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HomeMy WebLinkAbout16880-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N Y. Certificate Of Occupancy No. Z-16775 Date Apr~t 7, 1988 THIS CERTIFIES that the budding DECK ADDITION LocatlonofPrnn~rtv 1845 Henry's Lane Peconzc, N.Y. House No Street Hamlet County Tax Map No I000 Section 74 .Block 0 I .Lot 7 Subd~wmon .......................... Fried Map No ..... Lot No ............ conforms substantmlly to tile Apphcat~on for Building Permit heretofore fried in tins office dated Hatch 30, 1988 pursuant to which Budding Permit No. 16880 Z dated . April 7, 1988 ................... was issued, and conforms to all of the requirements of the apphcable provisions of the law. The occupancy for which tins certificate is issued is ........ DECK ADDITION TO EXSITING ONE FAMILY DWELLING AS APPLIED FOR The certificate m issued to ANTHONY & FLORENCE BRAND I .................. × ................. of the aforesaid building. Suffolk County Department of Health Approval N/A N/A UNDERWRITERS CERTIFICATE NO ............................................ N/A PLUMBERS CERTIFICATION DATED: B~ffdino 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 Date April 7, 1988 THIS CERTIFIES that the bmldmg AC CE S S ORY Location of Property .. .I.84.5...H.e. nr.¥.' s. L..an.e.., Pecon2~c, New York House No Street Ham/et County Tax Map No. 1000 Sect,on . 74 .Block 1 .Lot 7 Subdivision .................... Fried Map No ...... Lot No ........... conforms substantmlly to the Apphcat~on for Braiding Permit heretofore ~ed m this office dated March 30, 1988 16880 Z ................. pursuant to Much Bmldmg Permit No .................... dated.April.. .. 7,. . .... 1988 . . . was~ssued, and conforms to all of the requlrements of the applicable provisions of the law The occupancy for which this certtficate m issued ts ..... ACCESSORY SHED AS APPLIED FOR ANTHONY & FLORENCE BRANDI The cerhf~cate ,s issued to ............... ?o~n'ef','legr~'~,~Tt~f,~"tf, t~ f:, ............... of the aforesaid building. Suffolk County Department of Health Approval ....... .N./.A ........................... UNDERWRITERS CERTIFICATE NO . ,. N/A PLHMBERS CERTIFICATION DATED: N/A /~uu ng In pector Rev 1781 TO~WN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 6880 z Permission is hereby granted to: , ~ .... ./.~....~ ...... ~.~r~,~....~ ......... r,L -.,.- -.,-- "' '"~"~'"~""~'/'~""'~/'".:"' 'L'~';" ? -/- / //e ' ~t p~,,ses ,=ted ot ..x.,r.~.:~....~...,~..../~,~,...........~' ............................................ County Tax Map No 1000 Section ....... ~../ .... Block ........ .~..~.. ........ Lot No .......... ~... pursuant to °pplicot,on dated .............. ,~ ................ 19.~- .~,., and approved by the Budding Inspector. 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 This application must be filled tn typewriter OR ink, and submitted m~ to the Building Inspec- tor w~th the following; for new buddings 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 buddmgs, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responmble for the buildmg. 5. Submit Planning Board approval of completed site plan requirements where apphcable, B. For exmtmg buildings (poor to Apml 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 buddmgs. 3. Date of any housing code or safety inspection of buildings or premises, or other pertment informa- tion required to prepare a certificate. C. Fees' Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Cerhficate of occupancy New Dwellzng $25.00, Accessory,SI0.00 Buszness $50.00 2. Certificate of occupancy on pre-exiatmg dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C-O. $ 50.00 Date ... .~, .~.~.~. ......... NewCons tz"uct:Lon ...... Old or Pre-existing Building ........... Vacant ~d~ ............. Location of Property. 1.~. .L~ ;~ ..... ~C-.~ .~. ~...~. ,5 .... .~. (L..~../~ ....... .~..-g~. '.(-g.~. '?.'. ~_z... Owner or Owners of Property . County Tax Map No. 1000 Section ... 