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Home My WebLink About16028-zFORM NO 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of [he Building Inspector Town Hall Southold, N.Y Certificate Of Occupancy No Z- [6724 .... Date ..Ma.rc.h. 2.1.: . 1988 THIS CERTIFIES that the building Cg?S. TR.U.CT' DE.CK .AD.D.I..T.ION. ...... Location of Property 1130 Ole. Ju.l.e .L, an..e ......... .M.a.t.tit. u.c.k., N...Y. Hou*e No Street Hamlet County Tax Map No 1000 Section 12 2 Block 04 .Lot 0 2 .... Subdlvmmn .. Fi[ed Map No .. Lot No ..... conforms substantially to the Apphcahon for Building Permit heretofore filed in this office dated Ma y 7, 19 8 7 pursuant to wluch Budding Permit No. 160 28..z dated J un e 6, 198 7 was issued, and conforms to ail 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 DWELLING AS APPLIED FOR The certificate is issued to ~./I.LLI.AM & .BEP.:.T. MA .S. TARS (owner, i~d~.~l(~t¢~ X X of the aforesaid budding Suffolk County Department of Health Approval ~ / A . . UNDERWRITERS CERTIFICATE NO PLUMBERS CERTIFICATION DATED: N/A Rev 1181 FORM' NO. B TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWH HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 16028 Z Permission is hereby gronted to: ,~ o , ...... .......... ot premises located ~t ..~.1,.~.~. ........ ~.~.~..~--..~.~....~ ....... ~..~ ........ / County Tox Mop No. 1000 Sect,on ..... ,~....,~....2:~..... Block ...... ..~.,...~ ....... Lot No .... ..~..2:-. ....... pursuont to opphcotion doted ........ ..'~o.~..'J. ................ 19.~...'L, and approved by the BuiJdlng inspector. 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 OCCUPANCY Instructions A. This apphcat~on must be filled ~n typewmter OR ~nk, and submitted ,- ~ to the Building Inspec- tor with the followmg; for new buildmgs or new use: 1. Fmal survey of property w~th accurate location of all buddings, property lines, streets, and unusual natural or topographm features. 2.Fmal approval of Health Dept of water supply and sewerage d~sposal-(S-9 form or equal). 3.Approval of electmcal mstallat~on from Board of Fire U nderwmters 4 Commercml buildings, Industrial buddings, Multiple Remdences and simdar buildings and installa- tions, a cert~fmate of Code comphance from the Architect or Engmeer responsible for the bullring. 5.Submit Plannmg Board approval of completed ate plan requirements where apphcable. B. For exlstmg buddings (poor to Apml 1957), Non-conformmg uses, or buddmgs and "pre-existing" land uses 1. Accurate survey of property showmg all property lines, streets, buddmgs and unusual natural or topographic features 2Sworn statement of owner or prewous owner as to use, occupancy and condition of buddings. 3 Date of any houmng code or safety mspect~on of buddmgs or premises, or other pertment reforma- t=on required to prepare a cert~fmate. C. Fees' Additions $25.00 POOLS $25.00ALTERATION $25.00 1. Cert~ficate of occupancy New Dwellzng $25.00, Accessory $]O.O0 Buszness $50.00 2 Certificate of occupancy on pre-ex~st~ng dwelhng $ 50.00 3. Copy of cert~hcate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20 00 5.Updated C.O. $ 50.00 Date .~..~ ( ............ NewConstructIon .... Old or Pre-exlstmg Bu dd~ng ........ Vacant Land ............ Locat,on of Property ?/~P...O.~.~.t~. ~.~: ,..Z...~.~/.~... ',''' ~../)-..7'T'./'. ?..U.~..~. ............. House No Street Ham/et Owner or Owners of Property .0~ 1 .~'..~'.1.~. ~1...~... ~..~..~.T .1+ t~. ~F'°...~..'~.~..~'..~.. ......... County Tax Map ~o. 1000 Section ./~'~. .... Block ....~..4. ........ Lot...0.~.. ........ Subdivision ............... Fded Map No ...... Lot No ........ Perm,t No. /.~..~.~.Date of Perm,t~/~./?~'.~A... ppi,cant . .4~.././-.~/..~..~...~."~.~'.~.~? ......... Health Dept. Approval ............. Labor Dept. Approval ..................... Underwriters Approval .................. Planmng Board Approval ................... Request for Temporary Cert[fmate .... Fee Submitted $ ~-~, '~. ........ ·. Final Certificate ................... Construction on above descmbed bu dd mg an~ ~r~,ee_t~ ail ~e~codes and regulations Apphcant . .~~ ........................ Rev 10oi0-7a Ib 72¥ OUNDATIO:~ {1st) OU.~DATIO:~ (2nd) OUGH FRAME & PLUMBING NSULATION PER N. STATE ENERGY CODE FILIAL ADDITIOn;AL COMME~TS: -Z Oz. E dL/L,,4 AIE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION ZST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING ~ ] FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING r~NAL DATE 3 Examined Approved · D~sapproved a/c FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N Y. 11971 TEL. 765-1803 , 193../ Permit No .)