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HomeMy WebLinkAbout14437-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z~4097 Date December 16 19 85 THIS CERTIFIES that the building ...... ~. 0..0.D..S.T..Oy.E. .............................. Location of Pro err 815 LONGVIEW LANE SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section .... 0,8..8 ..... Block 05 .Lot 009 Subdivision ..... T.E..R.~.~..W..A.T,E.~S. ............Filed Map No, 290 ~ .Lot No. 4/4 conforms substantially to the Application for Building Permit heretofore filed in this office dated N o v. ~/4 19 8 5 pursuant to which Building Permit No. q/4/4 3 7 Z dated . .~9¥....2.~ .................. 19.8.5. , was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issned is ......... Installation of wood stove The certificate is issued toDiane & Jim Galarza ..................... ?oYn'e;, Ys & k' gCo't) ...................... of the aforesaid building. Suffolk County Department of Health Approval . .lXl,/.~. ..................................... UNDERWRITERS CERTIFICATE NO ...... N / A Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 14437 Z Permission is hereby granted to: ...~.:~.~..¥~.....~...~.~.. ..................... ..... ~.~:r,./..~,~...:.~...~....../..~.~.Z:... ~o ........ /....~..~ ......................... ~/.Zc..c.~.~.......~_~ ....... ...~ ...... .~...~ ..................................... at premises located at ............... -~..~.~..~.. .................. / ~ ,¢: . .... z.~....,.~.../-Z/~.£~.~ ............... ~..z..~. ....................... ~,,~.z ............................... County Tax Map No. 1000 Section ....,(~,...,?.,. ,~., ...... Block .....(~,...~i'. .... Lot No..~,..,~.,..~,. .......... pursuant to application dated ...~...~-~. ....... /....~... ...................... , 19.Z~..Tand approved by the Building Inspector. Fee $.....~,...,.~.....~. Building Inspector Rev. 6/30/80 ~vO~v NO. ~ TOWH OF $OOTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 14436 Z Permission is hereby granted to: .................... ...... .~.~.~.~.~,,~....-....~.~ ....... ~o ....... .~.~~~ .............. ,~.~...~.~.~....~ .~.....~ ............................... ......... ~~.~.....~ ............ ~ ............................................................................... ot ~re~,~ ~t~ ~t ..... ~.~: .............. ~..~.....~ .......... ~a~ ........................... / .... 2~ ........ ~~ ........ ~ ....... ~ ................................................ .~. .................. ~ ~ ~ uo. ~00o ~o~ .,~..~. ...... ~ ...~..~ ....... ~o~ uo. ~ ........... Building Inspector. .......... ..: ....... Building Inspector Rev. 6/30/80 FORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. Certificate O[ Occupancy No. Z14096. Date December 16 1985 THIS CERTIFIES that the building ....... D..e.c.k ..................................... Location of Property ....... .815 LONGVIEW LANE SOUTHOLD House No. Street Ham/et County Tax Map No. 1000 Section . 9.8.8. ....... Block ..... 0.5. ........ Lot...0.0.9. ........... . .. TERRY WATER 44 Subd,wslon ............................... Filed Map No.. ?.9.q ]..Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... ~gY.... 1 J ......... , 19@5. pursuant to which Building Permit No..1.4.4..3.6.Z .............. dated ..... ~ 9Y, ....25 ............... 19.8. 5, 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 ......... .... l)e.c.k. ~d.d.J. ~;[.on .~9..qr~, ?.~n~ .i .~y, .d..w.e.l.!~..rig.. ................................ The certificate isissued to . .D.%6~I~..~ .J~,M GALARZA ....... /o¥,,'~;, ?;~id~ ~¢~;0 ...................... of the aforesaid building. Suffolk County Department of Health Approval ........... N / A UNDERWRITERS CERTIFICATE NO.. N / A Rev. 1/81 Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR inA, and submitted m ~imam~ to the BuildihgJ,nspec- 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 unast~l 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: I. Accurate survey of property 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 $15.00 Date New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ...~.~F.~7 ..~..,~.7F.¥/..~c..'~?..~.,.~¢..Y?.~. ......... .O...d~.~..~......~. ~ House No. Street Ham/et O, ,er or Owners of Property !.<'tS.. . County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision .~,-¢-~--7...,., .~. .................... Filed Map No ....... _,, .Lot No .............. Permit .~-, ,~, .~.~.~ Date of Permit, ?.//.~. ~'.~, ~App licant ~./.~, ~,~', .c .,~,,' .~.~,~,_¥., .~.4//.~. ~ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Construction on above described building and ~~'/~;~nd regu lat,ons. Applicant. ~.~./~. ,- ~..