7.4. ........ .~lock .... .0.1 ......... Lot .... 7. .......... Subdiv,s~on ............................. Fded Map No .......... Lot No .............. PermitNo. 16880Z Date of Permit 4/7/88 .Applicant Anthony &..F.l.o.r. ence Brandz Health Dept. Approval ........ ~A. ............. .Labor Dept. Approval ...N..A. ............. . . . Underwriters Approval ........ ~A. .............. Planmng Board Approval Request for Temporary Certificate ..................... Final Certificate ...... Fee Submitted $. 25.00 Applicant .... .... ........ ¢ o % 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 ~n typewriter OR ink, and submitted .-~ to the Building Inspec- tor w~th the following; for new bui~dmgs or new use: 1. F~nal survey of property with accurate location of all buddings, property lines, streets, and unusual natural or topographic fea~Jres 2.F~nal approval of Health Dept of water supply and sewerage disposal-(S-9 form or equal}. 3.Approval of electrical installation from Board of F~re Underwmters. 4. Commercial buddings, Industrial buddmgs, Multiple Residences and similar buildings and installa- tions, a certtficate of Code comphance from the Architect or Engmeer responmb{e for the butldmg. 5,Submit Plannmg Board approval of completed site plan requirements where applicable. B. For existmg buddings (pr[or to Aprd 1957), Non-conforming uses, or build[rigs and "pre-existing" land uses: 1. Accurate survey of property showing all property hnes, streets, buildmgs and unusual natural or topograph lc features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of bu ddings. 3. Date of any houmng code or safety ~nspectlon of buildings or premises, or other per[merit mforma- t~on required to prepare a certlfmate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION 525.00 1. Qe~f~cate of occupancy New Dwelling $25.00, Accessory ~$10.00 Business $50.00 2. Certffmate of occupancy on pre-existmg dwelhng $ 50.00 3. Copy of cert~flcate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 .~.1~\ ~ ?.~ 5.Updated C.O. $ 50.00 Date ..... .~,..~. ........ NewConstructIon ...... Old or Pre-exmtmg Buddmg ............ Vacant Land ............. Location of Property . :3. ..... ~.. ~.t¢/, ~ .......... Owner or Owners of Property ...~.. '.~ .N.~p~.. . .-~.. .~L~.~.L~(~~ .... ~.~.1~ ~.... 74 County Tax Map No. 1000 Section .............. Block O ! Lot ..... Subdivm~on .......................... Fded Map No ........ Lot No .............. Permit No. ] .6.8.8.0..z.. Date of Permit .4../.7./.8..8..Applicant ...A.~.~.h.o. ?,y..&.. ¥.1.o.~.e.p.c.e...~.~.a.n.~. ~... H lth pt App I NA L b D pt App I ea De rova .................. a or e rova .... ~A Underwmters Approval ....... N.A. ............ Plannmg Board Approval ....... N,.A ........... . · Request for Temporary Certificate .................. Final Certificate ........ ~.~ ............. Fee Submitted $ 10.00 Apphcant . · .~ .~ ¢. · .~.~. · .~.~ .~.~.~..Y?~.~% .~4 ........ Rev. 10 10-78 K c.3qS05 e o OUNDATION DUNDATION )UGH FRAME & {1st) (2nd) PLUMBING ;SULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS' / / / ,/ / Examined. Approved Disapproved a/c BOARD OF HEALTH ...... 3 SETS OF PLANS ....... FORM NO. 1 SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. TOWN HALL gOUTHOLD, N.Y. 11971 ~.., 19. APPLICATION FOR BUILDING PERMIT NOTIFY CALL ................ MAIL TO: Oate .3.,19S INSTRUCTIONS a Ttus application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with sets of plans, accurate plot plan to scale. Fee according to schedule b. Plot plan showing location of lot and of buddings on premises, relationship to adjoining premises or pubhc stmel or areas, and giving a detmled description of layout of property must be drawn on the diagram which is part of this appl cation. c. The work covered by tlns application may not be commenced before issuance of Budding Permit d. Upon approval of this application, the Building Inspector will issued a Budding Permit to the applicant Such perm, shall be