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Home My WebLink About15184-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z14827 Date June 22 ............................................ 19...86 THIS CERTIFIES that the bmld,ng .. . .D.]~14 ................................... Location of Property 205 OLD FARM ROAD ORIENT House Ho. Street Hamlet County Tax Map No. ]000 Section :~ 5 ..... Block ....5 ........... Lot . .6. ............. Subdivision., .~,A..Y~.~E.~ .~.~..1~. .......... Fried Map No. 7.0.4..5 .... Lot No. 16 conforms substantially to the Apphcahon for Building Permit heretofore filed in this office dated ·.. A..ucj....3:.2. ~ ........, 19.8. 6pnrsuant to which Building Permit No 151847, dated ...A. qq :..3. 4. ............. 19.8.6., 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 ......... Extensa. on of ex:ls'cxnc~ deck on one fam/ly dwells, rig. -, The certificate is issucd to ROLLTE J. KENNEDY (owner, YJev~(1Xr~F,'YmY~X of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO ................ N/A. . . ............................ Rev 1/81 l[~O~v NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~,IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED} 15184 Permission ~s hereby granted to' .~.~/.....i..~......./. ~ e~ ~ at prem,ses I~ated at ........ ~..~.~......~....~~ ....... ~. ................... /./ ~U"~ Tax Map No 1000 Section ~ ~ Bilk ...... ~T. ...... Lot No.....~ ........ Bu~[ding Inspector Building Inspector Rev 6/30/80 Rece,pt No. 50 ] 02 TOWN of SOUTHOLD OFFICE OF BUILDING INSPECTOR Town Hall Southold, New York 11971 ........................ . ....... ............................. .... ..... .,)- Fee for Fee for Fee for ..... /100 Dollars Fee for r__~rtlficate [] [~ Budding Perm,t IVrof Occupancy [] M,sc ,tla- ng, ........... Budding Inspector ~ or topogF'a-phiE fe~tu res. ' ............. 2 Sworn statement of owner or previous owner as to use, occupancy and condition of buddings. 3. Date of any housing code or safety ,nspect~on of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5,00 2. Certificate of occupancy on pre-ex~stmg dwelhng or land use 3. Copy of certificate of occupancy $1.00 $5,00 Date ..... ~//~..L .~'. ,~ ....... New Budding / Old or Pre-existing Budding Vacant Land Location of Property .--~.~...~../~/7, fJD..RO ~ ~.,. ~g.i.~ .~,. ~.,~.. Hou~ No. Street Hamlet Owner or Owners of Property . . ~. .~... . ~-.~.~/ ........................ County Tax Map No. 1000 Section . ~ ~ Block ~ Lot Subd,v,s,on .... ~I~'.~ K~ ........ F,led Map No ~..Lot No . ~ ~ ... Perm,t No./~/~ Date of Perm,t ~¢/~ .Applicant. ~. ~/;X..~, .~ ~.~ ~ ~.. 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 p.er~pit meets all applicable codes and regulations. Rev, 10-10-78 FOUNDATION ( ls t) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL . ADDITIONAL COMMENTS: 765-180,/ BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ~/IFI NAL REMARKS: DATE: INSPECTOR ~c ~0 Examined ~ Approved Disapproved a/c FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ..~ ./,~ ,19~ a. Tlus application must be completely filled m by Wpewnter or in mk and submitted to the Budding Inspector, sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing locatmn of lot and of buildings on premises, relationstup to adjoining premises or pubhc stre or areas, and giving a detailed description of layout of property must be drawn on the &agram which ~s part of tlus apt catmn. c. The work covered by tlus application may not be commenced before issuance of Budding Permit d Upon approval of this application, the Budding Inspector will issued a Budding Permit to the applicant. Such pen shall be kept on the premises avadable 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 Occupa~ shall have been granted by the Budding Inspector APPLICATION IS HEREBY MADE to the Building Department for the ~ssuance of a Bmlding Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances Regulations, for the constructaon of buddings, additions or alterations, or for removal or demohtxon, as hereto descnb. The apphcant agrees to comply with all apphcable laws, ordinances, budding code, housing code, and regtflat~ons, and admit authorized mspectors on premises and in building for necessary fff~ect~ons ' (~S1 ~ature of a~lcant, or name, l~s~rporatlon) ' State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electrlcmn, plumber or bu,ld. Nameofownerofpremlses . (as on the tax roll or latest deed) If apphcant is a corporation, signature of duly authorized officer 2 (Name and title of corporate officer) Builder's License No ...... Piumber's L~cense No Electrician's License No Other Trade's License No Locatmn of land on which proposed work will be done. House Number Street County Tax Map No 1000 Sectmn ~ -- ~5~-, ~. Subdlvlslon ~ f~g~ ~qm (Name) 7'7 .tv . . .119 ,57 Hamlet Block ......... Lot ........ FfledMapNo 70 at/~... . Lot . /6 State ex~stmg use and occupancy of premises and intended use and occupancy of proposed construction a. Ex,sting use and occupancy . . J/~' e~ &.~.~ /.-~'q./~d ~'//~ ]~.o.e~..,¢.~ ..... b. Intended and occupancy 3. Nature of work (check which applicable) New Bmldmg ...... Addition ...~.... Alteration ..... Repmr ..... Removal ........ Demolition .......... Other Work. (Description) 4. Estn-nated Cost ............................ Fee ................................. (to be paid on filing this application) 5. If dwelling, number of dwelhng units ....... Number of dwelhng units on each floor ........... If garage, number of cars ................. 6 If business, commercial or mixed occupancy, specff, y nature and extent of each type of use ........... 7. Dimensions of existing structures, if any Front .... Rear .......... Depth ......... Height .......... Number of Stones ............... D~rnensions of same structure with alterations or additions' Front ......... Rear. Depth ............... Height ............... Number of Stones.. 8. Dumenslons of entire new construction Front ....... Rear ........... Depth ...... Height .......... Num.~ber of Stones lO DateofPurchase .... Il/g{-/ ..... Name of Former Owner ,~j~-~-~..~' .... 11 Zone or use &strict in which premises are situated ............................... 12. Does proposed construction vi~a~e any zoning law, ordinance or regulation' .....~..o .................. 13. Will lot be regraded .... ./.r..~ ...... .: ....... Will excess ffllbe re. moved £rom premises Yes 14 Name of Owner of premises~O ffi./'.';7'7.t~.'ff;'~"""'"z'a... 7Aadress ~i~°~o~,~,~.~ 3~ ~. ~ :?.~.~ Phone N~).~_.),,ff~ ....... $-~ Name of Architect ^. ., ...... Address ...... ,,...., ,-_ Phone No ..... NameofContractor . /O&{/~--...~ ..... Address'~.3.°..°.~.~'. PhoneNo .......... 15. Is this property located withznt~0 feet of a tidal wetland? * Yes ..... No ..~.. · If yes, Southold Town Trustees Permit may be requmred. PLOT D~AGRAM Locate clearly and distinctly all buddings, whether existing or proposed, and, indicate all set-back d~nenslons fro property hnes. Give street and block number or description according to deed, and show street names and mdlcate whetl- interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ... (Name of individual signing contract) above named · being duly sworn, deposes and says that he 15 the apphca He is the ........ (Contractor, agent, corporate officer, etc ) of smd owner or owners, and is duly authorized to perform or have performed the said work and to make and fide ti apphcation, that all statements contained m this apphcat~on are true to the best of his knowledge and belief; and that t work wdl be performed in the manner set forth m the application filed therewith Sworn to before me this .............. [ JaPROVED AS NOTED~ NOTIF BUILDING DEPARTMEj~T- AT FOLLOWING INSPECTIONS - =-I~ATION T~VO ~QUIRED FOR 13OIJRE~ PONCr~ . ~_ ALL CO~?~,'r,r,~ ,~,,, ~EFT I