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Home My WebLink About12602-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Cerfi icafe Of Occupancy No. Z121.7.3 ......... Date ..... JANIIAR¥..3 ................. 19 83. ADDITION THIS CERTIFIES that the building ................................................ Location of Property 760 OAK AVENUE SOD-TI{OLD io: ....................... 'S't/e i ....................... h d, iei County Tax Map No. 1000 Section .... 007....... .Block ... DX .........Lot ..... Q03 ..... : ..-. · Subdivision.. -GOOBE. B~Y- E~RT~.G ....... Filed Map No ..... 1:% 76Lot No. 2.8.6., .2.8.7., :~ 8.8., 289 conforms substantially to the Application for Building Permit heretofore filed in this office dated .... ~..Q.V~...b~.E..R..2.2. .... , 198.2.. pursuant to which Building Permit No .... ]:2..6.0.2.Z. ........... dated ...... S~.P.T~:~BE,R. 1.5 ........ 19.83, 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 ......... For a deck addition to an existing one family dwelling The certificate is issued to ...F~,, & MRS. JA~S Wr KOP~3~N (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval lq/R UNDERWRITERS CERTIFICATE NO.. N/A Building Inspector Rev. ;/81 FON~[ NO. ~ 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) 12602 Z Permission is hereby granted to: ..... ...~-~.~./..c.~...:..T..... .......... ././..~..~ ~o ..... ~~~......~.....~.~..z.z~ ....... z.~....~,~.~.. ..~.....~.~....~.~Z~......~ ........ ~.~....~~ ~, ~,,~,,., ~.,,~ ,, ....7Ed .............................. .~ ............................................................. ................................................................................................ ........ Building Inspector. Rev. ~/30/80 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 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. 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. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 land use --Pre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 Date ..... ! .I.~'...~. ~ .~...~..~. .... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location ofProperty .~. ~? 0 0t~;~/~ j~¢,.,) ~.~. O....'~...],~. Hou~ No. Owner or Owners of ProperW ...~ f. ,. . ~ ;...~ .... ~.;... ~.~. County Tax Map No. 1000 Section ...~.~..~ .... Block ... ~. ) ........ Lot .... ~.~..~ .... ........... =,, . ot PermitNo ~ b 0 ~. Date of Permit .~;J~:~.3lApplicant..~n~(~[~l .~.~.3O ' Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... " Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ........... i ................. Construction on above described building a n~l~ it/~, eets~. ~ '"~.~- --all appli, ~ns. Applicant .... , . ~ ~.. _ ~___..~. ......... Rev. 10-10-78 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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-(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 peoperty 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 New Building ............. Old or Pre-existing Building . .~.. ....... Vacant Land ............. Location of Property ............................ ~. ~/~.~'(...~..C~. ......... ~..¢~..~.. ~... Hou~ No. Stmet Ham/et O~ner or Owners of ~roperty ............................................................ County Tax Map No. 1000 Section .... ~2 ¢ ..... Block ... ~.~ ........ Lot...O~ ~ ....... Subdivision...~/. ~ ~. ~.~..~./~ .Filed Map No... //. ~..Lot No. ~7 ~7.~ Permit No./.~.~. Date of Permit. ~..Applicant..~ ~.~. Health Dept. Approval ........................ Labor Dept. Approval ........................ Unde~riters Approval ..... ~ ........... Planning Board Approval ...................... R~ueA for Tempora~ Certificate ..................... Final Ce~ificate Fee Submitted $ ............................. Con.ruction on above de~ribed building and permit meets all applicable codes and regulations. II/~ A,,,,ca.. .............. FIELDV INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY q. ODE FINAL ADDITIONAL COMMENTS: Regulatory Affairs Unit: Bldg. 40, SUgY--'Room 219~ Stony ~x~o~,. NY "1[794 ...... "(516) 751-7900 A reviev has been made of your proposal York Sta~ei;~partnent of Environmental Conservation ha8 iotmd the __ perceive__ project ~o be: Greater th~n 300' from inventoried tidal wetlands. Landward of a substantial man-~ structure ~O,~e./ b~./~ areater than 100~ in length coustrucZed prio~to September 20, 19~7.J __ Landward of 10' contour elevation above mean e~a level on a gradual, nat- ural slope. __ Landward of topographical crest of bluff, cliff or dune in &xc~e of 10 feet iu elevation above mean sea ~evel. Therefore. no permit under Article 25 (Tidal Wetl_A,de of the Conservation Law) is required at this time since the .current proposal ti beyond Stat~ mnndated Jurisdiction pursuant to ~hil act. H~ver, any additic~d~ voEk or modifications to ~he project may require e permit..It is 7our roopou~l~ili~y to notify ti~is office, in writing, if such