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Home My WebLink About15883-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z15638 Date April 13, 1987 THIS CERTIFIES that the building A d d i t i o n Location of Pro--ert' 770 LEEWARD DRIVE ' SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 79 .Block 7 .Lot 4 0.2 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... .M.a.~.: . .2.7. ,...1.9.8.7, .. pursuant to which Building Permit No..1.5.883 g .............. dated . .A.p.r. 5...~..9.:..1 .9.8. 7. ............ 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 ......... ...... ?.~..~. ??.~..~ .t.i.?..t.o..? .~?.s.t. ~. ?.g..?..~..~.?..~.~.y...~ .~?.l/..~ ?.g.. ................... The certificate is issued to MARGARET F. MAHAFFY (WE IDMANN ) ..................... ?o¥,;~;, ~fsf44xY$~b ...................... of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO.. - - ' N/A PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 FORM' ~0. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 15883' Z ~..c} 27 Date ................................... , 19. .. Permission is hereby granted to: p .... ~..~.~..~; ........ ~..~.....~..; ................... ~,~,~'.~....~..~., . ............, ;; ~ ....................... ~ ........................................................... at premises located at ...,~/, .,,~..~....~~..,.'~,.,~.~J~"..,....~.~ ................ County Tax Map No. 1000 Section ............... .cji ....... Block ........ .C). ..........at No ....................... pursuant to application dated .....~Y~...~J2~.....%d~l......~..~~-'~ '" -/) .................. , 19~..~.., Building Inspector. Fee $.~....: ............. and approved by the Building Inspector Rev. 6/30/80 ?~ ~'- ~c 7/ FORM NO. 6~ TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink. and submitted I I 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 topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval 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), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 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: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $10.00 2. Certificate of 0ccupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.'00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 ~3'.Updated C.O. $ 50.00 Date .......................... [/~WC°nstrucbiOn ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property. :7. 7..~......~...~.~....(~.. ~...~ .~..d~. [V'..~.. .... S~.~ ~ ....... '~ Owner or Owners of Property .~t~~..~.~~. ~.. L~.~J..~t~ ~ -- S~bdivision ................................. ~Qed Map-~ .......... Lot~ .............. P*rmit No .......... D~to of ~ormit ....... :.Applicant ..~ ~.~ .... ?St.~. ~. ~ F ~ Hea~th DeOt. AOproval ........................ kabor ~e~t. gpproval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ...... ;-... Construction on above described building a~.~d~p lica ............ Rev. 10-10-78 OUNDATION (1st) OU~$DATION (2nd) OUGH FRAME & PLUMBING 'NSULATION FERN. Y. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: 765-1802 BUILDING DEPT. INSPECTION []FOUNDATION 1ST []ROUGH PLBG. []FOUNDATION ZND []INSULATION []FRAMING []FINAL REMARKS. //,/ , 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] ~N~SULATION / [ ] FRAMING [//] FINAL DATE ' INSPECTOR _.~r ~ . . Examined .... 19~. 7. Approved .., 19~.?. Permit No.! .~.~..8..~.~.. ~ Disapproved a/c ..................................... BOARD OF HEALTH 3 SETS OF PLANS FORM NO. 1 SURVEY ........ TOWN OF SOUTHOLD CHECK ;~' . BUILDING DEPARTMENT SEPTIC FORM ..~/~ TOWN HALL NOTIFY . gOUTHOLD, N.Y. 11971 CALL .......... TEL: 765-1802 MAIL TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ................... 19... INSTRUCTIONS a. This application must be completely tilled 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. n~ommenced before issuance of Building Permit. c. The work covered by this d. Upon approval of this a [~Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises ~roughout the work. . e. No building shall be o~ ~ole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by th~ APPLICATION IS H~ .~tj~ 'ng Department for the issuance of a Building Permit pursuant to the Building Zone Ordinanc~tl ~ Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the c~'~t,~ql d~titions or alterations, or for removal or 4emolition, as herein described. The applicant agree~s~oj~.p tble laws, ordinances, building code, hou: i co~ regulations, and to admit authorized iri~o,~ ~building for necessary j~spections. ..,,. ~.(~ ~.1 ~Yc.~. ~,~ ~u .L l .... '~_~ '~, ($igr)atur~f applica or name, if a c~ion) ......... (~l'ahing addre'ss of applica~) State whether applicant is~ owner, lessee, agent, architect, engineer, general contractor, electrician, plucxmber or builder. ................... ; ..... .... Name of owner oFpremise, ....,,9~C~Liu.~ .... .A..~ ............. ~ 'las on the tax roll or late~deqd) . If applicant is a corporation, signature of duly authorized officer. .............................................. (Name and title of co~orate officer) ' ,.. ~ ,, ~ ~, P~ ~ 'THE ALL ~O~TRACTOR~S N~ST B~ SUFFOLK gOO~TY Builder's License N~. - -- - Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Locatmn of land on which proposed workwdl be done ............... ~,,..'~. ,...;., ..... ; .' .... ,_.. r ....... House Number Street Hamlet ~o~nt~ Tax*~p No. ~000 S~.o~ ........ 9. ~ ...... ~o~ ......... 7 ........ Lo~ .... .5~.g ........ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended~e and ocqupancy of proposed construction: ...... , ...... ': b. Intended use and occupancy ................. ) ~ ....... -..~~ ........ Repair .............. Removal .............. Demolition ............ i. '(~t't~er Work ~..~f. .......... .~../C9 , (Description) 4 d0 ' . Estimated Cost ...................... Fee ...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units Ion each floor ................ If garage number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each typel of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear ........ ! ...... Depth ............... Height ............... Number of Stories ............................. ~ ........................... D/n i ors with lte ti additio F nt ' Rear ~ens OhS' amc structure a ra OhS or ns: ro ............. : ...................... Depth ...................... Height .......' ................ Number of Siories ...................... 8. Dimensions of entire new construction: Front .......... ~. Rear i Depth Height Number of Stories . 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 10. Date of Purchase ............................. Name of Former Owner ' . ........... 1 1. Zone or use district in which premises are situated .......................... ........................... 12. Does proposed construction violate any zoning law, ordinance or regulation: . I ...... 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes 'No 14. Name of Owner of premises .................... Address .................. i.. Phone No ................ Name of Architect ........................... Address ............... Phone No ................ Nmne of Contractor .......................... Address .... : ........... ~ Phone No ................ 15. Is this property located within 300 feet of a tidal wetland? YesI ... 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 )roperty lines. Give street and block number or description according to deed, and show ~tre'et names and indicate whether nterior or corner lot. ;TATE OF NEW YORK, 3OUNTY OF ................. S.S ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) .~ove named, te is the ............................................................... ; .......................... (Contractor, agent, corporate officer, etc.) ~f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this pplication; that all statements contained in this application are true to the best of his I~ ~ork will be performed in the manner set forth in the application filed therewith. ;worn to before me this HELEN K. DE YOE NOTA~ PUBLIC, State of New Yerk Ne. 4707878, Suffolk Telm Expires M&rch 30, nowledge and belief; and that the (S~gnature of apphcant)