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Home My WebLink About17434-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPanCY No Z18208 Date JULY 25, 1989 THIS CERTIFIES that the building~ ADDITION Location of Propert~ 1790 PVT. RD. #7 DIEDRICKS RD. House No. Street County Tax Map No. 1000 Section 18 Block 03 Subdivision Filed Map No. ORIENT Hamlet Lot 05 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 29, 1988 pursuant to which Building Permit No. 17434Z dated SEPT. 15, 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 ADDITION TO GARAGE. The certificate is issued to DOROTHY ABBOTT-JANET SWANSON (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 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z18209 Date JULY 25~ 1989 THIS CERTIFIES that the building CHIMNEY ANDWOOD 8TO~E Location of Property i790 PVT. RD. #7 DIEDRICKS RD. ORIENT House No. Street Hamlet County Tax Map No. 1000 Section 18 Block 0~ Lot 05 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated J0-LY 29~ 1988 pursuant to which Building Permit No. 17434Z dated SEPT. 15~ 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 CHIMNEY AND WOOD STOVE. The certificate is issued to DORORRIY ABBOTT-JAnET SWANSON (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, hi. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 017~3~ Z Permission is hereby granted to: · ......... ........ .... ; ........................................................................ ~" .,,/-.~.../.. ;..'...'~...¥. ...................... ~ ............................ o, p,em,ses ,ocateda, ..... I'"'7'"~:£'~'"'~'~'"'~'~".~'"'~~../~.~..... . ................................................ ~~..~.......~..,~....: ................................................ County Tax Map No. '000 Section ..... /....~. ......... Block ...... ~.. ........... Lot No....~.~ .......... pursuant to application dated ..~ ........... ~.......~......., ,9.~...~and approved by the Building Inspector, Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION ...... OLD OR PRE-EXISTING BUIL UOUSE NO. STREET HAMLET ...... co-.~7 Tax ~ap No. 1000 Bectlo~ .~... Blo~ -.3.... ~ot'.53 ...... Subdivision ....................... Filed Map ........ Lot .......... Permit No. * ..... Date of Permit ~ Applicant .~.. . .... Health Dept Approval ' ' ' ................. Underwriters Approval .............. Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificate rev. 10/14/88 FOP~NO. fi TO~N OF SOUTROLD BUILDING DEPARTHEN~ TOWN tlAL~ 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS A. 'This application must be filed in typewriter OR ink and submitted to the Building Inspector with the following; for new buildings or new use: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusua! natural or topographic features. 2. Final approval of Realth Dept. of water supply and sewerag~-dlsposal(S-9 form). 3. Approval of el~etrlcal installation from Board of Fire Und~rwrlters. 4. Sworn statement from plumber certifying that solder used i~ system contains less than 2/10 of IZ lead. 5. Commercial buildings, industrial buildings, multiple resld~nces and similar. buildings and installations, a certificate of code complian~'ce from the Architect or Engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requilrements. B. For existing buildings (Prior to April 9, 1957~ non-conformlngl~ uses, or buildings and "pre-existing" land uses: 1. AcCurate sarvey of property showing all property lines, streets, buildings and unusual natural or tnpographlc features. 2. A ~roperly completed application, a consent to inspect slgn~d by the applicant and a certified abstract of title issued by a title company!which shall show single and separate OWnership of the entire lot prior in April 9, 1957. · If a Certificate of Occupancy is denied, the Building InspeCtor shall state the reasons therefor in writing to the applicant. ' 3. Pate of any housing code or safety inspection of buildings ~r premises, or other pertinent information required to prepare a certificate. For Vacant Land Certificate of Occupancy: i. An application for vacant land Certificate of Occupancy shall be submitted, and a certified abstract of title issued by a title companyishowlng single and separate oWnership of the entire lot prior to April 9, 1957!shall also accompany the application. If a Certificate of Occupancy is denied, ~he Building Inspector shall state the reasons therefor in writing to the applican~. FEES: i. CERTIFICATE OF OCCUPANCy - New Dwelling $25.00, Addi~iods to Dwelling $25.00, Alteration ~o Dwelling $25.00, Swimming Pool, $25 O0 - - A~eessory building $25.00 ~..Addition to Accessory buildings, $25.00 - Businesses $~0.00. Certificate of Occupancy on pre-existing dwelling - $100~00. 3. Copy of Certificate of Occupancy - $5.00 - over 5 years i $I0.00 4- Vacant Land Certificate of Occnpancy - $20.00 5. Updated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy - $~5.00 Residential $50.08 Commercial ev. TOWN OF SOUTHOLD BUILDING DEPART~ENT TOUN HALL SOUTHOLD. NEW YORK 765 - 1802 11971 Health Planning Beard Approval APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION / ....... OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........ HOUSE NO. STREET HAMLET - Subdivi:ion ....................... Filed Map ........ ~o~ .......... Dept. Approval .................. Underwriters Approva~ Request for Temperary Certificage ....... ......... Final Certificate PPLICANT: .. er. I0/14/88 FORM NO. 6 TO~ OF SOUTHOLD BUILDING DEP~RTf~NT TOWlq IIAL~ 765 - ~02 APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONSI 'Thxs application must be filed in typewriter OR ink and submitted to the Building Inspector with the following; for new buildings or new use: ]. 