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Home My WebLink About13357-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z14782 Date August 11,, .,19 86 porch addition THIS CERTIFIES that the building ................................................ Location of Property ~. §.5..F.~..e.e.m.a.n...~?.a. ~. ~ ............ .~.a.~. ¥ .5.~.u.c.k. ~..~. :~... ............. House No. Street Hamlet County Tax Map No. 1000 Section ...1.3.9. ...... Block ....3 ........... Lot .,..3.6 ............ M/o Garden Heights 577 41 & 42 Subdivision ............................ ...FiledMap No.- ....... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated J.u.~y.. 2..0., .............. 198.~.. pursuant to which Building Permit No. 13357z dated ...A.u.g..u.s?.. ! .6., .............. 19.8. ~., 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 ......... perch addition to existing one family dwelling The certificate is issued to ........ .J.a.m.e.s.. 3..J..a.n.e.~...g.n.d.e.p..s 9.n' ........................ (owner,~r~)~ x of the aforesaid building. Suffolk County Department of Health Approval ........... N/A UNDERWRITERS CERTIFICATE NO .................................................. Rev. 1/81 I~OB~ bO. B TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N, Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13357 Z Building Inspector. and approved by the Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ~ Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~mlmmmm~mm 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 featu res. 2. Final approval of Health Dept. of water supplv and sewerage disposal-iS-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" Jand uses: 1. Accurate survey of pz"operty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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. Fees: 1. Certificate ~ _.$5.00 ~. C~rtificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 $15.00 Date ...... .~ .-.~,{ .--. · .~. ......... NewCons truc tion ...... Cid or Pre-existing Building ............ Vacant Land ............. Location of Property . ,.//~ 5' /L~/~&-~M~/?,~ /~/ ~~C~ ~Z //~ House No. Street Hamlet Owner or Owners of Property .................. ~erdo ~ ............................ CountyTax Map No. 1000Section ...~,~ ....... Block .. ~ Lot. ~ , ... Subd~ws~on ............ ~ .................. Filed Map No.' .......... Lot No .......... Permit No. . Date of Permit .......... Applicant J ~ ~' ~='e ~ ....... ........... .............. Unde~riters Approval ....... ~ ......... Planning Board Approval, ,-~ ............. Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ................... Construction on above described buildin~l~(~ permit meets~J~l applicable co~s Rev. 10-10-7s and regulations. E1ELD INSFECTiON 1. FOUNDATION (1st) FOUNDATION (2nd) COMMENTS ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY ~ODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING ~ ] FINAL REMARKS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1803 Examine J {'0 19 Approved..~..~m~'.. ].~.., 19~.q. Permit No.. ). .~:~ ~ ~']. · ...... ~ I _ Disapproved-a~ ~..~.' ~?~ ~ -- ~ ....... ~F---'~' ................................ .... (Building Inspector) APPLICATION FOR BUILDING PERMIT Rece±vedg~ ..... Date ......... iT. (..2-~o. .... 19 ..~ INSTRUCTIONS a. Tins application must be completely filled in by Wpewriter 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 tins 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 throughout 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 regulations, and to admit authorized inspectors on premises and in building for necessary insp~ ~ (Sig~r'e'~!?icant, or nam e, if a corporation) . - . ........... (Mailif[g address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. d)cO~ e e. Nme 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 .... .-5' .~..'~v. ............... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. House Number Street Hamlet ,.~(o ~ County Tax Map No. 1000 Section .... /..'~...~. ........ Block .... ~,~. ........... Lot .~.~..~. ~.~.. ...... Subdivision ..... .~ ~ ?.e?.l....~..~. ~.~'~7'..~. ........ Filed Map No. ~.7..~....... Lot...~ ........... (Name) ' 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ,~m~ --/~ ~eao '¢//~ .~. b. Intended use and occupancy ..... .,~.~.-.m.t.J. y,...'.~..t~...e/~ .~.~ ...... t.~./.. ~ ................ 3. Nature of work (check which applicable): New Building .......... Addition ........ Alteration .......... Repair ............ Removal .............. Demolition .............. Other Work ............... -~ (Description) *-' (to be paid on filing thi.s application) 5. If dwelling, number of dwelling iunits.............../ Number of dwelling units on each floor ................ If garage, number of cars .... ; ................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............ , ......... 7. Dimensions of existing structur4s, if any: Front .... .,~t;>../. .....Rear . ~.~..~ ......... Depth . ~:~..~. ......... Height ..../.~. ......... Number of Stories ........ /. ................. /. ........... ,. ........... I)imensions o f same. structure fth alterations or additions' Front ~'tO ' ' 'R~,' Depth ...... ~.. .............. Height ....... ..61, ............. Number of Stones ....................... D~mensmns of entire new constructmn: Front...- ............ Rear .... ~.~ ........ Depth ............... ....... Number of Stories ........................................ y ............ 10~ Date of Purchase ..... ,,q7.4.~.../.q./q.~. .......... Name of Former Owner .......... 11. Zone or use district in which pr~mises are situated ..................................................... 12. Does proposed construction vi~oI~te any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ....... ~,5 ................. Will excess fill be removed from premises: Yes Name of Architect ........ ,_~. ,~&wt.~. ......... Address t / . . Phone No. . . Name of Contractor ............. ~..! .......... Address , t ... 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 blockinumber or description according to deed, and show street names and indicate whether interior or corner lot. ~ STATE OF NEW YORK, S.S COUNTY OF .................. ............................ ~ .................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ..................... ! ................................................................... (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 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 filed therewith. Sworn to before me this ............ ~.O.'..i~.. .... day oi....~.~ ......... 19~. ' Term Exp*res Ma*ch 30. 19~ i ~9 t.o~ NOTE ' O = MONUMENT FOUND ~ = MONUMENT PLACEO SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON JUNE 24., I929 AS MAP N0.577 II SURVEY FOR ,JAMES ANDERSON 8~ JANET ANDERSON ' PART OF LOTS 41 842,"MAP OF GARDEN HEIGHTS"* MAT,%ITUCK TOWN OF SOUTHOLD SUFF. CO., N.Y. GUARANTEED TO*. FARMERS HOME ADMINISTRATION HOME TITLE DIVISION OF CHICAGO TITLE INSURANCE COMPANY SCAL~: I"= 40' .NOV. 22,1968 NOV. 6,1969 PROFESSI~ AND LAN D S UR VEYOR,N.Y.S."~-/IC. NO.12B4'5 RIVERHEA D,, N.Y. *