The URL can be used to link to this page

Home My WebLink About14160-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ..... Z.] .35.%6. ...... Date July 25 ., 19 .8.5. accesser garage. THIS CERTIFIES that the building ............. ¥ ................................. Location of Property ... 5. 7.5 ............. 0.3:..cl..H.a.p.b..o F..~ d.: .......... ~..e ?..S.u..~.~.o. 1..k ..... Hou~e No. Street Hamlet County Tax Map No. 1000 Section ..... ] .1.7....Block 3 .Lot 6 Subdivision ............. .x ................. Filed Map No .... x. ....Lot No ..... .x. ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... qu..ly. ?.6. ........ 19 .~.5. pursuant to which Building Permit No. 1 4 1 60Z dated ........... .J.u. 1. 7' .2.5. ........ 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 ......... A three-car accessory ga..r.a~e.. The certificate is issued to RICHARD MOHRING (owner, ~ee~o~r~eta~ of the aforesaid building. Suffolk County Department of Health Approval ................. ~ ./) ...................... N/A UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 · 0~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PEP, MIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 14160 Z .................... ............................................................................................. County Tax Map No. 1000 Section ......... 1..~..,~. ...... Block .....,,.~..,~ ..... Lot No ....... ,,L~.. ............ pursuant to application dated ~.~..~...~ ............................. , 19.~,~., and approved by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ia ~ 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. 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 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 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 $15.00 Date... Z/?~L~..~./.~.' ·~-. ......... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. location of Property ...... ~ .... House No, Street Ham/et Owner or Owners of Property ............................................................ County Tax Map No. 1000 Section .... ,~- ('.7 ....... Block . .S ........... Lot..~ ............. Subdivision .......... ......................~ .Filed Map No. .../~. ..... Lot No...~. ......... Permit No .......... Date of Permit . cant .................................. Health Dept. Approval ....... ~./a. :~t/t .......... Labor Dept. Approval ........................ Underwriters Approval ........ ~/~. ......... Planning Board Approval ................ Request for Temporary Certificate ..................... Final Certificate .... ~ .............. Fee Submitted $ ........ J ......... C~onstrFction on above d~!ibed building and permit meets all applicable codes and regulations. _q , q _ ffApp icant ..... ......................... F[EL~S~ECTION COMMENTS FOUNDATION (1st) FOUNDATION 2, (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Disapproved a/c ..................................... Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled hi 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~ ~ation. 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 !hall 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 ~hall 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 ~uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or egulations, for the construction of ~buildings, additions or alterations, or for removal or demolition, as herein described. The applica~ggr:~s~'~0 coml~13~'Wi~k;,all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors.gn,'[pr?,mises a, nd~ .in building for necessary inspe,cf~ons. - ~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, genera~ contractor, electrician,, plumber or builder· Name of o~er of pte, mise~ .... ~.l F_/J./~.t~42....~..~A?~.[./~..~ ..... :" ....... ............................. , ,, , . , ('~ b~!t]~¢:ta~ ~{~11 or la,est d'e~d} f applican'fi§ a.cbrlSdfa[i6~/ signature o~ d~ 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 ...................... Location of land on which proposed work will be done .... ~ ./ff..~..~.F. ?......S'...~.~.~..Z .~.--./../..~..Z~./../~..~T ..... · oT.Z sT. ........ d ......... .... ................... House Number Street Hamlet County Tax Map No. 1000 Section ... ~..Z/. ~. ......... Block ..... ~.~ ........... 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 .... .~./~ [ ~.. ~..7~..&~.../7(?.~.~/~-.../J ~.. ~.~A~. ~;~.~. ~.~ b. Intended use and occupancy ...~ Z Z~ Z~... ~.~. ~ ~ ~ ~ Z ~,~t~":~ .~ ~.~:~ ~) 3. Nature of work (check which a ?plicable): New Building .......... A Repair .............. Removal .............. Demolition .. 4. Estimated Cost . . I.D...O..o~O...i .......................... Fee 5. If dwelling, number of dwelling units ............... Number of dx If garage, number of cars .... i ................................ 6. If business, commercial or mixed occupancy, specify ng_ture and extent 7. Dimensions of existing structu~'es, ifany Front ............... Rea] Height ............... Number of Stones ................... Dimensions of same structure With alterations or additions: Front ... Depth ....................... Height ...................... : 8. Dimensions of entire new cons(ruction: Front ............... Rem Height Number of Stories ldition .......... Alteration .......... ........... Other Work ............... (Description) (to be paid on filing this application) ailing units on each floor ................ )f each type of use .................. .............. Depth ............... ............. Rear .................. lumber of Stories ...................... ............. Depth ............... 9. Size of lot: Front .......... i ............ Rear ....................... Depth ...................... 10. Date of Purchase .......... i ................... Name of Forme Owner ............................. I I. Zone or use district in which plemises are situated 12. Does proposed construction vi )late any zoning law, ordinance or regulal ion:'; ................................ 13. Will 10t be regmded ............................ Will excess fill )e 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 distinctly a~l buildings, whether existing or propo~, property lines. Give street and bloc]: number or description according to dee~ interior or corner lot. OCCUPANCY OR USE IS UNLAWFUL WITHOU'I CERTIFICATE OF OCCUPANCY STATE OF NEW YORK, COUNTY OF ................ S.S ............................ 1 ..................... being duly (Name of individual signing contract) above named. t, end, indicate all set-back dimensions from and show street names and indicate whether APPROVED AS NOTED ~-1803 U ,~ '"0 4 PM ~R THE B2 CO~L~E FO~'~ C.O. ,LL CON~'T;UCT~ON ~LL ME~ HE REQUtP~ENTS OF THE N.Y TATE CONST~i~ & ~ERGY ODES, NOT ~S~N~E FOR ~IGN OR CONST~ION ERROr. lorn, deposes and says that he is the applicant He is the ..................... : .............................. ~ (Contractor, agent, Corporate of said owner or owners, and is drily authorized to perform or have perfo) application; that all statements contained in this application are true to the work will be performed in the manner set forth in the application filed therex Sworn to before me this .............. qf ................ Notary Public .................... County ricer, etc.) med the said work and to make and file this best of his knowledge and belief; and that the dth.