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Home My WebLink About16492-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z16293 Date October 16, 1987 THIS CERTIFIES that the building , .A, ,d.d.i.~, .i 9.n ..................................... Location of Property 2540 Yennecott Drive Southold House No. Street Ham/et County Tax Map No. 1000 Section ...0.5.5. ...... Block ...0.4 ........... Lot 34 Subdivision Yennecott Park . .Filed Map No. 5187 .LotNo. 40 conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .S.e.p.t.:.30, 1987 pursuant to which Building Permit No. 16¢92Z dated .S.e.p.t.....3.0.,..I.9.8..7 ............. 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 ......... .... W.C.~;. ~P.~.I r IP.~t. ?9. A~...E.X.~. S. T.t.~.q. 9.~.E. .F..~.I.n.¥. p.~.E.n, .n.t?.q: ................. The certificate is issued to TIMOTHY MC KIERNAN (o wrier, I~[ZoToX ~o~X X of the aforesaid building. Suffolk County Department of Health Approval ........... ~ ./.A ............................ UNDERWRITERS CERTIFICATE NO .............. ~ ./.A ..... PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 FOBM NO. ~B TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby grantec~o: ............ at premise ,ocoted at.~.~..~..- County Tox Mop No. 1000 Section ....(~....~...'~..~.. ..... Block ....... ...~...~. ...... Lot No ..... .~..~. ........... pursuant to application dated ...~~.~....~...., 19.~2, and approv~ by the Building Inspector. u d no nspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD 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 m~ 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, $25.00, Accessory ,$ [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 8uiJding ............ Vacant Land ............. Location of Property . .~.i~q. ............ ' ........ .~/.~.~1~..,~..C.~'~?..TL:.. o .~.~. ........... ?.~.? House No, Street /-/am/et Owner or Owners of,roperty ...~..~/~..6.-/~..//..~....~..c~..~2~ ~ ............................. County Tax Map No. 1000 Section . .~..~.. ........ Block .... .~.. ........ Lot .... ~.~. ........ Subdivision. ¥.C..~.'V.~..c.' .o..~.....~..~.(.~. .........Filed Map No. ~. !.~:?....Lot No....~?~...~.~... Permit No. ~.~../~.?.Z..~.. Date of Permit ?/~..°.,~.~?...Applicant' .~./..P4.O..~._.j.../~...c..~/.¢..~./~.~..,~. ........ 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 Fe~it meets all applicable c~odes and regulations. Applica .. .: ~..~'~... ................. FIELD FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: NV N~l:ilHO~ ~NI.L ~d¥,;)$(]N ¥'I hl'~! 1^ A Va Approvel~--*"~'~..i~), 19~..'}. Permit No. l .¢..~.~ .&...~. 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N.Y. 11971 TEL.: 765-1802 BOARD OF HEALTH .. 3 SETS OF PLANS SURVEY ...~ ...... CHECK TI* ......... SEPTIC FORM ............. NOTIFY CALL -- MAIL TO: Disapproved a/c ..................................... ................................ ..... (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 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 buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, b,u-itding code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary~i~sp.~ctions. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......... ............................................................................. Name of owner of premises . ~ P.']..~.~,....~..c.l~ ~-~. ~ ............................................. (as on the tax roi1 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 .......................... Plumber's License No ......................... Electrician s License o ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ............................. ]~;r;et ................... ' ' 'h;~n];; ....................... House Number County Tax Map No. 1000 Section . .~..~/ .............. Block .~/. Lot...~..u/. ............. Subdivision . ~./'~ Nta¢~°tT ' lO/tlzf' - · ........ ................................ . .... Filed Map No..~./..~'.'? ...... '.. Lot..~.c/.. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~l~[~ ./~l..~j . .Oc..~.. ........... - .......... i .............. ~. ~ ..... b. Intended bse and occupancy . · · & ..... ~ ...................................... 3. Nature ~f work (check which applicable): New Building ' Addition ...~.'../.', Alterati0fi((::, ..... Repair Rembval Demolition Other Work ' ~. (D .~scfiplion) 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?comm'el'ei'M or mixed occupancy, specify nature~ and extent of each,type of Use '; i ~ .'.. '..;../. ....... 7. Dimensi6ns o.f existing' structuresi if any: Front ....... ~.9. t..¢~.. Rear . .~ 7..'t-...'!~ ..... Depth.,; o~.~'.. nelgnt .~fd ............ ¢~umoe o atones...t../¢ ............... ~ ........... ; ........ ~ ....... Dimensions'o.f same structure With alterations or additions' Front (,' ? ~*'"~ Rear 6 ? ~ Depth..3g ............... I. · · Height . .~.d~'.. ................. Number of Stories ....................... .... 8. Dimensions of entire new construction: Front .......... . ..... Rear ............... Depth ............... Height ............... Number of Stories ................ ~ ................................... 10. Date of Purchase .......... : ................... Name of Former Owner .- ............................ 11 Z disti ti whihpr mist it d · one or use rc n c e seres uate ............... ' ...................................... 12. Does proposed cofistruetion vi61ate any zoning law, ordinance or regulation: ..~..O. ........................... 13. Will lot be regraded ....... 3 ........... ., ........ Will excess fill be removed from premises: Yes -- No l Name of Architect ......... i .................. Address ................... Phone No ................ Name of Contractor ........ i .................. Address .... : .............. Phone No ................ 15. Is this property locatedi within 300 feet of a tidal wetland? *Yes ..... No .~.. · If yes, Southold Town Trgstees Permit mavbe 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 blocl~ number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................. ............................. , ................... being duly sworn, deposes and says that he is the applicanti (Name of individual signing contract) above named. He is the .................................................................................... ' ..... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dqly 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 .'- ,..¢o - ' -. ,','- " ................... ,. :...day ~f ..... 'l'erm:txCres M~mh ~0,1~.~