kept on the premises available for inspection throughout the work. e. No budding shall be occupied or used m whole or in part for any purpose whatever until a Certificate of Occupanc shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bml&ng Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances c Regulations, for the construction of braidings, additions or alterations, or for removal or demolition, as hereto describe, The applicant agrees to comply with all apphcable laws, ordinances, bmldmg code, housing cgd~, and regulatlttnrh and t admit authorized inspectors on premises and m budding for necessazlgzA~spectlons ,,,~ (Signature of apl3hcant, or name, if a corporation) (Mailing addre,,s of applicant) State whether applicant ~'~, lessee, agent, architect, eno~neer, general contractor, electrician, pinmber or bullde~ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) ALL CONTRACTORrS MUST BE SUFFOLK COUNTY LICENSED Builder's License No .... Plumber's License No ......... Electrician's License No .. Other Trade's License No OCCUPANCY OR USE IS t NLAWFUL WITHO T CF.i TIFICAT': (}F OCCU?AI C¥ 1 Location of land on which proposed work wdl be done House Number Street County Tax Map No 1000 Section (~ ~- ~O( Hamlet Block . .C~ [ . . Lot. 2 Subdivision ......... Filed Map No .. Lot .. (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction a. Existing use and occupancy ~-/.0~?> b. Intendeduseandoccupancy ?to"6~. ' r.~. qgi<../~!. ''52. · -- Repa.u- .... Removal 4 Est,mated Cost ~S~. ....... Demolition 5. If dwelhng, number of dwelling units If garage, number of cars ........... · Alteration ........ Other Work (Descnp.tion) (to be paid on filing thru application) Number of dwelhng units on each floor ........ 6. If business, commercial or mixed occupancy, specify n~ajure and extent of each type of use 7. Dimenslonsofexmtmgstructures, lfany Front· .c{.~. . . . Rear .~f .... Depth ~?t Height [/~ . .. Number'o f Stories . . [. ............... Dm~enslons of same structure with alterations or additions Front ~g.( ...... Rear ~-/?t ....... ....... ~. ..... Number of Stones .../>... Depth .... S.~ ~ He,ght .. 8. Dimensions 9f~ntlre new construction Front (6 ~. Rear .. [.¢ ·...., . Depth fY/.. ..... . ... Height . P' ...... Number of Stories 9. Sizeoflot Front ilo Rear ".~.'./fi.~-/.~' iii'~e~l~'i./hl~l~: i,.~.~'~ 10 Date of Purchase '.l.~) ...... Name of Former Owner ]~/.J$..Y:;:,a&f;2' ........ 1 1 Zone or use d,stnct in which premises are situated . ge.~e.~-Pr~. .............. 12 Does proposed construction vmlate any zoning law, ordinance or regulation .MO ............... 13. Will lot be regraded . .. ~v~ . Will excess fill be removed from premises: Yes 14 Name of Owner of prem,ses ~i~.'~a.~ 4~ .~.e~. ~.~J~'Address (hq/.~. .ge.~r~ I~ ~...o~. Phone No .OeO-- Name of Architect ...................... Address ............... Phone No Name of Contractor ... ~,t~ ........ Address ........ Phone No ..... 15. Is this property located within 300 feet of a t~dal wetland? *Yes ..... No~... *If yes, Southold Tovm Trustees Permi~ maybe re~uzred. PLO~F DIAGRAM Locate clearly and dmtmctly all buildings, whether existing or p! property lines Gwe street a.~_d block numbenov descnphon accordmg~ intoner or corner lot. STATE OF NEW YORK, COUNTY OF ~)posed, and indicate all set-back d~mens,ons from ,~ ~.~, ee show street n.~ames and indicate whether (Name of mdlvtduaI sigmng contract) above named. · . being duly sworn, deposes and says that he is the apphcant He ,s the ............. (Contractor, agent, corporate officer, otc ) of said owner or owners, and m duly authorized to perform or have performed the said work and to make and file this apphcation, that all statements contained m thru application are true to the best of his knowledge and belief; and that the work wdl be performed ,n the manner set forth m the appllcat,on filed therewith Sworn to before me this ......... 3./. -- day of. Nota Pub, c, NOTARY PU 8,.lC, No 4;*07878, Suffolk C~nly~' (Signature of apphcant) BOARD OF HEALTH ...... 