Loading...
HomeMy WebLinkAbout10810-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hal% Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17167 Date AUGUST 5, 1988 THIS CERTIFIES that the building Location of Property 745 House No. Count~ Tax Map No. 1000 Section Subdivision ADDITION CEDAR DRIVE EAST MARION Street Hamlet 22 Block 2 Lot 42 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 20, 1980 pursuant to which Building Permit No. 10810Z dated AUGUST 4, 1980 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 ADDITION TO EXISTING DWELLING. The certificate is issued to THOMAS & PATRICIA CROWLEY (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH ~PPROYAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A Rev. 1/81 B~i~ld~Inspector BUILDING~ P,ERMI1 (THIS PERMIT MUST BE KEPT oN '~H.E P~EA COMPLETION OF THE WORK AUTHgRIZED) N9 10810 Z Permission is hereby granted to: ' , ........ ~o.7~.-.....T~.,~.~.i .r. ~ -- ~ ~c ~.. ~o ...~~..,< ................ ~....~~a~. · .... ~...~zz,~; ............ Z~ ............ klS~S UNTIL EULL Building Inspector. F~ ,.../....w...~ ........ Rev,, 6/30/80 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 Inspec- tor w~th 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 instaila- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5.Submit Planning Board approval of completed rote 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 property showing all property lines, streets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner as to use, occapancy 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: Additions $25.00 POOLS $25.00 ALTERATION $25.00 ]. Ce~ificete of occupancy New Dwelling $25.00, Accessory ,$I0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewCons tPuc %ion ...... Old or Pre-ex{st{rig Bui~d~ng ............ Vacant Land ............. Location of Property .. ~.q~.....~...~... ./.~..~. ............................. Owner or Owners of Property . .'~..~..~ .~..'~..~,'~. (~'~. ........................... County Tax Map No 1000Section CZZ- Block d ~..~ ...... Lot ............. Subdivision ................................. Filed Map No ........... Lot No .............. PermitNo ...... ate of Permit .?:,~). .... Applicant ,~,, ~e.! o ........ ............. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certify, cate ...................... Final Certificate . .~... ................. Fee Submitted $ ..... ~ .... C°nstructl°n °n ab°ve described bu ilding ~mit meets~12P..P:i~,e codes and regulations. c© /?167 TOWN OF, $OUTLiOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL, 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. /_~.An application for Certificate of Occupancy is not on file. JNo Underwriters Certificate on file~ The check is(outdated/n~ot o]~ /5/ No tIealth Dept. Approval on file. /-~/ NO final inspection bas been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit # ~_ ~,. ~_,__(_ .~,, Z Building Dept. No Plumber Solder Certificate on file. all permits involving plumbing being issued after April 1,1984 ) 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION [ ] FRAMING REMARKS: [Z~NAL FIELD INSPECT~0N COMMENTS FOUT~DATION FOUNDATION 2. ROUGH FRAME & PLUMBING (2~) INSULATION PER N.Y. STATE ENERGY cope 4o FINAL ADDITIONAL COMMENT . FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 TEL.: 765-1802 Approve~©¢ .... ?: ..... , Pc=it ...... Disapproved a/'c .... (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No. ~c~.¢.: ~. (.-. ........ INSTRUCTIONS a. This application must be completely fiIled 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 applicatlon 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 demo~on, as herein described· The applicant agrees to comply with all applicable laws, ordinances,~e, housing cqae~ a~nd regulations, and to g o?..c....~.:.-...~.......~..~. (Mailing address of applicant) ~ State whether applicant is owner, lessee, agent, architect, engdn~r, general con.~tractor, '~]ectrician, plumber or builder. :::::i ...... .... ........................ If applicant is a corporation, signature of duly authorized officer. Date .................. 19 ~f'0 (Name and title of corporate officer) / Builder's License No .... ...~... f..~...f.~ .~ / Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. · ...~...~:~: ................ .C ~.¥.~ ..... t.~. ~.,::~ ........ .:..~.~.. House Number Street Hamlet County Tax Map No. 1000 Section ..... O..~....~'..... Block ...... ~ ......... Lot ...... .~.....~--7.. Subdivision .................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a, Existing use and occupancy .......... . .~..~..~..~.*..~...-~..~..~._~. ..................................... b. ,ntended use ~nd occupancy ......... ~...~..~.:.. d..~. ~.~. .... ~...,.' 7Z, .... d.~ ?.~ ...... 3. Nature of work (check which applicable): New Building .......... Addition ...... ¢ ,; ..... Repair .............. Removal .............. Demolition .............. Other ~/ork. 4. Estimated Cost ....................... Fee .......... ;.. ................... (to be paid on f~iBg this application) 5. If dwelling, number of dwelling 3nits ............... Number of dwelling units on eac~ ~oor .............. If g~age, number of cars ..... ' ............................................ 5~ '~?.~ ................... 6. If bus~ness, commermal or m~xea occupancy, specify n~ure ~d extent of each ty~e of ua~} .................... 7. Dimensions of exist~g-stmctures, if any: Front . ~..~ . Rear ~ B :;¢~ 'Depth ~ ~ . Height .... ~ ...... Number of Stories ........ ~ ............................................. Dimensions of 39¢e structure w~th alterations or additions: Front ...... ~..~. ..... Rear ... ~. ~ ......... Depth ..... ~.~ ............ '.. Height ... ~...,...t ..... Number of Stories ..... ~ ............. 8. D~ensions of ~ti~q new construction: Front ..... ~ .~.., Rear ....... ~.2 .~.. bepth .... Z .~ ....... HeiSt .... [ ~. ~ ..... Number of Stories ........................................................ 9. Size of lot: Front ...... [.O. ~ .......... Rear ...... [ ~..Q. ......... Depth ... [. 10. Date of Purchase ...... ~.~'.. · 7 ~ .......... Name of For~e[ Owner ~ .... ~ ....................... 11. Zone or use district in which pre.mises are situated ...... ~ ~. ,..~ ~.~.~. ( .,~. ~ ................... 12. Does proposed construction violate any zoning law ordinance or regulation: ......... ~(~ .~ ................ 13. Will lot be regraded ........ :.. .................. Will excess fill be r~moved from premises: Yes No Nme of Architect ........ . .................. Address .................. Phone No ................. PLOT DIAGRAM Locate clearly ~d distinctly ~1 :buddings, whether existing or proposed, and, indicate ~1 set-back d~ensions from prope~y ~nes. Give street ~d block number or description according to deed, and show street nines and indicate whether interior or corner lot. STATE OF NEV~'~RK,,/ COUNTY_QOF~.. .... ~~1'~'' being duly sworn, deposes and says that he is the applic~t above named. He is the ............... ~ .................................................... ;~ ~ -(Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly authorized to perfom or have peffomed the said work and to m~e and file this application; t~at all statements contained ~ this application am true to the best of his knowledge and belief; m~d that the work w~l be peffo~ed in the m~ner set fo~h in the application ~ed therewith. Sworn to before me this ............ ~ .... day of ......... ~ ..... , NOIARY PUbiC,State of .o. Term ixp~*es Uar~h 30, 1'9~, Environment East PETER R. STOUTENBURGH 310 Akerly Pond Lane Southold, New York 11971 516-765 -3252 APPROVED AS NOTED NOTI~ BUILDING DE~TMENT AT ~6~-1802 9 AM TO 4 PM FOR THE FOI ! r)w'tlNG [NIc-r~ECTIONS' 1. FC'It','"'~,'"IqN ,- TWO REQUIRED FQ~ r,,~[,j,~ CONCRETE 9, R~UC'-~ - FRAMING & PLUMBING Al [ C'~:,,'~p' :CT~ON SHALL MEET THE gTATE CONcTRUCTION ~ ENERGY CODES NOT RESPONSIBLE FO~ DESIGN OR CONSTRUCTION ERRORS, ~z z o~° DRIVE "~ 6, lO' 4,6'00" E.