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Home My WebLink About10675-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20040 Date JUNE 28r 1991 THIS CERTIFIES that the building ADDITION Location of Propert~ 2500-1A MAPLE LANE House No. Street County Tax Map No. 1000 Section 38.01 Block i subdivision Filed Map No. GREENPORT, N.Y. Hamlet Lot lA Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY~ 1980 pursuant to which Building Permit No. 10675-Z dated MAY 14, 2980 ..... 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 PATIO & SCREEN ENCLOSURE ADDITION TO EXISTING DWELLING. The certificate is issued to JOHN T. AHEARN (owner) of the aforesaid building. S~FFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/__A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A.. Building ~nspector' ' 3 Rev. 1/81 FOP~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10675 Z Permission is hereby granted ........ ¢z...c~. ~ ~.. . ..~ ...... ,~. HE~ /~.~. . . ...... ~..Z.~.~.y.~..z~.~.....,,~z,~. ..... ,,~_~....£(~.~..~.....zv:..~....~.. ......... to . . . . .( J. .~. .t.~. s.z: ~. ~..c. .z. . . . . . :.: :.~.~. .z:.t. . c~.,~~ . . . ZTC. . / ~-~ :~. . . . .~ :.,Cz. c. . t- v. ..~. ~J~ ~. . . ........ ...~.~.....~..~z..,, .z:,r,~..~.....,,~..c,¢,,~.//.z,~:b ................................................... at premises located at .~. ,~.~:~.O...,..,~.~'.~t~'~''...~'~;~ ............. ~..~,Zf~....~.../.. ............. ................................................................................... ~>~--=~.,~,~ :,~.,..~.......y..... ................ (.:~. ~c~..,.¢,..x...../.~,zc~..... d. ~ ~,~., .......... bZ...z.~,~..l... ~ ......................................... approved by the pursuant to application dated '/~'~"7 .......... '~-" ........................ ' l~'r~''' and Building Inspector. Form No. 6 BUILDING DEPAR'rMENT ~ ' TOWN I~LL 765-1802 "' A~P~ICATIo~ PO~ CE~IF~CAT~ OF OCCUPAN~ ~~O i. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar b ' · uxldxngs a~d installations, a certificate of Code C~pliance from archiuect or engineer responsible for the building. 6. Submi~ Planning Board Approval of completed site plan requirements. ;. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property sbowing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in Writing to the applicant. :. Fees i. Certificate of Occupancy - New dwelling $25.00, Additions to dwellieg $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2.Certificate of Occupancy on Pre-existing Buildfng - $100.00 3.Copy of Certificate of Occupancy - $5.00 OVer 5 years - $10.00 Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ew Construction ........... Old Or Pre-existing Building.....~.. .......... ooation of Property. ~.~. Go - (& .~.~4f ~.~.~ lIouse No. Street Hamlet .... ,anty ra× ~ap No 1000, Section..3~:~! ..... Block .... [ ........... Lot ..... (..~. ............. ~bdivision ............................... Filed Map ............ Lot ...................... .rmit ~o. ~.7~..: Z . · -. Date Of Permit ................ Applicant. . alth Dept. Approval .......... . ...... ......... Underwriters Approval ......................... arming Board Approval ............... ~' 5''~ ....... 5 ....... C. ~,20~ APPLICANT co ~oo~ 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 ~ocation of a~l buildings, property ~ines, streets, and unusua~ natural or topographic features. , 2. F~nal 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 Planmng Board approval of completed site plan requirements where applicable. B. For existing buildings (p~io~ ~o April 1957), Non~conforming uses, or buildings and "pre-existing" land uses: 1, Accurate survey of peoperty showing all property lines, streets, buildings and unusum 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. Fees: ~ 1. Certificate of occupancy ~'-$5.00 ,/ 2. Certificate of occupancy ohq;~e-e_~g dwelling 3. Copy of certificate of occupancy $1.00 or land use $5.00 New Building .... ~ ..... Old or Pre-existing Building(X) .......... ~/Vacant Land ............ Location of Property ..... ~.,..~..~, .~?..~... .=/ ................. House No. Street Hamlet Owner or Owners of Property ,...~..~~-.~.'~.. ~.-.-~ .~. ~J~..' .~.~'~.... ~/~.~./f,,//~) .~. ~.~../.L,~.~ .~?... County Tax Map No. 1000 Section .... ~..~.: / .... Block ....... ./~. ...... Lot ..... /..~. ...... Subdivision ................................. Filed Map No ........... Lot No Permit No .......... ~.~.~'~Z--~.-. Date of Permit ~../~.~.~.~.~.~.~.~.Applicant ...~,~~.~ff.-~..~.. Health Dept. Approval ........................ Labor Dept. Approval ......................... Underwriters Approval ........................ Planning Board Approval Request for Temporary Certificate . .Final Certificate Fee Submitted $ .................... Construction on above described building and permit' mee~s all .(~,a~le,~ a ~egu lat io ns. Rev, 10-10-78 ~ ' ' ~'~ ' ~ .... I': 45; TOWN OF SOUTHOLD BU1LDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL PLEASE TAKE NOT1CE that yourt application dated ..../~. ~.)..~-~ ......... 19 ..... House No .... / ........... ~e~t / ~ mmlet County Tax Map No. 1000 Section . O.~ ..... Block ~ d ......... Lot .~( ....... Subd,vision /.¢7..~/. ~ Filed Map No ................. ~s returned herewith and d~sapproved on the following grounds ,~ A¢.C~ ~ ~ ~... (~ ..... Building Inspector RV 1/80 FIELD I]~SP~CTIO~ CO~ENTS ~ ''~ FO~ATION 2. ROUGH F~ & PLYING INS~ATION PR N.Y. STATE E~GY cope FINAL FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1803 APPLICATION FOR BUILDING PERMIT £, 3~' ~_O ~. -~-- <' INSTRUCTIONS 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 descriptmn 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 apphcafion, 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 Regulatmns, 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 bmldings for necessary inspe, qtions. , ,0 ,'~ ...... ................. (S~.~ature of applidant, or name, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner ofprem,ses..~'~.&--:~...' · ·. -~.'. ............................ , ............ / (as onb~e tax roll or latest deed) if applicant ~s a corporation, s~gnature of duly authorized officer. (Name and title of corporate officer) Builder'~ License No .... .~.~k)~./.~..'~.. ....... Plumber s License No ..... ¥ ................... ? Electrician's License No ....................... 1. Location of land on which proposed work will be done. · House Number Stree~J Hamlet County Tax Map No. 1000 Section .... ~.~:~../ ...... Block ....... /. ........ Lot.. ~."~.'/.-./ ...... Subdivision.. ~<~-d/~..'~.~'~'~OFiled Map No ...... ~ ..... Lot. ~:~ .... (Name) 2.aState exist~g use and occupancy o~premises and intended use and occupancy of proposed constmc~i°n: Existing use and occupancy~?~~~~..~, ~ ~..' 3. Nature of work (check which apphcable): New Building .......... Addition ....... ,.,. Alteration .......... Repair .............. Removal ............ Demolition .............. Other Work ............... ............. 4. Estimated Cost ......................................... (to be paid on filing this application) 5. If dwelling, number of dwelling Cnits ......... Number of dwelling units on each floor ................ If garage, number of cars ..... [ ................................................................... 6. If business, commercial or mixe~ occupancy, specify nature and extent of each typ/~ of use .............. 1/ ...... 7. Dimensions of existing structures, if any: Front... ~.t~../. ...... Rear .... .z/~ ........ Depth .... ,~. ....... Height .... ~...~. ...... Number of Stories .... ~ ..................................... ~ ........ Dm~ansmns of same structure w~th a __::: addltxo[ts: Front .... ~ ......... Rear ...... ~. .......... Depth ........ ,_~t~..'~. ......:.. HeiSt ...... /f'.'~'. i ...........Number of S)ories .... ..~ ............. 8. Dimensions of er¢ire new constrpction: Front ..... x~.~. ...... Rear ..... .z/~ ....... Depth ..... ~ ....... Height ..... .z/~z). ~. __. Nun~ber of Stories. --., .~-,~.. ......................... ~ ......... 9. Size of lot: Front ~/~,.d~fi~ff/.~0,~./,~.~.. lil~pth ~'j~-~.., ,~.~..~. ...... 10. Date of Purchase ...... ~//,~0/~,~.(/. z. ........... Name of Former Owner .~ .,~-~ ./?~. · .~/~,~. · · 11. Zone or use district in which premises are situated ...... ,,/~.~. ............ ~'. ........ ~.~. ...... 12. Does proposed construction vio~te any zoning law, ordinance or regulation: .... ~$ ......................... 13. Will lot be regraded ....... '/./Z~ ................. Will exce~s fill be removed from premises: , Yes No 14. Name of Owner of premises..~po?~,~. T..z~z~-~... Address . .~-~,~f~,~/.7,,~.~j~f~'f~Phone No... ~.~ ~ .~... 'f~.~.. Name of Architect ...... ;,~ff,~.. ~.~.~. ............Address ,.~'~. ~d?~./.~.,.~Phone No ............ Name of Contractor ..... ,Z//ffi, t~-~. ............. Address ............ ~r/.~z~. Phone No. PLOT DIAGRAM Locate clearly and distinctly all ibuildings, 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. STATIg OF NEW YIDI~K (Name of individual signing contract) above named. sworn, deposes and says that he is the applicant He is the ......................................................................................... (Contractor, agent, corporate officer, 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 cont0ined in this application are true to the best of his knowledge and belief; and that the work will b~ performed in the manner set forth in the application filed therewith, Sworn to before me this ' .......... 7. · .~..~ ....... day of[ ............ , 19 No,a ,?uhl ........................ County