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Home My WebLink About17821-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z 17909 Date MARCH 31, 1989 THIS CERTIFIES that the building ALTERATION Location of Property 180 CAROLE RD. SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 052 Block 02 Lot 06 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEB. 6, 1989 Pursuant to which Building Permit No. I7821Z dated FEB. 10, 1989 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 REPLACE EXISTING DECK WITH NEW MATERIAL SIZE TO REMAIN THE SAME AS ORIGINAL The certificate is issued to DR. MOOR-SANKOSKI (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N/A PLUMBERS CERTIFICATION DATED N/A ~ uilding Inspector Rev. 1/81 FOBM NO. D TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MU5T BE KEPT ON T)1E PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 0 7 8 2 Z Dote ~.~i':"':".^: .......I. D..........., 19. R...t Permission is hereby granted to: ....-~.~.x. 4,a to Ya~<:. ...1~..-~:.....4a::~~::....5?-:Rif.....!1~~..~'?'J....~.-g~-!-aQ...... ~ ~.Q.P..................................................... ct premises located at ....~...,~..Q.......4t.O!J!:~ti.....1~~:..........`.?~6>r!-~.e~IF-k~ 4. ~ 1-,~ County Tax Map No. 1000 Section .....Q.~.~-....,. Block ......Q~:....... Lot No.....~..b........... pursuant to application doted . ~~0~".~-~:°..'1:~...~ 19.~.~.,, and opproved by the Building Inspector. Fee ,t C~U-a_ ......9..~................................. Buildin I actor Rev. 6/30/80 t 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 ~e~s~ to the Building Inspec- torwith 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, acertificate 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 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 $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.0.0, Accessory$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $100.00 3. Copy of certificate of occupancy $ 5.00 , qv e r 5 years $ ] O . 0 0 4.Vacant Land C.O. S 20.00 ~~/~/S~ S.Updated C.O. $ 50.00 Date. NewConstruction,,,,,,OldorPre-existing Building Vacant Land Location of Property . Cs r- c { ,e . ~c?....... r~4Ff~~.41.~.... . House No. Street Hamlet Owner or Owners of Property , r , ~ o c~ r - ? e? /7. /~.,0 S ~ ~ . . , County Tax Map No. 1000 Section ~ `s?......... Block 8.?.... , Lot O. L , , . , , Subdivision .................................Filed Map No. ..........Lot No. . Permit No.d !?~'e?1.2. Date of Permit~~/.o,~8~..Applicant .~~.4.4 !`;~c....~~ ~!yy . . . . . . . . . Health De t. A royal , P pp ...........Labor Dept. Approval Underwriters Approval .............Planning Board Approval , . Request for Temporary Certificate , :............Final Certificate , . Fee Submitted $ . Construction on above described building and/ rmit meets all applicable codes and regulations. Applicant'i~4 _ " ' . ~'.4.'.. ~Crt'`~'~^." . Rev. 10~10~78 1~.~- s ~ ~a s' C o z / 7$ .~/3/~~y a ; '1cL,~ .~I;; ;PcC:lUN ~~UATE ~ OOMh(ENTS ti a ~ w _ - H FOUNDATION (1st) a ~ ~ ti nt FOUNDATION) (2nd) _ _ m Q~ 2. z o P,OUGH FRAME & ~ a PLUMBING ti 3 . ~ m+ m IIJSULATIOA! PER N, Y, y STATE ENERGY CODE 4 . I FIlJAL E ADDITIOPJAL CO m ~ D ,Q - ~ ' x ro H r„~ ~ a H p .9 z G m • rr` ~ a m H i ~ G ~ ~ - - 1 - i ~ ~ ~ ~ ~ -l- ~ a { _ _ i ~ ~ ~ ~ ~ J - ~ n . y 1 ~ 1 - ~ - - - - - a - - k-- - _ - - - i, - _ _ _ _ _-t - - - ~ I _ - - -I - - - - - - - - ~ - - - ~r - ~ _ - _ _ ~ - I~ ~ ~ - - _ - i - ~ i ~ - - - - - ~ ,x. , ~ I ~ fit- b _ . - 1 -a- ~ ~ ~ ~ ` - - - ~ - i I ~ ~ ~ - - - ~r-1-~ - - - r <r _ t ~ t-, s " ni - ~ ~ r r^ h^ f - , t t - - - - - - - - ( - r F ~ . ~ A~E- ~ . • ~ ~ ~ > b axr ~r ~ ~ - - - - - - I n , ~ ~ - ~ ~ ~ - ,_4 _ - - - ~N ~ - ~ ; 1 i ^l ~ JI ~ - - i - - - W1 I 1- - - - - - ~c.~ //A~ FORM NO. 6 ~ ~ ~O? 4 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 ~ APPLICATION FOR CERTIFICATE OF OCCUPANCY N Instructions A. This application must be filled in typewriter OR ink, and submitted ~ p~~ to the Building Inspec- torwith 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, acertificate 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 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 $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory 10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $100.00 3. Copy of certificate of occupancy $ 5.00 , over 5 years $ ] 0 . 