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Home My WebLink About16152-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-16051 Date August 14, 1987 THIS CERTIFIES that the building ARBOR-SCREEN ADDITION 1250 Plum Island Lane Orient, New York Location of Property ............................................................... House No. Street Hamlet County Tax Map No. 1000 Section 015 .Block 07 .... Lot 07 Subdivision..M./?..O.r.ient-By-The-Sea .Filed Map No..3.4.4.4 .... Lot No. 148 conforms substantially to the Application for Building Permit heretofore filed in this office dated June 22, 1987 16152Z ...................... pursuant to which Building Pennit No ...................... dated ......June ....... 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 ......... ARBOR-SCREEN ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to HAROLD D. WATSON & BRUCE A. CARR ..................... ioYn' ;, x .................... of the aforesaid building. Suffolk County Department of Health Approval N /A N/A UNDERWRITERS CERTIFICATE NO .................................................. N/A PLUMBERS CERTIFICATION DATED: Rev. 1/81 ~OR~ NO. O 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: ...... ..~.~....~..:~;.....l.(.~..~-...7.. .................... County Tax Map No. 1000 Section ....... ,,C).,],~ ....... Block ......O....~. .......... Lot No .......~.....').. ........... pursuant to application dated .... .....~.~....'~....'~.. ................. , 19.~..'1.., and approved by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 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 topograph'ic 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 "pm-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.$25.O0, Accessory ~$]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 $]0.00 4.Vacant Land C.O. $ 20.00 ~-~.l.?)(~ / ,~..~.~.. c.o. 50.00 Date' NewC°nstruction ...... Old or Pre-existing Building ............ Vaca~nt Land ............. Location of Property.. / .~..~..q..~.~..~..~./~..~.~....~.q~,% .... . .~...~./.~..~. ~. ............. House No, , / Street /~,~ ,,~ Ham/et Owner or Owners of Property . . . County Tax Map No. 1000Section ....~.//~-. .... i. Block..~../~. ........ Lot....~..~ ~' . 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions Subdivision ................................. Filed Map No ............ Lot No .............. Permit N~. /~/~./¢~.,. Date of Permi[~,~'~Y~E..~.. ~..Applicank,, ~, ,~.~...~.~~..~. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval . .......... Request for Temporary Certificate ..................... Final Certificate ....................... Rev. lo-10-7a 765-~.802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I/NSULATION / [ ] FRAMING [,/J FINAL REMARKS: ~!~/27, ~ DATE ~/~ .~.//~7 INSPECTOR ~u~ ?~ UNDATION 1st) UNDATION (2nd) UGH FRAME & PLUMBING SULATION PER N. Y. STATE ENERGY CODE · ADDITIONAL COMMENTS: Examined . · ..<~ *~.~ .... 19~.'~. Approved .. .~./y~'~..~.<:]., 19~..'/. Permit No..]..[q. ]. ~..~..~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT 3 SETS OF PLA~ 'FORM NO, I SURVEY .......... ~ TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL NOTIFY $OUTHOLD, N.Y. 11971 TEL.: 765-1802 CALL ................ MAIL TO: BLDG. DEPT. TOWN OF SOUTHOLD Date ~--~ .~7,)tt~ ..... 19 ~..'.~ INSTRUCTIONS a. Tkis app~lication 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. ~. 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 o~ Regulations, for the construction of buildings, additions or alterations, or fgr removal or demolition, as herein described. · The applicant agrees to comply with all applicable laws, ordinances, buil~'.~.g co~t~]t~l~usjng/od~, and ~regulations, and to admit authorized inspectors on premises and in building for necessary i~ .~/~ .~ ''' iff]g'~[r'e~gT~j~'~lic'ar~t, or name, if a ~;;3g[a'tio'd) .... .. ~.~..~...~okq.m...I.~....c~..., h~...-~...e~.. ~ (mailing address of applicant) /LQ/ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................................................... Name or owner of premises .~L~.i~'J~..O...~.. /~.O...~...~....~p~.'...-~.~.../.~.'.~....~..~j~..~.~ .~--w~.-,.~ .... (as on the 'tax roll 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 No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. .. z.5 . ......... ...s: .......... ...... ............. House Number Street Hamlet County Tax Map No. 1000 Section ... 1~. ........... Block ...~. ............. Lot...~. ............... Subdivision .O..~. 1..V:-4~r?...q .~..~.~....~P'~... 7..~ ....... Filed Map No....~..~.q.t{ ...... Lot...[.q.~. · ...... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...~...A/~...'.~.~-~.. ! .c~....~..~...~. '../.~. ~ ................................... b. Intended use and occupancy . .O.~..~../~-.~... j~..~t=..Cf~; !~.'.~'5~.~-'~ ............ 3. Nature of work (check which applicable): New Building· Addition ........ Alteration .......... Repair ......... : .... Removal .............. Demolition ..... / ....... Other Work ............... ~ ~ (Descrip~tion) 4. Estimate.d Cost ....~..h .c4 ............................. Fee ................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units . ~....'~--~ ........ Number of dwelling units on each floor..~.~...: ........ If, garage, ri tuber of cars ....... x- ........................................... If bus~ness, commercml,.or m~xed occupancyi,specffy nature and extent of each type of use 7. Dimenmons of existing strucffar~s, if any: Front ............... Rear ............... Depth. ~. ............. Height Number of Stories ~.~ ' ' =~Dimensions'of same structure W~th alterations or additions Fro.nt ...[.~.~.(~.*I..., .... Rea~rr Depth ................... ,., H'e~ght . .//~rs. 6. (~ ......... Number of Stories .... ~--8. Dimensions of entire new con_st, ruction,: Front .......... ..... Rear ............... Depth ....... Height . ... ...... ) ~.~x ;,~. ~I~er 0fi Stones ................................... -- 9. Size oflot~: Front.................,:...... ~ ~/t(;a Rear ....................... Depth ............. ......... 10. Date of Pt~rchase .. ,..~.~..15-1~'~.:...* ............ Name of Former Owner . .1~. ff~l.6.qqO..'35~. ~-.~..~. · ..... 11. Zone or u e district in which pr~ni~$a~ e situated...~.~..¢.,~.:~--Ag['/~'(~. .................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ..../~.O .......................... 13. Will lot be regraded ..... .~t.O. ~ ................... Will excess fill be removed from premises: Yes 14. Name of Owner of premises 4,e~ t4~r,3M./~¢.~ddress 1~. e.L.oD....~.~ L~gs~. Phone~£~ No..',,~.~.' .~ ~ .~'~-~-. Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .......................... Address .... : .............. Phone No ................ 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No .~.. · If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimeosions 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 $~,~~,,¢w.v~ S S COUNTYOF;~.~ '. ~ ,,,_._,,, \. ~ .......... ~.ff.t~..~.~.' ¢~.../,~. ,:..~.~/.~... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. .... ................................................................... (Contractor, agent, corporate officer, etc,) of said owner or owners, m~d is duly authorized to perform or have performed the said work and to m~e ~d file this application; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the work w~l be perfomed in the m~ner set forth in the application filed therewith. Sworn to before me this ...... ~.O~ ........... day of. ~ ............. 19 .~ / Notm~ Public ............... ~ ....... County N~aW Publl~ 8~e ~ N~ ~ . Term Explree ~m~r 31, 1~//; 0 I I r?. cD S9 80 79 7~ 103 Mignon Ryan to Bruce Ca~ .e, ~nen~ r'oint. 12/6/85 $10