The URL can be used to link to this page

Home My WebLink About16243-zFORM TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z-16359 October 30, 1987 Date ................................. THIS CERTIFIES that the building DECK ADDITION Location of Property 4715 Oaklawn Avenue Southold, New York House No. Street Hamlet County Tax Map No. 1000 Section 070 . .Block I 0 .Lot 14 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated July 13, 1987 16243 z ...................... pursuant to which Building Permit No ...................... July 19, 1987 dated ............................ 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 ONE FAMILY DWELLING AMBROSE R. & MILDRED TERP The certificate is issued to ..................... [o'd,n'o;','t~,go~'~X ..................... of the aforesaid building. Suffolk County Department of Health Approval ....... Iq /A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby gront~ ....... ...... ~..Z~/e....~.~.~...L2~..~ _ ...~~~;~..?..,...~..'..~.~ ........ . . a e esl ate t ...~.~ t pr mis Oc dcl ....... .~.. .~ ............ ~ ...... County Tox Mop No. 1000 Section ...... ..~.....~....0. ..... Block ....... ~._..~. ........ Lot No .....'.~...~.. .......... approved by the pursuant to application dated ....... ~,! . ./9...~%~.../...~S. .................. , 19.41._/.,~'~ and Building Inspector. Building Inspector 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 m~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Fina~ survey of property with accurate location of al~ 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 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. C. Fees: Additions $25.00 1, Certificate of occupancy New Dwelling $25.0D, Accessory,,,$t0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 /.~./3.O./~. 5.Updated C.O. $ 50.00 Date ... ~. ......... // NewCons truc tion ...... OJd or Pre-existing B~ild[,ng ............ Vacant Land ............. Location o f Prop erty ~o.u~ ~~/~/.~%~..~..~./~..~.. .................. Owner or Owners of P rope~f'_4'~(~.4'~. · .2fr~-.~., .,~.. · .~..~ ~ ......... /'/~m./~i County Tax Map No. 1000 Section ............... Block ........... ot ............. 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 Tempj;z~ary CertifLcat.e ..................... Final Certificate ....................... Fee Submitted $ . .~..~ Construction on above described buyng a;d~et~s a~ a~ ~d %lations. Rev. 10-10-78 ~J TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTtIOLD, N.Y. 11971 October 21, 1987 TEL. 765-I 802 Ambrose R. Terp d/b/a North Fork Varity Store P.O. Box 1086 Southold, New York 11971 TO Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. ~ An application .for Certificate of Occupancy is not on fil~. /'~/ No Underwriters Certificate on file. /~/ The check is(outdated/not on /~/ No Health Dept. Approval on file. /~/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit II J- -~ ~ 3-~ Z Building Dept. ***/]/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) U~DATION (1st) UNDATION ( 2nd ) UGH FRAME & PLUMBING SULATION PER N. Y. STATE ENERGY CODE ADDITIONAL COMMENTS: TOWN OF SOUTLIOLD OFFICE OF BUILDING INSPECTOR P.O, BOX 728 TOWN IIALL SOUTIIOLD, N.Y. 11971 October 21, 1987 TEL. 765.180~ Ambrose R. Terp d/b/a North Fork Varity Store P.O. Box 1086 Southoid, New York I197I To Whom This May Concer~, We are unable to complete your Certificate of Occupancy because.of the following reasons. ~ An application for Certificate of Occupancy is not on file. /~-/ No Underwriters ertlficate on file. /.?/ The check is(ou~dated/not on file.)~6lg, d~) /~/ No IIealth Dept. Approval on file. /~/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperationJ Building Permit tl .~ _~ ~ ~ Z Building [)opt. *~*/~/ No Plumbe'r Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~FINAL REMARKS: DATE /Q ~/ ~f~'~/ Y ~ INSPECTORShip, .7 Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH .~..-.. 3 SETS OF PLANS ....... FORM NO. I SURVEY TOWN OF SOUTHOLD CHECK ~ ~ ~ -~-' -~-~5-~ BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL NOTIFY $OUTHOLD, N.Y. 11971 TEL.: 765-1802 CALL ................ MAIL TO: Datl INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted~t sets 6f plans, accurate plot plan to scale. Fee according to schedule. the Building Inspector, with 3 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 thc 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 Dep~rtment for the issuance of a Building' Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk C~unt2~~ New York, and other applicable Laws, Ordinances or Regulati.o, ns, for the construction of buildings, additions or~lt6~?~ti~,'og .for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ~ffdinances, buil~i~)g code, hous~g code~nd regulations, and to admit authorized inspectors on premises and in building fol~ necessaw 3n~pe~.ions. L ' ............ a corporatlon) .. (Mailing add~ess of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. of owner of premises .......... (as on the tax roi1 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 ...................... House Number Street Harfil~t /o /.5 County 'fax Map No. 1000 Section .................. Block .................. Lot ............... Subdivision ..................................... Filed Map No ............... Lot (Name) 2. State existing use'and occupancy of premises and intended use and occupancy, of proposed construction: b. Intended use and occt~pancy,..~...fi0f. ~ ............. ~!],i! !.i... i:] .. ~. ,.. ,/~ i i ...... 3. Nature of work (check which applicable): New Building ..... · ..... Addition .......... Alteration .... :..'.x.. Repair .............. Rem:oval ............ Demolition .............. Other Work. ~0~a~ (Descfip~tion) 4. Estimated Cost ............. ........................ Fee ...................................... ~I " (to be paid on filing this application) 5. If dwelling, number of dwellin~ units ............... Number of dwelling units on each floor ................ If garage, number of cars .... I ..................................................................... 6. If business, commercial or mixed occupancy, specify natu? and extent of each typ_e of use ....... ,', ............. 7. Dimensions of existing structures, if any: Front .. ~.'~,,: ..... Rear ...~.~' ....... iDepth . ~ ~ .2..~ ........ Height ....[ ..... Number of Stories ' ~ · ' Dimensio,ns of~ajue structure with alterations or additions: Front ..... ~'..~'f ........ Re;r .... ~..~.2. -'-$. DD~mPtehnsio}s'~!f e~e~w' constructiHoen~.'g~ront...~iff......' ..... RearN. U.m. ~r. :[ ~I:77~. Dep~: .... Height ............... Num~ ber of Stories ........................................................ 9. ' Size of lot: Front .... _./'~'-'~' i ......... '... Rear 4~ ~" · .... /.. .... ~ ........... Depth ...,:/.~ .............. 10. Date of Purchase . . . .4.', .~.~..7i~..'~ ....... Name of Former Owner ~..Z~ .... ~ ........ 11. Zone or use district'in which p~emises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: 1~.~. Will lotbe, regraded ............................ Will excess fill be removed from premises: Yes No '/14. Name of Owner of premises .-~.'?: .Z"¢ ~./~,..~..~'. ~ .-~.~-. Address ~g.F.d.4.~.Z~..~'~ .~t/~ Phone No. 7~"J7' Name of Architect ......... i .................. Address ................... Phone No ................ Name of Contractor ........ [ .................. Address .... : .............. Phone No ................ 15. Is this property locatedlwithin 300 feet of a tidal wetland? *Yes ..... No ..~.. *If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly nil buildings, whether existing or proposed, and, indicate all s~t-back dimensio~ property lines. Give street and bloc~ number or description according to deed, and show street names and indicate ~or corner lot. from hether I ' l STATE OF NEW YORK, i S.S COUNTY OF...6"~ f.._(. 9./. ....~..,. i..,~....~.. ............ being duly sworn, deposes and says that he is the applicant (Name of individual signing co'htract) above named. He is the ................. ~. (x,4., .~...L-~f~ ............................................................ (Contractor, agent, corporate officer, etc.) .. of said owner or owners, and is duly authorized to perform or have performed the said work and to mal~e 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 ....... .......... ............ No, . Pub,, .......... UNOA J. COOPm ' Not~ Publlo, 8~te of N~ Y~