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Home My WebLink About17723-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Bulldlng Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20269 Date OCTOBER 7~ 1991 THIS CERTIFIES that the bulldzng ADDITION Location of Property 1550 BRIGANTINE DRIVE House No. Street County Tax Map No. 1000 Section 79 Block 4 Subdivision Filed Map No. SOUTHOLD r N. Y. Hamlet Lot 26 Lot No. conforms substantially to the Application for Building Permit heretofore filed ~n thzs office dated DECEMBER 22r 1988 pursuant to which Building Permit No. 17723-Z dated DECEMBER 23~ 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 CHIMREY ADDITION WITH FIREPLACE AS APPLi~u FOR. R~he certificate ~s zssued to ANN~TT~ & THOMAS P. JORDAN of the aforesaid, building. SUFFOLK COUNTY D~PARTMENT OF HEALTH APPROVkL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A y / ~uildlng Inspector Rev. 1/81 FORM 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) 17723 Z County Tox Mop No 1000 Sect,on .- C::),.'~..~ Block mot No .....~.,.. pursuant to opp/;cohon doted ~ ................... , ....... ond approved by the Budding Inspector. Rev 6/30/80 Form No· 6 TOWN OF SOUTIIOLD , ,). BUILDING DEPARTHENT TOWN I~LL 765-1802 ~ APPLICATION FOR CERFIFICATE OF'OCCUPANCY This application mus't be filled in by typcwrzter OR ~.k and suhmztted to the bu~ld~ng inspector with the following; for now bu~ld~ng or new use: 1. F~nal survey of property with accurate location of all buzldzngs, property streets, and unusual natural or kopograph~c features. 2. Fznal Approval from Health Dept. of water supply and sewerage-dksposal(S-9 form). Approval of electrmcal installation from Board of Fire Underwriters. Sworn statement from plumber certmfYzng ;hat the solder used in system contains less than 2/10 of i% lead· 5. Commercial building, Industrial bu~ ~ng, multiple residences and s~milar buzld~ngs and installations, a certificate of Code C~plzance from archz-eet or engineer r~sponsmble for ;he bu~ldzng. 6. Submz~ Planning Board Approval of completed smte plan requirements. For exzstzng buzldzn~s (prmor to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land ~scs: 1. Accurate survey 6f property showz~g ail property lines, streets, buzldzng and unusual natural or topograph~c features. 2. A properly completed application and a con,eat Lo %aspect s~gncd by the applicant. If a Certificate of Occupancy ~s des~ed, the Bu~ld~ng Inspector shall stale tho reasons therefor in wrzt%ng to the applzcaa[. I. Certzfzcate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alteratmons to dwellmug $25·00, Swimming pool $25.00, Accessor~ bumld~ng $25·00, Add,ti,ns to accessory build.ag $25.00 Bus~Pesse~ ~50. O 2. Certzfzcate of Occupancy on Fre-exxstzng Buzld3ng - $IO0 aa 3. Copy of Certzfzcato of Occupancy - $5.00 over 5 years - $IO.OO Updated Certzfzcate of Occupancy - $50.00 5. Temporary Certifz~ate of Occupancy - Residentxal $15.OO, Commercial $15·OO D~te ............................ o.str et on ........... Old Or os~:ion o~ Property../5..?. .... ~ ....~'T...;~...~Y.~, . ~'/~¢ ~ - . ...... ~4~.~ ~ ~ ............. I .use No. Street tlamlet o-,y ~=~ >~=p ~o ~000. s=~o,. PTK .... ~o& ..... ~ .... ;o~ ..... g6. .. ................... Filed Map.. · . ..Lot ................ .... . . alth Dept. Approval ......... Underwrzters Approval . . . ~nn~ng Board Approval ' FOUNDATION ( ls t) FOU~DATION (2nd 2. ROUGH FRAME & FLUMBING INSULATION PER N. Y. STATE ENERGY CODE FI~;AL ADDITIONAL COMMENTS: TOWN OF SOUTIIOLD OFf'ICE OF BUILDING INSPECTI'OR P O. BOX 728 TOWN HALL SOUTHOL[3, N.Y. I I971 SEPTE~IBER 20, 199t TEL. 765-1802 ~tOI4AS P. JORBAI~ 1550 'BRIGANTINE DRIVR SOUTHOLD, NY ] 197 I To 9~hom Th~s May Concern, We are unable to complete your Cert~flcate of Occupancy because of the following reasons. /~ An applzcat~on 5or Certlfzcate of Occupancy is not on £lle. (ENCLOSED) /--/ ~;o Underwriters Certzfzcate on file. /_~ Thc chcck zs~X~XX~/not on file.) /_--/ No lIealth Dept. Approval on file. /Z/ No final ~n~pcctlon has been macle. $25.00 Please contact our office on this matter. Thank you for your cooperation. Building Permlt It I 7 7 2 3 Z Bu~ld~ nq Dept. ***/--/ No Plumber Solder Certificate on file. { all permLts Involving p~umblng being ~ssued after April 1,1984 ) 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION ZST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS:.. DATE //~/~ INSPECTOR~/~,~ Excreted ,9 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, NY 11971 TEL.. 765-1~02 BOARD OF HEALTH ......... 3 SETS OF PLANS ......... SURVEY .................. CHECK ................... SEPTIC FORM NOTIFY CALL ~5.-.5 2 ~.t ....... MAIL TO: (Bmldmg Inspector) I TOWN OF SOUl. OLD, APPLICATION FOR BUILDING PERMIT Date ./.~/..~..o~. 