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Home My WebLink About14112-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z15862 Date June 18, 1987 THIS CERTIFIES tha~t~]~ building . inground pool & fence. · ~b'f~ih' 'g~'f .............................. Location of Property 500 8th Street Greenport House No. Street Hamlet County Tax Map No. 1000 Section ..... .4.8 ..... Block ... 1 .Lot 44.2 Subdivision X .. ·Filed Map No. X .Lot No. X conforms substantially to the Application for Building Permit heretofore filed in this office dated ....... J..u.ly..1. ~..1.9.8..5. pursuant to which Building Permit No. 14112Z dated ........ J..u.ly..5. t . .1. 9. 8. .5 ...... was issued, and conforms to all of the requirements of tile applicable provisions of the law. The occupancy for which this certificate is issued is ......... ..... I.n. cj.rg.u.n.d., pp. ql...a.n.d...f.e.n,c.e... ........................................ ' ....... The certificate is issued to .................. .E.U.G.E..N.E..a...M.5..R.Y...P.~.T...M.:~, .Z.Z.A,F..E.R.~.O. ....... (owner, ~K~liaY~ Of the aforesaid building· Suffolk County Department of Health Approval ................. N../.A. ..................... UNDERWRITERS CERTIFICATE NO. N 702719 PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~_ 14112 Permission is hereby granted to: ..~¼..~ .~ ........ ~.....~ ............. '....~.~...-~ ~..L.o....?......~. .......................................... .~,~.:~k ...... :~.:~:.....u...~.~......~.... ,o.£~: ........ ~~.J......~....~. .......... ~.;~.~..,...~.. ~ .......... .................................................~.~ ~i:/~ ......................... '~. ;l~ ~':"'::;: ................ ~u~-~; ................................................ at premises located at ..~.' ................ Y.~..~ ............................................ F...~~ ........... co~.~, Tax ~op No. lO00 ~,~onv :.......0...~.~ ...... ~ock ..... .~-.I .......... Lot No ...... ~..~.:..~. .... pursuant to application dated ....... ...~...~.~, ............................ , 19.~.~.~., and approved by the \- Building Inspector. Building Inspector Rev. 6/30/80 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 ink, and submitted m ~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of propertv 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. B. For existing buildings (prior to April 1957}, Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property 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 $25.00 -- BUSZNESS $50.00 ACCESSORY $i0.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewC°nstructi°n ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .~?..L( ..... - House No. Street Ham/et Owner or Owners of Property ~.~ County Tax Map No. 1000 Section Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. '[.~. {{...,2..Z.... Date of Permit 7/5.-/~..-~.~.A pp licant . .~?..~3 ~.~/.. ~. ,~Q .~. 9~pJ..~...~..c, ..... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval .... Request for Temporary Certificate .................... Final Certificate FeeSubm,,ted$.. Construction on above described building and permit meets all applicable codes and regulations. 15%L0% App.cant... ., . ........... Rev. 10-10-78 FIELD INSi'ECTION COMMENTS FOUNDATION {1st) FOUNDATION 2. (2nd) ~OUGH FRAME & FLUMBING INSULATION PER N. STATE ENERGY CODE FINAL A] ITIONAL COMMENTS: (3 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG, [ ] FOUNDATION 2ND [ ] I~ISULATION [ ] FRAMING [~FINAL REMARKS. ~ ~ ~, ~~ ~, , - .. ~ ' 765-1fj02 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FRAMING REMARKS: FOUNDATION 2ND [ ] INSULATION 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ..................................... (Building Inspector) ~PPLIC~IIO~ FO~ B~IkDI~G Pfi~MIT 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 the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shail 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 Y/o~, and other~appllcable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or/for]removal or ~m~ition,~s herein described. The applicant agrees to comply with all applicable laws, ordinances, buil~in~le, housi~ cod~r)~ regulations, and to admit auth°rized inspect°rs °n premises and in building f°r necessary insp~~ i ~~. }~i.~ !:I-_ ~ /n (Signatur'e of applicant, ord!