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Home My WebLink About13901-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...Z.q .4.3. ! .2.R. ....... Date .... .g.p.r. 5:..]...1.1. ...................19.86.. THIS CERTIFIES that the building A d d ± t ± o n Location of Property .... ~ 55.. Be ck~ J. Ch..A ¥ ~ ................. ~ 9.u.~.h. 9.1.d ............... House No. Street Hamlet County Tax Map No. ] 000 Section . .0.5 ~. ....... Block ...0.1. .......... Lot ..... .0.2.1 ......... Subdivision ............................... FLied Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore flied in this office dated .... gAY.. 3 ........... , 19 85. pursuant to which Building Permit No ..... .1.3.9.0. ! .Z .......... dated .... Lq ~.Z.. 1 .................. 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 ......... .... ~D.e.~l~. ra.d.~$.~.~.qr~, .~.o..s..e.c.o.n.d...s.t.q~.y r. qg.f. . ...................... The certificate is issued to THOMAS AND JENNIFER SCHLECHT ..................... ...................... of the aforesaid building. Suffolk County Department of Health Approval ...... ~ ./.3. ................... UNDERWRITERS CERTIFICATE NO .... N/A Building Inspector Rev. 1/81 FO~ NO. ~ 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~ 13901 Z Permission is hereby granted to: ~ .... at premises located at ......~..~...~.... ........ Co.nty Vox Mop No. 1000 Section .~....~../ .......... Block ....... ./. ............ Lot No. Building Inspector. ~e~*~.~..7...~.~... 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 A. This application must be filled in typewriter OR ink, and submitted aa ~ 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 featu res. 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 property showing all property lines, streets, buildings and unusual 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. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 ~\.~.\, ~ 5.Updated C.O. $15.00 Date . ~ New Building ............. Old or Pre-existing Building v/ Vacant Land Location of Property ....................................................... House No, Street Hamlet Owner or Owners of Property .. 5... ? ..................... County Tax Map No. 1000 Section . .O.(P..~ ......... Block . ..O.\ .......... Lot ............... Subdivision ................................. Filed Map No ........... Lot No .............. PermitNo.~O~ Z- Date of Permit ~"l~l.~5..'-,.Applicant ~O~C~:~ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ... ~ .................. Fee Submitted $. ~... · .~.. .................. Construction on above described building and permit meets i~icab, le codes and regulations. FIELD INSPECTION FOUNDATION ( 1 st) COMMENTS FOUNDATION 2. ROUGH FRAME & PLUMBING (2nd) INSULATION PER N. STATE ENERGY ~ODE FIliAL ADDITIONA COMMEN BUILDING DEPT. INSPECTION [ ] FOUNDATION AST [ ] ROUGH PLBG. FOUNDATION ZND ~NSULATION 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG, FOUNDATION 2ND [ ] INSULATION FRAMING REMARKS: ~FINAL 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 .... , pprove~ .~~ ..... : 19'.~.':.~Permit No./.Y .~.~. ~..~, )isapproved a/c-. .................................... Received ........... ,19... (Building'Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets 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- 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 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 dmit authorized inspectors on premises and in building for necessary ins ections. (Signature of applicant, or name, if a corporation) · .iLo.. .... (Mailing address of applicant)¥ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~2e~°°~Tw~:(°; ;;2~i;e;·' "'~ '~;' "~' "" ~'(~("ii~l?tlal' i:i ~i~'i~t~iil)''~'01~~ ..... ' ............ [f applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No...~.-. .............. Plmnber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. eo.tc.. . ................. .................. ................................. House Number Street Hamlet County Tax Map No. 1000 Section . .~..~..~..~. ~...~. .... Block . .~..~. :..~.. ~ ..... Lot..~..~.~. ~..O..O..~. ...... 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 . .~..L)~...~. ~.%..~.L},.'~ ','' .~...~...~...~..~..~..~.~..~..~t~....g..~..{~..... b. Intended use and occupancy ~e~. ~, .~.~..~(.$.o..-?....~...'~......~..~ .t~..~...~.%.%..~.~.~\..~..~..f~..~..~ .~ 3. Nature of work (check which a >plicable): New Building ..... ', ....Addition ......... Alteration ....... Repair .. ,; ~ .......... Remo al ......... ., .... Demolition ........... ~.. Other Work., ............. 4.' Estimated Cost..~0.O.O. ............... ! ........ .1. .... Fee ..~..o~.~..~..~. ............. ' I ~" (to be paid on filing this application) 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. Dimensions of existing structu~es, ifany: Front..g~:~. ........ Rear . .~O.:~. ........ 'Depth.. ........... .~t] ........ t ........ Height ............... Number of Stories .. ~, .................................................... Dimensions of same structure with alterations or additions: Front ................. Rear,~t~[.~.~ ......... Depth . i Height Number of Stories 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of, Stories ......................................................... 9. Size of lot: Front .... ~.~.: ,S0. ...... ; ... Rear .... ~.O: hO. ........... Depth. . .~.~. ~.~. ............. 10. Date of Purchase .... .~. ~L~.\.~ ................. Name of Former Owner .:~'.~.~.~¢.~...~.h..~SOfX, ......... 11. Zone or use district in which p~emises are situated ......................... £~ .......................... 14. ~ P ' .i ............... ~..~0~ ..... .1~ .... ne No. qt ......... Name of Architect ......... ! .................. Address ................... Phone No ................ Name of Contractor ........ i ...... . ............ Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property hnes. G~ve street and block number or description according to deed, and show street names and lndmate whether interior or corner lot. S.S STATE OF NEW YORK, COUNTY OF .................. ........ .2?. .................................. being duly sworn, deposes and says that he is the applicant (Name .of individual sig~ing contract) above named. He is the ..................... i ................ .: ................................................... i' (Contractor, agent, corporate officer, etc.) of said owner or owners, and is drily authorized to perform or have performed the said work and to make and file this applicatios~; ~that all statements coni~aiaed in this application are true to the best of his knowledge and belief; and that the work ~vill be perfOrmed in the man,er set forth in the application filed therewith. Sworn to before ma.this NOTARY PUBL C S ate olJNew Yofi( ' .... ~ ....................................... NO. 4707T/8, Suffolk C0unt¥. '~' ~ '~' "k~"' (Signature.of applicant). Tern/Exp,res March 30, '0 NIF N. ~9 ~0'00" $'f Y, 2 80.58 I ST'f 8 61007°00" N/F joO5'f 49' FR, 81.94 N~F HAitlKI NS MAIN S fREE T MA P OF DKSCi~ IBKD PR OPERTY A T SOUTHO£D TOWN OF $OUTltOLD SUFFOLK CO, AREA: 663;5 ~' ' 0.1523 ACRES CERTIP/EO TO: CHICA$O TIT££ INSURANCE CO. ~' ~'OREMO$ r ASS TROT . INC, THOMAS ~ $CHL~CHT J~NNIFKR C. BCHL EC~ , donock ossoci es 11515 ~f mei~ ~mef 1~5~) 569'1717 (212)746 ..N.o'E,I.F,Y. BUIL~ING D~P,A,R?~EN~ FOLLOWING INSPECTIONS; J. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE ~. ROUGH - FRAMING & ~LUMBIN~ ~. INSULATION ~ FINAL- CONSTRUCTION MUS~ BE COMPLETE FOR C. O, ALL CONSTRtJCTION SHALL ~HE REQUIREMENTS OF TH~ ~TATE CONSTRUCTION & ~ODES. NOT RESPONSIBLE FO~ DESIGN OR CONSTRUCTION