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Home My WebLink About13398-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Z.~. 354! ......... Date .......... ~...ay..1./4 ................ 19 .~. THIS CERTIFIES that the building-~-~, a~.~$S.o~2~/'. S~c[ ............................ Location of Property ...9.5 ................. C.~..e.~..z~.(.e.w..4¥.e....~.,.~.~. ...... ~.9 .~.'b~q~..c1... House No. Street Hamlet County Tax Map No. 1000 Section .. ~).~.O ...... Block ..... Q~. ........ Lot .. ,0.0~ ........... Subdivision ......... ~2 .................... Filed Map No... ~ .... Lot No...X.. .......... conforms substantially to the Application for Building Permit heretofore fried in this office dated ..... g_u~z$~..29 ..... , 19. ~3.Z~pursuant to which Building Permit No ..... ~. 33.c).~...~ ......... dated .... A~g~.q. E~ .............. 19 .~, 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 ......... ......... axe. a.eeess.oa?7. abed ................................................... The certificate is issued to ~AIxI~ ]3~D~R _. {owner, &~e-o~er~) of the aforesaid building. Suffolk County Department of Health Approval .... ~I/.]~ .................................. UNDERWRITERS CERTIFICATE NO. n/~ Rev. 1/81 Building Inspector FORM NO. S TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. N? BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 13398 Z Uote .~....~. ......................... , ............. Building Inspector. County Tax Mop No. 1000 Section ..... ,0,.,~.,.,?, ....... Block ......... ~, .......... Lot No ......................... 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 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: I. 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 pZt)perty showing all property lines, streets, buildings and unusual natural or topographic 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 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 Date ...... ~.. ,~./~.~.. ......... New Building . ...~...~.~_?. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ?~.. ' ~ ' /~'- ~''~'~H~ . House No. Street ie't Owner or Owners of Property ~..~/./Y'....~.....-~...~7.../?./.~..~...~,...~.C~,;~7..Z? .~.~.~ ............... County Tax Map No. 1000 Section ...~..~.(~. ........ Block ... ~.~.~ ........ Lot.. ¢7.4~..~. ........ Subdivision .~.<~/.~....~..~'..~'.. z~..-~../~.. ·~. .......... Filed Map No.~..~.~?'.<~. ....Lot No .............. Permit No</. -~..~ ~---... Date of Permit ?.~.~/~.~..Applicant..~.-./-~/~.~'. ~... Z~.~.~.~. ~.~. ...... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .... (.-~T. ................ Fee Submitted $ ............................. Construction on above described building and p~)'mit meets all applicable codes and regu lations. ~O~:= /,~4zL~/ Applicant..~.~Z~,...~../~'~,Yc~f~/-/ ............... ' . FIELD I~N S P ~Fi' I 0 N COMMENTS FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: ~ ~PImF-OVi~D AS NOTED FE~. /~,~ ~: , ? - * ~- v.~ NOTIFY BUILD Nm ~EPA~fMENT ~T ~5~802 9 AM TO 4 PM FOR THE ~[ROWlNG INSPECTIONS: ~ ~UNDATION . TWO REQUIRED o ~R POURED CONCRETE ~ R~.UGH. ~RA~ING & PLUMBING ~F~AL - CONSTRUCTION MUST m B~CO~PLETE FOR C. O. ~L ~ONSTRUCTION SHALL T~E ~EqUIREMENTS OF THE. S~T~, CONSTRUCTION ~ CqD~. NOT R~SPONSI D~I~ OR CONSTRUCTION /'. Construction.' Pleasenote t,,hat roof of s~e~ be "Barn type!' The overalI heignt wili still be 8feet. GABLE END Q ~ 3 - ATTACH LEFT ~LEAR OABLE END Q TO ~IGHT ~EAR GABLE END 4" framing siding - ATTACH LEF~ SIDE QT0 ZEST $IDEQ DOOR OPENING 8 - ATTACH RIGHT RIGHT ROOF PANEL [0 - ATTACK LEFT ROOF pANEL G II - ATTACH DOORS 1~ i2 - ATTACH TRIM Q 13 - ATTACH SHINGLES Q START AT LOWER LEF__~T HAND CORNER OF HIGHT ROOF PANEL COMPLETING HACH COURSE OF SHINGLES UNTIL YOU REACH THE HI~E OF THE ROOF. THEN REPEAT PROCEDURE WITH THE LEFT ROOF PANEL. WHEN SHINGLES ARE COMPLETE, THEN PLACE A CAP STRIP OVER THE RIDGE OF THE ROOF4 Copyright i~?