The URL can be used to link to this page

Home My WebLink About16140-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z-16170 Date September 15, 1987 THIS CERTIFIES that tile building DECK ADDITION Location of Property ....5.0.0..gy.o.v.e., .~.o.a.d. ...... Southold, New York House No. Street Hamlet County Tax Map No. ] 000 Section . .0.5. ! ....... Block . . .0. 6. .......... Lot .... 2. .0 ........... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated June 16, 1987 16140 Z ...................... pursuant to which Building Permit No ...................... dated ... ?.u.n.e...2.6. :..I .9.8. 7. ......... was issued, and conforms to all of the requirements of tile applicable provisions of the law. The occupancy Ar w~ch this certificate is issued is ......... DECK ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to JAMES FRANK (ownorXf~e~RFe~X of the aforesaid building· Suffolk County Department of Health Approval ....... N / A UNDERWRITERS CERTIFICATE NO ................. ~ ./.A .............................. N/A PLUMBERS CERTIFICATION DATED: Rev. 1/B1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT {THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO_ t ,~ !1/4~(~ Z Permission is hereby granted to: · ....~.~....~.;.~.;...L./..~..~.. ,q , ,o .~......~...~l~......~~ ........................ ~..~.~ ........... .. .~....-,..-,,~..~.,....~_ ....,~,,'~~-.~ ......................... at premises located at ...~.,.D~........~,~.~....~.: .............................................................. County Tax Map No. 1000 Sect,on .......... .~.....I ....... Block ...... ..C~...~. ....... Lot No ......,~ .............. pursuant to application dated ...... .**~t* .~..L.~ ................... , 19~.~..,-- and approv~ by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southoid, N.Y. 11971 765- 1802 BLDG. DEPT. TOWN OF $OUTHOLD APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ ~ 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-IS-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 featu res. 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. Certifieate of occupancy New Dwelling,$25.Q0, Acc~ssory~,~$~0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0 ,. 0 0 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 .......................... NewConstruction... ... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .................................................... House No. Street Ham/et Owner or Owners of Property ~'~v~:) ~...y? ~ · County Tax Map No. 1000 Section . ..LP. ~ ....... Block .... ~. ?-~. ...... Lot .... . .~..O. ....... 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 dbscribed building and permit meets all applicable codes and regulations. ' Applican .................. ' Rev, 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLO, N.Y. 11971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. /_~/ An application for Certificate of Occupancy is not on file. /~/-' No Underwriters Certificate on file. The check is(outdated/ot.~q~_D~.)~ ~.~ /5/ No Health Dept. Approval on file. /5/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit # _]_ _~_~ _[_ ~ ~ Z Building Dept. ***/5/ No Plumber solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) Occupancy or use is unlawful without a Certificate of Occupancy. Clear up this ma~ter as soon as possible so that legal action does not have to be taken. Thank you for your prompt attention. TOWN OF SOUT] OLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 ~ ~j To Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. /_~ An application for Certificate of Occupancy is not on file. /Z/-'-No Underwriters Certificate on file. The check i$(outdated/~ot Qn fil~.)~ ~.oO /Z/ No Health Dept. Approval on file. /Z/ No final inspection has been made. Please' contact our office on this matter. Thank you for your cooperation. Building Permit # ] & ~ _q_ o Z Building Dept. ***/Z/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) Occupancy or use is unlawful without a Certificate of Occupancy. Clear up this matter as soon as possible so that legal action does not have to be taken. Thank you for your prompt attention. UNDATION (1st) UNDATION (2nd) UGH FRAME & PLUMBING SULATION PER N. Y. STATE ENERGY CODE · ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .~. ~..I.~ .., 19 .~.~ Approved..~eC~<~C..IlL .~..., 19'~ ~. Pe~it No./. ~ ]. ~.~ Disapproved a/c (Building Inspector) APPLICATION FOR BUILDING PER~IT Received ........... ,19... INSTRUCTIONS a. This application must be completel filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. F ~according to schedule. b. Plot plan showing location o~filo~, }~]~of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed d~oi~ 5t' l~{~of property must be drawn on the diagram which is part of this appli- cation. . ,~.