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Home My WebLink About15951-zFORM NO 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N Y. Certificate Of Occupancy No %15714 Date April 30, 1987 THIS CERTIFIES that the bur(drag ..... A..d.d z.t ~. on .................... - -- .. -50..Eastw°°d Ct. & 19380 Main Rd. Natt£tuck Locatlon of Property House No Street Hamlet County Tax Map No. 1000 Section .I 1.5. Block 07 .Lot 0 ] Subdlvm~on .............. Fried Map No. . . Lot No ............ conforms substantmlly to the Apphcahon for Bmldxng Permit heretofore filed ~n flus office dated March 31, 1987 pursuanttowluchBmldmgPermltNo. 15951Z dated A p r. i 1 . 3.0., . .19 $.7 .... .. was ~ssued, and conforms to all of the reqmrements of the apphcable prowmons of the law The occupancy for wtuch fins certtficate m msued ~s ........ Deck addition to an existzng one £araily dwellzng as applred for. BARRY K. AND KAREN JEAN MURPHY The certtficate ts ~ssued to .... (owner,~e~r][l[o]~( X X of the aforesmd braiding. Suffolk County Department of Health Approval . N/.A UNDERWRITERS CERTIFICATE NO .......... ~/.A PLUMBERS CERTIFICATION DATED: Rev 1/81 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) N~ 15951' Z Permission is hereby gr~nted to: ~.~....i..~..~...o. ............................................ County Tax Map No. 1000 Section ..... ).L .~.'~.. ........ Block ....... ~:~..~ ........ Lot No .......c~....I ........... pursuant to application dated .... ....~J~...~....~.( ................, 19..~..~.., and approved by the Building Inspector. Fee $...',R~'~...: .............. Bu~ldin~ Ir~or Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions Thru application must be filled in typewmter OR mk, and submitted ~ -,,-,-,---, to the Buildmg Inspec- tor w~th the followmg, for new buildmgs or new use. I. Final survey of property with accurate location of all buildmgs, property lines, streets, and unusual natural or topographic features. 2. Fmal approval of Health Dept of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electmcal mstallat~on from Board of F~re Underwriters. 4. Commercml buddings, Industrml buddmgs, Multiple Residences and similar buddings and installa- tions, a certificate of Code compliance from the Architect or Engmeer responsible for the buildmg. 5. Submit Planmng Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to Aprd 1957), Non-conforming uses, or buddings and "pre-existing" land uses. 1. Accurate survey of property showing all property hnes, streets, bullrings and unusual natural or topograph ~c features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buddings. 3. Date of any housing code or safety mspectlon of buddmgs or premises, or other pertinent Informa- tion required to prepare a certificate, C. Fees' Add~tzons $25.00 1. Certihcateofoccupency New Dwellzng $25.Q0, Accessory ,$10.00 Buszness $50.00 2. Certificate o{ occupancy on pre-existmg dwelling $ 5 0.0 0 3. Copy of cert~flcate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 s.u~at~ c.o. $ 5o aa Date ...... .V.-/.7..-.~.. ........ NewCons%r'uct~on .... Old or Pre-exlstmg Buddmg ........... Vacant Land ............. Lo~at,o. of Proper~. ~..~......~..)~,..~. ~..c~.. ~./.~3~o...~.~..~. ~ ....... .~.~..~.~.. House No. Street Hamlet Owner or Owners of Property __ .1 County Tax Map No. 1000 Section .... ~.~ .~."¥ ....... Block ..... ? ........ Lot.. Subd~wmon ........................ Fded Map No ........ Lot No ........... Permit No. ~. Date of Permit .......... Applicant Health Dept. Approval ....................... Labor Dept Approval ........................ Underwriters Approval ...................... Planning Board Approval .................... . . Request for Temporary Certificate ............... Final Certificate ....................... Fee Submmtted $ ...................... OU~;DATIO~ (1st) OUNDATIO:~ (2nd) ,I 0UGH FRAME & ?LUMBING ~SULATION FER N. Y. STATE ENERGY CODE .,, FI;~AL ADDITIO~AL COMME] BLDG O£PT TOWN OF $OUTHOLD Examined Approved (~.. Disapproved a/c FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL gOUTHOLD, NY 11971 TEL.. 765-1802 BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... CHECK .......... SEPTIC FORM ............. NOTIFY ~ CALL ............... MAIL TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .',-~- ~ [ .... 