The URL can be used to link to this page

Home My WebLink About11191-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z10661 Date September 4 1~1. TH1S CERTIFIES that the building ................................................ 1425 Trumans Path, East Marion, New York Location of Property ............................................................... House No. Street Ham/et County Tax Map No. 1000 Section . .0.3.1. ....... Block .... 0.1. ~. ........ Lot .... 0.1.3. .......... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated May 18 1981 pursuant to which Building Permit No. 111J~.1. Z dated June 14 19 81 , 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 D..wg.ll.i.n.g The certificate is issned toJohn Gorga ..................... ................... of the aforesaid building. Suffolk County Department of Health Approval .... UNDERWRITERS CERTIFICATE NO ....... N../.R ........................................ Building Inspector Rev. 1/81 z~o~t~t ~'o. ~ TOWN ~OF SDUTH0bD TOWN' HALL SOUTH'OLD, H~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON T~HE PP, EM s~s UNTIL COMPLETION OF THE WORK AUTHORIZED) , ~U LL N°. 11191 Z Permission is hereby grar~ted to: /~ '~'~' -~~~'~; ~:~.... · ~.~..~...~..~ .~. i .......... :. at premises located at ............................................. ~ ......... :~ ........... ,,,, ................................. Buildingi InspeCtor Building Inspector, ............. Re¥. 6/30/80 . . ~ 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 m typewriter OR ink, and submitted in duplicate to the Building Inspec- tor w~th the following, for new buildings or new use: 1. Final surYey of property w~th 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 buddings, 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 ex~stmg 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 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 buddings or premises, or other pertinent informa- tion reqlnr0d to prepare a oert~ficate. Fees: 1. Certlhcate 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 ..... ~ ..... ,~OId or Pre-ex~sting Budding ............ Vacant Land t. ............ Locat,on of Property /..~-.~-.-.~ ...... .-7~/~.(.2~..:¢?.~2~..',., .~ .......... ~.~¢~.'.., Nouse No. ~ .~ Street Ham/et Owner or Owners of Property ...~0~ .~:~ ....................................... County Tax Map No. 1000 Sect,on .~.~ ......... Block ...~.~. ...... Lot. ~/~' Subdivision ..... ,F~led Map No, . ,~:~..'...Lot No. ~ PermltNo.///~Z,. Date of Perm t~/ App cant ~¢/~, ~ .~ l . / ~ ''' ~ Underwriters Approval ..... ~J/~% ............ Planning Board Approval ~ ...... ~,. ~..~ Request for Temporary Certificate ........ Fna Cert f cate. ~ ~..~, .~o ~¢.~1~' ....................... Construct,on on above described building and~t ~ ~pplb~le codes and regulations. ~ ......... Z ............................ 1. FOUNDATION (1st} FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY QODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 kpproved .... ~77': ........ , 19 ermit No ............ )is~pproved ale ........ :'-~"_ '_::".:.:~'=u :: ::.' .... (Building Inspector) APPLICATION FOR BUILDING PERMITDate ~''~,¥' ~ ./,~.'. .... INSTRUCTIONS Application No... (. ! .( .?. / ...... a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building nspector, 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 ir areas, and giving a detailed description of layont of property must be drawn on the diagram which is part of this appli- ation. 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 hall 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 ,hall have been granted by the Building Inspector. APPLICATI~)N IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the tuildlng Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or {egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ['he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to ,dmit authorized inspectors on premises and in buildings for necessa~sp,0qtions. · );A~ignature'~~e,' i~ ~ 'c;~'~;~a'tio'~) .... ............. ~ _z" ~. (Mailing address of applicant) ~tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~eo~ownerofpremises .JO.t~... ,~....g..O.X~. .................................................. (as on the tax roll or latest deed) ,f applicant is a corporation, signature of duly authorized (Name and title of corporate officer) Builder's License No...~O_~.. ............... Plumber's License No ...... ~.~,f~ .............. Electrician's License No .... /~.'/g~. .......... ' .... Other Trade's License No.../(///q= .............. 1. Location of land on which proposed work will be done .................................................. ..... /.e. >..o: ....... .-:.~.,,.,.~..,.~.~..£~.~ ....... ..:.~.e..,M~..,--.,?.-....~......:...//~6.?...: ...... House Number Street Hamlet County Tax Map No. 1000 Section . ..~/.': .' .......... Block ...... /.~ .~. ........ Lot ..... /(..~'. .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: b Intended use and occupancy Nature of work (check which applicable): New Building .......... Addition .......... Alteration Repair .............. Removal ............ Estimated Cost ..... .~.0.0.,..~b. .............. D liti Oth W k (' cmo on .......... er or ......... . ..... [ ~'~ (Descriptiol~) ....... Fee ........................ ~ ........... ~'~ ~ (to be paid on filing this application) If dwelling, number of dwelling Bnits ............. Number of dwelling units on each floor... ,., If garage, number of ears .....', ................................................................... If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... Dimensions of existing structurels, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions ' ' ' Rear of same structure wlth alterations or additions Front ................................... Depth .................... ~.. Height ...................... Number of Stories .......... , ............ Dimensions of entire new const~pction: Front ............... Rear ............... Depth ...~ ............ Height ............... Number of Stories ....................................................... .... ~.~ ............. Denth ..... /.0 .............. Size of lot: Front ...... .~'~..i ........... Rear .. t ~ I Date of Purchase .... ,_/~..q~ .;/.~.~[ ............ Name of Former Owner ~.tl. ~/. ~. ,~... ~·o. y-,,~. ,~.,~.~ ..~.~ Zone or use district in whicl{ pr~mises are situated ...... Does proposed construction violate any zoning law, ordinance or regulation: ...~.0 ...................... Will lot be regraded ......... i I~.O ............... Will excess fill be removed from premises. , Yes ('NO) Nmne ~)f Owner of premisesx/O~...~.o'(6C. 4~. ..... AddressZ '.M,. ]~7..a~. ...... Phone No,,~/.~-. 2a,~': .~.7.g.~'~r. Name of Architect .......... j ................. Address . ~,-~[/.ed/.e..P.~../.~' ~.. Phone No .............. Name of Contractor ......... ~ ................. Address ................... Phone No ............... PLOT DIAGRAM Locate clearly and distinctly alll buildings, whether existing or proposed, and, indicate all set-back dimensions from ,operty lines. Give street and block ;number or description according to deed, and show street names and indicate whether terior or dorner lot. ' 'E OF~ NEW ~K i .... l s.s ~i)~ .~. o,~ ...' .. being duly sworn, deposes anal says that he is the appilea~ (Name of ~nd~ dual s~gmng contract) /. 0ore named. ~ .e is the. ~ ................... . ..... ~ ............................................................... ~ (Contracior, agent, ~corporate officer, etc.) f sa~d owner or owners, and is d~ly autho~zed to perform or have perfo~ed the said work and to m~¢~d file pplication; that all statements contained ~ ~is application are true to the best of his knowledge and belief; and that the ,ork will be perfomed in the m~ner set forth in the application filed therewith. worn t¢ b~ore me this ...' ........... 19~ ~C