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HomeMy WebLinkAbout14488-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-15680 Date April 22, 1987 THIS CERTIFIES that the building .A..d.d.~.t.i..o.n..t.o...e.x.i.s. Location of Property ...1.7.6.5...G.u.l. 1.. ?.o.n.d...L.a.n.? ......... Greenport, New York House No. Street Ham/et County Tax Map No. 1000 Section 035 . .Block 04 .Lot 15 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated November 15, 1985 pursuant to which Building Permit No. 1/4/488Z dated.. .... December. ..... , ...............27, 1985 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 ......... ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to GENE KE S SLER (owner, of the aforesaid building. Suffolk County Department of Health Approval ...... ~./fi. ......................... UNDERWRITERS CERTIFICATE NO ............... N 7587 19 N/A PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 FOR,~ 8'0. 0 TOWN OF SOUTHOLD BUILDING DEPARTMEHT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NB 14488' Z Permission is hereby granted to: ...~...o...~....~.~. ............. :..~...~......~ .... ~..~....~.~....~..:.%.:.../..(.~...s...~ ,o ot premises located at ..... ~,,~, ,,,~,,~, ...... ,,,~,,-~, ,~,,~,,,,,,,~,,~ ............. ,~, .~~ ............... ........... %.....~.~.......g..~ ........................................................................................... County Tax Map No. 1000 Section ....... O..~l.~,. .... Block .....,~,..,~, .......... Lot No....l ................... Building Inspector. Fee $.~..: ............ Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Bu{Iding Department Town Hall Southold, N,Y, 11971 765- 1802 BLDG, DEPT, TOWN OF SOUTHOLD 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 instalta- 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: I. 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. 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 .................. New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property/..~.../-~.~..¢.~ZZ. ~V~. ~X, .......... ¢ ~¢~ .... House No, Street ~ / Hamlet Qwner or Owners of Property . ~.~... ~.~. ~. ~ ........................ County Tax Map No. 1000 Section ........ Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Hea~th ~a~t. Approval ........................ kabor Dopt. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate . Y Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. Rev. 10fl 0-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS 100070~ BUREAU OF ELECTRICITY ~]~:[ SE, JOHN STREET, NEW YORK NEW YORK 10038 0.,,. .Tuty ~5,1986 .~ppa,,,,ao.~o.o. fi,. ~06787/86 N7587 .9 TI-IlS CERTIFIES THAT only the electrical equipment as described below and introduced by the appllcat~t named on the above application number in the premises Cene Kessler, 201 Gull Pond Lane, Greenport, New York in the following tocation~ ~ Basement ~ Ist FI. .~s ~x.,,,i,,ed o. July 7, ] 9 ~ 6 [] 2nd FI. Section Block Lot attd fottt~d to be in co.tplia~ ce w h the re lu re nen s ~if this Board. RANGES OVENS DISH WASHERS EXHAUST FANS 26 14 17 26 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET EERVIC~ DISCONNECT S E R V I C OTHER APPARATUS: Track Lighting-12'-O"- 6 lites NO'O E COND OF ~C. COND. HI.LEG A, W, G OF HI-LEG NO, OF NEUTRALS OF NEUTRAL Sal Pratt), Electrician Wiggins Lane Creenport, N.Y., 11944 This certificote must not be a)tered in any manner; return to the office of the Board if incorrect, inspectors GENERAL be identified by their COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST:NOT BE ALTERED IN ANY MANNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because ,of the following reasons. /2/ An application for Certificate of Occupancy is not on file. /~/~- No Underwriters Certificate on file. /2/ The check is(outdated/not on file.) No Health Dept. Approval on file. /5/ No final inspection has'been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit Building Dept. I 4 4 8 6~ Z No Plumber solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) TO3~TN OF SOUTIIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802. To Whom This May Concern, Please complete the enclosed application for Certificate of Occupancy and enclose a check for $5.00 (the fee for the C.O.) and I will be able to complete the Certificate of Occupancy. Thank you so much for your cooperation in this matter. 765-1802 9 AM TO 4 PM FOR THE ~OLLOW~NG ~NS~ECTIONS: L FOUNDAmlON . ~0 REQUIRED FOR P~URFD CONCRETE 2. ROUGH .. FRAM[N~ & PL-UMB]NG 3. INSUI A-UON 4. FINAL CqV~' '-"~ h3N MUST BE C'~,,~m "~F FOR C. O. ALL CON~':~R~C~iON S;~ALt_ MEgT THE REO~ '~=~q:h~S.-or T',= ~ CODES. NQT ; R~SPONS[~LE FOR D~SIGN OR CONSTRUCTION ERRQ~q ,I 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. ~ FOUNDATION 2ND [ '1 INSULATION [ ] FRAMING [ ] FINAL REMARKS: /'~ '~',~ ~ DATE / :~///?/~ ~ INSPECTOR ~. ,~'./-% 76~-1802 9 A~ ~O 4 9M FO~ THE FOLLOWING ,b.'SPECT 1. FOUNDATION - TWO REQLJ~RED FOR ~O JRFD cONCRETE 2. RoUG~ - ER~,M~NG & PI.LJMB~NG INSUi A ~' F NA ~ C.?fi ...... tqN M:JST ~r: C'''-~r --'[' ,,p, C A L (.0,4, ~ , ~ ". ~ .... ~qT~!ICTION & ENERGY DESIGN OR coNSTRUC/Iu .1 II NEW YORK- Ilq-~q ;. Y. State Lic. Land Surveyor, Date 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 Approve~.~.-[. -, 19 ~.~. Permit No. J .q..q.~..~..35.. Disapproved a/c ..................................... ................................ (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,~9.. · ~~o 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 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 a.pplication, 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 necess~~,~// . ~1~ (Signature of applicant, or name, if a corporation) ~ a~ . q:. . . . :.