HomeMy WebLinkAbout13832-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z17270 Date SEPTEMBER 7~ 1988
THIS CERTIFIES that the building. ADDITION
Location of Property680 R.O.W. OFF (PVT #17) PARADISE PT RD. SOUTHOLD
House No. Street Hamlet
County Tax Map No. 1000 Section 081 Block 03 Lot 27.2
subdivision xx Filed Map No. xx Lot No. xx
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 2~ 1985
Building Permit No. ]3832Z dated APRIL 3~ 1985
pursuant to which
was issued, and conforms to all of the reqn/irements of the applicable
provisions of the law. The occupancy for which this certificate is
issued is ADDITION TO F~XISTING ONE FAMILY DWELLING.
The certificate is issued to DWIGHT WEIST & DORIS DAVIS
(owner, ~Q~)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N734873 FEB. 10~ 1986
PLUMBERS CERTIFICATION DATED N/A
B~filding Inspector
Rev. 1/81
FORM NO. 0
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PER~IT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
13832 Z
Permission is hereby granted to:
..~/,~....~......~ ....... I ............
..E;.~~...~......~..,....u...t.~..~.... ~
· ~.~ ...~.,~,~L,..~, ~~ .... ~....~ ' . ...........
~'~..~.~..~.....¥~~ ............................. ~ ............... ; ........................... ._. .......... .
at premises Iocat"~ at ....~...~.O.....,..~..,.?.:.-~..,...~.L.~..~.?...m..l...~..3....~' '.~l~n~..~e~....~.~...~......s~~
o etion ..O....g,. ! .
County Tax Map No. 10 0 S c ~ ................. ac .......C~. ............ Lot No ........................
application dated .............. ' ..L.........~... ................. , 19..~...~,~., and approved by the
pursuant to
Building Inspector.
Building Inspector
Rev. 6/30/80
FORM NO. 6
TOWN OF SOUTHOLD
BuildingTown DePHallartment
Southold, N.Y. 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted m~ 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 ~,pr~l 1957); N0n-conform'ing uses, or 6pildings 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: Additions $25.00 POOLS $25.OOALTERATION $25.00
1. Ce~ificateofoccupency New Dwelling $25.00, Accessory ~$10.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00
4.Vacant Land C.O. $ 20.00
5.Updated C.O. $ 50.00 Date Aug. 22,1988
New C cna truc t i on ...... Old or Pre-existing Building ............ Vacant Land .............
6..8.0 .R.O. ?. !~).v.t. ~17) Paradise Point Road Southold
Location of Property ; : '. ...................
House No, Street Ham/et
Owner or Owners of Property Hr. Dwight Waist & Ms. Doris Davis
County Tax Map No. 1000 Section 81 Block . 3 Lot....2.7...2.
Subdivision ................................. Filed Map No ........... Lot No ..............
PermitNo.l.3.8.3,2,7<, OateofPermitaP.~,~Z. 2,..'.BA~plicant Dwayne H. Early
Health Dept. Approval ........................ Labor Dept. Approval . .~.~.',', ...................
Underwriters Approval` .r~/~ .......... ~ ........ Planning Board Approval., ,/~.~.~ .............
Request for Temporary Certificate .... ' F nal Certificate ~,~
FeeSubmitted$. 25:00 k/:J~lOl(.p
ConstructiononabovedescribedbuildingaF~.~itmeets~/p~abl~codes and regulations.
.........
Rev. 10-10-78
--
E.O 2/2~.2d
TOWN OF SOUTIIOLD
OI:FICI'~ OF BUILI)ING INSPECT()R
P.O. BOX 728
TOWN tlALL
SOUTttOLD, N.Y. 11971
December 9, 1987
TEl.. 765-1802
This was inspected and approved on 11/7/85 and to
date we have not received your application and check.
TO Whom This May Concern,
We are unable to complete your Certificate
of Occupancy because .of thc following reasons.
/~$ An application for Certificate of Oc6upancy
is not on file. _~D~p_l_j_~enclQsed
/5/ No Underwriters Certificate on file.
/~R The check is(outdated/~Pt_o_.n__.f_j~!.~}_ $25.00
/_-/ No Health Dept. Approval on file.
/_--/ No final inspection has been made,
Please contact our office or)
Thank you for your
Building Permit t}
Building Dept.
***/~/ No Plumber Solder
cooperation.
I 3 8 3 2 Z
this matter.
Dwight Weist/Doris Davis
Addition
Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
OCCUPANCY OR USE IS UNLAWFUl, WITIIOU~ A CERTIFICATE
OF O(]CUPANGY ·
CLEAR UP TIIIS MATTER AS SOON
IIAVE TO BE TAKEN.
Thank you.
Sent to: Dwight H. Early
310 Third St.
Greenport, N.Y.
AS POSSIBLE SO TUAT LEGAl. ACTION I)Ol'::; NOT
11944
FIELD ~NSPECTION
FOUNDATION
(1st)
FOUNDATION (2nd)
ROUGH FRAME &
PLUMBING
INSULATION FEE N.
