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HomeMy WebLinkAbout15245-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. Certificate Of Occupancy No. z- 15636 Date April 13, 1987 THIS CERTIFIES that the building DECK. A.D. DI..TIO. N ....................... LocatlonofProperty. I5.? Seawood Drzve Southold, New York t~ouse tva. Street Hamlet County Tax Map No. 1000 Sechon 8 8 . .Block 2 .Lot 8 Subdtvmion .M/p..8.,e.a.woo.d.A. or..e.s ..... F~ledMapNo 2575 .LotNo. 5 conforms substantially to the Application for Bmldtng Permit heretofore filed in this office dated July 29, 1986 15245 Z .................. pursuant to which Braiding Permit No ................ July 29, I986 dated ......... was issued, and conforms to all of the requirements of the applicable provmlons of the law The occupancy for which this certificate is msued m ....... DECK ADDITION TO EXISTING ONE FAMILY DWELLING EDWARD & The certificate is msued to ...... of the aforesaid building. Suffolk County Department of Health Approval ELLEN WILLIAMS N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED: N/A 'Inspector ........... Rev 1/81 TOWN OF $OUTNOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERi, IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 15245 Z Date ..................................... 19 . Permission ~s hereby granted to' ..~~..~ ..... co,.~....~... ...z.~ ...... ~.....~.. ~.,,~.... ..... ~...~.:~.: ...... !.1...~..~ .L ......... ' O- ~ ~"~ ~ ,;al ~-'~:~ ............... ~ ~- '~'"' r--~ ..... ~. ~-~~ ........................................... at premises located at ..../..~.'~.....~l~,~ ......~-~.~ ....... ..~....~ ..... County Tax Map No 1000 Sect,on ~..~. Block ...... ..~......'~'.. .... Lot No ..... ..~.~... · 'o apDlicat,on do,~ ...~ ~.~ ....... , 19~.~, and approv~ by the pursuant Building Inspector. Building Inspector Rev 6/30/B0 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions B Th~s apphcation must be hlled ~n typew.ter 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 buddings, property lines, streets, and unusual natural or topographic features. 2. F~nal approval of Health Dept of water supply and sewerage d~sposal-(S-9 form or equal). 3. Approval of electrma[ installation from Board of F~re Underw.ters. 4. Commercial buddings, Industrial buddings, Muluple Remdences and similar buddings and installa- tions, a cert~hcate of Code compliance from the Architect or Engineer responsible for the building. 5 Submit Planning Board approval of completed s~te plan requirements where apphcable. For existing buildings (prior to April 1957), Non-conforming uses, or buddings and "pre-existing" lend uses: 1 Accurate survey of p~operty showing all property hnes. streets, buildings and unusuat naturat or topographic features 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buddings. 3. Date of any houmng code or safety inspection of buddings or premises, or other pertinent mforma- tion required to prepare a certificate. C Fees' 1 Certlficate of occupancy $25 00 -- BUSINESS $50°00 ACCESSORY $]0.00 2. Cert~fmate of occupancy on pre-existing dwelhng $ 50.00 3. Copy of certlfmate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................-- ~/ NewCons trucb~on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ~ ................ Hou~ No Street Ham/et Owner or Owners of Property .......................................................... County Tax Map No. 1000 Section ..~b~...-. Block ............... Lot ................ .............................. F~ed Map No ......... Lot No ............. Ferm~t No ........ Date of Ferm~t ...... Applicsnt.. ~ . . ( ........................ Health Dept Approval ..................... Labor Dept. Approval ........................ Underwriters Approval ................... Planning Board Approval ...................... Request for Temporary Certlfmate ................ Final Certificate ...................... FeeSubm,tted$....~....~,'.x~.~ Construction on above described budding and permit meets all apphcable codes and regulations. Apphcant .................. Rev 10 10 78 TOWN OF S01JTtIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-I 802 TO Whom This May Concern, We are unable to complete your Certificate of Occupancy because,of the following reasons. /Z/ An application for Certificate of Occupancy is not on file. /Z~. No Underwriters Certificate on file. The check is(o~/not on file.) ~.5-.OO /~/ No Health Dept. Approval on file. /Z/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Dept. ***/5/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) FIELD INSFECTION A COMMENTS FOUNDATION ~ {lst) FOUNDATION (2nd) ,m~ ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE . 4. /. I-/ /' ' '~ ' /) ~ 7 '7~ ' '~ ~ . ~_ ADDITIONAL COMMENTS: TOWN OF sOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 MLDG. DEPT. TOWN OF SOUTHOLD To Whom This May Concern, We are unable to complete your Certificate of Occupancy because,of the following reasons. /5/ An application for Certificate of Occupancy is not on file. /~.