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Home My WebLink About16196-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy N~Z16715 March 17, 1988 · ~ .................. Date ................................ THIS CERTIFIES that the building ...... 3:. d..d ~.t.~. o..a ................................. · 165 WENDY DRIVE LAUREL Location of Property ~s~ County Tax Map No. 1000 Section . .I.2.8. ....... Block 05 .Lot 06 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated June 22, 1987 pursuant to which Building Permit No. 16196Z dated ..... .a.u.l.y.. ! .0.,.. ! .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 ......... Deck addition to an existing one family dwelling, as applied for. The certificate is issued to KATHERINE & BRUCE DE YOUNG ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N / A PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 i"OR'M' NO. Jl TOWN OF SOUTHOLD BUILDING DEPARTM£NT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ...... ~.~.~..~.~..~.,...~...~,~ ...J..~ ....... ~.~..~.~ .~.. q.~~.~.~...~....~~~ ............ ~ ................................................. at premises located at ....J,..~...~.....~..~~...~...M~..,.......~.~ .............................. County Tax Map No. 1000 Section ..... J....'~..~.. ......... Block ...... ..C~..~. ..... Lot No ........~......J~. ......... pursuant to application dated ......... ...~.~......'~'......~.. ............. , 19..~...'J.., and approved by the Building Inspector, Rev. 6/30/80 APPLICATION FOR CERTIFICATE OF OCCUPANCY FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southotd, N.Y. 11971 765 - 1802 Instructions A. This application must be filled in typewriter OR ink, and submitted m~ to the Building Inspec- tar 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 P[anning 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: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25o00, Accessory,S10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewC°nstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ....~.~5....~...~.-.1~.'~..~....'~..~,~..~.~. ................ . .~. ~.~. ~-z'~ .... House No, Street Hamlet Owner or Owners of Property ................... ~ .~..'~r~'.. .... County Tax Map No. 1000 Section .... to~ ..... Block .... Q~ ....... Lot...(~)~:=' ......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. UIIDATION ( 1 s t) UNDATIO~ (2nd) UGH FRAME & PLUMBING SULATION PER No Y. STATE ENERGY CODE . ADDITIONAL COMMENTS: formerly o( ~o~ ~o~soo 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST I- ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING REMARKS: [~FiNAL Examined ...~../.o..., 19~..~. Approved.~ ~44 . I P. . ., 19~.'~. Permit No..l.~ Disapproved a/c ..................................... 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL,: 765-1802 (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH 3 SETS o ANS CHECK SEPTIC FORM . NOTIFY CALL MAIL ~:''~ ~'' BLDG, DEPT. TOWN OF SOUTHOLD INSTRUCTIONS a. This 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 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 inspections. (Signature of applicant, oVname,~rI a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... .0. .................................................................................... Name of owner of premises .'~.~. (Jd.~...~.. ~/~.77d ~./~lJ ~....~. D.O IQ.{~ .................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of co~orate officer) . ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. ... 1 ............... ..... House Number Street Hamlet County Tax Map No. I000 Section 1~ Block ~. 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 use and occupancy ........................................ ' ¢:'"7t.~ 3. Nature of work (check which applicable): New Building ... ' Addition ... Alteration . ' Repair .............. Removal .............. Demolition .............. Other Work .@O~--O(4 ......... (Description) 4. Estimated Cost . ~ ~ OOO ....... , ......................... Fee ...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage number of cars ' 6. If business commercial or mixed qccupancy specify, nature and extent of each .type of use ...... ,' ' it ....... 7. Dimensions of existing stmcture~,]f any: Front .... {~.~.'.t'/'l', .... ,Rear . 6~.'.~/.~ .... Depth'..¢.~..'~ ......... Height ............... Number of Stories I ' ' ' ' Dimensions of~sa~e~'s~re with! alterations or additions Front ~.q,.ct t.,. Rear...~.c/) .~ t, .... Depth ... b.Lal..~ ................ Height ...................... Number of Stories ... I ..... 8. Dimensions of entire new construction: Front . 1~;. (~. .... ' ..... Rear ............... Depth il.. .. Height ..... Number of Stories ..... / . ....... , ............ 9. Size of lot: Front ... J.q.' .,. ~/~ ............ .Rear .'. [ ~.q ,q~5 ........ ' ..... Depth . .t,h~ ................. 10. Date of Purchase .... ~.l.8.O ..... , ................ ~ame of Former Owner . .~0L..P~t.lp.E..T2t~eiLff,~.l~ ...... 11. Zone or use district in which premises are situated, t~Z~l~l)'Fl'~.~ ...................................... 12. Does proposed construction violet6 any zoning law, ordinance or regulation: 13. Will lot be regraded .... t~. ...... ~ ........... '>,~t Will.~xcess fill be removed from premises: . Yes 14. Name of Owner of premises g~..00~ [ k~fi]')k~t.O. ~..~.~Al~Oc~e~s J/0$./.tlErk)~/.'l)~l 0.~... Phone No. ~q.8 .-q,;3¢.c~ ..... Name of Architect ............ ................ Address UqOg~C ... Phone No. Name of Contractor .......................... Address .... : .............. Phone No ................ /5. Is this property located within 300 feet of a tidal wetland? *Yes ..... No ~,... *If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly ali b~ildings, whether existing or proposed, and. indicate all set-back dimensions from ~roperty lines. Give street and block nu'mber or description according to deed, and show street names and indicate whether nterior or corner lot. gTATE OF NEW ~RI~.// ~OU, jNTY OF. ~ ...~~. ~.~.O0~.. J .................. being duly sworn, deposes a~d says that he is the applicant (Name of individual signink contract) ~bove named. te is the ..... O~ 0.~ ......... ~ ................................................................. ~ (Contractor, agent, corporate officer, etc.) )f said owner or owners, ~d is duly ~utho~zed to perform or have perfomed the said work and to m~e and file this :pplication; that all statements contaihed ~ this application are true to the best of his knowledge and belief; and that the vork:w~l be perfomed in the m~ner ~et forth ~ the application filed therewith. ;worn to before me this .... ........ - ' 4ora' Public, ~~. ~...//' County ............. ........... ~ ~ 8m~ ~,New YOrK ~Signa~e of applicant) ~~~r8,,~ ?ITtE NO. 80 -5P-30971 HO T£ ~ SURVEY ~'OR BRUCE DEYOUNG 8 KATHERINE DEYOUNG AT LAUREl- DA'r[ = ,ff.4r 6, 1980 TOWN OF SOUTHOLZ)' SCALE.' ! "= 4'0' SUFFOLK COUNTY, NEW YORK NO. = ~'0 - 255 ~UNAUTHORIZEO JLTEHATION ON ADDITION TO THIS I GUARANTEED TO: SURVEY IS n WOLAT~OH OF SECTION ?ZOS OF THE R/VERH£AD SAVING~ BANK NEW YORK STATE EDUCATION LAW N' COPIES OF THIS SURVEY NOT BEARING THE LAND BRUCE 6~ KATHERINE I~EYOU/VG TO ADDITIONAL INSTITUTIONS OR SUSSEOUENT OWNERS. i~lmlm. mi YUUI~J~J II --~ m I ALDENW. YOUNG, PROFESSIONAL ENGINEER II ~ I AND LAND SURVEYOR N.~S. LICENSE NO 12845 ~ N.Y,S. LICENSE