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Home My WebLink About5387-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. ~IFI~ATE OF No Z-23912 Date SEPTEMBER 26~ 1995 THIS CERTIFIES that the building Location of Property 845 FANNING~D. House No. County Tax Map No. 1000 Section 117 Subdivision ADDITION NEW SuF~OLK~ N.Y. Street Hamlet Block 4 Lot 25 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated J~LY 6, 1971 pursuant to which Building Permit No. 5387-Z dated JULY 6, 1971 was issued, and conforms to all of the requirements of the applicable previsions of the law. The occupancy for which this certificate is issued is ADDITION TO EXISTING ONE FAMILY SEASONAL DWELLIN~ AD APPLIED FOR. The certificate is issued to JA~B P. & OLIVE B. HOWARD of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. H-046953 - BEPTEMBER 13, 1995 PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 FOII~I NO, ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMIS ~E~ UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5387 Z Permission is hereby granted to: ................... ~,'~ ~.-.~F,~ ................ : ................. to ............ ~l~.. ~u~..~&~i-~-. ~n...e~'~ ~'t~ ..~e..t,~ .................................................. at premises located at ........~/~..F~D~:JJ~g..~t~'~. ................... ; ......................................................... .................................................... ~e~..~:~.....~..~-.. ......... ~ ......................................................... pursuan¢ to application dated ......................~:.~.~ ....... ~ ......... ;....., 19..~.~., and approved by the Building Inspector. Fee $...~.,00 ............ Building InSpector APPLICATION FOR CERTIFICATE OF ~CCUPANCY 'rOWN OF SOUTUOLD BUILDING DEPARTMENT TOWN HALL This application must be filled in by typewriter OR ihk and submitted to the building inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of~Fire Underwriters. 4. Sworn statement from plumber certifying chat the ~older used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate.of Code Compliance from architect or engineer. responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-~onforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and uuusual natural or topographic features. 2. A properly completed application and a consent to'inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. ; 1. Certificate of Occupancy - New dwelling $25.00, A~ditions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25~00, Accessory building $25.00, Additions to accessory building $25.00. Businesjes $50.00. 2. Certificate of Occupancy on Pre-existin~ Buildings- $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential ~15.00~, Commercial $15.00 Date ......................................... New Construction ........... Old Or Pre-existing Building ................. Location of Property ........... ~. ltouse No. ~ Street Subdivision .................................... Filed Map..., ......... Lot ...................... . " ' · -~,,,/. // ... ?,~,.~ ~o. .~,:~,~.7. 7-..~,~ or ~..~, .......... ~,,,, ....................... ~: ..... ~,~,, ~p~. ~o~ ....... U~ .............. ~nd~r~: ~pp~o~o~ ......................... 'lanning Board Approwll ........................ qequest for: Temporary Certificate ........... Fim~l Cert±cate ........... Tee Submitted: TOWN OF SOUTHOLD BUILDING DEPARTMENT ' .....~.... ........... , ........ Appelation No...~.~,.~ ........... Disapproved a/c ............ ~ ........ ~..~ ....... ~..~..~ ......... ................................................. ............... .................................................................................... (Building Inspector) Date ................................ , 19 :, ~/ Thi*'~lic~tion must be complotel~ filled in by ~pewriter or in ink ~nd submitted in duplicate to the Buildin~ b~ Plot plon showin~ Ioc*tion. of lot ond o{ buildinos on premises, relotionship to ~djoinin~ premises or public streets or ore.s, *nd oivinfl o detailed d~scription of I~yout o{prope~ must be drown on the dio~mm which is p~ of this ~pplicotion. c. The work covorod by this ~pplic~tion moy not be comme~od before issuance of Buildino Permit. d. Upon opprowl of this opplicotion, the Buildin~ Inspector will issuo sh~ll be k~:on the premises ovoilable for inspection throughout tho profess e. ~o buildino sholl be ~cupied or usod in whole or in po~ {or ony pu~ose whotever until sh~ll h~ve ~ oronted by the Buildino Inspector. APPLICATION IS HEREBY /v~ADE 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 o~terations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordi nances, buildin/g code, housing c~:J_je.,,~i.n~J ~keg~ul~l~.