HomeMy WebLinkAbout15955-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z17533
Date NOVEMBER 21r 1988
THIS CERTIFIES that the building
Location of Propert~ 760 OAK STREET
House No.
County Tax Map No. 1000 Section 136
Subdivision
ADDITIONS
CUTCHOGUE
Street Hamlet
Block 01 Lot 39
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
fzled in this office dated MARCH 20, 1987 pursuant to which
Building Permit No. 15955Z dated MAY 4~ 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 ~s DORMER ADDITION & 2ND FLOOR DECK ADDITION.
The certificate is issued to JAMES AND NANCY LONG
(owner, ~)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N045271 NOV. 11r 1988
PLUMBERS CERTIFICATION DATED N/A
Building Inspector
Rev. 1/81
FOIr, M: NO. 9
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)
Budding Inspector.
Fee $~...:..~..
Rev, 6/30/80
FORM NO. 6
TOWN OF SOUTHOLD
Budding Department
Town Hall
Southold, N.Y. 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Thru apphcation must be filled in typewmter OR ink, and submitted I ~ to the Building Inspec-
tor w~th the following, for new buildings or new use:
1. Final survey of property w~th 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 dmposal--(S-9 form or equal).
3. Approval of electrmal installation from Board of F~re Underwmters.
4. Commercial buildings, Industrml buddings, Multiple Residences and mmdar buddings and installa-
tions, a certificate of Code comphance from the Architect or Engineer responmb{e for the budding.
5. Submit Planmng Board approval of completed site plan requirements where apphcable.
B. For exist~ng buddings (pmor to April 1957), Non-conforming uses, or buildings and "pre-exmsting"
land uses'
1. Accurate survey of property showing all property lines, streets, buddings and unusual natural or
topographm 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 Inspection of buildings or premmes, or other pertinent informa-
t~on required to prepare a certificate.
C. Fees: Additions $25.00 POOLS $25.00ALTERATION $25.00
1.Certihcateofoeeupancy New Dwelling $25.O0, Accessory ,$]0.00 Bu$1ness $50.00
2 Certtflcate of occupancy on pre-existing dwelling $ IO0.00
3. Copy of cert~hcate of occupancy $ 5.00, over 5 years $ 0.00 ¢
4.v c tc.o.s 20.00 f
5.Updatecl C.O. $ 50.00 Date ..... I.t.. · ...............
NewConstruct~lon ...... Old or Pre-existing Building .......... Vacgnt I~and ...........
Subd,v,s~on ....................... ~,..[ . . .F,led Map No ........... Lot No .............
*erm,tNo. J.~.CJ..~.~G..J-DateofPerm,t . ../.LU: .7.Apphcant .... i
Health Dept. Approval ........................ Labor Dept. Approval ...........
Underwmters Approval ....................... . Planmng Board Approval .................... . .
Request for Temporary Certificate .................. Final Certificate ................... ....
Fee Subm.tted $...,RG, ~.O. ..................
Construction on above described building and permit meets ail apphcaJa, le codes and regulations.
Applicant ..... ,,,~¢~-~,~.-- . .~. ~ . .~.~vd .........................
R~. 10 10-78 ~ ~
OUNDATIO.U
$UNDATION
OUGH FRAME &
PLUMBING
(15t)
(2nd)
I;SULATION PER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIONAL
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
~- N< f~%;~R*~;~ 11 *~ ~85JOHN_~ STREET, NEW YORK, NEW YORK 10038
~te Application No. on f~l~
THIS CE~IFIES THAT
~y t~ ~t~ ~u~me~t ~ ~ ~w a~ intM~ by t~ ~t ~M ~ t~ e~ ~t~ numar in t~ ~m~s of
w examin~ on and found to be in compliance with the r~ui~menls of thD B~.
IANOES COOKINO DICKS OVENS DISH WASHERS
¥
EXHAUST FANS
DIMMERS
C
KO. OF HI-LEO C~' ~:~6 ~o. o~ mutr^~s OF~h~OTO~L
This c~ifico~ m~t ~t ~ olt~ in any mon~r; return to tht offic~ of ~ brd if i~orr~, In~n ~ b i~ntifi~ by t~ir crtd~ntioli, '
~ P~ ~1~ DEPARTS. ~IS C~ ~ ~TE ~T ~ ~T~ M~ ~R. '
TOWN OF SOUTtIOLD
OF)'ICI; OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTIIOLD, N.Y. 11971
TEL. 765.1802
To Whom This May Concern,
We are unable co complete your Certificate
of Occupancy because of the followlng reasons.
/~-~ An application for Certificate of Occupancy
is not on file.
/_~ No Underwriters Ccrtlfica~e on file.
/~ The check
/~/ No Health Dept. Approval on file.
/Z/ No final inspection has been made.
Please contact our office on this matter-
Thank you for your cooperation.
Buildxng Permit t~ / D- ~ 3~ ~ Z
Building Dept.
***/~/ ~o Plumber solder Cert%ficate on file.
( all permits ~nvolv~ng plumbing being
issued after April 1,1984
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION ZND [ ]~SULATION
[ ] FRAMING
REMARKS: ~,, ~,~~
/
l /
iNSPECTOR ,"'~ ~//~
F
[IJ
OESI'GI4. ,~,LLO\~/F.D' DE.51GI4 ALLO'~ED
5U 55h'STF_.F'i,., AREA
V, TEP-IOP-'WALL (G.IZoS6) ..z£~ o, z2 .. "
X, TEI2.1OP. WALL (OPAQUE). 2 q? 0.06 7~o ,
'.'5' '" ~' 370
LAZING .s,~. °/o / It..~
~ ~S 0.40
LOOP_ - o. oD
~ FI DTP-~,T IO,M z¢3a
OTTO.%' 'TOT-~,L% ~.,7 ~o ~,~',, o
/
5. coHG'rP-.uC.TioH T° 1,4F-~T H."i',5. EHE,RC.,¥
,/
Disapproved a/c
'FORM NO 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N Y 11971
TEL.: 765-1802
, 19~ 7 Permit No
(Budding Inspector)
APPLICATION FOR BUILDING PERMIT
BOARD OF HEALTH
3 SETS OF PLANS ''.~f'..'.
SURVEY ..........
CHECK ..........
SEPTIC FORM ............. :
NOTIFY
CALL .....
MAIL ~'~
Date 2 //~/ ...,19
INSTRUCTIONS
a. Tins application must be completely fiBed m by typewriter or in ink and submitted to the Building Inspector, wi
sets of plans, accurate plot plan to scale. Fee according to schedule
b. Plot plan showmg location of lot and of buddings on premises, relatmnsinp to adjom~ng premises or pubhc stt
or areas, and glvmg a detmled description of layout of property must be drawn on the d~agmm which is part of th~s a
cation
c. The work covered by tlns application may not be commenced before issuance of Budding Permit
d. Upon approval of this application, the Bufldlng Inspector will issued a Bmldmg Permit to the applicant Such pe
shall be kept on the premises available for inspection throughout the work
e. No budding shall be occupied or used in whole or in part for any purpose whatever untz! a Certificate of Occup
shall have been granted by the Bmlding Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant
Bml&ng Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinanc.
Regulatxons, for the construction of bmldmgs, additions or alterations, or for removal or demohtmn, as herem descn
The applicant agrees to comply with all apphcable laws, ordinances, bufldmg code, housmg code, and regulations, an
admit authorized mqpectors on premmes and m budding for necessary ~nspec. lqons~
.. .... ......
(S~gna~/re of apph~ant, or name, ff a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, generaI contractor, electrician, plumber or buff
Name of owner of premises .. JC..v~q4. ,.o /~O~h.c~? .........
.~as on the [~)(roll or latest deed)
If applicant Is a corporation, s~gnature of duly authorized officer
(Name and title of corporate officer)
ALL CONTRACTOR'S HUST BE SUFFOLK COUNTY LICENSED
Builder's License No .I ,~,~ q c~. ~._ /_4/.~
Plumber's License No . .
Electrlclan's L~cense 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 [ % ~q . Block
Subdlv~s~on Filed Map No
(Nan~e)
· Lot. 3
· . Lot ........
State ex,sting use and occupancy of premises and intended use and occupancy of proposed constructmn
a Existing use and occupancy a.~ ~ .. ~ ......
'W
b Intended use and occupancy /~ ~
3. Nature of work (check which applicable) New Budding .. Addition . . Alteration . t,' . ..
Repair .... Removal ..... Demolmon ............ Other Work .........
~ '~Or (Description)
4. Estimated Cost .. {9 ~) ~) ................ Fee ................................
· (to be paid on filing thls application)
5. If dwelling, number of dwelling units . I ...... 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. Dimensions of existing structures, if any Front . ~ ? > ... Rear . .~.2...5 .... Depth .~ 2. ........
Height . ~'~' .. . Number of Stones .... I " '~L7'3''i ...... l~;ir" ~.'"J~! ....
Dnnenmons of san3e structure with alterations or addlt~ops Front ...
Depth . .. ,5 ........... Height ..... (-,) ........... Number of Stories...,r2, ..............
8. Dunenslons ofentlre new construction' Front ... ~, .,-~,~ .... Rear ............. Depth ............
Height ........ Number of Stones .........................................
9 Size of lot Front .............. Rear ................. Depth .................
10. Date of Purchase .................. Name of Former Owner .......
1 t. Zone or use district in which premises are situated .....................................
12 Does proposed construction violate any zoning law, ordinance or regulation ...... .~.5'. ...................
13. Will lot be regraded ..... ~ C ...... Will excess filI be removed from premises. Yes 4~No
I4. Name of Owner of premlses ,J¢,,w,~,~..: ]~.' ~ .Address. ?.~. [~..,~..'~....PhoneNo .7.~q.-.TYct.,...
Name of Architect ..... -.~f. Address ................ Phone No ....
Name of Contractor .................... Address .............. Phone No ....
15. Is this property located within 300 feet of a tidal wetland? *Yes .....
*If yes, Southold Town Trustees Permit maybe required.
PLO~ DIAGRA~
Locate clearly and distinctly all buddings, whether existing or proposed, and indicate all set-back dunenslons from
vroperty hnes Give street and block number or descnphon accordmg to deed, and show street names and in&cate whether
interior or comer lot.
gTATE OF NEW YORK, S.S
2OUNTY OF ..........
.................... being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
tbove named.
te is the ............................
(Contractor, agent, cor~;;a'te o'f~ce;,'e't~ ) ..... ,'-" g~ .........
ff smd owner or owners, and is duly authorized to perform or have performed the said work and to make and file ttus
tpphcation; that all statements contained m this apphcat~on are true to the best of his knowledge and belief, and that the
york w,ll be performed in the manner set forth m the al~phcatlon filed therewith.
;worn to before me this
c~gd day of.. ~c~ ., 19~,.7.
,otaryPubhc, .~. ~'. 4.~....~/..~'~... County
(Signature of applicant)
,~UPANCY OR
IS UNLAWFUL-
*lOUT CERTIFICATE
OCCUPANCY
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