0 0 4. Vacant Land C.O. $ 20.00 S.Updated C.O. $ 50.00 Date~~~~/~~,,,,,.,,,, New Construction,,,,,,OldorPre-existingBuildin Vacant Land g Location of Property ~g~? C3 r ~ ~e , 1Cd., , . ~^?.QK /.~.41.4y. . House No. Stre,e/t Ham/et Owner or Owners of Property r , ~ o c~ r - ? 3 !7, K.,O S . ! , , , . . k CountyTaxMapNo.1000Section ~.`S.Z,........ Block a.?+.......... Lot 0.~.... Subdivision .Filed Map No. ..........Lot No. . Permit No.~? !7b,'-?l, g, Date of Permit~~/.o~89..Applicant .~i,~,Q , ,!e G!Z 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 rmit meets all applicable codes and regulations. /~j Applicant .~'.~i.• ~C.-R.~-.,~.- Rev. 10-10.78 O ~ 3~ yas~ 3r3i ~~y - ~ , L5 Q ~VJ ~ ~ ~ FORM NO. 1 0;; , n ~~~.M TOWN OF SOUTHOLD ~II,~ C FEB -'g ~ BUILDING DEPARTMENT TOWN HALL ~ 9OUTHOLD, N.Y. 11971 t3LnG. t,[P~: TEL.: 765-1802 ..,..yYOnWN~ fir. g~MOLU ~ Examined .Q~(~!-~.. • ~ d., 19~~ Received........... , 19.. . Approved ~~.4~Ia., 19'9. Permit No. ~.?g •~ti. S-- S`~~Z ~ 1`f `f Disapproved a/c (:~-c,c~v 3 (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . c~/°.~! 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 park 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, build' code, housing code, and regulations, and to "7 admit authorized inspectors on premises and in building for necessary insp t ' ..r ~ (S' ature of appl, or na , if a c ) ' (Mailing adflress of applicant) State whether applica~is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder. ..~~CL.. ~ /E' Name of owner of premises ~~..~~02 f ~i"F . (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. . 1 s3 v y1 Plumber's License No . . Electrician's License No . . Other Trade's License No . . 1. Location of land on which proposed wo/rk will be done . . House Number Street Hamlet County Tax Map No. 1000 Section Block ~ Lot . Subdivision Filed Map No. Lot . (Name) 2. State existing use and occupancy of pr miser and 'ntended use and occupancy of proposed construction: a. Existing use and occupancy S(••.r~6Z,L,~,,,,,, - ~ b. Intended use and occupancy ..cJG? .l,?.~ . k ~ r 3. Nature of work (check which a plicable): New Building Addition , Alteration . Repair Removal , . , Demolition ..............Other Work . 8« (Description) 4. Estimated Cost . ~ ~ ~.'...4~.4'~- Fee . , . (to be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor l . 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 ...............NumberofStories........................................................ 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 ...............Nur}rberofStories...........,........,................................... 9. Size of lot: Front Rear . Depth . 1B1. one or use district in which pr • ' • ' ' ' ' ' • Namg of Former Owner . emises are situated f2.e r..r.c/.~: h'~. ~ .a . 13. Wi]] lot be re raded , elate any zoning law, ordinance or regulation : . . g 14. Name of Owner of s remises h`.o • • ' • ' • • Will excess fill be removed from premises: Yes ~No p Jd n /Cas k 1.... Address ...................Phone No......-......... . Name of Architect .................Address ...................Phone No............... . Name of Contractor ..................Address ...................Phone No... , I PLOT DIAGRAM Locate clearly and distinctly al} buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. j I C r ~ S ) r•. 6 r r I _ 12 E 3(' H J s o 1 V ~~I L T E S ~I E• z y y tSrVl j ~ f 2'-.err 7.1~+•~r pccl< C. Y"L'E E)'t i ~Ep~AC~ I rl 7 ~ DLD SRvh I i~~ I STATE O NEW YORK, III S.S COUNT - [ r:... • • • • • • • • • • • • • being duly sworn, deposes and says that he is the applicant (Name of individual signing cont act) above name/d.' He is the . 1°°."~,.!t:'f~-~,-~,.~ .Ili . I (Contractor, agent, corporate officer, etc.) of said owner or owners, and is du~y 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 manner set forth in the application filed therewith. Sworn to before me this Notary Public, fix!, . !1.-, U~........ County • _-__-z-•---- NEIEN K DE VOE . . NOTARY PUBLIC, stofo of ' New York (ignature of applicant) No. 4707878, Suffolk Couniy~ Term Expires Mxrch 30,19--4-/ c r