~. ~ .':,~. .~.a. /.,,/. . :..,. ~. . .'o. ~. .// /.: ~, (Mailing address of applicant) State whether applicant is owner, lessee, agent, axchitect, engineer, general contractor, electrician, plumber or builder. .~...~.:.~...,~ .('.o. ~..:m~ :.:..,~....-...~.:.'../.O:.--./d ................................... Name of owner of premises~'~..-~.~-~. '~7 '~" '~" '~'~--/~--~(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. ~ ./..~..~: ...... ~ ......... Plumber's License No ......................... Electrician's License No ........ ...~..~....//.~..~4~"'-~ Other Trade's License No. 1. Location of land on which proposed work will be done .................................................. .Z~4~..~/~ ~ ~.. .......... ~~~e~ ........... House Number Street Hamlet County Tax Map No. 1000 Section ~,~/.g ...... Block .. ~7~: ...... Lot ................... Subdivision ................................ Filed Map No ............... Lot ............... 2. State existing use and occupancy of premises and intended use and ocqupancy of proposed construction: ~. ~,t~ng~s~ndo~p=, / ~.<~/.~T:<~ .~ ...................... 3. Nature of work (check which applicable): New Building ..... ~ Addition ~ Alteration Repair ...... Removal , . Dem~)lition ..... i' ' Other Work ..... ' ~,. ~ (D ril~ti ) - ~ ~ ' ~ ~ esc on 4. Estimated Cost . .~/... C~..~. .......... · .............. Fee ..... [ .... / ' (to be p~id on filing this application) If dwelhng, number of dwelhng units ............... Number of dwelhng umtsjon each floor ................ If garage, number of cars .... ~ ..................................... 1 ........................... 6. If business, commercial or mixed occupancy~ specify n,,ature and extent of each ty~pO of use ..................... 7. Dnnensmns of e~stmg structures, if any: Front .... (:zp.'~-? ....... Rear . ~. .... I ...... Depth .~ ......... Height . ./.~..~ ....... ,. Number of Stories .... ~. ..................... >'i ........................... Dimenslons~of same structu?e with alterations or additions: Front Depth . ~_~>.~.. .............. Height .../..7. ............... Number of Stories ..... /.... :' , ..... 8. D~mensmns of entire new constructmn Front ............... Rear .~.~,5'....: ...... Depth f'~?...W:w.~ .... Height . ./. ~. ......... Number of S.tones ...... /.:.. y ...... ... · ......... ~ ......................... 9. Size of lot: Front .,]l~[~[li~ .,fffd2f. ' R~ar/.t~..~lll~ ..... .. .... ~ Depth .~..~f. ~ ~ .~'.' ~ f... 10 Date of Purchase Name, of Former Owner ' 1 1. Zone or use district in which premises are situaied..: .... : .................. ! ........................... 12. Does proposed construction violate any zoning law, ordinance or regularion: ..... I ........................... 13. Will lot be regraded ............................. Wilt excess fill be removedifrom premises: Yes No 14. Name of Owner of premise~.~.A(.~..,~.~..~2~...~..'~..... Address/. ~.'y.~.~f. c4'/. ~0.~..~.. Phone No ................ Name of Architect · y'2~,t,Z:,L~ ........... Address ...... ' .... ~... Phone No ....... ~,~_/; ..... Nmne of Contractor~/d~..~~ ...... Address .~,-~..~. ~.d../-f~... 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 O? description, according to deed, and showistreet names and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................. ................................................. being duly sworn, deposes (Name of individual signing contract) aOove namea. and says that he is the applicant ~e is the .......................................................................................... (Contractor, agent, corporate officer, etc.);~ ~f said owner or owners, and is duly authorized to perform or have performed the sa:id 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 ~ork will be performed in the manner set forth in the application filed therewith. gworn to before me this ............. /..~..~. ....... day of ................... .~....t~.. , 19~f''~... qotary Public, . ....................... County .~ ~, ,~ ~ -~ ~_ ~~,~7~i~- ~A~It'~'~'~'~ ' (Signature of ap~plicant) 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 ,.musual 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: 1. Accurate survey of p_--'operty showing all property lines, streets, buildings and unusual natura~ or topographic features. 2.Sworn statement of owner o~ previous owner asto 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: Additions $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... New C'ons truct i on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ............................. - ...................................... House No. Street /Yam/et Owner or Owners of Property ............................................................ County Tax Map No. 1000 Section ............... Block ............... Lot ................ · Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. Applicant ............................................... , ..... Rev. 10-10-78 ~65-180Z BUILDING DEPT. INSPECTION FOUNDATION 15T [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING ~,~] FINAL REMARKS~ TO VN OF SOUTtIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802. To Whom This May Concern, Please complete the enclosed application for Certificate of Occupancy and enclose a check for $5.00 (the fee for the C.O.) and I will be able to complete the Certificate of Occupancy. Thank you so much for your cooperation in this matter.