The URL can be used to link to this page

Home My WebLink About10347-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Zl 1532 Date Flarch ? 19,8,3, THIS CERTIFIES that the budding Addition Lo ..... q~O0 Isla~dview Lane Greenport, N.Y. canon o~ vroperty h3tJs'o 'N'o ......................... 'trl .............................. · $eet Hamlet County Tax Map No. 1000 Section ... 9.5.? ..... Block .... .0.2. ........Lot .... .0.!0. ......... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... .g..u.g.~.s.t...7. .... , 19~.9.. pursuant to which Building Permit No ..... '1.0..3./4.7.Z. .......... dated . .A.u.g.u.s.t..7. ................. 19.79., 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 ......... r I porch enclosure on existing foundation o£ dwl~. The certificate is issued to . . . .J.a.m.e.s...]3.qn...d.a.r. qh..u.k ..................................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .,..37./.A. ................................... UNDERWRITERS CERTIFICATE NO .................................................. .../. .... -.~:i ...... Building Inspecto~r Rev. 1/81 FOENI NO. ~ TOWN OP SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10347 Z Permission is hereby granted to: / ,~ ~ __ .......... .~~ .......... ~:~.~.~ ,o ....~.....~~.~ ~~~...~.~~ · ............. ~ses located at ~-.~.~..~:; .............................. ................. ~ pursuant to application dated ...... ~ ....... ~ .......... , 19.~, ~nd approved by the Building Inspector. Fee $./..~..~..~ ...... ~~Jnspector - ~ 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--(S-9 form or equal). 3. Approval of electrmal 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- t~on required to prepare a certificate. / C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date ....... New Building ............. Old or Pre-existing Building(:~) . _. ~.. -- ~/Vacant Land -. ........... Location of Property .... /'.//~ ~0 .... ~/'"¢/'¢:.f)'44¢¢..~-/z~/../~-~/~/~. ..... '...~z~.4~tY'/.~q ~-7~'~ .......... House No. Street Ham/et Owner or Owners of Property , ~!//..l::T¢. .~L/~:.Z.. Z.,/<~._./~OA~/~¢¢.~ ~/¢~/¢/~ ................... County Tax Map No. 1000 Section ..... .(~.' .~ ~7.... Block' .....E~...~.~. ...... Lot .... .o. ,/.(3. ....... Subdivis on -';; ·. :. .Filed Map No ........... Lot No .............. Permit No. /.~. ~.z~.Z.. Date of Permit ,~/..~,~.~.~..Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ...................... ,., Underwriters Approval ........................ Planning Board Approval .................. , .. ~ Request for Temporary Certificate ..................... Final Certificate ..... ckS.- ......... , Fee Submitted $ .... ~ ~ .................... Construction on above described building and permit' meets.~app~z~le~c_.o.des and regulations. Applicant.; .;..~.~_,. ,/.. , ..~. ,.,~. ~ ...................... Rev 10-10-7a TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 11971 TEL. 765-1802 This is to advise you that the job under Building Permit No. ~ issued to on ~]?/?U for ~¢~ -~c~ is completed and a fingl inspection has/--7 has not/~ been done. In order to complete this file~ it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form(s), return same to the above office with a check for $5.00 payable to the Town of Southold. Please indicate to whom the Certificate of Occupancy is to and arrange with this office for an inspection date. Thank you for your prompt attention. Very truly yours, Victor Lessard Adm~nis trator VL:ec Enclosures be mailed, Al) DIT~c.~N/AL (~ D L/t lV~, ~- I''J'T'''J¢ .... Examined. ~..,~. .... ,19 (./ Approved .... 7 .... ,19 7/?Permit No.../.~..'~..¢:~ APPLICATION FOR BUILDING PERI,lIT FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Application No..../.t?..~.~.: .... 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 necess~n~ spections. _ £? ,~ ............... ./~ {~S~ature of applicant, or name, if a corporation) ......... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........ ............................................................................. Name of owner of premises ...~.~.'.~/.~...~.../Y.~f.[/.~..~. '. g/~.~o..~.~g).~..~.{ .p~..~. J~ ................................ (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 ...... .~.~.~. ~ .~.. .......... t Plumber's License No ........ .] / Electrician's License No ......I' ................ Other Trade's License No ...................... 1. Location of land on which proposed work will be done....//~ .~.C?..../..~.j, .~..~>/.~...I/j.~.b.~G. ~./.ff. ~. .......... .. ............ /. .>/ : House Nmnber Street Hamlet County Tax Map No. 1000 Section . .~..~'7 ........ Block ...t~...,~. ........... Lot..~. {.~ ............ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ... Jiq.~,~ l/2.~/-e£/~t~..'..":'. ............................................ b. Intended use and occupancy ~J~TtQ~.."T..~.-./d.(.~.~,5'./~.~../~. ¥.~7'/~. ~.' ' 3. Nature ~f work (check which applicable): New Building .......... Addition....~. ..... Alteration .......... Repair .............. Removal ............... Demqlition .............. Other Work ............... ~ i ~.~./..~-? ~, .~. ,.~, (Description) 4. Estimated Cost ....... ~...(J. O. { ........................ Fee ............................ (to be paid on filing this application) 5. If dwelling, number of dwelling ~nits ........ ~ ....... Number of dwelling units on each floor... / ............ If garage, number of cars ..... i ................................................................... 6. If business, commercial or mixed occupancy, specify, i)ature' and extent of ed, ch type of use ......... i ............ 7. Dimensions of existing stmcturei, if any: Front ~..~..+. 1~ :.¢q/.~?... Rear,JA ~g.~!~. *..'4~'~./'. Depth .., A .{'. ~ ......... Height.. Z~; ........... Number of Stones .... / ................. D~mens~ons of same structure w~h alterations or additions Front .~,&....~..~. ~' ??/~. ...... Rear . Depth ...... 2 ¥. ~. .......... !.. Height .... ~ ' //~. ............... Number of Stones~ ............. ~ .....,. 8. Dimensions of entire new construction: Front . 771 "~!: ~'~r,, ~' ~r~ear '/:4 t:~.,~./,~'! ': ?~epth ...~ ?.. (./.~ Height /d ~. e;, ~0i, ,o~ .r Number of Stones .... ;~ .......................... ~ .............. 9. S~ze of lot: Front ...... ~ ...: ............. Rear ...................... Depth ..... ". .......... .10. Date of Purchase .............................. Name of Former Owner ............................. 11.. Zone o~ use district in which premises are situated ..................................................... 12. Does proposed construction v~o, la~te any zoning law, ordinance or regulation: /Vr~ . .13. Will lot be regraded ......... -~ ........ . ......~. :..,. ,~i~l~excess fill, be remp;/~,f~2~.~r~jldses: Yes No Name of Architect ......... ; .... ; ............. Address ................... Phone No....~. 7.,7,..y'..~7~.. Name of Contractor ....... :,, ....;.: ..... ; ....Address ................... Phone No .............. PLOT DIAGRAM Locate clearly and distinctly all ibuildings, whether existing or proposed, an& indicate all set-back dimensions from property lines. Give street and block humber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK .... ~.'-:,.; .~--'/~..;~.~..[.. ~ ....... ,~,.. ¢.. being duly sworn, deposes and says that he is the applicant '' ~'(Nam of indivi~fl~ng above ~ed. He is the ~ ~ ¢~ (ContraCtor, agent, corporate officer, etc.) of said owner or owners, ~d is dul~ authorized to perform or have perfo~ed the said work and to m~e and file this application; that all statements contained ~, this application are tree to the best of his knowledge and belief; ~d that the work will be perfomed in the manne~ set forth in'the application filed therewith· Swo~ to ~efore me this ,. ........... ....... NOTARY PUBLI~, St~te of N~ (Signature of applicant)