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HomeMy WebLinkAbout13995-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certi[icate O[ Occupancy No. Z. 1488.0 Date .... Sept. 17 .......................................... , 19...86 THIS CERTIFIES that tile building Deck Location of Property ...1.4.1.5...Ng.r.~h.. ?.a.r.i..~.h..D.r.: ............... S.o..u.t.h.o. 1..d ...... - ...... House No. Street Hamlet County Tax Map No. 1000 Section 071 .Block 01 .Lot 14 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... M..ay..7. ........... 19.8. 5. pursuant to which Building Fermit No.. J-3.9.9. ~ .Z ............. dated ....J.u.n..e..3. ................. 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 ......... Deck addition to .existing one family dwelling. The certificate is issued to NANCYE & [vI~CK RADMIN ..................... .................... of the aforesaid building. Suffolk County Department of Health Approval .......... .nJ.a. ............................ UNDERWRITERS CERTIFICATE NO .................. B./.a. ............................ Rev. 1/81 IrOlt~ 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) 13995 Z Permission is hereby granted to: County Tax Map No, 1000 Section ...... ~)...~..( ........ Block ....... ..~....}. ........ Lot No ...... (...~. ............. ..... Building Inspector. Fee $ ........................ Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Bu ilding Department Town Hall $outhold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted .- ~ 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. 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: I. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 5.Updated C.O. $15.00 Date ... :' '1 ...... New- C on s t r u c t i on.//r'' elj or Pre-ex isting Building Vacant Land Location of Property ..... , .............................. ~ ...... /, ...... House No, ~Street ~_) t Ham/et Owner or Owners of Property . - o, .l 0 t /...Y. County Tax Map No. 1000 Section ............... Block ............. Lot ............ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No./.$.~/; .~..~. Date of Permit .. O/.ff .~Applicant Health Dept. Approval ........................ Labor Dept. Approval . ...-'7..---7 ......... Underwriters Approval . Planning Board Approval ................ Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $.. ~) ' b b Construction on above described building and permit meets all applicable codes and regulations. Applicant ! .~.L/.L,G/¢~..,.'.Q.. ~LC~-./L~.~*, /. : Rev. 10-10-78 American Title Insurance Comp n A Meridian Company Date: January 14, 1988 Title No.: 07-112,958 Tax Map No.: 1000-071.00-01.00- 014.000 Town of Southold Building Department Main Road Southold, NY 11971 Dear Sir or Madam: Please provide this Office with a Duplicate Original Certificate of Occupancy affecting the hereinafter described premises. Enclosed is our Check #}6~%1~, in the amount of $ 5.00 in payment of this service, along with a stamped, self-addressed envelope for your convenience. ( X ) Street Address: 1415 North Parish Drive (Southold) ( X ) See Survey attached: ( ) See description attached: ( X ) The present Owners are: BM (N) Holding Corp. You~ cooperation in this matter is greatly appreciated. JS/det Enc. Very truly yours, American Title Insurance Co. 130 Osborne Avenue Riverhead, NY 11901 (516) 727-5500 FlESh INS[~ECTION COMMENTS FOUNDATION (~st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY QODE FINAL ADDITIONAL COMMENTS: BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION ~.~..?.) ] FINAL 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N,Y. 11971 TEL.: 765-180:3 Examined . .~, .~.1,~,..~. ...... 19~...~f Approved .'~("~..~. ..... , 19 .~SPermit 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 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 code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. . .~.~.~.~. 6:~...~.-.':...G.~.,.~.~ ~.c.~. ....... (Signature of applicant, or name, if a corporation) ~ (~o Io n,.~ ~... f~.4=,..~,.~.%.~. !©..la.~. ~ ..... ....... (Mailing ad(tress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........ b.~&~_c ............................................................................. Name of owner of premises . ..]~[ i~,..~.~(~C~¥} .... (k) .............................................. I (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...(~.: ~../9~c~{,.,) ........... Electrician's License No .... .~.~. ~. .............. Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ......... ......... p. ........ ! ...................... House Number Street Hamlet County Tax Map No. 1000 Section ...... .-7...} ........ Block ...... I ............ Lot ..... {.y .......... 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 . .0~.. ~.--~.,~'~7~,.. ~..r2,~ 6</,dg.¢~ ........................ /~i' '" .......... o~. W.~.~ ZP~/~> ' . ~-.~.~ -' b. Intended use and occupancy ....... ~22~... . ~ .............. 3. Nature of work (check which applicable): New Building ..... ' .....'Addition .......... Alteration . '~. ...... Repair .... '.a..4:..... Remloval .............. Demolition ............ -- OtherWork .~,~. ~'?~o ,d,4¢~¢¢¢: ~ ~" (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. ~.o' .. Rear ~..~ . . Depth . . ~ ......... Height ./.~." Number of Stories Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ................... ~ Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... ~N~urnbar of Stories ........................................................ Size of lot: Front .... [/.~....'. ........... Rear .... ./~gD..~/o.r. ........ Depth /£~9 Date of Purchase .......... , ................... Name of Former Owner ............................. Zone or use district in which premises are situated Does proposed construction viQlate any zoning law, ordinance or regulation: ................................ Will lot be regraded ........ i..,~.? ................ Will excess fill be removed from premises: Yes Name of Owner of p~remises .,/lJ~tl~e~.... {.(O~ffl ~... Address ................... Phone No ................ Name of Contractor (~k~ f3.~4tm.~. ~.t.~. ~;~.¢?. ..... Address~.~..~.lgo~.aJ. ~.~.,.~.'~t.~.°!~hone No.."7..(~':/AX~. ..... 10. 11. 12. 13. 14. Locate. clearly and distinctly all property lines. Give street and bloc~ interior or corner lot. PLOT DIAGRAM 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 STATE OF NE~ YORK, COUNTY OF..kt.-~.~}C~. ........ i S.S (3 ckm' ' ...... ~ ...... ..................... being duly sworn, deposes and says that he is the applicant (Name of individual sigRing contract) above named. He is the ...... ~Or.9~..~ f~k%~ ........................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is d~ly authorized to perform or have perforated the said work and to m~e and file this application; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the work w~l be perfo~ed in the m~ner set forth in the application filed therewith. Sworn to before me this ........................ day qf ................ 19 ~C Nota, Public, .... ~..~.. ~. ~ .... County NOTAR~ pUBI.IC, State ~t New York· ·' ............... ~ o, 4707878, Sulio~k Connt~ (Signature of applicant) '0 MAP OF DESCRIBEO PROPERTY. "°4'"eo4//¢ TITLE I~. ¢~fZ/(27'33 · / FIN. FLR. ELEV)*TION IS FIEFERENCED TI2 ;JS¢ ~G. D.4TLIM. SURVEY FOR BAYV I E W TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y GUARANTEED TO: TN~ TtTLE ~IJARANT~]~ LAND 8URVE YOR N.¥.,~. L/C. NO. E8 T-~S FI~V~RHEAD. SCALE: I''= 40' OCT. 3 I, 1980 SEPT. 23,19,94 MAR. 27, 1985 NOTE= · .MONUMENT ROVED A.S NOTED FEE: ~. ~,-_ DEPARTM~-t'l NOTIFY BUU-u'~'~ FOR THE 76~-1B02 9 AM %0 4 PM ~ iNSPECTIONS: ~NTONUCCI & LAWLESS ARCHITECTS & ENGINEERS 480 NORTH BROADWAY YONKERS, N.Y. 10701 CO G~ OR coNSTRUCTiON ER DF_Gl P&,Z~,,9 / C 8AV PLO: PL/',,t / 4,_AL~- I = ,40 1'3,/-0