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HomeMy WebLinkAbout15156-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building . 977...~.~.~.z.%¥..DJ~S. 5EV!9' ?.!V.~..~y. Tb.c.~.ED.. · 1080 gorey greek Lane Southold, New York Locatmn of Property tO~s~ hiol ....................... 's't/o$i ....................... County Tax Map No. 1000 Section 078 .Block 04 .Lot 15 Subdivision M/o Corey Greek Ests. .Filed Map No. 4923 .Lot No. 13 conforms substantially to the Application for Building Permit heretofore filed in this office dated July 30, 1986 pursuant to which Building Permit No. 15156 Z dated .......... · .........July 31, 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 ......... ONE FAMILY DWELLING WITH ATTACHED GARAGE The certificate is issued to JOHN & CAROL O' HAGAN ..................... ioh;.'~£ '/~ ¥;4~/~y ..................... of the aforesaid building. Suffolk County Department of Health Approval .... 86- S O- I 16 UNDERWRITERS CERTIFICATE NO ............ FEND August 4, 1987 CERTIFICATION DATED: PLUMBERS Rev. 1/81 fiG.'ur NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING P EI~41T (THIS PEP~IT MUST BE KEPT ON THE PR£MISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15156 Z Permission is hereby gronted to: .... ~.~,~......~'...~.%.~ .......................... ............... :::::::::::::::::::::::: County Tax Map No, 1000 Section .... ..~..~.....~.. ........ Block ....... ..0....~. ....... Lot No ..... I...~..Z ............ Buildln9 Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANC~ Instructions A. This application must be filled in typewriter OR ink, and submitted I ~ to the Building Inspec- tor with the fol[owin§; 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 disposai-(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.landF°r uses:eXisting buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-ex~sting"* ' 1. Accurate survey of pzgperty 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 $25.00 -- BUSINESS $50.00 ACCESSORY $I0.00 2. Certificate of occupancy on pre-existing dwelling $ 50,00 3. Copy of certificate of occupancy $ 5.00, over 5 years $I0.00 4.Vacant Land C.O. $ 20.00 /.~. ?.~. 5.Updated C.O. $ 50.00 Date ..'.~,~¢ ......... ' ...... NewC°nstructi°n. ..~-... Old or Pre-existing Building ............ Vacant Land ............. /o o co.?e/ ... Location of Property ....................~ ~i~/¥ ................. HoU~ NO. Street ' H~m/et Owner or Owners of Property ~- ~cF, ~/~ ~ g~d~ CountyTax Map No. 1000Section .~ .......... Block ..... ~. ....... Lot.../~ ........ Subdivision...g . ¢~-<e;.e~. ~ T~7. .Filed Map NO..~2..Lot No.. X~ ......... Permit ,o. Z~Z~:~ Date of Permit ([~1/2~..Applicant'S' ¢.~.~,. .~.. Health Dept. Approval. ~Z~¢.7. .......... Labor Dept. Approval .... =- Unde~riters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ~ ~ Final Certificate .~ Fee Submitted $ .................... ..... Construction on above described building a~ p~e(,~jt meets a~ applicable codes and regulations, Rev, 10-10-78 TOWN OF SOUTHOLD OEFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 CERTIFICATION TEL. 765-1802 Building Permit No.~/~ Owner ~/3 (please prlnE; e prxnE) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plu~er's signature Sworn to before me this 19 - Notary Public, r~~ County Notary Pubic NMIIW ~ ~ d NewYo~ TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-180:2 To Whom Thls M~y Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. /_--~/ An application for Certificate of Occupancy is not on file. /~/~ No Underwriters Certificate on file. /~ The check is(outdated/~) /]~No Health Dept. Approval on file. /Z/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit # _~ 5- _~ 5- ~ Z Building Dept. ***/~No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) O~cup~ncy or use is unlawful without, a of Occupancy. Clear up this matter as soon so that legal action does not have to be taken. Thank you for your prompt attention. Certif~ate as possible Office 0f.'gui"ld~ing fnspec~0r}~.'