STATE ENERGY
FINAL
COMMENTS
ADDITIONAL COMMENTS:
THE NEW YORK BOARD OF FIRE UNDERWRITERS
~LO0009~. BUREAU OF ELECTRICITY
~.~ 83 JOHN STREET, NEW YORK, NEW YORK 10038
THIS CERTIFIES THAT
in the following Iocaeion; ~ Basement ~ 1st Ft.
was examined on
[~ 2nd FI. Section Block
and found to be in compliance with the requirements of this Board,
Lot
FIXTURE
OUTLETS SWITCHES
I 1 FIXTURES
INCANDESCENT FLUORESCENT
DRYERS FEEDERS
RANGES OVENS DISH WASHERS EXHAUST FANS
SYSTEMS
NO. OF FEET
E
OTHER APPARATUS:
E R V I C
NO OF HI-LEG
A. WO
OF NEUTRAL
Sou~hol~, ~ 11971 ~ic%137~ GENEI~AL MANAGER
Per_ ~
This cerhf,cote must not be altered ,n any manner; return to the office of the Board if ~ncorrect. inspectors may be ideat[fied by their credenfia
cOP~ EOBBU LDING DEPABTMENT. TH ~ CO~y OF ~E~I~CATE~T~0.~E ~[~ERED1N ANY MAN~
· FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y, 11971
TEL.: 765-1803
Examined . .., 19~' ~
Approved .., I9 .$'.~. Permit No.
]Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Received ........... ,19.. ·
a. This application must be completely filled in by typewriter or in ink and submitted to the Buitding 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, ordinant~uilding code, jaousingqode, and regulations, and to
admit authorized inspectors on premises and in building for nece~ry jn~4pections. ///'~ /
(Signa$fire of applicant~fir name, if a %0 ppr~,~tion) /
(Mailing address of aepplicant)
State wheth;17Iic~ i~l~w~ssee, agent, architect, engineer, general contractor, electrician, plumber or builder.
... .rW. ........................................................................
........... ( ..... ;a'x' ;o'li ;; ilt;}t' ri;id') .........................
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No .... .~..Y~..~ .............
Plu nber s License No .........................
Electrician's License No .......................
Other Trade's License No ......................
Location of land on which~proposed work will be~done...~. ~.~.......~.La.'.c?..C/..P?,.~.~. J. ?~--..~. ~ ...............
.............. . . , k.t. ............. . /&. . !lo. !d. ,. . . 4.[.. .'. ...............
House Number Street Hamlet
County Tax Map No. 1000 Section ....... .~.../. ....... 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 .../r]/.~. ~'gO(~f.~ ~. ....................................................
b. Intended use and occupancy .......................................................
/
3. Nature of work (check which ~pplicable): New Building ..... ' ..... Addition .......... Alteration ..........
Repair .... !{ .-..;?~f.~... Removal ......... Demolition .............. Other Work ...............
~-~/') 000 .~.~..~.-- (Description)
4. Estimated Cost ... ~.v,, ........................... Fee ...............................
*" (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. Ifbu~iness, commercial or mix~d occupancy, specify nature and extent of each type of use ....':~T. ...............
~**~,~ Dimensions of existing structu}es, ifany: Front ............... Rear .............. Depth ..............
Height ............... Nu~nber of Stories .......................................................
' Dimensions of same structure With alterations or additions: Front ................. Rear .................
iDepth .................. J... Height ...................... Number of Stories .....................
Dimensions of entire new construction: Front ............... Rear ............... Depth ..............
Height ............... Nuinber of Stories .......................................... ~ .............
Size of lot: Front .......... i ............ Rear ...................... Depth ......................
10. Date of.Purchase ......... i ................... Name of Former Owner .............................
11. Zone or use district in which pyemises are situated .......................................
12. Does proposed construction violate any zoning law, ordinance or regulation: . ./~t.~. .............. .
13. Will lot be regraded ...... ..~..,. ·, ..... ...~ ......... Will excess fill.be removed,from premises: . ,.Yes ~,"~o
14. Name of Owner of pi[er~ises.~..*~?.~:~.?~/1 .~. ...... Address ~t~f.~?. ,~..~,.1~... Phone No. ~}.?,~.~. ....
Name of Architect ~ ~ (,t.,/~(~,f~] Address,~/¢.~/. ,~. }~J~ h
~f'.. ,..~.. ~ .............. ~..~f~...~? oneNo .... ~...~ .......
Name ofContractor ~/~)~lg. ~¢~'1~ .... Address-~/.O..,l~{~.~..~'~.~' Phone No ~.~./.o~.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from
¢ number or description according to deed, and show street names and indicate whether
property lines. Give street and bloc
interior or corner lot.
STATE OF NEW YORK,
~ S.S
C~[~I~ITY OF .,~ ............ j .
above na~ea(. .... g~' g ' ;tractj ..........
duly sworn, deposes and says that he is the applicant
He is the... ~ .....
(Contractor, agent, corporate officer, etc.)
of smd owner or owners, and ~s duly authorized to perform or have performed the said work and to make and file this
pphcattoa; that all statements con~mned m th~s apphcation 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.
Swor~ to b~fore me this
........... da~S£ ..................... , 19.~
Notary Public, .. · .I ................. Count~N[ ]/~ /
i ....
No, 4707878 Suffolk Count~ I
Term Ex~ro.~ ~arcll 30, 19~'7 I
::z
WALL OF
NOTIFY BU,LD,
2, ROUGH - FRAMIN,~ ,:" 'PLLIM~ING
STATE CONSTRUCTION & ENERG~
COMES, NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERR~Rg.
5CALl: V4" ':' ILo"
~SE
NIO~Uf"H