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Home My WebLink About16137-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. ZI5915 Date July 2, 1987 THIS CERTIFIES that the building ....a.d.d.i.t ~9.n ..................................... Location of Property ...5.5.5 .............. .8 .t .e .r .l ~ .n ~ . Place Greenport House No. Street Hamlet County Tax Map No. 1000 Section . .3.4 ......... Block ....3 ........... Lot 5 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · ,lupe..1/.,..I ~7 .......... pursuant to which Building Permit No..I.6.1.3.7.g ............... dated June 27, 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 ......... Construct a deck addition to an existing one family dwelling as applied for. The certificate is issued to William Pruitt ..................... ?o~tn'e'r, 'l;s~ge' ~r 't~l;a'n't) ...................... of the aforesaid building· Suffolk County Department of Health Approval ........ .N/.A ............................... UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED: N/A Rev. 1/al ~0~ NO. ~ TO~ O~ $O~THOL~ BUILDING DEPARTMENT TOWN HALL SOUTHOLD, H. Y. BUILDING FERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO_16137 z Permission is hereby granted to:..-~. __. · ~,...k..'3..k ................................................. .~.~~..;.~.:~:.....~.~...%. .......... ..~.~....~...~&.~~2~....~...~ ........ ~ ..... at premises JocatecJ at .....~'..~..~.....~.~...,~:. ....... ..~..~.~ ........................... County Tax Map No. 1000 Section ...... .(~...~.~ ..... Block ...... ...e~....,~ ..... Lot No ..... ...~...~..'~... ...... pursuant to application dated ....... ..,~...~..J.[ ..................... , 19..~..."].., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 AP LICATIO~,., FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted I~ to the Building Inspec- tot 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 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 .., New C OhS tpuc t i on ...... Old or Pre*existing Building ............ Vacant Land ............. Location of PropertyHouse~' ' ' 'No. '~' ' .......... ~"~'~"U~'" '~"~h' '__ ~ St~oet' 5 '~' "~" ....... .~. .~. .~..~,'~..~ Owner or Owners of Pronertv ~ ~ ' ¢~ u,"~"JiL County Tax Map No. 1000 Section .~.~' ........ Block . .. ~-~ ot....~.. ...... Subdivision ................................. Filed Map No ........... Lot No .............. Perm it No. IA I ~.7.'~, Date of Permit ~./'~, ,~./~'..~.Applicant .1~..~. ~.. 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 permit meets all applicable codes and regt~lations. Rev. 10-10-78 ~? 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FRAMING FOUNDATION 2ND [ ] INSULATION If F~INAL REMARKS: UNDATION ( 1 st ) UNDATION (2nd) UGH FRAME & PLUMBING SULATION PER N. Y. STATE ENERGY CODE ADDITIONA'L COMMENTS ' ~'>0 ~'~ ~ o; . .,,,>, ~ Lot" .3Z r' ............... : .......................................... ; , '...: ...... ;. "; J .'. :>:""":::: ':~ ~.::'.: '?7 ~ ~Npo~r'" ' , / .,, e . ~o.~f~.?t,:,:':,-,...,~;, . ": :-..,::.::.['.,,:.,c,.'-a.~ ,~-"~.,.,¢,.s ~.m. , / ,' ~''.: -, , , , :.~Praf/on ~ ~ur~ NoV /~ .'/.'::.. Lof rtutn~dr~ '~ho~a: r~[~r ~o "...';' :,;":"~.':'- ': VAN ~uYC ~ 6'o~ "~" . 1, :'Wok. ¢ a~,.,,,k/,~ *~.~.";-F,7~".::'.;::::::? ':'::/:.. . .. , . . , '." :l[)~ JUN I 21987 /i! TOWNHALL NOTIFY ~ ' ~ ........... i ~ ~)/.i $OUTHOLD, N,Y, 11971 ~ " "' ' '" ~'~" . CALL ~ "O "/,,it';~,' "/% -. TEL.: 765-1802 · '' ~'~;'~'·~' MAIL Examined .. .4~,~f..~..~.., 19 .~.q Approved..~,u,~. ~,.'~., 19L~. Permit No./.~l..~?..~ Disapproved a/c ..................................... ............... (Building Inspector) , APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ..... 3 SETS OF PLCNS TOWN OF SOUTHOLO C.ECK BUILDING DEPARTMENT SEPTIC FORM ~/./~. ...... : Date..~J'.t~...l~. ff... )l., 19%7. INSTRUCTIONS a. This application must be completely filled in by Wpewriter 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 a 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 l~uildings, additions or ait~xations, or for removal or demblition, as herein described. The al~plicant agrees to comply with all applicable laws, ordtnonces, building.qode, housing code, and regulations, and to admit authorized inspectom on premises~.and in building for necessary inspections. (Signature of applicant, or name, if a cbrporation) · , (Mailing address of applicant) State whether applicant is owr~er, lessee, agent, a~chitect, engineer, general contractor, electrician, plumber or builder· Name of owner of premises .: ...... ~. rwt.,.. ,~. ( ' 'or latest deed) ............ If appl'~e a~te officer) . ' 'nt is a corpora ' , si re of duly authorized, officer Plumber's License No ......................... Elect lcmn s License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. .... ...... .... ........... House Number Hamlef " County Tax .ap No. , OOO Sec,,on ..... Bloc ...¢. ............ Lot .... ....... Subdivision ..................................... Fried Map No ............... Lot ............... (Name) 2. 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 ~. ~-$~.c~.~ ~,~ .ar~ , - 3. Nature of work (check which applicable): New Building . ' .... Addition .,4[~. ~.~.](~ Alteration .......... Repair .............. RemOval ............ Demolition .............. Other Work ............... 4 Estimated Cost Fee , ~ (to be paid on filing this application) 5. If dwelling, number of dwelling ~nits ............... Number of dwelling units on each floor ................ If garage number of c~s 6. If business, commercial or mixed occupancy, speedy nature and extent of each type of use ..................... 7 D~ensions .... Front Rear Depth · of exxstmg st~ctures, If any: .......................................... Height ............... Num~ber of Sto~es ...................................................... D~ensionsof same structure with alterations or additions: Front Rear Depth .................... ~.. HeiSt ............. ~ ......... Number of Stories .............. / ..... ,8. Dimensions of entire new const~etion: Front ...... I% .' ..... Rear ..... I.Z ........ Depth ........... , Height ..... ~. ....... Number of Stories 9. Size oflot: Front ..... ,..~ ........... Rear . · ~.,.~." ' Depth 10. Date of Purchase .... ~a~,..;~q¢~ ............. Name of Fonker Owne~ .... t ....... ~ ............... 11. Zone or use district in which premises are situated ....... ~..~ 3~/.... ~?>.,.~ ~N4.~ ~. ............... 12. D~es proposed construction violaJ~any zoning law, ordinance or regulat~on: ...~¢ ........ . .................. 13. Will lot be regraded ....... ~[ ~. ~ ............. Will excess fill be removed from premises: Yes No 14. N~e of Owner of premises ~.~ .... t~.*~ ..... Address ~2..$~.~.~.~ ,~ .. Phone No .......... N~e of Architect .......... ~ ................. Address ................. ~. Phone No ................ N~e of Contractor ~ . .~.~ ~ ~ ~ ~.~ ........ Address g~ t ~%.~ ~.. ~ Phone No. ~ .~ ~. c I ~.~. ,. 15. Is this property located Within 300 feet of a tidal wetland? *Yes ..... No · If yes, Southold To~ Tru~stees Pe~it maybe required. PLO~ DIAG~M Locate cle~ly ~d distinctly ~1~ bu~d~gs, whether existing or proposed, and. indicate ~1 set-back d~ensions from prope~y Hnes. Give street ~d block mmber or desc~ption according to deed, and show street names and indicate whether ~te~or or corner lot. STATE OF NEW YORK, 3OUNTY OF $.s ............................. i .................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) ~bove named. is the ...................... : ................................................................... ~ (Contractor, agent, corporate officer, etc.) said owner or owners, and is 'dul~ authorized to perform or have performed the said work and to make and file this lpplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the ~tork will be performed in the manner set forth in the application filed therewith. 5worn to before me this