~,,j~/,/~-~, ?, ~. .... ~, ....... FIELD INSPECTS[ON DATE COMMENTS___ ( ~ s t ) FOUND~ITIO~ FOUNDATION (2nd) ,-- , ~o~ I{OUGH FRAME & FLUMBING ~ INSULATION PER N. Y. ,- STATE ENERGY ,,, ADDITIONAL COMMENTS: _ DEC ~ ~/~PP. RO.,YED AS 'NOTED ~ 765-1802 9 AM TO 4 PM FOR THE FOLLOVqING INSPECTIONS: 1. FOUNmATION - TWO REQUIRED FO~ p~U~ED CONCR~ ~. ROgg'd - FRAMING & PLUMBING ~. FfN~[ . C~N%T~LJC~ION MUST ~E C~MPt CTE FOR C.O. ALL CONSTRUCTION SHALL ME~ THR REQUIREMENTS OF THE N. Y, STA~ CONSTRUCTION & ENERGY COD~S. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. 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 m ~ 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 featu res. 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 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. 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 $15.00 Date or Pr xisting Buildi '~ Vac t La d New Building ............. Old e-e ng ............ an n ............. Location of Property. Z./.~-,)... Owner or Owners of Property / County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ........................... ,...,, .Filed Map No ........... Lot No .............. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $, _¢~,~,..~. ,~9..~-. ~.~.'?.o.~.~...,~. f~,,,~ ,~,'.~-~''- Construction on above described building and p~e~t~Z'l appti%a~¢s and regulations. Applicant Rev, 10-10-78 ~IELD INS?ECT~ON ~ FOUNDATION (1st) COMMENTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: NOTIFY 'BUILDING DEPART/',,/~ AT ,1. FOUNnATION - -IM/O REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C, O, ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONS]~EE FOR DESIGN OR COHSTPlJCTIOF! F2P©mC , HALL~ Memorandum from.... BUILDINO INSPECTORS OFFICE TOWN OF SOUTHOLD TOWN HALL, SOUTHOLD, N. Y. 11971 765-1802 t NOTIFY BuILPlN~ ~54802 9 AM TO 4 P~ FOR THE FOLLOWING iNS2ECTIONS: 1, FOUNDATION ' ~0 REQUIRED FOR pOURED coNCRETE 2. RouGH - FRAMING & pLUMBING 3. iNsULATION 4. FINAL - CONSTRUCTION MUS~ BE COMPL~T~ FOR C. ALL coNSTRUCTION SHALL MEET THE REQUIREMEN¢S oF ~ATE ~oNSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FOR DESIGN OR coNStRUCTION ERRORS, H .,~ L LVg~,V 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 \ , --"' TEL,: 765-1802 Disapproved a/c ......... ~ ................... APPLICATION FOR BUILDING PERMIT Receiyed ...... ~.>1 9... Date .................. , 19... 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 t~r 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 ~ 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 co_de, and regulations, and to admit auth°rized inspect°rs °n premises and in building f°r necess~.~,_______ ~ ~' ~-- (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................... ............................................................. 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 ..... ~C~..~. ............. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. County Tax Map No 1000 Section .~. t~. ........ Block ...... (2~.~. ....... Lot...~ .......... 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 ..... ~'~ ~..~~...~ ~(~.~ ......... ~ ........ b. Intended use and occupancy ~5~: ~/~ ~~J~ ~ 3. Nature of work (check winch applicable): New Building .......... Addition .... ....... Alteration ...~ ...... Repair .............. Removal .............. Demolition ........... i" Other Work/..~.r/~.~'.~.//.~ 4. Estimated Cost.. . : .................... Fee ........... ........................... (to be paid on filing this application) 5. If dwelling, number of d~velling units ...... Number of dwelling units on each floor If garage, number of cars ......... 6 Ifbu ines ommercial or mix d upancy sp ify tur and extent of each typ~ of · s s,c e ccc , ec na e use ................ 7. Dimensions of existing structures, if any: Front ............... Rear ....... 2 ...... Depth ............... Height Number of Stories It dditi : R Dimensions of same structure with aerations or a OhS: Front ............ ~ .... ear .................. Depth ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ........ ~ ...... Depth .............. Height Number of Stories ' 9. Size of lot: Front ...................... Rear ...................... Depth ................... 10 Date of Purchase Name of Former Owner 11 Zone or use district in which premises are situated 12 Does proposed construction violate any zoning law, ordinance or regulation: 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No 14 Name of Owner of premises Address ' Phone No Name of Architect Address ' Phone No Name of Contractor Address . Phone No PLOT DIAGRAM : Locate clearly and distinctl.y all buildings, whether existing or proposed, and, indicate all set-back dimensions from street names and indicate whether property lines. Give street and block number or description according to deed, and sho~ interior or corner lot. COUNTY OF .... S.S being duly depoies and says that he is the applicant ............................... , ................. sworn, (Name of individual signing contract) ubove named. 