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Home My WebLink About13240-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y, Certificate Of Occupancy No.. z-15576 Date April 2, 1987 ENCLOSE EXISTING PORCH THIS CERTIFIES that the building ................................................ 4105 Oaklawn Avenu.e E. xtension Southold, N.Y. Location of Property ............................................................. House No. Street Ham/et County Tax Map No. 1000 Section 0 70 ..... Block 10 .Lot 0 10 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated June 18, 1984 13240 g ' pursuant to which Building Permit No June 20, 1984 dated .............................. 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 ......... ENCLOSE EXISTING PORCH THOMAS F. & MARIE LLOYD The certificate is issued to ..................... [ohJn'o;','/"d~'7~/ft$,~'M'f~ .................... of the aforesaid building. Suffolk County Department of Health Approval N / A UNDERWRITERS CERTIFICATE NO ................. N 66 I 730 N/A PLUMBERS CERTIFICATION DATED: Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERJ~IT (THIS PERAAIT MUST BE KEPT ON THE PREMISES UNTIL FULL COAAPLETION OF THE WORK AUTHORIZED) N? 13240 Z Permission is hereby gronted to: ....... ........................... et premises locoted o, ~.t.~..,.~ ..~..~ ~ ~,*. County Tax · '"/o ~ ~ Map No. 1000 Section ir-.,.O ................Block ........ J..~ ........ Lot No .......~. .............. \, pursuon, to opplicotion doted ...... .~.../...'~. ....................... , 19.~..~.., oncl opproved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall $outhold, N,Y. 11971 ,o~,i 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY ~¢cf. C-g, ~ohis application m~st bo filled in Wpewritor OR Ink, and submitted m~ ........... ~ to the Buildin9 In~ec- r wi~h the following; for new buildings or new use: I. Final su~ey of prop~rW with acetate location of all buildings, prope~y lines, streets, and unu~al neturat 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 Unde~riters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and in,alia- tigris, a certitlcate of Cod~ 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 ~ey of p~perW showing all property lines, streets, bui)dings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancv and condition of buildings. 3. Date of any housing coda or safety inspection of buildings or premises, or other pe~inent inferreR. tion required to prepare a certificate. C, Fees: 1. Ccrtificate of occupancy New Dwc. llln,,;,$25.00, 'Accc.~or~' ,.$I0.00 Bu~illea:~ $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0 3. Copy of ccrtif~cate of occupancy $ 5.'00, over 5 yeare $10.00 4.Vacant Land C.O. $ 20.00 ,../V~^~c , ,~ ,~ ,~,c,'~ 5. ur~datod C, .O. $ 50.00 D~te ... I. l~J~.. ~. ?~...~7~.; ./.7. ~f .' ./. 6. hltcrat~on $25.00 . . / NewCOllS t,z-uc t, ion ...... Old o¢ Pre-existing Building ... ~. ....... Vacant Land ............. Location of Property ....,. ............................ .,.~. ............ I/ ......... Owner or Owners of Proper ...... ,.. .... : ....................................... County Tax Map No. 1000 Section .... ,~, ,'?.P. .... Block ..... /, .~, ...... Lot ............... ' ' ' Filed Map No Lot No Subdw~smn ......................................................... Health Dept, Approval ........................ Labor Dept. Approval ....................... Underwriters Approval Planning Board Approval Construction on above described building and permit meets all applicable codes and regulations. Ap~ficant ..... ~.~ ...... FORM NO. 6 TOWN OF SOUTHOLD i]uilding Department Town Hall $outhold, N.Y. 11971 765- 1802 .... ~ APPLICATION FOR CF. RTI FICATE OF OCCUPANCY ~/~r.u.