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Home My WebLink About11271-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z10605 July 27 81 Date ................................ ,19... THIS CERTIFIES that the building ................................................ Location of Property .. 1150 Capt. Kidd Drive Me[ttituck, N.Y. House No. Street Ham/et County Tax Map No. 1000 Sechon 106 .Block 02 .Lot 0&6 Subdivision..C.ap.~. ~, .K.~.d.d., ~.s.~.a..g.e.s ......... Filed Map No...1.6.7.2...Lot No. Lo t~ 150 conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .~.u.~.y...9 ........... 198. .1. pursuant to which Building Permit No. 11271 7. dated ........ ~.u.I..3r..1.3. ............ 198. 1.., 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 ......... Accessory Storage Shed The certificate isissued to Chris and JeAnne Pappas ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval N/ I1 UNDERWRITERS CERTIFICATE NO. Iq/I~ Building Inspector Rev. 1/81 l~O~ NOo ~ TOWN OF SpUTHOI~ BUILDING D£PARTMI~H~ TOWN HALL SOUTHOLD, N~ ¥. BUILDING P, ERMIT~ (THIS PERMIT MUST BE KEPT ON THE PI~E/~ISES UNTIL COMPLETION OF THE WORK AUTHORIZED) ~ FULL No. 11271 Z Dote Permission is hereby granted to: .~.~. ............. ~ ...... ....... ~.~....~..c..../.:. ~.~¢..,~;.~, . ........ ~z~.~.~ ...... ~.~ ........... ~o .. ~ ~z~.~:~:~....~L~.~.~~..~.~~...~ ............ .............................. .~.c¢.., .......... ~.~c~..~ ...... ~~....~/~ .......... at prem sas located at ...... Z~.~ .......... ~.~...~..~ZC, ...................................... ........ ..... ~f..~..~z.~~......~.z~.~c.;. ..................... ~....z~...... CounW Tax Map No. 1000 Section ....... ~(.~, .... Block .r...b/~ ........-~t No. ,.~.~ ........ pursuant to application dated ................................ 19, an~ approved by the Building Inspector. ........ Rev. 6/30/80 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 with 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 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 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 featu res. 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. C. 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 .....zT"~'.. ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property /'../..~..~ ......... .~'.'.'~.~/.--. ~../~.-~...~.../'~., ......... House No. Street Hamlet Owner or Owners of Property . .~/?'.,~../.~..~....~/..~..~..'~../~'.~-.'.....~,2~../~.~..x?.'~'. ................... County Tax Map No. 1000 Section ...//.~. -~ ....... Block ..... ~. ?. ...... Lot .... /~.'~..~. ..... Subdivision .~'/~ .~?..~/'.~...~.~..77~...Z'~-..~.' .......Filed Map No. /~. ~..Z ..... Lot No... ~..~-~..~. ..... Permit No. fZ'~..7.~... Date of Permit .~//~/.~.~.Applicant...J,~..~~,~. ..... 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 meets all applicable codes and regulations. Applicant.. t~ . .~ .~..-. ..................... Rev. 10-10-78 ~- -. FIELD.~NS~ECTION FOUNDATION (1st) FOUNDATION (2nd) 2o ROUGH FRAME & FLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE FINAL DATE COMMENTS ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ^ppro,,ed .T. eZ.7 .... :.: ..... Permit No. Disapproved a/c .............. ' ."7.. .................. .r Application No .......... APPLICATION FOR BUILDING PERMIT Date .......... , INST RUCTIONS a. Tins application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildi Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing locatmn of lot and of buildings on premises, relationship to adjoining premises or public stree or areas, and g~vmg a detailed descritmon of layout of property must be drawn GU the diagram which is part of this apl: cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon appr(~,'al of this apphcation, the Building Inspector will issue a Building Permit to the applicant. Such pern shall be kept on the premises avadable for inspechon throughout the work. e. No boildiug shall be occupmd or used in whole or in part for any purpose whatever until a Certificate of Occupan shall have been granted by the Budding Inspector. APPLICATION 1S IIEREBY MADE to the Building Department for the issuance ora Building Permit pursuant to t Budding Zone Ordinance of thc Town of Southold, Suffolk County, New York, and other applicable Laws, Ordiuances Regulatmns, for the constructing of buildings, additions or alterations, or for removal or demolition, as herein describe Thc applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in buildings for necessary.. ~ .