additional work of mod~ficatio~8 are contemplated. very truiy yo s, / Daniel J. ~n P~glonal Supervisor of Ragulatory Affairs NE~¥ORK,ST&TE DEPAR~4EN~ OF ENVIRONMENTAL CONSERVATION Regulatory Affairs Unit Bldg. 40, S~--Room 219 Stony Brook, NY 11794 (516) 751-7900 NOTICE OF NEED FOR PE~IT January 3, 1983 Envirenment East, Inc. R.R. Ne. 3 - 3075 Indian Neck Lane Pecenic, New Yerk 11958 RE: James W. Kephen Dear Sir: A review has been made of this Parcel X Proposal to: censtruct a deck onte an existing heme. Location: Geose Creek; Oak Ave., Great Heg Neck, Tewn ef Seutholi Suffelk Ceunty It appears that a permit is required from LTSDEC in accordance with the Environmental Conservation Law(s) indicated below: X Article 15, Protection of Waters Act Article 24, Freshwater Wetlands Act Article 25, Tidal Wetlands Act Enclosed is an ~ppliga~ion form (directions on back), a .Questionnaire and a Co~lete Appl~cati~ Chec~ist for pr~aratio~of a petition ~or per~ miC.?o avoid d~lays, be suh~ all speci~ied information,s included (~ee Checklist) applicable to the ~pe of acti~tity, co~lete an~resub~it alll fo~s wXth plans.' Daniel J. ~rkin Relional ~upe~isor of Regulatory ~faira Enclosure DJL:~T:cz FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 i9F. eermit APPLICATION FOR BUILDING PERMIT Application No.~ ....... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted .~ to the Building Inspector, with 3 sets o£ plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and o£ 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 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 o£ 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 £or necessary inspections. (Signature of applicant, or name, if a corporation) (I~I~ ailing address of applicant) c.c,.,.,¢ IIq 5-8 State whether applicant is owner, lessee, agent, architect, engineer~ntracto~ electrician, plumber or builder. Date ......... 19 .-~..~ Name of owner of premises...~..L...~./'~.'[~.../.(,o./9.//.~ ~ ~ ........................................... (as on the tax roll or latest deed) If ~~o~~ duly authorized officer. (N~ and title of co~orat~office~ Plmnber'sLicenseNo ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................. ...^ ............... . . . .......... .o. . .... .,,. . .,,,_ .............. ............ House Number Street Hamlet County Tax Map No. 1000 Section .... ~:.~. ~ ....... Block ...... / ........... Lot...~-o~. ............. Subdivision.Q.O.~ Z .~. ...~_'.~..~..-v..~ Filed Map No. I/ 7 ~ Lot..'.~.1~.) ........ - ~-~7 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy ..... ~J~ ?, .~.t'i ~. ~."~..q~ .... 9P.;.. ,~ .... ,~f?,- .~../,% .................... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ........... Repair .............. Removal .............. Demolition .............. Other Work... (Description) 4. Estimated Cost .... ~(D..O....~.., ~ ................. Fee ..... ~..~.O~..."~..'~~. ................. (to be paid on Fding 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 ty. pe of use ..................... 7. Dimensions of, existing structures, if any: Front ....... ~7. ....... Rear .. ~..~' ........ Depth ...--~....~. ........ Height .... /~;. .... Number of Stories ........ ./...~.'7_._ .......... ,, .............. . Dimensions of same structure with alterations or additions: Front ...... .~. ......... 'Rear' . ii ~.i ~.. Depth ..... ~.~. ............. Height ..... /..~. ............. Number o.f ~tories ...... /. :~./.7,._,.... i .... 8. Dimensions~q_f e~¢e new construction: Front ...... ~. ....... Rear....~..6/. ...... Depth .../. ~. ........ Height .. ~t. ~'. ....... Number of Stories ......................................................... 9. Size of lot: Front ...... ~.O ............. Rear ~.,O Denth 10. Date of Purchase ...~..//'/~?.~..3.'T-~ ..... "~a~;~'o'r~ir'6~;;' * .~": .... i ........... 11. Zonebrusedistrictinwhichpremisesaresituaie~iill ..... ~'~e*t'~..~.'~j ............... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........... ./t~. 0 ................. 13. Will lot be regraded ...... ~ ............... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .../'fi~x,..l.(q ~/~ .~..~... Address .~..t;,. ]~} ./o.~.<'-/t.S ~:~,~Phone No. ~"/.q.'~ Name of Architect ........................... Address t~' ":"~'~e'ra.. l 0.?.q 1 Phone No ................ Name of Contractor .... ~..-.~.-~. .............. Address . '6,'/5~ ~'4~ ......... Phone No.. PLOT DIAGRAM Locate clearly and distinctly all buddings, 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. STATE OF NEW YJt~RK~/~. ~, ff S S r ............ (Name of individu~ si~g ~n~act) above nmed. duly sworn, deposes and says that he is the applicant He is the ....................................................... 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 ... dayof Notary Public, ~./,.~.c~..~'' ~.~.~_z/,,~oUnty ~ ~_ fy/// Comrni~ion gxpires uarcU a0, 19.~,..,~ / (Si~. 5~ture of applicant)