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Home My WebLink About15224-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ~. ~4555 Date Se.p t e.mber .~, ! 9 .~.~ deck addztlon THIS CERTIFIES that thc buridm§ ............................................... '. Hou~ No. Strut Ham/et County Tax Map No. ~000 Section 1 03 ..... ~oc~ 1 ~ .... ~t 3 Subdivision ............................... Filed Map No ......... Lot No ............. . conforms substantially to the Application for Building Permit heretofore Fried in this office dated · .~.u.g..u ?.~..2.7.: ......... 19.8.6. pursuant to which Building Permit No. 1.5.2..2.4. z dated ...~.e.p..t .e.m.b.e.v...3., ........... 19 ~.6., was issued, and conforms to all of the requirements of the applicable provisions of the taw. The occupancy for which this certificate is issued is ......... deck .addition to exzstzng one famxly dwelling. . . -' Stephen & Frances Stemdel The certificate Is issued to . ....... ... (owner, Iwie~ ;6tct6ffe~f~ x of the aforesaid building. Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO ................. . N,/?. ......................... ... . ....... g Inspector ........ Rev. 1181 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PEI~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHOPdZED) N9 15224 Z Permission ~$ hereby granted to' ...~..~..~...~L~..... ....~1 ?. ~." .~.,,,.:~...~ ..,.~...... ~., .... ...~..,?~..,~...v.?l....I.z.'~;~.~.... ,o..~.~.....~....~?.A ..~ ~~ ~.....~...~....~ County Tax Map No 1000 Sec~. J 0...~ . Block ....... ,~....~.. ..... Lot No ........~i, . . . pursuant tO application dated ~-~j~-,..~'~ .-~. ~'~ .... , 19.J~(O, and approved by the Budding Inspector Building Inspector Rev 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hail Southold, N.Y. 11971 765- 1802 , ,: ,-- OE~ T. APPLICATION FOB CERTIFICATE OF OCCUPANCY Instructions A Thru apphcat~on must be filled ~n typewriter OR ink, and submitted ~m~ to the Budding Inspec- tor w~th the following; for new buildings or new use' 1. Final survey of property w~th accurate location of all buddings, property hnes, streets, and unusual natural or topograph m featu res. 2. Final approval of Health Dept. of water supply and sewerage disposal-iS-9 form or equal). 3. Approval of electrical installation from Board of F~re Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Remdences and mmdar budd,ngs and mstalla- tions, a certffmate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. For exmtlng buddings (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 prewous 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 mforma- Uon reqmred to prepare a certificate. C Fees. 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-exmtmg dwelhng 3 Copy of cemficate of occupancy $1 00 4.Vacant Land C.O. $5.00 5 .Updated C.O. $15.00 NewConstructzon ...... Old or Pre-existing Budding $15.00 Date.. f/2 ~.4.~.0/. ......... ........ Vacant Land ............ Location of Property .% [g.~. .... .L.~.T/.~..~..~?.CJ.C., .~.d ......... C~j.~?~(..~.' .C??..~. ............ House No. Street Hamlet Owner or Owners of Property . .3I.~.~ ~..~.... y~..F?..~,¢ .~.~. .... .~..-/~.~.IZp.C..~. ....... CountyTax Map No. 1000 Section . 1.0 5 ....... Block .... /..~ ........ lot .... ~. ......... Subd~wmon ....................... Flied Map No ...... Lot No .......... Permit No. J~.~.~ .~' . Date of Permit ....... Apphcant .................................. Health Dept. Approval .................. Labor Dept. Approval ........................ Underwriters Approva~ ..................... Planning Board Approval ...................... Request for Temporary Certificate ................ Final Certificate ...................... Fee Submitted $ ..................... Construction on above described budding and petit meets all applicable codes and regulations Appl ~cant .... %-~-f o~..--:~-¢¢/.. ~..?~. ................ Rev 10 10 78 R .x. 3o "I~OTIE ELEVATIONS/~.~E BASED ' ' - ~: ' ELEVATIOI'4 OF' IE,.O'AT N.'~/.COP...OF TITLE:i ", MAP OF PP. OPE~T'Y A.T PECOhHC' TO',,,./N OF $OUI'HOLD~N.~ 1'[.ST HOLE, I SUF~;CO D~P'T. OF~E^LrH ~ '[ .. , ---' ,:, ! Fo~ ,',,,~p~.ov^u OFCONSr~UOr~O,'-'. ~ ~- t-.--':.=-- ,,. ',, I ONLY -T-- f=--';-'; ~ ~ i ' - I i '~I ' . _,__ ~. ~ t ~ ' APPP. OVr~ O: "~N~S ¢ LO~ ~SSOC. ,,".,. ', .." ,: ,. , ' ~/ILL~NcOD_N ~ THE GT AN :.A~ D5 0F 5UF FOL~ COUNI~ D~PA~Tt~--, .S H~TH. APPL 1CA!,,¢i- Examined ~" ~ Approved ~Z~'¥. ~ Disapproved a/c FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y 11971 TEL.: 765-1803 ·, 19¥ · , 19~ Permlt No./~3-~.~ ~ ........ .x~ .~,~.. (Building Inspector) APPLICATION FOR BUI LDING PERM IT Recezved ........... ,19.. Date INSTRUCTIONS a Tins apphcation must be completel ' filled in by typewriter or in znk and submitted to the Budding Inspector, w]tl- sets of plans, accurate plot plan to scale. ~, according to schedule · b Plot plan showing locahon of Io{ ~kof b,~ldmgs og premzses, relatzonshlp to adjomlng premises or pubhc stre or areas, and g~vmg a detmled desc, lil~to] ['l' ;S~%kil~i~f [r~YWty must be drawn on the dtagmm winch is part of tins apl catton ~ ~, ~.