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Home My WebLink About17141-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspectgr Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 217328 Date SEPT. 20, 1988 THIS CERTIFIES that the building ADDITION Location of Property 580 SMITH DRIVE NORTH SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 076 Block 02 Lot 15 Subdivision GOOSE NECK/BAYVIEW Filed Map No. 1663 Lot No. 93 & 94 conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 15, 1988 pursuant to which Building Permit No. 171412 dated JUNE 21, 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 GARAGE ADDITION TO EXISTING ONE FAMILY DWELLING. The certificate is issued to JOHN & ADRIENNE OLIVER (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE N0. PENDING 9/19/88 PLUMBERS CERTIFICATION DATED N/A uil ing~ector Rev. 181 sos~ xo. s TOWN OF SOUTHOLD DUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No 017141 Z Date ........~.~!s:.....`.?t.l 19g~ Permission is hereby granted to: .~.a ~..~l:1 to .l.i..!?1~r.9S~....~. .Ss~r.1•r.~l.L.....~R.~C..VI.~M1f+rGS.1.J.. ~~....~1....~s~!,~trq'R,~-"h~. ~ at premises located at ...s~~.D....Rs?.:Y!^'':Sr~... V-~.~.f..........~!~J!~ ...........I................................................... Caunty Tax Map No. 1000 Section...,.(..~S.R.7.~....... Block .....Q.1:.....p.~nLot No....1.w7 pursuant to application dated .........~{..~.IiKASi...~•~••..••.•.•••.•.•.., 19.A.r., and approved by the Buildings I7n~spector. r Fee $...r[7.::.:... ./.~~dl.. . g ulldin 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 A. This application must be filled in typewriter OR ink, and submitted ~ 9~~ to the Building In~tec- torwith the following; for new buildings 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 buildings, Multiple Residences and similar buildings and installa- tions, acertificate of Cade compliance from the Architect or Engineer responsible for the building. 5. Submit 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: 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 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 1. Certificate of occupancy New Dwellino,$25.00, Accessory,$16.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5 . 0 0 , over 5 years $ I 0 . 0 0 4. Vacant Land C.0. $ 20.00 5.Uodated C.0. 50.00 Date , 1. ~ ° NewConstruction, • • „ • Old or Pre-existing Building Vacant Land Location of Property • • • . • • • • • . • .........l~F.• ~!1?1 ~~S'.~.~•.. ~ !4,/, CF 4? l~ House No. / Street ffamlet Owner or Owners of Property ~ .S , • ~c? h. ®7. ~ i V ~ s County Tax Map No. 1000 Section ~ Block . ~ Lot ..~.5.......... . G' o cs 9 ~ /j/e p ~ a'>f... . Subdivision ~ . ,'N,! W. , , , . , • , , ,Filed Ma No. r~' ~:~..Lot No. .J..`~~.-. ~ y. • P Permit No.v.~ 7~ Date of Permit . . ~oApplicant L......: . Health Dept. Approval ........................Labor Dept. Approval Underwriters Approval .............../....Planning Board Approval . Request for Temporary Certificate ~ q , / ./..........Final Certificate . Fee Submitted $ . , v~~..