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Home My WebLink About15891-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-16518 Date December 21, 1987 THIS CERTIFIES that the building Construct Addition & Deck Addition Location of Property 32260 Main Road Orient, New York h~s~ hiol ....................... 'S't/e~i ....................... h~/niei 019 0I 11.2 County Tax Map No. 1000 Section ............ Block ............... Lot ................. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated April 8, 1987 15891 Z ..................... pursuant to which Building Permit No ...................... dated.....AP .............. r i 1 12, 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 ......... ADDITION & DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED JOYCE BURTON The certificate is issued to ..................... [o~;n'o'r,)~6~f~Y~'f .................... of the aforesaid building. Suffolk County Department of Health Approval .......... N./..A ............................. UNDERWRITERS CERTIFICATE NO. PENDING - Dec. 7, 987 PLUMBERS CERTIFICATION DATED: Oct. 16, 1987 - John E. Walters Plumb~aring Buildin~nspector FOR Rev. 1/81 TOY/N 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) N~ ~589~ Z Permission is hereby granted to: ..~..~.....~....~.~ ....... ~ ......... .............................................. , ~- ' ~, 1~ .... ..~......0~.......~~ ......... ~.. ...... ~ ..... ~.~ ~ .~.~.....~...~..~.~...~....~...~...~~ .. at premises Iocated~at ..~..,.-~r,,,..~. ,~...?,. ....... ~.~..,...~.,.. ........... ,(~..~ ........................... County Tax Map No, 1000 Section ....... ..~...L~ ...... Block ...... ..~....~ ......... Lot No ......IX :.~-~... ..... pursuant to application dated ...... ...~. ........................ , 19..~.~..., and approved by the Budding Inspector. Rev. 6/30/80 OUNDATIO.U OUNDATION ( 2~ OUGH FRAME &~ PLUMBING NSULATION ?~d~NN. STATE E N ~/Y CODE FIUAL ADDITIONAL COMMENTS: TOWN OF $OUTIIOLD l(I ()l BUILDINGINSPECIOR I'.O. [lOX 728 '1 OWN llALL So[IIIIOI IL N.Y. 11971 October 22, 1987 John C. B~rn, Builder Box 208 Re: JOYCE BURTON East Marion, New York 11939 'J'~, ;'~h~ ,aiThl',, M. ly Concern, TEL. 765.1807 ?,- ,~re unnlo]~, ~o complete your Certificate ~f I>~, ~,!.~n."y b~',',m',,, of the following roasons. fi1,,. D, pt. ADproval on file. ~n',l.,ct lon has been made. t,n ,,,[pi~,.,~t~;n Ior Certificate of Occupancy $25.00 office on this matter. coo[>eration 0 certmfmcate on file. all p,'tm~t:, ~nvolving plumbing being [~',°.1)¢"1 after Alu il 1,1984 ) ~,,ncy or use is unlaw£ul w~thout a Certificate of Occupancy. h~ martyr as goon as possible so ~hat legal actlon does yon TO'tN OF SOUTI~OLD OFFICE OF BUILDING INSPECTOR P O BOX 72g TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. f~/ Owner ~ ~7~ (please print) (please print) I certify %hat the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber's signature) Sworn to befor~ me th~s ' Notary Public, ~ ~/County ~ Notary Public ~ ELIZABETH ANN NEVILLE Nota~ Public, State of New York No. 52-8125850, Suffolk Count~ Term Expires October 31, 1~'*:~' 0 INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING [ ] FINAL INSPECTOR BOARD OF HEALTH 3 SETS OF PLANS .Q-.~..~. FORMNO. 1 SURVEY ~..~ ., TOWNOFSOUTHOLD CHECK-----PS:': . BUILDING DEPARTMENT SEPTIC FORM ............. TOWN HALL $OUTHOLD, N Y 11071 TEL.: 765-1803 Disapproved a/c ...... I (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS NOTIFY CALL MAIL Date . fl ? ........... I97./ a This application must be completely filled m by typewriter or in ink and submitted to the Building Inspector, with sets of plans, accurate plot plan to ~cale Fee according to schedule· b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or pubhc street or areas, and glvmg a detmled description of layout of property must be drawn on the dlagmm which is part of this apph cation. c. The work covered by this application may not be commenced before issuance of Buddmg Permit. d. Upon approval of this application, the Building Inspector will issued a Bmldmg Permit to the apphcant Such perral shall be kept on the premises available for inspection throughout the work e. No building shall be occupied or used in whole or m part for any purpose whatever until a Certificate of Occupanc, shall have been granted by the Bmldlng Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Budding Permit pursuant to th Bmldmg Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of bmldings, additions or alterations, or for removal or demolition, as hereto described The applicant agrees to comply with all apphcable laws, ordinances, budding code, housing code, and regulations, and t~ admit authorized inspectors on premises and in building for necessary lnspr~ctl, pns · . ..... (Sigtiature of applicant, or name, if a corporation) (Mailing address of applicant) ! State whether applicant is owner, lessee, agent, architect, engineer, general contractm, electrician, plumber or builder ....... ~, ~0, .