The URL can be used to link to this page

Home My WebLink About16302-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPAR3'MENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-16449 Date November 30, 1987 THIS CERTIFIES that the building ...C .O.N.S.T..R.U.C.T...D.E.C.K...A.Dp.I.T..I .Op. .................. Location 2605 Deep Hole Dr. Matcituek, New York of Property h~dsb hiol ....................... 'S't/e3i ....................... h~d~iel County Tax Map No. 1000 Section I 15 .Block 14 .Lot I 1 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Jul y 29, 1987 pursuant to which Building Permit No. 16302 g dated Ju 1 y 31 , 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 ......... CONSTRUCT DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR THOMAS A. PALMER The certificate is issued to ..................... [o~n'o'r, ~dzo~×Y ................... of the aforesaid building. Suffolk County Department of Health Approval ... N /A UNDERWRITERS CERTIFICATE NO ............. N / A PLUMBERS CERTIFICATION DATED: N/A ~' B~vi~d in g Inspector Rev, 1/81 1~0~11~ NO. ~ TOWN OF $OUTHOLD 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_* 16502 Z Permission is hereby granted to: .....~.~.~..~.L.~ ................................................... at premises Iocat ...¥~. .: ............... ....................................................................................... ........................... County Tax Mop No. 1000 Section ....... ./../..~.. ....... Block ...... .J....t/.. ........ Lot No. ) / Building Inspector. Fee $..~.~...:..~ ..... 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 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--(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 property 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: Addifions $25.00 1. Certificate of occupancy New Dwellin§.$25.00, Accessory i$]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.Updated C.O. $ 50.00 Date New Cons truc tion ...... Old or Pre-existing Building .. ~' ....... Vacant Land ............. Location of Property . C~.~,,0~.. ..... /~'.(~ Owner or Owners of Property ...... ,. ,. ~-¢/~ ~.~. ................................ County Tax Map No. 1000 Section./Z~7 ....... Block.../.~'./. ....... Lot..IZ .......... Subdivision ................................. Filed Map No ........... Lot No .............. ........ . . ff . . PermitN°//-~302'~Date°fPermit ~/;~' ~ ow',Vcg-. R,cf/a~,[~ W,'~N,) .... Health Dept. Approval ........................ Labor Dept. Approval .................... Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Applicant .... t~¢.} .............................. Rev. 10-10-78 TOWN OF SOUTIIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN ItALL SOUTtlOLD, 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. ~d2~ /_--/ No Underwriters Certificate on file. /~'~ Tile check is(outdaterl no~o~l-~-~e.~ /~f/ No }lealth Dept. Approval~on file. /-_'/ No final inspection has been made. Please Thank you for your cooperation. Building Perlait t~ / ~ 3 ~ ~ Z Building D.ept. contact our office on this matter. No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) UND~TION (lstl UNDATION (2nd) UGH FRAME & PLUMBING SULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-SB02 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ F4~INAL~ /? DATE /////~//~/~ ~ INSPECTO~/~/~~ / / BOARD OF HEALTH ...... 3 SETS OF PLANS ....... 'FORM NO. 1 SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved ....4~b~..~i ,19~?.eermitNo.~.~.~-.{~..~...~ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT NOTIFY CALL 70' ........ 1' .... MAIL :' Po ~e~ · '~ Date ................... 19... INSTRUCTIONS a. This application must be comple .,B0~riter c.~ ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to b. Plot plan showing loc,ati~o~ ~~b ~~5~t,~ ~e~,' relationship to adjoining premises or public streets or areas, and giving a detail_eqr~kq~ ~[~tion ~f~l~ll~t ~.~ ~et~nust be drawn diagram which is part of this appli- cation. ~'"~'~'~ , ~... ~,}~- 5o~ on the , c. The work covered by~[~[~.~ l~li~on ~v~ty ~'~c~menced before issuance of Building Permit. · d. Upon approval of this~I~ ~ )~l,~'~B~lild~n,~f'~or will issued a Building(Permit to the applicant. Such permit , shall be kept on the premises a~[la ~ ~l~]~qt[~l~out the work. ~ or in part for any purpose whatever until a Certificate of Occupancy e. No building shall be oc°~ N ~ ~o~ ~' shall have been granted by the But~ ~n ,II~c~.