~.~.~. ~ .:inspections- ............ (Signature of applicant, or name, if a corporation) .... (Mailing address of'a~;3ii~ant) ' ~;'~. ' ' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build (as on the tax roll or latest deed) 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 ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done..~..'~/~'..~.. ~../.~..,~....z. 7.~'.7-.,~..7'..,~h ................... ............... ..... R ................................... ,.. d ........... House Number Street Hamlet County Tax Map~o. I000 Section .... ~.~ ........ Block ....... '.. ~ ...... Lot .... ~ ....... Subdivtsion~ c'..~<~¢,¢'(~..~,4.(~.~;-~.~... Filed Map No...~.~¢~ ..... Lot ..~C).-(~ ....... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~ ~ /W ~ ~g ~ (~'1~ ~ b. Intended use and occupancy :: ~ .~. ~ · · ~.~Rd~h~:~ .:x~ '4:' :.:: .~, ,c'~ :, 3. Nature of work (check which applicable): New Building . .~. ...... Addition .......... Alteration .......... Repair .............. Rem6val .............. Demolition .............. Other Work ............... Estimated Cost .................................. Fee ........................ 4.. ......... (to be paid on filing this application) ;. If dwelling, number of dwellinglunits .. '-"- Nmnber of dwelling units on each floor .':-2. If garage, number of cars .... ~ ................................................................... i. lf business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... I. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions " ' ' ' Front Rear of same structure xwth alterations or additions: ................................... Depth ...................... Height ........ ~., ............ Number 9f Stories ............. ~ ........ .... ' ' ~.' R ~p t pth ./.~. ' I. Dmmnsmns ottent~re new constmctmn: Front ............... ear .............. De ............ Height .. ~. ........... Number of Stories ........ .a...,~. ~ .......... ~ ............................. /. Size of lot: Front .......... ~ ........... Rear ...................... Depth ....................... ) [)ate of Purchase ' Name of Former Owner [. Zone or use district in which premises are situated ..... .R.ze. ~'J.o..~/'! F.,7. ~ ...............' .................. ~ Does proposed construction violate any zoning law ordinance or regulation: 1. Will lot be regraded ........ i ................... Will excess fill be removed from premises: .Yes 1,'"' No *. Name of Owner of premises .~.~.~.s....~.,~..~'.A'.~...<. ....Address 7t'4~....~.~.~..A'/.~.~...~.,~. Phone No. ~.~. ,~'..".'~.,.~.~ ~0.. Name of Architect ..................... .,~j,... Address ...... '...: ......... Phone No ................ Name of Contractor ~.,e,,~.~./4 i .x4f. e,.r.,q~¥ ......~.. Address ,~'eJr.~.~.~..'~..~..~F.,f.~.~[,~'~Phone No. ~..~'~..~ .5"('.~.~'.... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, an& indicate all set-back dimensions from roperty lines. Give street and block!number or description according to deed, and show street names and indicate whether terior or corner lot. 1.[0I 'l rATE OF NEW ~'f~RK, - -- , OUNTy OF ' s.s .~x~~~.-~.._.(Name ofindMdual signing contract) rove named. e is the . .' ........... .~/~.q .,~(..~,4~..,~.~..7'?. 2~. ......................................................... (Contractor, agent, corporate officer, etc.) f said owner or owners, mid is du,ly authorized to perform or have peI~formed the said work and to make and file this ~plication; that all statements con[ained in this application are true to l:he best of his knowledge and belief; and that the 'ork will be performed in the manner set forth hi the application filed therewith. worn to before me this .............. ....... ...... , NO. 52-81258§0, Suffolk Term,Exulres March .qfl lo ,: 3o"& Iz, ,~,¢¢-,~ - ¢,,//-¢/~H /,~ ,4//,o, : c-o" T~-/,¢W BE- Iq, ¥. · I · · · · I ! --!