~ Instructions ~,O, i~ c~(- ~obiS application m~st bo filled in Wpewriter OR Ink, and submitted m ~ to the Building r with the following; for new buildings or new use: 1. Final su~ey of property with accurate location of all buildings, pmpe~y fines, streets, and unumal natural or topographic fea~res. 2. Final approval of Health Dept. ef water mpplv and sewerage d[sposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Unde~riters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and in.alia- tigris, a cert{fic~te of Coda compliance from tho 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 ~957), Non.conforming uses, or buildings and "pre-existin9" land uses: 1. Accurate ~ey of p~perty showing all property lines, streets, buildings and unusual natural 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 ?few inspection of buildings or pram{sas, or other pe~inent informa- tion required to prepare a certificate. '. C. Fees: 1. Certifieateoloccupancy New DwellJ. n~.$25.00, 'Acce,.~or~, t$10.OO Bu~.[ne~, 2. Certificate of occupancy on pro-existing dwelling $ 5 O. go 3. Copy of certlficate of oecupancy $ 5.'00, over 5 yeare $10.00 4,Vacant Land C,O, $ 20,00 A4~- - 5.Updated C,O, $ 50,00 D~te ,, ,/, j~. ,c~-~, ,~,, ,~.~ ,/.7,4.'./' 6, hlteration $25,00 . ~/ ' NewCons truc tion ...... Old or Pre-existing 8uildtog ,,, }',. ....... Vacant Land ............. 'goat,goof Property ....+.)..O..5. .... House No. Stl'~t Ha/hie t Owner or Owners of Proporty ..~v.{.~....~,~L~,j.~.~;./1 --~ ..............: _~/~1 LL..O..~.... ....................... County Tax Map No. 1000 Section .... ~.'~..~. .... Block ... /O Lot ..... · ' ' Filed Map No Lot No Subd~v~smn . ........... ...... , .... Health Dept. Approval ........................ Labor Dept, Approval ....................... Underwriters Approval Planning Board Approval Request for Temporary Certificate ..................... Final Cortiflcato ...................... ' "ubm tied ~' ~ ~ '~: reeb e ...... ,,,, ,, ,, ............ Construction on above described budding and permit meets all apphcablo codes and regulauons. Applicant ........... II,v. 10'10 78 TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 'rowN HALL $OUTHOLD, N.Y. 11971 TEL. 765-1802 This is co advise you that the job under building permit no, 13240Z issued to Tom Lloyd on 6_/_~2_0./84____-~-'fo--~- Now Dwelling is completed and a final inspection has ( ) has not ~---~'~-been done. in order to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a check for $25.00 payable to the Town of Southold. Please indicate to Whom thc Certificate of Occupancy is to be mailed, and arrange with this office for an inspection date Occupancy or nsc in nnlawful without a Certificate of Occupancy, Please help us to clear up this matter so that legal action does not have to be taken, Thank you for yo.r prompt attention. Very truly y~, Victor Lesaard Executive Admiuia~rator VL:gar ~ooo~ T H E October 1, THIS CERTIFIES THAT NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 19~,~;b,~ 85 JOHN STREET, NEW YORK. NEW~:~.O~8__ ~ ~p,,~,o. ~. ~.~,,~ N 66~730 only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of Thomas Lloyd~ 765 Oaklmwn Avenue,~it 1, ~ou~hold, N.Y. 1 in tt~e followlmg location; [] Basement ~ep~;~3er OUTLETS 1 4 2 1 [] /st FI. FIXTURES [] 2nd FI. ~ Section Block and found to be in compliance with the requirements of this Board. RANGES COOKING DECKS OVENS ,FLUORESCENT Lot EXHAUST FANS DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME ?lOCKS MULTI-OUTLE1 SYSTEMS ' NO. OF FEET DIMMERS SERVICE DISCONNECT OTHER APPARATUS: S E R V NO. O~ERCC~CONO. A W O, [ I C E OF HI-LEG NO, OF NEUTRALS OF CC, COND. NO- OF HI-LEG A.W. G OF NEUTRAL P~ul Burns Town ~ku-bor I~ne ~outhold, N.Y. 119~1 This cerTiTicate must not be altered in any manner; return to the office of the'Bo6rd if COPYFOR BI JlLDING DEPARTMENT. LIc 11 Per ,may be identified by FIELD INS?ECTION COMMENTS FOUNDATION (15t) FOUNDATION ( 2nd ) ROUGH FRAME & PLUMBING INSULATION FERN. Y. STATE ENERGY ~ODE ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR I'.0. BOX 728 TOWN IIALL SOUTHOLD, N,Y. I [97t '[ F.L. 765.1 'ft, ls [,'~ to advlne you that the job under bnildtng permit no. 13240Z issued to Tom Lloyd ~._/.~0/8~ ...... for New Dwel~ [~ completed final inspection has ( ) has not ( x ~been done. and in order ~o complete this file, it is necessary that Certificate of Occupancy be issued. Please fill out the (!nclosed forln, return same ~o the above office with n check £or $25.00 payable to ~he Town of Southold. Please {ndicate Whom the Certificate of Occupancy is ~o be mailed, and arraDge with ~his office for aa inspection date Occupancy or use in unlawful without a Certificate of Occupancy. Please help nn to clear up this matter so that legal action doe~ not have to be taken. Thank you for yo,r promp~ attenCiono Very truly Victor Les~ard Executive Administrator VL:gnr FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined..~ .~..~,..~'..~. .... , 19~.~.. Approved .~..t'P'~4....~.9 .... , 19~. '.q. Permit No. J.~ .~. t.~.O. . .~5-. Disapproved a/c .......................... ' ........... Application No .................. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must b~ 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 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 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 Occupahcy 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 build/ngs, addit/ons or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, ~nd regulations, and to admit author/zed inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) (Mailing add~ess of applicant) ~ ~ ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as o/{ 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 ..... .6~.'7/. ................ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. O. ......... o. ............. · .................... House Number Street Hamlet C;hnty Tax Map No. 1000 Section . .0...'~ ..O. ...... Block ........ /..O. ....... Lot...O. [..O. .......... ~ 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 ....~.O..~.f,~4~ ................................................. ......... b. Intended use and occupancy · .~./.7:'~&"~.t~. - · .~5'./.O..~. ..................................... o 11. 12. 13. 14. Nature of work (check which applicable): New Building .......... Addition ...... Alteration ..... · · Repair .............. Remoyal .............. Demolition .............. Other .... Work ............... Es ate st ......................... Fe .......................... (to be paid on filing this application) If dwelling, number of dwelling hnits ...... / ....... Number of dwelling units on each floor ................ If garage, number of cars : If business, commercial or mixed! occupancy, specify nature and extent of each type of se ~ Dimensions of existing structured, if any: Front.. ,~..~./. ........ Rear ...~-~'.~./. ...... Depth ....~,. · ?' Height .... 1.4./........ Number of Stories '. .... ./ .................................................. Dimensions of same structure with alterations or additions: Front .. ~S~t'~2.~. ..... Rear ...,~"~-~. ..... pth ' Hight ..... ber of Stories ........ De .................... ,. e ................. Num .............. Dimensions o~f/entire new construction: Front ....... Rear ...... e ...... ight 1~. N 6e fSt fi ........ Size of lot: Front ........... i ........... Rear ...................... %.~.~_ .~ ................... Date of Purchase 0~'-/.., .~ .[. ~.~..~. ............... Name of Former Owner ~ ...... .~...~'g~. ......... Zone or use district in wtfich premises are situated ......... Does proposed construction violate any zoning law, ordinance or regulation: ................................ Will lot be regraded ......... i ................... Will excess fill be rem~vedr~rom premises: Yes No Name 6f Owner of premises . ,Z~-~O/~ ............ Address: .O~P. X4~r~ .~Yt~F~ZSF./7. Phone No ................ Name of Architect .......... . it ............... Address ............. .~ .... Phone No ................ Locate clearly and distinctly all ibuildings, property lines. Give street and block interior or corner lot. PLOT DIAGRAM whether existing or proposed, and, indicate all set-back dimensions from umber or description according to deed, and show street names and indicate whether STATE OF NEW YORK, S.S COUNTY OF ................. .................................................. being duly sworn, deposes and says that he is the applicant (Name of individual sigmng contract) above named. He is the ......................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dul~ 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 manne.r set forth in the application filed therewith. Sworn to before me this HELEN K. BE VOE ,, _r~~ .~ .................. NOTARY PUBLIC,, State of New York No.~7~;Sr78, ~,*,,olk ~0untl ~ (Signature of applicant) Z <( 0 ' t h