The URL can be used to link to this page

Home My WebLink About15271-zFORMNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No Z-15186 Date January 9, 1987 CHILDS PLAYHOUSE ADDITION TO AN ACCESSORY THIS CERTIFIES that the buridmg .. 'BU I LB TN ~: .............................. Locatxon of Property 8.0. Ja..c.ksqn..S.t.r. eet ......... N. ,e.w.S..uf.f.o.l.k..,..N.: .Y.....C.o.t,t.a.g..e House No Street Nam/et County Tax Map No I000 Section . [ I .7 ...... Block .. l .0 ........ Lot .. ! ............ Subdivis, on .................. Fried Map No ....... Lot No .......... conforms substantially to the Apphcation for Buridlng Permit heretofore fried in this office dated August 27, 1986 ~.pursuanttowt'achBmldmgPerm~tNo. 1527tZ dated . September. . ... ...17'...1986...... , was msued, and conforms to all of the requ,rements of the apphc~le provistons of the law The occupancy Ar w~ch tls certfficate is Issued is ...... CHILDS PLAYHOUSE ADDITION TO AN ACCESSORY BUILDING KIMOGENOR POINT CORP ( KENNETH W. AKESON) ...... ~de;, ~&~ &~ ............... The certzficate ts tssued to of the aforesaid budding. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS Rev 1/81 CERTIFICATION DATED: NIA TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PEILMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15271 Z Map No 1000 SectJon~ .. t,/..~..... Block ................ ..'~..,'~.- County Tax I. ~ ........ Lot No..! pursuant to appJlcat,on doted ~ ~J~ '~ , 19..~, and approved by the Budding Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions Thru application must be filled ~n typewriter OR ink, and submitted I Immm~m to the Building Inspec- tor w~th the following; for new buildings or new use: 1. F~nal survey of property w~th accurate 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. Commercml buddings, Industrial buddings, Multiple Residences and simdar buildings and installa- tions, a certificate of Code comphance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed rote plan requirements where applicable. For existing 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 previous owner as to use, occupancy and condition of buddings. 3 Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- t~on required to prepare a cert~fmate. C. Fees: 1. Cert~hcate of occupancy $25.00 -- BUSINESS $50.00 2. Cert~fmate of occupancy on pre-ex~stmg dwelhng $ 50.00 3. Copy of cert~fmate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ......................... NewConstruction ..... OIdorPre-exmtmgBuildmg ............ Vacant Land ........... House No. Street Earn/et Owner or Owners of Property ....... ?'..../.-~. ~.~.~ ~.~<~'. ................................... County Tax Map No. 1000 Section/./.7. ........... Block . ./.D. .......... Lot .~. ............. Subd~wmon .......................... Fded Map No ....... Lot No ............. Perm,t No. 1~1.~1. ~: .... Date of Permit .~./I~.L¢~....Apphcant ................................. Health Dept. Approval ..................... Labor Dept. Approval ....................... Underwmters Approval ..................... Planning Board Approval ...................... Request for Temporary Certificate ................ Final Certificate ....................... Fee Submitted $ . ~, .c~J....(~ ii.3 ......... Construct,on on above descr,bed bu,ld,ng an~t meets all ~:d regulations.~'~" '~-~'~' ' Apphcant ........................ Rev 10 10 78 FiELD INS~ZCTIDN DATE COMMENTS FOUNDATION { 1st} FOUNDATION (2nd) ROUGH FRAME & PLUMBING · k'~ INSULATION PER N. Y. STATE ENERGY CODE · ' ' ~ /~ '~ ~-~ / / FINAL ADDITIONAL COMMENTS' FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N Y. 11971 TEL: 765-1802 Examined Dtsapproved a/c ........... No J (Bulld~ng Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... ,19.., a. Ttus apphcat~on must be completely filled m by typewriter or in ~nk and submitted to the Bmlding Inspector, w~th sets of plans, accurate plot plan to scale. Fee according to schedule b. Plot plan showmg locatmn of lot and of buddmgs on pr~m~ses, relationship to adjmmng premises or pubhc street or areas, and g~vmg a detmled description of layout of'property must be drawn on the dmgmm which ~s pa~ of thts apph carton c. ~e work covered by t~s apphcat~on may not be commenced before ~ssu~ce of