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Home My WebLink About16409-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No .... .Z.-.1.6. 5..6.1 ...... Date .... 4 ~ p.u.&r, y. ,5 .... 19.8.8. .......... THIS CERTIFIES that the building Construct Deck Addition Location of ]Property .... 1.0. 8..0..C.q r. ? y..C.r. ? .e.~. A. y.e.n.u.e. ......... S.o.u..t .h.q 1..d ~..N.e.w.. y.q r..k.. House No. Street Hamlet County Tax Map No. ! 000 Section . . . .0.7.8. ..... Block . . ,0 .4 ........... Lot .... ] .5 ............ S ..... M/o Corey Creek Estates ............. uoalvlslon ............................... Filed Map No...4.9.2.3...Lot No. 13 conforms substantially to the Application for Building Permit heretofore filed in this office dated August 28, 1987 pursuant to which Building Permit No. 164Q9 Z dated......Au g ..... u s t .3 ............ 1, I 987 . .... 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 EXISTING ONE FAMILY D~LLING AS APPLIED FOR The certificate is issued to JOHN & CAROL 0 ' HAGAN ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval ............. N./..A .......................... UNDERWRITERS CERTIFICATE NO ..................... N./..A .... PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 ~O~lW NO. o TOWN OF $OUTHOLD BUILDIHG DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLY,ON OF THE WORK ^UTHORIZEO~ ..~.~r......~! , N_o 1640~ Z Dote ................. Permission is granted to: ! ...... . :t premises Iocoted':t ...J.:~...~.:~.....~...~:::~::::::~:::::: co,,,.,,,,, Tox Mop No. ,000 Sec~,,~......O~.~. ..... B,o~k ....... .~.~ ....... Lot No ..... .t.~--.. ........... ,,,.,rs-on, ,o opp,,cot,o,., da,ed ~...~...~...~ ............. ' '9'~"1" ,'.nd approved 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 OCCUPAN( Instructions BLDG, DEPT. TOWN OF SOUTHOLD A. This application must be filled in typewriter OR ink, and submitted m ~ 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, 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. 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. B. For existing buildings (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 unusua~ natural or topographic features. 2.Sworn statemont 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. C. Fees: Additions $25.00 POOLS $25.00 1, Certificate of occupancy Ne~ Dwelling $25.Q0, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 5.Updated C.O, $ 50.00 Date ..... /. ........... NewCons t~ruc t,~ on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .... House No. Street Ham/et Owner or Owners of Property ~0 Cou~W Tax ~ap ~o, ~000 ~ecdon ~ '~ ~loc~ ~o~ ........ · /. ...................... F.l~d Ma~ N ........ :...L~tN .... PermtN?~O~/DateofPermit ............ ........ .................................. Health Dept. Approval ................ ' ........ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $..~:..'~. 7~ ,O... ~.~...~..6...lT- Construction on above described building ~,~ p_e~mit me.fable codes and regu lations' Rev. 10-10-78 BLDG. DEPT, TOWN OF SOUTHOLD TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-I 802 December 30, 1987 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. ENCLOSED No Underwriters Certificate on file. The check is(outdated/not on file.) $25.00 No Health Dept. Approval on file. No final inspection.has been made. Please contact our office on this matter. Thank you for your cooperation. -Building Permit # 1 6- 4 0 9 Z O'Hagan Building Dept. ***/5/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) Sent to: JOHN 0'HAGAN 240-72 DEPEW AVE. DOUGLASTON, N.Y. I 13 13 FIELD INSPECTION FOUNDATION (1 ~OMMEN'IS FOUNDATION (2nd) ROUGH FRAME PLUMBING INSULATION PER N. STATE ENERGY ADDITIONAL COMMENTS 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [/~INAL ~ REMARKS: BOARD OF HEALTH ...... 3 SETS OF PLANS ....... FORM NO. 1 SURVEY TOWN OF SOUTHOLO C ECK BU~LD~MG DEPARTMEMT SEPTIC FORM ............. : TOWN HALL $OUTHOLD, N.Y. 11971 TEL,: 765-1803 Examined .~¢4~.1~.,0~. ~,,~.1.., 19 ~.7 Approve~t~'-"x 1: .tr~...I~. ?~.].., 19 .~2 Permit No. ] .~..~. ?..'~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT NOTIFY CALL -~-~-~ ........ Date ................... 