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Home My WebLink About16850-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...z.: .1.6.9.9.2. ....... Date ..... ,l.u.n..e..1.4. ~. 1988 THIS CERTIFIES that the building .... A.p.D.I.T..~ 9.N..T,O.. ,A,G,C.E..S .8.0.R.y .............. Location of Property ..... 1.5. 7. 2. L.a.q ql ~..E.n. cl..R.q q d. ...... 9.r.ie. n..t..P.q z.' .n.C.,.. ItJ .. y.. ......... House No. Street Hamlet County Tax Ivlap No. I000 Section . . ! .5 ........ Block . . .9. ........... Lot 1 . I 9 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ifarch 21, 1988 pursuant to which Building Permit No. 16850 Z dated .... Ifa...............reh 22', 1988 ..... . .... was issued, and conforms to all oftberequirements of the applicgble provisions of the law. T ~e occupancy for ~hich this certificate is issued is ......... ADDITION'TO EXISTING ACCESSORY BUILDING AS APPLIED FOR The certificate is issued to ROBERT NICKS ..................... /oh;.'oi,'rlr.~'~:zo~' ..................... of the aforesaid building. Suffolk County Department of Health Approval . . ~ ./.A ...... UNDERWRITERS CERTIFICATE NO .................. .g/.A. ............................ PLUMBERS CERTIFICATION BATED: N/A Rev. 1/81 FOB]~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, No Y. BUILDING PERMIT [THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted tc~: . . /.. ~, ~ ................ ~ ................. ~~.....~ 4~. z.~.....z.~~....~..:..;} ........ , ...... ........ at premises located at ..../~....,~..Z~...,.~.,.~........'~...~../. ..................................... Coun'o/ Tox Map No. 1000 Section ......... Z, .~..,.... Block ................. .~... Lot No ........ ././..../...g... pursuant to application doted ........ ..~.W..;'~'~'~'~'~'~'~'~.~.. ................................. , 197.~..., and Building Inspector. Fee $. Z/..,~.~ approved by the Rev. ~/30/80 FORM NO. 6 TOWN OF SOUTHOLD Bu ilding Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A1 This application must be filled in typewriter OR ink, and submitted I. ~ to the Building Inspec- tor with the following; for new buildings or new use: I. 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. 51Submit 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: I. Accurate survey of p~operty 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 $25.00, Accessory i$~0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificete of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 / ,~,~,~ ' 5.Updated C.O. $ 50.00 Date ' ' '~ :ii'' [~ ............. Newc°nstruct±on....,. Old orPre-existing Building .... ....... . Vacant Land . . . Location of Property ./.~.~....'~'.../~...~....~,..g.~. ..... '...~..~,~- .~.~. //f.,5~7 " 'hL e' House No, Street Owner or Owners of Property ............................................ F. ,{ lq. County Tax Map No. 1000 Section ............... Block ............. Lot.. · ......... ................................. Filed Map No ........... Lot No../.~. ........ Subdivision 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 permit meets all ,aphelia. bi! ~odes and regulations. Applicant., ,~'~. ~ ........................ Rev, 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INsPEcToR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 TO Whom This May Concern, We are unable to complete your Certificate of Occupancy because,of the following reasons. /W/An_ application for Certificate of Occupancy is not on file. ~ _./~/~/ No Underwriters Certificate on file. The check is(outdated/~ot on /Z/ No Health Dept. Approval on file. /Z/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. ~ ~[~ ~uilding Permit # -~_ _~.~ ~ ~_ Z Building Dept. ***/5/ No Plumber Solder Certificate on file. all permits involving plumbing being issued after April 1,1984 ) ?'iELD DATE FOUNDATION ( FOUNDATION I 2nd) ROUGH FRAME/ .PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FI'NA/ ADDtTIONA'L COMMENTS: 765-1802 BUILDING DEPT. INSPECTION 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. / [/~/ FDATION ZND []INSULATION [~FRAOUN MING ,r. ]FINAL INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION []FRAMING [//~INAL /~ DATE ,INSPECTOR THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRIGrrY 85 JOHN STREET, NEW YORK, NEW YORK 10038 T~t$ CE~IFIES THAT in ~ ~lo~in~ /~=t' n-. ,~tion Bilk ~ ~s examin~ ~ and found to be in com~ion~ with the ~qui~ments of th~ ~. RXTUIE RXTUIIS RANGIS OVENS EXHAUST FANS OUTLETS FL~,IOWESCEm DRYBRS RJRNACE MOTORS I'UVUIm AF~dANCI FIIOIIS TiMi CLOCKS MULT~OUTi~T DIMMERS SYSTIMS SERVICE m"mCONNECT (} & S CONTRACTOR BOX 215 SOWI'HOLD, NY, ]1.99t This cerlificate must not be alt6red in [,'~Cg~S~'; NO. 578 )': manner; return to the office of the Board if incorrect. {nsp~--tors may be identified by their credemiafs. B .DG. D TOWN OF BOARD OF HEALTH 'FORM NO. I SURVEY TOWN oF SOOTHOLD C~ECK ~:] ]f4~.SX BUILD{NG DEPARTMENT SEPTIC FORM ............. TOWN HALL NOTIFY ~OUTHOLD, N.Y. 11971 TEL.: 765-1803 CALL Disapproved a/c ..................................... APPLICATION FOR BUILDING P~RMIT · INSTRUCTIONS a. This application must be completely filled in by Wpewriter 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 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 co~, anl~l/fegulagons, and to admit authorized inspectors on premises and in building for necessary insoecti~as~ (Signature of applicant, or name, if a corporation) (~failing address of applicant). State whether applicant is owner, lessee, agent, architect, engineer, general contrac!?, electrician, plumber or builder. Name of owner of premises .................................