The URL can be used to link to this page

Home My WebLink About14608-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z15113 Date November 20 ...... 19.8.6. THIS CERTIFIES that the building .A.d..d..t.o...a.c.qe..s .s.o.r.l/ ............................ Location of Property 55 si.n House lye. Street Hamlet County Tax Map No. 1000 Section 026 .Block 01 .Lot 22 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · .F. e. .b .. . .1. 3. ........... ,19..8.6pursuant to which Building Permit No. 146087. dated . .M..qr..c.h..4. .................. 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 ......... · .J~qtglii.t.i. 9 .n..t.o...e.x.i.s.t..i.n.q.a..cg.e.s..sp.r2( .g.a.r.a.q .e: ................................. The certificate is issued to qh~t.r.l.e.s..and Eleanor Harris (owner, of the aforesaid building. Suffolk County Department of Health Approval N/A N/A UNDERWRITERS CERTIFICATE NO .................................................. Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERJ~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 14608 Z Permission is hereb/granted to: ,~ ....;..~.~..~.~.~,..~..~...~ .... ~~.,...~.~., ...................................... ~..~.~.,....~....~~...~ ......... : ........ :.¥>......:.....~.....~. ..... :.._..~ at prem,ses I~ated at .....~ ............. ~.~.~.~ ....... ~.....~.~ ................. ~ .... Count/ Tax Map No. 1000 Section ..... ..~.....~....~. ..... Block ...... ..~....] ......... Lot No ...... ~,~..2.. ............ pursuant to appJicotion doted ...................... ~""~"~"~~...J..~ ............. , 19.~..~., and approved by the Building Inspector. Building Inspector Rev. 6/30/~0 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 NOV 2 01986 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. 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 ali 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 instetla- 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 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. Fees: 1. Certificate of occupancy $5,00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 $15.00 Date .......................... NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ...¢~.~. ~ .~.....~.!~.N. .~.~.~..~ .~.'Y?. ..... ~ ......~)..~./¢¢¢. ~ ................ House No. Street Ham/et Owner or Owners of Property (~Z~./)~& ~..A ~ I~. l~_ t~.~r. QK¢. . .J:~..~.n t ~; ................. County Tax Map No. 1000 Section .~:~.2~- ......... Block ...~../ .......... Lot.. ~.?~. ......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ..................... Underwriters Approval.../~.4z/~-% ............. Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. App,icant ~ .~..~ , 7L5-1802 BUILDING DEPT, INSPECTION [ ] FRAMING REMARKS: [ ] FOUNDATION 1ST []ROUGH PLBG. [ ] FOUNDATION ZND []INSULATION []FINAL DATE /~///~./~" INSPECTOR ~iELD INSPECTION ~OUND~T~O~ __~ ~___~ ~O[JNDATION (2nd) ~OUG ME & PLUMBING COMMENTS !NSULATION PER N. Yo STATE ENERGY CODE ADDITIONAL COMMENTS: D 0 0 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ., 19 ., 19 ~.b. Permit No.}..ti..~.O. 7..~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILD{NG PERB,'IIT BLDG. DEPT, TOWN OF SOUTHOLD Received ........... ,19.. , Date ................... 19. INSTRUCTIONS a. This application must be completely filled in by Wpewriter 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 prem. ises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever tmtil a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HER~¥ MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance ot~l~Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construct!on isf 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. ~re of applicant, or name, if a cor~poration) .4/.__ f... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......... : ./~_7/e. d~. ~.~&~...x.~.....,~-'....,~..~. ,,e. :, .............................................. Name of owner of premises ~.~2./~. ~.. ~..-~.....~.~,:~/r~.../.~.~. ....................................... (as on the tax roll or latest deed) If applica, n,t 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 .... ................... Other Trade's License No ...................... o~( ff-J"- 1. Location of land on which proposed work will be done .......... ¥ t A ~( z~ C-.