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 sewera~e-dlsposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that solder used xu system contains less ' than 2/10 of IZ lead. 5. Co.m~.erczal buildings, i~dustrial buildings, multi le r ' · · ' · bu~ldzngs and ~nstallatlons. a ce~ ..... P es~ences and ....... ace o£ COUe complx~nce from the Architect or Engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (Prior to April 9, 19570 nnn-conformidg uses, or buildings amd "pre-existing" land uses: I. Accurate survey of property showing all property lines, st!feets, buildings and unusual natural or topographic features. 2. A properly completed application, a consent to inspect sig~ed by the applicant and a certified abstract of title issued by a title compan~ which shall show single and separate OWnership of the entire lot priori to April ~, ~957. · If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 3. Date of any housing code or safety inspection of b~ildings,lor premises, or other pert'neet information required to prepare a certificate. Fur Vacant LandCertlficate of Occupancy: ~. An application for vacant land Certificate of Occupancy shalI be submitted, and a certified abstract of title issued by a title Compan~ showing single amd Separate oWnership of the entire 10t prior to April 9, ~95~ shall also accompany the application. If a Certificate of Occupancy is denied, lthe Building Inspector shall state the reasons therefor in writing to the applicant. FEES: ~. CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, dd~tx~ns to Dwelling $25.00, A ° Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00 Addition to Accessory buildings, $25.00 - Businesses $150.00. ~- Certificate of Occupancy nn pre-existing dwelling - 3. Copy of Certificate of Occupancy - $5.00 - Over 5 yearsi- $~0.00 4. Vacant Land Certificate of Occupancy - $20.00 5. Updated Certificate nf Occupancy - $50.00 6. Temporary Certificate of Occupancy - $~5.00 Residential $50.0~ Commercial! ~_v. 10/14/88 FOUNDATION Ilst) FOUNDATION (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: 7 APPROVED AS NOTED NOTI~"¥ BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - IWO REQUIRED FOR POURED CONCRI=tE: 2. ROUGH - FRAMING 8, PLUMBING 3. INSULATION 4. FINAL CONSTRUCTION MuST BE COMPLETE FOR C.O. .............. -ALL-CONSTRUCTION-SHALL MEET ....... '- O~ TOWN OF sOUTHOLO Examined .. ~. .... 19 ... Disapproved a/c ..................................... FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL.: 765-1803 Application No .................. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 issue 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 buildings for necessary insp, e~ctions. __ , __ (Sigpatu, re of applicant, or name, if a corporation) [Mailing address dff applicant) State wheth~see, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant i~s a cpJiPoratio_.n, signature of duly authorized officer. (Name and title of corporate officer) Plumber's LicenseNo ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ...... ( 7 ? .0 ...... ?../~.....~......~.. ~ ............... House Number Street Hamlet County Tax Map No. 1000 Section ........ -:~.../...~. Block .... 3 ............ Lot....'~...~. ............ 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 occupaucy .... b. Intended use and occupancy . . . ~[t~'g~... ~..,~1~...~.~ ................................... 3. Nature of work (check which a~plicable): New Building .......... Addition . Repair .............. Removal .............. Demolmon .............. ~r VI/~ .~. I! .... (to b ftfi'g this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars ;c~~ 6. If business, commercml or mixed occupancy, specify'nature find extent of each type of use ...; ...... }, .......... 7. Dimensions of existing structures, if any: Front.....'.]/_~ .... '... Rear .... /. ~3 ....... Depth . .~/.0~. · ........ Height . .l_~ ............ Number of Stories .... ~ ...................................... ~ ........... Dimensions of sam_~e structure with alterations or additions: Front ..... 3.6/(. ....... Rear . .~'..C/. ........... Depth .... ~C~ ............. !.. Height .... [.~. ....... ' ....... Number of Stories ........ .t.. ........... 8. Dimensions of entire new constructiom Front '7'.."~ ........ '?.. Rear ............... Depth ............... Height ............... Number of Stories.. i'. ..... :....( ........................................... 9. Sizeoflot: Front .......... ~ ........... Rear ...................... Depth ..: .~.. ................. 10. Date of Purchase ........... . ................... Name of Former Owner ............................. 11. Zone or use district in which pr~mises are situated ..................................................... 12. Does proposed constrnctign vioiate any zoning law, ordinance or regulation: ..... /~<'..l~ ...................... 13. Will lot be regraded ... plzti'~.~.~ .................... Will excess fill be removed from premises: Yes PLOT DIAGRAM Locate clearly and distinctly alll buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. G~ve street and block'number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, . COUNTY OF .... ~..-.~.- .~..o.\.\.C.... ~.~ .............. (Name of individual signing contract) above named. ' . being duly sworn, deposes and says that he is the applicant He is the .............. .(,.O....-..~ ........................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly 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 mannfir set forth in the application filed therewith. Sworn to before me this ......... ...~.... ~.*>..~...day o~ ........ ; ............. 19 ?..~ Notary Public, . ..... ?.~..~..~./<. ~i~ .x~. · .... County ~ ,qEL,~t,I ~ ~,: . ........ g.,,.~/C.~d'ff'~ .......... Term Expitos ~atcl~ 30,