The URL can be used to link to this page

Home My WebLink About12095-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z, 148].4 Date August ~..9~ ....... 19 S6 THIS CERTIFIES th b ildi chicken coop · at the u ng ................................................. Location of Property q285 N'ew Suffolk Lane C. utc.h.og.u? House IVo. Street Hamlet County Tax Map No. ]000 Section .... 1.0.~ .....Block ...... 0.7. ....... Lot ... 00.7 ........... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · .p.e.c..e.m.b.e.F' .2.3., ....... 19 .~3.2pursuant to which Building Permit No.. J ~.0.9.5 $ ............. datJcq~tn .u.a.q 7... 7 .................. 19.8.3., 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 ......... chicken coop Walter Teresko The certificate is issued to ............................ ....................towner, 'l~tT~tlXa~ of the aforesaid building· Suffolk County Department of Health Approval .......................................... N/A UNDERWRITERS CERTIFICATE NO ................................................ Building Inspector Rev. 1/81 FO~M bO. ~ ~ TOWN OF SOUT.O~i~ i BUILDING 'DEPARTMTNT TOWN HA, LL ~ SOUTHOLD, N. Y. ~ BUILDING; pERMIT (THIS PER~IT MUST BE KEPT ON THE PREMISES UNTIL ~ULL COMPLETION OF THE woRK AUTHORIZED), i! : Permission is hereby granted to:. __ to ...~.. ~.;....~:...~..~ ....... ;....;.......'...~';.'...: ............... =t ~r~ml;e; located at/..~(..~ ..................................................... m"; ................ ~./"~/~--'~'~'~'~'~'~" ........................................................ ...~ ................. ~ ..................... ~ ................ ................. ~ ............................................................................. ...;,.~ ~fv, w .......... t' ............ :- '"s~"~ 'MY' ....... County Tax Map No. 1000 Sectm0~ ................. '2 ....Block ~...,-. ...... ,.~;j~.~J. ot No. ~ ....................... pumuant to application dated ~.~. ..................................... ',;........., 19,....i!,, and c!pproved by the Building Inspector. Building nspecto~ FORM NO. 6 TOWN OF $OUTHOLD Bu ilding Department Town Hall $outhold, N.Y, 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions TOWN OF 'SOUT~OLD 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-(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· For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty 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: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $ Z 5.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 ~./f. 5/ 5. Updated C.O. $15.00 Date .... ... New Building '~ Old or Pre-existing Building Vacant Land Location of Property...~..'~.~..'~/ ................. t.~. ~.~.~.. ........ .~1~.- ....... House No. Street Hamlet Owner or Owners of Property . · .k~. · '..~..~C...%.~..~. ............................... County Tax Map No. 1000 Section [(5c~ Block ¢J Lot Subdivision ................................. Filed Map No ........... Lot No .............. Permit No./~..Q~/~...3:'7 Date of Permit 1.1.~. !.~..~,..Applicant...~.~. ~..~('...'-~.. ,"~..~'~..~...~. ........... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporarv Certificate ..................... Final Certificate ....................... Fee Submitted $ ...... ~.~......0~. ................. Construction on above described building and permit meets all applicable codes and regulations. i t Rev. 10-10-78 R c. 3c0 , 7 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF ( Instructions A. This application must be filled in typewriter OR ink, and submil tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildi~ natural or topographic featu res. 2. Final approval of Health Dept. of water supply and sewerage 3. Approval of electrical installation from Board of Fire Underw~ ,;~, ~' .i~,~ ~,~. ~i >~ ~ 4. Commercial buildings, Industrial buildings, Multiple Reside~ 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 p~operty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancv 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 occupancv on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4,Vacant Land C,O, $5,00 $15,00 ...... ..... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ......................... ~ ¢~).~,~J2L~/~./,~.. ,~..~., ..... ~. C).. ~. ...... House No. ~ Street Ham/et Owner or Owners of Property Z~..~?-~. ~-~"~-¥~ ...................................... County Tax Map No. 1000 Section ./.~. ~'. ......... Block .... ~. ......... Lot .... .