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 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 ...................... dayof .... .~......~. ~.,19.~" . ' ' - ,': ,-~ ~s~ocr~ ' F '/" .......... ? A, Notary Public oi I¢*w ]#1/~ ·[ / / 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 TEL,: 765-1803 19~.~.-- 1 . .~7~. ~e~it No.. X .~.~.( Z Disapproved a/c ..................................... (Building Inspector) APPL!CATION FOR BUILDING PERMIT Received ........... ,19... 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 thc 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 alt applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for ne~S. ~.~ ~(Signature of al¥1icant, or fldme, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................... ...................... Name of owner ofpremises .~../.~0/~V...O/.. ..'-,~..~..tf?..~. .... 4~.~...~..(~....~.--f.,~.. ........................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ....... (Name and title of corporaie officer) ,ff Builder's License No ........ .~.(~.~. .... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on which proposed work will be done .................................................. County Tax Map No. 1000 Section ~ Block Lot ~ Subdivisioa... ~.~...~$~ ............ Filed Map No. ~e ( ....... Lot.. ~'. ........ (Name) State existing use and occupancy of premises and intended use and occupancy of proposed ~onstruction: a. Existihg use and occupancy..~.~.. ~[~..~ ~{.~ ~ .... ./ ......... ' ...... b. Intended use and occupancy ~.~...~(~..~~/~ ~.~ ......... 3. Nature of work (check which applicable): New Building .......... Addition ........ Alteration .~7 ~ .~.~.~d. ...... Repair .............. Removal .............. Demolition ............ ~.. Other Work ............... XfT~ 7 ~ ~ ~,3~_~ ~iif'~,~',{~ z~ c'~~ ~ (Description) 4. Estimated Cost ............... : ....... :-: ........... Fee..............---~f/.-.;/fl.'-c~.?.~-.- .~.. . ..., ~ (to be p~id on filing this application) . 5. Ifdwelling, numberofdwellingun~its,.~5~fe'~...'...'t Number of dwelling unitsl on each floor ....... . ........ If garage, number of cars ..... ~.~L/& .................................. i ........................... 6. If business, commercial or mixed occupancy, specify nature and extent of each typ~ of use ..................... 7.. Dimensions of existing structures, if any: Front :'". ............. Rear ............... Depth ............... Height ............... Number of Stories ............................. i ........................... Dimensions of same structure with alterations or additions: Front ............. i .... Rear .................. Depth ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ......... , ...... Depth ............... Height ............... Number of Stories ............................. ! ........................... 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 10. Date of Purchase ............................. Name of Former Owner . .. ........................... 11. Zone or use district in which premises are situated .............................................. ....... 12. Does pr0posed construction violate any zoning law, ordinance or regulation: ................................. 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No : 14. Name of Owner ofpr~mises .................... Address ................ ! Phone No ................ Name of Architect ........................... Address .................... Phone No .......... ! ..... Name of Contractor .......................... Address ................ j.., Phone No ................ 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 showistreet names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ................. S.S ................................................. being duly sworn, deposes (Name of individua! signing contract) above named. and says that he is the applicant He is the ......................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the sald 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 filecf therewith. Sworn to before me this ........ .l L.,..:, ....... day of...~.O.q...~...~.., 19 Notary Public, ; .~X.~. .-.~.. :...~ '~ Notary Public of ~'%'" %~;~;] ~1' ' ' I ........... qkJ~r' 'f - r · · , · · C-~Signatur~o f apphcant)