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Home My WebLink About14379-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z14107 Date December 19 19.8.5 THIS CERTIFIES that the building ..... a.ddSti.on ................................. Location of Property ...4.05 .............. .ivI.~[O$~..~.~D~ ................ .M.a.~.~. $~.u.c.k. .... House No. Street Hamlet County Tax Map No. 1000 Section ~...1.0.7. ..... Block ........ .2 ......Lot ..... 1.2. .......... Subdivision ...... X Fried Map No. .X. Lot No. X conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... 9.c.t. qlo.e~c..1..1..., 198.5.. pursuant to which Building Permit No. 1437 9Z dated ....O. ctob. er. 1.7 ............. 19.35, 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 ......... The certificate is issued to ........ .A.L.F.R.E..D. E, & CLAIRE BOUFFA.RD (owner,~ of the aforesaid building. Suffolk County Department of Health Approval ................... .N/.A. ................... UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 FORM NO. 0 TOWN OF SOUT~OLO BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERAAIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) No 14379 Z Date .................................................. , 19 Permission is hereby granted to: ....... ...R...t..~....~. ........ ~.~.~.~.~ ........... ........ ..~:/~......~.~......~.~.~ ......................... ......... ,~:~:.'.:0~..~ ....... ~.:.~. ......................... ,o .......... ..c..~:..+.r.~. .......... ~&.;.~.....~.,......~.~.:'.~..¢...i?~. ......... ~...¢~'~:~.. ........... I~o; ~,~ ~,~ . .. at premises located .................................. ? ......................... ~ ................ ;'.~*.' ............ ,~ .... . ..* County Tax Mop No. 1000 Section ....... /..0....~. ........ Block ............. ~.~.. .... Lot No. Iai- pursuant to application doted /~)/// i0...~....~., anti approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY ['~LDG. DEP¥. I'OWN OF SOUTHOLD Instructions This application must be filled in typewriter OR ink, and submitted i=,,III 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 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 $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 Date ...1.2./.1.2. ,/.8.5 ............... Accessory New Building .A..d.~.~.~.~. ,o.~..t.~ld~oxPre.existing Building ............ Vacant Land ............. Location of Property 405 Maple Lane Mattituck, N. Y. House No. Street Ham/et Owner or Owners of Property . .A.~?.~.e..~. ?.... ,~ Cla±re Bouffar~, County Tax Map No. 1000 Section lO7 Block 02 Lot 012 Subdivision ................................. Filed Map No ........... Lot No .............. 10/17/85 A.E. ~o~ffar~ PermitNo. 14379 Z DateofPermit .......... Applicant Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate . .~.e.s. .................. Fee Submitted $..6...q0...fp.r...C....q:..&..1....CpLq,Z %/~? ~),C~ ~ . Construction on above described building and permit meets all applicable codes and regulations. :lq la--/ ................................ Rev. 10-10,78 FIELD INSFECTION COMMENTS FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & FLUMBING INSULATION FER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 76S-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH pLBG. FOUNDATION 2ND~[ ]/ INSULATION FRAMING //~ FINAL DATE ')~//~'/~- INSPECTOR 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~JDUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined /0//7 19~ Approved .... ./.0../(/?. ..... ,197..t~Permit No./.¢.~.'~..??.~ Disapproved a/c ..................................... BLDG. DEPT. TOWN ,,OF SOUTHOLD, Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS 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 ~t 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, fo~ 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 al~fi%ant, Or name, if a corporation) .. .:.:. l:,.+. . . .F.,. . ¥,.. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner ......................... ~m · .v .*~'-neo~ownero~"rem:se~ Bou~fard, Alfred E. & Claire (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...s.e..1.~ ................... Plumber's License No ......................... Electrician's License No ....................... t. Location of land on which proposed work will be done. N.qr. ·t.h. .s.i .c.1.% .~.esp l.e..L~-v.,.EasL..of. G.r. and. Age .... 4.0.5 ......... .M.ap 1. e....~.a.n.e. ................... M.~t t it.uc k ................... f. House Number Street Hamlet County Tax Map No. 1000 Section ...... 1.97 ......... Block ....... 02 ......... Lot .... 03-.2 ........... 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 Residential b. Intended use and occupancy ~.t.o. ro.g.e..~:p,~...fgr..Gord.en. T~>.o.% s ................................. 13. Nature of work (check which applicable): New Building ..... ' .....A~dition~ ......... Alteration .......... Repair .............. Removal .............. Demolition .......... Other Work ..... .... ....... ~.~ ~_~ .~..~...~.IO.O. (Description, 4. Estimated Cost ..... Fee ............ (to he paid on filing this application) 5. If dwelling, number of dweiling units ............... Number of dweiling u~its on each floor ................ If garage number of cars ~ 6. If business, commercial or mixed occupancy, specify nature and extent of each fype of use ..................... 7 Dimensions of existing structures if any: Front ~. ' Rear i 2.6., Depth 3 2, Height ...............Number of Stories .......................... ! .............................. Dimensions of same structure with alterations or additions: Front ....... 2 ~.' ....... Rear ...... 2.~. '. ......... Depth 4 4, Height ~ 8 ' Number Of Stories 8 Dimensions of entire new construction: Front Rear ' Depth FIeight . . 18.' ...... Number nf Stofi~ . . 1 ............ · .. .~oq" Depth 9 Size of lot: Front ~.~9 .............. Rear ............. !. .3 10. Date of Purchase ... 7/.7.]. ...................... Name of Former Owneri .gr.a.r~I~. ~.o.~n ................ 11 Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation: , ......~.o ...... ~ .................. t3. Will lot be regraded ........... No ............... Will excess fill be removed from premises: Yes i4. NameofOwnerofpremises .~,~...~..c:.~.qu.f.~.~.~.d..Address ?i.a.p.~.e..~.a..n.e ,i .... PhoneNo~ 2.9?.-.5.9.7.2 ...... ..... ~ :~fi2 ~ Name of Architect ....................... ' Address .................. Phone N~ ............. Name of Contractor .......................... Address ............. i ......Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and.iindieate all set-back dimensions from property fines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ~~gr~t, ~lo.o STA' 1] O~ NEW YORK, COUNTY OF....8.u.f..f93.k. ..... S.S ......... /k~l[ ~ ~t..l~,. ~B.o. tl ~_ .f/a,r. cl .................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ........................................................... i .............................. (Contractor, agent, corporate officer, etc.) 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 /~otary Publte, State of New York (/ No. 52 - 4663491 ..... Qualified fn Suffolk Cowry Commission E~p~es Ma~h ~, 19 ~ '1 )i FP-..ANKLIN ,.,,JOHN BOP-.N q f. ~) ¢, I' i: APPROV~ FEE: o~'~ (9 0 765-1802 FOLLOWING fNSPECTIONS; ,). FOUNDATION . ~O ~QUJRE¢ FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUM~IN4 3. iNSU~TfON 4. FINAL .COh, ST~UCT)gN BE COMPLETE ALL CONSTRu~)oN ~ALL '~-' THE REQUtREMEN% STATE CO,NST~UCT)O~ & 'ENERGy COD~ NOT RESPONSIBLE FO~ D~SIGN OR CONSTrUCTiON ERROr, IT 'I ~iI ................ , ...... L