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Home My WebLink About13438-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y, Certificate Of Occupancy No. Z12896 Date October 17 198.4. THIS CERTIFIES that the building Addition to One Eamily Dwelling Hay Harbor ROW off Equestian F.I. Location of Property/-I&Js~ h/el ...................... 's't/e~i ....................... County Tax Map No. 1000 Section 009 ·Block 01 .Lot 013 Subdivision X .Filed Map No. .Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·...S.e.D .~: ......1.2 ..... ,19.8.4. pursuant to which Building Permit No. 13438~. dated .............. .S.ep.~:...1.3.... 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 ......... ... Ad~]i~AQr~. ~.o..~.i.~.~J~g..0..r,_.e..~m..J...1.~. ·D..w.e..]:$$pD'. ............................ The certificate is issued to CATHERINE LESLIE (owner, of the aforesaid building. Suffolk County Department of Health Approval ......... N../.A.. ............................. N/.A UNDERWRITERS CERTIFICATE NO ................................................. Building Inspector Rev, 1/81 FORM NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13438 Z Permission is hereby granted to: . ,, ~) . -- .... ~...~....: ........ ~.....,~.?,~,....~... ...... .............. '"~"~'~"'~~': .......... ~-'::--":"_' ...... ~:'-~ ....... 'r'" at premises located at .....1~..,..~.......~_..)..~...~'..~'aL~,~q~...d.~k1~.....~.....~.~...b~.., County Tax Map No. 1000 Section ...... ..(~....~. ........ Block ......... !. ........... Lot No ......... ).....~. ........ pursuant to application dated . ...~.' ............................... , 19.JJ..kJ., and approved by the 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 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 peoperty showing a~{ property lines, streets, buildings and unusum 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 or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date .......................... New Building ............ ./Old or Pre-existing Building ............ Vacant Land ............. House No, / f ] Street Hamlet County Tax Map No. lOOOSection ...~...~.' ....... Block .... f. ......... Lot. Subdivision .............................. ,...Filed Map No./c) ....... /'.~-ot No .............. Underwriters Approval ...... ,/~'/~. .............. Planning Board Approval .. ~././~. .............. Request for Temporary Certificate ..................... Final Certificate ....................... Fee submitted $ .~.~. ....................... Construction on,_above, described building and p~ermit meets all applicable codes and regulations. Rev. 10-10-78 COMMENTS FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: FORM NO, 1 TO~'N OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Yo E am ned .... Approved ..~...~:~..~....)..~..., 1~2.~..~.. Permit No ............5 ...................... Disapproved a/c ............................................................................................ Application No ................................. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or' in ink and submitted in triplicate 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 oF areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. 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 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 buildings for necessary inspections. ..... ~(Signature of oppli~, or name~, a corporation, ........ ..................... (Address of applicant) State ~er applicant je'~/vner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. / ; I ' .......... .L:Z'~z.~.~ L .....~...~~ ................ ., ......... . ................................................................................................... Name of owner of premises ~ ~ ................................................................... If applican~is a corporate, signature of duly authorized officer. ........ ......... ~ (Name and title ~corporate office I .o ....... ...................... Plumber's License No....~.~...C...~ ...................... Electrician's License No. ~ ~ ~ D~ Other Zrade's License No ...... ./.~.~.~ ................... 1. Location of land on whic~,proposed~rk will be ~ne. Map No.: ........................................ Lot No ......................... Street and Number ..~'' ...... ~-~....~¢~.~ ............................................................................................... Municipali~ 2. State existing use and occupancy of premises and in~ed use and occupancy of propped construction: a. Exisiting use and occupancy ....b~.~......~.~4(~c~ ......................................................................... b. Intended use and occupancy ................................................................................................................................ property lines. Give street and block whether interior or corner lot. 3. Nature of work (check whichiapplicoble): New Building,. ................. Addition .~. .......... Alteration ................. Repair .................. Removal i .................. Demolition: .................... Other Work ..................................................... ,~ j~, ' (Description) 4. Estimated Cost '""~"~"~'""i~ ...................................... Fee (to be paid on filing this application) 5. If dwelling, number of dwelli,ng 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 ................................ ~ Height ............................ Number of Stories ...... ~ ..................... 8. Dimensions of entire new cohstruction: Front .................................... Rear ............................ Depth ........................ Height .................... Num~;~r~.~of Stories ................................................ ;~ ................................................ ~. ................. 9. '~ize of lot: ,Front ............./.~.'... ................................... Rear ....... ./'..~'~. ........................... Del~th ...../..~..~. ..................... 1'0. XDate of Purchase"..~. .....' ....... ~:.;...' .................................. Name of Former Owner ..~....~..~.......~...t~.~..$. .............................. I J. Zone or use district in which ,'premises are situated .................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded ....~.~",~" ...........Will,excess fill be removed from pre,~'~'.~mises: ( ) Yes ( ) No 14. Name of Owner of premises .(..~!~'.~.¢.¢......~...~..'...~r. .................... Address~fC¢.'.~. ~.~.~..,~ ........ Phone No..?..~.-C.~...~..~..... Name of Architect ..... ~.....i.,7)....,..~......./~)/~ / - ................... Address., .............................. Phone No ....... L' .............. Locete clearly and distinctly a!l buildings, whether existing or proposed, and indicate all set-back dimensions from number or description according to deed, and show street names and indicate ........ .~.%..;~.~.~.~ ....... ~.~ ...... ~.~..~,&~ .................... : ....... being duly sworn, deposes and says that he is the applicam (Naif individual sig~ing contract) above named. (--) He is the ................... ~ ............. ~ ..................................................................................................................................... I (Contractor, agent, corporate officer, etc.) of said owner or owners, and is ddJy authorized to perform or have performed the said work and to make and file this application; that ali statements contained in this application are true to the best of his knowledge and belief; and that the ~ork ~i[ be performed ip fha manner set foffh in the application filed therewith. Sworn ~efore'me this J~ [ [ / ~ _ ' ; ........ ~ (Signature of append) ~tlfled in ~ffoIk County ' Term ~plres lor water distributing syslem~ piping shall be ~ ~.%~ ;~x,~ ~es K or L only ;'"' '"" ' . APPRO¥~-D .~S NOTED NOTIFY BUILDING DEPARTMENT AIl 765-1802 9 AM TO 4 PM FOR FOLLOWING INspECTIONS: 1. FOUN~A~ION - TWO REQUIRE~ FOR POUREO coNCRETE 2, ROUGH - FRAMING ~ PLUN~BINC 3, INSULATION ~. FINAL - C~'ST~t~CTI~N BE C~'~ FTE FOR C.O. ALL CONSTR CTION S~ALL T~E REO~ ~2~M~NTS O~ TU~ .... ;+':- ~;ONqTRUCTION ff....]" ~r ' :S ~NOT REqP~ ~ ;IGN OR ~NSTRUC