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Home My WebLink About17445-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23605 Date APRIL 24, 1995 THIS CERTIFIES that the building. Location of Propert~ 1220 THIRD STREET House No. County Tax Map NO. 1000 Section 117 Subdivision FOUNDATION NEW SUFFOLK NY Street Hamlet Block 7 Lot 15 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 19, 1988 pursuant to which Building Permit No. 17445-Z dated SEPTEMBER 19, 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 A FOUNDATION UNDER AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to AGNES & ROSE BURKHARDT of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 (owner's) N/A N/A /ydi~ Inspector FO~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT ('THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 017445 Z Permission is her_~by granted to: , / ~ .~......~ ........... ~:..~,~.....~~~/- ~ /~"~ / ..~,.....~.~.... ............. :.-, .................... ., ....... // ,o.~,~z......~~.~..~:.....~ ...... ,~..~....~.>......,~ o, ..................................... County Tax Map No. 1000 Section .......... ,/.../,...?..... Block ........... ~.. .......Lot No ........ .Z, .~... ..... pursuant to application doted ......... ~x,~.~. Building Inspector. 19.~, and approved by the Rev. 6/30/80 Or SOU UOLr TOWN IIALL 765-1802 APPLICATION FOil CERTIFICATE OF OCCUPANCY This applicatio~ must be filled in by typewriter OR ink and submitted to tbe building inspector with the following: for new building or new use: 1. Final survey of property with ac£urate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Uehlth Dept. of water supply and sewerage-disposal(s-9 form). 3. Approval of electrical installation from Board of Fir~ Underwriters. Sworn statement fromfplumber certifying that the solder used in system contairs less than 2/10 of 1% lead. Commercial building, industrial building, multiple residences and 'm' ' · and installations,~\a certificate of Code Compliance fro~ ~_-~ s~ ~lar.bu~td~ngs responsible for the building. ~ ,. architect or engineer Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '.'pre-existing" land uses: 1. Accurate survey of property sho~ing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occup~Rn¢~l - New dwelling $25.00, Additions to dwelling $25.00, ~'~i--~ns ~'~-g~-l~-n~-~'~]-00~, Suimming pool $25.00, Accessory building $25 00, Additions to a~ ~$25.00 Businesses $50 00. ' 2. Certificate of Occupancy on Pre-existing Buildine - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00-, Co~ercial $15 00' "' ' County Tax Map No i000, Section ........ Block... ~ ..... . 47 ... Subdivision ................................. Filed Map ............... .. Lot Permit No ....... Date Of Permit ......... ' ..... . ..... Applicant ........................ Health Dept Approval Underwriters Approval ..................... Planning Board Approval ...................... Request for: Temporary Certificmte ........... Fiaal Certicate. - ....................... FOUNDATiO~// (lstl FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ~/~UNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL DATE INSPECTOR FORM NO, 1 TOWN OF SOUTHOLO BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK ...................... SEPTIC FORM ................ Disapproved a/c ..................................... ,'~~ / ~ '~ / (~uildi. lghis~e°t°r) NOTIFY CALL MAIL 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 lhyout of property must be drawn on the diagram which is part of this appli- cation. ¢. 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 .*9. 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, a,d, ditions or alterations, or for/-emoval or demolition, as herein describe~,. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized insp~[ll~r~t~d hi building for necessary inspect!~r~, //// _ ' va ' ~ ~ (Signatflr5 9/applfcafft, °r name, if a c°rp°ran°n) (Mailing address of applicant) State whether"~lS~l~a-fi~ll~/ll~,~8~,6~}t) architect, engineer, general contractor, electrician, plumber or builder. ............................ ~O[t~.L~ ffi. A~ ........................................................ Name of owner b~ premis.O,$~~). L.. n ~ ~ ~'.~.~. ..................................... ~ ~ ~~ t J~, (as on the tax roll or latest deed) .~ ~_ ~. . ~1 'ze (Na ~~d~'d~f~ ofh cer') Budder s L~cense No ........................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No... ~.~ .~./jt.~.... .... 1. Location of land on which proposed work will be done ...... 7. ........ ~ ................................. .... . ........................ Coun, , Tax Sec,on ..... 11.7 ......... , ock ........ ? ......... Lo, ..... ........... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy o£ proposed constrnction: a. Existing use and occupancy ,. ~':/./l/~'.~..~-= .~. ~.'~.'l./r/-((. · · )t~ ./.5.el. ~ ..................................... b. Intended use and occupancy ,..,ff.p~.Y//.~' .... /~' '/' "~' '/~" · ' · '~.-~/'f-~,~ ~,~ ................................ 3. Nature of work (check which hpplicab e): New Building .......... Addition .......... Alteration ......... Repair .............. Removal .............. Demolition .............. Other ',York. 4 t6d '~3~aV [ (Description) · Estima Cost ......... '" i ...... : .................. Fee ......................... , (to be paid on filing this application) 5. If dwelling, number o f dwellin~ units .............. Number of dwelling nnits on each floor... ' If garage, number of cars ... i ...... ' ............ 6 If business ............................................... · , commercia, l or mixled occupancy specify nature and extent ot each type of use ............... 7 Dimehsions of existing structures if any: Front Rear ' ' ~ ................. Height Number of Stories ............................. Depth .............. Dim ensi~ ............ ' ....................................................... of same structure with alterations or additions: Front Depth tleight , ................. Rear .................. ................... ' ...... Number of Stories 8. Dimensions of entire new construction. Fr~,-* He,- ~t .... ' ..... wear ............... Depth .. ~ ............... emmoer of Stories -'- ';~ ' 10. Date of Purchase ............... Depttt . I 1. ,~one or use restrict ~n winch premises are situa~,,a ' ' '~ .... ~ ;,i,.~' ' ' 12. ~l;Slf[;PeO;e:.,draCfe~Structmn v,olate any zoning;;~ ;rfin'anc; or regulation'.' ': '::' 13... .~ _ '. ''", ............. Wlllexcess fill be removed from 14. l'~nme olUwner ot'prem,ses . .; .................. Address ................... Phon Name of Architect ,. ' ''- '. .... ,i .................. Address ................... Phone No ......... e~ame of Contractor· K.]/~ g,b:.)~. ~,,: .,~../.¢~,~ .... Address..~d~.T/.X~r.O.~/~'.¥5~Phone No..,:$qff.'~O.~7~. ' 15.Is this property located wxth~n 300 feet of a tidal w&land? *YES ..... ' mil yes, Southold Towh Trustees Permit may be required. ... I 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 interior or corner 10t. STATE OF NEW YORK, COUNTY OF ................. S.S (Name of individual signii~g contract) · · being duly sworn, deposes and says that he is the applicant above named. fie is the ' (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 tlfis application are true to the best of his knowledge and belief; and that the work will be performed in the mannerlset forth in the application filed therewith. Sworn to belbre me this ............... · ~. g. ..... day of