The URL can be used to link to this page

Home My WebLink About16019-zFORM NO 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No Z-16019 Date June 18, I987 THIS CERTIFIES that the budding DECK ADDITION Locatlon of Property .65.5 .S.m.~.th. Road Peconic, New York House No. Street Ham/et County Tax Map No. 1000 Section 098 .Block 4 Lot 7 Subdivm~onM./~o..I.n. di.a.n..N.e.e.k..P, ar.k. ........... Flied Map No. 551 .Lot No. 14 conforms substantially to the Apphcahon for Braiding Permit heretofore filed In this office dated M..a.y 8, I 987 pursuant to which Braiding Permit No. 160 I 9 z dated . . .Ma.y .2. 8 :. 1.98.7 .... was msued, and conforms to all of the reqmrements of the apphcable prov~mons of the law The occupancy for wbach this certfficate ~s msued ~s DECK ADDITION TO EXISTING ONE FAMILY DWELLING JOSEPH & DONNA ST. PIERRE The certificate is ,ssued to ....... ?o~,.o),.l~..~tXt~r~.~7t ......... of the aforesaid bmldmg. N/A Suffolk County Department of Health Approval .............................. UNDERWRITERS CERTIFICATE NO N /A PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev 1/81 FOB~ NO. B TOWN OF Sou'rHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Perrmss~on is hereby granted to: ~ ~-~ ,~), County Tax Map No. I000 Section . ..~..~t.~, ,.. Block ...... ..O.....k~. ....... Lot No ..... .1~...~ .... .... , 19.~..~., and approved by the pursuant to application dated ..... ~%'~' -- ....L.J ~..g~..~ .............. Building Inspector. Fee $ ~j)' / Building In~:~ctor Rev 6/30/80 FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF Instructions This apphcatton must be fdled in Wpewrtter OR ink, and submitted m ~ to the Building In~ec- tor with the following; for new buildings or new use' 1. Final survey of property w~th accurate location of all buddings, property lines, streets, and unusual natural or topographm features, 2. F~nal approval of Health Oept. of water supply and sewerage dlsposal-(S~9 form or equal). 3. Approval of electrmal installation from Board of Fire Underwmters. 4. Commercial buddings, Industmal buddings, Multiple Remdences and simdar buddings and installa- tions, a certd~cate of Code compliance from the Architect or Engineer responsible for the budding. 5, Submit Planmng Board approval of completed rote plan requirements where applicable. Bo For exmt~ng buddings (prior to April 1957), Non-conforming uses, or buildings and "pre-ex~sting" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographm features. 2. Sworn statement of owner or prewous owner as to use, occupancy and condition of buddings. 3. Date of any houmng code or safety inspection of buildings or premises, or other pertinent ,nforma- tion required to prepare a certificate. C. Fees' 1. Cert~hcate of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $10.00 2. Cert~fmate of occupar]cy on pre-exmting dwelhng $ 50.00 3. Copy of certlhcate of occupancy $ 5.00, over 5 years $]0/'.0~ 4.Vacant Land C.O. $ 20.00 Date 5.Updated C.O. $ 50.00 ... ] J~'/ ........... / / NewConstructzon ...... Old or Pre-exlstlng Budding .......... Vacibnt [.and ........... Loeat,on ofProperty ........... House No S~reet ~arnle~ CountyTax Map No. lO00Sectlon .. ,~, .~.~-- .... Block .... .~ ........ Lot ..... ~ ........ .... Lotto .... ...... 5/28/87 5oseph & Do~a S~. P~er~e Perm~tNo. ]6019 Date of Permit ....... Apphcant NA NA Heaith Oept ApprovaJ .................. Labor Dept Approval ........................ NA NA Underwriters Approval .................... Planning Board Approval ................... Request for Temporary Certihcate .................. Final Certificate ..................... Fee SubmKted S. 25 · 00 Rev 10-10 78 OUt~DATtO~J OUNDATION (1st) (2nd) ti OUGH FRAHE & PLUMBING t~SULATION PER N. STATE ENERGY CODE l,I ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. REMARKS: FOUNDATION 2ND [ ] ~NSULATION FRAMING ['"3 FINAL INSP£(.~T'OR ~ ~/ 765-1802 BUILDING DEPT. INSPECTION INSPECTOR Disapproved a/c .... BOARD OF HEALTH ...... 3 SETS OF PLANS ....... FORM NO 1 SURVEY ......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPABTMENT SEPTIC FORM ............. TOWN HALL $OUTHOLD, N.Y 11971 NOTIFY TEL.: 765-1802 CALL ~,~.~.-.~SP'ZI.~,¢~ MAIL TO: .,19'11-/. .,19~'~ PennitNo I ~.°.lei (Bmldlng Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS ...... jLUJ BL~ ~PT TOWN OF SOUTHOLD a. Ttus apphcat~on must be completely filled in by typewriter or ]n ~nk and submitted to the Budding Inspector, with sets of plans, accurate plot plan to scale Fee according to schedule b Plot plan showing location of lot and of bmldmgs on premises, relahonshlp to adjoining premises or pubhc stree or areas, and giving a detmled descnptmn of layout of property must be drawn on the diagram which ~s part of this appl cat~on c The work covered by t~.