on of ~ro~erty ..... :...~. :o. ' ~',¥.~.~.../_.~... ~.~¢~.~ Hou~ No. ' ............... 'S'~r;e~ ......... f~ ~ ~ ~. ~ ~ .:. /~ :'. . Owner or Owners of Property .... B ....... .~.. . .~-..Z~./.'~,, ,~. .......... County Tax Map No. 1000 Section... ............ Block .... ... .. .. Lot ..... Subdivision ................. ' ................ Filed Map No ........... Lot No .............. Permit No./. >77..Y:.¥ Date of Permit :/~..~,/.~. %,i,cant...~C~..'~.'/.~.~.' ........ Health Dept. Approval ........................ Labor Dept. Approval ...................... .. Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ...... ~ ........... Fee Submitted $. ~.~, .'~.. ~..~ .~ ............ Construction on above described building and permit meets all app~able code, s and regulations. App, cant.. ................ 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS ].000]..~] BUREAU OF ELECTRICITY l~ 85 JOHN STREET. NEW YORK, NEW YORK 10038 rate ~Jepte~aber 26, 1~6 429033/86 N 771440 THIS ~E~TI~IE$ THAT only the eJectrlca~ equipment ~ ~scrlbed be~ a~d i~t~uc~ by t~ applicant ~med on the a~ve application ~u ~ber in the premises of in thefollo~'ingloc.tion; ~ Ba~nt ~ tst Fl. ~ 2nd ~. G~ Section Bl~'k Lot ~,as exa~nined on ~e~r ~2 ~ 1~8~ and found to be in con~pllance with the req~iretnenls ~f this Board. FIXTURE I FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS I SWITCHES DRYERS SYSTEMS NO. OF MET OTHER APPARATUS: Z-G~.~'. C. I, PanelbOards~ 1-3cir. lOOemps E R V COND PER ~ I C E NO OF HI-LEG A W G, ] NO OF NEUTRALS A.W G OF HILEGj OF NEUTRAL paul B~rns ~75 Tc~vn }~rbor Lane So~tJ~ld, N. ¥. llgT1 Lic. 282E GENERAL MANAGER This certificate must not be altered in any manner; return to the office of the Board f incorrect nspectors may be dent~ed b ty heir credentia~//,,~ COPY FOR BU LD NO D. PARTMENT TH$ COPY OF CERTF CATE MUST NOT BE ALTERED IN ANY MANNER FIELD INSI'ECTION FOUNDATION (1st) FOUNDATION ( 2nd ) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL C OMM EN TS ,/,.Z. Examined...~4'a~ .'~. ·~. .... , 19~..~. 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved Disapproved a/c ..................................... (Building Inspector) 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 tkis 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 Btfilding 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. ~ (Signature of applicant, or name, if a corporation) .J:. . . .C ./. (Mailing addre~'s of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .<e ....................... ..................... .... . .................. Name ................ of owner of premises ..... . .~...~.~..... ~...~..~..~...O(-~..~.~-.~ ~ ................. (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 ....................... Otuel Tladc s Llcease ~u ...................... 1. Location of land on which proposed work will be done .................................................. .... ............... ......... ............ House Number County Tax Map No. 1000 Section .................. Block .................. Lot ................... Subdivision ........ .~.h ~'~ ................... 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 '" "~' '~ '~' ~x ~ I .......... ~; ~ ~- · ~:~ ...,.~{.~,qr. ............. 3. Nature of work (checl/W Repair .............. 4. Estimated Cost ......... 5. If dwelling, number of dwelhng' ' 'un2ts;' ........ w--'--' Number of dwelling units on each floor If garage, number of cars ...... i ................................................................. 6. If business, commercial or mixed Occupancy, specify nature and extent of each type of use ..................... 7. Dimensions: of existing structures,:iif any: Front . ...... Rear .............. Depth ............... Height .' .............. Number of Stories ........................................................ Dimensions'of same structure witll alterations or additions: Front ................. Re.ar .................. Depth ..................... i Height ............. 2 ........ Number of Stories .............. 7 ...... 8. Dimensions of entire new construction: Front ~ ~r '. Rear ~ / De th Height ............... Number of Stories .... "1 ' ' i ................ P ............... 9. Sizeoflot: Front ..................... Rear ...................... Depth ...................... 10. Date of P~urchase ............................ Name of Former Owner ............................. 1 I. Zone or hse district in which premises are situated ..................................................... 12. Does proposed construction violat anyzoninglaw, ordinance or regulation: ..... /~..~ ........................ 13. Will lot be regraded ................. . .......... Will excess fill be removed from premises: Yes No 14. Nmne of Owner of premises ................... Address ................... Phone No ................ Name of Architect .......................... Address ................... Phone No ................ Name of Contractor ....... j .................. Address .... : .............. Phone No ............. 15. Is this property located w%thin 300 feet of a tidal wetland? *Yes ..... No . i~ *If yes, Southold Town Truseees Permit maybe required. ' ' 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 'nterior or corner lot. )pficable): New Building .......... ddition .......... Alteration .......... ~val Demolition ' Other Work ' (D ripti ) KC) 0 esc on " (to be paid on filing this application) ;TATE OF NEW YORK, S.S ;OUNTY OF ................ .......... ~ ............... being duly sworn, deposes and says that he is the applicant (Name of individual signin~ contract) bove named. [e is the (Contractor, agent, corporate officer, etc.) f said owner or owners, and is duly guthorized to perform or have performed the said work and~to make and file this pplieation; that all statements containled in this application are true to the best of his knowledge and belief; and that the 'ork will be performed in the manner s~t forth in the application filed therewith. worn to before me this ........... .~.'.0.--~.--__.day of..i ............ 19 .~.~. I ~ ~'~O.~ ~ ~7 (Signature of applicant) 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH, PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ '~FI NAL DATE 765-t802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING ~'~NAL , _IN~,PECTOR ~ NOTIFY i~UILD~NG DEPARTM/~IT AT 765-1807 ,9 AM TO 4 PM FOR THE 1 FOUidt'~A~'~ttl 'rvvo REQUIRED FOR POURI~D 7;ONCRETE 2 ROUG~ I:RAMING & PLUMBING 3 INSULATION ~!-. FINAL CONSTRUCTION MUST IBE COMPLETE FOR C.O. ALi. CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE ~'FATE CONSTflUC130N & ENERGY CODES. NOT R~SPONsII~I.E FOR rtRSIGN OR CONSTRUCTION ERRORS. ROOF SHEATHING LAYOUT ,SECTION "4 C" SECTION "4A" (turn down slob) SECTION "4B" (formed foundation) ISHEET TOTAL 4 5 CORNER DETAIL "SA" SECTIONAL GARAGE DOOR ,,JAMB DETAIL"3 C",-~ 2184 SHEET TOTAL $