15 INSTRUCTIONS a. Tiffs application must be completely t-filed in by typewriter orln ink and submitted to the Building Inspector, sets of plans, accurate plot pIanlto scale. Fee according to schedule. b. Hot plan showing location o£ lot and of bmldmgs on premises, relationship to adjoining premises or pubhc st or areas, and givmg a detmled ~escnphon o£ layout o£ property must be drawn on the diagram which is part o£ th~s cation. I c. The work covered by flus application may not be commenced before issuance of Buildmg Permit. d. Upon approval of this apphcatlon, the Building Inspector wdl issued a BmIdmg Permit to the apphcant. Such pc shall be kept on the premises available for mspechon throughout the work. e. No bmldmg shall be occupmd or used m whole or m part for any purpose whatever until a Certificate of Occup shall have been granted by the Bmldmg Inspector. APPLICATION IS HEREBY MADE to the Bmldmg Department for the issuance of a Bml&ng Permit pursuant Building Zone Ordinance of th~ Town of Southold, Suffolk County, New York, and other applicable Laws, Ordmanc~ Regulations, for the construct~6n of buddmgs, ad. dmons or alterations, or for removal or demolition, as herein desert The apphcant agrees to comply with all applicable, laws, ordmances, buddmg code, housing codc, and regulations, an admit authorized mspcctors on premises and m bufldmg for necessary inspections. __ , ............... ' '(S~'gn;tu;e'o'i'a~plic'ant, or name, if a corporanon) ~ (Mailing address of apphcant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bull Name of owner ofpremmes .. 3//~-.c~..~..~.r.~. a~. ~ ................................... (a~;on thet~x roll ~ latest deed) ir apphcant,. 1~ a co~qra~n/~2~ur~,,A, ~, ~ ,.,-, -, -~.oF~uly authorized of~c~.... , n,~ ~ ~ 9 Plumber's License No ........................ Electrician's Lzcense No ..................... Other Trade's License No .................... 1. Locat,on of land on wtuch proposed work ,vlll be doqe. Z~.c'?. 4'~f~.~.~.~...c~.. ~-~'., ~~ //~ House Nun]ber Stree~ Hamlet County Tax Map No 1000 Scctmn .................. ck .............. Lot ............ Subdivision ........................... Fried Map No ............... Lot ............. (Name) 2. State existing use and occupaacy of premises and mtendgd use and occupancy of proposed construction' a. Exatmg use and occupancy .. ~ .......................... :e ............................ 3. Nature of work (check v,h:ch applicable): New Bmldmg ..... ' ..... Addle:on .......... Alteration .. . I (Description 4. Estimate'd Cost. . .~ ............................................................. (to be pa~d on fihng this application) 5. If dwelhng, number of dwe!bng units ............. Number of dwelling units on each floor ............. If garage,, number of cars .~ ................................................................. 6. If business, commercial ar mpted occupancy, specify nature and extent of each type of use ................. 7. Dimensmns of existing structures, if any Front .............. Rear ............. Depth ........... Hmght ............... Number of Stones ....................................... Dimensions of same structure with alterations or addmons Front ............... Rear ................ Depth ..................... tlmght ................... Number of Stones ........ .... ....... . 8. Dimensions ~lt~e~Onstruction Front ............. Rear ............. Depth Hmgbt .... .'?'~..'. 7..'7 ....Number of Stones ............ ] .......................... 9. Size 9£1at. Front ....... ~ ............. Rear ................... Depth 10. Datebf Purchase ....... : ................. Name of Former Owner ..... 11. Zone ~ use district m whicl} premises are situated ....... I2. Does proposed constructmnIvmlate any zonmg law, ordnance or regulation .............................. 13 Will lot be regraded ... J .............. Will excess fill be removed from premises: Yes 14. Name of Owner of premises .................. Address ................... Phone No .............. Name of Architect ......................... Address ............... Phone No. Name of Contractor Address Phone No IS.Is this property 19coted within"400 feet of a tidal ~tetland? ~¥ES .... NO .... ~[f yes, Southold Town Trustees Permit may he required. PLOT DIAGRAM Locate clearly and dlstmctly a/1 buddmgs, whether existing or proposed, and indicate all set-back dunens~ons fr~ property fries. Gwe street and bl{ ~ck number or description accordmg to deed, and show street names and mdicate whet} mtenor or comer lot OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY APPROVED AS NOTED FOLLOW'lNG INSP~C~ FOR POURED CONCR~E 2. ROUGH - ~MING & PLUMBING 3. INSU~TI~ 4 FINAL CONSTRUCTION MUST BE ~MPLETE FOR C.O ~E ~IR~E~ ~ ~E N.~ ~TA~ ~ · ~ERGY ~ ~ ~ ~R STATE OF COUNT5.' OF..~...'~. ~.{.~.X. S S (Name 8'f mdwlduai stgnmg contract) above named ,, ...................... C ......... (Contractor, agent, corporate officer, eec ) of smd owner or owners, ~d ~s duly authorized to perform or have perfo~ed the said work and to m~e and file apphcat~on, that all statements contamed m th~s apph~tmn are true to the best of ins knowledge and behef, and that work w5l be periom~ed m the m~ner set forth m the apphcauon tiled therewith Swam to before me tins ........... day,of ........ 19... ...... ...... ~bl~ ~Y~ u (S~=namre of apphca N~ ~O~l~ln S~ ~ ~/~