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Home My WebLink About10426-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z1729t Date SEPT. 13~ 1988 THIS CERTIFIES that the buildin~ADDITION TO ACCESSORY Location of Property 17130 NEW SUFFOLK AVE & 600 SECOND ST. NEW SUFFOLK House No. Street Hamlet County Tax Map No. 1000 Section 117 Block 09 Lot 28.1 Subdivision XX Filed Map No. XX Lot No. XX conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPT. 25~ 1979 pursuant to which Building Permit No. 10426Z dated OCT. , 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 ADDITION TO ACCESSORY TWO CAR GARAGE. The certificate is issued to JOHN BONNAR (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED Rev. 1/81 Building Inspector FOI~M NO. ~ TOWN OF $OUTHOLD BUILDING D£PARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10426 Z ,o ..~~..~-..F~.....~JZ~.....~..~:o ........ o, ~ ,o~,~ o~ ..~..,..~.,..~o..~.~.~. ............................................ ........................................ ~.~.~.o...~~-~ .................................................... Building Inspector. uilding nspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hail Southold, N.Y. 11971 7a7 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 natu raj 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 instaila- tlons, 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 alt 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 certihcate. Fees: 1. Certificate of occupancy $5.00 2. Certihcate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1,00 $5.00 Date New Building ............. Old or Pre-existing Building(X). ~ ....... =/Vacant Land -. ........... Location of Property Hou~ No. Street Hamlet County Tax Map No. 1000 Section ..... //.~ .... Block'. ....... Y ...... Lot .... ~..,. Subdivision ................................. Filed Map No ........... Lot No .............. .......... , /rz Permit No. /a <~ Date of Permit .... Applicant ...; ......................... Health Dept. Approval ........................ Labor Dept. Appro~/al ...................... ,.. Underwriters Approval ........................ Planning Board Approval .................. Request for Temporary Certihcate Final Certificate Fee Submitted, ............................. Construction on above described building and permit' des and - '~-~ -~7----~' ~0 Applicant., .... ,. ...... Rev. 10-10-78 ~'~ ~ regu lations, Fi ~,u A 1,. 765.-~802 BUILDING DEPT. INSPECTION FOUNDATION ~.ST ~- ] ROUGH PLBG. FOUNDATION ~ZND [ ] INSULATION FRAMING [ ] FINAL INSPECTOR FORM NO, 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined . .~ ...... , 19 Approved C~.~.~ ~ .~...~. ..... ,19..~Permit No.7' Application No./L~ .~.~ ........ Disapproved a/c ....................... -~7 ...... ;,..~'. ............. ......... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ~//~f~' 7~. .................. , 19 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, w~th 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 Pel~nit. 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 braidings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, bujtfl~ng code, housing code, and regulations, and to authorized inspectors on premises and in buildings for necessary~i~s}/Ce~ons. _/,4~ admit .... ..................... ~Signat'fire'6f 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 .~..~.~..~1...~,..+..~.~..~.~..L...~-~. ~.~. ~:}.g ........................................... (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 .......................... PJumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done. C'~t~/dd(.~..~ ~ -/~..~'~. r..~._~..~...~, dT~ .................. .................. ................. Itouse Number Street Hamlet County Tax Map No. 1000 Section..·/.L.7 ......... Block ..... ~. ........... Lot..~. 0~.-. ~ ..~./ ...... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed ¢enstruction: .................. , / , b. Intended use and occnpancy ...~,~/~..~ .~. ~..~../..V?...-~. ..... ~ .......................... z 10. 11. 12. 13. 14. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ........... Repair .............. Removal .............. Demolition .............. Other Work ............... : (Description) , (to be paid on filing this application) If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars If business, commercial or mixed ioccupancy specify nature and extent of each type of use .......... ~ ......... D~menslon§ 9f existing structures, if any: Fron .t~A?.../.~ ........ Rear .~:~.... ~. ....... Depth ~ ........... Height/.'~'ff. ........... Number of Stories .g ..................................................... Dimensmns,of same structure wl~h alterations or,ad&nons: Front ~-*h* ............. Rear .,.;'~o.r. ........... Depth .' ..................... Height ./. ................... Number of Stories. E ................... Dimensions of entire new construction: Front/..~f. ........... Rea,/~ .: ........... Depth ;2~. f. ......... Height ............... Number of Stories ........................................ , ............... Size of lot: Front . ~.J ................... Rear . Date of Purchase . .f..~.~. ?.... Zone or use district in which premises are situated ............................................ i ........ Does proposed construction violate any zoning law, ordinance or regulation: Will lot'be regraded .~./~ ...... , ..... ~...~.~ ..... Will excess ~11 be removed frpm premises: jr'es No Name of Architect .......... ~ ................ 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 accordin :to deed, and show street names and indicate whether interior or corner lot. STATE OF NEWcSiORK, ~gName of individual signing contract) above named. being duly sworn, deposes and says that he is the applicant He is the .............. I (Contractor, agent, corporate officer, etc.) of said owner~ot~owners, and is duly a~thorized to perform or h,,a,~ performed the said work and to make and file this applicationi th~t~211 statements contained[in this application are t.~ tb lge 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