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. OCCUPANCY OR (Name and title of corporate officer) USE IS UNLAWFUL Builder's License No .... ./.,~.d:r 'V~/'--'/....l~../77/..d~ ....... '5~ ~ W THOUT CERTIFICATE Plumber's License No ......................... Electrician's License No ....................... OF OCCUPANCY Other Trade's License No ...................... 1. Location of land on whi.ch proposed work will be done. g~..~...~:ff~....~.~...~?......~.~..~. ................ .......... ....... .............. s..7 ..... , ............. House Number Street Hamlet County Tax ~ap No. 1000 Sect,on ...... ./. ~.--. ...... Bloc~ .... ~.. ........... 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 occupancy ..... ~.........~/...,a~. ~ ................... ,'. ....................... b. Intended use and occupancy ............................................... 3. Nature of work (check which appIicable): New Building .... ' ..... Addition ' Alt~}}{i~n~ ....... Repmr ............. RemovW .............. Demolition .............. Other Work..,l~!.',i .......... ,~ r.~ -i _ ~ " ~(~escriplion) .' -I0 6 4. Estimated Cost .... .~. . .~ . ~ : ' , '. '._' _. '_. u': . . ~ , , rte oe para on inlng this. application) 5. If dwelling, number of dwelling_.units ..... i ......... Number of dwelling units on each floor ................ If ~,mragc, hum bet of cars ... ~. ii ...... , 6. If business commercial or mixed Occupancy specif~( natur~ and extent of each tyne ~of use , . 7. Dinensionsoe'stingstructures,dfany'Front ~.~ O ,' Rear ~.~ 'I~; '~h' ' ~ .... , . ...... ................ p . ..¢. ...... Height .../..~. ....... Numb~r'of Stories ...... ~ ............ '.._ ....... : .............. ,, .......... Dhuensions'of same structure with alterations or additions: Front '~. ~. . Rear . . ~.~,~. Depth...,.~.~,..'~. ......... i' Height ..... ./. ~ ........... Number oJlStories ...................... · 8. Dimensions of entire new construction Front . / .~, . Rear ./. ~., Depth Height /...~. NumblerofStoriesi.ii.i~iii.il .... i ............. ...i. i'i ....... 9. Size oflot: Front ~.././.,: ..t~...' . Rear.. 10. Date of Purchase ............ I ................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..... .~.~. ~. .................................. : ....... 12. Does proposed construction violMe any zoning law, ordinance or regulation: ...... /'~/. P ....................... 13. Will lot be regraded ...... 2']x .o .................. Will excess fill be removed from~ premises: 14. Name of Owner of premises . ~.~..~',..;~.,d//.c.,~& Address ./~.4qA~././.~' I~ .~../?t~Phone No ................ Name of Architect ........... i ................ Addres~'%'"~/~o'~9~ .~'. · .]~.~'~... Phone Nol ............. Nane of Contractor .......... ................ Address .... : .............. Phone No ................ 15. Is this property located wlithln 300 feet 'of a tidal wetland? *Yes ..... No .~.. · If yes, Southold Town Trusltees Permit ma~be required. PLOT DIAGRAM Locate clearly and distinctly all )uildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block nhmber or description according to deed, and show street names and indicate whether interior or corner lot. ~YORK, ~f ~ '" COU~FY OF ........... ~¢ ..... ~,. , (Name of individual sigm ag contract) above named. being duly sworn, deposes and says that he is the applicant He is tlie ......................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duB, authorized to perform or have performed the said work and to make and file this application; that all statements cents ned in this application are true to the best of his knowledge and belief; and that the work will be performed in the manne~ set,forth in the application filed therewith. Sworn to before me this day ofl...: .. ~,~.,-.,~:.--~..'. ........ 19 Notary Public ...... i,. 1~.. ...... County NOTARY PUBL C. State of New,YoI~ No. 4707878 Suffolk Ceunl~,~ (Signature of applicant) Term ExpireS March t Lot 20 s. ~8 °5;, ',w "E. Lo; /.9 I Area = 40, 090 ~.f '~1 ~ wOOD ~ - _ - . ~ ' N. 88 ~'57 '40 190. O0 ' Lot /8 190. O0 ' HEALTH DEPARTMENT-DAT~[ FOR APPRO~L TO CONSTRUCT NOTE (~ -' STAKE SUBD/WSION MAP FILffD IN THE OI~iCE OF ~HE CLff~ OF SUFFOLK COUNTY ON MAY 5, 19Y~ AS FI~NO ~909. SURVEY FOR t~OBfft7 T HICKS LOT NO. 19, "LAND'S AT ORIENT TOWN OF SOUTHOLD END" NOV. ~, 1984 DATE. FEe. 21, 1984 SCALE: / ",: 50 ' SUFFOLK COUNTY, NEW YORK YOUNG s YOUNG ALDEN W YOUNG, PROFESSIONAL ENGINEER AND LAND SURVEYOR N Y.S UCENSE NO 12845 HOWARD W. YOUNG, LAND SURVEYOR NYS L!CENSE NO 45893 NO. 84 - 130 ~ OS~NDER AVE~E RIVER~AD, NEW YORK I4OTIFY"BUILDING DEPAI~MENT AT ' '765-1802 9 AM TO 4 PM FOR THE FOLLOWING IN~ECTIONS: FOR POURED CONCRETE ~. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL ~ COBBTRUCT[ON MUST ALL CONSTRUCTION SHALL MEET THE REOIHRr~ENTS 0F THE N Y STATE CONgTRUCTION & ENERGY CODES NQT RESPONSIBLE FOR 0CCLIPANCY OR USE i~'UNLAWFUL tl WITHOUT ,CERTIFICATI~I OF OG~LIPANGY 7:4/ 97' 40' ~J