The URL can be used to link to this page

Home My WebLink About16145-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N,Y. Certificate Of Occupancy No. Z-16172 Date September 16, 1987 THIS CERTIFIES that the building CHIMNEY & FIREPLACE Location of Property 755 Long Creek Drive Southold, New York House No. Street Hamlet County Tax Map No. ]000 Section . . .0.5.5. ...... Block .. ?.4 ........... Lot,..........10 .... .. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated June 18, 1987 .. pursuant to which Building Permit No. 16145 z dated Jun e 29 ,' 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 ......... CHIMNEY & FIREPLACE AS APPLIED FOR The certificate is issued to JOHN & HARRIET COSTRO ..................... ?o¥0'o;, Kz44 g ..................... of the aforesaid building. Suffolk County Department of Health Approval N /A UNDERWRITERS CERTIFICATE NO.. N/A N/A PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 FORM' ~0. ft 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) Permission is hereby granted to: ...~.~..~~.....~ ......... .....~.~.~..~..~..,. ................. ..... ~..~.,...~.:~.,...~..~..~...! .... ,-~ at .......................................................... premises located at ....~...~...~......C~...~....~.~.~ ............. ~'1': ..... f~-'~".".~.";'i'"'i.~. ................................................. ....... County Tax Map No. 1000 Section ...... ..~...~. .....Block ........ ..~...~. ..... Lot No ......L.~.. ............ pursuant to application dated ....... ..~. ,~k~.~...~. ......................... 1c) ........ , and approved by the Building Inspector. Building Inspector 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- 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. Commercia~ buildings, {ndustria~ bui{dings, 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 requ ired 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 $ 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 .......................... NewConstruction ...... Old or Pre-existing Building ./.~.~. ...... Vacant Land ............. Location of Property ~-'~ ~:f~- 0~--~__=~ D/~/~/~ ..... Hou~e No. Street 't Owner or Owners of Property ./~./~ .~,~.. ~, ~.0/~/... ~(~ ............................. CountyTax Map No. 1000Section .............. ~ .~,%~. Block .. ................ J.~.- Lot--/.~. ...... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No./.~/..~.~, .~. ,. Date of Permit ,~/..~/~.7..Applicant.. j~)~./,J....~.,/~.,~ ............... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above codes and regulations. described building and permit meets all applicable Applicant. ~. ~ ............................. . Rev. 10-10-78 Co U~;DATION 1st) UNDATION (2nd) UGH FRAME & PLUMBING SULATION PER N. Y. STATE ENERGY CODE ADDITIONAL COMMENTS: BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] I~NSULATION FRAMING [//]/FINAL REMARKS.; DATE INSPECTOR ~.~ ~ / BLDG, DEPT, TOWN OF SOUTHOLD Examined . ..~..g,~,~"-.....,~c]...., 19~ 5. Approved ...~ ./~?A~.....~.~ .... 19~,?. Permit No..~.¢./.~..8.~.~... Disapproved a/c ..................................... ................................ .... (Building Inspector) APPLICATION FOR BUILDING PERMIT 3 SETS OF PLANS 'FORM NO. I SURVEY ......NID.. TOWN OF SOUTHOLD CHECK -~-,.5-'~-0- .... BUILDING DEPARTMENT SEPTIC FORM ............. TOWN HALL NOTIFY ~OUTHOLD, N.Y. 11971 TEL.: 765-1803 CALL - MAIL T'O':' ' 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 1S 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, building code, housing code, and regulations, and to admit auth°rized inspect°rs °n premises and in building f°r necesi~7, i::~ti~s.'/...~..._/. ~ ............... (Signature o~gJFpliCant, orCfiame, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ·. .......................................................... Name of owner o f premises .. J.~.~. · .~.~..[~.'.~{.'~.~...~.~.. g. ~ ~. ........................................... (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 ...................... Location of land on which proposed work will be done~ ................................................. .. ................................. .......................V-- House Number Street Hamlet County Tax Map No. 1000 Section ...... ~ .~-.~. ....... Block ..... ~ .......... Lot .... /.(3. ............ 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 .... .~.~.~.~.../~.~./.t..(.~...~.~../p~fy,.~.~_~ .......... ....:..... ~ ................. b. Intended use and occupancy .... .~. ~/.~./.b.&t. 0~-.. ~.,~,~..~..O.~.. ..... :. ......................... Repmr .............. Removal .............. Demoht~on ......... ~ .-.. O~her, Work ........ , ...... . t~ ~ es np.t~on) 4. Estimated Cost . .q~'....~) .... . ........................ Fee ...... .. .............. ~ ................ · (to l~e paid on filing this application) 5. If dwelling, number of dwelling units ....... [. ....... Number of dwelling units on each floor If garage, number of cars ..... --t' .............................................................. - 6. If business, commercial or mixed occupancy, specify nature and extent of each iype of use . .- ................... I)imensions,o,ftexisting structures, if any: Front .,, ~-~/~.. ...... Rear ...~..37~... ..... Depth,. ~ t.~. ........ 7. tteight .. ]~. ~ ....... Number of Stories..[.~....~.: .... ' ........... ! ......... : ........... ....... ,... Dimensions:of same structure with alterations or additions Front ~-_~ t.d~.-f7 .%.' .'7/? .... Re0r ~--jt_~ .lc. ~t.~.[.t Depth. 2~ta~ .............. '.. Height. ~-~/. t.-'l~ ............... Number of Stories. [.~-. ................. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... ............... Number of Stories lteight ............................................... Size of lot: Front... ~.~'e'~_,./]._t~ ...... :.:;............ DeN .{.¢.C.'q; i i., ........... 10. Date of Purchase ... ~,t~_ .e~../.~/~, ................ Name of Former Owner ~r/*/, ~; ~/.~.O*~. I I. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction vioiate any zoning law, ordinance or regulation: /,/.0 ......................... 13. Will lot be regraded ......... ~ ................... Will excess fill be removed from premisesk- _ Yes (No~ 14. Name of Owner of pr mis. es ~/~2~..~.~-J[[ ........ Address '~.~X ..C.I~t~C~. ~-./A2.":~.. 0~[, Phone No~/.(,). Name of Architect . ~O~.t~..O/~/~..k .......... Address 7~7~i ..L~ i~t~E/'~'Og; Phone No.~'~g~.C) Name of Contractor .. ~ .................. Address .... : ............ Phone No ................ 15. Is th±s property ~.ocated 'w±th±n 300 feet of a t±dal wetland? ~ .... b!o ..... *Tf yes, Southold Town Trustees Perm±t maybe reclu±red. PLOT DIAGRAM Locate clearly and distinctly ali 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 and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ............ ............................ . ..................... 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.) 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. Sworn to before me this ................ .. ....... day of....~L-~... ............. 19 .~,~ Notary Public,..,J~-~.. K...~..~.-.{-J...~.. ........ County (Signature of applicant)' i E N o 5O