The URL can be used to link to this page

Home My WebLink About13835-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z14467 Date June S 1986 THIS CERTIFIES that the building a c c e s s o r y s h e d 22950 Main Rd. Orient Location of Property/:/~;~s~ 74oi ....................... ~r'e3t' ....................... County Tax Map No. 1000 Section q 8 .Block 5 .Lot 1 0 Subdivision × .Filed Map No. .X .... Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated April 3 q3835Z ..................... ,19 85 pursuant to which Building Permit No, dated ...... g,p..v ?_.~..3. .............. 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 ......... ... ).qc. ?.s.s.qv..y. shed. The certificate is issued to ARTHUR A. SPANGEL (owner~Ye)~ ~t~ of the aforesaid building. Suffolk County Department of Health Approval ......... N/A UNDERWRITERS CERTIFICATE NO .................. ~l / A Building Inspector Rev. 1/81 FO~wr NO. 0 TOWN OF $OUTHOLD EUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NM 13835'Z Permission is hereby grante~ ~7 ~ ~ ~.~,...~.~.~ ............................................. ~~.....~.:..~ ...... u...~..~:..~ ............. ,o ..~~......~.....~......~...~...~...~,-....~ ....... ,. ~-~. ~--, y~ .~ ... ~ .......... et premises located ............... ..~. .................... ~, ........................ ...~~ .............. County Tax Map No. 1000 Section .......'~/..:...~ ........ Block ........ .~. ......... Lot No ........ ~ ............... pursuant to application doted ........ ~....~. ........................ , 19.~...~.~.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 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 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. Fina~ 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 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.upham:ed O.D. , SZS.oo Date ....... Location of Property g ~S 5~.. ~ .~e.~~ ...................... .O r.': ~. Owner or Owners of Property ........... '.~~, ........................... CountyTax Map No. 1000 Section ..... ,,O k ........ .... COt..1.0 .......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. ~.3.~-~2, Date of Permitl~ l~llo°S. .Applicant J~.~.~'~..~...~... S~-~-~I · · Health Dept. Approval ........................ Labor Dept Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .....~;~,.. .............. Fee Submitted $..~., ~..V'. ~1~..~. 1% Construction on above described building and I~-¢~meets all appJ~ab.I/~ codes and r~lations. ................ FI~£LD ~NSFECTION COMMENTS FOUNDATION (1st) FOUNDATION ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY QODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT, INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~FINAL 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 k,~{,~4~{, 19'17.. Permit No. ] .......... Approved · .~..-, ~" ~ ~ 1~ ~ ~ Disapproved a[c ..................................... . (Building Inspector) APPLICATION FOR BUILDING PERMIT BLDG. DEPY. TOWN OF SOUYHOLD 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 °f 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 applicabl~',mances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein"cl~cribe.~d( The applicant agrees to comply with all applicable laws, ordinances, buil~g"~de, housing c~ode~nd regulations, and to admit authorized inspectors on premises and in building for necessary i~ ~~ ' ' ' iSignature of apt~li~~;o'n') .... ..... .At,. r,. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, eiectrici4tf, plumber or builder. Name of owner of premises. ~. ~..~..~. ~...,~..'....~. · .~. · .~..~. · .~ ~''/ ........... (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 .................................................. ......... o.. ............................ [louse Number Street Hamlet County 'Fax Map No. 1000 Sectiou ... ~ .~. ~. ....... Block ...... ~.. ......... Lot .... .~. -~. ........... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and qc~upancy of proposed construction: a. Existing use and occupancy ..................................................................... b. Intended use and occupancy ....~..O..~. ~....~.~..~..~.....~... ?..~..h/.C.'..~. ......................... · Nature'S'of work (check which a~plicable): 3. New Building ..... Addition .......... Alterat ..... Repair ........... ,t" Rej~oval .............. D~molition ............. Other Work·~ .... ;.." )~ ~ ~ (Description) 4. Estimated Cost ~-- ~.. ................ 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. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth .............. Height .............. '. Nucber of Stories ....................................................... Dimensions of same structure With alterations or additions: Front ................. Rear ................. Depth ' Hei~t Number of Stories 8. Dimensions of entire new construction: Front ...~i ....... Rear ...~.~ ........ Depth ...~ .......... Height ..~ ........... Nu*ber of Sto~es .... 1 1. Zone or use district in which p~emises are situated .................................. 12. Does proposed construction vi61ate any zoning law, ordinance or regulation: ............. ~ ~ ~[[~ ~ ~ ~ [~ . 13. Will lot be regraded ...~ ..... ~... ~. ..... Will ex[ess f~ be removed from premises:~ Yes 14. Nme of Owner of premises ~ ~.~ Address ~ ~.'.~~ .... Phone No~.".~.]~... Name of Architect ......... 1 .................. Address ................... Phone No ................ Nme of Contractor ........ .................. Address ................... Phone No ................ PLOT DIAG~M Locate clea~l~ ~d distinctly ~1 bulldogs, whether existing or proposed, and. indicate all set-back d~ensions from prope~y ~nes. Give street ~d block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ..... . ............ iS.S ' being duly sworn, deposes and says that he is the applicant of individual siglning contract) (Name above named. He is the (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dfly authorized to perform or have performed the said work and to make and file this application; that alt statements conltained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith· Sworn to before me this ........... i .~..A~- ..... dayif ...... ~ ...... ' 19 ~>~~.~.~ ~~.. Notary Public ..... ~<~.......~-. i ~).~'..~ .... County · H£L~N K DE VOE NOTARY PUBUC State of NeW Yo~'k ........ \ No 4707878, Suffolk C0unt~ f (SignatureJ6f ,applicant) · le~m Expires *,,~ 146.II TO VILLAGE; LA GO' N DATE: ~ 4_.~_~ B.p. ~ ,/ ~ g.~.~'2c4 ~ r'.,& ~.__ , '' NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: REQU I RED FOR POURED 2. ROUGH - FRAMING PLUMBING 3. INSUL.A"f fON 4. FIN,At. CQN'STRLJf ~ON ~UST BE C~Mm ~TE FOR C t~' ~ ALL CONS-~RUCT[ON S-~,LL MEET ST~TE CONCTRUCTION & EN~,GY CO~ES. N'~T RESPON~SL8LE tUFOR VAN TUYL ~. SON