Loading...
HomeMy WebLinkAbout13286-zFORM NO. ~, TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z-I5559 Date April 1, 1987 THIS CERTIFIES that the building DECK ADDITION 23780 Main Road Orient, N.Y. Location of Property//~Os~ County Tax Map No. 1000 Section 0 ! 8 .Block 5 ..... Lot 1 7 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated J u i y 9, I 9 84 pursuant to which Building Permit No. 13 28 6. Z July I6, 1984 dated ............................. was issued, and conforms to aH of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... DECK ADDITION TO EXISTING ONE FAMILY DWELLING The certificate isissued to EDWARD & CATHERINE LOPER ..................... ?o¥,,'o'r, ..................... of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... N/A UNDERWRITERS CERTIFICATE NO .................................................. N/A PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 FOB,M NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMEHT TOWN HALL SOUTHOLD, No Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted o' , ~..&!.3 .................................................... · ©~.~....~:.~: ...... u.~...~. ........... .. ~ at premises located at ...~.,.~....-~....~...~. ....... ~.C~......~. ............ .~.~ ................................ County Tox Mop No. 1000 Section ~ [ ~ Block "~ Lot No. .-] ~ursuont to application doted ...... ~.4~4,t....~. .......................... , 19.~...~.., and approved by the Building Inspector. Fee $.~....~....~ ..... Rev. 6/30/80 FORM NO, g TOWN OF $OUTHOLD Buildin[I Department Town Hell Southold, N,Y, 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must bo filled in Wpewriter OR ink, and submitted ,~, ~ 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 unu~al natural or topographic features· 2, Final approval of Health Dept, of water supply and sewerage disposal-iS,9 form or equal), 3, Approval of electrical installation from Board of Fire Underwriters, 4, Commercial buildings, Industrial bu~ld'ngs, 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 appl'cable, For existing buildings (prior to April 1957)0 Non-conforming uses, or buildings and "pro-existing" land uses: 1, Accurate survey of property showing all property lines, streets, buildings end unusua~ 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 inspectior~ of buildings or premises, or other pertinent informa- tion required to prepare a certificate, C. Fees: , ' 1, Certilicata of occupancy New Dwell~n~'~.$25,00, Acce.~,~ory tS10,00 gua~ne.~: $50.00 2, Certificate(~foccupancyonpre-ex~stmgdw II ng $ 50 00 3. Copy of certificate of oecupancy $ 5,'00~ ove~ .5 yeare $I0.00 4.Vacant Land C.O. $ 20.00 $ 50.00 Oa e ..... 5. Ur~datecl C.O. 6. Alteration $25.00 NawCons ~uc~ion ~... Old or Pre.existing Building ............ Vacant Land ............. Location of Property ~..,5.. ,?'~;:".~. .... ./~.,~2././f/:'..,~..~.-~. ~. ................. ~.,'~/.~-.-/~.~ ............ House No. Street Ham/er Owner or Owners of Property .¢~,'~/~¢~,~.~,..¢~,',..~..¢'~"~' ~k~"f', '/~'' '~'' ~' ''' · · '----C'"~' "~'~2~' .... County Tax Map No. 1000 Section .. ,~, ,/~, · ....... Block .., ,4~. ,-~, ........ Lot... ,~,~,'. ,'~ ....... · · · Flied Map No Lot No . . Subdmws~on ........................................................ Permit No./,3,,~,~,~.~. Date of Permit ?,~,~f~',t..Applicant Health Dept, Approval ........................ Labor Dept, Approval ........................ Ur, derwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ... ~. ................. Fee Submitted $. ~,~,~ ....................... Construction on above described build'ng and permit meets all applicable codes and regulations, TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN ItALL $OUTHOLD, N.Y. 11971 TEL, 765-1802 Ti~ia is to advlac you that the job under building permit no. 13286Z issued to Edward Loper on ..... 2/161Bg___ for Addition £a completed a final ~nspect~on has ( ) has not ( x Y-been done. and In order to complete this file, it is necessary that a Certlf~cate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a check for $25.00payablc to the Town of Southold. Please indicate to Whom the Certificate of Occupancy ks to be mailed, and arrange with this office for an inspection date Occupancy or use is unlawful without a Certificate of Occupancy. l'leat~e, help ns to clear up th~a mutter ,o that leg;il action does not have to be taken. Thank you for yo.r prompt attention. Very truly y~, Victor Lesaard Executive Admlntstrator VL:gar earl. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION /ND [ ] INSULATION [ ] FRAMING REMARKS: ~ FIELD INSPECTION FOUNDATION (~st) FOUNDATION 2. ROUGH FRAME & PLUMBING (2nd) ~NSULATION PER N. STATE ENERGY ~ODE COMMENTS ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL.: 765-1802 ApprovedEXamined i~..,. I .~.~. ....., 19~. · · ' Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No .................. Date.. ?/..~. / ......... , 19~.z~- INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to thc 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 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 necessaw inspections. . .ox . . ........ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, pluinber or bfiilder. .... .................................................................................. Name of owner of premises .~..~.16et~.~..~.- ~.'.-,~...~.~.;?'~.*/~'7,~./.~.~..~.,...~.O~. ~. ..................... (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 ............. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. · .......... ...................... OX I ........................ House Number Street Hamlet · C~unty Tax Map No. 1000 Section ., .O/ff. ........... Block . · · 67. ~.. .......... Lot .... tTtt.ff.. ........... Subdivision ................................ Filed Map No ............... Lot ............... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . ../...~.~.'~/..~' .~.. ,~gk'~..'~q ~" ....................................... b. Intended use and occupancy ~-~. · · ~. · .' .,,- ' : i .~. 3. Nature bfwork (check which applicable): New Building .......... Addition ......... Alteration .......... Rep air ........ i ..... o ~ ......... e n ....... r r ............... Rem val ..... D molitio ....... Othe ~.W? k (Description) 4. Estimated Cost . . .~.d?~. ...... ~ ........................ 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 ..... ' .................................................................. usiness commercial or mixed occupancy, specify natur~ and extent of each.type of use ........... i ........ 6. Ifb , _,~,, Dimensions of existing structure~,if any: Front .~..~..~ ........ Rear .fi-:../(. ........ Depth .,~2...~. ........ 7. ight /~· ......... b [ ~'tg T ~" He ...... Num er of Stories '. ........................................... ~; ........ Dimensions of same structure with alterations or additions: Front .~ .... .ti ....... . Rear .. ~.. .......... · · ' ; .H ' t... · Depth .... ~.~. ............. :.. elgh ?'.~. ............ Number of Stories. ~ ...... ~ ......... 8. Dimensions of entire new construction: Front ~'t¢'*~''° ' ' ' ' ~ ~"~'t*' ' ' ' · .............. t~ear . ~..-, ........... Depth .tZq. .......... Height /.t(.t ......... Numiber of Stories .../. ................................................... 9. Size of lot: Front . ./.~..0 . ., .......... Rear . ~.~-'~. ............... Depth . ./l~'.~...~..~. 10. Date of Purchase ..../~,~....! .................. Name of Formar Owner ............................. dmises' it t d ~.~. 11. Zone or use district in which pr are s ua e ................................................ 12. Does proposed construction viol'ate any zoning law, ordinance or regulation: . ~O ............................ 13. Will lot be regraded .. ~0 .... ; ................... Will excess fill be removed from premises: Yes 14. Name of Owner of premises ~"~/.td,~. ~... g'~M?.~-/~. Address/~.~'/d{.~,/. ~/.~i~,F,~.. Phone No. 4~.. 7 .~.,~'~, ·... Name of Architect ! Address Phone No ............... Name of Contractor ......... i ................. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctl ali buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and lock!number or d~scrip~{~>n, according to deed, and show street names and indicate whether interior or corner lot. ____} ............... t50.Q STATE OF NE~ , y/4 ~.~ .... .~.~...~. ~0.. ~..~. ~.Q~&. ¢... being duly -- (Name of individual signingtcontract) sworn, deposes and says that he is the applicant 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 ail statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manher set forth in the application filed therewith· Sworn to before me this ~7~ UJ~ 19°0 Notary Public, .... _______ _.~_'~~~ County~ ~~// '-~ . ' TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR I'.0. BOX 728 TOWN IIALL $OUTHOLD, N.Y. 11971 TEL. 765-I 802 This in to advise you that the job under building permit no. 13286Z issued to Edward Loper on ..... 71.~.6_L~A .... for A~dition is completed a final in~lpeetion I'~n,'~---(- ) has not ( x )"been done. and tn order to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed forla, return same to the above office with a cheek for $25.00payable to tile Town of Southold. Please indicate to Whom thc Certificate of Occupancy is to be mailed, and arraage with tills office for an inspection date Occupancy or use is unlawful without o Certificate of Occupancy. Plenne. help ns to clear tip th~e matter so that legal action doe~ not have to be token, Thank you for ye)ur prompt attention. Very truly yo~.~, Victor Lesaard Executive Administrator VI,: ga r CtlC ] . .Zk ~ : ~ FEE: ~----ST;,'; -;:,T,.. ~ DEPARTMENT NOTIFY 7.65-180? 9 AM TO 4 PM FOR TH[' FOt~t.[DgVlNG iNsPECTIONS; 1. FouNDATION ' TWO REQUiReD FG~' 90UR~D GoNCRETE 4 FIN~I _ C~:~rRLi~TiON MOSq STATE ~SN~RU'CTION' & ENERGY ................................ CODES. NOT RESPONSIBLE FO~ ~GN'~ coNSTRU6T~N ER~. ~c~vb S ' ' ALL Cr ........ STATE CON~TI'RUCTION CODES. NOT