The URL can be used to link to this page

Home My WebLink About15162-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z15110 Date November 19 ., 19.8..6 THIS CERTIFIES that the building Addition Location of ProDertv 325 Korn Rd. & 3~85 Cottage Place South01d County Tax Map No. 1000 Section 062 .Block 03 .Lot 17 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... J..u .1 y.. 3. .0 ........ ,19.8..6 pursuant to which Building Permit No. 1. ~ 2.6. 2. $ .............. 86 dated August 2 19 .., 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 ......... Garage addition to an existing one family dwelling. The certificate is issued to Jeanne Walters (owner,~e.~O~ of the aforesaid building. Suffolk County Department of Health Approval ....... N../.A ................................ UNDERWRITERS CERTIFICATE NO ............... bJ773.8. O 9 ........................... Rev. 1181 Building Inspector FO~ NO. J TOWN OF SOUTHOLD BUILDING D~:PARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDIHG PEi~4 IT fi.HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby gronted to: ..... ..2. ~...~.:..~........~.~.,. ...... ,~ ...~.~.......~...~.~ ~,.......0,.~.~,, ~ . ...... .L..~.......-F~.~...~t~u.... v.~.m.~..~....~...~~....,-~__ ; .............................. ~ ....................... ~, ~rem,~e~ ,~o,ed o, ...~,.¢.......K.....~....~..~..~...~.~.....~...~.'....f.~.~.'.....~~. County Sox Map No. 1000 Section ...... ...(~...~....3m.. .... Block ...... .(~....~. ........ Lot No....h..~. ............... pursuant to application dated ,,~. ,.,.~ ~ 19-~.(~., and approved bYthe Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD 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 ,~ ~ 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~operty showing all property lines, streets, buildings and unusuat 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 $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5.u. dated c.o. 5.00 Oate NewC ohs truc t ion ....... Old or Pre-existing Building ............ Vacant Land ............. Location of Property House No. Street Hamlet Owner or Owners of Property ... J~..FI-/~/.'~.,...~..~,~'C.~-~' ................................ County Tax Map No. 1000 Section ,..D..~.~. ...... Block .... ,O. ~3 Lot .... '/7 Subdivision ................................. Filed Map No ........... Lot No .............. Permit No..I.$.1,~.., Date of Permit ~6,,Z-.,.,Applicant .... ~.~.~-~.. 9./~.~... ,kt¢~.D..~.-~... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval .?. ~..7 3.7,~..O.O. ......... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .................... Fee Submitted $ ............................. Construction on above described building and p~e~it~meets all applic~le codes and regulations. A licant '"J~-- (~/~ pp ..... :.'~ ~ ......./.~.~ .......................... ,.,.,o-:o-,a 3 0 THE NEW YORK BOARD OF FIRE UNDERWRITERS 100012~ November 6,1986 ' ,.,e N 777800 John Walters~ Cottage Place, Cot. Kern, Southeld, N.Y. in the folfowlng location; [] B~ement [] 1st FI. [~ 2ad FI. ,~ect~oa Block Lot tt~s e,ramined on OCrobe r~ 0 ~ ~ 9 ~ ~ and found to be in compliance with the requirements o,f this Board. FIXTURE OUTLETS 4 4 FIXTURES RANGES OVENS FANS FLUORESCENT DRYERS MULII.-OUTL~T SYSTEMS OTHER APPARATUS: 1.-30amp. transfer switch G.F.C.I.-1 E R I C Paul Burns 27~ Town Harbor Lane $outho]d, N.Y.~ 11971 lic.#282 E GENERAL MANAGER This certificate must not be altered in cmy manner; return to the office of the Board if incorrect, inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST:NOT BE ALTERED IN ANY BUILDING DEPT. INSPECTION []FOUNDATION 1ST [] ROUGH PLBG. []FOUNDATION 2ND []INSULATION []FRAMING []FINAL INSPECTOR ~ .... FOUNDATION FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE ADDITIONA'L COMMENTS: FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION 765-1~02 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ] FINAL DATE INSPECTOR .... 'FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ~..'b~'..~. ..~.., 19.~.~. ...C~i .'~..~...~..., 19~.6. Permit No../.~7,/.~..~..~.. Approved Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19.. · Date ................... 19... IN STRUCTIONS 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 inspectio?~,ns~t ' ......... .... (Signat Iicant, or name, if a corporation) ....... (Mailing address of applicant) / 19 3 ~' ' ' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...... ~ tx..~t~.¥).~ ................................................................... Name of owner of premises ..... '.~.. ~.~. ~/..~.... ~/ff~'TC~9 ............................................ (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... )J ~-T-....~0.] fl.$.9 ......... · Plumber's License No ......................... Electrician's License No....~.~cClk..(~.v,/'¢,4,~ ...... Other Trade's License No. ~PN..~ .~g ~' ~ ~ ~ ~ 1. Location of land on which proposed workwill be done ..... '~"r .gCS~..gP... ~.. ~..~.' ........ House Number Street Hamlet County Tax Map No. 1000 Section ...... ~ .~ ........ Block .... ,.~ ........... Lot... t ~ .............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy O/r~...~ b. Intended use and occupancy MC ~ ~.. ............................ 3. Nature of work (check which applicable): New Building '.... Addition . ... Alteration ......'.., Repair Removal Demolition ' Other Work (Description) 4 Estimated Cost I O? Cb~O Fee ! ' · (to b~ paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ....... , ........ If garage number of cars ~2,~.~- 6. If business, commercial or mixed occupancy, specify nature and extent of each t3Jpe of use ..................... 7 Dim i f i ti struct if any Front R Depth · CBS ons o ex s ng utes, '. ............... ear ...... . ....................... Height ............... Number of Stories ......................................................... Dimensions'of same structure with alterations or additions: Front ~ Rear Depth ...................... Height ......... ~_ ............. ,, Number o:f Stories ........ ' '~¥~" Dimensions of entire new construction: Front ...~'P....q .' ..... Rear ....... j ........ Depth ............ Height ............... Number of~S, tories ...... .o¥~-... 9. Size of lot: Front . .~.e..a-. 2fI:Ts/~4.(/~..,).~g~.~.~ Rear ....... .............. Depth ...................... 10. Date of Purchase ............................. Name of Former Owner I ............................. 1 1. Zone or use district in which premises are situated ................ ' ........... 12. Does proposed construction viotate any zoning law, ordinance or regulation: ...i ............................ 13. W/il lot be regraded .................... , ........ Will excess fill be removed from premises: Yes 14. Name of Owner of premises ..~-.~./'/~N~.~tg~-TEl~Address ..~.'UT~e,~&.F:. . PhoneNo .~.~-q'~.Ot~..'~.. Name of Architect .................. Address . ~.~.~..~. ?> ~O ~; "Phone No' ' i ' ' ' · o o t<o t~ *i6~"~ ......... '-'"o ..... Name of Contractor . .~.~.14-~..C.../~..tTad .......... Address e:~.aT:..rat~rd~m,4.; ..... Phone No. ~t.7. 7../. ?. ~.... 15. Is this property located within 300 feet of a tidal wetland? *Y:es ..... · If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly ail buildings, whether existing or proposed, and. ihdicate all set-back dimensions from property lines. Give street and block number or description according to deed, and sh6w street names and indicate whether interior or corner lot. STATE OF NEW YORK, S,S COUNTY OF ................. ................................................. being duly sworn, de (Name of individual signing contract) above named. ~oses and says that he is the applicant He is the ........................................................... ~ ............................. (Contractor, agent, corporate officer, et{.) of said owner or owners, and is duly authorized to perform or have performed th~ 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 that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this .............. · '-fl.~..., .... day of ..... ~ ........... 19~.. ~,t~..~7 (Signature of applicant)