~ons. df1 t~XL '- (Signature of applic~ant, or name, if aj~orporation) .... (/J (Address of applic~J}) ~ 1. Location of land on which proposed work will b,e done. _/v~o~ No.: ................ I.....-~..~......~.. Lot No ........................ ,~ Street and Number ,.~...~.,.~'., ....... ,~,..~I..,,.,~..~,..,.~,L~...* ................... 2.State existing use and occupancy of pre.es ~n~ iDtended use and ~cupancy of pr~osed const~ction: a. ~isiting use a~ ~cupancy ...... ~.~..~ .................................................................................. b. Intended use and ~cuponcy .~ ~..~..~ ................................... t .............. 3. Nature of work (check whi~;~ applicable): New Building .................. Addition Alteration Repair .................. P~mo~l .................. Demolition .................. Other Work (Describe) ........................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ~) ........ 6. !f business, commercial or mixed occupancy, specify~j ,~., nature and extent~of,~ ~-.teach type of use ...... --,~;¥'"'~ .............. 7. Dimensioq~pf17 existing structures, if any: Front ...... I'~''''?'~'' ............. Rear .....e..Z..: .................. Depth ...'~...~.. ............ Height ........................ Number of Stories .................................................. i~"l ........................................ '2 ................ DimensJon~( sqr~e~structure with alterations o additions: rant .................................... t~ear ............................ Depth ...~ ..................... Height ...... .9. .................. Number of Stories ........ .'~. ..................... 8, Dimension¢oj¢ entire new construction: Front ..T.?~..,.,~..: ..................... Reor......~....~...' .............. Depth .~.,..~..' ............... Height ................... ., Number of Stories ...................................................................................................................... 9. Size of lot: Front .......... =..u...;, ....... Rear .................................... Depth ..,'...;..7..." ................. ,.~ , 10. Date of P,rchase ..... /..../....~...?.. ..................................... Name of Former Owner ....~..~.~..(~,~,..I;.,....~..?....~....~...~..(,~,. ......... 11. Zone or use district in which premises are situated ..................................................................................................... ] 2. Does proposed construct on v o ate any 7.oning aw ordnance or r~gu at on:) ..... Name of Owner of fetuses0~/gI~'s ~)/~/~c~'A~ Address ..~'.~.../~.../~'..//Y~/~' /Y~'~ .... : .......................... 13. p ................................................................................... Phone P~o ..................... Name of Architect ...................................................... Address ...~.(....~..fi.Z~!.Q~Z~.,,.~'..~'?,.~ ........ Phone No ..................... Nome of Contractor ................................................................................................... r ....... No ..................... PLOT DIAGRAM Locate clearly and distinctly QII buildings, whether existing or proposed, and indicate oil set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF N£W(~_R)~ ,q~ t,- ,- COUNTY OF ..";'~¢~'......,,,..~':~ / ........................r~ ~.~-~- ~,~ ~, ,, ~ ,.~....~,,~,,,~.~_.?..,....!.~:.......!,..~........~........i.~../,yr. ~. ~ ............. being duly sworn, deposes and says that he is the applicant (Name of individual signin~li~a~ above named. He is the ......................................................................................................................................................... u ~ (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 conta:ined in this application aka true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the ~pplic~ion filed therewith¢ Sworn to before me this ~ / ~ II / ...~ ......... r]~ay of ...... ~ ................. : ........ , c~~~ ........................ (Signature~J'"':'-Z'~of .................................... Notary ~ ~.. County~~(~'] applicant) ~LIZABET~ AN NOTARy PUBHn ~ N NEVIL/~