~s appllcahon may not be commenced before issuance of Budding Permit. ~ d. Upon approval of fins applicatzon, the Bmldmg Inspector wall zssued a Bmldmg Permit to the apphcant Such perm shall be kept on the premises avadable for mspechon throughout the work e. No bmldmg shall be occupmd or used ~n whole or m part for any purpose whatever until a Cerhficate of Occupam 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 tl Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances, Regulations, for the construction of buddings, addztmns or alterabons, or for removal or demohhon, as hereto descnbe, The applicant agrees to comply wzth all apphcable laws, ordinances, bu~I, mg code, housing cp~[~, and regulatmns, and ~ admit authorized inspectors on premises and m bmldmg for necessaw lnsl~e~tlons.[~] C-, ~,,.-~--~ · = ...... (Signature ~ apphcant, or name, lf~-6rporation) (Ma]hng address of apphcant) \ \ ~ 4G State whether apphcant ~s owner, lessee, agent, archCect, enDneer, general contractor, electncmn, plumber or budde .............. ¢ ...... Name of owner ofpremlses . (as on the tax roll or latest deed) If apphcant zs a corporation, s~gnature of duly authorized officer 2 (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .. .~,.~L, .. Plumber's License No .... ~//Dr Electncmn's License No . W./I~ .. Other Trade's Lzcense No. ' ' ~' t ~' ' Location of land on which proposed work will be done }louse Number Street County Tax Map No 1000 Section (Name) State extstlog use and occupancy of premises anCfntendcd use and occupancy of proposed constructmn a Exlstmg use and occupancy i~(,,.~I~I~I~;C 1~ . 1..~ ........... b. Intended use and occupancy I 0~'~tt~ .C'~-e~ ............ Hamlet Block . . .'4' ...... Lot . t~ ...... Fried Map No . .~. -'-~/. .. Lot J*'~ Nature of work (check which applicable) New Building Addition . Aheranon Repa2r . Removal . . Other ~\'ork ~, ~ ~ ......... Demolition .... .~. (Description) · Estimated Cost ................ ,.0'700 ........ Fee ................. (to be paid on fihng this application) If dwelhng, number of dwelling units .. ~k~Za .~k~. Number of dwelling units on each floor ........ If garage, number of cars ....................................... If business, commercml or mixed occupancy, specify nature and extent of each type of use ........... D~menslons of existing structures, if any Front .. Rear .. Depth ......... Hmght ... Number of Stories ..................... Dunenmons of same structure w~th alterations or additions Front ....... Rear ........... Depth,. . !];t1,~. J,/'~ Hmght. Dnnenmons of entire new construction Front.. . Height .......... Number of Stones S~ze of lot Front .. kOO~- 0~. ..... Rear Date of Purchase ... I~"F'. ¥Cl.tl~l ........ Number of Stones ............ .. Rear .............. Depth ........ · ~- ~' --~ .................. ~ ....... · I ~ .:k~ ....... Depth I.~.4 ~r¢.,. ~ k~l, ~'~..~ · .Name of Former Owner . .C~k'O~. . J ......... Zone or use district in which premises are sltuated ......................... Does proposed construction violate any zonlng law, ordinance or regulation ........................... W,I1 lot be regraded ................ Will excess fill be removed from premises' .Yes No Name of Owner of premises .'~ ~ .~...~l~¢,~-Address Q~uza.~llqg,-.-T'ox~. I'~Y. Phone No ,57'.4.~. ~ ~. Name of Architect ............... Address .............. Phone No ............ Name of Contractor .... ~>~o.~.P~ . Address ............ Phone No ............. ,. Is this property located wJ. thin 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold To~n Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and dmt~nctly MI buddings, whether ex,sting or proposed, and in&cate a/I set-back dunenslons from operty hnes Give street and block number or descnphon according to deed, and show street names and ~n&cate whether enor or corner lot. ATE OF NEW~O~K, ! \_ S ~ )UN-FY OF . .~.X~O..M%-. ~ '~ (Name of ~n~v~dual slgrung contract) ove named being duly sworn, deposes and says that he is the applicant ls the g t, rp a officer, etc.) said owner or owners, and m duly authorized to perform or have performed the said work and to make and file th~s phcatmn, that all statements contained in this apphcatmn are true to the best of his knowledge and behef, and that the ~rk will be performed ~n the manner set forth m the application filed therewith. 'om to before me this ...~ZAeETH ANN NEVI \ ',~ ~l~phcant) ~bl,e.~i~'~ NewLwL~York ~ ~ -~ ~ No 52-812~, S~olk ~ ~ Term ~r~ ~ 31, 19~