3 SETS OF PLANS ....... 'FORM NO. I SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL SOUTHOLD, N.Y, 11971 TEL,; 765-180;3 CALL ................ MAlL TO: APPLICATION FOR BUILDING PERMIT INSTRUCTIONS 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 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~e~ and regulati(~d to admit authorized inspectors on premises and in building for necess~l~Z'iospections. % I !; ~,'~..~] .~'a~o.*.-9..+....~.. h~:~ .~.~ .~ (Signature of al~icant, or name, if a corrgqration) (Mailing address of applicant) State whether applicant i~s o~lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. ........................ © .................................... ¥ _ Name of owner of premmes ......... . . . ~,~ ............. (~ ~ ..................... ~,3(as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE ~UFFOLK COUNTY Builder's License No ..... .~..' .'~%.Xr-....".C~. ~ ~ ~ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... A3N'VdlI ) )O lO lfll 'V'lNfl SI 'UO g)NVdll ) )O Location of land on which proposed work will be done] ................................................. ..... .................. ...... ............. House Number Street Hamlet County Tax Map No. 1000 Section ...~...~...~ ....... Block ..... ~ .~. ........ Lot ..... 1~.,..~. ....... 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 ..................................................................... b. Intended use and occupancy .... ~ ...O,_..C-.C..~. :~'~.~/-..L~.....'7'..,-~ .~..~-..& ........................ Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... ~lo0 (Descriplion) 4. Estimated Cost · (to be paid on filing this application) 5. If dwelling, number o f dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front..~. ............ Rear .............. Depth ............... Height ............... Number'of Stories ........................................................ Dimensions'of same structure with alterations or additions: Front ................. Rear .................. Depth ....................... Height ........ ~, ............. Number~ of Stories .......... :_., .......... Dimensions of,~e~tire new construction: Front ....~. ..... ..... Rear ... ~ .......... Depth ....~. .......... Height .... ? .......... 'Number of Stories /. ........................................ 9. Size of lot: Front .... ((O... Rear ,r,3~..[[~.,.,/~... Depth ~..~.~ " 10. Date of Purchase ...... [.~.~4~ .................. Name,of ~F,o. rcer 6~v~;;'. ?. !.?.~.,{~;(t.. iiiiiiiiiiiiiiii I 1. Zone or use district in which premises are situated ..... ~r,~..'~.,-¢'~-.~'{ ...................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .......................... Address .... : .............. Phone No ................ 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold Town Trustees Permitp~ beDiAGRAMrequired. Locate clearly and distinctly all buildings, whether existing or proposed, and~ indicate all set-back dimensions from property J~e stre~umber or d~scripJJ. Ql~_a__ccording to deed~ and show interior or corner lot. /~x ~" ~ A STATE OF NEW YORK, COUNTY OF ................. S.S street names and indicate whether 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: ~_. FOUNDATION _ TWO REQUIRED ~ FOR POURED CONCRETE ~. ROUGH - FRAMING & PLUMBiI~.~G 0. INSULATION al. FINAL - CONSTRUCTION MU~T BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL THE REQUIREMENTS OF THF b! v STATE CONSTRUCTION & CODES. NOT RESPON$!gLF DESIGN OR CONSTRUCTION &PPROYED AS NO'PEi~ iNOTIF~BUILDING DEPARq'MEN'T AT ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He 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 this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this .............. ~. { ....... day of .... . .~..~ ...... , 19 $otaryPublic .... ~ ...~.-. g~.~. ~..t~.. County ,'2..~..,' '¢~!(~:~.}.~ ~ -~ ~ ... ......... ...,. ¥ ~ ~Btlg ~t~ ~ ~ ~ (Signature of applicant)