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Home My WebLink About17384-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17496 Date NOVEMBER 7, 1988 THIS CERTIFIES that the building. Location of Propert~ 815 ORCHARD ST. House No. County Tax Map No. 1000 Section 117 Subdivision ADDITION NEW SUFFOLK Street Hamlet Block 05 Lot 41 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUG. 22, 1988 pursuant to which Building Permit No. 17384Z dated SEPT. 1¢ 1988 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 NON CONFORMING SEASONAL COTTAGE. The certificate is issued to UBALDOGONZALEZ¢ M.D. (owner, ~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PEIUvIIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 017384 Z Permission is hereby ,~ranJ:ed to: ,~ . .,..~* *~,***...~..~.~ ................................ ~ ~ .~o~ ,~ ~, ...~.....~~..~ ........... ~.~ ............................................... ~o~ ~ ~o~ ~o. ,000 ~,o~ .... /~ ....... ~ ...... ~. ~o~ ~o ......... ~A ....... pursuont to ~pplic~Hon doted ........................................................ , 19 ........ , ~nd ~pprov~ by tho Building Inspector. Fee 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 ~ ~ 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 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 certifJca~e.~- F,,~. /~_Addlt ions 25 00 POOLS . C ...... .. ~_~=_..__:___~_.__~_ $25.00//%£T~RATION $25 00% 1. Certlflcate of occupancy New Dwellzng.$25.00, Accessory~<$10.(~0 2. Certificate of occupancy on pre-existing dwelling $~00.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C,O. $ 20.00 .. .... ~.~.~.~ ~.~.. _~5-..Up~. $ <----Ne~~.~,n/.~ ·.. Old or Pre-existing Building ............ VacantlLand ............. Location of Property .................... ' .......................... .~.~..~.- · · ~..& ~K .~ Owner or Owners of Property . f ........ .~ ........... ................... C°unty Tax Map N°' 1000 Secti°n/l' ~'~' 'Q' 9 .... Block Lo .............. Subdivision ........................ '-' ...... ~J~iled Map No ............ Lot No .............. · /- ·/. · ?J..Applicant Health Dept. Approval ........................ Labor Dept. Approval ......................., Underwriters Approval ............... · -,-, ,, .,Planning Board Approval ,equest for emporary Card,ate ..................... F,na, . ~.~ ~- ~ ~, ,/ Certificate ............... FeeSubm,tted ..... ...... Construction on above described building and perm, it r~ets all applicable co~es and/~gulations. , TO VN OF £OU /IOLD 'ICH OF BUILDING INSPECTOR P.O. I~OX 728 TOWN IIALL sOUrIIOLI), N.Y. 11971 TEL. 765-1802 To ~,qhom This May Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. / /_--// An application for Certificate of Occupancy is not on fi.le.~ /'-/_// ?lo Uaderwriters Certificate on file. [_~ The check is~/not O',1 file.)~3,~-~ /_-/ i-lo Ilealth Dept. Approval on fil~. /_--_/ ~:o final in~4pection has been made. P]ea.';e contact: our office on this matter. Thank you for your ' ~ cooperatzon. Building Building Dept. Plumber Solder Certificate on file. all permits involving plumbing being is.'~ued after April 1,1984 FOUNDATION (1st) FOUNDATION ROUGH (2nd) FRAME / .PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] ~/SULATION FRAMING [,~ FINAL REMARKS~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST []ROUGH PLBG. [ ]F~UNDATION 2ND []INSULATION [/~FRAMING []FINAL REMARKS: //i OCCUPANCY OR USE IS UN~WFUL DATE: ~LR J /~ 76~-18~ 9 AM ~ 4~ FOL~WING INSPE~IONS: I. FOUNDATION . ~ REQUIRED FOR POURED ~NCR~ 2. ROUGH . ~MiNG & PLUMBING 3. INSU~TiON 4. FINAL CONSTRUC~ON MUST BE COMPL~E FOR C.O. ALL CONSTRUcTiON SNALL ME~ THE REQUIREME~ ~= ~ WITHOUT CERTIFICATE OF OCCUPANCY · = N.~. STATE CONSTRUCTION & ENERGY CODEs. NOT RESPONSIBLE FOR D ,~SiGN OR CONSTRUCTION ERRORS FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined. ~.."../(. ......... , 19 ~...~' Approved ......... Disapproved a/c ..................................... BOARD OF HEALTH ............ 