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Home My WebLink About16162-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z16115 Date September 2 1987 Outside shower THIS CBRTIFIBS that the building ................................................ Locatiou of Property3.,3.6..5 .KE.N..N.EY' S..R.O.A.D. SOUTHOLD t~ouse No. Street Hamlet County Tax Map No. 1000 Section . .5.4. ........ Block 5 . .Lot 24 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... J.u.n..e..2.2.,..I.9.8. 7.. · . pursuant to which Building Permit No.. ! 6. .1.6.2. z. ............. dated .... .J.u. 1. I~... I. ,...1.9.8. 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 ......... Outside shower addition to an existing one family dwelling. The certificate is issued to FRANK AND GIOIA B. ALDRICH [owner,/'ds~ 7~Kt~l X of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO... N / A PLUMBERS CBRTIFICATION DATED: Rev. 1/81 N/A MO~M' NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CI"HtS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO_ 16162 Z Permission is hereby granted to: .... ............... at prem,ses loc ted at .....~.....~..~..~....; ~" ~ }.~~....~.,' ~ ' '.....~ Coun~ Tax Map No. 1000 Section ..... .O..~:~ ...... Bilk ...... .~..~ ..... Lot No ..... ~. ............ pursuant to application dat~ ..... .~.~...~ ................. , 19.~.].., and approv~ by the Building Inspector. Fee $..,.~..**'~**.:.....**/~... .... Building Inspector Rev. 6/30/80 FORM NO, 6 TOWN OF SOUTHOLD Bu ilding 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~tt~perty 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 I. Certificate of occupancy New Dwelling $25.00, Accessory i$ ]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 $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ..~J~{~.~.,I.?~.~.-{?.~,r~ c~ n°~ NewCons truction ...... Old or Pre-existing Building ............ Vacant Land ............. House No, Street Ham/et Owner or Owners of Property .............................................., , County Tax Mac No. 1000 Section ........... B~ock .............. lot ............ Subdivision ................................. Filed Map No ........... Eot No .............. z - 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 described building and permit meets all applicable codes and regulations, Applicant .................................................... Rev, 10.10-7a U~DATION ( 1 st) UNDATIOI~ (2nd) UGH FRAME & PLUMBING SULATION PER N. Y. STATE ENERGY CODE FINAL · ADDITIONAL COMMENTS: 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT SEpTTC TOWN HALL NOTIFY $OUTHOLD, N,Y, 11971 TEL.: 765-1802 CALL MAIL Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH 3 SETS OF PLANS ''~.'. SURVEY .-,-., .... o r~ CHECK FORH · "ZSq/:.Lq ..... TO: '%' 'tOWN OF itO~OtZ} Date. ~/../.~. .......... 19 .~.7 INSTRUCTIONS a. Tlfis 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· APP~LICATION 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 ~pplicant agrees to comply with all applicable laws, ordinances, building code, t~using code, and reg, ulations, and to admit authorized inspectors on premises and in building for necessary,~.f [/ ~co/cc /-/o~r~'~/~O~'.~ . · k'./. -"; · · ,~ r.~.~ . ~ ........................... (Signature of applica~/~ name, if a corporation) (Mailing address of applicant) I State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...... .................................................................... ,/z q'..: ?, Name of owner of premises . .~..~..,.~. .... '-'.: · · I '~"~' (as on the tax roll or latest deed) (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. ff/.~-./~-~..~, f~..t/, .~.o~/~ e'/o 1. Location of land on which proposed work will be done'..-~..~..~.~.'~....~lff..~...,~..~..~....~..'...~.. ?. 3 s-- ........ ................................. , ............. House Number 'Street Hamlet County Tax Map No. 1000 Section .... ~...~.~ ........ Block ..... .~.~... ........ Lot .... .~.~..'.~.. ........ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...................................... ;.' ·; .~ ,,;% .~ .................... b. Intended use and occupancy . (~.r..,.~., ~:~.r~ -~'~/~,''~'c'¢-/r-' ';'~"'"~'~" ................................... , .,~.,,! ~ .~¥ ~.~,~,,~ ................ 15. Is this property located within 300 feet of a tidal wetland? *Yes *If yes, Southold Town Trustees Permit maybe required. · PLOT DIAGRAM 3. Nature of work (check which applic.able): New Building ..... ' ..... Addition .......... Alteration~.,,~ ........ Repair .............. Removal. ............. Demolition ............. Other Work... E ........ Estimated Cost.. fi~..j. ~..~..(?. ....................... Fee ...................................... 4. (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, commerciai 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 ............... "" ~' ' ................ t' ................... Dimensions'o~[q~ i~Ikre with alterations or additions: Front ................. R~.r .................. Depth ..... .~ .~Y'.~..~.~..~"~A?. .... i. ,Height ...................... Number of Stories ...................... Dimensions of entire new ~or~st~ct!on: Front . .'7.. f . . Rear ...--Z..¢ ..... Depth .. ~ t ...... Height Size of lot: Front .. :l~.,~:~.':'.. '~/... ....... Rear .../.~. (~ ......... ' .... Depth ...~. ~ ] ............... Date of Purchase ............. ? ............... Name of Former Owner ............................. Zone or use district in which premises are situated ..................................................... Does proposed construction violate any zoning law, ordinance or regulation: ...g~t ~ ......................... Will lot be regraded . .t:3 t:~..., ................. Will excess fill be removed from premises: Yes ,~ Name of Owner of premises/:.,~.~..~..~,b;~. ~. ~/k~/Address --'~.~.~..$~../'~..e'.~X.~.~hone No. 7~.~/. ~..~.. .... Name of Architect .......... Address .................... Phone No ........... ~., ~ ._ NameofContractor ]~.'~i~.'~71~.~'~ .Address,~c'~/,7.~,~'.~?.'.... ehoneNo..2',&--~..-./.~...J.i. Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate ail set-back dimensions from ~roperty lines. Give street and block number or description/according to deed, and show street names and indicate whether interior or corner lot. STATE OF ~EW ~tlli1~4 . b'.~ COUNTY OF. ~z]'7-...~f/%.~.~ ~'--~"'~ ~"~'~ YL .~.. (Name of individual signing contract) ~bove named. He is the ................... ............................................................. (Contractor, agent, corporate officer, etc.) 3f 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 ~vork w/al be performed in the manner ~et forth in the application filed therewith. Sworn to before me this ......... ..... day or. q°tary Public'~' "~'"I~JItE .......................... ~tfl SuffolkCountv _ _ (Signature of applicant) , ! ~elltllt~lelt ra~re~ D~cembe r