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Home My WebLink About16258-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-16457 December 3, 1987 Date ................................ · THIS CERTIFIES that the building DECK ADDIT I0N Location of Property 330 Maple Lane Orient, New York House Ale. Street Ham/et County Tax Map No. 1000 Section 0 i 7 ...... Block 03 , .Lot 02 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated July 7, 1987 16258 z ....................... pursuant to which Building Permit No ...................... dated J u 1 y 23, 1987 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 JANICE M. SHRUHAN The certificate is issued to ..................... ~o'~n'o'r,'f~f~X .................... of the aforesaid building. Suffolk County Department of Health Approval N / A UNDERWRITERS' CERTIFICATE N / A PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 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) Na- 16258 Z Permission is hereby granted to: .......... .~e..~..~.::¥.,...~.~..~ .............. . , at premises located at ..~,~.~.........~,...~.J~ ......... (~.~ ............................. County Tax Map No. 1000 Section .... ...~...1..~. .......... Block ..... .C~....~. ........ Lot No .....,,~....7~.. ........... pursuant to application dated ..... ..~...~.....~. .......................... , 19~...~.., /- Building Inspector. Fee s.~..:...~ and approved by the ...~....~....:.; ............. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 BLDG. DEPT. TOWN OF SOUTHOLD 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. 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--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 req,uirements where applicable, B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accura[e survey of pt: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 1. Certificate of 0ccuDancy New Dwelling $25.00, Accessory ,$]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $|0.00 4.Vacant Land C.O. $ 20.00 5. Upda ted C. O. $ 50.00 Date .. Deosmbe.r. · 1 ~ · .1.9. 8..7 ..... New C o'as truc ti on ...... Old or Pre-existing Building ............ Vacant/and ............. Location of Propert¥ 3~Q ~L~ ~BA~ O~$ent~ N.Y. House No. Street NataNt Owner or Owners of Property . ~.~..~.o.l~e.]~..S.~¥p.h.a.~. ..................................... County Tax Map No. 1000 Section 17. Block 3 Lot 2 Subdivision ................................. Filed Map No ........... Lot No ............. Perm it N ol 6 2 Bg.g .... Date of Permit 7.-: 2 3 ...... Applicant . .]:)~p:q.~.e.. ~....]~ ~-.1.$ ............. Health Dept. Approval ............. ' ....... Labor Dept. Approval ....................... Underwriters Approval ........................ Planning Board Approve~ ..................... Request for Temporary Certificate ' Final Certificate Fee Submitted $ . .Q,?~...~-~.. ................... Construction on above described building and permit meets all applicable codes and regulations. ¢o UNDATION (1st) UNDATION ( 2nd ) UGH FRAME & PLUMBING SULATION PER N. Y. STATE ENERGY CODE . ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ~SULATION [ ] FRAMING [/] FINAL REMARKS: ~/~-~% ~' O DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND FRAMING REMARKS: INSULATION TOWN OF SOUTHOI,D OFtqCE OF BUILDING INSPECTOR P.O. BOX 728 TOWN IIALL SOUTIIOLD, N.Y. 11971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because ,of tile following reasons. /_~An application for Certificate of Occupancy is not on file. ~ /--/ No Underwriters Certificate on file. Tile check is(outdate¢t~ /~/ No tlealth Dept. Approval on file. /-~/ No final inspection has been made. Please contact (>ur office Thank you for your cooperation. Building Permit t~ / ~ ~ ~- ~ Z Building DQpt. on this matter. ***/5/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) JUL ?1987 !:i BOARD OF HEALTH 3 SETS OF PLANS '~';"'' 'FORM NO. 1 SURVEY ......... TOWN OF SOUTHOLD CHECK - BUILDING DEPARTMENT SEPTIC FORM · TOWN HALL NOTIFY $OUTHOLD, N.Y. 11971 TEL.: 765-1802 CALL ~77r1007 ........ Examined...~.~ .~..~.., 19~.~. Approved Permit No.'. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT MAIL TO: D. H. Early 310 Third S%. Greenporb~ NY 1194~ Date ~A!Y.D ............ 1907. 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 sh~all 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 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,,J~uilding code, housing code, and regulations, and to admit authorized inspectors on premises and in building for neces_sa~f,~)~ns///, _./;~:~,~d ·..3. ~. 9..T.h.i..r.d..S..~ ....G.~een.~orl:.,. 3J. ~.... 1 19.4.~. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Cent r ~ gt o~ ./C.~pen.t er Name of owner of premises . Mr.s...RQI3.e. Kg. Sb. nuhaz~ ................................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) , ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED BufideFs License No..:%87 ....... ; ............. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done~ .3.3.9. ~a. ple. Lane.,..0riaxqt ...................... ................. ................. .O.. ........... , ............. House Number -- Street Hamlet County Tax Map No. 1000 Section ..... t'.~. .......... Block ........ 3. ........ 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 Single Family Same b. Intended use and occupancy .................................................................... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other~/~tg..D.e.q~. ~ ........ il ~.~ !"' T (Description) 4, EstimatedCost,,$9~D.O0.0/).. Fee *.~.O- , ' (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 ....... i ................................................................. 6. If business, commercial or mixed o~cupancy, specify nature and extent of each type' of use .'. ~.. · ~ 7 Di f xistingstructur if y Front ~ Re D pth menslons o e es, an : .... ~ . ,.. ar ....... .... e ...... Height ........... Number of Stories .................................... ~ ...... [ ......... Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... jHeight ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front .24 ~. ...... ..... Rear5 t ............. DeptlB 0.' ............. Height ... 8! .......... Number of Stories...1 ........... . ......................................... Si a ~. i D pth 9. zeoftot:Front ............. ......... · Re r. '.:...;. ........ . .... e ...................... 10. Date of Purchase ............. i ............... Name of Former Owner ............................ . i 1.Zone or use district in which premi!ses are situated .................................................... [2. Does proposed construction violat~ any zoning law, ordinance or regulati~n: ...nc) ........................... t3. Will lot be regradedn9 ......... ~ ................ Will excess fill be removed from premises: Yes No t4. Name of Owner of premises Sb.r:u~a~ ........... Address3.~OI~lia~o.l.e.t..O.r.i..n.y.. Phone No.32.3.3.6..4.0 ........ Name of Architect ........... .............. Address ................... Phone No ................ Name of Contractor . ZI~tto..KarllY ............. Address3.10. Tlxirct..G.~ eela.p, cl~bne No..4.7.7.10fi.7. ...... [5. Is this property located within 300 feet of a tidal wetland? *Yes ..... No ..... · If yes, Southold Town Trust~es Permit may be required. ~ PLO~i' DIAGRAM Locate clearly and distinctly all b~ildings, whether existing or proposed, and. indicate all set-back dimensions from )roperty lines. Give street and block number or description according to deed, and show street names and indicate whether nterior or corner lot. 3TATE OF NEW YORK, S.S 2OUNTY OF ................. ....... p~.a.g.n..e..H.....E~ ~:.~.~. ...... ~ .................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) ~bove named. te is the ......... .q °, .n.e.r.a.c.e. 9.r/.qa..r ? .r ........................................................ (Contractor, agent, corporate officer, etc.) )f said owner or owners, and is duly huthofized to perform or have performed the said work and to make and file this ~pplication; that all statements contaihed in this application are true to the best of his knowledge and belief; and that the' . york will be performed in the manner ~et forth in the application filed therewith. ;worn to before me this ,!otary Public ......... Cou NOTARY PURLIC, ~kate of r~lew York N~. 470~8'/8 Su~olk lerm Expires Malch 30,)19