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Home My WebLink About16120-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall $outhold, N.Y. Certificate Of Occupancy Z]5873 Date June 23, 1987 THIS CERTIFIES that the building de ck add i t ion Location of Pro crt 785 Oakwood Drive Southold House No. Street ............... ~/~r~/e~ County Tax Map No. 1000 Section 70 .Block 13 ..... Lot 8 Subdivision .... .X.x.x..x ...................... Filed Map No. X ..... Lot No. x conforms substantially to the Application for Building Permit heretofore filed in this office dated June 8, 1987 pursuant to which Building Permit No. 16120z dated .... .J.u.n.e...2.3.,.. ! .9 .8.7 .......... was issued, and conforms to all of the requirements of tlte applicable provisions of the law. The occupancy for which this certificate is issued is ......... deck addition to an existing one family dwelling The certificate isissued to NICHOLAS & RUTH CHICK ..................... ...................... of the aforesaid building. Suffolk County Department of Health Approval ...... N./.A ................................. UNDERWRITERS CERTIFICATE NO... N/A PLUMBERS CERTIFICATION DATED: N/A Building Inspector ........... Rev. 1/81 1~0~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~_ 16] 20 Z Date ............. Permission is hereby granted to: ........ ....c~.~~,....~.;~.;....~.!..~.~.~C. ............. ,o.~.~.~..~ ...... ~....~...~. . at premises I~eted ot ..~ .......... ~. ..................... cou,~ T~x M,p No. lO00 S~ctio, ....... Q~ ..... B~k ....... ~.~ ....... Lot No ...... .~ ........... pursuant tO opplicotion d~ted ........ ~..~.~ ........................ , 19.~..~., and opprov~ by the Building Inspector. Building Insl:mctor 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 Instructions A. This application must be filled in typewriter OR ink, and submitted ~ I~mmmmm 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: I. 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: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $10.00 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 truction..X.X, ~.. Old or Pre-existing Building ............ Vacant Land ............. 785 OAKWOOD DRIVE SOUTHOLD Location of Property ................................................................... House No. Street Harn/~ot NICHOLAS & RUTH CHICK Owmer or Owners of Property ............................................................ County Tax Map No. 1000 Section 70 Block l 3 Lot .8 Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and pe~~.~le co~ regUlation Applicant . . .~..~-~?'./ ..... ~ .............. Rev. 10-10-78 UNDATION (1st) UNDATION (2nd) UGH FRAME & PLUMBING . ADDITIONA'L COMMENTS: SULATION PER N. STATE ENERGY CODE JUN 8!9a'f Approved 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... CHECK .......... SEPTIC FORM ............. NOTIFY CALL ................ MAIL TO: Disapl~roved a/c I I,~c~.?..,t' APPLICATION FOR INSTRUCTIONS 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 street: 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 permil 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.f.f.f.f.f.f.f.f.~filding Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and/6ther ~pplicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for rem./~al or ¢,~molition, as herein described The applicant agrees to comply with all applicable laws, ordinances, building cod'e, ~hous. jdg code, and regulations, and tc admit authorized inspectors on premises and in building for necessary inspection~.~/~_..~...~ /~...~ ........ (" ' 'h;ili ;: o"}'il, pl' 'Z t: .......... State whether applicant is_owner, lessee, agent, architect, engineer, general contractor, electriciah, plumber or builder, ...... .............................................................................. Name of owner of premises J~. ..~ >o[ ...................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of co, orate officer) . ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location ofland on which proposed work will be done .... b.l~.~...x~.~.~. ............. .b..~.~.O~. ~_.~.f~. ..5. .... House Number Street Hamlet County Tax Map No. 1000 Section ....~. ~0 .......... 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 ................. . ...... %7; · ,'.... ·., ,*'+~.-, ..................... b. Intended use and occupancy ................ ,. eJ .: ,,... ~ .............. k ( p!pli ) ' 3. Nature ofwor check which a cable: New Building .......... Addition .......... Alteration · .'. Repair .............. Removal ............ Demolition .............. Other Work ............... ~ ~ - (DescfipJtion) 4. Estimated Cost ............................. Fee .. ~ .............................. · (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 ............... Nun bet of Stories ...................................................... Dimensions'of same structure w th alterations or additions: Front Rear D.epth .... 7 ............... i. FIe.~t~ ...................... Number of Stories .................... '- 8. D~mensions of entire new colls~i~)~) or~nt .,a ........ · ..... Rear ............... Depth ............. 12. Does proposed ci~llt)~ltL'rfioi~l%~ at~lll~lSnilll[jaw, ordinance or regulation: ................................ 13. Will lot be regrade~t-i~%~'~ ~.' J ~l~lN[lk:a.~ ...... Will excess fill be removed from premises: Yes No 14. Name of Owner ot~l~)nlsgs~.~l~~ [.~tq~t~.~.~.'7 ...... Address ................... Phone No ................ Name of Architect .t~,~,..~]~O.~ ~.~. ............ Address ................... Phone No ................ Name of Contractor ~td¥~...~...: ................. Address .... : .............. Phone No ................ 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No ..... · If yes, Southold Town Tru'stees Permit maybe required. PLOW DIAGRAM Locate clearly and distinctly alll buildings, whether existing or proposed, and. indlcate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ....... ~ P~JJMB~NG ALL ~ '. '¢.v L ~ ~,':, ~:: ~ M~ P,) .......... (Name/of individual signing ' ' o above named. being duly sworn, deposes and says that he is the applicant Nffi~lffy HELI[N IL DE VOE ...... PUBLIC, ShN df 14ew Yo~k 470787,8, ~uffolk I~_ ~¢~o o 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. Sw°rn t° bef°re meF . ' ~.,~_ t~/2 ..... day of ., 19 Notary Public, .,~..~,-. 'Oi~ ~/,,t~-s,, ......... County