~ v • Y `"1 Construction on above described building and m't meets all a plica y codes and regulations. APPlicant :...l... ' ..ff n v Rev. 70.70-78 )r~ - 3 5~- 7 ~LS! C°. G. z j)3z 'r'1ELD I;:SP~C:iU;: ~~llbiE ~ ~Ot`{MLNT°. m ~ 1 'I • Y H _ - H FOUNDATION (1st) ' 4yy[y~ FOUNDATION (2nd) - m - C~.~.Y z . ~ 3 z o P,OUGH FRAME & O PLUMBING . ti ~ H 3. d ran A ra . INSULATION PER N. Y. , y Z STATE ENERGY CODE 5 4 . FIiJAL O ` ADDITIOPIAL COMMENTS: x d ' x w• H ~ H r H O z o, ~ ~ ca ~ • r 2S H x C3 R7 w H 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST f ] ROUGaI PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING ( FINAL REMARKS: er-~ DATE C~ INSPECTOR _ _ ~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [~RAMING [ ]FINAL REMARKS: `~ti~ 0 1~~--~ ;~,~_~L - ad's.. o-«.~.~ a-~.~ /~V~6 AM L~/V? /V~ /n r-lire-~(•a.., ~ ~ CCV~~ DATE ~ 3 0 ~ INSPECTOR , _ T i THE NEW YORK BU'ARD OF FIRE UNDERWRITERS +F,F€3s`~7 "P'f BUREAU OF ELECTRICITY ~i~~ay~yy y~~ 85 JOHN STREET. NEV{! YORK, NEWFJ IOR Kr~~~ 38 yl,y t,=, { - ,r 4w, ~ t~Applivation No. on file _ Dace I ation number in the premises o THIS CERTIFIES THAT only the electrical equipment os described 6elom and introduced by the applicant reamed on tke gboce appl"u,'F "F$)}g l}~x~.~~~U`S:a sidQ ~~z~ ~l°rSri~~i:.x ~3.T~Kit7 s'#;S _ Section Block Lot ~1 y3~ in thefollotcin hre ao~t ~l $a5ve~et V Ist FI. ? 2nd F-L +t~ R ~U4$~16N'~ "'{'e' acid found tube in compliance ixi[h the reyuirericeats u(this Board. e inns exomined;un RANGES COOKING 6ECK5 OVENS D15N~ W,ASN~RS. EXN'pUST FANS P` FIXTURES.: FIKTURE ECEPTACLES SWITCHES MER uav ~T. K. W. AMT. K. W. AMT. "K.W PMT. K W AMT. N. P. y OUIIEi$ INCANDEXENi ~ FLUORESCENT ApOa UNIT HEATERS MULTJ-OUTLET D4MMF:RS ~ 5 TERA$ ry ...:DRYERS FURNACE MOTORS: FUTURE APPIIANCE'FEEDER$ SPECIAL REC'PT TIME CIAGKS BELL N~~F FEET ~T' WAT[s ' AMT. K.W. Oll H P. GAS -.H.P AMT' NO. ` A W.G. AMT AMP PMT PMPS TRANS. AMT. H P NO.OF 4 P W G NO.OF NEUTRALS A W: G. :$ERV{CE DISCONNECT METER - NO OF CG COND A. W. G. NO OF: HI LEG OF HI LEG Of NEUTRAL .EQUIP. 1.$ 4W t ,B 3W 8 $ 3W 3,CJ 4W PER H OF CC. COND q AML.. AMP.. TYPE y5 „I *S t ~ls~l ~I>I. R OTHER APPARATUS: i rr T 1^. `ri~43 `0. h~llsi£Y~ GENERAL MANAGER rts.~ F:E; `;;3~ Per rl 7f I'~ Thrs certrfimte must not be altered..irt any~eturn to the office of the Board if incorrect. Jnspectors. may be identified by..iheir credential;. , i ~ - ~--.-.~z: COPY Fit BUILDING DEPARTMENT. TNIS COPY OF CERTIFICATE MUST NCT BE ALTERED IN ANY MANNER. _ r - FORM 1110. 7 TOWN OF 50UTHOLD BUILDING DEPARTMENT TOWN HALL :;OUTHOLD, N.Y. 11971,. TEL.: 765-1$02 Examincd.~.~'~'.... ~--1....,198 Received...........,19... / Approved l 19 ~ Permit No. ~ .7. ~ . Disapproved a/c (Building Inspector) APPLICATION FOR BUILDING PERMIT i o Date ...`r. ~ r5 I4~°. 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 permi4 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 inspectoxsszn premises and in building for necessary i ections. - (Signature of applicant, or r(afne, if a corporation) (Mailing address of applicant) State/nwhether applica//n~~t is o~~/wner,,~,l//essee, a ent, arch//ite/ct, engineer, general contractor, electrician, plumber or builder. V x k[. e.~-. a ~ .1.i4?2 Y.r'?4:T.o!2~,~`.,( t-Lt G~`e.2....... . Name of owner of premises Jo. !Z S • .C.1. ie:.