The URL can be used to link to this page

Home My WebLink About13380-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z. 13223 Date Feb. 20 ................................................. 19.85.. THIS CERTIFIES that the buildh~g .......... .R.e.t? .a.i.r. .............................. Location of Property 4295 Camp Mi. neola .Rd. Mattituck County Tax Map No. 1000 Section .... 1.2. .3 ..... Block ...... 0..5 .......Lot ...0.2.4. ........... X Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Aug. 20 , 198..4. pursuant to which Building permit No. 133.80Z dated ...... .A.u.g.: ..... 2. .7 .......... 19..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 ......... Construct and Repair Deck damaged .by storm The certificate is issued to ................. MALONEY ,. JAMES & JANET (owner, ~te~ee-o,~ ~a,~-) of the aforesaid building. Suffolk County Department of Health Approval .............. .N/.A. ........................ UNDERWRITERS CERTIFICATE NO ................. N/A Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEFAF~TMENT TOWN HALL SOUTHOLD, N. Y. BUILDING FERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13380 Z ,o at premises located a{/ t ....~....~....~...~.~......~....~~..~Y.........~.... ....... ...~...~ Coun~ Tax Mep No. 1000 Section ...... [.~ ..... Bilk ......~ ............ Eot No .....~.~ ........... ~ursuont to application doted .... .~.~.~.~l....&~.... ........................ .1,.~...t., Building Inspector. end approved by the 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 TOWN OF SOUTHOLD 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: 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. 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 $15.00 // New Building ............. Old or Pre-existing Building .... ........ Vacant Land Location of Property ¢~2.~..~. ...... .~. ..... .~. ~.~ . ./~ ........ House No, Street Hamlet Owner or Owners of Property...,..~.~'~..__.~ ...... Q .~......-~..~..~...'~..~ ........ ~...~..0.,.~..~ .~,/ .... County Tax Map No. 1000 Section .. ~. ~,..~. ...... Block ....... .~-~.. .... Lot ..... Subdivision ................................. Filed Map No ........... Lot No .............. Health Dept. Approval ........................ Labor Dept. Approval ........................ U nderwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ...... 5;~. ................ Rev, 10-1a-78 F1ELD ISSFE~TION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY G,ODE FINAL COMMENTS ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved · .~.'Y. · .~.~ ·., 19 ~. ~.. Permit No. J. '.~..~.~..0..~. Disapproved a/c ..................................... Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 9,ode, and. regtllations, and to admit authorized inspectors on premises and in building for nec~¥ary i~e.c, tions: ,/~//, ~?,/~ / ~' '~~7~,i~~7~;a'ti~) .... ,, (Mailing address ~ i~, '~ State whether applicant is owner, lessee, agent, architect, enoineer, general contractor, eleertriciari, )luh/ber or builder. ................................................................................. Name of owner of premises . .'.~./z~.../~.~5~ .~.~.~.. ................. ~' 'd"' ........................ (as on the tax roll or latest ee ) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ....... ~ .~..~. ........... Plumber's ~icense No ........ "H .......... 1. Location of land on which proposed work will be d~on~S.~.../~..4..~../.~.~. ~... ,,. ~ .~...7~...~.....~././~:~ ..... .... .......o. ............................................... House Number Street Han~let County Tax Map No. 1000 Section .../..~...~. ........ Block ..... ~.. ........ ... Lot.....~..~. .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................... b. Intended use and occupancy .. ~.~..~.[~ · .~.G. ·~. .... . .~.~..~.~.~..~..~... ~..~z:.....~p,~. ~..~...~. ...... 3~of svork (check which applicable): New Building ..... ' ..... Addition .......... Alteration .......... · ~-~t~ ..... Removal .............. Demolition .............. Other Work ............... //rro i .o?. (Description) 4. Estimated Cost ..... t.~....; ......................... 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 mixed occupancy, specify nature and extent of each type of use ..................... 7~ Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ................... i · · Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... tteight ............... Nuniber of Stories ......................................................... 9. Size of lot: Front .. .,.. i .......... Rear , ~,, b~.. ~:~/,¥" '" "' "'¢' · ...................... De~th ..................... · ............... Name of Former Owner /.~.(..~.~. (.~.~'/~.. ............ 10. Date of Purchase 11. Zone or use district in which pr~mises are situated ..................................................... 12. I)oes proposed construction vie!ate 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 .. i ................. Address ................... Phone No ................ Name of Architect ......... i ................. Address ................... Phone No ................ Name of Contractor ........ ! ................. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blockl number or description according to deed, and show street names and indicate whether inter/or or corner lot. STATE OF NEW~0R~ . 1 COUNTY OF ......... S.S ....................... · ........ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. (Contractor, agent, corporate officer, ere.) of said owner or owners, and is du!y authorized 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 mann0r set forth in the application filed therewith. Sworu to before me this