The URL can be used to link to this page

Home My WebLink About15929-zFORM NO 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ..zl..5.924....~ .... Date July 8, 1987 THIS CERTIFIES that the bmldmg two deck additions. Locanon of Property . . )3.0.9 . . . .Bro. a.d..w.at:e.r..~..R.o.a..d ...... C..ut.c.t}.o.~.u.e. . House No. Street Hamlet County Tax Map No. 1000 Section 104 . .Block .... 9 .. .Lot 4.1 Subdivtslon .... X. ............. Filed Map No X Lot No. X conforms substantially to the Apphcanon for Budding Permit heretofore filed in tins office dated ·. A. prxl. 1.5.,..1.9.8.7 pursuant to wluch Building Permit No. 15929Z dated ...... Apr. % 1 .2.5 t 1.98.7. was issued, and conforms to all of the requirements of the applicable provtsmns of the law The occupancy for Much tlus certificate m issued ts ... ~wQ .deck .a. dd..iti, on.s .(one i.n..f.ront; o.n.e i.n .b.ac.k.)..t.o..e.x.l.sti..ng dw.e..lllng. The certificate is lssugd to ............ TH. OYeS..KE.LL?.R ............... I (owner~{~~ of the aforesaid building Suffolk County Depaxtment of Health Approval .......... NrA .................... UNDERWRITERS CERTIFICATE NO PLUMBERS CERTI,FICATION DATED: ............. .................. N/A Buitflmg Inspector Rev 1181 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PEI~.IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHOI~IZED) 15929 Z Perm:ssion is hereby granted to'. // ~ ,, ~ ...... ....~.....~....~.:.~..,....zL~..~. ,o ..~~...~.....~....L~~...~.~Z..~ .... ~ ...... ~~~.~ .............. ~~~ .................... at premises located at .,~,..~ pursuant to application dated ....... ./.. . Building Inspector. .......... , 19.~..7.., and approved by the Fee .'. . Rev. 6/30/80 FORM NO 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 BLDG. DEPT. TOWN OF SOUTHOLD APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Thru application must be filled in typewriter OR ink, and submitted ~, ~ to the Building Inspec- tor with the following; for new buildings or new use' 1. Final survey of property with accurate location of all buddings, property hnes, 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. Commercml buildings, industrial buildings, Multiple Residences and s~milar 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 s~te plan requirements where apphcable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-ex~sting" land uses' 1. Accurate survey,of property showing all property lines, streets, buildings and unusual natural or topograph ~c featu res 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 mforma- t~on required to prepare a certihcate. C. Fees' 1.Cert~ficateofoc~upancy $25.00 -- BUSINESS $50.00 ACCESSORY $I0.00 2. Cert~hcate of-occupancy on pre-ex~st~ng dwelhng $ 50.00 3 Copy of cert~f~cate of occupancy $ 5.00, over 5 years $I0.00 4.Vacant Land C.O. $ 20.00 ~ ,~-~/~,-~) 5.Updated C.O. $ 50.00 Date ..... ~..~.~ .... ~ ........... NewC°nstruc%~on'~.~.. O~dorPre-ex~mgBu~ldlng ............ Vacant Land ..~,~.~ ..... Locat,on of Property... ~.~. ~ ~.... ~¢ ~.0~ 9. ~~...~ ~... ~%.L~. Hou~ No. Stree~ Owner or Owners of Prope~v ............................................... .................................. Health Dept. ~p~roual ....................... kabor ~e~t. A~roval Underwriters Approval ................... Planning Board Approval .................... Request for Temporary Certificate ................ Ftnal Cert~hcate .................. Fee Submitted $ ...................... Construction on above desenbed building ,nd ~eets all appt~a~bl~ codes and regulattons. OUNDATION (1st) OUNDATION (2nd) OUGH FRAME & PLUMBING NSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: TOWN OF $OUTIIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN tlALL SOUTHOLD, N.Y. ! 1971 TEL. 765-1802 To Whom, This May Concern, We. are unable to complete your Certificate of Occupancy because of the following reasons. An application for Certificate of Occupancy is not on file. /Z/ No Underwriters Certificate on file. Tile check is(outdated/,n_ot on file.) /Z/ No Health Dept. Approval on file. /Z/ No final inspectlon has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit # ~_ ~ ~ ,_7 ,~ Z Building Dept. ***/Z/ No Plumber Solder Certificate on file. all permits involving plumbing being issued after April 1,1984 ) TOWN OF SOUTIIOLD OFF[CI:' OF BUILDING INSPECTOR P.O. BOX 728 TOWN ItALL SOUTIIOLD. N.Y. 11971 TEL 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because of the following reasons. An application for Certificate of Occupancy is not on file. /5/ No Underwriters Certlficate on file. /_~ Tile check is(outdated/~t on file.) /5/ No' Health Dept. Approval on file. /5/ No flnal inspection has been made. Please contact our office on Thank you for your cooperation. Building Dept. this matter. ... ~ Z No Plumber Solder Certificate on file. { all permits involving plumbing being xssued after April 1,19B4 ) 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING ~FINAL DATE INSPECTOR us~ ~s u~l~w~uL NOTED Examined .