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HomeMy WebLinkAbout14267-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Cerfificafe Of Occupancy No. Z15065 Date. Nov. 3 86. THIS CERTIFIES that the building Alter an accessory building. Location of Property 800 Saltmarsh Lane Peconic County Tax Map No. 1000 Section 068 . .Block 3 .Lot p/o .8 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore tided in this office dated ·...A.u.~: .16 19 .85. pursuant to which Building Permit No. 14267Z dated Sept,. 11 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 ......... Alter interi, or of an accessory building. The certificate is issued to Edward & Sharlotte Pochtrager ..................... i: .................... of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... N/A UNDERWRITERS CERTIFICATE NO ................................................ Rev. 1/81 · ' · ..... ilding Inspector ..... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SO.UTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No- 14267' Z Permission is hereby granted to: ..... L..~...~ .............. ~..~. ....................................... .(~.~......~.:..%.....L/...~..s..Z..7.. ............... ...... ~ ........ '~' ..... '~""'~ ............... Z'"'".'";~ ........... ~ ............... ;' ................... at premises located at ...~.¢~.......~.'..~.~......~.,..~ ............ ..-~..;~ .............. Map No i000 Secton C~...~.~2~ Bock ...... ..~ Ln, KI % C~ County Tax ...................................... o ...................... pursuant to application dated ...... ~..~... [..(g. ....... , 19..~..,, and approved by the Building Inspector. F.e *..~.~.:.~.. Building Inspector Rev. 6/30/80 ~iELD I~Si~ECTION ~OUNDATION (1st) 'OUNDATION (2nd) COMMENTS tOUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: (']om om Z30 © 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 ~ ~ to the Building Inspec- tor with the following; for new bui(dings 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 disposa[-(S-9 form or equal), 3, Approval of electrical installation from Board of Fire Underwriters. 4, Commercial buildings, Industrial buildings, Multiple ResMonces and similar buildings and installa. tions, a certificate of Code compliance from the Architect or Eng neer responsible for the building, 5. Submit Planning Board approva of completed site plan requirements where applicable. B, For existing buildings iprior 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, 1, Certificate of occ_upancy $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 $15.00 Oats ....................... New C OhS truct i on ...... Oki or Pre-existing Building ............ Vacant Land ............. Loc t,on of Property.. .0. .. L ... House No. ' ................... Street H~mlet Owner or Owners of Prope~y ~~ ~ S~/. ~ ~r~ ~g.~ County Tax Map No, 1000 Section ~ .... Block Lot, Subdivision ................................. Filed Map No ........... Lot No .............. PermitN°'~2 Date °f Permit ,~,<(~plicant V¢ '~ ~ ..... . .... ........ .... Hea~th Dept. Approval ........................ Labor Dept. Approval ........................ Unde~riters 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. 76~.1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: FINAL DATE: /,~//~////O~ INSPECTOR 'l" Examined .~P~.-~....~... !1..., 19 ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1803 ~pproved ...~.~ .~.. )[.., 19~.~. Permit No.! ~..~.¢. 7..~.. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BLDG, DEPT TOWN OF SOU1 HOLD Received ........... , 1 9 ~..~ INSTRUCTIONS a. Tkis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 · ~ts 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 6r 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 ~tall 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 ~ Certificate of Occupancy [tall 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 luilding 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 trait authorized inspectors on premises and in building for necessary inspection~/~, m. ./. . . grate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................. .eT../g ................................................. lame of owner of premises (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 ..... .'$-'./..ff. ................ Plumber's License No. /V'~x'Y~' Electrician's License No. /~xFE' Other Trade's License No..../~..O..N..c~. ........... Location of land on which proposed work will be done .................................................. .r../q..*.% ................... ?. ..................... House Number Street Hamlet County Tax Map No. 1000 Section ...t...~..~..~. ....... Block ...... .~. .......... Lot...¢...~ .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~/V~'/~/'q/~//N)/ b. Intended use and occupancy ...................................... ¢~,~¢¢~.~>x.~:t,:~%$.~4 ................ · ~.-~.,~,_. ~/ ,{~t . i . . 3, re ofworlL eek1 which ~pphcable): New Building .......... Addition .......... Alteration .......... Repair ~ Removal Demolition Other Work ?~.~. ~. /.?'(..~.o. ' ./. ..... o!q.,.o.o. ............. 4. 'Estimated Cost... O Fee .. i ~' (to be paid on filing this application) 5 If dwelling number of dwellin~ units Number of dwelling units on each floor number&cars 4 /' '~' g'~' q'~"~ ~' ~' If garage, ... ................................................. . . . . ... .. .. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... ?. Dnuens~ons of existing structures, ~f any: Front .... ~ .~. ....... Rear ,.. ~.~.~. ..... Depth...;~, ~..~ ....... /~.t Number of Stories Height .................................................................. Dimensions of same structure With alterations or additions: Front ...... O'~..~.r~..~.... Rear . 5'rq-~'~ I Height .,~.~..~.~. ... Number of Stories /.. Depth ..... ,~ d ~ ~ ..... ~ ........................... 8.Dnnenslons of entire new construction Front ............... Rear ............... Depth ............... Height ............... Number of Stories 9. ...... I 1. , Zone or use district in which plremises are situated ..................................................... 12. Does propos, e.d construction viplate any zoning law, ordinance or regulation: ................................ 13. ,W, fll lot be regraded ...... liter,w ._ ......~ ......._... Will excess fill be removed from premises: Yes 14. ~ame of Owner of premises .ff~.C./f~..~f~.tq'.g-..~./.~ Address ................... Phone No ................ Name of Architect .......................... Address .................. Phone No ................ Name of Contractor .4~.~ ~ .~>.~/./f4 ........... Address ./.~./.O,..~.~.~../~.,, .f~.4.D.. 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 or description according to deed, and show street names and indicate whether interior or corner lot. ,N O~ TO SCALE s, 5 °21'o d t,' ,413,00 GARAGI PROPOSE TO ALTER THIS GARAGE INSIDE ONLY STATE OF NEW YORK /~ . .i COUNTY OF.. ~.~.-.~../?...t'~. I ........................... ~ ..................... being dul~ (Name of individual si~ning contract) above named. He is the .. i, , (Contractor, agent, corporate officer/etc.) of said owner or owners, ~d is d~ly autho~zed t~' perform or have perfomed the said work and to m&e and file this application; that all statements cogtained h this application are true to the best of his ~owledge and belief; and that the work will be perfo~ed in the m~Oer set forth ~ the application filed therewith. Sworn to before me this .............. t¢ ........ ............. ...... , (Signature of applic~Q and says that he i