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Home My WebLink About13346-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z13219 ...... Date Feb. 15 19 85' THIS CERTIFIES that the building .......... .A.d.d..i .t.i.o.n. ............................ Location of Property 3750 Vanston Rd. Cutchoque h~ds~ ~ol ....................... 's'do~i ...................... h~r~/el ........................ Lot ................. County Tax Map No. 1000 Section 111 ...Block 05 013 Subdivision ...... X Filed Map No. .Lot No. conforms substantially to the Application for Building Permit heretofore f'ded in this office dated A..u~/.. 8 ....... 19 .8.4pursuant to which Building Permit No. 13346Z dated ........ .A.u. cj: ...... .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 ......... Deck Addition to Existing Private One Family D,w.e.l. 1..i.n.g. McLAUGHLIN, ROBERT The certificate is issued to ..................... ?o.v~n-e;;-,~.~de~r~J ...................... of the aforesaid building. Suffolk County Department of Health Approval ................ .N.[.A. ...................... N/A UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 !~0~ NO. Il TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y, N? BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) Date .z"~'°~' ../(....~..... 133~[$ Z ..... ..~. ....................... . ~-~ Permission is hereby granted to:-, , , .... ~..~.~.,...~..:~.......Lt.~...n...I ...... ... at premises located at ,...~;~..~...~ ....... .~..~"'~,....~., ....... ~g~',----- ........... .... ...................................................................... County Tax Map No. 1000 Sectiory-~.~.~..~..' '. ........ Block ....... g.,..~,. ,, Lot No ...... ~L..~.,,. ........... pursuant to application dated .... ...~...~:~.....~......~... ............ , 19..'~...~.~, and approved by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions BLDG. DEP)', TOWN A. 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. B. For existing buildings (prior to April 1957). Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p=operty showing all 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 $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 Date....~.."'..?..'-..~...~.. ........ New Building . .~?. ¢..~.~. .... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ¢ c~ -z' ..... House No, Street Ham/et Owner or Owners of Property .~..o...~..~.~..1~.i- County Tax Map No. 1000 Section .... //f Block ~ ~ Lot . .~. t'.~.... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. ~. ~.~..~..~.~. Date of Permit ~".-.[ .~.~...~..Applicant...r-~.~) ~ .... ~.~./..~,.~...~../.~'. ........ Health Dept Approval ~ Labor Dept Approval Underwriters Approval...~. .................... Planning Board Approval ."T ................. ... Request for Temporary Certificate ..................... Final Certificate .... ~ ............... Fee Submitted $..~..~.~. ...................... Construction on a.~ove described building and permit meets all applicable codes and regulations. CO ~ I,°~,~c~ Applicant ...... ~ ......................... Rev. 10-10-78 & FIEL ECTION COMMENTS FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & FLUMBING INSULATION FERN. STATE ENERGY Ye FINAL ADDITIONAL COMMENTS: 'FORM NO. 1 ToWN OF sOUTHOLD BU I LDING DEPAR~'NIENT TOWN HALL ~oUTHOLD, N.Y. 11971 TEL.: 765-1802 ;xamined .~. ~'~ '~' ' '" 19 kpproved~.~o..~. } .~. , 19'~x/ PermitNo / ~a~.~. 3isapproved a/c ..................................... ........... · (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 scale. Fee according to schedule. . o~*~ ot n ns accurate plot plan to .... ~ u-aa~,~ n oremises, relationship to adjoining premises or public streets b. Plot plan snowing ,u ........ of progerty must be drawn on the diagram which is part of this appli- or areas, and giving a detailed description of layout of Building Permit· cation. c. The work covered by this application may not be commenced before issuance of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit d. Upon approval -:o~ ~v~ilable for inspection throughout the work. shall be kept on the prem~ ........ part for any purpose whatever until a Certificate of Occupancy e. No building shall be occupied or used in whole or in 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. Th~ applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to '" i~ig~ufe of ap~lican'tl or na potation) ....... ~" ~l'ailing ad{lress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................... · ............ .......................... ........................ If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate office ) Builder's License No ..... .~ -~[ ~ plumber's License ............. · 's License No ..................... Electrician , ..... Other Trade's License No ...................... ~ ,..a.W C ~ 0 C~ ~,'- ~ ......... ~ ' of land on which proposed work will be done .............. 1. Location ~ .fid ............. ....... · Hamlet ·. · · ...... Street ' ~''' ' House Number . ..., · ii[[ ,~ Block .. pN ........ County Tax Ma o. 1000 Section . · · ' ' ~ .......................... Filed Map No ............... Lot .............. Subdivision ........... (Name) · '~ - ~ -.~^ and occupancv of proposed construction: r ,x ........... a Existing use and occupancy ........ ~' ........ b. Intended use and occupancy ....... · '<~' '~' ' '( '~'- .......................... '~ 'x'h"f ........... . .... 3. Nature of work (check which applicable): New Building ..... ' ..... Addition .......... Alteration .......... Repair .............. Rem6vai .............. Demolition .............. Other Work .... C~.~.q IC~.. .~'"~'..Fee. ~ (Description) ~ ~" (to be paid on filing this application) 5. If dwelling, number of dwelling ~nits ............... Number of dwelling units on each floor ................ If garage, number of cars ..... . ................................................................... 6. If business, commercial or mixed occupancy, specify natur~e and extent of each type of use ..... cg, ¢T.~ ..... .. .... Height ..... 1 ..cD,. ....... Number of Stories ......... ! .............. Dimensions of same structure with alterations or additions: Front . ,..~ . . Rear ,.. /~.~D... ~ ... Depth. ~:4.1~..': ,~ ......... i. · Height ...................... Number of Stories .................... · 8. Dimensions of entire new construction: Front . ).. ]..~..: ..... Rear ..... ~..~m-..r. .... Depth .... ~o, .c2. f. ..... q,r . · Height ..... ~. ........ Number of Stories ...... ~ · I. ............................ ~' ' ;t .............. 9. Sizeoflot: Front ...... ~..o..~. f ......... Rear ..... .t.i.~.t ........... Depth . .~..~. .............. 10. Date of Purchase ........... ~ .................. Name of Former Owner .............................. 11. Zone or use district in which premises are situated ..... ,~ .............................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: .... ~..O. ........................ 13. Will lot be regraded ...... .~c~ ............... Will excess fill be removed from premises: Yes No Name of Architect .......... i ................. Address ................... Phone No .......... PLOT DIAGRAM Locate clearly and distinctly alll buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block inumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ................. ............................................... being duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contract) above named. He is the ..................... i .................................................................. i (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 all statements conthined 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 ............ ~..~. ....... day of ..... ~ ...... 19... Nota~ Public, . .~..~.,. ~1~. ~..-~ ........ County ., ! ...... , ............. ':.i ....... ...:. NOT/t,¥ PUBLIc }lairdLy,- ,, i.' ' -~'-~-' '~'-i~ig~ture of applicant) , .No, 4707878, $~ffOIN County ~5/ - ~erm Expires M~rc~ ~0, 19 W~