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Home My WebLink About16924-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certi[icafe O[ Occupancy No..Z.1.6.8..2.3 .......... Date April 26, 1988 THIS CERTIFIES that the building Alteration Location of Property 2400 Grathwohl Road .New Suffolk h~Os'o bio: ....................... 's't/e;i ...................... h~,~iel County Tax Map No. 1000 Section I 17 .... Block 2 .Lot I I Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated April 12, 1988 pursuant to which Building Permit No. 16924Z . dated April 26/ 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 ......... Alterations to existing one family dwelling. The certificate is issued to HARRY AND PHYLLIS ROSS ..................... ?o¥.'o;,~&;x~j ...................... of the aforesaid building. Suffolk Coun{y Department of Health Approval . N/A UNDERWRITERS CERTIFICATE NO H 002036..4 / 19 / 88 PLUMBERS CERTIFICATION DATED: N/A Building Inspect6~ Rev. 1/81 ~R~' ~qO. ~ 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) No_ 16924 z Permission is hereby granted to: O/Z.~ ' .................. ~.-_. ~,.~/ ........ .,r..~?~ , ,o .... ..~.~.~.........~.....~~./~ ....... ~....~ ................................... at premises located at ......~.....~..~...0......~.~....../..~.~ ...................................... County Tox Map No. 1000 Section ..... ./../.....~.. ....... Block ................. ~ Lot No .......... ./../.. ......... ~..~5~' , 19..~....~'.., and approved by the pursuant to application dated ~.~.....~,~2~.~ ................... Building Inspector. Buil~fg Inspector Rev. 6/30/80 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ]FRAMING [~J/~INAL REMARKS: ~, ~'*~_~ ~ C,_ ~, / DATE LIE. ~. BLDG. "'?~ TOWN OF SOUTHOLB APPLICATION FOR CERTIFICATE OF OCCUPANCY FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 Instructions A. This application must be filled in typewriter OR ink, and submitted ~ to the Building Inspec- tor with 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, a certificate of Code 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 POOLS $25 . 00 ALTERATION $25.~00 1. Certificate of occupancy New Dwelling $25.00, Accessory ,~$ ]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 O,. 00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50,00 Date .......................... NewConstruction...x..x. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ..... .2400 Grathwohl Rd New Suffolk House No. Street J~a~n/et Owner or Owners of Property .. . Harry and Phyllis Ross County Tax Map No. 1000 Section . 1 ! 7 Block 2 ! ! ............ Lot ............. Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. 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 p~tmit/~/.~ meets all app~ codes and regulations. Applicant../~/~..~.~. ~ ....................... 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION ~,ST [ ] ROUGH PLBG., [ ] FOUNDATION 2ND [ ~NSU~TION [ ] FRAMING IN FINAL REMARKS: ~ ~/~~ THE NEW YORK BOARD OF FIRE UNDERWRITERS FAG~. [ ~03517 BUREAU OF ELECTRICITY 8!5 JOHN ~TREET, NEW yORK, NEW YORK 10038 Date .~PRIL [9 , ~988 Appliretion No. o,/ite 54398788/88 fl 002036 THIS CERTIFIES THAT !~ NAERY ROSS, 2400 GRAI'N~/OtIL ROAD, ClJ?CNOGU~., N.Y. in the following h,cation~ [] Bc~sement [] Ist FI. [] 2nd FI. Section Block Lot ' ' u~as examined oti APRTL ~.~ · 1988 attd found to be in compliance u'it h the req, ire,~ents ~f this Board. < DRYERS FIXTURES RANGES COOKING DECKS OVENS OTHER APPARATUS: S ' E OF CC CONO I C E p~O OF HI-LEG PHYLLIS ROSS GRATNWOHL'S ROAD NEW SUFFOLK, NY, 11956 GENERAL MANAGER Per ' This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors re'ay be identified by their credentlals. 'FORM NO. 1 TOwN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~ $OUTHOLD, N.Y. 11971 ~ TEL.: 765-1802 Examined ....... ,19 .~..~ Approved .... ~. ~ ..... , 19 7'~;Permit No. l~ ?..52..,.~.' ..' ./ Disapproved a/c ..................................... BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... CHECK .......... SEPTIC FORM ............. : NOTIFY CALL ................ MAIL TO: (Building Inspector) 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 znust 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, buildin/g code, housing cod.~ and regulations, and to admit authorized inspectors on premises and in building for necessary insp~gfions.,,, ~/'// (J~~, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................................................................................... Name of owner of premises..//.-b~../C..,,t/ .... ~¥ ./f)/~//f,.~/...} f.?.q.. ¢-x. Of> "~ ............................................ (as on the tax roil or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ALL CONTRACTOR'S HUST BE SUFFOLK~COUNTY, LICENSEII Builder's License No. dS~: .,fi~'d~-e'~,?~..~&(.'ff...~q'.~..~..~o~,~e/~,'~d Plumber's License No. ~./7~..I./7-d/.d'/~'.. Electrician's License No..?~.ZZ//.4~4~....~./?.e.~./'/~.~ t~)~/b/fi', Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. .................... . . ............ ............. House Number Street Hamlet County Tax Map No. 1000 Section . ./'./..~. ............ Block .. ~ ............. Lot.../. ~.. ............ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and Al 3. Nature of work (check which apphcable): New Building Addition ' '~ '' Repair Removal Demolitio ' Otb r Work i ~ I . (Description) 4. Estimated Cost ............................... Fee ...................................... *' (to~b~ paid on filing this application) 5. If dwelling, number of dwelling ttnits . . ~.Z/.''. ........ Number of dwelling units on each floor ................ If garage number of cars ' 6. If businesS', commercial or mixedl occupancy, specify nature and extent of ea6h type of use ..................... 7, Dimensions of existing structure~, if any: Front... ~.c~ 1. ..... Rear ...-ff,:~ ....... Depth. a~.d .......... Height N robe 'of St ' /. ............... u r ones .............. ; ........................ Dimensions'of same structure with alterations or additions: Front,, . .,ST~9 ............ Rear ...~7~. .......... Depth ~. ' Height Number of Stories Dimensions of entire new const~ction Front "~ Rear Depth Height ............... N[l~ber of Stories ........................................................ 9. Size of lot: Front ...... ~c~.~i~..! .......... Rear ....... ~¢~ ........... Depth ./~_.~..~. ............... 11. Zone or use district in which premises are situated .,f/.~.,~.~.,.o/.,~./.~ ..................................... 12. oes proposed construction violate any zomng law, ordinance or regulation../k/~.. ........................ 13. Will lot be regraded ...... ,f/ff...~/ ....... ;4 ........ Will excess fill be removed from vr, e,,rp~_:,~/ Yes ame of Architect .......... .~ ~ ............... Address ................... Phone No ................ ~N~.~an]e of Contractor ~fi~£./.~./~Z'~. · ........ Address .J~.d e~,~e.~. ........ Phone No ................ oo, No I~ this property located Within 300 feet of a tidal wetland? *Yes .. *If yes, Southold Town TruStees Permi~ maybe r~uired. i PLOT DIAGRAM Locate clearly and distinctly alii buildings, whether existing or proposed, and Indicate all set-back dimensions from property lines. Give street ond blocl~ numbers or description according to deed, ond show street nomes ond indicate whether interior or corner lot. ~ i -- -8. tlS. STATE OF NEW COUNTY OF .../~z~'&4~..~.~. k~..'7-''~' (Nam~Ydi~ai signing contract) above named. He is the ....................... (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly[ authorized to perfom or have performed the said work and to m~e ~d file t~s application;that ail statements contained ~ this application are true to the best of his knowledge and belief; and that the work w~l be perfomed in the m~ner~set forth in the application filed therewith. Sworn to before me. ,~this ....... ,~of .............. !y : .... 19. Nota, Public, . . .~~~.. County . No. ~7 / ~ (Signature of applic~t) uu~l~t~ Commission Expire~ De~m~r 8, 19~