The URL can be used to link to this page

Home My WebLink About11644-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.. 7~'1']77~, ........ Date ............ J.¢¢.e..9 .............. 19.85 THIS CERTIFIES that the building .. g. ddJ-~.J,o~ .................................... Location of Property . .9~..Glea~.v. iew..west;. House No. Street Hamlet County Tax Map No. 1000 Section .... 0.~.Q ....Block .... 08 ......... Lot ..... 0.0.z~ ........ Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ....... Apr&l..q .~ ..... , 19 B2 pursuant to which Building Permit No.. q ~. ¢.Zl~ ............. dated .......... lV/~y. ~.q ........... 19 ~3~, 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 ......... A deck addition to an existing dwelling The certificate is issued to . .Ja~e, .J., E~nder ......................................... (owner, levee or tenant) of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO ......... .~./..A ..................................... Building Inspector Rev. 1/81 TOWN OF SOUTHOU~* BUILDING DEPARTMEHT::~, TOWn SOUTHOLD, BUILDING P,E~IT (THIS PERMIT MUST BE KEPT ON THE PR IS UNT L FULL COMPLETION OF THE WORK AUTHORIZED) N°. 11644 Z Dale c/ ~/ . .: 19.~ Permissi~is hereby granted to:~ ~~:~...~.~.~. ............. . ......... ~,~~...~,.~,. ............. ~o ..~..'~~ ~ ~:....~&....,~ ~,:..:~...~ m:~.~ ....... .... ,.~..~4z~:~......:: ......... ~ ....... ~, ...... , .............. }..,.~:. ....... ~ ...... .L..~ ......................... .................... .......: ~ ........................ : ~..~.~. ........ ~...~..z.~..: ~...~: .~.~ ....... ~.: . .. pu~;ont t;' opplication dated ..~.~...~,...;.....;,:........, Building nlsPector ~ee~.L.~. ......... ~ ond 6pproYed by the 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 in duplicate 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-(S9 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 peoperty 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, t 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 et land u se 5'/5~/$5.00 Date ....... New Building .... /~ ....... Old or Pre-existing Building(X), ~, _.~/Vacant Land '. ........... Location of Property ~..~' House No. Street ~ -Ham/et Owfler or Owners of Property .J&'/~J~/0. ~' ~',~.~.~.~.-' I~, ~-'~..1~,~'.~.'_~.~.-....~.. County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Health Dept. Approval ........................ Labor Dept. Approval ...................... ,.. Underwriters Approval ........................ Planning Board Approval .................. ~ ,., Request for Temporary Certificate ..................... Final Certificat~ ................. Fee Submitted $ ............................. =' Construction on above described building a~pe,~rrr~t~meet~s~ll ap~able_.c~d~_s and regulations, Applicant.,. ..... .¢?. ~,..~~ .................. Rev. 10-10-78 ~ FIELD INS?E~T FOUNDATION FOUNDATION ROUGH FRAME & INSULATION FLUMBi PER STATE ENER ~ODE FINAL )l~ DATE COMMENTS {1st) (2nd) N. Y, ADDITIONAL COMMENTS: ~ohn D. & Jane J. Berder Application for building permit - proposed 16' X 16' Deck ~upports - 22 con~rete reinfor0ed ~P0!es_(~'' sEuare .x 50" l~ng~h) Placement of supports- 36" of each pillar will be in the ground - -averagJ ~ 2''~ ~0 ~1~" ~bo~¢e-~he ground-slight grade of pr~e~y awayj~f~0m~ th~ house - ~2 concrete p~Ies equally spaced around -thg pe~i~r ' spaced in the interior ,, · - ,.,~ sections of reinforcing rod protrude f~om the top G~ each pole to receive the joists. outer perimeter -~($2) 2" X 6" X 16,~GCA wood joists ~or each-s£de~-- - - (5) 2" X 6" X 16' ~Joists equally Sp~6e~ in the mntermor of t~e frame. - attachment to ....... joisbs as below *2" X 6, .X 16~, dCA wood_planks Method oists to concrete R.ol~es .... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 76§4803 Application No. ,/.. .... : .......... Examined. ~. c'~.~7'( · ,/. (..., 19~?/ Approved...~..~..cf..././.. ~v ~.~ ~ .~ ., l~Pe~it No. ~ Disapproved a/c ......................... ~ .......... ~ / .. .'.~:~.., ........... APPLICATION FOR BUILDING PERMIT Date ~.~/.~.. A~ ..... 19~& INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building I~spector, 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 diagra~n 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 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 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 inspectors on premises and in buildings for necessaw inspections. ~/ (Signaff:ffe of applicant, 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 .~.O./~/A/. ~,./~,~z-/~. ~F~.. ,97'.. ~.]'~-~. K(. ~"..,~.~ . g~?.~r~/(,/~. &r. ~ ................. (as on the tax roll or latest deed) If applicant is a corporation, 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~6.__ of land on which proposed work will be done .................... ~'-q))/' ~/t~ o'/~ '-'--' ' ' ' --'-- ~5~ .... County Tax Map No. 1000 Section .. O..7.0, ........... Block ... ~. ............. Lot .... ~ ............. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o 10. 11. 13. 14. Nature of work' (check which applicable): New Building .......... Addition . .~. ...... Alteration .......... Repair .............. Removal ....... ....... Demolition .............. Other Work ............... . ~- (Description) Estimated Cost. · .~.7P.~2, .~.. 1 .......................... Fee ...... ./,~,-z2~7 ......................... i (to be paid on filing this application) fd Iii g ~ fd hr If dwelling, number o we n units ............... Number o welling units on eac oor ................ If garage number of cars -- If business, commercial or mixed occupancy, specify nature and extent of each type of use .v' ................... Dimensions of existing structures, if any: Front.. ~-'t~.: ........ Rear .............. Depth .. ~g.'. ......... Height ............... Number of Stories ....... [ ................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ................... !... Height ...................... Number of Stories ...................... Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Heigh:t ............... Number of Stories ........................................................ Size of lot: Front /.9~,./.~. ":~i ............ Rear ../.~.~:' ............... Depth ... ,/~.6~ f ............. Date Of Purchase ~/4,. [~'..i../.~'P .............. Name of Former Owner . ~ ~"~./~ ~"..~d./. 7~// ........ Zone or use district in which premises are situated .......................... ~ ........................... Does proposed construction violate any zoning law, ordinance or regulation: ...~].{) .......................... Will lot be regraded ........ ! .................... Will excess fill be removed from premises: Yes (~ Name of Owner of premises,T~AiO'.~O-~A/~7 d7¢4<.~'.~ Address~..~. C-/~',~V/.~'~,,~. ~'~':~. Phone No.TY.-Cr~.~..fi. ...... Name of Architect .... .o./~,'M. 4~ ............... Address ................... Phone No ................ Nam~ of Contractor ...a ~A/~'.R, ................ Address ................... Phone No ................ 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 whether interior or corner lot. COUNTY :Ot~.~faf-~ . . .I ...... · ~),-~-~--c~'/~'~' · · i~" being duly sworn, deposes and says thane is the applicant f'f (Name of individual signing contract) above ha'med. r~He ia 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 co~tained in this application are true to,the best qf ~, nowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this i ~ , "." .......... /.~.-:...day f ...... ~ ...... 19~c~L '~__.~~~//~. County~ ..~.t~..~~ U ~~'[~'~' ~ ~~ ~C0~uart~Vor~ ~ f~ ( Sig nature of ap plicant)