19 INSTRUCTIONS a. This application must be completely filled in by typewriter 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 parr 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 Cerrificate 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 pursuant 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 i~pec~ns. , t · X.. ............. (Signature of applicant or na~e, if a corporation) ............. (Mailing ffddress of applicant) ._ .. t~/ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or budder,d Name of owner of premises (~ .t. ~.~¢..A. ~.J~...'-:~.~. Q..~...)~...~....~..4..IFC.. ? .(~7 .............................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) - ALL CONTRACTOR'S MUST BE ~$UFFOLK COUNTY LICENSED Builder's License No.. ,.~.~L~. ~. ~'.'(~ ............. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on which.proposed work will be done ............. · ..................................... House Number Street Hamlet County Tax Map No. 1000 Section Block Lot ........ ? ..... (h'a~) ..................... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy ............................ ./.. ..................................... b. Intended use-an~ occupancy ....... ~..~~ ...... - ................................... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ........... Repair .............. Removal .............. Demolition Other Work.. (Descrip~tion) 4· Estimated Cos ........... ~ ........................ 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;mensmns of ex;sting structures, ff any. Front..~. ~,'..t5~. ...... Rear . ~/~d?...~ ...... Depth .4~.¥.: .~. ? ...... Height' . .............. Number of Stories .... /. ..... . ............ DnnensJons'of.s~ structure w3th alterations or additions: Front . ¢.Q. ~. .......... Rear . ./o... ff. .......... Depth...~..~. '.5". '.' .......... i. · Height ..... .~.. ............... Number of Stories ...................... -"8. D~menslon. s of entlre new constructmn: Front .t~. ...... ' ..... Rear ./..&. .......... Depth .{~v.? ........... Height . ~.Q.'.~ ......... NuMber of Stories ....................................... ,; ................ 10. DateofPurchase /.9 ? 3....:. Name of Former Owner :~O~,v,a t..O 1 1. Zone or use district in which premises are situatdd ..................................................... 12. r)oes proposed construction violate any zoning law, ordinance or regulation: Al.c! ............................. 13. Will lot be regraded . ..~. ..... I ................... Will excess ~11 be re.r0oved from premises: Yes Name of Architect .......... , ................. Address .......... i~t-~ Phone No ...... . ....... Name of Contractor ......... i ................. Address .... ; .............. Phone No .......... ~. ..... 15. Is this property located.;within 300 feet of a tidal wetland? *Yes ..... ~ ..... · If yes, Southold Town TrUstees Permit maybe required. PLOW DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and~ indicate all set-back dimensions from property lines. G~ve street and blockinumber or de! :~.0'.m.K.~.o_. d..e~e_9l ..~a~9~ d' s~hp~_street names and indicate whether interior or corner lot. /dO ~ STATE OF'NEW YORK, COUNTY OF ................. (Name of individual signing contract) above named. He is the Otc tV~ & duly sworn, deposes (Contractor, agent, corporate officer, etc.) tnd says that he is the applicant of said owner or owners, a~d is duly authorized to perform or have performed the said work and to make and file this application; that all statements fion~alned in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith· Sworn to before me this ! ,' ' ......................... day of ....... ~ .......... 19... Nota,y. Public, . X~--a'z,%~...../~. x~-fflXC, St~..~..~l I~n ' ' 'A'/'aF' 'df' '~'~' 'i .... Couniy '~ .Q.~..,~-..~...c:j~...CL/r~.. i 'rt''" . . No..lT07lq,8,,~01~ ~C~anl~l~~ . '-~] -- 'f .... (Signatu~ of applicant) :1~_ ,~,~,,: I SUFFOLK CO. HEALTH DEPT. AI~OVAL I. NO~5, ~F-~I2 TO '~AP ~f:' CO~E~7' C'[2~E ~ ~['~T~-m ' ~ H. S NO. IN T~FFCO. CL.EFZ~ OFF CE A5 ~A[~ ~ ~'~ -:" ~ .... ~ : , ~-- 50' N /' STATE~NT ~ {; ~'~ ~ ~ ~'~* ,,/? THE WATER S~Y AND ~WA~ DI~AL ~~ ~ ~ ~ SYSTE~ F~ THIS R~E WILL _/ t ~ ~ ,r~ C~ORM TO T< STA~AW~ ~ THE L~T' ~ ~ : / SUFFOLK CO, DE~. OF HEALTH ~ ~ / ~<ANT ~ N,~ ~ JO ~, / ~ ' ' SUFFOLK COUNTY ~PT. ~ HEALTH ~ '~ ~ 0 t DATE: ~: ~, , ~co~ ~:: :-~ ~ ' ' ~.- %~ .~ ~ ~ :-~ O'I~N PIPE ~ .~ ~E'PE'~ / / ,' ,, ~.~. .'~ ." ,, ,,:.~', Ol 0 / / JO[4N AI20L 0 NA zAN LI~N~ LAND ~V~ ~E~RT ~W ~K