~ ........... Subdivision ............... · .................. Filed Map No ........... Lot No .............. Permit No, ~l,~ D~e of Permit .......... Applicant , ~,f/.Z~ ~,~.w~. ,~, / Health Dept, Approval ........................ Labor Dept, Approval ......... ~ ............ Unde~riters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate . ~ . . '.~,. Fee Submitted $ ............................. Construction on above described building and ~p~?it meets aTp~/cabl~._odes and regulations. Applicant, ,,,_~2_~,~_~. ~,.: ...................... COMMENTS FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined~.~../~. .... .~....., 19~ Disapproved a/c ...:...... .......... ~.. ....... U) ..... }" / ~(Bui ing nspector) -- APPLIGATION FOR BUILDING PERMIT INSTRUCTIONS Application No ......... a. Tkis 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 permit shall be kept on the premises available for inspection throughout the work. e. No building shail 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 building for necessary inspections. ..< .~.~...o~_~.., .~z,~2N:-... ~q ~ (Signature of applicant, or name, if a corporation) (.. ~.e~..~.~.&., .~. ?.,. qo..~.~?.~.., ~.. (/.V.~ ...... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. N~me of owner of premises ../....cd. al3.e£...7..e~ ~0 ................................................. (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 LicenseNo ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. L~ocation of land on which proposed work will be done ........... ~9..et,-9~ ............................... ...... ~.~..~ ~ .~..~ ~.~.:. ....... X~.. House Number ~Street ' &;n'l ....... /County Tax Map No. 1000 Seotion .... l .O.~ ........ Block ..... 0.'7. ........ Lot .Og~.. Subdivision .............. ~'(iq'a'n~) ................ Filed Map No ..... ~. ......... Lot.. ~ ........... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ~/~a. Existing use and occupancy ....... ~.'./~.t~.~..O~.......~..Or/. i .~. ~./. ?...~('..~.~.../2~.0. .C)~.~...~..~../5.~. /b. lntendeduseandoccupaFnc~y(3/5/~CC//[~/T-eFx C~O0~ l . .~. . .x4)4~. . ,,~l~'.[~/~ ~ . .~. .~ .~. . .~ .... Nature of work (check which applicabl~): NOw Bu~ilding .......... Addition .......... Alteration .......... Lstlmated~ ' Cost ~ II~.~ ~ [.~. ........... .................. ........................... (to be p~d on filing this application) If dwelling, number of dwelling.units ............... Number of dwelling units on each floor ................ If g~age number of c~s ' 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 ............... Number of Stories ........................................................ D~ensions of same structure w~th alterations or additions: Front ................. Rear .................. Depth .................... '.. HeiSt ............ Number of Stories ........ I)~ensions of entire new construction: Front... [~ ......... Rear .... ( ~. ........ Depth . ~ Q ............ 2' f St Height ............... Nu er o odes .............................................. Size of lot: Front ...................... Rear ...................... Depth ...................... Date of Purchase ........... ~ Name of F~r ~wner ................ Zone or use district in which premises are situated ..................................................... Does proposed construction violate any zoning law, ordi~nce or re~lation: ................................ Will lot be regraded ......... ~ ............. ~ Will excess fill be removed from premises: Yes Name of Owner of premises . .~ (~*(.. ~0 ..... Address .~g ~(~ ~C ..... Phone No. ~ 7.. ~3.~... Name of Architect ...; ...... ~ ................. Address ................... Phone No ................ f Contractor . W ...... .... Address Phone No. ~ PLOT DIAG~M Locate clearly ~d distincflg ~1~ build~gs, whether existing or proposed, ~d. indicate all set-back d~ensions from prope~y lines. Give street and block :number or desc~ption according to deed, ~d show street nines and indicate whether //3. 10. -11, 12. /13. /14, interior or corner lot. COUNTY O~l~'~. 7~. ~ ........ (Name of individual signing contract) being duly sworn, deposes and says that he is the applicant above named. ~ / (Contractor, agent, c a't; 'o'f~icer, e't~.) 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 contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this Notar3q Public, ........ ~.~ ...... ~] I~Lli~AB~I'H AN~, N~ILL~ NO~flRY PUBLIC, State of Now Yot~ No. 52.8125850, Suflolk C~ Term Expk?s March 30, ~ County (Signature of applicant)