*a.r'l.t..C1,..~ ~~2 . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corpor--ayytegqof5c`er') Builder's License No. ~ ~..J..J...N. • • • • • Plumber's License No . . Electrician's License No. 4 .a-!ai' • •K~ wYR.s• Other'I'rade's License No . . 1. Location of land on wllicli proposed w~or/k will be done. ..~./...e.~.../.......~.-+ . ~~4 s/n i ll1S. ~~Z~1~C..I.Y.G~I'./. !'1..... <?.c??,t~~ AC...:............. House Number Street Hamlet County Tax Map No. 1000 Section .........7.~.'~...... Block Lot Subdivision Filed Map No. Lot............... (Name) 2. State existing use and occupancy of premises/and inot~end..e~d/use and occupancy of proposed construction: a. Existing use and occupancy ..C4~~S l.4 °C-.Y1.! °ul :^;a.... . •#kt gym,, =r a i~:,* ~'7 ~ c~.. . b. Intended use and occupancy .../'~-1°.-S L~.L°iYE. I Z.~ ,,,,,o~,~; ya ,~~.~i ~...,.-~.,i . 4 - 3. ~ etuarl= of work (check whiRem phcable): New Building AdditickY.y~ztf'Oy~ Alteration • . • . • p oval . Demolition Other 1Vork Q ~ ~ (Description) 4. Intimated Ctcbt • C?.~G?Q, Fee . ` (to be paid on Elting this application) 5. if dwelling, number of dwellinglunits , Number of dwelling units on each floor ...J . 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 structur¢s, if any: Front Rear . ~J.~......... De th ~ . . ~ ...p height Number of Stories . ' ith alterations or ad itions: Front Rear . Dunens~ons' f same structure w ~I Depth ....2. ~ .Height ~ I .........:..Number of Stories ...I.. ! . ruction: Front Rear . , .....Depth c2 .y . 8. Dimensions of entire new c Nu 13eight nber of Stories ,l . 9. :iize of lot: Front Q O ~ Rear j . C70 ~ llepth . ~Sq. ~ . 101. lone or use district in which r,~ ~ ' ' ' ' ' ' ~ Name 1of Fo_ qmer caner - . p p remises are situated . C.S. icl.Grt,~ b2,~ . 12. lloes ro osed construction ~o 13. Will lot be re raded , , , ~ date any zoning law, ordinance or regulation: t7 . g p ..........Will exces~ll ~ re~oved from premises: Yes No 1,~4. 1Vame of Owner of remisesm`''(. m'~~' D 1 i v~ a , . , , Address'.3e,u~..y~e i 1I-.r;~ Phone No. Name of Architect .Address Phone No............... . I5. ?Cs thisCproperty located•...,...,.~. " " "Address ....:..............Phone No. (within 300 feet o£ a tidal wetlandY *Yes No *:[f yes, Southold Town Trustees Permit ma be reywired. ' PLO~I' llIAGIZAM Locate clearly and distinctly alb 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 nterior or corner lot. I S M 'l' 1-F S ' Ex~sy; l g'u ~o...yE 1 t c0 *SS'~ Cz ,1f' I o a ~ 4 m3g~ tsa~ ~ 0 ~ i` c..t-~ k a E Y ~Z~ ~.xv[-rtoro iTA'fE OF NEW YORK, ' S.S :OUN F • • • • • • being duly sworn, deposes and says that he is the applicant ~ ( ame of individual si ng contract) ~bovc named/. Q~ (Contractor, agent, corporate officer, etc.) ~t said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ipplicntion; that all statements contained in this application are true to the best of his knowledge and belief; and that the .vork wit! be performed in the manner seY forth in the application filed therewith. sworn to before me this . . ~~....~.d~a~y~of 19 Votary Puplic, !Y'~.. ~ . "'"t' County /J PUBLIC, ~ of NM YOA ' ' " . t~ y (S' ature of applicant)