The URL can be used to link to this page

Home My WebLink About11321-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y, Certificate Of Occupancy No ...11100 ........ Date .............. July.20 ............ 1982. THIS CERTIFIES that the building ................................................ Location of Property .. 240 .The .C re s cent. Lane, . Ea~ t. garion,, lqY. 11939 ................. House No. Street Hamlet County Tax Map No. 1000 Section .... 030 ..... Block ... 02 .......... ]Lot .. 033 ............ Subdivision ............................... Filed Map No ......... ]Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ....... August .7. ....... 19 8J-. pursuant to which Budding Permit No.. 1132~ ............... dated ..... August 7. ............... 19 B2., 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.existing.dwelling ........................................... The certificate is issued to ...l~dwa~d .A, Shine ......................................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .~I/A ..................................... UNDERWRITERS CERTIFICATE NO ..... bJ/..~ .......................................... 1/81 TOWN OF SDUTHOL!D BUILDING Di~PARTM~N1 TOWN HALL SOUTHOLD, N~ Y. N? BUILDING P, ER~iT! (THI'S PERMIT MUST BE KEPT ON THE PRE/~IS~S UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ' 11321 Z Date .... ~'..~.~ .................. Permission is hereby granted to: ...... ~.~.~.~...~........~Zz, ~ ....... .......C~.~Z4,..~.g~......~.7~g ~o .... .~ ~.~Z~ ....~.Z~....~/~.~.~Z ~.~..z~......~z.~.,.~ ~.~. / at premmes Ioceted et ............................ ~ .......... /. , .~~ O .......... .... ,~ ....................................... , .................................. .~.~.....~c~...~~ .......... :...~....~ ................. ~....~....r ....... CoUOW Tox Mop No. lO00 Section ........... ~. .... Block ],...~ ................~ t N ............ , ............ pursuont to opplicotion doted ........ .~. ................. ?....,....., 19.~, ond opprov~ by the '7 Building Inspector. Fee $... .......... ~ :~ ~:ln,ector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic featu res. 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. 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 buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: J. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3, Copy of certificate of occupancy $ J .00 $5.00 Date ....... New Building / Old or Pre-existing Building(X) /Vacant Land - Location of Property . ..~ ~.. Hou~ No, ,v , S~reet ' Ham/et Owner or Owners of Property ....... - ..................................... County Ta~ No. 100~ Section ¢~'~ ...... Block ..... ~ ?~ ..... Lot, .¢~%' ........ PermitNo. K¢%.¢L . Date of Permit . . . Health DepL Approval ....... 4 ................ Laber Dept. Approval .............. ,.. Reques[ for Temporary Cert f cate ..................... Final Certificate ./~'.-. ........ * - Fee Submitted $.. Construction on above described budding and permit~mee~s all appl~cable~co,de~ and. regu~btions. Rev, 10-10-78 FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL,: 765-11302 APPLICATION FOR BUILDING PERMIT Application No. d('~.. ~t/. ....... Date . .'. .. INSTRUCTIONS a. Th~s application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildi Inspector, w~th 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of bmld~ngs on premises, relatmnship to adjoining premises or public stref.. or areas, and giwng a detaded description of layout of property nmst be drawn ou the dia~am which is part of this apl: cation. c. The work covered by this application may uot be commenced before issuance of Building Permit. d. Upon apprc.'al of this apphcation, the Building Inspector will issue a Buildzng Permit to the applicant. Such peru shall be kept on the premtses available for inspection throughout the work. e. No budding shall be occupied or used m whole or m part for any purpose whatever until a Certificate of Occupan shall have been granted by the Building Inspector. APPLICATION IS I IEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the constructmn of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized ~nspectors on premises and in buildings for necessay,g inspections. , ,. . :..,. ......... (Signature of applicant, or name, if a corporation) (Marling address of applicant) [?,~fl~.~ State wheth,~r applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build, Nmne of owner of premises . .. : .... . : ......... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corpprate 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 ................................................ ....... , . ::.-a:>::. />:. e_ ..... .W. ,. . :. ................. House Number Street ' Hamlet County Tax MaDL_No. 1000 Se~ction ..... ~. ~'~.~9..'. ..... Block .... ~.. 7,~.. ....... Lot...(-~..~..~. S u b d ,vtsion . (~..-,-~/~C;, ~..~x'~../~,~: ..... Filed Map No ............... Lot :,~7. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy .... ~4~/~.~.- ................................................ I. Nature ofxvork (check which applicable): New Building Addition . Alteration ......... Repair .............. Removal .............. Demolition ....... q ...... Other Work ............... ~, .~e (Description) ' Estimated Cost ....... . ......................... ee ...................... ~ ......... (to be paid on filing thi~?plication) ;. If dwelling, nmnber of dwelling units ............... Number of dwelling u~its on each floor., ............... If' garage, nmnber of cars ......................................................... \ .............. ). If' business, commercial or mixed occupancy, specify hature and extent of each type of use .......... ' ........... ~. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ................ ' ........................................ Dimensions of same structure with alterations or additions: Front ~ ................. Rear .................. Depth ...................... Height ....................... Number of Stories ...................... ~. Dimensions of entire new construction: Front .......... ': .':..',,R'~ttr ............... Depth ............... Height ............... Num~ber of Stories ........................................................ L Size of lot: Front ...................... Rear ...................... Depth ...................... ). Date of Purchase ............................. Name of Former Owner ............................. 1. Zone or use district in which pr~mises are situated ..................................................... 2. Does proposed construction violate any zoning law, ordin, ance or regulation: ................................ L Will lot be regraded ........ ~.'' ...... ....... ~ .~ddress~4'.:.. Will exces~ flll~b~e iemoved from premises: Y.i~ii No L Name of Owner of prmmses .. a,~/t~.~f~.~one No ................ Name of ,A, rchitect ........................... Address .... r.. ,g//~-~./°'Phone No ......... Nmne of Contractor ........................... Addless ...: ............... Phone No .......... PLOT DIAGRAM Locate clearly and distinctly ali bnildings, whethcr existing or proposed, and. indicate all set-back dimensions from roperty lines. Give street and block gumber or description according to deed, and show street names and indicate whether terior or corner lot. rATE OF NE;V_,A'OaR.t~,,' ~ z ~S.S OUNTY~- · '~q~' · ' I ............................................... being duly sworn, deposes and says that he is the applicant (Name of individua s gn'iug contract) )ore named. e is the (Contractor, agent, corporate officer, etc.) f said owner or owners, and is duliy authorized to perform or have performed the said work and to make and file this >phcalion;i that all statements contained in this application are true ~o the best of his knowledge and belief; and that the ork will be performed in the manner set forth in the application filed therewith. worn to before me this (Signature' of applicant) · -- I NOTIFY BdlLr);NG DEPAR:LMF'~-~ 765480? 9 AM ~O 4 PM FOR THE FOLLOW;Nc; 'NcPFCTIONS: l, FOI.I~Jr~A'~ION - TWO REQUIRED FOR POURED CONCRETE 2. ROU~fq - F"ZAMING & PLUMBING 3. INSUI. A' IqN 4. FINAL_ - r'ONSTeUCTION MUST BE COMPI ':-FE ~OR C O ALL CONSTRUCF~ON SHALL MEET THE REQUIREMENTS OF THE N Y. STATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FOR DESIGN OR CONSTRUC]ION LRRORS