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Home My WebLink About13541-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. ZI5720 Date May 4, 1987 THIS CERTIFIES that the building . .P 9 g..r.u..n..a.q d.. f.e.q c..e .......................... L .... ert 930 Village Lane Orient ocatlon o! l'rop y ............................................................... House No. Strebt Ham/et County Tax Map No. 1000 Section . 0 25 .Block .0.! .......... Lot 0 I 7 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .O.c.t.:..I.5.:..1 .9.8.4. ..... pursuant to which Building Permit No..1.3.5.4. ! .z .............. dated ...N.o.v.: .I.6. ,...1.9.8.4. ........... 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 ......... · p.o. ~. ~.~.~...~.~?., .6~..~.i..~.~..~.~..~.?..~..~.~.~A ~. ?.~.~.,...~?..?. ?.~ ?.~.. ?.I: ................ Th~ certificate is issued to LINTON AND DIANA DUELL. ..................... ?o'.;.b;,~~ ..................... of the aforesaid building. Suffolk County Department of Health Approval .... N/A UNDERWRITERS .CERTIFICATE NO ............ N / A PLUMBERS CERTIFICATION DATED: N/A /Building Inspector Rev. 1/81 FOIlaE NO. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ ~3541 Z Permission is hereby granted to:. ....... .6.~?~.~..../...:.....~.~.~ ...................... ......... ~.~.~ ........ 7...~.~ ...................................... ....... .0.~¢~....T....~.. z:Z......~. .......... r.z~.7. ,o ..... .e~.,,~x.o..~z.-... ....... ....~..~..... ...... ~.o.....w.......= ............... ~: ....................................... ...z~.,~.W~....~ ....... ./.~/..~,...~..~....~ ........................................ at premises located at ......?....~...Q ........ .~,,~..~,,~-~.,,--~,,,,,/~,,..~.~-'/....,~.,,,.O.~.~--J~.'~,,.~...~'.~ County Tax Map No, 1000 Section ...~.~.....~... ...... Block ....~....O..~.. ....... Lot No. ~.../.,~.. ............ pursuant to application doted ,.O.~Z~...,....,~..~.,'~., ........................... , 19...~..../"/~, and approved by the Building Inspector. Fee $..~.....~..~...~. ..... Rev. 6/30/80 FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m~ 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 disposel-(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 p~operty 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. C. Fees: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $]0.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5/00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5. Updated C.O. $ 50.00 Date ..... ./L/-/'~.- New Cons t r uc t i on Old or Pre-existing Building Vacant Land Location of Property ............................................ House No. Street Flare/et Owner or Owners of Property ..................................... CountyTax Map No. 1000 Section ............ (~,~'~ .O.~. Block ... ,O.[, ..................... CO Lot.. Subdivision ................................. Filed Map No, , ~ ...... Lot No .... ;,, ~-. .... ' Permit No. ~.~.~..~,z./',/,~z Date of Permit .... Applicant .. ~/?.A/, £-704~'. .............. Health Dept. Approval ........................ Labor Dept, Approval .................. ; ..... Underwriters Approval -- · ......... Planning Board Approval ..... -. ................ Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ./.E?.. ~ ..................... Construction on above described building and permit meets all applicable codes and regulations. Applicant . . ~_.. ,~., + ..... .z / FIELD INSPEcTiONTM COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ?DE ADDITIONAL COMMENTS: TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR ILO. BOX 728 TOWN tlALL $OUTHOLD, N.Y, 11971 TEL. 765d 802 'l'hJ~; i,'l 1:o advise you that the job under building petrol I. no. ~135~_1_~. issued to Linton Duell .11/._!.6/.8_4__ for .... A_q~_~sory is completed and final ;aspect{on has ( ) has not ( x ~bee~ done. In order to complete this file, it is necessary that ,, Cer t J f/cate of Occupaecy be issued . Please fill out the encloned form, return nome to thc above office with a check for $10.00 payable to the Towu of Southold. Please indicate to l./hom the Certificate of Occupancy ia to be mailed, and arrange with this office for an inspection (late Occupancy or uae in unlawful without n Certificate of Occupancy. l'leaae help un to clear up thla matter ~o that legal action does not have to be taken. Tharik you for your prompt attention. Very truly Victor Le~ard Executive Adm[niatrator Vl,:gar encl . 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:2 Examined ~..6r7(....L.~. .... ,19S~' Approved g4odtO~.../(~ ...... 19~ermit No. ,t(.~ .~..~..~.Z (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by Wpewriter or in ink and submitted 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 issued 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 building for necessary inspections. ( Sign a t u r~/~h~ 1:~ Iqm~,F:o"iOFarg'~l~l~0~r p o r a tio n ) P~O Box 476 . N~h ~oad .............. ~ck, ~xig .1.1~:} ·: ............. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises /~/g+ /~'~5 ~-//v"r'O/¢ /. (as on the tax roll or latest deed) If applicant is a corporation, signatu, lce of duly authorized officer· ik'a~d nfi 't/ti/;} ~)~(~r'aie offi~;r') ......... Builder's License No...~-.~..~.... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. xL.,ocation of land on which proposed work will be done ......................... ; ........................ House Number Street Hamlet u Tax Map No. 1000 Section ..... ~).'.~..~. g.z.? .... Block ..... d.....O'.re. ....... Lot...49..[7.: .qz?. ....... bd' 'sion ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy ........................................................... 3. Nature of work (check which applicable): New Building ..... ' ..... Addition .......... Alteration .......... Repair ............. Removal .............. Demoht~on ............. 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 m~xed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structurels, if any: Front ............... .R. ear .............. Depth ............... Height ............... Nun}ber of Stories .................................................. DL, J1, ensions of same structure with alterations or additions: Front ................. Rear .......... Depth .................... i' · Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... (~Height ............... Number of Stories ........ , ................................................ Size o~lot: Front ........ [ ~? ........... Rear ..... ~..s? .............. Depth ......~.. ........... 'a'v. Bate of Purchase ........... .................. Name of Former Owner ........................" 11. Zone or use district in which pr4mises are situated ..................................................... 1.2. Does proposed construction violate 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 ~.,.~b.~.. ]~. D.~..eh( ..... Address q'b~..[(.;.l{q~ e'.~6 ..... Phone No.'3..~;. 3. :..o,.2.5.- .~. .... Name of Architect .......... ................. Address ..... P(.~. Phone No ................ Name of Contractor ......... ! ................. Address ................... Phone No ................ ~. I PLOT DIAGRAM Locate clearly and distinctly all buildings whether existing or proposed, and. indicate ail set-back dimensions from property lines. Give street'and blocklnumber or description according to deed, and show street names and indicate whether interior or comer lot. STATE OF NEW YORK, :S.S COUNTY OF ................. ............ ~(.~..q.. ~- !tc~'~'rct{ r~o .......... being duly sworn, deposes and says that he is the applicant (Name of individual sigOing contract) above named. He is the ...... ~ O/~ .T~/2. c~. ?t .............................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dully authorized to perform or have performed the said work and to make and file this application; that all statements con~ained in this application are true to the best of his knowledge and belief; and that the work will be performed in the mannor set forth in the application filed therewith. Sworn to before me this ............ l .~ .......... day o.'f ....O .c~. ............... NOTARY PUBLIC, Sto.te of'New York ...... No,. 4/0,7878, Suffolk Co,Oli~y Tem~ ~z~rres March 30, l~_~re'' (Signature o.f applicant)