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Home My WebLink About13321-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z ]5549 THIS CERTIFIES that the building ..... .A.d.d. ~..t ~.o.n. ................................. 670 Grove Road Southold Location of Property ............................................................... House No. Street Ham/et County Tax Map No. 1000 Section 05 1 .Block 6 .... Lot 26. I Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · ~...4u..ly..2. 4. ,.. 1.9. .8.4 ....pursuant to which Building Permit No .... 1.3.3. .2.1 .Z ............ dated ....A.u. g .u .s.t.. 3..,..ltl. 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 ......... Deck addition to ex±sting one family dwelling. The certificate is issued to ALBIN & CELIA CZELATKA ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval Iq /A lq/A UNDERWRITERS CERTIFICATE NO .................................................. PLUMBERS CERTIFICATION DATED: lq/A Building Inspector Rev. 1/81 FO~e NO, II TOWN OF $oUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERJV~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13321 Z County Tax Map No. 1000 Section ........ .~...~..~'.l ..... Block ........ ~. ........... Lot No....'~....~..:.../. ........ to application dated ....... '' -.'~.....~...~o ..................... , 19.~..~.,-- and approved by the pursuant Building Inspector. Building Inspector ..... -'~ ................. Rev. 6/30/80 FORM NO, O ~· , ,, ',, , · MAR 2 3 1987 TOWN OF SOUTHOLD ' !~'~ I Building Department !- ~I~ ~i Town Hull ............................ ~ ~'~ Southold, N.Y. 11971 TOW,¢ o: 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must bo filled in Wpewritor OR Ink, and submitted ~ ~ to the Building tot with the fo lowing, for new budd ng or new use: 1. Final su~ey of property w~th accurate IocaUon of all buildings, property lines, streets, and unumal natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage d[sposal-[S-9 form or equaB. 3. Approval of electrical installation from Board of Fire Unde~riters. 4. Commercial building% Industrial buildings, Multiple Residences and similar buildings and tion% a certificate of Code 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 1957). Non.conforming uses, or buildings and "pre-ex st 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 safety inspection of buildings or premises, or other pe~inent informa- tion required to prepare a certificate. C. Fees: · ' 1. Certificate of occupancy New Dwollxn~.$25.00, Acce.,~ory ..$10.00 Buatnes.' 2. Certificate of occupancy on pro.ex~sting dw({ll'ng $ 50.0 0 3. Copy of certificato of occupancy $ 5.00. over 5 yearn $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C..O. $ 50.00 Date .......................... 6. ~%lterat~on $25.00 ~.~ NewtOns true tion ...... Old or Pre-existing Building .... Vacant Land ............. Location of Property ...................................................... ; ............ House ~/o. St'cot Ham/ct or Owners of Property ~; ~ ...'.'. Owner .. ............................... County Tax Map No. 1000 Section ............... Block ............... Lot ............... Subdivision ................................. Filed Map No ........... Lot No ............. Permit No I~-.~ I,'.Z. Date of Perml~ Applicant ., Health Dept. Approval ........................ Labor Dept. Approval ....................... Planning Board Approval Underwrhers Approval .............................................. Request for Ternporaql Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. COMMENTS FIEL~N~ECTIO~ FOUNDATION FOUNDATION 2. (2nd) ROUGH FRAME & FLUMBING INSULATION. PER N. STATE ENERGY qODE Ye FINAL ADDITIONAL COMMENTS: TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 March 10, 1987 This is to inform you that everything 'for your deck (building permit no.. 13321Z) is in order. Your check is outdated so we are return- ing it. Please send a check fQr' $5..~00 made out to Town of :Southold. ,r~tru ly y~s, Victor Lessard Executive Administrator VL:lmr Enclos. [ ] FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ~NAL REMARKS: DATE INSPECTOR FORM NO. 1 TOWN OF ~OuTHOLD BUILDING E EPARTMENT TOWI~ HALL ~OUTHOL£ N.Y, 11971 TEL,: 65-180:3 Disapproved a/c .................................. i ' ' (BuildingI Inspector) APPLICATION FOF~ BUILDING PERMIT INSTR~JCTIONS Received...~.~..~l~,19... Date .................. , 19... a. This application must be completely filled in by typewriter or ~n mk and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to scl~edule. b. Plot plan showing location of lot and of buildings o9 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 Im ced before ~ssuance of Building Permit c. The work covered by this application may not be on} en ' · 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 throughCut the work. e. No building shall be occupied or used in whole or in Ipart for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. ,I 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 lalterations, 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 necessary inspections..,O (Signature ,o~?,licant, or n~ame, if a co/r~orati~?), . ! (Mailing address (ff applicant) State whether applicant is owner, lessee, agent, are~hitect, ,en~neer, general' contractor, electrician, plumber or builder. Nan~e of owner ofpremises C ~l/~ ~ .~l~']~a- (~s 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 ...................... I. Location of land on which proposed work will be done. .................. House Number Street County Tax Map No. 10013 Section ....... ~.~.~. · Hamlet 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 ....... ~'.~'] ~<. ..................................................... b. Intended use and occupancy ....................................... 3. Nature of work .... . (check which applicable): New Building ......... Addition .......... Alteration .......... Repair .............. Rempval .............. Demolition .............. Other Work '.~ ........ ¢~.! .0 _.~. fi: ~ (Description) 4. Estimated Cost .... .Q Fee . ! '-. (to be paid on filing this application) 5. If dwelling, number of dwellingi units .............. Number of dwelling units on each floor ............ If garage number of cars 6. If business commercial or mix6d occupancy, specify nature and extent of each.[tyj~ of use .................. 7. Dimensions of existing structures, if any: Front .... ,)Y.. ........ Rear ....~. ~ ...... Depth. "~'. ...... Height ............... Number of Stories ..................................................... Dimensions of same structure" ' additions:Front Rear with alterations or .................................. Depth,' Height Number of Stories 8. Dimensions of entire new construction: Front ....... ........~ Rear . ......... . . ... Depth .......... . ... · -'Height Number of Stories 9 Size of lot: Front ~ Rear ' Depth 10. Date of Purchase .. ~.q.,,9.",.,~l ................... Name of Former Owner ............................. 11 Z ~ d' 'ct' wh' hpl ' 't t d · one.or use lstrl in lc cruises are si ua e .................................................... , 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ........ , .................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .. '...: .............. Address ................... Phone No ................ Name of Architect ......... ' .................. A~ldress ................... Phone No ................ Name of Contractor ' Address Phone No PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and bloc} number or description according to deed, and show street names and indicate whether interior or comer lot. NOTEtJ' .5' STATE OF NEW YORK, COUNTY OF ................. 765-1802 9 AM TO 4 PM J~OR TH~ FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO' ~[~QUIP~[~ FOR POURED CONCRgTE 9. ROUGH - FRAMING & PLUMBINO 3. INSULATION 4. FINAL - CON'STRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REOUIREMENTS OF THE N.Y. STATE CONSTRUCTION & EN[~,GY CODES. NOT RESPONSIBLF, FOR DESIGN OR CQNSTRUCTION ERRORS. S.S .................... being duly sworn, deposes and says that he is the applicant . (Name of individual sigfiing contract) above named. He is the . .~ agent, ~o/ · ~ \ , .,: (Contractor, rpgrate officer,~'etc.) of said owner or owners, and is du!y 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 manner set forth in the application'fifed therewith. Sworn to before me this ........................ day of .................... ,19... Notary Public, ................ ,, ................ County ~ ' ' . ./ (Signature of apphcant) I