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Home My WebLink About13037-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-15364 Date March 18, 1987 THIS CERTIFIES that the building B e c k A d d i t i on 1505 Leeton Drive Southold, New York' Location of Property ~/$~$~ }V'o] ....................... ~/e~t' ....................... P~r~/e~ County Tax Map No. 1000 Section 59 ,Block 1 .Lot I 7 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated April 4, 1984 13037Z ....................... .. pursuant to which Building Permit No ...................... dated............................April 13, 1984 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 ......... DECK ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to CLIFFORD & VIRGINIA SMITH ..................... .................... of the aforesaid building. Suffolk County Department of Health Approval N / A N/A UNDERWRITERS CERTIFICATE NO .................................................. N/A PLUMBF. R$ CERTIFICATION DATED: Rev. 1/81 //Building Inspector ~0~ NO. ~ TO~ O~ $OUT~OLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. N? BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ....,.~..~~..~ ......................................... ~..~.-~ ....... ~...~.~.~...~.:..~....l.~.~..o. ,o....~...~.~.~.' "'...~~.~... ~,....~..'..~.~.....~.~.. ..~~.~.~...~~..,.~.~....~~.~ ........... ,. ............................ ~s~'~ed at ..J.~~.~..'..~.. ~ ....... c~...J~....~ ....... · . .............................................. , 19.~.. .... ond a roved b the Building Inspector· Bu~lJding Inspector Rev. 6/30/80 TOWN OF $OUTHOLD ;, ,. ~ ,,~/ Building Department f: ,' iv . 4199 !II Town Hell Southold, N,Y, 11971 ~-: ....... ih~ 765- 1802 , ,. .... ~ APPLICATION FOR CERTIFICATE OF OCCUPANCY- · ,-' '::" '~-P .... Instructions This application must bo filled in typewriter 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 Pire 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 buitdings (prior to April 1957}0 Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate ~e¥ of p~perty, showing ali 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. C. Fees: 1. Certificate of occupancy New Dwelllng,$25,00, Acces,3ory ~$10.00 Bu~me.;~ $5(I.00 2 Certif cam of occupancy on pre-exmUng dwo! mg $ 50, 00 3. Copy of certificate of occupancy $ 5/00, over 5 yeare $10.00 4.Vacant Land C.O. $ 20.00 ~ /¢~7 5.u a t.a c.g. $ 0.o0 ........... 6. hlteration $25.00 New C on s t ~ u c ~ i on Old or Pre-existing Building Vacant Land . Location of ProperW / ~ 5-- L ~i ~ ~Z~ .. County Tax Map No, 1000 ~octlon ........... Block .............. Lot ............ ' ' ' Flied Map No Lot No Subd~wsmn .......................................................... Permit No. Data of Permit . .Apphcant / ' Health Dept. Approval ........................ Labor Dopt. Approval ........................ Underwriters Approval Planning Board Approval Request ~or Tempora~ Gertificate ..................... Flnal Certificate .................... Fee Submitted $...~..~...~ .................... Construction on above descmbed budding and permit meets all appli.ca]~)l~ d~es and regulations. Applicant .......................... TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN ItALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 This ' ' ' ' zs to advzse you that .the job under building permit no. 13037Z issued to Cllfford Smith on 4/13/84 for Addition is completed and n final inspection bas ( ) has not ( x ) been done. [n order to complete this file, it is necessary that a Cert~ ficate 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 {ndicate tn Whom tire Certificate of Occupancy is to be mailed, and arrnnge with this office for an inspectlo~ date Occnpancy or use is unlawful without a Certificate of Occupancy. plenne help ns to clenr np this mntter so that legal action does not have to be taken. Thank you for your prompt attention. Very truly y~, Victor Lessard Executive Administrator VL:gar encl. FI EL]i~ I ~S~ ECT ION COMMENTS FOUIIDATION (1st) FOUNDATIO[1 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PE~l N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: Disapproved a/c ..................................... 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 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 throuy~hout 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~regul.~ations~ and to admit authorized inspectors on premises and in building for necessary inspecti~~ ~.- (Signature of a~p~.ic~nt, or flame, if a corporation) (Mailing addres§ of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........ ............................................................................ Name of owner of premises (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 ~frade's License No ...................... 1. Location of land on which proposed work will be done. / Ogd ~'~ ~?~c]~ L~ House Number Street Hamlet /.7.' County Tax Map No. 1000 Section .~..'~/ ............ Block ..... ~;[. ........... Lot.. 7 . ............. 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 ../... ~.~../~..'~7..~ ..................................................... b. Intended use and occupancy 2) ~/~ ~/'[' , 3. Nature of wor check which a plicable): New Building ..... Additio ........ Alteration .......... Repair .............. RemOval ............ Demolition .............. Other Work ............... (Description) 4. Estimated Cost ............. ~ ....................... Fee ..... ,.. ................................ i ~" tto be paid on filing this application) 5. If dwelling, number of dwelling nnits ............... Number of dwelling units on each floor ................ If garage, number of cars .....i... ...................................................... .... ...... 6. If business, commercial or m~xed 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 .................... 1.. Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Sizeoflot: Front .......... i ........... Rear ...................... Depth ...................... 10. Date of Purchase .......... i .................. Name of Former Owner ............................. 11. Zone or use district in which promises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ...... "!t~['- ............... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises~-/.. ~)~..~.~.~ i ~ Address .4L ~./~..~_...?~' ..... Phone No.~.'~..~.~.~. ~... t'qame ot infect ...... ~_, .~_. .............. Aa(tress ....... t ............ Phone No ................ Name of Contractor ..... ~ ~-, 7-. ......... ' .....Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly alt buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ......... ~S.S ..... igtig being du sworn, deposes and says that he is the a cant ........................................... ly ppli ~tName of individual s ng contract) above named. He is the ..................... i ................................................................... . (Contractor, agent, corporate officer, etc.) of said owner Or owners, and is duiy authorized to perform or have performed the said work and to make and file this applicationi 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 manner set forth in the application filed therewith. Sworn to before me this ................. ayo ............. 19 - , . ................................ County /~ ~ / / / _ NOTARY [~L}~[IC. Stat,~ et :,l~r,*i Ytlrk .............................. r~0.4/o~l~is, ~::,~{~,~[~ c ,,,%.,_ (Signature of applicant) ;