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Home My WebLink About10341-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z-16119 Date September 2, 19.87 THIS CERTIFIES that the building Deck & Bedroom Addition 2305 South Harbor Lane Southold, New York Location of Property/tD[~s'e ~]o~ ....................... 'S't/e~i ....................... P~rbie~ County Tax Map No. 1000 Section 75 .Block 4 .Lot 24 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated August 2, 1979 pursuant to which Building Permit No. 10341z dated .... .... Aug..............u s t 3, 1979 ...... 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 ......... DECK & BEDROOM ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to ..... ALBERT T. & MARIAN Ff. FICKEISSEN ................ X X ................... of the aforesaid building. Suffolk County Department of Health Approval N / A PENDING UNDERWRITERS CERTIFICATE NO .................................................. N/A PLUMBERS CERTIFICATION DATED: / Building Inspector Rev. 1/81 FOP, M NO. 2 TOWN OF $OUTtlOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~,EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ]~ISULATION FRAMING [/"] FINAL ..5 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1803 ..... , ...... Disapproved a/c ........... (Building Inspector) APPliCATION FOB BOILDI~G PERMIT Date .... ~? .......... 19~. INSTRUCTIONS a. This application must be completely filled in by typewriter or 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 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 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 necessary inspections. , , (Signature of applicant, or name, if a corporation) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. Name of owner (as on the tax roll or ~~EP. If applicant is a corporation, signature of duly authorized officer. N~I~70 B~JII.DING ~ ........ DEP~RTMffNT~ ~AT 765~0~ 9 AM TO 4 PM FOR THE (Name and title of corporate officer) Builder's License No....~x. · ~. ................ Plumber's License No ..... .~..'. ~ .......... Electrician's License No ...... ~.. .......... Other Trade's License No. ........ "~ ........ FOLLOWING IN'SPECTIONS. l, VOUNr~ATION ~ TWO REQUIRED FOR ~'OtJRED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3, IN~IJI.ATIC~N 4. FINAL - CONSTRUCTION MUST DE C~MPI.FTE FOR C. 0 ALL CONSTRUCTION SHALl. MEET TFI[ REOUIREMENTS OF THE N Y. ~TATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FO.R.. 1. Location of land on which proposed work will be done ................. DESIGN'OR'CON'SYR'0~?[(~ d o .¢--o. . ? . H o . . .,, ,.% o.o/ z:./.j, o.z.. ..O . /< ................ H~e' ~nber Street .............. Hamle~ County Tax Map No. 1000 Section .... ~. ~.~. ......... Block .... .~.. ........... Lot.. ~.~.. ........... Subdivision ................................. Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occup, ancy of proposed construction: a. Existing use and occupancy., ./..~.~.t:~/.~/~..~.~. ~..1..~./t.~/.~...//,~/; ............/ ]" /'o . .. rg. · .~ ................ b. Intended use and occupancy ......... ..~...~I.. ~...~.....~'./(?,-~--4~..~'~,~(...../~J~...~ ........ 3. Nature of work (check which applicable): New Building .......... Addition ...(,,~'f..... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... , (Description) 4. Estimated Cost ..... ~ c, .O ......... ' ............... Fee ................................ ' ' ' (to be paid on filing this application) 5. If dweliing, number of dwelling units ..... ./. ........ Number of dwelling uhits on each floor .... ..' ........... If garage, number of cars ........................................................................ 6. If business, commercial or mixe4 occupancy, specify nature and extent of each type of use ............ , ......... 7. Danens~ons of ex~st~ng structure~, ~f any: Front....'-~.,,~ ......... Rear ....'~ .......... Depth ........... i~ll~e~ si a e structu or itions: Front... ~;;~ 8. Dimensions of entire new construction: Front .."'; .~.... ........ Rear ............... Depth ............... Height ................ Number Of stories ................. : ...................................... 9. Size of,lot: Front ..... ~-~,. i ........... Rear .... .7.,,~.' ............. Depth . ~.~..~.. ............... 10. Date of Purchase ..... ~.~. ,'2'. !.~/. ............... Na~ne of Former Owner ,~ff?.~v£~/..~... 11.. Zone or use district,in which pren~ises are situated, ,,,~..~J~,,~. ~ ~.//~t/,-~.~ .... '.:/...' ..... ~.".. ~ ......... ' 12., Does proposed construction violate any zoning law, ordinance ~r regulai~oni .. ~. & ......................... 13. Will lot be regraded ........ ,~.9 .............. .x Will excess fill be removed from premises: Yes ~No 14. Name of Owner of premises~lA~ tO'~/~-/.~,to~;[4~.t$1r~;~ddress . ~ ............ ~: ....Phone No .... ,~..: .....¢;:... . Name of Architect .......................... Address . .' ................. Phone No ............. '.,. Name of Cont~aatOr, . . .~../~--/,/?7vt. ,~ ~-~..' $. ~.~.'... Address ................... Phone No. ,/"2' ~.~.-~.'.~., ,~'~'-. ~... PLOT DIAGRAM Locate clearly and distinctly all i buildings, whether existing or proposed, and, indicate all set-back dimensions from tumber or description according to deed, and show street names and indicate whether property lines. Give street and block interior or corner lot. t~ STATE OF NEW YORK, COUNTY OF ................. iS'S ...... ...... 'C,, ,x,,: ,,.. ..... tz ........ i (Name of individual signling contract) above, named, i being duly sworn, deposes and says that he is the applicant (Contractor, agent, corporate 6fficer, 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 contained in this application are true to the best of his knowledge and belief; and th3t the work will be performed in the manner set forth in the apl~lication filed therewith. Sworn to before me this ~ .day o( ..... ~ .... 7/. . .-; .~.' ...... 19..'. Notary Public .............. County ~nETTE ¢. CtOllRO'f .......................................... -IqOTARY PUBLIC, State of New YorI~ , (Signature of applicant) Suffolk Couuty BIo. 52-579~$00 ~ ] ~nm, i-,,e~ion Ex[circa Match ~0, l~,t~'~ L .q FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m~ to the Building lnspec- tot 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 p~operty showing all property lines, streets, buildings and unusual naa~ral 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. (.JPCertificate of ocCupancy New Dwelling $25.00, Accessory ,$t0.00 Business $50.00 2, Certificate of occupancy on pre-existing dwelling $ 50,00 3. Copy of certificate of occupancy ~ 5,00, over 5 years $I0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewConstruc tion Old or Pre-existing Building Vacant Land House No, Street Hamiet Owner or Owners of Property County Tax Map No. 1000 Section ....¢. ?.~.". ...... Block ., . Z/{. .......... Lot. ,~2. ,~'. .......... Subdivision ................................. Filed Map No ........... Lot No ............. Permit No. I.o..,~/. .... Date of Permit .~.'.3. ~ 7;¢, .Applicant ,..~t~,~. ¢~--7.... ,~t,q ./~. ?,~..~? ............ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. 33071