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Home My WebLink About13363-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No... ~1~784 A Date May 22, 1987 THIS CERTIFIES that the building ..... .a.d.d. ition to dwelling. Location of Property .... .7.1.5. .... Shore Road Greenport House No. Street Hamlet County Tax Map No. 1000 Section ..... .4.7. .... Block . . 02 .Lot 19 Subdivision ~reenport Shores Inc. Filed Map No. 1759Lot No. 6 conforms substantially to the Application for Building Permit heretofore flied in this office dated ..... Auc~;. J- 5.,,. . .19.8.7 .~ pursuant to which Building Permit No. 133 63Z dated ....... Au.cj.u$t;..1.7. ~..1.9.8. 7.... 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 ......... ..... Stozage..shed..addi.t. ioo..t.o., ag..e.x.i.s.t.%n.g..o.n.e. ? .f.a.m.i..ly. ,d,w..e.l.l.i.n.g: ....... The certificate is issued to ................... I~I¢~L%I~ .L..J.....A.N.E.S.Q .N .................... (owner of the aforesaid building. Suffolk County Department of Health Approval ................ N./~ ...................... UNDERWRITERS CERTIFICATE NO ........................ N./.A ...................... PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ~6~ z Do,. ..... ..~..~.!..~ ........ ,,..t~ Permission is hereby granted/p: ~ . ...~..~~~...L.....~.., .......... .~..~....~.:.~:...../.z~..~./. ........... or--premises Iocoted ot ....~...~..~....~.....~:~.,. ....... ~,,~~ ................... :::,::.::::'. .................... ............ :: ...................... pursuant to i io ........ appr by the Building Inspector. Fee $ ..................... Building Inspector Rev. 6/30/80 Ag FORM NC). TOWN OF SOUTI*IOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE O F OcCt ,~/~ ,,~, ~ ~ This application must b0 filled in Wpowritor OR ink, and submitted m ~ to the Building In~ec- tor with the following; for new buildings or new use: 1. Final su~oy of property with accurate location of all buildings, property llnos, streets, and unu~al natural or topographic fea~res. 2. Final approval of Health Dept, ef water mpply and sewerage dlspesal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Unde~riters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and in~alla- tions, a certlii~ate et Code compllanco from tho Arcl~itect 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-existing" land uses: 1. Accurate ~ey of p~perty showing all property lines, streets, buiJdings and unu~al natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Data of any housing code or safety [~spect[on of buildings or premises, or other pe~inent informa- tion required to prepare a certlficato. C. Fees: . ' ' 1. Certificate of occupancy New Dvell,n,3.$2.5.00. ^cce.,~ory .$i0.00 2. Certificate ~f occupancy on pre-exi~ting dwelling ~ 50.00 3. Copy of certificate of occupancy $ 5.'00, over 5 ye~r~ $10.00 4.Vacant Land C.O. $ 20.00 5 U~dated ~ O $ 50 O0 Oa~e .... 6. Alteration ~5.00 NewCOns LPuc~ton ~ Old or Pre-existing Building Vacant Land Location of ProperW Owne~ or Owners of Property ..................... ' ......................... .... ......... Health Dept Approval Labor Dopt Approval . Planning Board Approval Underwriters Approval .... Request for Tempora~ Certificate ..................... Final Certificate .................... Fee Submitted $ ........................ Constructlon on above described building end permit meets ~t applicable codes and regulations. ,, Applicam~~~'~ · *Q~-~.~..-;-r ................. FOUNDATION COM~EN I S FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY qODE ADDITIONAL COMMENTS: ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Appro Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT ReceivedL . ~.'< .~.... , 19 . .~ 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 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 i ections. ~ ._ if ';o'r ' g ia'tiJ/ ' " (Signature o~ appficant, , ' P : ~ (Mailing address of applicant) / /l,,~7 / State whether applicant is owner,' lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . ............................................................................... Name of owner of premises . .