3 SETS OF PLANS ...~'-. ........ SURVEY ... ~ SEPTIC FORM ................ NOTIFY CALL MAIL (l~ailding t~pector) APPLICATION FOR BUILDING PERMIT ; ~ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Buildlng 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 givinga detailed, description of layout of property must ~be drawn on the diagram whicti is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. i d. Upon approval of this application, the Buildin~ 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 Bui.t¢ing 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 ;-emovai 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 pre~aises and in build~g for necessary inspe.~fions. .// ~/ , ' ........ (Signature ot applicant, or name, if a corpora~uon) (Mailing address of applicant) State whether applicant is owner, lessee, agent, ar~chgect, engineer, general contractor, electrician~ plumber or builder. ....... ' ........... .... ............... Name of owner of premises ....~.[.,... [dk .~../1.L..'~...~' (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 ]-~0,~.~...~..~-.~.~.?.~.wx...°o~..~- /.;e., ;I~/~'~'(P 7~~ [ , ' .. 1. Location of land on w~zich pro~posed~ '1 b .. .............. , ...... ~.~.~ .... .,., .............. ~~;~;; ~'u~g;r ................ Street ' Uamlet '': ....... //7. ............. . . O¢ .... 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..f~ ~ .... ~ O. ~ ~.~ ......................................... b. Intended use and occupancy ...................................................... 3. ature of work (check which apphcable): New Building .......... Addition . Alteration ...... Repair .............. Removal '. ............. Demolition ......... :i.. ii O;h'e} Work~.. ~i ... 4. Estimate'd Cost ........................ Fee ........ ~ .............................. .~..: (to be paid on filing this application) 5. If dwelling, number of dwelhng u.nit~ ~ .......... Number of dwelling Units on each floor ........... , .... If garage, number of cars ..... /I// fg[. . ; ............................. ! ............ ,...~, ......... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use g~././.-~. .... ' ' Dunenmons of existing structures, if any: Front....~..~./. ...... Rear ... ~!¢). ! ...... Depth .. [ ~.z. ..... Height .. ~ ......... Number of Stories ...... ; C2 rl ~. ........... 5.1 ............... ~ ........ Dimensions of same structure with alterations or additions: Front ~ , Rear . ~ ~o .. ' ' ' · 8. Dimensions of entire new construction Front -/~. ~. ~ ~ .... i?~,~, ~'7ff~;~, '.~ ' ~e~'t~ ............ 10. Date of Purchase ....... ............ ^.. N me qf,F, qrmer Owne tYqq. h. it'/O.C/',ge$ . .. I 1. Zone or use district in which premises are situated .~.OJt. q.P~.¢:~.. . ~ . J.. . t/ ' '. ' '. ' i.. ' ' 12. Does proposed eonstructiony~o~lete any zoni,~g law, ordinance or reeulation: ..! ........... u+. c~ame of Owner of premises L~..~.t. C40~2~o~o~/.~_~.~Addres~ 15.Is this property located within IO0 feet of a 'tld~'l''~etland* *¥g$.t.~..]O.'..,' ' *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all 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 L STATE O~ N~W YORK, C ' SS OUNTY OF ............... ' . .................. . .... ~.being duly sworn, deposes and says that he is the applicant named(Name, of individual signing contrac0'." "' above .................. x .................. (Contractor, agent, corporate officer, et~.) of said owner or owners, =d is duly authorized ~o perform or have perfo~ed thei said work and to m~e and file this application; that all' statements contained ~ th~s applicatibn '~re 'trffe to the best of l~is knowledge and belief; and that the work will be perfo~ed in the m=ner set forth in the application filed therewith.. Sworn to befoYe me this Not~ary Public . L_INOA J. C~OOPER r',~Y Notary Publio, etat~ of New ~ ff"// ,~('~ . No._48.225aa, Suffolk Cou_ntl~//~/ tO; , mrm ~:xp~ree December 31, 1fa ~ ~ ~ ..... County /~I (Signature of applicant)