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Home My WebLink About16459-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N Y. Certificate Of Occupancy No ..... Date . September 25, 1987 THIS CERTIFIES that the building ALTERATION TO EXISTING CARPORT Locatlon of Property 1355 Kenny Road Southold, New York House No Street Hamlet County Tax Map No 1000 Sechon 0 59 ..... Block 07 .Lot . 0 l 8 Subdivision ............... Filed Map No ..... Lot No ......... conforms substantially to the Apphcahon for Building Permit heretofore filed in ttus office dated .. S.e.p.C.e.m.b.er 12, 1987 pursuanttowluchBufldingPermltNo 16459 Z dated .. Septemb. er. 16.: J987.. waslssued, and conforms to all ofthe requirements of the applicable provisions of the law The occupancy for Much ttus certificate is msued ~s . .. ENCLOSE EXISTING ATTACHED CARPORT TO ONE CAR GARAGE The certificate ts issued to JAMES K I M B I S ........................row. or,'/~:~;X'l~lgX' .................... of the aforesaid braiding Suffolk County Department of Health Approval . . N/A N/A UNDERWRITERS CERTIFICATE NO ..................................... PLUMBERS CERTIFICATION DATED: N/A Building Inspector TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO. t6459 Permission is hereby granted to: ...... ................... ,o.~/,~ i..' ........ ~*"?'~'/~-"~:"~"'"'~? ,o ~.~,,,,,..,. ~..~.,.-~:...~~..~~.'... ot ,,~em,,, ,=,ed ,., ...Z~.....~~...~~~~,*,?,y......~....~. County Tax Mop No. 1000 Sect,on . ..~.,~... ..... Block ........ ¢~....~.. .... Lot No .... ~. ~'.~... pu~uo,t ,o o,p,,co,,o, doted .... ~/~..~/..~.~. ............. , ,,.~...z, ond op,~ed by th. Building Inspector. Fee $.....~'-~.... Bul~ng Iflsj:~ct'or Rev 6/30/80 -1ELD ihS. ECTiu:~ ~ID~m j] uOMMgNT~ FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & FLUMBING 3. INSULATION PER N. Y. STATE ENERGY CODE ADDITIONAL COMMENTS: FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Holl Southotd, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Th~s apphcation must be filled ~n typewriter OR ink, and submitted mm--,~--, to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property w~th accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. F~nal approval of Health Dept of water supply and sewerage dmposal-(S-9 form or equal). 3. Approval of electrmal installation from Board of Fire Underwriters. 4. Commercial buddings, Industrial buddings, Multiple Residences and similar buddings and installa- tions, a certWicate of Code compliance from the Architect or Engineer responsible for the building. 5. Submtt Ptanmng Board approval of completed rote plan requtrements 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, buddings and unusual natural or topographic features, 2.Sworn statement of owner or prev.ous owner as to use, occupancy and condition of bu ddings. 3, Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- Uon required to prepare a certificate. C. Fees: Addit£ons $25.00 1. Cert~hcate of occupancy New Dwe[[zng $25.00, Accessory ,$10.00 Buszness $50.00 2, Certificate of occupancy on pre-existing dwelhng $ 50.00 3 Copy of certificate of occupancy $ 5.00, oYer 5 years $]0.00 4.Vacant Land C.O. $ 20.00 ~/ 5.Updated C.O. $ 50.00 Date ....... /..A~. ........ NewConstruct~on. '?.... Old or Pre-existing Building ............ Vacant hand Locat,on of Property . ~.3 ~.../<~.~tt'~. ......... ..~ ~' .~.O. ~ ............................... House No. . Street Ham/et Owner or Owners of Property ....~-~'.~ 3 .... ~:~.l .J/~ .~. (..~ ............................... County Tax Map No. 1000 Section . . . .~).:~'~ ..... Block .... O. ,r~ ...... Lot . . ~./.o°. ....... Subd,v,sion... ~.~,~.~..~..~o.l ........... F,led Map No. ~..[ .~O....Lot No...~. .......... Permit No ........... Date of Permit ........ Apphcant .................................. Health Dept. Approval ...................... Labor Dept. Approval ...................... . . Underwriters Approval ........................ Planning Board Approval .................... Request for Temporary Certificate Final Certificate .. Fee Submitted $. ~, $~?~.0 ................. / / 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: ~FINAL DATE INSPECTOR ~- ~ 765-1802 ~ILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ~/F~NAL ~ REMARKS: DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION FOUNDATION 2ND FRAMING [ ] ROUGH PLBG. [ ] INSULATION [~FINAL REMARKS: DATE, SUR VE Y FOR JAMES PATR C A KU B S AT SOUTHOLD TOV/N OF SOUTHOLD SUFFOLK COUNT')/, N Y TAX MAP NO 1000-059-07-0/$ SCALE I"--$0' N.Y$ LIC NO (515) 1596 ROANOKE AVENUE RIVERHEAD ,, N. Y o 11901 erepared in accordance with I~ minimum f~e I. I.A L S. and approved and ittte CERTIFIED TO Alt,IERIC4N TITLE/NSUR,4NCE COMPANY-TITLE NO 07-/07157' FIRST NATIONV/IDE SAVINGS ~AMES KIMBIS ~ PATRICIA KIMBIS LOT NOS REFER TO ~MAP OF SUSDIVISION KNOV/N .~S KENNEV~OOD' FILED MAP NO. 3. Nature of work (check which apphcable) New Budding Repatr ........... Removal 4. Estimated Cost .'