~a_~if %corporation) ~.'~'~ .. /(Mailing address of applicant) ~1 State whether applicant is owner, lesse(~gen ~,)~/architect, engineer, general contractor, electrician, plumber or builder. is. a~~ (as on the tax roll or latest deed) If ap: 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.. J.. [ .~.. ~...~.-..~..,.d~ Location of land on which proposed work will be done..~...O..~...~. -..O~. ..... ~....~...~..../~.. ............... House Number Street Hamlet County Tax Map No. 1000 Section ..... '~' 8' ........ Block .... / ............ Lot ..... qq~ .c~ ....... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy oflp)remises and intended use and occupancy of proposed construction: a. Existing use and occupancy... ~ ~ 4 .'~..-~X~.'.~ .................................................. b. Intended use and occupancy ..... ~.~...~.....~...~....Q~ ..................................... 3. Nature of work (check which applicable): New Building .......... ddition .......... Alteration .......... Repair ~' I''' lb~' ..~Removai .............. Demolition .............. Other Work ~..~!.~~.~.~..~..~ '' ~ ...... ~ ~ ~ (Description) 4. Est ated, ost .......... u/. .................. .................................... ~ ~u~ ~ (to be paid on filing this application) 5. If d~elling, number of dwellin~ units ............... Number of d ~lling units on each floor If garage, number of ears ...:. ~ ~ .................................................... 6. If bus~ness, commercial or mix,ed occupancy, specify nature and extent of each type of use ............. 7. D~ensionsofexistingstmetures if any: Front ............... Re~ .............. Depth .......... Height ............... Number of StoNes ..................................................... D~ensions of same structure with alterations or additions: Front .............. Rear .................. Depth .................. ~... HeiSt ..................... umber of Stories ...................... .... 8. Dimensions of entire new cons'traction: Front ............... Re~ ............... Depth ............... Height .......... Number of Sto~e~ .... · lC ........ .................................... 9. S~ze of lot Front ..... ~0 ......... Rear ~ ~ . . Denth ~ ~ 10. Date of Purchase .~.l.~,. ~7 .................. Name of Fora r Owner ............................. 11. Zone or use district in which premises are situated .......................................... 12. Does proposed constructmn wolate any zomng law, ordinance or re.la non: .............................. 13. ~fl110t be regraded ..... ~ ~ ...... ;~ ......... Will ex~s rill be removed, from premises: Yes 14. ~me of Owner of premises . .~.~.(/~Address ~P Jf.~.. ~... Phone No. Q2 ~.~q/~ .... Nme of Architect ..... ~ · · ~ a .............. Address ................ Phone No Nme of Contractor ~ ~ .~.~ ...... Address.~ ~. .. Phone No. ~ ~ ff... P~T DIAGR~ Locate clearly ~d distinctly ~1 build,cs, whether existing or propoi d, and. indicate ~1 set-back d~ensions from property ~nes. Give street ~d block number or description according to dee ~d show street nines ~d indicate whether interior or corner lot. DATE: OR NOff~9-~(~-~i'NG DEPARTMENT AT , ~f 765-1802 9 A~M TO 4 PM FOR THE 1. FouNr)ATI~N - TWO REQUIRED 3. INSULAT{O~ ,. ,,,.,.,._ OF OCCUPANCY B~ J MPL~T~ FOR C.O. , , AI_k CONSTRUCTTOM SHACk ~[T T~[ ~[~ '~5~ENTS OF THE M. ~. STA?~ CONST;RUCTION & ENERGY COmEg. NO~ RESPONSIBLE FOR D~SIGN OR CONSTRUCTION ERRORS. STATE OF NEW YORK, COUNTY OF ................. S.S ............................ i ..................... being duly s torn, deposes and says that he is the applicant (Name of individual sJg~ing contract) above named. He is the ..................... (Contractor, agent, corporate o 'ficer, etc.) of said owner or owners, and is dqly authorized to perform or have perfo application; that all statements con!ained in this application am true to the work will be performed in the manner set forth in the application filed there' Sworn to before me this ........ .... / ........... day~;f .... otary Public, . ~ ..... '..i ....~ .......... County HELEN K. DE VOE NOTARY PUBLIC, State of New York No. 4707878, Suffolk Term Exp)res March 30, reed the said work and to make and file this best of his knowledge and belief; and that the pith. ~' ~~'re of applicant),