19 INSTRUCTIONS a. Ttus apphcation must be completely filled m by typewnter or in mk and submltted to the Budding Inspector, wil 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 pubhc str. or areas, and giving a detmled descnptmn~o) cation. c. The work covered by flus application may not be commenced before ISSUanCe of Budding Permit. d. Upon approval of this application, the Building Inspector will issued a Budding Permit to the apphcant. Such pe~ shall be kept on the premises avadable for inspection throughout the work. e. No budding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupa shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bmldlng Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as hereto descn! The applicant agrees to comply with all applicable laws, ordinances, budding code, housing code, and regulations, ant admit authorized inspectors on premises and mbulldmg for necessary.~ectl?ns. ~(/..~,_ .~ (S~gnatur~ff applicant, oi' naffie, if a corporation) (Marling address of applicant) ( State whether applicant m_ owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or built Name ofownerofprem~ses ~/'d/~. K-, 4-. ~"g}/'daCr.,'~ "~ /~ .c/-/~.. J~/ ..... (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 SUFFOLK COUNTY LICENSED .... B fi ila e ~'~L f~ris~ N~o- ~. . .~ ................... Plumber's License No .. Electrician's License 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.. .~. ...... Lot.. ? ...... Subd~vlsion Fried Map No Lot (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction a Existing use and occupancy / . .~ff_'~,, t~-~ .~-d,)zg..,.,.,.,.,.,.,.,.~. - ............. b Intended use and occupancy ...... ~ ............. Nature of work (check which applicable) New Budding ...... Add~tlon Repair . Removal ., Demolition ....... 4 Est,mated Cost ...... .~:? 9 5. If dwelling, number of dwelhng units. If garage, number of cars ...... · .. Alteration - .. Other Work .~~. (Descnphon) (to be paid on filing this application) ..... Number of dwelling units on each floor ....... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............. 7. Danenmons of existing structures, if any Front .......... Rear .......... Depth ..... Height . Number of Stones ..................... D~nenmons of same structure with alterations or additions Front .......... Rear ......... Depth ...... Height .......... Number of Stones ....... 8. Dimensions of entire new construction. Front .... Rear ........ Depth ........... Height ............ Number of Stones ................................................ 9. Size of lot Front ........... Rear ................... Depth ......... 10 Date of Purchase ............. Name of Former Owner ........................ 11 Zone or use district ~n which-premises am mtuated. .. -- ................. 12 Does proposed construction violate any zoning law, ordinance or regulation' . ..................... 13 Wall lot be regraded ................ Will excess fill be removed from premises: Yes No - Name of Architect ................ Address ............ Phone No .......... Name of Contractor ................ Address ........... Phone No ............ 15. Is this property located wzthzn 300 feet of a tzdal wetland? *Yes ..... No ..... *If yes, Southold Town Trustees Permzt maybe required. PLOT DIAGRAM Locate clearly and distinctly all buddings, whether existing or proposed, and indicate nll set-back dmaenmons from oroperty hnes. Give street and block number or descnphon according to deed, and show street names and indicate whether ntenor or corner lot. STATE OF NEW 2OU~T~OF .... . .... (Na~me of individual mgmng contract) ibove named ·. being duly sworn, deposes and says that he is the applicant te is the .................................................................... (Contractor, agent, corporate officer, etc ) )f said owner or owners, and is duly authormed to perform or have performed the smd work and to make and file flus tppbcahon; that al1 statements qontaln~d m this apphcatron are true to the best of h~s knowledge and belief, and that the ~ork wdl be performed m the manner set forth m the application filed therewith. ¢worn to before me this , ... .~/ ..... day of .... ~.~ .... , 19 .~. qotary Public ..... ~..~ .~.~..~...~.. County ~ ~ . .............. . ~_4707878, Suffoll~',~ ~__~ ~ (Signature of apphcant) ~e,'m ~l~res March 30, 18 '~ ./