~ .... ~.~,*%,~ ...... /9. ~ .'.~. ..... ,x~:, ~ ~,.. s,~ ..................... ................ i ...... .. 4~.~.x~ ~.w.,..~,. ,.v.~ k'.. ...... House Number Street Hamlet County Tax Map No. 1000 Section ..... .~ .~..' ........ Block .... ~ ............. Lot....~..~. .... ... '. '.... Subdivision ..................................... Filed Map No ............... 'Lot ............... (Name) 2. State existing use and Occupancy of premises and intended use and occupancy of proposed constructio~i: a. Exis'tfng use and occupancy .... ~-~t'?-.~-..t~ .......... ~ ..................... ' ....................... b. Intended use and occupancy .. ~¢.,( ** rl~.~-~i.., i~-..~.r& ~,-~..-. ..................... ' 3. Nature of work (check which applicable): New Building '. .... '..,.'c. ~dditi0n ...!~ ..... Alteration ....... '... Repair .............. Removal .... '.,: ....... Demolition ............ :.. Other Work ............... ' (D ripti ) .~./.~' i,~' ' ? . ese on 4. Estimated Cost ~. ~ ~ Fee ........... (to be ~aid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling unit{ on each floor ................ If garage, nu/nber of cars .... 2....W~.~qh-~a,,.g .............................. i ................... : ....... 6. If business, commercial or mixed occupancy, specify nature and extent of each ty~p6 of use ..................... ' 7.' Dimensions of existing structures, if any: Front .... IA../ ....... Rear ...~...i ....... Depth Height . :1.~...~'..q~ ..... Number of Stories ...... ~.O.~.~_ ................ i ............................ · ~..g ...... . .... Rear ..... z.~/., i ....... Dimensions of same structure with alterations or additions: Front ... t i Depth.. ,~'~2~11~. ........... Height ..... t. 2 ............... Number o~ Stories t~.. ,4.1~ ......... 8. Dimensions of entire new construction: Front ............... Rear ..., ...... ~ .....'. Depth ....... ))...'... Height .............. :. Number of Stories .................... : ........ i ........................... 9. Size of lot: Front ...................... Rear ...................... ?~oth ........... ~i ......... I 0. Date of Purchase .: ... b.~..~. ~7 ................. Name of Former Owner . ~.~...~g:-L£~ ...... 11. Zone or use district in which premises are situated .............. : .......... "[ .................... i ....... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..~.p.! ................... ~... 13. Will lot be regraded ...... ~c/'o ................... Will excess fill be removed! from premises: Yes '~j~ 14. Name of Owner of premises . ~.t%~-.o.~.~.~....~...~..~.,.~ldress .... V~ ~.-.'c.~..c.~...,~A~hone No.. )'...,z.~..~i .~.'~. Name of Architect .../,/a~,.: ................ Address ................ ... Phone No ................ Name of Contractor .............. 2'. ........... Address ................ !... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. ind property lines. Give street and block number or description according to Iced, and sho~ interior or cornerlot. .~ oo ,~ ~ ~ ,,, g, ~- ~ £ ~ STATE OF NEW YORK, ~ ~ Vt ~ COUNTY OF-, ............ 'i'.. '... o.,~ , ...... ~ .... ~..., ~ .......... being duly (Name of individual signing contract) above named. sworn, deposes and says icate all set-back dimensions from street names and indicate whether that h' e is the applicant He is the .............................. . .~..~ ..................... i ........................... (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 ~pplication; 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 therexw~th. ~worn to before me this .... day . ..... , NOTARY PUBLIC, S,oIo of N,w York J j j (Signature of applicant) APPROVED AS NOTED ?' NOTIFY BUILDING ..,~PARTMENT AT .. 765-1802 9 ~,1~ 'cO 4 PM FOR THE ' FOLLOWING I~CTIONS: 1 FOUNDATID~' iWO REQUIRED FOR POUR~o CONCRETE 2 ROUGH ~MING ~PLU:* 3. INSULA FI( 4. FINAL C~ ,JSTRUCTIOh~ BE -~OMF~ ~TE FOR C.O ALL CONSTRUCTION SHAt.[ .,~. T THE~REQUIREMENTS OF THE ~ Y ~ATE CONSTRUCTION & ENERGY ~DES' NOT ~ONSIBLE FOB ~IGN'OR CONSTRUCTION EY~1ORS.. J 0 0 OTIFY BUILDING DEPARTMENT AT 55-1B02 9 AM TO ~. PM FOR THE )LLOWING INSPECTIONFJ. FOUNDATION TWO ~hQLURED FOR POURED CONC',F~, ~ r_~ 'ROUGH FRAMING & INSULATION ~CCUPA~;~Y OR SE IS uNLAWFUL IWlTHOUI' ~r, RTIFICATE DF OOCUPAN~IF 1-- ---- ~- -I- L mi AUGUSTUS SUGLIA, A.I.A. ~050