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Home My WebLink About14081-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ...... Zfi. 6. ~9.0. ..... Date ...... .S.e.p.t..e.m.b.e.r.. J.8.,. ........... 19..8.6 THIS CERTIFIES that the building Screened ? opch 350 Fourth Street New Suffolk~ N.Y. Location of Property [-I[~ds'e ~io: ....................... 'S't/e$[' ....................... County Tax Map No. 1000 Section .. J.l.7. ...... Block .. J .0 ........... Lot ..... q. 6. .......... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fled in this office dated June 2 ~ , 1985 pursuant to which Building Permit No ............... ..................... , ... ~408~ Z. ...... dated ..... .J .u.n.e...2 .6., ..............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 ......... .S.c.r..e.e.n.e.d...P.o.r.c..h..t.o..?-.x.i.s.t.~.n.g. one family dwel. lin,g. The certificate is issued to Cornelia B. Rogers (owner, of the aforesaid building. Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO .......................... Rev. 1/81 ~t~OR,lt~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDI~IG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No- 14081 County Tax Mop No. 1000 Section ...... )...J...~. ......... Block .......~....~,. ......... Lot No../..~. ................ pursuant to application dated ........ ...~...~...~. .................. 19..~..~.."~, and 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 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 pz~perty 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. Co Fees: 1. Cartificate 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 New Cons trb c t i on ...... Old or Pre-existing Building Location of Property ....... .~.. !..., .......... Hous~ No. $15.00 Date.,..~./~, ~f G ............. ............ Vacant Land ............. ........ .... Street ' ' H~mlet Owner or Owners of Property ..... f'~q~.(~t ~ .............................. County Tax Map No. 1000 Section ..... J.( .~. ...... Block ...... ~j l~. ..... Lot ..... (.~. ........ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No..j.~ .(~. I. ~-~ Date of Permit . .~'./.~.~ .'~..Applicant... ~:~.. ,Or~_~ ~...~-~,...~.,~r,~,.. ,( Q~I~ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ .... .~'~....~ .(~'J ......... Construction on above described building and permit meets all applicable codes and regulations. Rev, lO-lO.7a TOWN OF SOUTttOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 August 18, 1986 TEL. 765-1802 Ms. Patsy Rogers 315 Fourth Street New Suffolk, N.Y. While reviewing our fi s~I find that your expired building permit ~ '14081Z~has never been finalized. Kindly return the enclosed application with a check for $5.00 so that we may issue a Certificate of Ocoupancy an~ complete this outstanding file. Yours truly, Southold Town Building Dept. ELD; IN~FECTION COMMENTS ?OUNDATION (2nd) hOUGH FRAME & ~LUMBING INSULATION FERN. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: ., 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined. · .~...O/'D~....~..~ ·., 19ti.~. Approved ....~..~r%O-...~.~., 19 .~.. Permit No. J.~.°..~.(.~... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... ,19... 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 properW 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 necessa..~inspection~. · .lS.o. ~ ~.~$:?..O..fW.~.>./. I...~..e.. .............. (Signature of applicant, or'name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder· .................. · ........ (as on the tax roll or latest deed) If applicant is a corporation, sig?ature of duly authorized officer· .... (Name and title of corporat~officer) Builder's License No...~..~ .~. 1 ............. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ............... .s:. o ......... ............ .......... House Number Street Hamlet County Tax Map No. 1000 Section ...... (! .r] ........ Block .... /..O ............ Lot .... /~. ............. Subdivision ..................................... Filed Map No ............... Lot (Name) State bxisting use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ..~ '~.gJ, (~..~..~...~?. ~, .~.. ,.../ ................................... /I b. Intended use and occupancy ............................... /...~..~ .... ~..~ .... 3. Nature of work (check which applicable): New Building ..... ' .....'Addition... t~. ..... Alteration .......... Repai,~l~~ j.~[~ .... .... RemOval ......... ~. ............... Demolition . ................................. .Other ~ork ~- '~ ,.} ~ (Descriptio 4. Estimated Cost ~. .7. .] .~ 0. a ~ Fee ' i ~)~" ~ (to be paid on filing this applic~, 5. If dwelling, number of dwelling: units ............... Number of dwelling units on each floor., .~.~ ......... If garage, number of cars .... '. ................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............. ~ ........ 7. D~ensionsofexistingstmctures, ifany Front .~.~ ~ . Rear ... ~.~.( .... Devth ~ .. Height ~ .. . Number of Stories .... ~.q D~ensmns of same structure w~th alterations or ad&tmns: Front ~] I , . Rear .. ,~ Dep ~ ~ Hei t · · ................ ,. · · ~ .................... Number of Stones ...................... 8. Dimensions of entre new const~ction: Front ..... ~( ...... Rear .... ]~f ....... Depth .. []. .......... Hei2ht ..... [~.( ..... ,.~u~er of Stories .... .0~ ....................................... 9. Size of lot: Front ~/.~K.'. . . Rear /~ ~ ..... Denth . .l~ ~ ..... 10. Date of Purchase . .~... ~ .... /.~.~ ........ Name of Foyer Owner ..................... 1 1. Zone or use district in whic~plemises are situated .................................. 12. Does proposed construction vi61ate any zoning law, ordinance or regulation' ~ . 13. Will 16t b~ regraded ~, ~q~.....m .......... Will exces;fill b~ r~gved" ~;o~ ~e~; ' '~'" ~ 14 me of Owner of premises ft~, ~ ~O~ Address Phnna M~ 14~ ' Z '': ............................................ ~ Nme of Architect ~. ~0~. ~ff¢~ .... Addres~J.~V~.~t. Phone N~t~ e of Contractor-g* 6J~: ~f./~ q, ...... Address&~ ~.~ ~.. mone No.~7. 7.~ / .W~.. PLOT DIAG~ Locate cle~ly ~d distinctly ~] bufld~gs, whether existing or proposed, ~d, indicate ~1 set-back d~ensions prope~y lines. Give street ~d bloc~ number or description accord~g to deed, and show street nines and indicate wM~er interior or corner lot. STATE OF NEW YORK, CO~Y ~.... ~S.S "'Z.... ( d f g iG d Vdi fi?nZdn' ddt .......... duly sworn, deposes and says that he is the applicant above named. He is the ..... ~. ' ........................................ ~ (Contractor, agent, corporate officer, etc.) of said o~ner or ownem, ~d is d~ly authorized to perform or have perfo~ed the said work and to m~e and file this application;that all statements contained ~ this application are true to the best of his knowledge and belief; and that the work will be perfo~ed in the m~n}r set forth in the application filed therewith. Sworn to before me this ............. ~.g.~ .... day~f ...... ~ ........ , 19 .~-- Nota, Public ........... ~..~.~ Count~:. ~ ~ /-~ NOFfiR? PUBLIC, State o~ Ne~ Yor~ // (Sigffature of ~ No 4707878, S~lffolk ~C0t.lty applicant) ~erm ~x~t)m Morcl~ 3~, 19._ i ID MAP OF: PROPERTY o~.._~ o ~-~,~/o ~ .......... ~ ...... ~ ._~ ~/Y~ . _ . ~~-~_ _~. _~~ ~ ............ DONALD J. TASE, L.S. -- SUCCESSOR TO RICHARD WILl-Il AS NOTED FEE:_~: ....... ~: - ' ' - '- T A~ NOTI~ BUILDING DEPARTMEN 765-1802 9 AM TO 4 PM FOR FOLLOWING iNSDESTIONS: 1. FOUN~AZ~ON - TWO FOR pOURED CONCRET~ . 3. INSULATION , . ,,.,~:~, BE C~h~PL~TE FOR C.O. ~" ALL CoNSTRUCTiON SHALL M~E~ ~'. THE REOt*~R~M'~N'TS OF THE STATE CONSTRUCTION ~ ~N~GY CODES. NOT RESPONS1Bt. E DESIGN OR CoNSTRUCTIO~ ~D~S'~