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Home My WebLink About16118-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building ...D.E.C.K., .Ap.D.I.T..I.0.~ .............................. .... 1450 Longview Lane Southold, New York Location oI t'roperw ............................................................... House No. Street Hamlet County Tax Map No. 1000 Section 88 , .Block 4 ..... Lot 43 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated June 8, 1987 pursuant to which Building Permit No. 16118z dated ....J.u.n.e..2...........,.......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 ......... DECK ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to MARY ANN FARLEY (owner, of the aforesaid building. Suffolk County Department of Health Approval ......... .N./.A. ............................. N/A UNDERWRITERS CERTIFICATE NO ................................. PLUMBERS CERTIFICATION DATED: N/A Bmld~ng Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°-1611f3 z Date / Permission is hereby granted to: .. ,4,~,I .~ ................. .................... ...~.La~. ................................................... .. )!.~ . ..~.~~:.,~..:.~ .............. ~ ............. .~....~.~...~.....~.~:~. .................... ,~ .......... i ................................................... atp m,ses ocated at ...................~ ........~.~...~...0. ........... .~.~ ............. County Tax Mop No. 1000 Section ....... .~...~..~ ...... Block ...... ..C~....~. ........ Lot No .......L~..~ ............ pursuant to application dated .......... ,,'1...~...~%..~.. ....................... Building Inspector. and approved by the Building Inspector Rev. 6/30/80 TOV~N OF $OUTHOL9 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.¥, 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted m mmmemm 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 p~Operty 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: Additions $25.00 1. Certificate of occupancy New Dwelling,S25.00, Accessory ,$I0.00 Business $50.00 2. Certificate of occupancy 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 5.Updated C.O. $ 50.00 Date .......................... NewCons%ruction ...... Old or Pre-existing Building / Vacant Land Location of Property ./.~=~'~'~.../~.~:)~7~'.~.....~'~.~ ............ ,'~..¢.~¢'..1~1~.~. ........ House No. Street Hamlet Owner or Owners of Property . ./~/~.y/~Y~,/~.. ~..~-../..~ County Tax Map No 1000 Section '<~ ~r' Block ~.. Lot Subdivision ................................. Filed Map No ........... Lot No .............. Permit NoJ ~/./. ~.... Date of Permit . ,~/ca~cT/~.")Applicant ...J,'~.c~.~,n....~.( ¢ ~q, )/~..~ ............. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $... ,~..,. ,¢-~D. ........ ~.~ .~../..5~.., . Construction on above described building and permit meets all applicable codes and regulations. Rev. 10-10-78 765-1802 BUILDING DEPT. INSPECTION FOUNDATION XST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [~FINAL [ ] FRAMING REMARKS: UNDATION (1st) UI~DATION (2nd) UGH FRAME & PLUMBING SULATION PER N. Y. STATE ENERGY CODE ADDITIONAL COMMENTS: BOARD OF HEALTH ...... 3 SETS OF PLANS ....... 'FORM NO. 1 SURVEY .......... /OWN OF SOU/HOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL SOUTHO,O, N.Y. NOT FY TEL.: 765-180:3 CALL .... ~ · · MAIL TO: 19~.7. Examined . .~..., . .~/,,4.A"I~, .&TI, ~., 19~ .~. Permit No./..~'././..~..~., Approved Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDtNG PERMIT Date ................... 19... INSTRUCTIONS a. Tkis 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 tot 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 a Certificate of Occupancy shall have been granted by the Building Inspe:tor. 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 in, spe~ons.<_;?~. ~ ~ ~ (~g~ur'e'~f applicant, or name, if a co potation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (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 MUST BE SUFFOLK COUNTY LICENSED Builder's License No ...... /. ~...c~..~..f.../?/..~... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. ·/. ?...x2.z? .............. ~.<~..?. ~q.~...4..~.~ ............. .?.~...~.(~.: (¥ .................... House Number Street Hamlet County Tax Map No. I000 Section ..... .~..~. ......... Block ... ~ ............ Lot .... .~.3 ........... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing rise and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ .~../y:o. ...................................... b. Intended use and occupancy ..~....°~.....~?..~...~...~.~:~ ..... .'-, ................ 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Rembval .............. Demolition .............. Other Work .-~.. ?.4 '~ ~00,~o01 (Description) 4. Estimated Cost ........... ~ ......................... Fee ...................................... ~ " (to be paid on filing this application) 5. If dwelhng, number of dwelhng! units ............... Number of dwelling units on each floor ................ If garage, number of cars .... ~ ............... ; ................................................... 6. If business, commercial or mixeld occupancy, specify nature and extent of eack type of use . .' ................... 7. ]Dimensions of existing structures if any: Front ............... Rear ..., ........... Depth ............... lteight ............... Number~.~gtories .......... '..'..' ........... ' ....... .' Dimensions of same structure,,~tth~a~tions~ "~'~ or additions: Front ................. Rear .................. Depth .~{ ......... ~.lh.~.'~.~ .--n-- ~l~e]al~e~..~. ................. Number of Stories ............. ,8. D~menmons oL~t~l'~,1~Oo'flstr, t~ctl~'~'~-lro~t~.. ..... Rear ......... ; ..... Depth ............... 'bt ,V · ,e g .. .... .. .................................................. 9. Size of lot: ~llc~n, lL~,~. ~..~. ,~.~ :t~ .~.~k~.~.~, %~;ar ...................... Depth .................. ' .... 10. Date of Purcl~a}l~,,~ a~.,~,-. '¥~' 'll-.~, ¥~' .-~[~'$?' ~1 ........ Name of Former Owner ............................. 11. Zone or use di~I'iEt ~'a~l~il~A--~'~ ~,~ ~,~ ~fflr~mises'a~'~t~ated ................................ ,. 12. Does proposed ~i,~!~t~ t~ 1~i v,~ial~ing law, ordinance or regulation: ................................ 13. Will lot'be regra~'~%.. ~,~. _~.~..~..~ .'~ ............. Will excess fill be removed from premises: Yes No' 14. Name of Owner o~'~m~,~vde)/.tC¢./?..~/..~,/¢.r. ~.e.~/. Address ./~..~(9., ~.a/z~ ~./,~o~. Phone No. '7O.a~.'..~.. 3. o.~.~.. Name of Archltect~.I ....... ,i ............... '., Address ............ L ...... Phone No ................ Name of Contractor ........ ~ .................. Address .... : .............. Phone No ................ 15. :Is this property locatedlwithin 300 feet of a tidal wetland? *Yes ..... No · If yes, Southold Town Trustees Permit maybe required. i PLOT DIAGRAM Locate clearly and distinctly al1 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 street names and indicate wl0,ether [4oo~O'j STATE OF NEW YORK, I S.S COUNTY OF ................. : ............................ i ..................... being duly sworn, deposes and says that he is the applicant (Nmne of individual signing contract) above named. He is the .................. ............................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith· Sworn to before me this · '. ............. .~'. ....... day ojf ............. ,19 ?~. $ota,,~ Public, ~--,ae~... ~:. ~.., ~....~t7~... 'a-- ~ ....... County , )