-" .Town-Hall ~ - · .... . , ~ . - ~ · So~thold, ,Ne~w Yo_k 1197~ .... ~ ~ ~.1 Dear Mr. ~Lzssard: ' I hay9 ~us~ been~adv.$s~d~ by my buzl~d~,~ Mrna. ~Wzllzams, that- the~ front r~m ~adjace~ proper szze wzndgw aKd ~dzd no~t~:pa~s~ yo~n~pm~Zion, ~We are ~awa~e' of the. pro~er s-~ze ~e~e~t~ for egress ~n bedroom~ aS y~u c~n' se~ ~f~o~--~'~o~s ~:~n.~e. bedrooms; We had dec~ded, ~owe~e~.~> t0' ~ ~hzs room.as a d~n and apol~gzze ~or ~not. ~ad~s%n ou that we ~had made ~a chang~ from ~he~rzg~znal pl~ans~ F (1st} FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE ADC rIONAL COMMENTS: BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ]FRAMING [ ]FINAL REMARKS: '~~J~'~O/L/ 7GS-XS02 BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: [ ] FOUNDATION XST [ ] FOUNDATION 2ND [ [ ROUGH PLBG. INSULATION FINAL BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ] R~~OUGH PLBG. 76.5-1802 BUILDING DEPT. INSPECTION FOUNDATION 'wST [ ] ROUGH PUG. ~FOUNDATION :)ND [ ] INSUI. ATION [ ] FRAMING [ ] FINAL REMARKS-. ~ 765-X802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION []FRAMING []FINAL REMARKS:,~--~ ~/~,~. . ~'~, .. ,,x'~-x--x-'..'..x?~'. ~o~ DATE, 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING ["~"'FINAL REMARKs' DATE ~INSPE~TOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING FINAL FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL £OUTHOLD, N.Y. 11971 TEL.: 765-1803 me it Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... Date ................... 19... IN STRUCTIONS a. This application must be completely tilled 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. fi(Signature of applicant, or name, if a corporation) .~:~.5...~...?b ............. ....... ' .... ~;~[ii~' ~/t/t;:~' $~ ' ~ii~E~ ...... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · .o..~.. ~.e..a...::...~..~...a..~ .~....:.~¼.4...©: '~'~' '~' '4 ~.2., ................................. Name of owner, of premises (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.. ~ .t/k~.. ............... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ............ ....................................... ..... ...................... ". ......... House Number r Street Hamlet ~ ~ ~' Loi'i..[ .,5: ........ County Tax Map I'Io. 1000 Section .... .O .... ~.. ~ .... ~Block,.....~ .............. Subdivision...~..~ .~.~.'.] · ,~.~.~ ~ .~'-. · ·b-=.~. .{ .~-'.~.~. - Filed Map No ?FT..~..~..3 .... Lot... J.3 (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a Existin useandoccu anc 'T'o (~o',L~ s,',~ Ce P~4,~_ · g P Y '''~,, , ..................... '~ ............... 'J'';:}i':''':' ................ b. Intended use and occupancy ................ ~ ..................... . ,..: ..v..~ .,...; ................. 3. Nature of work (check which applicable): New Building ...... )kddition .......... Alteration .......... Repair .,: r ......... RemOval .............. Demolition .............. Other Work ............... ., · (Description) 4. Estimated Cost ............. ~3/~).~./.~..0.0 ...................... Fee ...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling t~nits O '~ (~ Number of dwelling units on each floor. O ,a..~. If garage, number of cars .... ? v~..H ......................................... k' r ................ 6. It' business, commercial or mixed occupancy, specify natur~e and extent of each type of use ...) .'~. ? ............... 7. r)imensions of existing structures, if any: Front...~..D..~.t;- ...... Rear .............. Depth ............... Height Number of Stories Dimensions of same structure with alterations or additions: Front ... Rear Depth .................... :.. Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front .x~..~....~ .... Rear ...~.8...~. .... Depth ~..~. .......... H~ght .../..~. ......... Number of Stones ...... .O..*q..G ........ ' .................................... 9. Size of lot: Front .... .I o..o. ~. j .... Rear ..... I..~.q.t. ...... : .... Depth ...~..~. ~:-/. { .t .......... 10. Date of Purchase . .',1'~'.°. e.~ .'l..qI. ~.e[ .-U3 ............ Name of Former Owner pfl..q..~../~.~.~.., j~.o..~ .~..~.% ..... 11. Zone or use district in which premises are situated ....................... ~ } .......................... 12. Does proposed construction vioiate any zoning law, ordinance or regulation: .. l'.'X..~. ........................ 13. Will lot be regraded ... I~ ~.. i ..... S ............. Will excess fill be removed fro. ra,prejnises: 14. Name of Owner of premises-4/.°~ ·~. .O. !{~. $.~.,~. .... Address~-ficOr-~ ~..~..~ P4n, .Oval. Name of Architect ~.T~~ v+Z,q...&, .~.~..~./Ald,[ ~ ..... Add(~s~ ~. ? .'r.~-. ~.?'7.~ .~.~.ero~,q Yl~[~neeNo, ............... ~., Name of Contractor..?-~o..l~.fi .l~.fi i~.: ) .~.*..,'[..~.4 ..... Address .~...4q°. v?.g..~.~..~.~?.~.~P~e~N~!~q~l~ 15. Is this property located within 1~0 feet of a tidal wetland? *z~. .... No . · If yes, Southold Town TrUstees Permit may be 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 bloc~ number or description according to deed, and show street names and indicate whether interior or corner lot. '' .... STATE OF NEW YORK, COUNTY 'OF .................. i (Name of individual sil above named. He is the .................... S.S ..................... being duly sworn, deposes and says that he is the applicant ning contract) (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 cofltained/n this application are true to the best of his .knowledge-.and belief; and that the' work will be performed in the manper set fOrth in the application filed'therewith. Sworn to before me this (Signature of applicant) t~ N.Sa £6,10 E, 5,.~2 4'7' 50 v,/, I":'x~PIRES GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. iLE FAMILY DWELLINO ONIY O YEARS FROM DATE OF APPROV,a STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFO~'K~.CO{~ DEP'Tc~)Fi %HEALTH SERVICES. ~APPLICANT L~ SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCT'OI~ ONiL¥ DATE: '7/j.~ fib APPROVED: ~ (---~ ~~ SUFFOLK CO. TAX MaP DESIGNATION: DIST. SECT, BLOCK PCL. i.Oz, L"C,D . . 078 4- l'S OWNERS ADDRESS: TEST SEAL su.o~ oou.~,~T~ ~~ .?..,.. / .- ~' ~ ~ "'P" "~'~ '~ '~ ' ~ .... -~::(~ E t '--~:' 'b'i~ I ~-- ~: ........ ,. _ / ~=.~.7~~ .-,,~ .: .. MAP OF ~OPE ~T Y ~UI~ tA~/ " .... ~ ' .~ " GREE~T ~W Y~K 54'- ~' -U_-J L-] L--] L_.--I ,.//////,,, L ' TOP OFWA.LL EL ~. ,~LO' FO~JklDATIO~: PLAN OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIRCATE OF OCCUPANCY SOLDER U~ED IN SUPPLY ~I'~EM ~.AIINOT EXCEED 2.~ W PLUM~ER CERTIFICATION ON I..EAD CONI'ENT ~EFORE CEII~FICATE OF OCCUPANCY APPROVED AS NOTED NOTI~ 8UI~ING DEPARTM~T AT ~6~1802 9 AM TO 4 ~ ~R THE FOLLOWING IN~PEC~ONS: FOUNDATION 1~0 REQUIRED FOR ~UREO CONCRETE 2 ROUGH FRAMING ~ ~UMBING 3. INSULATION 4, FINAL CONSTRUCTION MUST ~E COMPLETE FOR C.O. ALL CONSTRUCTION SH~L MEET THE REQUIREMENTS ~ ~ATE CONSTRUC~ON & ~ER~ COD~. NOT RE~NSIBLE ~R ~tGN OR CONS~ON ~RORS. 5' IC~. g(o A~PHALI' $OALE: I' -' 1" __' I~i:2.,10K ONIMN,C.¥ A~PHAL1 ~HNGL.~-'~ I"x o" WOOO FASOIA 19" 2" ~ lO" - 'ToP ~P PlA'r~ BI., '~'~A ~ P HAm[ ~-I",( JO" ~/000 FA¢IA PI L A'~TF4~. A~pLIBD FLOOR EL, O'-O" ',% F~ONT F::: L CVA~T I©kl ~" ¢. ia," LONG ~'-0" 7¥PICAL ;x~' ATIG' COliC, I* ~_ ...... ~ Al.V, ~ETAL AR~.4.WA¥ ~IGHT 51DE, ELEVATIOkl W,~LL ¢£CTtON 8CA L ¢"; 3/El= ,GH INGL D, '~ WCX:X3 Sim OPEN 5A~EM~,BI ~'-oo~. ~.~FT 51E~ E::LP_.VATIOM SCALE; V4:'.-' I'-0'! APC,Or~ PiN, GRAIZ~ I OV~ CO~, PiT cO, I'l¢12" I ¢1~" I~' 'Ill[' J I I I I' PLG~ING ~A~A~. _ 4" ~OIb,