The URL can be used to link to this page

Home My WebLink About16403-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certi[icate O[ Occupancy No. Z16478 Date December 15, 1987 THIS CERTIFIES that the building A d .d i t i o n Location of Property 280 Fawn Lane Cutchogue h 3 ds '~ ~'E ....................... 's't/o3 i ....................... County Tax Map No. 1000 Section . . J .0.3 ....... Block ..... .0.6. .......Lot ...... 0.2. 7. ........ S 'div'' MOOSE COVE -, . 49 uo ~mon ............................... t~'i~ea Map No. 3. 2. .3.0 .... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... g:.u.g... 27, 1987 pursuant to which Building Permit No. 16603Z dated . .~.u.g~ ....3.0.,.. ! .9.8.7 ............ 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 ......... Deck addition to an existing one family dwelling. The certificateisissued to PETER & NANCY KREPPEIN ..................... ?o¥.~), '~A~'~ k .................... of the aforesaid building. Suffolk County Department of Health Approval ........ .121/.A ............................... UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED: N/A Rev, 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CTHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO- 16403 Z Permission is hereby granted to: ~ ~ r~ ..~...~.....~.~. ...................... ~~.....~.....%...l..,..~.z..~ ..... , ~o ~...% ,i~..~..?~.~...~......t~ Z>'--. ~. '""T .... ~:'" ...... ~'tr .... '~'~'~ ......................................... at premises located at .z:~_"/~_(~~.~....O-~m...~.~ .............................. ....... ~?; ........ ~ ............................................... ~ ............................................................................. ...~ ........ .~.....~.~...~~ ........................................................................... To .I O ......... .......... O ........ ......... ~ County x Mop No. 1000 Sect~-~..[..~....~.. Block ~ Lot No ~ pursuant tO opplication dated .-~:~.~...~.....~.~.~ '} ........... , 19.~..~.., and approved by the Building Inspector. Fee $ .~..~...,..j. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted in duplicate 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, end unusual natural or topographic featu res. 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, For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic features. 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. -~ Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $ 1.00 $5.00 New Building ............. Old or Pre-existing Building(Z). _.~.~ .~/Vacant Land i ....... ,... Location of Property ,~...t¢,' . ,~,..~ .~..~' (~j ~ ~L¢~¢. ~/~ Owner or Owners of Property . ..~.,. ~ --- ' . . . County Tax Map No. 1000 Section .~{.0.,¢~ ......... Block ............... Lot ................ Subdivision .IYI ,v'~,:~ ......................... Filed Map Nealth Dept. Approval ~ .Labor Dept. Approval Underwriters Approval ........................ Planning Board Approval .................. Request for Temporary Certificate .... ~ ............ Final Certificate ..... ~ ...... · · Fee Submitted $...~.. 51'3~)( ................... Rev, 10-10-78 Construction on above described building Applicant and per~jC,mee.ts all/~¢i, ca~_ _des af regulations. FIELD INSPECTION COMMENTS FOUNDATION (1st FOUNDATION (2nd ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY Y e FINAL ADDITIONAL COMMENTS ~ /5' BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING REMARKS: Z,, 0 .? ...... LIJ 'FORM NO. 1 TOWN OF SOUTROLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 i ['-~i ~_.~ ' TEL.: 765-1802 Exam .....~.., 19 .~.? Appro~~...~.., 19~.~. Permi} No. I .(e.[/.O.g. ~ Disapproved a/c ............................ ....fo)... ............................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .: R~ -m · .'- · CHECK SEPTIC FORM NOTIFY CALL 73. ('Y ...... MAIL TO: AU$ 2 Tlg i' a. Tkis application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pumuant to the Building Zone Ordinance of the Town 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 applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary in~e.ct~nff//~ U~ ~ ,~ .... ...... (~gnature ofa¢plican ,~n/~ if acorp at'on) ~ (Mailing address of applicant) State whether applicant is q.vLner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................... ........................................................ Name of owner of premises f~T'/~'"~ ~J J/~t//qTI/C-~f 1...~._ ..~1~,;/~ ............................ ..................... --'('as 'o'n' ih e'~a'x' lo'l{ ;; ilt;}t' fieed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No.. I ~..~..~..~.O....~-J.. ,.~. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................. h' ' '" ........... ............... ............. .... : .... House Number Street Hamlet County Tax Map No. 1000 Section ../0 ~ . ...... Block ..¢ .... Lot...~- ~ .......... Subdivision P~fr/') qP~oO£ff Col/~~ FiledMapNc.~q~'~.O. Lot (Name) 2. State existing use and occupancy of premises and intended use ~d occu_~n~?~/of p[oposed construction: a. Existing use and occupancy .... /... ~.~..~..'~.././.~.,..//)....~..~..- ./~ ./f../~.~.: ........................... b. Intended use and occupancy ...... ~ .... ~ .... - ................................................. 3. Nature of work (check which apphcab e): New Building Addition ..... Alteration Repair .............. Removgl .............. Demolition .............. Other Work ...... (Descriplion) 4. Estimated Cost ~ c> o .i : ~ (to be paid on filing this application) 5. If dwelling, number of dwelhng umts ............... Number of dwelling units on each floor If garage number of cars i 6. If business, commercial or mixed Occupancy, specify nature and extent of each type of use ...............: ...... 7. Dimensions o_I; ~xisting structures if any: Front.. ~. i~. ·.; ...... ~ Rear . ~.~r. ......... Depth..~ ~. ...... Dimensions'of same structure with~ alterations or additions: Front . .~'.2<-. .......... Rear ...~..d.;., .......... 8. Dm~ens~on3 of entire new construc:tlon: Front .......... ..... Rear ... l .~..ff ....... Depth .t fi.....~, r ...... 10. Date of Purchase ............. i ................ Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..... f.~v~-d./. ~q~..; ............................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... ./~..~.; ...................... 13. Will lot be regraded ..../~.O~, .,..,_. ,~._ _ ..... ~!. .~ ............... Will excess fill b~ removed from premises: Yes 14. Name of Owner of Name of Architect .., .......... i ............... Address ................... Phone No ................ 1.5. Is th±s property local:ed w~l:h±n 300 feel: of a l:±dal wetland? *Yes ..... No ...1~. ~:l:f yes, Soul:hold Toxqn Trusl:.ees Perm±t maybe requ±red. PLOT DIAGRAM Locate clearly and distinctly all b~ildmgs, whether existing or proposed, and, indicate all set-back dimensions from ~roperty lines. Give street and block nu'mber or description according to deed, and show street names and indicate whether :nterior or corner lot. STATE OF NEW YkO'~, ,v~. S S COUNTY OF ....~:::~(.~',l/ff--~.. ......... ~.~.'~.. · .~.~. ~ .~../~. f. ~..~.- ............... being duly sworn, deposes and says that he is the applicant (Name ..... of ind~vldual s~gmng contract) above named. He is the ' i (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 ~'ork will be performed inthe manner s~t forth in theapplication filed therewith: ~worn to before me this ~ .......... <~ .... day of ........ 19 .~.~ ~otary Public,,: ................... ~.. County 6t Notary Pub,lo, State of New York : N~! 258_50, ~uffolk Te~ire~ O~tober ~101