~. ~...~./..~...P'.~.. ~.'. ¢.~. >.e../....~..~.~. ~...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./~'~.J..~..ri..-..~.t+.fif .& .~ t'~l e ~; 1. Location of land on which proposed work will be done .................................................. ........ oW. .............. ................. House Number Street Hamlet County Tax Map No. 1000 Section ...~.~ ........ Block O ~ Lot 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 us~ and occupancy ~. ~.~.~. ~ ~t~i~ ~r~,=~ ~. IF~ ........................... 3. Nature of work (check which applicable): New Building ' Addition .......... Alteration .......... Repair Removal D moliti Oth W ................... . ........ e on .............. er ork ............... ,stimated cost (I, escription) 4 .... ,. O...~. .................. Fee ...................................... ~ *" (to be paid on filing thi~ application) 5. If dwelhng, number of dwellingiunits ............... Number of dwelling units on each floor... ~ ........... If garage, number of cars .... i · · ~ .............................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ... ~ ..... / ........ 7. Dimensions of existing structures, if any' Front tteigh~ }.t..].! ........... Nuniber of Stories ..... ] .................................................. Dimensions of same structure with alterations or additions: Front . ~ ~. ..... Rear . ~ .O.~. ........... Depth . ,...~ g.'> .............. ~.. Height . ! .t.] .....J ............ Number of Stones .... /. ................. 8. Dimensions of entire new const'truction' Front tteight ..J ti /. ....... Number of Stories ...... /. .................. ~ ... Sizeoflot Front ~..~. Date of Purchase .......... i ' ~ ................ Name of Fo~mer Owner ....-7 ........................ Zone or use district in which pr~mises are situated, f~.e $~.~.e ~.~t].,./.. a'l ............................. Does proposed constru, ct~on violate any zoning law, ordinance or regulation: fkt. O ................. Will lot be regraded Name 6f Owner of premises~ ~ .~.t'. tr .~.t ]~.~.~. 1~O. ~[ddress ................... Phone No ................ Name of Architect ...... ~ .~ ........ Address ..... .-:w... a ..... , ,, aPhone No .~. ............. Name of Contractor~'~¢o;.~.~: .i~, .~e..r~. ¥ ...... Address ~?.~o¢~ ~.,.~.~.. i~hone Nol ............... 11..9'71 PLOT DIAGRAM 10. 11. 12: 13. 14. Locate clearly and distinctly allI buildings, whether existing or proposed, and. indicate ail set-back dimensions from property lines. Give street and block ~umber or description according to deed, and show street names and indicate whether interior or Corner lot. STATE OF NE~Wk4rl))RK~./,¢0¢t S S ~~.?~...-.. (.~ ................... being duly sworn, deposes and says that he is the applicant (Name of individual signi.ng contract) above named. He is the...' .7 ......................................................... (Contractor, agent, corporate officer,, etc.) of said owner or owners, and is dul~ 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 mannei set forth in the application filed therewith. Sworn to before me this ......... ~k..~f~ ....... day of! .... (Signature of applicant) TOWN OF SOUTHOLD OIq';ICE OF BUILDING INSPECTOR ILO. BOX 728 TOWN IIALL SOUTtlOLD, N.Y, 11971 TEL. 765d 802 This is Co advise you that the job under building parfait no, 13363Z issued to Michael Aneson on 8/17/84 for Addition~-- is completed a f]7{;{7 i--~;~'Cion has ( ) has not ( X Y--been done. and [n order to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a check for $25.00payable to the Town of Southold. Please {mdlcate to Whom the Certificate of Occupancy ia to be mailed, and arrange with this office for an inspection date Occupancy or .se in unlawfn! without a Otc,panty. ['leslie help u~ to clear up this legal ~ct~on does ~tot have to be taken. Certificate of matter so tbst Thank you for yo,r prompt attention. Very truly Victor Le~sard Executive Administrator VL: liar eric I ,