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Home My WebLink About15616-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N Y. Certificate Of Occupancy No .. Z,-:.1523.1 ,. Date .... .Jan. ua..fy .3.0~. fi.98.7 ......... THIS CERTIFIES that the budding .D..E.C.K ADD IT ION ................. Locatlon of Property 910 0akwood Drive Southold, New York H3~ No ........... 'S't/ed .............. County Tax Map No. 1000 Sectzon 70 Block ...12. ........ Lot ...27 ...... Subdlviszon .......... Filed Map No ..... Lot No ............ conforms substantially to the Apphcahon for Building Permit heretofore filed ~n ttus office dated J.a.n..u.ar.y. 2:.[9..8.7 -, pursuant to wtuch Bmlding Permit No. 15616Z dated . J anu a r .y. 1.0, . I 98. 7 . .. , was ~ssued, and conforms to alt of the reqmrements of the apphcable provisions of the law The occupancy for wbach ttus certificate is issued is ........ DECK ADDITION TO EXISTING ONE FAMILY DWELLING RICHARD OSMER The certificate is issued to ............... fo wner, 1~ ~'x ............... of the aforesaid building Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO .. PLUMBERS CERTIFICATION DATED: NTA N/A N/A · l~'%~ding Inspecto~ Rev 1/81 FOn-M' lqO. · TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL Sou'rHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NM 15616' Z Perrmssion is hereby granted to: .....~.J.~.....~ ......... ..~._~ ............... ...... ~.~........o:...,..~..,.~....~.~ .............. ...~......~.:.~.:......U.~.2.!... ~-~.,,,-~....~..~.:....~......~~~--_..-; ................. at premises located at .....~./...~.. ...... ~....~...~., ...... .'~.~ ................. County Tax Map No. 1000 Section ..... ...C~....~..~.. ...... Block ....... J....Sm... ....... Lot No .... ...~:..g .......... Building Inspector. Fee $. ~,.,,,. ;...~... 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 ~n typewriter OR ~nk, and submitted m~ to the Budding Inspec- tor with the following, for new buddings or new use. 1. Final survey of property with accurate location of all buddings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage dmposal-(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- tlons, a certificate of Code comphance from the Architect or Engineer responsible for the budding. 5. Submit Planning Board approval of completed site plan requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p;Coperty showing all property lines, streets, buildings and unusual natural or topographm features. 2 Sworn statement of owner or previous owner as to use, occupancy and condition of buddings. 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 $5 00 2. Certifmate of occupancy on pre-existing dwelling 3 Copy of certificate of occupancy $1 00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 New Cons truc t ion ...... Old or Pre-existing Building Location of Property ?../4. ........ ,~/"..~'./-C',~./-"~ .. House No. Owner or Ow,ers of,roperty .. b County Tax Map No. 1000 Section .~?,~'D.~ $15.00 .............. .......... Vacant Land .......... Street Hamlet .... ,..¥. .,ff. ........................ B ock ....... Lot. ..K 5d.. ..... Subd~wmon ......... · .Fded Map No ...... Lot No ............ Permit No .......... Date of Permit ......... Apphcant .................................. Health Dept. Approval ....................... Labor Dept. Approval ..................... Underwriters Approval ................. Planning Board Approval .................... Request for Temporary Certificate .............. Final Certificate ...................... Fee Subrmtted $. ~' ~ ~?/.~, Construction on above described building and permit I:neets all apphcable codes and regulations. Applicant. ~,, ,~/~-~¢'1~,.. ,~-'~,~, ...................... Rev 10-10-78 Co?. )5~3l OUNDATION (1st) OUNDATION ( 2nd ) OUGH FRAME & ?LUMBING NSULATION FERN. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL.: 765-1802 Examined .~~10- .,19~. Approved ~0~44-.~ .O. , 19~1] Permit No / ~""~1 ~..~-' Disapproved a/c ............... (Bml~ting Inspector) APPLICATION FOR BUILDING PERMIT Recezved ........... ,1 9 · Date .... 