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Home My WebLink About13810-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.Z13565 Dat~ June 26, 1985 THIS CERTIFIES that the building ....... p.e.q g .................................... Location of Property 850 Ruch Lane Southold House No. Street Ham/et County Tax Map No. ! 000 Section .... .5.2 ...... Block .... 2. .......... Lot ........ 3. 0. ....... Subdivision ............................... Fi]ed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·.. ~.~. v..c .~..2. 7. ......... 19 .8.5. pursuant to which Building Permit No.. 1 3 8.1.0 Z ............. dated ......... O.a.v.c..h..2.8. ......... 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 ......... ...... ~..o.c.~.. a..0.~.~.~. ~..o.n..t.?..e.x.~. s..~3.n.~. 9.n.e...~ 9.m.~.~.¥..o?..~.~.kn.~.: ................... The certificate is issued to THOMAS HIGGINS (owner,xAx~ ]~tXt~q,~ X of the aforesaid building. Suffolk County Department of Health Approval ...... .N./.O ................................ UNDERWRITERS CERTIFICATE NO... N/A Building Inspector Rev. 1/81 FOB~ NO. O TOWN OF SOUTHOLD BUILDING DEPARTMEHT TOWN HALL SOUTHOLD, No Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 13810 Z Permission is hereby gronted to:. ~.~.~....~7.,....~.... ~....~..o...~.....~...J. ................................................ ~ ~.~..~.~......~..:~ ...... I.L..~..~.~ ..... , ,~~ - ~, --~,,~-~.~..~.~,..~....~?~,...~ ....... ~ ........... , .................... at-- ----premtses located at ....~..~..~ ...... ,~...~l.,.~.~....,~T~,.~,,,,,~ ............. County Tax Map No. I000 Section ...... ~...~'~....2m.. Block ........ .~/.. ......... Lot No ....... ..~...0.. ........ pursuant ,o application dated .... ~.~I ...... ..~..~. ............ , 19.A]..~., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ~euthold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions in duplicate A. This application must be filled in typewriter OR ink, and submitted, , ,,V,,, i:~:o~.he 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 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 bu ildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to predate 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 O0 ~'Z ~ · ..... Date ....... g~.-~; ~. Old g B V t L New Buildin ,. or Pre-existin uilding ............ acan and ............. Location of Property .... ~.~..~ ............ .~.~p.~._~... ~,.~. ~ ........ ~..~...~7-~r.-,-~.. House No. Street Ham/et Owner or Owners of Property . .~...Aj~. .....~ ~ C=. ~ .,~.~. ........................... County Tax Map No. 1000 Section ............... Block ............ Lot ........... Subdivision. ................................ Filed Map No ........... Lot No .............. Permit N(~I~.~. [ ~'~ Date of Permit~p~y.4~..Applicant .................................. Health Dept. Approval ................... ' .....Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate Y Fee Submitted $., ~...~., .~..d~. .................. Rev, 10-10-78 d. Z IB FIELD INSPECTION FOUNDATION {1st} FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ?DE FINAL COMMENTS ADDITIONAL COMMENTS: ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-180:3 Approved .. ~../~...~.g.., 19.~.b~. Permit No.]. .~...~. J..~. ~ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 shall 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 York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building cj}de, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspectio, o~. ,~ ,~ / ..... ~../~.....--z~..... ;.; ......... (St'gn~ure of applicant, or name, if a co p ration) ...... .~..o.~. ~.4./. ..... ..l~:r.o..~7.. .......... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder· ........... . .~...~..? .... ~o.o...~..~.. ?..~.. .................................................... Name of owner of premises c>rul~ ~C~ ~ q (as on the tax roll or latest deed) If applicant is a corporation, 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 ...................... 1. Location of land on which proposed work will be done .................................................. ·. ~.~...0. .................... .~. o~....c.~ .,.~ ............. .~.o..~....~.. ~ ................ House Number Street Hamlet County Tax Map No. 1000 Section ...{5 & .......... Block ..... .~.. .......... Lot .... %.0 .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... .~. ~].~-.-~ .......~.~.~...~. %..-{ ..... .~..v4T~ q.~, ~ .~.c,a ..................... b. Intended use and occupancy ................................................................... 10. 11. 12. 13. 14. property lines. Give street and bloc interior or corner lot. k ( ~ppli bl ) ildi ' Additi//' Alt Nature Of wor check which ca e: New Bu ng .......... on .......... eration .......... Repair .............. Removal .............. Demolition Other Work.. /2~1 ~' 5;; ' ~' _ i _, (Description) Estimated Cost'....~.~.~.~. ~: .~..*" ............... Fee ...................................... i ~' (to be paid on filing this application) If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ ' If garage number of cars , If business, commercial or mix,ed occupancy, specify nature and extent of each type of use ............ } ........ Dimensions of existing structures, if any: Front .... ~.7/ ........ Rear ... Z,.~'. ....... Depth .. ~.~. ........ Height ............... Number of Stories ...... t ............................... 'Dimensions of same structure With alterations or additions: Front ... i ii~ i~. i i i i i i i t~ir' ..... .~'. ;~- ......... Depth .................. i · · · Height ...................... Number of Stories ...................... Dimensions of entire new consiruction: Front ..... 2 .~. Rear ~ ."/ ..... Depth ... ¢.~. Height .............. ,. Number of Stories .......................................... ~ ............. Size of lot: Front .. ~'O.... I ............ Rear ........ ~.~. .......... Depth ..... /..~.~-~' Dat f ,P h ~ N f F O eo utc ase ......... ~ ................... ameo ormer wrier ............................. Zone or use district in which ppemises are situated ..................................................... Does'proposed construction viplate any zoning law, ordinance or regulation: ................................ Will lot be regraded ....... i ...... , ~ ............. Will excess fill be removed from premises: Yes No Name of Owner of premises~ .M.~...¢~..~.~. ~.~. p .... Address .. ~..q .~.~..r_.~..,:q .~. .... Phone No.. ?.~..;~..z. ?.~..~... Name of Architect ·...... " .Address ................... Phone No ................ Nmne of Contractor .'~.~.' ~. i i .~.' .~.' .~.~. i i. Address . ~.*. ~.~.r,. (...~ P.~¢.~:.~.~Phone No.. ~..Z.. 7. ~.~. 7..~. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, an& indicate all set-back dimensions from number or description according to deed, and show street names and indicate whether STATE OF NEW YORK, COUNTY OF ................ (Name of individual si above named. · i ..................... being duly sworn, deposes and says that he is the applicant ~ing contract) He is the .......................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is doly authorized to perform or have performed the said work and to make and file this application;that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the man~er set forth in the application filed therewith. Sworn to before me this ..... ............. day ........... , . . Notary Public, ........... '~ 'f~' ~,gnature of appl;cant), · · MQNt/M~ .~V~S~ONS YOUNG & YOUNG ALDEN W. YOUNG * HOWARD W, ~1 OUNG SURVEY 'FOR: THOMAS F. HIGGINS I~ CAROLYN El. ' ~o~ IvIU ~u THETI~RA~E~ ~.~.: ,,,= ~o, i~.~~:o.~,,,~,~,~ -i~.~ ~;-,,.~ ,/ .~V'S,ONS YOUNG & YOUNG ALDEN W. YOUNG HOWAR~ W, THONAS E HIGGINS ~ CAROLYN B. HIG~~ ~ NOT FY BU!LDI¢,!¢ DE~RTM~: 'I~6~-1802 9 AA TO, PM FOR ~. FOUNOATh3, _. q%~/O JfRED OU~H - FP~Mf~% ~, p~ r~MSiNG ' ~,~ ~ ':~' MUST