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Home My WebLink About10692-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.. 1.1.09.$ ........... Date;.. 20. Ju~y. ~-9.82 ................... 19... THIS CERTIFIES that the building ................................................ Location of Property .. 2500.Map le. Lane, House No. Street County Tax Map No. 1000 Section ... $6-. 1 ..... Block ,., 1 ........... Lot ... ?D ............ Subdivision ............................... Filed Map No .... .6.7_..Lot No..7.1] .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ·..Ma7.20 ............. 19.8.0. pursuant to which Building Permit No... 10692 .............. dated . .Hay. 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 exisiting dwelling The certificate is issued to ... James. P., Kavanagh ....................................... (owner, lessee or tenant) of the aforesmd building. Suffolk County Department of Health Approval ... n/a .................................... UNDERWRITERS CERTIFICATE NO... n[a ............................................ Rev. 1/81 FORi~I[ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTt~ENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10692 Z Permission is hereby granted to: ..... ~.~.~.-.~..~. .~.~.,~h- ....... /~g.,y,......zz,~. ............................. ...~/~C.. ~.~ ~:7/~'""-1~ ~.~/7~ ................................~;-~ : ........................................... ~ ~m,~o, ~o~.~ ~.~ ~ .....~/2Z~ ~ ~ ~'"./~ ................... ~ ~.~.~...,..~.~x~ ...... .... ~ ~ 7 pursuant to application dated ...~...~ ........................ , 19~ and approved by Building inspector. Fee $../~...~ ..... FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Th~s apphcation must be filled in typewriter OR ink, and submitted in duplicate 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 topographm features. 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 installa- tions, a certificate of Code compliance fr,o.~ the Architect or Engineer resoonsible for the building. 5.Submit Planning Board approval of compleLed 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,c features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any hous,ng code or safety inspection of buddings or premises, or other pertinent informa- tion required to prepare a certificate. /' C, Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-exmting dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date.. New Budding .... Old or Pre-existing Building(X) ....... ~/Vacant Land ............ /~ouse No. z Street .......... ~' ' ' ' "~ .......... / ~ z ~ / Ham/et Owner or Owners of Property . .~. :/,~.~//~ ~_-..~*:...~d.,. /~~-~ ~. ............. CountyTax Map No 1000Section /~ ~/ Bock / / ....................... Lot .... Z. ~ ....... Subdiwsion ................................. Filed Map No. · ~..~...Lot No ............ Permit No./~.~ ~ate of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ...................... ,., Unde~r~ters Approval ........................ Planning Board Approval .................. Request for Tempora~ Certificate ..................... Final Certificate ........ Construction on above descr,bed build,ng and ~ meets all appall:nd regu 'ations. ....... FIELD ~'INSPECTION COMMENTS FOU mATEON FOUNDATION (2nd) t ROUGH FRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 11971 17 June 1982 TEL. 765-1802 Mr. James P. Kavanaugh Box 223 Greenport? NY 11946 - Applicant Dear Mr. Kavanaugh : This is to advise you that the job under Building Permit No. 10692 issued to James F. Kavanaugh on 5-29-80 for deck addition is completed and a final inspection has/~-~ has not/-~ been done. In order to complete this file, it is necessary that a Certificate of Occupancy be issued. Flease 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 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 NOTIFY BL!!I"!'ih~. '"~',,,\ FOR THE FOLLOWING ~'"~'"' ...... ~'" ~,o~. FOUNDATION - I"W:3 ~EOUIP, ED cON ..... FOR pCr, U',¥~D .~ l, M~. ~NG ~, ROUGI4 - F~./x, - 3. IN:~DLA .... ---, MUST 4. FINAl- - coNST~UJ i{ON BE C')Mpi ETF i:OR C, O, ALL coNSTRUCTiON SI'ALL MEET FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined... . .. (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No./.~.d~.2 ....... 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, Ctqlding code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary ig/spections. / 5 (Signature of aplilicant, ~r name, if a cor/p'ora~i~on) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. Name of owner of premises ..... ~..~.~'~ .~.~.~ ~. .... ./.~'..../~ .~.~.. ~.~..~. d ..................... (as on the tax roll or latest d~d) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ...... -~ .~. ............ Plumber's License No ......................... Electrician's License No.../.kt/.4?/~.~-- ........... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .............................. ./~.Y./..~.~..z ......... 17...D ......................................................................... House Number Street Hamlet County Tax Map No. 1000 Section ..... ./..~..~.~..~. ~.' .//Block ........ /. ......... Lot ...... 7. ~ ........ Subdivision ..................................... Filed Map No....~.. ~. ...... Lot....~....~. ..... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed constructign: a. Existing use and occupancy ....... 7./..iT..dAg~../f.~.....~:...~.~. ) .O/.../~. le.~.....~..~. ( .~'/.~...~--~..~.'~vy ...... b. Intended use and occupancy ...... 7-.~'].~//~...,~...5.... ~ ./~ZT...../'~'./..~'.'~....~.~.t/~..~d/.~./... 3. Nature~ of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal ...... · ....... Demolition .............. Other Work ............... ' (Description) 4. Estimated Cost ............................... Fee .............................. ,' (to be paid on filing this application) 5. If dwe!ling, number of dwelling Chits ...... ~..~..~.... Number of dwelling units on each floor ................ If garage number of cars ' 6. If busifiess, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. DimenSions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ..... ~.~..~. ................ , ........................... Dimensions of same structnre with alterations or additions: Front .... .~.. ~.. :.,,~. ..... Rear .................. r)epth .................... '.. Height ............... , ....... Number of StoCes ............... > ...... 8. r)imen~ions of entire new construction: Front ..... /.6...'... Rear ..... ./.'~'...'.... Depth ... ~'.~.. ....... f St Height ............... Nu er o aries ................................................. 9. Size of lot: Front .......... , ........... Rear ...................... Depth ...... ,~ ............... 10. [)ate of Purchase .~..--. ~.-..~. ............ Name of Former Owner .. 11. Zone or use district in which premises are situated ............. /.ri ..................................... 12. Does proposed construction viotate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ......... ~,~'. $:~. ......... , ..... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .~'.[/t"~Z-(/~t'(4'~'.,~ .... Address <~,4t~..'~'[~.,~ ......... PhoneNo..~'.7.7.-:.~..-~..~....,~.. Name of Architect ................. /. ....... Address ~..,r'd~?~'~'~P.~'~. .... Phone No ................ Name of Contractor ......................... 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 according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW, YORK, COUNTY OF..4~.~(t~..~..~*t~ .... S.S ........ i .~7~A?.~./?..~...~.,....~.~.~; .td.~.~.~..~. ~ .......... being duly sworn, deposes and says that he is the applicant (Name of individual sighing contract) above named. He is the (Contractor, agent, corporate officer, etc.) of said owner or owners, and is ddly 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 of ...... ~./OC.~.. ........... 19 ~.~, Commission Expires March 30,