19. INSTRUCTIONS a This application must be completely filled m by typewriter or m ink and submitted to the Budding Inspector, wltl- sets of plans, accurate plot plan to scale Fee according to schedule. b Plot plan showing location of lot and of buddings on premises, relationship to adjoining premises or pubhc stre. or areas, and giving a detailed description of layout of properW must be drawn on the diagram which is part of tins ap! cation c The work covered by ttus apphcatlon may not be commenced before issuance of Building Permit d Upon approval of this apphcatlon, the Building Inspector will issued a Building Permit to the apphcant Such pern shall be kept on the premises available for inspection throughout the work. e. No budding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan shall have been granted by the Bmldmg Inspector APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Building Permit pursuant to t Building Zone Ordinance of the iTown of Southold, Suffolk County, New York, and other apphcable Laws. Ordinances Regulations, for the construction of buddings, addltaons or alterations, or for removal or demolition, as herem descnbL The apphcant agrees to comply with all apphcable laws, ordinances, budding code, housing code, and regulations, and admit authorized inspectors on premlsesl and m building for necessary,~s~ ~l ect ns - ~ .......... (Signature of app 'cnt, or m if a corporation) .... ............ . . : . /. ? ..... ...... (mail~n~ "'' '-'' '~'addre~ of ~i~c~nt) .... State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or bmld~ o. ......... Nameofownerofpremlses '~-~';l~.' ~lS~k'{~~. ............ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer 2 (Name and title of corporate officer) Builder's License No Plumber's L~cense No Electncmn s License No ..... Other Trade's L~cense No Location of land on winch proposed work will be done tS)[~ House Number Street Hamlet County Tax Map No 1000 Section 0 D Block 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 ~ ~Ck~ ~AJ TO ~rOt,/. ....... b Intended use and occupancy .... ~,.~ Y 3. Nature of work (check which applicable) New Bufldmg .. Addxtlon ....... Alteration ...... Repmr ........... Removal ..... Demolition ...... Other Work ~/,7..~(-K ... ~.:~ .~. ~SL (Description) 4 Estnuated Cost ". ,~ ..................... Fee ...... (to be paid on filing this applicatmn) 5. If dwelling, number of dwellmg units ...... Number of dwelling units on each floor ........... If garage, number of cars .~ ............................................... 6 If business, commercml or mixed occupancy, specify nature and extent of each type of use 7. Dnnenslonsofexistmgstructures,~fany Front 7~.~(~ ..... Rear 7~l(. . . Depth .,'~.,.(.1 .... Hexght ........ Number of Stones / ~ ..................... Dmaensions of same structure w~th alterations or addxtlons Front ....... Rear ............. Depth ....... I . . Height ....,,,~,to~, ~//' .: . . Number of Stones .................. 8. Dimensions of entire new construction Front t.~.4t.T,~t,'c..~:&.. Rear ............ Depth ...... Height .. .INumber of Stones ................................. 9. Slzeoflot Front i~q,?t ...... Rear Iql..O'7. fl ............ 10 Date of Purchase ./.~)b:~ ................... Name of Former Owner :7~... ~ .................. 11. Zone or use district in which premises are situated I-~'~ .~-.k~ ~ 12 Does proposed constructxofivlo/~7 any zoning law, ordnance or regulation' ' .~.c~i. ii .ii.. i ii ...'.. 13 Will lot be regraded ... ~ ........... ~... Will excess fill be removed from premises. Yes 14 Name of Owner ofpremlse~ ~/(-/'P~..~>. .~-f~'~,~' .~ Address~(.~ ~,~'.O.'~ ~P:.. Phone No Name of AJchltect ...... Address ............... Phone No .......... Name of Contractor . .g~'.'J/4~' ............ Address ............ Phone No .....~.. 15. Is this property located w~thinl00 feet of a tidal wetland? * Yes ..... No ..... %,- · If yes, Southold Town Trustees Permmt may be required. PLOT DIAGRAM Locate clearly and dmtmctly all bufldmgs, whether existing or proposed, and. mdlcate all set-back dnnensmns fr, property hnes Give street and block number or description accordmg to deed, and show street names and red,cate whorl interior or corner lot. STATE OF NEW YORK, COUNTY OF SS (Name of individual slgmng contract) above named bemg duly sworn, deposes and says that he is the apphc~' He ~s the ............. (Contractor, agent, corporate officer, etc ) of smd owner or owners, and m duly authorized to perform or have performed the smd work and to make and file t apphcatmn, that all statements contamed m this apphcatmn are true to the best ofhm knowledge and behef, and that ~ work w~ll be performed in the manner set forth m the apphcatmn filed therewith. Sworn to before me thru - . ~ ...... day of NotaryPubhc, .~-4_~Z~,~- ~'...'O...*,~/.Z: