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Home My WebLink About9397-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z16473 Date December 14 , 1987 THIS CERTIFIES that the building .... .A.d.d.i.t..i .off...a .ri,d, a 1 t e r a t i o n Location 405 Halyoake Ave. Orient of Property P~s~ )do] ....................... ~/e~t' ....................... County Tax Map No. 1000 Section 2 7 .Block 1 .Lot Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... .A.u.g. :..1.0. ,.. J .9.7.~ pursuant to which Building Permit No .... 9.3 .9 7.z ............. dated . .A.u.g:. ,I.0. ,...1.9.7.7. ........... was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy ~r w~ch this certificate is issued is ......... Addition and alteration on existing dwelling. The certificate is issued to DORI S B · MORGAN (owner, ]~t~Yat Ye~)X X X of the aforesaid building. Suffolk County Department of Health Approval ... N / A UNDERWRITER S CE RTIFICATE NO. P e n d i n g 12 / 10 / 8 7 PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 'soUTi~OLD, N, ¥. BUILDING ;pERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 9397 Z Permission is hereby granted to: Tor4~...;~a ~kl ~n...../~C...J. oh~ ..&.. 1)o~ .. ~e r4~a~ ............. .0rie;~l; .................................................... · ddition d ~3te~t~'~:~ on e~isting dwellin e ~o ..~...~...~.~..~ ............. ~ ....... ~ ...... : ......... ': ................................................................................ (a roved b Bd a~peals) at premises located at ...N/.~..Z,,~]~.Oke.....~...(.~.!~ ................................................................ Orient ............................ A~-.-..$ ............. , 19..~.~.., and approved by the pursuant to application dated ~ ~ Building Inspector. Fee $ ~ -~.. ~ .~.~ ............ · Bu Id:no FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y, 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 featu res. 2. Final approval of Health Dept. of water supply and sewerage disposal-iS*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 featu res. 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: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.0 0 3. Copy of certificate of occupancy $1.00 Date .......... ) ...... New Building /~ Old or Pre-existing Building Vacant Land Location of Property .............. ' ......... : .................................... House No, Street Hamlet Owner or Owners of Property ....~.~.(&~,~(~. ~.. ~...-~F.~.~....~...~ .... .~.~.. ,~..~"~. ............. County Tax Map No. 1000 Section ... ~-~ .~-~ ........ Block ....~. .......... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit ,~. }9. .Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .... '~ ................. Fee Submitted $ ............................. Construction on above described buildimj-a~d permit meets all applicable codes and regulations. Applicant' ~"~--....~.. } 4:~,~. ~~{ ........................ FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N,Y, 11971 765 - 1.802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ai ~ 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 ?OOLS $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre~existing dwelling $ 5 0.00 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 ..... ,/~/.///.¢,7. ............ New C on ,~z t p u c ~; ~ on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property s kt Ham~t House Owner or Owners of Property .'-~ --.~..)?'~'~ ~ ~ ' County Tax Map No, 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approvat ...................... Request for Temporary Certificate ................ '. .... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and p?L,mit meets all applicable codes and regulations. Applicant n..,o.,o.,a 83 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. t 1971 December 3, 1987 TEL. 765-1802 Doris B Morgan This is to advise you that the job under building permit no. 9397Z issued to John Morgan on 8/10/77 for addition & alteration is completed a final tnspection has (xxx) has not ( ) been done. and In order to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a check for $ 25.00payable to the Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with this offike for an inspection date Occupandy or use is unlawful without a Certificate of Occupancy. Please help us to clear up this matter so that ~al action does not have to be taken. Thank you for your prompt attention. Very truly your~.~, Victor Lessard ~ Executive Administrator VL:gar enc[. An Underwriters also Certificate is required TOWN OF SOU~-~OLD OFFICE OF BUILDING INSPECTOR · P.O. BOX 728 TQ\VN HALL SOUTHOLD. N.Y. 1 I971 TEL. 765-I 802 Per,.m~t ~'o ~q~ i~su' ~ ~ ~ ~-t= So,~ uncer Building ........ [ / ~,as no~ oeen done in Order to c ,,1~_~ oh!s f~i~ it is necessary that enc~ s~.~ fill o.._c~ th a check for $5.00 payable to the Town of Southo!d ~nS~ate to whom the CerE~facase of Occmsancy is to be mailed, and arrange with this office for an inspec~Jion date. Thank you fop yoMP DPomot attention VL:ec Enclosures Very truly yours, Victor Lessard Administrator q2'-0" ' '' 'u ' ht Nu~mDer,ot brones ....... )epth, ..,,.~..~- ...................... ne~g ....................... )~i;~', ~,, ' ' ~, LCd'-0" De~t~ )imensions of enhre new construction: Front ..................... ' Stories 2 4eight .................... Number of £' l_aa.~2' Depth ~.~0 0' ze of lob Front ............. .~. .9.. .9. :. ~ ................................. Rear ............. x/...~. .............................................. se .................. Nome of Former Owner ........................................................ Date of Purcha .................................. ,,A" ~ ' · - ' remises are situated ..................................................................................................... Zone or uae dtstnct m which p Y~ - side v&rd requirement Dces proposed construction violate any zoning low, ordinance or regulahon ............... Fill lot be regraded ~o Will excess fill be removed from premises: ( ) Yes (X) No ............................ premises John C. & Doris B. Morgan Address See other side Phon~ No. l .................. lame of Owner of ............................................................................ Name of Architect .............................................................. Address ........................... Phone No ....................... Address ................................ Phone No ....................... Nome of Contractor ............................................................ PLOT DIAGRAM bcate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from }y lines. Give street and block number or description according to deed, and show street names and indicate ir interior or corner lot. /rd IE OF NEW YORK, [S.~S . i ~C]_U~lf(t ~Toh_,~ Bo~& V, EES.t .................................. being duly sworn, deposes and s~y~ th~t ~'~e of individual signing contra~e ~ named. i Attorney an& A~?.~ ........................................................................................ ~ the .............................................. (Contractor, ogent, corporate officer, etc.) ~ - - authorized to ~erform or have perFor~d the said Work and to make and file ~ d owner or owners, and m, auw . · .c- '~¢~ ~n are t~'~he b st of h s ~wtedae and belief; end ~ ,- '- . -~-~ ~H Ftatements contained ~n m~s app,m .... ,. . '~F~, ~, e.,,_ ~ _ pppHcar~on u,u. ~,. ¢ - ' -". ........ f forth n the opp cot O(tlled tDerewlm. / [the work wdl be pertormed in rnum ......... / ~ j ~n to before me this ~// MAP OF LAND TOWN OF $OUTHOL~. BUILDING DEPARTMEN TOWN CLERK'S OFFICE ~UTHOLD, H. Y. Aoorov~ , . . ',. . ~, ...... , 19.~..Z. Permit No...K~ E,.L ~, ~ ~ ,-~ ................. ~ ........... ~ , ~/~;~ e (Building Inspecto~ . ~'~ ~X~.( ~ ' ~ ~x~ ~ ~:~.~"~ ~APPLICATION~L~' cl ~, FOR BUILDING PE~IT~ ...................... . . " uate .................. ~.....( .................... ] ¢.....x ..... INSTRUCTIONS a. This application must be completely filled in by typewriter o¢ in ink and submitted in triplicate 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 areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. 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 issue 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 Deportment 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 lows, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. ..... I ......... ;'" (Sigr~ure of app ican, or name, ir a co po 'o (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...~...~....4'1~......~.:....~....~..2~....-~....~..........~...~/...'~.. .......................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of land on whlch~ /~, ~-~ ~--~ z~Pr°'°°sed wo~ will b~done. Map No.: ..................... ..-m. ........... :~ Lot ,No~x.4...s,,. ............. Street and Number ..~~.-~......."'~../...~....~..~*"~. ................................... ~'?...'?..i.~..T.~.,~ .............. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupa.cy '"i~";-:7 ............ ~i,i-?.'.'~.'~.':':'"~>~ .............. :~:>:::/ ........................... b. Intended use and occupancy .....................;.~..... ................ ~.,.~.. ........................................ ./..... ........................ 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration ............ ;.~ · Repair .................. RernQval ................... Demolitior. ................... Other Work .................................................. (Description) d 4. ~stimated Cost ....~ ..................................................... Fee _k ..................................................................................... (1o 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. 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 ..... ~..~.L ....... Number of Stories '.~..~ .......................................................................................................... Dimensions of same structure with alterations or additions: Front Depth .... ~.~....~ .............. Height ............................ Number of Stories ................................ 10. D~te o~ ~rc~e~e ........................................................ H~e of For~er Owner ........................................................ ~. Zone or ~ ~tdc~ ~n which pre~es ~re ~mmed ...~.~ .................................................................................... Will ~o~ ~e r~gm~ed ............................ PLOT DIAGRAM Locate clearly and distinctly all 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 ,vhether interior, or corner lot. /~, /¢,¢z?o,c/r' z 6 - . ~./X~t. OF NEW ~ ORIx, ~e ¢ COUN'FY OF ..... ~U~,~O.~k .......... ...... ~.~ ~D.E~ .............................. being duly sworn, deposes and says that he is the applicon~ (Name of individual signing contract') above named. Fie is the .. q¢.~.e~p.~ ................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said ~vork and to make end file this application; that all statements contained in this application are true to rhe best of his knowledge and belie~; that the work will be performed in the manner set forth in the application filed therewith, Sworn to before me this ............ ~P.~... day of .......... ~.~.~. ................... , 19.~.~... ~,,, ~, ~.~/ _ ~ ..... :; % ........... ............. NoteW Public, . ......................... ¢.~,Q~ ......... Coun~ ~/ (Signature of opplicont) ¢ gUZABETH ANN N~I~LE - ~/ NOTARY PUBLIC, S~te of New York No, 52.8125850, Suffolk Cou~ Term Expires M~rch 30,