~' ,.~!~'~ c The work co~ Li~ a~'' nah%~til ~,~a'v ~e~enced before issu~ce of Building Permit d. Upon app~i~ ~p~ ~n~spector wflhisued a Bmldmg Pemlt to the applicant. Such pe~lt shall be kept on th~ [~a~ffo~ ~ throughout the work. e. No bufld~g ~ ~c~r~ [~'[~ole or in part for any purpose whatever ~til a Certificate of Occup~cy shall have been gr~t~j t ~%~Ini ~!1 ' APPLICATION IS~ g"~ '~ Building Dep~tment for the issu~ce of a B~lding Permit pursuant to the Building Zone Ordinanc~ ~ :h~ ~f Southold, Suffolk County, New York, ~d other applicable Laws, Ord~ces or Regulations, for the con~ ~tioWof bulldogs, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to c~ ~ly with all app~cable laws, ordinances, bu~ding code, housing code, and regulations, and to admit authorized inspectom on premises and ~ bufld~g for necessa~ inspec~ns. ... ............. .(S~ature of a~licant, o5 name, if a corporation) ........ ....... State whethe~plicant is owner, lessee, agent, architect, engneer, genelai contractor, electrician, plumber or builder. .......... ...... .... ............ Nme of owner of prem,ses ~ ............ ~ .......................... . .9~,~ ~O.,[~ ...... (as on the tax roll or latest de[~)" '~ .... ~' ' If applicant is a corporation, signature of duly authorized officer. , ~r~: ~/~.1 B.P ~ L~_~ .............................................. ......... (Name and title of co~orate officer) NOT~F'~ ~J~tD~N~.; oEPA~YM~T AT Builder's License No ................. ~Ou <l '~. c~,.,;~ Plumber's License No. {}('a a:~ a, ~,::.[~ai~i%f ........................ Other Trade's License No ...................... ALL ~:}:~} m *C~C,.,~SH~,~.~ 1. Location of land on which proposed work will be done....z~.~: ~-~.v ,~~x , . ~ ...... House Number Street 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~roposed construction: a. Existing use and occupancy ~ -.~'7. ~ ..... ~..F~h. ~.. · . ......... ,,' . , , ' ",r/ ".' NZ ' "f ..... b. Intended use and occupancy .... ~ ..... ~.t~.... ~-~.... 6~. Z,v~.'~ ............... 3. Nature of work (check which applicable): New Building" Addiffon. i teration . I' · Repair .............. Removal .............. Demolition .'..~! ....... l... Other Work ............... '~," "i (Description) 4. Estimated Cost ...................... · '¢)'~ Fee .. ' ~ d nfil nth ppi ) w [to be pal o in is a lcatlon 5. If dwelling, number of dwelling units ..............., ' Number of dwelling unit,!s 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 .................. D pth Hight N bet of 'tortes e ...................... e ...................... gm ~ ...................... 8. Dimensions of entire new construction: Front ............... Rear .,.. Depth ............... Height ........... , ....Number of Stories ............................ 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 10: Dot fP ha ' Na eofForme O ' eo urc se ............. , ......, .......... m r wner ., ............................ 11. Zone or use district in which premises are situated i ~ .... ?. ' . 12. Does proposed construction violate any zoning law, ordinance or regulation: .... '!: ~. i i i ii i i ii i i ii i i~ii i i i ~-~' 13. Will lot be regraded .......... .................. Will excess fill be removed from premises: Yes ~o~ 14. Name of Owner of premises ... Address ................................ ~ .... Phone No ................ Name of Architect ........................... Address ............... !... Phone No ................ Name of C6ntractor .......................... Address ............... i... Phone No ............... 15. Is this property located withinl;00 feet of a tidal wetland? * Yes ..... No . · If yes, Southold Town Trustees Permit may be 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 street names ahd indicate whether interior or corner lot. / STATE OF NEW ~zO.RI~, , , S S COUNTY OF. ~ .... ' ........... · ~.~...~.'..~r~. ~.~. ~. .... ~ .......... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ~ ~ ~ ~ (Contractor, agent, corporate officer, etc.) J of said owner or owne~, ~d is duly authorized to perform or have perfo~ed the said work and to m~e and file this application;that all statements contained ~ this application are true to the best of hls!kno~ledge and belief; and that the workwfll be perfomed in the m~ner set forth in the application filed therewith. Sworn to before me this No~, Public, ~. .. . Count ' UN~J.~ ~ ' ..... ,N~~~~ , ~;? (Signatum of applidlnt),