~ by N. $o Martin FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examinedu~. ~..~.. ,urg.~..&.~., 19~ ..~ Approved ~.u~..~..~.~..., 19~]. Permit No. Disapproved a/c ..................................... Recemved ........ ,19 . · (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ........... , 1 . 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 necessaryjl~spections. f (Signatur~of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general' contractor, electrician, plumber or builder. Name of owner of premises . .,~'r'ff..H. gt(... ~.....~'...(7~z-L~.. · .,.77.,../~.4F~.,~i. eff[.~.. ' (as on ~the tax roll or latest deed) " If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ~ U Plumber's License No ......................... '~ Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done/~?~.~'~.~x-/7 .~./TZ. ¢~.~-/.~.~Z~-~. ~F~.~&~ ~.~. ~ . .............. o.L ................................ House Numbe} Street Hamlet County Tax Map No. 1000 Section . .~ ~ .......... Block . .~ ............ LotO.~q. ............. Subdivision~~/~. ~ ............... Filed Map No.~.~ ....... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed const~ction: a. Existing use and occupancy . ~ ~.~ ~4L'. ~,vAO~ ....... ...................... b. Intended use and occupancy ~ff.~(~ .~. ~ ~Y~~O~x ~.~l/~ ...... Repmr ~::. ~--~tlremgval .............. Demohtlon ............. Other Work ....... ........ ' "~ ~i (Desc~ption) 4. Lst~ma~eac6st .... ~..., ......................... Fee .................................... k,_,.l~lling]units ............... Number of dwelling units on each floor .............. lf~ _ ._.z:,-:. _~garag~ number of ~...; ................................................... : ............. 6. If business, commercml or mlxe~d occupancy, specify nature and extent of each type of use ..... . ................ 7. D~ensions of existing structures, if any: Front..~. / . Rear Depth Height ............... Number of Stories .... / ................................................... D~ensions of same structure With alterations or additions: Front ................. Rear .................. Depth . HeiSt Number of Stories new construction: Front Rear Depth 8. Dimensions of entire ............................................. -Height ......... Number of Stories ...................................................... 9. Size of lot: Front ../~cg~, ~ ........... Rear .~F~,T ................ Depth .~ ............... 10. Date of Purchase .Or/~/~ ................. Name of Fomer Owner ~/~/~. ~x ~ ............ 1 I. Zone or use district in which )remises are situated ..................................................... 12. Does proposed construction rio,late any zoning law, ordinance or regulation: ~ ............................ 13. Will lot be regraded ../~... ~ .................... Will excess fill be removed from premises: Yes Nme of Architect ..... ~ ............... Address ................... Phone No ................ Nme of Contractor ... p.~&&. .............. Address ................... Phone No ................ .PraT DIAG~M Locate cle~ly ~d distinctly ~! bu~d~gs, whether existing or proposed, and. indicate ~1 set-back d~ensions from prope~y ~nes. Give street ~d bloc[ number or description accord~g to deed, ~d show street nines and ~dicate whether interior or comer lot. N ~ °51' I00" IAI i J~u~ t CLEARVIEW AVE -WEST STATE OF NE~ir~)RK: . ~ ·..~.~.,'V. ~...~7~.,. ~..~¢.~.49.~..~ .... ~ ..................... being duly sworn, deposes and says that he is the applicant (Name .... of mdwldual s~gmng contract) above named. He is the ' ! (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly 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 tile 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 ' Notay Public,, .......... ~:~...~ . County