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Home My WebLink About15269-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No... Z.-15294 D February 24 19 8.7 ............ ate ...... ' ....... , · THIS CERTIFIES that the braiding D e c k A d, .d ,i,~ i o ,n . , . 1.4..5.5. .A.lb.o..D.rz.v.,e Laurel, New York Location of Property .. ..... House ~vo. Street Ham/et County Tax Map No. 1000 Section ! .2.6 Block 3 L 16 Sub&vmion ............................... Filed Map No ......... Lot No .............. conforms substantially to the Applicatton for Buri&ng Permit heretofore fried in this office dated August 29, 8.6. p hi h Bmldhlg P rmit No ...................... 19. ursuant to w c e .................. September 17, 8.6~ dated ........ _.. ................... 19.. 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 TO EXISTING ONE FAMILY DWELLING The certificate is issued to HARL. E.Y &o JOY.CE ARNOLD ................. X ................... of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO ................... N./. .~. ......................... . . Rev. 1/81 ~'O~l,~ NO. 9 TO~N OF SOUTHOLD I~UILDING DEPARTJ~ENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 15269 Z Date ......................... !..7.. ............ Permission ~s hereby grontedlo~ __ d... / '~Tax No -- .~ I,~ Block ...... ..(~.....'~... .... Lot No....l...~ ...... County Map 1000 Sectl~k. ~'--. pursuant to apphcatlon dated .k~~. ;~.~ . . , 19.-~..(~, ond approved by the Building Inspector Building Inspector Rev 6/30~80 FO~ NO. 6 TOWN OF 8OUTHOLD Building Department Town Hall Southold, N.Y, 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Thru apphcatlon must be fdled in typewriter OR ink, and submitted m ~ to the Building lnspec- tor w~th the following; for new buildings or new use: 1. F~nal survey of property w~th 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 disposal-(S-9 form or equal). 3. Approval of electrical Installation from Board of F~re Underwriters. 4. Commercial buddings, Industrial buddings, Multiple Remdences and similar buddings and installa- t,ons, a certificate of Code comphance from the Architect or Engineer responmble for the building. 5. Submit Planning Board approval of completed rote plan requirements where apphcable. For existing buddings (prior to Aprd 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 topograph m features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buddings. 3. Date of any housing code or safety inspection of buddings or premises, or other pertinent mforma- t~on required to prepare a cert~hcate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelhng $15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.C. $5.00 5.Updated C.C. $15.00 Date .... g ............ NewConstructzon ..... Old or Pre-exmt~ng Budding ......... Vacant Land ............. Location of Property....x/..~..~..~.. .......... ~..~..'% .......... . ,/~..~, .~.~....~.. ......... House No. Street Ham/et Owner or Owners of Property ..................................................... County Tax Map No. 1000 Section ./?~...~ ..... Block L~ Lot....~...o~. Subd~v,sion ............................ Flied Map No .......... Lot No ........... Permit No ....... Date of Permit . .Apphcant ..................... Health Dept. Approval .................. Labor Dept Approval ........................ Underwmters Approval .................... Planning Board Approval ...................... Request for Temporary Certificate .................. Final Certificate ....................... Fee Submitted $.. -~'- .~).,~ ................ Construct)on on above descmbed building and perm~t.~eets all appljca, ble codes and regulattons Apphcant .... ~ .(~7..~ ............................ II d ¢ ::X if' 0 ,0 FIELD Ih ~PECTION FOUNDAT!O~ (1st) COMMENTS FOUNDATION 2. ROUGH FRAME & PLUMBING (2nd) INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FINAL DATE: INSPECTOR ~~) FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~°OUTHOLD, N.Y. 11971 TEL,: 765-1803 Disapproved a/c Approved ~.~'~. ]'l, I9 ~$Permit No J ~. ~. ~ ~ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Recezved ........... ,19. a. Tlus application must be completely filled in by Wpewnter or in ink and submitted to the Building Inspector, wltl sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showmg location of lot and of buddings on premises, relationship to adjoining premises or pubhc stre or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of thts ap cation c. The work covered by tins application may not be commenced before issuance of Budding Permit d. Upon approval of tins apphcahon, the Bmldmg Inspector will issued a Budding Permit to the applicant Such per~ shall be kept on the premises avmlable for inspection throughout the work. e. No budding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupm shall have been granted by the Building Inspector APPLICATION IS HEREBY MA~DE to the Budding Department for the issuance of a Bmldmg Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance- Regulations, for the construction of buddings, additions or alterations, or for removal or demolition, as hereto describ The applicant agrees to comply .w~th all apphcable laws, ordinances, budding code, housing code, and regulations, and admit authorized inspectors on premises and m budding for necessary inspections ~..s...~/,fi//.z~.~ (~lgnature of applicant, ~; ~lam~, ~f ~ corpoiat;(~n') State whether applicant is owner, lessee, agent, architect, engineer, g~ae. ral contract.~r, electrician, plumber or buff, (as on the tax roi1 or latest deed) If applicant Is a corporation, signature of duly authorized officer 2 (Name and tatle of corporate officer) Builder's License No .6/"? ~.~. .... Plumber's License No Electrician's License No Other Trade's License No Location of land on which proposed work wall be done / House Number Street County Tax Map No 1000 Section /~.,L. d .... Hamlet Block .3 .... Lot. /.6"... Subdivision Filed Map No ..... Lot (Name)' 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 ................... 3. Nature of work (check which applicable) New Building ........ Addition Y.-....... Alteration ....... Repmr ...... Removal .......... Demolltlon .......... Other Work ............. (Description) 4. ~st~natedCost. ~..~ ...................... Fee. . ..~.- ......................... (to be prod 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, commercial or mixed occupancy, specify nature and extent of each type of use .................. 7. Dnnenslons of ex~stlng structures, if any Front . Rear ........... Depth ........... Height .......... Number of Stones ..... DunensIons of same structure with alterations or additions' Front ............. Rear ........ Depth ............. Height ........... Number of Stones .............. 8. Dunenslons of entire new construction Front .......... Rear .............. Depth .. Height ........ Number of Stones ......................................... 9. Size of lot Front ........ Rear ................ Depth .......... 10. Date of Purchase .............. Name of Fermer Owner ...................... 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation' . ..................... 13. WflI lot be regraded ................... Will excess fill be removed from premises' Yes I~ 14. Name of Owner of premises ............ Address .............. Phone No ....... Name of Architect . . . Phone No. Name of Contractor .d~o~. /.~c~'.~. '~2. i' iii .' Address ............ · . Address ~.(,X~ :/,'7~i 5. ~. Phone No. ~.~.~.~. ~.~ ~ * Yes ..... No ..... 15. Is this property located withmnt00 feet of a tidal wetland? * If yes, Southold Town Trustees Permit may be required. PlOT DIAGRA~ Locate clearly and distinctly all buildings, whether existing or proposed, and~ indicate all set-back dn'nenslons fro property hnes Give street and block number or descnption according to deed, and show street names and indicate wheth interior or comer lot STATE OF NEW YORK, COUNTY OF ......... S.S (Name of individual signing contract) above named ..... being duly sworn, deposes and says that he is the applic 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 file apphcatlon, that all statements contained m this apphcat~on are true to the best of bas knowledge and belief, and that work w~l be performed in the manner set forth in the application filed therewith. Sworn to before me thru ....... d ~ ..... day of... NotaryPubhc,. ,.~_,.e~o. ~. /0. ~.~.~.Q.. County. ttl(I ~..~... ,~ ~"~.~,..,.~ ..................... Ne. 4"~7~. Suffolk .C,~. ~YI~7 (Signature of apphc