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Home My WebLink About15669-zFORM NO 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office ot: the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No z-]5282 Date February 18, 1987 THIS CERTIFIES that the bmldmg . · DECK ADDITION Location of Property 17190 Soundvzew Avenue Southold Hou~ 'No .............. '8't/eet ..................... County Tax Map No I 1000 Section 05 I Block 02 .Lot 05 Subdzwmon I Filed Map No Lot No conforms substantial!y to the Appilcat~on for Budding Permzt heretofore filed m thzs office dated February 2, I987 . pursuant to wh~ch Buddmg Permit No. 15669z dated F e b r u alt y.6, . ! 98.7 . , was issued, and conforms to all of the reqmrements of the applicable provm~ons of the law The occupancy for whtch tim certificate is issued is .... DECK ADDITI'ON TO EXISTING ONE FAMILY DWELLING The certificate islssu~d to GEORGE & HELEN MICHEL ......... ~o¥. ~ c -~:o5~4g.,~/~ x ........ of the aforesaid building. Suffolk County Department of Health Approval .. N / A UNDERWRITERS CERTIFICATE NO ......... N / A PLUMBERS CERTIFICATION DATED: Rev 1181 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) N9 15669,Z County Tax Mop No 1000 Sect,on ..... ~ .'.'~...I ...... Block ...... ..~....3::.. ...... Lot No .... ..~ ~' ...... Budding Inspector. Fee $...~..- ............ and approved by the Bulrdlng Inspector Rev. 6/30/80 FORM NO, 6 TOWN OF SOUTHOLD Budding Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This apphcat~on mu~t be filled in Wpewmter OR ink, and submitted ~ to the Building~/Inspec- tor w~th the following; for new buildings or new use: 1. Final survey of prpperty w~th 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 buddings, Industrial buddings, Multiple Residences and similar buildings and installa- tions, a certificateI of Code compliance from the Architect or Engineer responmble for the building. 5.Submzt Planning Board approval of completed rote plan requirements where applicable. B. For existing buddings (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 topo§raph~c featur,es. 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 buddings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees. I. Certificate of occupancy New Dwelling $25.00, Accessory ,$tO.O0 Business $50.00 2. Cerhflcate of occupancy on pre-existing dwelhng $ 50.00 3 Copy of cert]hcate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O., $ 50.00 Date .......................... NewConstruction ...... Old or Pre-existing Budding ........... Vacant Land ............. House No, Street · IYamlet County Tax Map No 1000 Section ... ?.! ........ Block .... ~ ........ Lot .... .~. ......... Subdlwmon .................... · . .Filed Map No ...... Lot No ........... Permit No ........... Date of Permit ........ Applicant ................................ Health Dept. Approval ....................... Labor Dept. Approval ........................ Underwriters Approval ....................... Planmng Board Approval ...................... Request for Temporary Certificate ................... Final Certificate ....................... Fee Submitted $ .......................... Construction on above descmbed budding and pe~rmt mee~ all apphcable c?des and regulations. Rev 10 10-78 CO Z 152¢0- 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION FRAMING REMARKS: DATE [ ] ROUGH PLBG. 2ND [ ] INSULATION [ ] FINAL OUNDATIO.U { 1st) OUNDATIO:~ (2nd) OUGH FRAME & FLUMBING NSULATIO~; FERN. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: Exam,ned ~.~~. Approved ~~ Disapproved a/c FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N Y. 11971 TEL.: 765-1B03 19''~'1 Perrmt No / ~h/'e~1 ~c: Received ........... ,19. (Bmld~ng Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a Tlus application must b~ completely filled m by typewriter or m ink and submitted to the Building Inspector, sets of plans accurate plot plan to scale. Fee according to schedule b. Plot plan showing locah6n of lot and of buddings on premmes, relationship to adjoining premmes or pubhc stre or areas, and giving a detailed d~scnptlon of layout of property must be drawn on the diagram which m part of this ap, cation c The work covered by flus apphcatmn may not be commenced before issuance of Bmldlng Permit d. Upon approval of this application, the Bmlding Inspector will issued a Building Permit to the apphcant Such pen shall be kept on the premises available for mspechon throughout the work. e No budding shall be occupied or used in whole or in part for any purpose whatever until a Certfficate of Occupm shall have been granted by the Bfiddmg Inspector APPLICATION IS HEREBY MADE to the Budding Depmtment for the msuance of a Bmldmg Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances Regulations, for the constructio ~ of buildings, additions or alterations, or for removal or demolition, as hereto descnb The apphcant agrees to compl5 w~th all apphcable laws, ordinances, bmldmg code, houmng code, and regulations, and admit authorized inspectors on ~remises and m building for necessary ~nspecbons (Signature of apphcant, or name, ff a corporation) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or u 1 , (as on the tax roi1 or latest deed~ If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builder's License No [/~l ~ ' Plumber's License No Electrician's L~cense No ' Other Trade's License No Location of land on which proposed work will be done House Number Street County Tax Map No 1000 Section ~/ Hamlet Block c>~ .. Lot ~ Subd~v]mon Fried Map No Lot (Name) State exmtmg use and occupancy of premises and intended use and.gccupancy of proposed construction b. Intended use and occupancy ~ I [~ ~i[ .~.. ~~.{~.. 3. Nature of work (check which applicable) New Budding .... Addition ](... Alteratmn .... Repmr ....... I Removal ........ Demolition ......... Other Work ....... 4. Estu-nated Cost ....................... Fee ............................. (to be paid on filing this application) 5. If dwelling, number of dwelling umts .......... Number of dwelling units on each floor ........... If garage number of cars , 6 If business, commercxai orlmlxed occupancy, specify nature and extent of each type of use ............ 7 D~menslons of exishng structures, if any. Front .......... Rear .............. Depth ............ Height .......... L Number of Stones ..................................... Dimensmns of same structure w~th alterations or additions Front .......... Rear ............ Depth ......... Height .............. Number of Stones ............... 8. Dunenslons of enhre new construction Front ........ Rear ............. Depth ...... Hmght~ '.~ . ! Number of Stones ............................... 9. S~ze of lot Front ~ ....... Rear ............... Depth .............. 10. Date of Purchase ! .......... Name of Former Owner .................. 1 1 Zone or use dlstnct in which premises are situated .............. 12 Does proposed construction violate any zomng law, ordinance or regulation 13 Will lot be regraded . . I .... Will excess fill be removed from premises Yes 14 Name of Owner of premises ...... Address .......... Phone No .......... Name of Architect I Address Phone No. Name of Contractor ..I . .. ..... Address .......... Phone No ....... 15. Is this property located withinl00 feet of a tzdal wetland? * Yes ..... No ..... · If yes, Southold Town Trustees Permit may be required. I PLOT DIAGRAM Locate clearly and distinctly all bmldmgs whether ex~stmg or proposed property lines Give street and Block number or descnphon according to deed, and show street names and indicate whett intenor or corner lot. STATE OF NEW YORK, COUNTY OF. . SS (Name of lnd~wduaI s~gnmg contract) above named. being duly sworn, deposes and says that he is the apphc; He is the ....... (Contractor, agent, corporate officer, etc ) of smd owner or owners, and is duly authorized to perform or have performed the said work and to make and file apphcahon, that all statements contained m this apphcation are true to the best of his knowledge and behef, and that work will be performed in the manner set forth m the application filed tt~erewith Sworn to before me this .. c~ .. . day of. ~--. Notary Pubhc, . .~'~-~. ~ . .~¢~ ~ (S~gnature of apphca