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Home My WebLink About11054-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z10756 October 30 Date ................. ; ............... 19 ... THIS CERTIFIES that the building ................................................ 1170 North Sea Drive~ Southold, New York Location of Property/:/~s~ 05/* 05 010 County Tax Map No, 1000 Section ............ Block ............... Lot ................. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated March 6 , 19.8. ! pursuant to which Building Permit No. 1 1 054 Z March 16 81 dated ............................ 19 .... 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 Dwelling The certificate is issued to Joseph W. and Patricia E. Dwws ..................... ..................... of the aforesaid building. N/R Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO... N / R Building Inspector Rev. 1/81 BUILDING DE~P~RT~E~T TOWN HALb SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES COMPLETION OF THE WORK AUTHORIZED) 11054 Z Date ..... ...~.. .~.r.:~.~.~.~......./.~.~,...: ....... c~.7..7 ¢ 7 .... ....................................................................... .., ........................................ at premises located at .....~......./../.Z~. ........ d..~..~V..~.....dt~,.....~/.~.~;- ......................... County Tax Map No. 1000 Section ...~.~.~.~.. ..... Block .,..~..~.,~, ...... ~ ' !Lot No....;C~/(~ ........... pursuant t~) application dated ..~/~C/..~. ....... ~'. ...... i,...'.. ..... 19. ~ and approved by the Building Inspector. Fee $ ........................ Rev. 6/30/~80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town HaH $outhold, 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 propertv with accurate location of all buildings, property lines, ~treets, and unusual naturaJ or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-g form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, industrial buildings, Multip~e Residences and similar buildings and installa- tions, 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 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 buiMings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate 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 .,.. , .......... ~ o House No. Street Ham/et Owner or Owners of Property ..'~/..~.~¢.F~ ~] :..~._¢~'.~},~. /~.¢ S County Tax Map No. 1000 Section .., .~, ~/~ ........ Block ..... ~. ........ Lot. ,../.O. .......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No././.~..~·~, -~'.· Date of Permft':~./~./'~, .... Applicant .',~.~f./. Health Dept. Approval ........................ Labor Dept. Approva! ................... ~ ~j.,. · Underwriters Approval ........................ Planning Board Approval ....... .~. ~./~. Requ, est for Tempera ry Certificate ..................... Final Certificate.,.,' .~,',..~i~. ! ~, ~/~, Fee Submitted $ .~..~ ..................... \~ X~,. ~,~ Construction on above described building an~,~,rmit~ n'm~s all a,C~a . ble~co,des and regulat[ons. ~,~ Applicant., .~.. ~ ,-.,~, '..'~.;: ~ ......................... Rev, 10-10-78 F/~,WJD ~k~NSPECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME& PLUMBING INSULATION PER N.Y. STATE ENERGY CODE FINAL COMMENTS ADDITIONAL COMMENTS: ~O-~" ',' -,% ~ 4. F:,h: 'L - ~,~ r- .3. ~= ,--' ~ ,.~ MEET ALL ,_.:N ....... T~dE N.Y- %~:E r~L: .... mi tO~x & ENERGY ~TATE cco~mBLE FOR coDES- NOT A:"~Y~X~ ERRORS- D~tGN OR coNSTRUu~'~ ......... t~.,.,', aI, .! FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOI. D, N.Y. 11971 TEL.: 765-180:3 Examined../.~.w..~.?ff.. ?.~..., 19 ~ Approved ./.~..~..C~.c~.'Y...If..., 19 ?./. Permit No./?..~...~.' .~.~.: Application No..././..~..~..~. ....... Disapproved a/c ........ APPLICATION FOR BUILDING PERMIT Date 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 dia~'am 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (SiffFhtu3e of applicant, or name, if a corporation) ,, ~Y.¢. . . (?:/.~, .?/...¥¥:.J:':*'.':':../2 ::?-i. ¢,':? ?. 7. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corpor_~ate officer) Builder's License No.. ( .c-( . . .~?.~..~ ~.-.77..-~.... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. .............................................................. .>.2 ~. . .z :? :~/. ~ .................. House Number Street Hamlet County Tax Map No. 1000 Section '6~5L Block '5'~ Lot /o Subdivision ........................... : ......... Filed Map No ............... Lot ............... (Name) 2. St0te existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...~w~-,,-~ e,- ,~-s'/~',,,~ c. b. Intended use and occupancy ~' ~-' -~' "'~" ,~a ~ e/,~c c 3. Nature of work (check which applicable): New.Building . .' ........ Addition...~ ..... Alteration .......... Repair .~. ........... Remoyal .............. Demolition .............. Other Work ............... (Description) 4. Estimated Cost.. . ~ ......................... Fee ...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... 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 structures, if any: Front ...B.~.~. ! i'. ...... Rear .3. ¢_).I.'[ ....... Depth . .&. .~.'. /.". ...... Height ............... Number of Stories .../. .................................................... Dimensions of same structure wi(h alterations or additions: Front 38 ~ ?" Rear <78 / /" Depth 30 ' . ........ ~. Height Number of Stories.. / ............. 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................ ................ .../..o.o.,...; .. /o~::~"q th/.- .~.~ 9. Size of lot: Front ........ Rear ..................... D~e,p 7 ....... .. ~ ........ 10. Date of Purchase .zj~_,¢,]7?" Name of Former Owner ~--/,or-/o~- /v4aoo. i~, 11. Zone or use district in which pre,rises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: 13. Will lot'be regraded .... .ff4.ce ... i. ·; .,...r .... ,, ...... Will excess fill be remove;t from premises: Yes No 14. Name of Owner of premises ... e~.../ ............. Address ...... Jet....~ ....... Phone No ..... Name of Architect .......... : ................. Address ................. ~. Phone No ................ Name of Contractor ......... ................. Address ................... Phone No ................ &: i,~e [o d~ ~ e¢ ~ 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. STATL OF N;E-~---56~g, ~ S COUNTY~F ,We r~,, ~, ~' , , . .~/..oq. C .~.~...'.~. ~;. '. '.~.~. '.~fj'.?~..7(?( ./.,?..~...~..~..~:~..~... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. FI-Ie),ls the ........................................................................................ i (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 ail statements contained 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 ........ .g. .............. day of. ~,,,,~c,~ ., 19 ~. o.d.~?,.~ County Notary Pub msl[ ......... FjI _O' ':'. b ' atule'ofap~l'icant) NOTARY PUBLIO OF NEW IERSI:¥ ] My Commissio, Exl)ires J~n. 4, Igg~ Unauti~orl;:ed altemtlon or addition to t'nis su~'ey is c~ violation of ~eclion 7209 of the New york State Ed,.~cotion Law. Copm~ Gl t~is suT'~e¥ map ;v~t beating Ihe lond surveyor's inked SURVEY FOR MARLOR ASSOCIATES AT $OUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. SCALE: t'= 40' MAY 16, 1974 REFERENCE~ gUAFIAIiiTEED TO~ CHICAGO TITLE INSUI~ANCE CO. EASTERN FEDERAL SAVINGS g~ LOAN ASSOC. _MA~OR AS~IA~ LAND BURVEYDR N;~I, LIC, NO ~aT~15 81VEf~HEADI N.Y.