~. ........ Name of owner of premises ... [[J'~.¥ f- ~.. ~ t~/~/'O ,',).. !' (as on the tax roll or latest deed) If applicant is a corporation, signa[ure of duly authorized officer (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK Builder's License No .. ~97..Z..Z?.. )4~T Plumber's License No. 3-.o, .m? ~.~.%!.e~.. .... Electrician's License No ~.,tt-. Other Trade's License No ............... COUNTY LICENSED 1 Location of land on which proposed work will be done .. .3770 ;o ...... .. ............ House Number Street ' Hamlet County Tax Map No 1000Section Ol ? .... Block .. l ....... Lot..l.[~.:~.. ........ Subdtvlmon . .. Filed Map No ...... Lot .. (Na~e) ' 2 State exmting use and occupancy of premises and intended use and occupancy of proposed construction a. Existing use and occupancy. O~/e F~ntt..~ ~ ~LL~.tq. 6 ...................... b. Intended use and occupancy ..... .~'FH -~- ]~: .c~ ...... i .................. 3 Nature of work (check which applicable) New Building Addition ./x/..~ . AlteratJon Repair ..... Removal . ., Demolition ......... Other Work Est]mated Cost .. ?,.-D). 9C~? . If dwelhng, number of dwelhng un]ts . If garage, number of cars ..... (Descnptmn) · . ... . Fee . . .... .... .. . ...... . ' (to be prod on fihng this apphcatmn) ....... Number of dwelhng units on each floor ........ If business, commercml or m~xe.d occupancy, specify nature and extent of each type of use ...... D~mens~ons of exlshng structures, if any Front. . Rear ....... Depth ....... Height ...... Number of Stones ...................... Dlmens~ons of same structure with alterations or add,nons Front .. Rear .......... Depth ~',~ lll~' ' Hmght .... Numberflf Stones ........... /.' ' 9/ .... 8. Dnnensmns of en-ti'~c~l~e:,v*l~Plstructmn Front ...... Rear .. I t..-.o.."... Depth . t. 0 . .0. . Hmght ......... Number of Stones . ~> ~q ~ ............................... 9. S~ze of lot Front ......... Rear ........... Depth ............... 10 Date of Purchase .... ~ ........... Name of Former Owner ................... 11. Zone or use d~strict m which premmes are s~tuated ......................... 12 Does proposed constructmn wotate any zoning law, ordinance or regulatlon' . tqO ..................... 13. Will lot be regraded . . . Will excess fill be removed from premmes Yes No I4 Name of Owner of premises .~o, y e¢~ .~,gT~ ii ' '. Address n~,~q, fl,~).,e4q-~. Phone No .......... Name of Architect ................. Address ......... Phone No ............ 15. Is th~s property 1 d n 300 feet o . · · If yes, Southold Town Trustees Permit maybe required. PLOW DIAGRAM Locate clearly and dmhnctly al! bmldmgs, whether extstmg or proposed and. md~cate all set-back dnnensmns from aroperty hnes G~ve street and block!number or descnpnon according to deed, and show street names and mdmate whether interior or corner lot. STATE OF NEW YORK, S.S 2OUNTY OF ...... ........... being duly sworn, deposes and says that he is the apphcant (Name of individual s]gmng contract) ~bove named. Is the ............................................................................... (Contractor, agent, corporate officer, etc.) said owner or owners, and m du~y authorized to perform or have performed the smd work and to make and file this ~pphcahon; that all statements contmned m this apphcat]on are true to the best of his knowledge and behef, and that the ~ork will be performed in the manner set forth m the apphcat~on filed therewith. lworn to before me thru 7 .......... ..... day of ...... , 19 ~'7 dotar~ Pubhc, . .~/-~... ZPX'f. ..... County ~M~t~at~.st~. _~ (S~gnature of apphcant) Ho. 470'787& S4d~olk Couflq,,~~ ~ Tern Expres March 30,19--.~ / PLUMBER CERTIFICATION ON LEAD cONTENT BEFORE cERTIFICATE OF OCCUPANCY · usED IN WATER DER NOT SOL ~ M CAN ,.,rePLY sYS . E . 40/, LEAD' o,.,-- ;, ~o If ~o1~' t~blng Is used ExcEED 2/10 o ~. water di~tributlflg ~/.teml plpln~ ~hall ~ OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY ,f I ,/ ,/ / [] [] [] [] ENGINEER NOT RETAINED FOR CONSTRUCTION, SUPERVISION,OR INSPECTION DATE SCALE