~z~ff'~ ~ 5. If dwelling, number of dwelhng umts If garage, number of cars ..... Addition .. Alteration ,. ....... Demohtmn ...... Other Work ........ (Descnpllon) ......... Fee ............. ~' (to be paid on filing this apphcatmn) ..... Number of dwelhng umts on each floor .. 6 If business, commercml or mixed occupancy, specify nature and extent of each type of use ......... 7. D~mensIonsofexlst~ngstructures,~fany Front .. Rear .... Depth Height .... Number of Stones Dnnenslons of same structure w~th alteratmns or additions Front ...... Rear ...... Depth ..... Height ............. Number of Stones ............. 8. D~mensmns of enbre new construction' Front .. Rear ........... Depth ....... Height ...... Number of Stones ...................................... 9. S~ze of lot Front ...... Rear ............. Depth ............ 10 Date of Purchase ................ Name of Former Owner ...... 11 Zone or use district in wh,c,, premises are ,~ru~,~e¢ .............. 12 Does proposed construchon vmlate any zomnglaw, ordinance or regulatmn .... .. ....... '~' ' ' 13. Will lot be regraded .................. Will excess fill be removed from premises. Yes ~ 14 Name of Owner ofpremmes ...... Address ........ Phone No ......... Name of Architect ............... Address ............ Phone No .. Name of Contractor ................. Address ............. Phone No .... 15. Is this property located withzn 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold Town Trustees Permit maybe required. PLO*F DIAGRAM Locate clearly and d~st~nctly all buddings, whether ex~sting or proposed, and mdmate all set-back d~menslons fro property hnes G~ve street and block number or description according to deed, and show street names and mdmate whet? interior or corner lot. OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OCCUPANCY STATE OF NEW.YjOJlK, COUN'rv u .. s s ... ~r"¢{/~1 ~.,..~ ~. i ryj 4~ [ _~ ....... being duly sworn, deposes and says that he is the applic~ (Name of md~wdual s~gmng contract) above named He ~s the .... % O~l~ ~~ ......... (Contractor, agent, corporate officer, etc ) of smd owner or owne~, ~d ~s duly authomed to perform or have perfo~ed the sazd work and to m~e and file tJ apphcahon, that all statements contained m thru apphcabon are true to the best of h~s knowledge and behef, and that t work will be perfo~ed ~n the m~ner set for~ m the apphcat~on filed therewith Sworn to before me th~s ..... N~a; mubhc, ~, ~. NOT~ %" ~ ~ ~, State of New Yo~ ...... ~ .......... '. - ~g43353 ( ~ature ofapphca ~mmms Examined Approved Disapproved a/c ..................... BOARD OF HEALTH 3 SETS OF PLANS FORM t~O 1 SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORH ............. TOWN HALL NOTIFY $OUTHOLD, N Y. 11971 TEL.: 765-1802 CALL ................ MAIL TO' APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a Ttus apphcahon must be completely filled m by typewriter or in ~nk and submitted to the Budding Inspector, wit sets of plans, accurate plot plan to scale Fee according to schedule b. Plot plan showing location of lot and of buddings on premises, relationship to adjoining premises or pubhc stn or areas, and giving a detmled descnphon of layout of property must be drawn on the dmgmm which ~s part of th~s al: canon. c. The work covered by ttus apphcahon may not be commenced before assuance of Budding Permit d. Upon approval of th~s apphcatlon, the Bmldmg Inspector will ~ssued a Bmldmg Permat to the apphcant. Such peJ shall be kept on the premises available for mspectmn throughout the work. e. No budding shall be occupied or used m whole or m part for any purpose whatever unnl a Certificate of Occup_a shall have been granted by the Bmlding Inspector. APPLICATION IS HEREBY MADE to the Bmldmg Department for the issuance of a Bmldmg Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinance Regulations, for the constructmn of buddings, add~bons or alteratmns, or for removal or demohtaon, as here~n descnl The apphcant agrees to comply w~th all apphcable laws, ordinances, budding code, housing code, and regulatmns, ant admit authorized inspectors on premises and m budding for necessary inspect, ions /' ] (S~gna(tlre of apphcant, or name, if a corporation) ~ { ( g~/1 pp ) State wkether applicant ts_owner, lessee, agent, architect, en~neer, general contractor, electr/c~{m, plumber or bml eofownerofpremlses. .......... (as on the tax roll or latest deed) If apphcant ~s a corporation, s~gnature of duly authorized officer (Name and htle of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No ........ Plumber's License No Electrician's License No Other Trade's L~cense No 1 Locatmn of land on which proposed work will be done ............ House Number Street Hamlet County Tax Map No 1000 Sectmn Q),.,fi'c/ Block O ~2 Lot. Subdl~lsmn [~q_.w~t,,JqOg. . . FfledMapNo .,2, f~(3. Lot (Name) 2 State ex~stmg use and occupancy of premises and ~ntended use and occupancy of proposed constructmn a Ex~stmg use and occupancy b Intended use and occupancy