~ .'~.~ . Approved(~... Disapproved a/c ...... FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:~ 19 1. 19~1 Perralt No/ ~.t~.~.Ol ~¢' (Building Inspector) APPLICATION FOR BUILDING PERMIT 3 SETS OF PLANS-- SURVEY .......... CHECK .......... SEPTIC FORM ............. NOTIFY CALL ........... MAIL TO: '~O7,~ Date . .., 19 INSTRUCTIONS a. Ttus apphcatmn must bl completely filled m by typewriter or ~n ink and submitted to the Building Inspector, w~ sets of plans, accurate plot plan to scale. Fee according to schedule b. Plot plan showing locatmn of lot and of bmldmgs on premmes, relationship to adjoining premises or public str or areas, and g~vmg a detailed description of layout of property must be drawn on the dmgmm which [s part of ttus a! cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of thru apphcanon, the Building Inspector will ~ssued a Budding Permit to the apphcant. Such pe shall be kept on the premises available for mspechon throughout the work e. No building shall be occupied or used ~n whole or in part for any purpose whatever until a Certfficate of Occup shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bmldmg Permit pursuant to Buil&ng Zone Ordinance of th~ Town of Southold, Suffolk County, New _York, and other apphcable Laws, Ordinance Regulations, for the construction of buddmgs, additions or alterations, or for removal or demohtion, as hereto descnl The apphcant agrees to comply with all apphcable laws, ordinances, buddmg code, housing code, and regulations, an~ admit authorized inspectors on premises and m bmldmg for necessary ~nsp~cc.taSm~- .//~ (Signature of applicant, or name, if a corporation) (Mailm~ address of apphcant) //?o~g' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bml, · Name of owner of premises 7~ ~) .~-?',,,St ~.q. ~,,~'-/-~. Z. ~-',~ ....... i (as on the tax roll or latest deed) If applicant ~s a corporation, signature of duly authorized officer (Name and title of cprporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No . M.3/~ :~ Plumber's License No .. Electrician's License No .. Other Trade's License No .. Location of land on which proposed work will be done t louse Ntlln ber Street County Tax Map No 1000 Sect,on //O ¢1~ ttamlet Iock 0 ? .0.0 . .. 00. 0..0 l Subdtvmlon 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 b Intended use and occupancy ........... 3 Nature of work (check which applicable) New Budding .... Add~hon . .~ .... Alteration .. Repmr Removal .... Demolition ......... Other Work ......... '* i~ '*'~ (Description) // 4 Estimated Cost ~. '..62/ {9¢ .F__~. .......... Fee ......................... " (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 ........... 6 If business, commercial or mixed occupancy, specify nature and extent of each type of use ........... 7. D~rnenmons~>.fj},xistlngstructures, ffany Front... ~-/& ~.. Rear ..qz~z¢..~. .. Depth ..~'=P/.~. Height . ~'~[1, ~... NumberofStones . ~ '/&- .......................... Dunensions of same structure with alterations or ad&hons Front .......... Rear .......... Depth .......... Height ....... Number of Stories .......... Dimensions of entire new cgnstructlon Front . .. Rear ....... Depth .. . Height ..... Number of Stones ............................. ,: ........ Size of lot Front ~ .t i .... Rear . ) 6. C' ~ ...... De~h . .~5..O~. ........... 1 0. Date of Purchase ................. Name of Former Owner ~ ~4ddr . ~/e,-~/.4't~.Z:>.fi . . 1 1 Zone or use district in which premises are situated ................. 12 Does proposed construction wolate any zoning law, ordinance or regulation, ' ,,~.. ........ 13. Will lot be regraded .AZ/-) ............ Will excess fill be removed from premises Yes 14 Name of Owner of premises . .2"'/'/~/'t',~g. ~('4/~..z~'~.. Address l~c~. ,a~,~'e~,,qo..~ F%.. Phone No .,~./.a' 7~'.7.~0~ Name of Architect ............ Address ........ Phone No. Name of Contractor . . ! ..... Address ............. Phone No ......... 15. Is this property located with~.n 300 feet of a tidal wetland? *Yes . .~.. No ..... *If yes, Southold TownlTrustees Permit maybe required. PLO~f DIAGRAM Locate clearly and dishnctl~ ~1 buddings, whether ex~sting or proposed, an& ~ndicate ~dl set-back dn'nens~ons rrm number or descnphon according to deed, and show street names and indicate wheth, property hnes Give street and bl6ck ~ntenor or corner lot STATE OF NEW YORK, S S COUNTY OF ..... (Name of mdlvldual signing contract) above named · . being duly sworn, deposes and says that he is the apphcar He 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 th: apphcat~on, that ali statements contained m this application are true to the best of his knowledge and belief, and that th work will be performed in the manner set forth m the application filed therewith. Sworn to before me tlns ? · . ..... day of ,,-~, . -- ~--.. Notary Pubhc, ~...~:.. O..g/..~/~..q'' (Signature of apphcan: