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Home My WebLink About10691-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Otr Occupancy No....1-1~99. 6. .......... Date ...... .~.ay..2.0 ..................... 19 .82. THIS CERTIFIES that the building ................................................ Location of Property .. 2599.i~i0-p .lc..Lave,. Srecrtpgl:l: ,. I31¥.. tJr~il:..8.-13 ..................... House No. Street Hamlet County Tax Map No. 1000 Sechon ... 38.1 ..... Block ... l ........... Lot . 81) .............. Subdivision ............................... Filed Map No...kg .... Lot No...SD ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ ~ay 20 ....... , 19 .8.0. pursuant to which Building Permit No. 10691 ................ dated ...gay. 29 ................... 19.8.0., 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. exis ting. dwe i ling ........................................... The certihcate is issued to .. James. P., Kavanagh ........................................ (owner, lessee or tenant] of the aforesaid building. Suffolk County Deparhnent of Health Approval .. n/a ..................................... UNDERWRITERS CERTIFICATE NO .n./a ............................................. ................. Rev. 1/81 FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTN~ENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT (DH THE P~EM[SES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10691 Z Permission is hereby granted to:,~.~_ ~-,,,. ...... ~/,~....~.. ,6~.~,~..~.~... ...... .../~.~....zz~ ............................. ~c~ccz~/~.~.......-.......-/.~.~.~......~.~.~. ~......~kz~, ~ z/~ ........................................... ~, , __ j_ / .,.,'"~ ,--..,/ ..~...~ M. at premises located at~...~"~.~.C_f~.....~,C../,f-/~'....~'~l',"~"~~:5~''' '~ ~ ~/~:Z.....~:.~ ................ ./. ............................ / pursuant to opplication dated ..~.,~...~..0 ........................ , 19<~/~.., ond approved by the , / Building Inspector. 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 w~th 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 disposel--{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- tmns, 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 topograph ic 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 inspectio, n of buildings or premises, or other pertinent informa- tion required to prepare a certificate. 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy S 1.00 $5.00 D ate ....... Ne,>/ Bui!d,ng .... [.~.~. ¢?, ,/~', Old or Pre-existing Building(X) ....... ~ ~Vacant Land -. ........... Hou~ No. ~. Street Subdiwsion ................................. Filed Map No ..... Lot No ........ Permit No./."~/.~. Date ofPermi, ~/ZR (~¢plioant ~4~ Health Dept. Approval . Labor Dept Approval Underwriters Approval ........................ Planning Board Approval .................. ~ .., Request for Temporary Certificate ..................... Final Certificate ........ - ......... , · ./ ¢ Fee Subm,tted $ .... /.~..~ ...... .~. ?.¢~...J.3....~ I0~2 ~ Construct,on on above described budd,ng and per.eels all anp~oa~and regulations.~ FIELD I~SPECTION !. FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY CODE % 4. FINAL COFIMk~NT~ ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O, BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 16 June 1982 TEL. 765-1802 James P. Kavanagh Box 223 ___Greenport: NY 3]qAfi - Applicant Dear Mr. KavsnaCh _: This ms to advise you that the job under Building Permmt No. 1069~ issued to James P. Kayana~h on 5~29_89! ~for deck ms completed and a final inspection has /~7 has not/~7 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 $5.00 payable to the Town of Southold. Please indicate to whom the Certmfmcate of Occupancy is to be mailed~ and arrange with this office for an inspectIon date. Thank you for your prompt attention. Very truly yours, Victor Lessard Administrator VL:ec Enclosures 4. Y- ~OR ~.0~-$. N- ' ' o,z~-- ..q ............................... .o~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180'3 Examined .... Application No. ........ ~ Cr~ ~ ~~ Date .... ~.T[~. ~..., 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 delnolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, bui~jng code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary i~;s~ctions. ~(.2~,~ /~ ...... J /('Sigffature o f apphcant, o~ nam e, ifil/corporation) j ./.... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................... ........... i ..................... ;g .......................... Name of owner of premises ...... 41 '~'~'~*'/~"~"'- '~' "' '~' '~" ' '~' 'J'~' '~' :~'' '7 ........................... (as on the tax roll or l~est deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..... .~': .~../-..~. ............ Plumber's LicenseNo ......................... Electrician's License No.. ?~_~) ~ ~.~. Other Trade's License No ...................... 1. Location of land on which proposed work will be done. ~¢.-~Z~.,~',~. ~.....~.~..~..~.'~.~-~./~b¢/~./. t~./../~..J?.~[. House Number Street Hamlet County Tax Map No. 1000 Section . .~/~.~7~2....~..~: ./... Block ....... 4 .......... Lot .... . .~. i~/~ ......... Subdivision ..................................... Filed Map No... ~'.~ ....... Lot....<fir. ~. · ....... (Name) 2. State existing use and occupancy of premises and intended use ~nd ~q, oupancy ~f proposed construction: a Existing use and occupancy . .. 7.././.~.d¢. ~/~.~?. .'~. · · · 4.~..~..~?~,/~..~.'~..~..~..'?..~..~./?.~:.~. ........ b. Intended use and occupancy ..... .~ .... J~../~...J~..~ .~... ~...~.~././.~'./..~..'~.. ,~.~..~..~ .~..~. ~.~ ....... 3. Nature of work (check which applicable): New Building ..; ....... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... ~ ] (Description) 4. Estimated Cost ........ .~....x~.. .................... Fee ...................................... i (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 ......................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structure!s, if any: Front ....... 2~ '~)c ~' Rear .............. Depth ............... Height .......... Number of Stories ........ '~' ' '~' '~ ............ " ......................... i ' Dimensions of same structure with alterations or additions: Front ... ,~. t .3. ....... Rear ............... ' N St Depth .................... :.. Height ...................... umber of eries ...................... 8. Dimensions of entire new construction: Front ...... /.'~. ..... Rear .. ~..~'.. ....... Depth .../..~. ....... I-[eight ............... Number of Stories ........ ~J~..<~. ......................................... 9. Size of lot: Front ..... ' . . Rear ...................... DepJ~a >~ ./)/~ma#~,.~_~-Z~.7-~a_q- 10. Date of Purchase ...... .~..'..~. 7..~ ....... Name of Former Owner ...d~.t. ~..~'~.Jt¢7.~-t'~'/~.~g.~' ....... 11. Zone or use district in which prqmises are situated ............ ~tt']... '7 "~'~'~' ~' ........................... 12. r)oes proposed construction violate any zoning law, ordinance or regulati'6n: ................................ 13. Will lot be regraded ....... ~ 'i '/>~ ' ~.t7 ..... , ...... Will excess fill be removed from premises: Yes No 14. Name Of Owner of premises ~/.i.?l'~/~q~. ~ .... Address ................... Phone No. ~. ~..~.*..~..,~..-.,~.. · Name of Architect .......... . ......... / ....... Address ................... Phone No ................ Name of Contractor ' Address Phone No Locate clearly and distinctly ali property lines. Give street and block interior or corner lot. PLOT DIAGRAM buildings, whether existing or proposed, and~ indicate all set-back dimensions from number or description according to deed, and show street names and indicate whether STATE OF NEW YORK, COUNTY OF. ..... (Name of individual above named.. S.S ting contract) being duly sworn, deposes and says that he is the applicant He is the ..................... ~ ........................................................ ~ ........... (Contractor, agent, corporate officer, etc.) ~ ~ of said owner or owners, and is dally 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 that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this : ............ ........ day 9f, .... ......... 19¢?. Notary Public ~'~..~.~ ..... '"C~//2 ,//?/'// j . , NOTARY PuuLIC~.~t'-~,R~:~'l~e'r~rr~g//'. . ~'~ .~.r.~..%~.,-./. ~ ....... I ' N~'52'~524,,7~ (Signa~r~'o f applicant) ' I Quailed m Scfl~lk County ~/ Comrnissl n E~N~I~s March,a0, 198~,~_~ ,