~- APPLICATION IS HEREBY M~'~"E to the Building Department- ,for the issuance of a Building. Pbrmit pursuant to the Building Zone Ordinance of the Toy7 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 applic/tble la~vs, ordinances, building code, housc~4g code, and regulations, and to admit authorized inspectors on premises and in building for necessa (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......... · p~)g@V¢~ ~; 2¢OTgD ...... Name of owner of premises ~.C~/n~ ~,C:~: ~ ~ ............... ' ' ~ : (as on the tax roll or l~[lee3~~'-'~ 'g'P' '{ ' If applicant is a corporation, signature of duly authorized officer. NOTIFY ~)~[)h~G OEP~RTM~Y AT .............................................. (Name and title of co,orate officer) - FOLLOm ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Plumber's License No ......................... Electrician's License No ....................... f~[ CQ~.~: ~¢~t~C~'~O~. ., . SNA~L MEET Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................. .... House Number Street Hamlet County Tax MapNo. 1000Section ..~.~ ........ Block ...~ .......... Lot .... ~ .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~/g~.3. L~... ~/'~/.~../....~..~..~ .~.~/,,2t~/..~. ................... b. Intended use and occupancy ........... ~..~...)/~..~. · · '. . .... 3. Nature of work (check which applicable): New Building Addition ....... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... ~.~..~ ~. o/Q,~ (Descfip~tion) 4. Estimated Cost . ..il .............. ............ Fee ...................................... I ~' (to be paid on filing this application) 5. If dwelling, nurgber of dwelhng umts .. ]. Number of dwelling units on each floor ..... ~ ........ If garage numbfr of cars 6. If baroness, commercial or mixed occupancy' ' specify ~atur~ and~xtent of eaehtype of'use~ r~ .~2~}.. ~ ........... 7. Dimensions of existing structures, if any: Front.. ~ ~ ....... Rear ..... ~ ...... :,.~vc ...h.~ ............ Number of Stories ~ Height .... ' D~ens~on~,~0~a cture th alterations or additions: Front ........ Re r .................. Depth ................... L.. HeiSt .... . · .~4. · · ,..,. 2 ...... Number of Stories ..... ' ................. 8. Dimensions of entire new cons~mctmn: Front .... Rear ............... Depth ............... Height Nmhber of Sto~es 9. Size of lot: Front .......... l ...... ~. ..... Rear...~ ............ ....... Depth ...................... 10. Date of Purchase .......... [ ................... Name of Foyer Owner ............................. 1 I. Zone or use district in which p~emises are situated ......................... ~.~ .......................... 12. Does proposed construction ~i~late any zoning law, ordinance or regulation: ...ZV.O ...................... 13. Will lot be regraded ..... ~.~ ~ .................. Will excess fill be removed from premises: Yes 14. Nme of Owner of premises Rt~.[.C.~l~.~ddress ~.~.~.~. Phone No ................ Name of Architect ........ I .............. Address ............... ~. Phone No ................ Nme of Contractor ~ Address ' Phone No 15. Is this property located!within 300 feet of a tidal,, wetland? *Yes ..... No ..... · If yes, Southold To~ TrUstees Permit-may~be ~equired.~ ~ Locate clearly ~d distinctly ~i build~gs, whether existing or'prop6sed, hnd, indicate ri s~t-back d~ensions from property ~nes. Give street and blockl number or deschptionhc~ord~g:to ~eld,,~nd s~9~;street names and indicate whether intefior or corner lot. ~ ~' 'C ~ :,_~.,~ ~ ~1 STATE OF NEW YORK, COU~Y OF .................. ....................................... .......... being duly sworn, deposes and says that he is the applicant (Name of individual sigffing contract) [lbove named. }te is the ...................... ~ ................................................................... (Contractor, agent, corporate officer, etc.) .of 'said owner or owners, and is duly 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 manne~ set forth in the application filed therewith. Sworn to before me this ~ ............ ~.~ .day ofx .... ~ .......... ,19 ~ ~__~~~ Notary Public ...... ~..~. (-;'...~f~-~-. (, ...... County ~ Iqtlm K.I)E rot (Signature of applicant) NOTARY PUBLIC, State of New Yolk . No. 4707878 Su?olk County (7~ iltr.1 Expire~ MarchiBO, 19....LA / ]