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Home My WebLink About13213-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.Z15567 Date April 2, 1987 THIS CERTIFIES that the building A d d i t i o n Location of Property .3. 8..0..P.I. ~ .~.I~.O.O.D...R.O.A.D... HOUSe NO. ' County Tax Map No. 1000 Section 1 I 0 .Block 2 .Lot 14 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·...H.a.y...2.4. ,. 1984 .. pursuant to which Building Permit No. 13213 Z dated June 12, 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 tn side yard. The certificate is issued to R 0 B E R T A N D P A T R I C I A K U L L ..................... ?o¥.'o;,rv C r xt 'g8 .................... of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO. N/A PLUHBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 FOaM NO. ~ 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? 13213 Z Permission is hereby granted to: ........... at premises located at ............. ....~...~~.....~,.....~~. .~................'~ <20 ' County Tax Map No. 1000 Section ...... ).)...~.. .......... Block ........ ...~::.. ......... LotNo ...... .............. pursuant to application dated .......... ~.~...~'.....~. · ................ , 19.~....~..., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. ~'his application m.ust bo filled in typewriter OR Ink, and submitted ta ~ to the Building In~pec- 'tot with the following; for new buildings or new usa: 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-[S-0 form or equal}. 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial ,b. ui[dlngSo Industrial .buildings, Multiple R. asidences a.nd slmilar bu. ildings and in~talla- tlons, a certificate of Coda comphanco from tho Arclutect or Engineer responsible for the building. 5. Submit Planning (3oard approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957i, Non-conforming uses, or buildings and "pre*existing" land [Jses: 1. Accurate survey of p~;operty showing all property lines, streets, bulJdings and unusual natural er 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 tlcw 0~11[n~,.$25.00, 'Accessory ~$10.00 gush. ness $50.00 2. Certificate of occupancy on pre-existi~g dwelling ~ 50.00 3. Copy of certificate of occupancy $ 5.'00~ over 5 years ~1~00 5.Upd~[ed C.O. ~ $ 50.00 D~te. N~wCon= b~uc ~ton,. ~.. Old or Pre-existing Building ......... · .... Subdivision ................................. Filed Mep No ........... Lot No .............. Permit No. ~.t~.. Date of Permit. Health Dept. Approval ........................ Labor Dept. Approval ........................ Hnde~{i~er~Appro~al ....... ~ ............. ~lann n oar roual ......... fleque~t ~or Tem¢ora ert~flcato ..................... Final Cert~ cate ........ Construction on abovo d~eribe~ buildin~ ~nd permit meet~ aU ~Olicablo eodo~ an~ regulations. FIELD YNsP~CTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING 3. INSULATION PER N. STATE ENERGY ~OD~ FINAL ; TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN tIALL $OUTHOLD, N.Y. 11971 TEL. 765-1802 This is to adviae you that the job under building permit no. 13213Z issued to Robert Kull on __6__[l_!~J._~____ for Addition is completed n final inspection has ( ) has not ( x ) been done. and in 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 $25.00 payable to the Town of Southold. Please indicate to Whom thc Certificate of Occupancy ia to be mailed, and arrange with tills office for an inspection (late Occupancy or n~e is tmlawful without a Certificate of Occnpancy. Pleaae. l~elp u. to clear np thl. matter so that legal action does coL have to be taken. Thank you for your pcompt attention. Very truly_~, Victor Lesaard Executive Administrator VL:gnr encl. 'FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined..~./...~:..., 19~..~. Disapproved a/c ..................................... Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT IN STRUCTION S 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 grm~ted 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 anthorized inspectors on premises and in building for necessa~./,~,~... .... . - .:~ ........... .. ......... : ...... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... ................................. ........................................ Name of owner of premises.--'"'-D,...'~/~>..~'-~ -~--'.~' · · · .~.~.~.L;..{_:_.. ................................................ (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...t~.r'l/..~...~../.'/..-~. · ....... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... I. Location of.land on which ~romosed work will be done .................................................. ........ ......... House Number Street Hamlet County Tax Map No. 1000 Section ...... J.J...0 ........ Block ....... .~. ........Lot ..... ~] .~. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupan~.A~mises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...~v-r~/.d/~/~......~. .......... ./ ....................................... b. Intended use and occupancy . .~~)./z...~..~...~......~./..~.~.~..~. ............................... 3. Nature of work (check whicka plicable): New Building ..... ' ..... Addition ......... . Alteration .......... ! Repair .......... ,... Removal ............ Demolition .............. Other Work~f~-r.C'~ ....... (Description) 4. Estimated Cost..'..,,.-'r~ff....'~ .......................... Fee ...................................... [ ~" (to be paid on filing this application) 5. If dwelling, number of dwelling! units ............. Number of dwelling units on each floor .................. If garage numberot~ears.' If business, commercial or mixed occupancy, specify natture and extent of each type of use ................... Dimensions of existing structures, if any Front..7.7 .......... Rear ....-2.2/. ...... Depth .-Z,~f.~.~.r ..... /. ~. t Nuraber of Stories / Height ................................................................... Dimensions of same structure With alterations or additions: Front ................. Rear ................. Depth ................... !... Height ...................... Number of Stories ..................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Num. ber of Stories ............. ~ .......................... 7 ............... 9. Sizeoflot Front /.'~.~.i~ ........... Rear.../.~.c~, ............. Depth .~;.O.(5 ................. 10. Date of Purchase .......... i ................... Name of Former Owner ............................. 11 Zone or use ....... · d~stnct ~n which premases are s~tuated ..................................................... n '~l g 1 12. Does proposed constructio va ate any zonin aw, ordinance or re ation: ................................ 13. Will lot be regraded ...... ~ .................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises'~}~..](.ff.c.G .... Address~u) ~ ~)Z.~.~?ar~ Phone No ............... ' Name of Architect ....... 1 ....... Address ~ , ............................ Phone No ................ Name of Contractor ~ .~'.,.."~154 .~f2~xx/.T¢.. Address .~..l[.~.~./51~.,.. Phone No..:7~7. 7. '. ~. .~ ?. .... PLOT DIAGRAM Locate clearly and distinctly al! buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and bloct/number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NE~ YO.~K,, ~ S S ........................... ! .................... being duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contract) above named. He is the ......................................................................... (Contractor, agent, corporate officer, etc.) .. of said owner or owners, and is duty 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 manta r set forth in the application filed therewith. Sworn to before me this .... .......... ..... T'--T : : I