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Home My WebLink About13594-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z13143 Date Jan. 16 198.5. THIS CERTIFIES that the building ....... .A.d.d.i..t.i.o.n. ............................... PYt. Rd. ~11 off of Location of Property 1785 South Harbor Rd. Peconic House No. Street Hamlet County Tax Map No. 1000 Section 086 .Block 03 .... Lot P/O 003 X Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated Nov. 21 19 .84. pursuant to which Building Permit No. 1359.4Z dated ........ N..o.v.. ........2. .9 ......19 .8.4., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy ~r which this certificate is issued is ......... Shed Addition to Existing One Family Dwelling The certificate is issued to ............ RUTH COOKE (owner, le~exsr-ternenO of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO ......... .............N/A ........................... . Building Inspector Rev. 1/81 TOWN OF $OUTNOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 13594 Z Permission is hereby granted to: ..~~~......¢~.~.~.~.: .............. ....................... ....~ ..J.~.~ ~.......~.....~. .................................... i ,~. ~ ~....o~...~ ~ .'.~.v.. ~ .... at prem,s s ocated at .................. ...~.~.~.. ......... ~ ....... ~ ................... County Tax Map No. 1000 Section ..... ...(~....~...~ ...... Block .....~..~. ......... Lot No....~./..~....~ .......... ~,,,,o,t to op,,cot,on doted .... ~.~~.....~! ............ , ~.~..~.., on~ opp~v~ by t~e Building Inspector. Building Inspector Rev. 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 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 Iocatior~ 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 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: pr~ - ~_~O - '~/~-: ~O 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use ~J~E,~:~L~L~L~ ~. (~ ~' 4'-, DO 3. Copy of certificate of occupancy $1.00 Date ....... . New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ., . !'Y.~ .'/i ~]..q?.?..S.o.~.~.~.~..'t.~?.~.o.~.. i:~.o.~.~_ ............................. House No, Street Ham/et Owner or Owners of Property .. ~p.~?,t. ~p.q~;~ .............................................. County Tax Map No. 1000 Section ........ ~ ..... Block ....Q~ ......... Lot...3 [p2.r.~. O.~).. Subdivision ................................. Filed Map No ........... Lot No .............. Permit NOTL'~r~C~14 ...... Date of Permit ,-I:l,/,~?/~)~Applicant . -' Health Dept. Approval ...... ~ .~..~. ............ Labor Dept. Approval ...... ~...~.~.. ........... Underwriters Approval ... ~ ~' .... Planning Board Approval ~. ~...~. Request for Temporary Certificate ..................... Final Certificate ...... ~ ................ · FeeSubmitted$.~..QO ............. ~ /,O ~//-~~~ ~~ ~1=~~/~'~ -~'r~ Environment East Inc, . App ~ ...... ~ .................................... do .... "l' Rev, 10-10-78 FIELD INSPECTION FOUNDATION FOUNDATION 2. (1st) ROUGH FRAME & PLUMBING (2nd) INSULATION PER N. Y. STATE ENERGY ODE FINAL COMMENTS ADDITIONAL COMMENTS: Environment East, Inc. R. R. No. 3 - 3075 Indian Neck Lane Peconic, New York 11958 516-734-7474 ¢'tr. V. Iessard Southo]d Town Bldg. Dept. M~tn Road Southold, NY 11971 Re: Permit ~): ] 3~9~2 Cook Woodshed Dear Vic, Enc]os~d is an alteratio~ requested by the ow~er to ba a~p!ie~ to ~ae subject i~]~as~ aSvise t~is off~ce i~ tbera ar~~ any objections. Thms ~.s a sma[[] j~~y to go. I would appreci- ate an e~r.~y Peter R. Pre si~ ent~ .~ . Envir,~mt East, Inc. / i~ncl~ ~RS: jm FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined .~.&Coz~n.~t,~ .~2.%, 19~L.t. Approved .~ .~yJ~4...~...~.. ~q., 19 .~./. Permit No ............ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT TOWN OF SOUTHOLD '. Received .......... ,19... INSTRUCTIONS a. This application must be completely filled in by typewriter 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. . ............ (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, ~ontractor, electrician, plumber or builder.' Name of owner of premises (as on the tax roll or latest deed) ature of duly authorized officer. - (~fne and title of corporate officer) Builder's License No...-~,.'.C~.... '.2./..~ ..... Plumber's LicenseNo ......................... Electrician's License No ....................... Other Trade's License No ...................... "'~, ~j¥"1~,..~ //~ 17~--'~-, ,~, .// ,,3. 1. Location of land on which proposed work will be done...~.42G:. .... ./'~.4~'../"4~.¢~....,~. ....................... ......... ......................................................... House Number Street Hamlet County Tax Map No. 1000 Section .... .~..~. .......... Block ..... .O.~ .......... Lot ...... .~. ....... q.. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . ./.~.~.3"/..~?..,~.'.~..~./. ..... Intended use and occupancy ............... 3. Nature of work (check which applicable): New Building .......... Additior~. ~',~q~.~..~lteration ........ Relit~i,r~ a. ~,. ~ ... }.. Removal .............. Demolition .............. Other Work ............... ~u~l I ~ ~ ' I (Description) 4. Estimated Cost .... '~..p~..."~..(~.: 5 .................... Fee ...................................... ' : I (to be paid on filing this application) 5. If dwelling, number of welhng umts ............. 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 .... ~ if any: Front Rear Depth · D~mensmns of existing structures, ............................................ Height ............... Number of Stories ........................................................ · Dimensions of same structure With alterations or additions: Front ................. Rear .................. h ~ ' Dept ................... :... Hmght ......... ; 't ........... Number oftStories ............. ) ........ 8. Dimensions of entire new construction: Front .... ~.. Rear ..... ~ ........ Depth .../..-~'. ......... Height .... .7.t ........ Number of Stories ....~Z-. ................................................... 9. Size of lot: Front (' .~ q~.¢/f..C=~... ~ R-ear I~j~.~. ...... Depth ........... 10. Date of Purchase .......... i ................... Name of Former Owner ............................. 11. Zone or use district in which p~emises are situated ........................ z ~ ........................... 12. Does proposed construcrio~ violate any zoning law, ordinance or regulation: .. [.V~. .......................... 13. NWilm~/t:tofb;Tng~d;: ....~.q.~. ~...-~ '~"~ ...... Will excess fill b,e rem.~,ed from premises:7(,,.ff Y~s),q? No 14. N premises ./.<~w~.' ...(~ .~. ..... Address ...~.~..5.,(~:~..~.~.~,~ ..... Phone No ................ Name of Architect ......... ! .................. Address ........ ~ ....... Phone No ................ Name of Contractor ........ : .................. Address ...... .~._ .......... Phone No ................ Locate clearly and distinctly al! buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and blocki number or description according to deed, and show street names and indicate whether interior or corner lot. 5ce Y-f c ed STATE OF NEW YORK, COUNTY OF ................. ............................. i .................... being duly sworn, deposes and says that he is the applicant (Name of individual signlng contract) above named. e ~s the ...................... i ...... ~ ........................................ ! ~ [_Contractor,)agent, corporate officer, etc.) of said owner or owners, and is dul~ authori~ to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith· Sworn to before me this ................... day o~ ..... ~ ........... 19 Notary Public ..... . : ....... County 1. FOU, ' 3. INcULA~I~N~,Sq'~ cTION MuST ,~ 4. Bc ,-~MPL~T~ FOR C. O. ST~UCT~ON 'sHALL MEET' ALL cON ~..--'TS OF T~E N.Y. ~ ~[s~oNStBLE FO~ CO~cq' ~NSTR~CTION, ERRORS 5' o~ :r/¢ ' W',¢ ,~z~,,:2£ ;,Cd. 'b