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Home My WebLink About15363-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17152 Date AUGUST 2~ 1988 THIS CERTIFIES that the building_ Location of Property 270 MOOSE TRAIL House No. County Tax Map No. 1000 Section 103 Subdivision ADDITION Street Block 04 Filed Map No. CUTCHOGUE, N.Y. Hamlet Lot 10 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 30, 1986 pursuant to which Building Permit No. 15363-Z dated OCTOBER 6, 1986 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 DECK ADDITION AROUND INGROUND SWIMMING POOL AS APPLIED FOR. The certificate is issued to ROBERT & BARBARA HARKINS (owner, X~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 Building Inspector TOWN OF $OUTHOLD TOWN HALL SOUTHOLD, N. Y. I~UILDiHG PER,AlT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15363 Z Permission is hereby granted to: ' ~.....~....!..~.~ ................................................ ..... ........... at premises located at ..~,...~....~,.....,.~,.~.~.~~ ....... ~.~,~ .................. County Tax Map No. 1000 Section ....... J...?.....~. ...... Block ........ .q~,...~ ...... Lot No ....... !,..~,. ........... Building Inspector. Building Inspector Rev. 6/30/80 /5'3(e3 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUNDATION 2ND [ ] INSULATION FRAMING [ '/J/FINAL REMARKS: ?'iELD ireS. 1. FOUNDATION FOUNDATION (2nd) ROUGH FRAME & .PLUMBING 3e INSULATION PER N. STATE ENERGY CODE Ye FINAL -- ADDITION[L COMMENTS'. ! ! £ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Yo Examined .......... , Approved .~.~....~. ........ , 19.~.~.. Permit No..L.~..~.~ ....... Disapproved a/c ............................................................................................ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ................................................. 19 ............ INSTRUCTIONS a. This application must be completely filled in by typewriter or~ in ink and submitted in triplicate 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 o~ areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. 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 issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No buildi,ng shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been grqnted 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 applic~able laws, o~i~ admit authorized inspectors on premises and in buildings f~ / nc~/s, building code, housing code, and regulations, and to ec/~ssa ry inspections. (Signature of applicant, or name, if a corporation) ..... ~ ............ x ~X;~i;.~;G;T .~;;~;ii~Zfi .......................... ,. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...~.D.~..~ZP~.......~.....~.....~.~.~;.....~...h....~.Z~..~...~/.~.~..'.~.~ ................................................. If applicant is a corporate, signature of duty authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade s L'cense No ............................................... ................ ........................... .......: ....................... ii , ........ State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy Intended use and occupancy ........ ..~...~.../...~...~..~....~.. ~ ... ~ ~...~.'.~......~..... ~...~; ........... b. property lines. Give street and bi whether interior or corner Iol. 3. Nature of work (check whichiapplicable): New Building~· ................. Addition .................. Alteration.;...>. Repair .......... ~.~;. Re, oval~ .................. Demolitior. .................... Other Work (Description) 4. Estimated Cost ...................................................................................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwellihg units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ..... L ....................................................................................................................................... 6. if business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structu:res, if any: Front ............................ Rear ................................ Depth .................... Height ........................ NumBer of Stories ................................................................................................................. Dimensions of same structur~ with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ ' 8. Dimensions of entire new co6struction: Front ................... , ................ Rear ............................ Depth ........................ ~ Height .................... Numbe~ of Stories ...................................................................................................................... 9. Size of lot: Front ................. i ....................................... Rear .......................................... Depth ................................ 10. Date of Purchase ................. i ...................................... Name of Former Owner ........................................................ 1 1. Zone or use district in which ipremises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded . ............. .; ............. Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ~ ........... m~.~,,.r~.~..,.¥. Phone No. ............... Name of Architect ..............~ ............................................... Address ................................ .Phone No ....................... Name of Contractor ............ ; ............................................... Address ................................ Phone No. ...................... PLOT DIAGRAM Locate clearly and distinctly aH buildings, whether existing or proposed, and indicate all set-~ck dimensions from ~ck number or description according to deed, and show street names and indicate STATE OF NEW YORK, i ¢ c COUNTY OF ................................ ~'~ ............................................................................................... being duly sw~'n, deposes and says that he is the applicam (Name of individual signing contracf) above named. He is the ....................................... ' ........................................................................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is d~ly authorized to perform or have performed the said work and to make and file this application; that oil statements contained in this application are true to the best of his knowledge and belief; and thor the wor~ will be performed in }he manner set forth in the application filed therewith. Sworn to before me this ' ~ ~ ........... ....... ....... ........ ;. ........... Notary Public ........~_..~.,.,...~.£..~/.~.. County ..... /~....~. ............... ~~..:;......:: ............................. j ~ gnaTure oT appHcanT.~ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUP A, This application must be filled in typewriter OR ink, and submitted ,= ====~=- to the Building Inspec- tor with the fo[Iowing; for new buildings or new use: 1.Final survey of property with accuram 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 propertv lines, streets, buildings and unusual natural or topographic featu res. 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 p repute a certificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.(10, Accessory '$10.00 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..0.0! 4.Vacant Land C.O. $ 20.00 NewCons %puc tion ...... Old or Pre-existing Building ............ Vacant Land ............. Hamlet House No. A Street County Tax Map No. 1000 Section .... /..~..~. ..... Block ..... ~. ........ Lot .... ~..~. ......... Subdivision ................................. Filed Map No ........... Lot No .............. Hea{th 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 me, ts all applicable codes and r/egula~ons. Applicant ~.~ '