~ No Underwriters Certificate on file. /~-~/'_ The check is(ot~eeta~/not on file.) ~-~0 O /~/ No Health Dept. Approval on file. /Z/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Dept. ***/Z/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) ~ ~_6°3S/C)O' '~, ~00 0 Examined ~~ ~ Approved ~"~ ~ Disapproved a/c . . FORM NO 1 ,A TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ,19~/o , 199(o Permlt No }. ~-~ ~t ~' (Budding Inspector) APPLICATION FOR BUILDING PERMIT Rece!ved ........... ,19. Date cT oly z.. , INSTRUCTIONS a. Ttus application must be completely filled m by typewn.ter or in ink and submitted to the Budding Inspector, wltl sets of plans, accurate plot plan to scale. Fee according to schedule b Plot plan showing location of lot and of bmldings on premises, relahonsh[p to adjoining premmes or pubhc stre. or areas, and giving a detmled descnptlon of layout of properW must be drawn on the d~agram which ~s part of tlus ap.~ catmn. c. The work covered by this apphcatmn may not be commenced before ~ssuance of Budding Permit. d. Upon approval of ttus apphcatlon, the Building Inspector will issued a Braiding Permit to the applicant Such pen- shall be kept on the premises available for inspection throughout the work. e. No budding shall be occupied or used m whole or ~n part for any purpose whatever until a Certfficate of Occupan shall have been granted by the Budding Inspector APPLICATION IS HEREBY MADE to the Bmldmg Department for the ~ssuance of a Bmldmg Permit pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buddings, additions or alterations, or for removal or demohtmn, as herein descnb. The applicant agrees to comply w~th all apphcable laws, ordinances, budding code, housing code, and regulations, and admit authorized mspectors on premises and m budding for necessary ~nslxmt, m'jas. ,m - ,,~ ,,~ , (Signature of applicant, or name, if a c0rporaBon) (Marling address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build. Narneofownerofpremmes ~-J~,o va ~-//~t,/ .~4..Y? ///'~'"lY. ..... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and t~tle of corporate officer) Builder's License No Plumber's License No Electrician's License No Other Trade's License No Location of land on which proposed work will be done [louse Number Street Hamlet County Tax Map No 1000 Sectton ~ Block c~. Lot ~ ~Z. .. Subd~v,s~on ~0~ ~ FfledMap No ~ff 7~ Lot ( (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction a Existing use and occupancy / ~l/y dfi'O~-~//g--~q b. Intended use and occupancy ~ ~ l~ ........ 3. Nature of work (check which applicable) New Budding .. Addltlon .... Alteration Repmr .... Removal ........ Demolition . . OtherWork.~J~-~-.~ ...... 4. Estunated Cost ~."' ....... Fee .. . $Ot .................... (to be paid on filing this apphcatmn) 5. If dwelling, number of dwelling units ....... Number of dwelling units on each floor .... If garage, number of cars ............................... 6 If business, commercial or mixed occupancy, specify nature and extent of each type of use .. .... ,. 7. Dnuenslons of existing structures, if any Front T~L~' Rear J'"~ ! .. Depth . ~ ........ 7 t · Height [ ~( .. Number of Stones ] Dtmenslons of same structure with alterations or addltmns Front ~.J]P4~s" . . i'" l~;ar 'i ~*t~... ' ' ' ' Depth '~0'~ Height ~"]~. . . . Number of Stones . ~ ............. 8. Dimensions of entire new construction Front . .~..~' tg" .. Rear . ,5'q'.6': ..... Depth . .~.~..t .... Height ............ Number of Stones .......................... 9. Slzeoflot Front t°m Rear ,./,.~:?. : ~);;[t~ ?~.~. ....... 10. Date of Purchase ........ Name of Former Owner ......... 11. Zone or use district m whmh premises are situated 12 Does proposed construction violate any zomng law,'ordlnanc; or r'eguiatlo~ 'ii'~.b '. i i. iiiii ..... i~,~ 13 Will lot be regraded fi,2© . Will excess f'dl be removj~d from premises' Yes ~ 14 Name of Owner of premises . ~,t~, .~'~5. ''.. i.. Address ./.5'° ~5~.~o.co./.,~... Phone No..D. 6~..':~°v~. .... Name of Architect ......... Address ............. Phone No ........ Name of Contractor .............. Address .............. Phone No ............. PLOT DIAGRAM Locate clearly and dastmctly all buddings, whether existing or proposed, and indicate all set-back dnnenslons from property hnes. Give street and block number or description according to deed, and show street names and intimate whether interior or comer lot, STATE OF NEW YORK, S.S COUNTY O~Z_~_~j'~ ... ~//~ ",/~/,~' · . ,w-~. ~,e--', *-~r~ r~m,F, being duly sworn, deposes and says that he is the applicant (Name of individual s~gmng contract) above named He is the .(~) ~ .......... (Contractor, agent, corporate officer, etc.) of said owner or owners, and ~s duly authorized to perform or have performed the said work and to make and file this application, that all statements contained m th~s apphcat~on are true to the best ofh~s knowledge and belief, and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ... o~fl ........ day of..~-~ ...... ,19~ Notary Public,.... ~----~-*q'....../~..? .~, ~:.~;t..f.f,~.~ County ~ £~i~h ~11~-'? (S~gnature of applicant)