/wO&~'~ (Build~ng Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Tow., , OF 'SOU qOLO Rece~_ved ........... ,19.. a Tlus application must be completely filled in by typewriter or in ink and submitted to the Bulldmg Inspector, with sets of plans, accurate plot plan to scale Fee according to schedule b Plot plan showmg location of lot and of bmldmgs on premises, relationship to adjoining premises or pubhc strec or areas, and giving a detmled description of layout of property must be drawn on the diagram which is part of th~s app cation. c. The work covered by tlus apphcatmn may not be commenced before issuance of Bufldmg Permit. ~ d Upon approval of this application, the Building Inspector will issued a Budding Permit to the applicant Such pern shall be kept on the premises available for mspectlon throughout the work e No bufldmg shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan, .sk*ll have been granted by the Building Inspector [APPLICATION IS HEREBY MADE to the Bmldmg Department for the xssuance of a Braiding Permit pursuant to't Bu~id~ng Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordmancep Regulatmns, for the constructxon of buddings, additions or alterations, or for removal or demolition, as here~n descnlSc The apphcant agrees to comply w:th all apphcable laws, ordinances, budding code, housing code, and regulatmns, and admit authorized inspectors on premises and m budding for necessary ~,!~ct~o//ns //. (Signature of ap~fhcant, or name, ~f a corporation) . fi..*'&. ......................... .,y.:.¢... .... State whether applicant is owner, lessee, agent, architect, enDneer, general contractor, electncmn, plumber or bmldc ...... Nameofownerofprem~ses [..c;l,t.~-t4,q.~, ~ t'~'~T.t'{t-~ T-- ~"VI~,q-~ ... ~ (as on the tax roll or latest deed) If apphcant ~s a corporation, s~gnatum of duly authorized officer. (Name and title of corporate officer) Braider's License No Plumber's License No Electrician's L~cense No Other Trade's License No 1 Location of land on wtuch proposed work will be done .... House Number Street Hamlet County Tax Map No I000 Section /"~r2fix , . Block ...'~ . Lot ,~ Subdmsion .. F~led Map No Lot (Name) 2 State existing use and occupancy of premises and intended use and occupancy of proposed construction a Enstmguse and occupancy ~ t b . ~ b Intended use and occupancy ~'~ ~C [C ..... 3. Nature of work (check which apphcable)' New Bufldmg ...... Addition ......... Alteration_____ ..... Repmr ..... . Removal .......Demolition ....... Other Work .. ~9~{ S" ',__ (Descnption) 4 Estmaated Cost . .~..~, .~f~ ................. Fee ............................... (to be prod on ~ing this application) 5. If dwelhng, number of dwelling units ..... Number of dwelling units on each floor....--. ......... If garage, number of cars ..... '-x ............................................... 6. If busmess, commercial or mixed occupancy, specify nature and extent of each type of use ................ ?. Dimensions of exmtmg structures, ff any. Front. . d-/~,~ ~ ... Rear 5~.. ...... Depth ~'~ ?~. ....... Height ......... Number of Stones . ///d-- .~.,h?'~¥. ff:~,¢.~/'~: ,, ~/..Ae~.~.. ................... Dimensions of same structure with alterations or additions Fro{~t .. ~2 ?~ ...... Rear ~. ! ........ Depth. .o~9: ..... Height .......... Number of Stones . c.~ .4. ~ .~ O (~ ...... 8. D~rnens~ons of entire new construction' Front .- ..: t- - Rear t. · t ......... Depth ...... He,ght ...... Number of Stones ~'t~ ~....~../,<a~;.~../)~[~'/,o.- ................. 9 Size of lot Front ........ Rear .................. Depth ............... I0. Date of Purchase ..... Name of Foma_er Owner .......... 11. Zone or use dmtnct in which premises are s~tuated ............... 12 Does proposed construction violate any zomng law, ordinance or regulation ...~/'~. ........... 13. Will lot be regraded ,~. ~r~ ' ' b .......... Will excess fill be removed from premises. Yes 14. Name of Owner ofpremlses/Oqd'. Fa~,~ .~rgt-~. Address/dCrr/~'<t¢ . Z/~.~.. . Phone No. Name of Architect ........... Address .............. Phone No ......... Name of Contractor ................... Address ............. Phone No 15. Is this property located wzthint00 feet of a txdal wetland? * Yes ..... No ~.'.~..'' · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distmctly all bufldmgs, whether existing or proposed, an& mdlcate all set-back dimensions fro property hnes. Give street and block number or description accordmg to deed, and show street names and indicate wheth mtenor or corner lot STATE OF NEW YORK, S S COUNT. Y OF . . (Name of individual signing contract) above named being duly sworn, deposes and says that he ,s the apphca He is the ........ (Contractor, agent, corporate officer, etc ) of smd owner or owners, and is duly authorized to perform or have performed the smd work and to make and file tl apphcatmn; that all statements contained m this apphcation are true to the best ofh~s knowledge and behef, and that t work wdl be performed in the manner set forth ,n the application filed therewith Sworn to before me this · ...?~ ....... dayof, ..~t~.,.~, .. ,19~.~ Notary Public,/~_. --n //ln"~FO~ _~ County //~ /~ ............ · ~°;'iNa~O~'-,~ Sutt.ojk_~Couan~¥lg_~g / (Signature ofapphcm