~-~ v. ~k~-~ c. The work covered b~ ~p~['ic~ ~]~k{~l;~&~b~nmenced before msuance of Bmldmg Permit d. Upon approval o/~a,~ ~%a~[~ ~,~'~,. 'lnsp?ctor wall msued a Budding Penmt to the apphcant. Such peru shall be kept on the~.~.h~ea~ tblOgt [~lt%][%h_~roughout the work e. No budding~-~e~_c }[ed~f~ ~-~.~ or m part for any purpose whatever untd a Certificate of Occupan shall have been granted 1~ .~ ?eclil~,-~n~.,,.7~ APP L ICAT ION I S ~a~l~F~l~ .~ ~k~e Budding Department for the issuance of a Building Permit pursuant to t Budding Zone Ordinance ~'[q]~ ot~~ ~uthold, Suffolk County, New York, and other apphcable Laws, Ordinances Regulahons, for the constr~ch d/~,IMfldmgs, ad&huns or alteratmns, or for removal or demohtton, as herein describ. The apphcant agrees to comfl nth all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized mspecto~s on~p?emtses and m building for necessary tnspeTions ~._ ,. o (Signature of applicant, or name, ff a corporatton) ..... ·.. ......... ................ ~'~.~.~ :; ..... e · · · (mazling address of applicant) State whether apphcant ts owner, lessee, agent, architect, engineer, general contractor, electrlctan, plumber or build, Name of owner of premises . If applicant ts a corporation, signature of duly authorized officer (Name and title of corporate officer) Budder's Lmense No .......... Plumber's License No ...... Electmclan's License No Other Trade's License No. .. Locatton of land on whtch proposed work will be done. House Number Street County Tax Map No 1000 Sectmn [ 0 ~ Subd~v~mon (~ame)' 2 (as on the tax roll or latest I'f',, ¢ ~ ' ,I, ',NsP~CTION,S: F .... ' ..... ~. INSUL~K ~. FINAt, (3~~' 'T~ItCTION MUST ALL CONSTRO~ 'D~'~ S~LL MEET THE ~EQUIP~E~ ~ ~ OF THE N Y ~ ~C HO G o~OES NOT ~SF~ ~NSI~.E ~R Block .. Lot ~ Fried Map No .... Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction a. Exlstinguseandoccupancy 0 [0 ~ .C- At'3. ~ l-.~/ .[J o.'o S ..0_ ........ b. Intended use and occupancy . . .~. ~? .ex. ~ . 3 Nature of work (check wh,ch applicable)' New Bufldmg ..... Addition ....... Alteration .. . Repair ....... Removal ........... Demolition .......... Other Work . .~.~. ~i (Description) 4. Estnnated Cost ............................... Fee ............................... (to be prod on filing this appl,cation) 5. If dwelling, number of dwelling units ............ Number of dwelling units on each floor ........... If garage, number of cars .......................................................... 6. If business, commercml or mixed occupancy, specify nature and extent of each type of use ............... 7. Dtmens, ons of existing structures, if any Front ............ Rear .......... Depth .......... Height ........ Number of Stones ............................................ Dnnens, ons of same structure wuth alterations or additions Front ......... Rear ............. Depth ............ He~,ht .............. Number of Stones ................... 8. Dimensions of entire new construchon' Front ......... Rear .............. Depth ............ Height ............ Number of Stones 9. Size of lot Front ........ Rear ................ Depth .............. 10 Date of Purchase ................ Name of Former Owner ........... 11. Zone or use &strict in which premises are s~tuated ................................... 12. Does proposed constructmn violate any zomng law, ordinance or regulatmn ........................... 13. W~I1 lot be regraded .................. Will excess fill be removed from premises Yes 14 Name of Owner of premises ................ Address ................. Phone No .. Name of Architect .............. Address ................ Phone No ..... Name of Contractor . ~ e /. ~=: ............. Address ............... Phone No ......... 15. Is this property located withint00 feet of a tidal wetland? * Yes ..... No ..... If yes, Southold Town Trustees Permit may be requ~ired. .~ PLOT p AG Locate cle~ly ~d d~cfly ~1 budding, whe~er e~ pr pro~, ~cate ~1 set-back d~ensmns fro prope~ hnes G~ve street ~d block number or descnphon ac~g to ~4, ~{sh~ street nines and red,cate wheth interior or corner lot. , _,, ~ ¢ becXc STATE OF NEW YORK, S.S COUNTY OF .......... (Name of ~n&wdual signing contract) above named bemg duly sworn, deposes and says that he is the apphca He m the ................... (Contractor, agent, corporate officer, etc ) of smd owner or owners, and ~s duly authorized to perform or have performed the said work and to make and f'de ti appbcahon, that all statements contmned m th~s apphcation are true to the best of his knowledge and behef; and that ~C work w,ll be performed in the manner set forth in the apphcatlon filed therewith Sworn to before me th~s .................... day of .............. ,19... Notary Public ......................... County (Signature of applicat