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Home My WebLink About14204-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy NO. Z13868 Date S.e p.t. e .mb e r. 12 ,98..5 addition THIS CERTIFIES that the building .... ............................................ Location of Property ~/&Js~ lh/06.'75 Lower Rd. Southold ....................... '~e~t '~ ...... Hamlet County Tax Map No. 1000 Section 69 .Block 5 . .Lot 13..2 X X Subdivision X Filed Map No ......... Lot No. conforms substantially to the Application for Building Permit heretofore f'fled in this office dated July 29 19 --85pursuant to which Building Permit No. 14204Z dated August 16 19 85 ............................... , 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 garage & storage building. ARTHUR CARLSON The certificate is issued to ..................... [oh;n'e),~~ ..................... of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... N/A UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 TOWN OF Sou'rHOLI) BUILDING DI~PARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 14204 Z Date ... ~...~...~ .................. , Permission is hereby granted to: ......... ............. .............. ,~.~ ........... ~..?....~. ........................... .......... ~T~.~.T~.o~.~...-..~:..~ ............... ~o ...................................., Z......~.....~....Zm.~....~ .................................. .C~ ~. ~ .... ............... ,2~m~,.~...~..: ................ ..... ..................................... ._...~ ........................................................ et premises located at ...... ................................................. !.... ...................................................... County Tax Map No. '000 Section .... .,,C~...~..~.. ........ Block .....(~.....~...-~.. ...... Lot No...~../...~..:....~.. .... pursuant to application dated ......... ~.C2..~,..~... ...... ..~...~.. ................ , 1 ..~...., and approved by the Building Inspector. Fee $.4~' .................. Building Inspector Rev. 6/30X80 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 ~ ~ 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 propertv lines, streets, buildings and unusuat 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. , ./?, ,~,/,O. , ./~. ,~,, ,'~ ........... New Building .... ~. ........ Old or Pre-existing Building ............ Vacant Land ............. Location of Property ./.b/.7~.-'. ....... ~.~'/~/~/"~./~..-... ~ ..................... Hou$8 No. Street Ham/et Owner or Owners of Property .../~.-. ........................................... County Tax Map No. 1000 Section ...(:~.~/'. ,~, ....... Block ............. Lot.. .~ ...... Subdivision .............. ; .................. Filed Map No./,~, ..... Lot No. r~.~ ;'. ........ Permit No. t<..~..~...~..'~ate of Permit ~. ,/.~...~/o(~'..Applicant,, ,/;'~/,~, ~...<~'i~'.'~-. ......... Health Dept, Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate .... Final Certificate ~ . .. Fee Submitted $. Constr~J, ction on above described build{ng and p~-~t,m~_~all p~~g ~, L~ ~ ~[3b~L~ / ! ///// a ulations. ................ Re~. 10-10-78 FIELD INSPECTI(~N ~ COMMENTS FOUNDATION ( 2nd ) f~OUGH FRAME & PI,UMBIBG iNSULATION PER N. Y. .~?ArE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1B02 Received ..... 19.' / Disapproved ajc ~ (Building Inspector) APPLICATIOhl FOB BUILDING PERMIT Date ..... ',7, .... 19 INSTRUCTIONS a. Tkis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 lets 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 ~r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- iation. c. ~.:The work covered by this application may not be commenced before issuance of Building Permit. d~~ ,'UP0.n approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit ihall b& 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 g 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 milding 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. 'he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for necessary insp~ ~. (Signature of applicant, or name, if a corporation) ........ 0..o. .¢.?.2. .... (Mailing address of applicant) ~tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~ame of owner of premises...Z~. ~..~-.Z. fis. ~.. ~... ~/.~..- ~..~..~...~.C. 9..'~'. ~ ............................... (as on the tax roll or latest deed) !f applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ,-~L. ~ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... t. Location of land on which proposed work will be done .................................................. ,~ c~ Z-'. r'.~.¢ ~ ~. ................. House Number Street Hamlet County Tax Map No. 1000 Section' ~ ~'- 5~- [3, ~.. Block .................. Lot ................... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy ~'-,x' 7-~,~r~ ~-;~o,~ d'e~ ,~/4~-~ .................... 3 Nature of work (check which applicable): New Building Repair .............. Re~oval .............. Demolition . 4. Estimated Cost ......... .O..o. :.?.o. ................ Fee '8. 10. 11. 12. 13. 14. ,ddition .......... Alteration ....... .... ........... Other Work ............... (Description) (to be paid on filing this application) If dwelling, number of dwelling units ............... Number o f d' yelling units on each floor ............... If garage number of cars ' .~. If business, commercial or mix:ed occupancy, specify nature and of each type of use extent ....... ' " ..... ' .... Danens~ons of existing structures, if any: Front ..... 2.7. ~ .....ea Height ...... >... (v ..... Number of Stones .... [ ............. D~rnenslons of same structure with alterations or additions Front ................. Rear ................ D pth } He'ght her of Stories / e ..................... , ...................... am Dimensions of entire new construction Front ............... Rear Depth Height ............... Number of Stories ....... .e~..4/~. ............................................. Size of lot: Front ......... } ............ Rear .................... Depth ..................... Date of Purchase . .~.t~:. ~?..~? ............... Name of Former Owner . ~. ?. ~. [.~.//....7~.g~ .¥ ...... Zone or use district in which premises are situated ................ Does proposed construction v~iplate any zoning law, ordinance or regula ~fla~l leOtofb;rweng;;dffdp ....................: ~.o ~ . ddW~}IsseX, c.e:s. .illl be removed from premises: Yes No remLes --..-.-,.: , ~.. · ...... A ............. Phone No ................ Name of Architect ........... ./:~ ....... ... Address .................. Phone No Name of Contractor .......... .v/-......... ...Address . . .... PLOT DIAGRAM 'Locate clearly and distinctly all buildings, whether existing or propos property lines. Give street and block number or description according to dee interior or corner lot. STATE OF NE~. YOI3~K~9 , ] S S COUNT~ OF .'0~. ' · ....~.~ .~/.-. ~..d~.. ;.. being duly s (Na~f/~i(ifi ~i/s}gning contr~dt3 .......... above named· He is the ~ ~ 4~'~ .............................. ..................... ~' ' (Contractor, agent, corporate o: of said owner or owners, ~d is d~ly authorized to perform or have peffo: application; that ail statements contained ~ this application are true to the work will be perfo~ed in the m~ner set forth in the ap~lic'ation filed there~ Sworn to before me this ...d ................ ....... Notary Public, quatlft~ i~ Suffolk ~ty , ........... Phone No ................ and, indicate all set-back dimensions from and show street names and indicate whether vorn, deposes and says that he is the applicant 'ricer, etc.) mod the said work and to make and file this best of his knowledge and belief; and that the tith. (Signature of applicant) USE iS, UNLAWFU£" ~ifb~f CERTIFICAE OF OCCUPANCY 765-1802 9 AM TO 4 FOLLOWING INSPECT ,I. EOUNDATION _ TWO FOR POURED CONCRETE, ., 3., ROUGM . FRAMING & PLU/~B INSULATION 4: FINAL _ CONST/~UCTiON BE ~OA4PLETE FQR C, O.i '~ ALL' CONSTRUCTION SHALL;, THE REOUIR~MENTS OF THE S-rATE ~ONSTRUCTION & CODES. NOT RESPONSIBL~ ,DESIGN OR CONSTROCT/ON £