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Home My WebLink About15847-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-I6445 Date November 27, 1987 THIS CERTIFIES that the building ACCE S SORY BUILDING Location of Property 205 George Road New Suffolk, New York /:/t~ ~$~, ~/o: ........................................................ Street Hamlet County Tax Map No. 1000 Section 1 17 ..... Block 0 2 .Lot 15 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated March 31, 1987 15847 Z ....................... pursuant to which Building Permit No ...................... dated April 3, 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 is ......... ACCESSORY BUILDING AS APPLIED FOR The certificate is issued to JAMES NEKERMAN ..................... .................... of the aforesaid building. Suffolk County Department of Health Approval N/A N/A UNDERWRITERS CERTIFICATE NO .................................................. N/A PLUMBERS CERTIFICATION DATED: Rev. 1/81 FOItM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. N°_ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15847 Z Da,e ....... ...~. .................... Permission is hereby granted to: ~ ~....~......~~...~ ...................... ..~.~....~p~ ...... ..~.:~.: ..................... ;T;Z;;;2';;;;;';;"2';'iii~i~i;.Ci~ ............ iii'~i;i'iiii~iiii~;"~,~. '""'ii"ii'i"~ ........ i ......... z_ .... I.~ . County Tax Map No. 1000 Section ....L!..7 ........... Block ...... ~ ............ Lot No .................. pursuant ,o application doted .....~~....~,1 ................. , 19~..~.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in typewriter OR ink, and submitted j ~,JJ~,~, 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 topograph c features. 2.Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3.Approva~ 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), Nonconforming uses, or buildings and .... pre-ex~stmg" land uses: 1. Accurate survey of pz~operty showing all property lines, streets, buildings and unusual natural or topographic featuros. 2.Sworn statement 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 New Dwelling $25.00, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on prmexisting dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $I0.00 4,V~cant L~nd C.O. $ 20.00 5.Updated .C.O. $ 50.00 Date ,./~..T,~..~.?...~.h ....... New C on s t p u c t i on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ...-~ ~'- G .~.~'?? ,~ .~..~, //V~..~. .~.~..~../~.~.~./,.¥~. House No, Street Hamlet Owner or Owners of Property .~.~...'"~. ¢ ./. ~... /Y" ~' ¢'~'~'~ County Tax Map No. 1000 Section ../../.~. ....... Block ..... .~. ........ Lot.../~...5'.: ...... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No../..-'~.~..~. 7~... Date of Permit ~.. ~?..'..~.~Applicant...~..~..'~t..~. ~.. ~...//~...~.~. Health Oept Approval ' Labor Dept Approval Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ................ '. .... Final Certificate ....................... Fee Su bm itted $ ...... /. .~..~ ~. , ~. ................ Construction on above described building and permit meets al~p?cable codes and regulations. Applicant ~..,'~../..~'. ,,~....~--------~"Y~..,...~;7 ..... : .......... Rev. 1o.1a. Te OUNDATIO:I ( 1 st) OUNDATION (2nd) OUGH FRAME ?LUMBING 'NSULATION PER N. Y. STATE ENERGY CODE FINAL · ADDITIONAL COMMENTS: 'l TOWN OF SOUTHO .~ ~, 'FORM NO. 1 TOWN OF SOUTHOLD CItECK BUILDING DEPARTMENT SEPTIC TOWN HALL N0?TF¥ gOUTHOLD, N.Y. 11971 TEL.: 765-1803 CALL MAIL ., 19 .~.-/ ., 19~..3. Permit No. J .~.~.~"1. Approve ...... Disapproved a/c ..................................... BOARD OF HEALTH~%... 3 SETS OF PLANS ~%'.. SURVEY .. ~ .... FORM · (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date.. ?..". 7.fi. ......... 19 .~..~' 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 part 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 ~ Certificate 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 inspections. ~/(Signature of applicant, or name, if a corporation) .~ ?.:~.+.. ~..~...,Z..-..~..~.. ~./.,~. ...... (Mailing address of applicant) State whether applicant is_owner, lessee, agent, architect, engineer, g~neral contractor, electrician, plumber or builder. .......... .~ .~ ..~..e...-7. ....................................................................... Name of owner of premises ~.~...---~..~..~... ?....,~..a{ .'~...-~...~-../?....ff..(-..~,.. ~..~7..?~....~'~..."~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 ~.H~U~T ~E_ SUF~.~[~C~.O.~U~N.~Y~II;.~Cy~,~ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. ..... ..........' '/g'¥ ......... ............. House Number Hamlet County Tax Map No. 1000 Section .../~..~. ........ Block ...... ~. .......... Lot. '.../~...~.~... ~'. ..... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................... b. Intended use and occupancy .... .bE. ?. .". /~. ..". · .~.)(..../~.../..~. ...................................... 3. Nature of work (check which applicable): New Building . .... ;.~....'. Addition .......... Alteration .......... Repair ............... Removal ............ Demolition ....... ~. Other Work ............... 4. Estimated Cost .~....~.. (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. Dimensions of existing structures, if any: Front ............... Rear ............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions'of same structure with alterations Or additions: 'Front Rear Height ' Number of S!ories Depth 8 ' pth · Dimensions of entire new construction: Front ............... Rear ......... i ..... De ............... Height ............... Number of Stories ............................. 2 .......................... 9 Si fl D' pth · ze o ot: Front ...................... Rear ...................... e ...................... 10. Date of Purchase Name of Former Owner l 1 Zone o~ use41istri~t4n~vhich premise~-are~ituated-. .' ]2 Do p ed t tion iolate i gl di Iation · es pro os consruc v anyzonn aw, or nanceorregu : .. , .......................... ~t 3.Will lot be regraded ............................ Will ex~ess fill be removed from premises: Yes No Name of Architect ........................... Address ................... Phone No ................ Name of Contractor Address ' ; : Phone No 15. Is this property located within 300 feet of a tidal wetland? *Yes,. .... No ..... *If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and~ indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show ~treet names and indicate whether :.nterior or corner lot. ~',TATE OF NEW YORK, ~OUNTYOF .......... ....... S.S (Name of individual signing contract) ~bove named. being duly sworn, deposes and says that he is the applicant is the ......................................................................................... (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ipplication; that all statements' contained in this application are true to the best of his knowledge and belief; and that the a, ork will be performed in the manner set forth in the application filed therewith· ~worn to before me this' .............. · ~../... ,...day of ...... ~'q ~... ..... qotary Public, ...... ~ :.'i..~.~..~).j¥..~..~.... County NOTARY. PUBLIC, ~{ate of'New~Y~li' // (Signature of applicant) . NO. 4707878, Suffoik CountYl~q