Budding Permit. d. Upon approval of tlns apphcat~on, the Bmld~ng Inspector will ~ssued a Bmldmg Pem~t to the apphcant Such pem~ sh~ be kept on the premises ava~able for mspectmn throughout the work. e. No bmldmg shall be occupied or used ~n whole or ~n p~t for any purpose whatever until a Ce~ificate of Occup~c! shall have been granted by the Bmldmg Inspector. ~PLICATION IS HEREBY MADE to the Braiding Dep~tment for the ~ssuance of a Bmld~ng Pem~t pumuant to th Bmlding Zone Ordinance of the Town of Southold, Suffolk County, New York, md other apphcable Laws, Ordm~ces o Regulations, for the constmctmn of buddings, additions or alteratmns, or for removal or demohtton, as here~n described The apphcant agrees to comply w~th all apphcable laws, ordinances, budding code, housing code, and regulatmns, ~d ti admit authorized mspectom on premtses and m bmldmg for necessa~ ~nspectmns (S~gnature of appbcant, or name, if aForporat~~) (Mamng address o[ appucant) State whether apphcant ~s~lessee, agent, ~chztect, engineer, general contractor, electricmn, plumber or budder Nme of owner of premzses ~O g~ ~ ~ ~... (as on the tax roll or latest deed) If apphcant zs a co~oratmn, szgnature of duly authorized officer (Name and tztle of co~orate officer) Bmlder's Lzcense No Plumber's License No Electnman's License No Other Trade's Lmense No Locatmn of land on which proposed work wall be done House Number Street Hamlet County Tax Map No 1000 Sect,on //7 Block .. .~.~ ..... Lot. Subdiv]smn. Fried Map No ..... Lot (Name) State ex~stmg use and occupancy of premises and ~ntended use and occupancy of proposed construction a Exlstlng use and occupan, cy ~ .~t~ro~ .4- ~ .... . . c, zo4. d //-a2 / ........ b. Intended use and occupancy 3. Nature of work (check which applicable) New Building ...... Addition ..... Alteration · · Repmr ..... Removal .... Demolition ~er Work~.. ~ · (DescnlMlon) '8. 4. Estimated Cost .......................... Fee ............................. ~ ~6,6~9 ' (to be paid on fihng this application) 5. If dwelling, number of dwelling units ... fi/O ..... Number of dwelling units on each floor ........ If garage, number of cars .... ~O ...................................... 6 If business, commercial or m~xed occupancy, specify nature and extent of each type of use ....A/~. .......... 7 Drmenslons of structures, any Front. ...AJr~.. . Rear ........... Depth... Height ......... Number of Stones ...................................... D~rnenslons of same structure with alterations or addmons Front .............. Rear ........... Depth ............... Height ............. Number of Stones ................ D~menstonsofentxrenewconstructmn Front ..... ~.' Rear .... ~..Z .... Depth .. ~' Height ...~..8.".. . Number of Stones . t. . . i .............. ' ................ 9. Size of lot Front ............ Rear .............. Depth .............. 10. Date of Purchase .. (/~ .......... Name of Former Owner ..................... I 1 Zone or use district m which premmes are situated .......................... 12 Does proposed construction violate any zomng law, ordinance or regulation A~.~. ........................ 13. Will lot be regraded .................. , . Will excess fill be remo'le.d from premises: Yes I' Name of Contractor ............... ~ a~a,~O~.~?'- Phone No ~47.. . . 15. Is this property located within 300 feet of a tzdal wetland? ~Yes ..... No ..... *If yes, Southold Town Trustees Permit maybe required. PLO~F DIAGRAM Locate clearly and dmtmctly all buddings, whether existing or proposed, and. lndlcate all set-back dtmenmons fro property hnes Give street and block number or description according to deed, and show street names and indicate wheth mtenororcornerlot ~ ~--f,,t_~ ~Lt'~ ~ /,'~('4 - , STATE OF NEW YORK, S S COU~Y OF .............. ............... being duly sworn, deposes and says that he ~s the apphca (Name of ~nd~wdual mgnmg contract) above named He is the ....................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file ti application, that all statements contained m thls apphcat~on are true to the best of his knowledge and behef, and that work wall be performed in the manner set forth m the apphcatmn filed therewith. Sworn to before me thru ......... d 7... dayof. Notary Public, ~..~/~ ii ~.~lZ i .~.f~-.' 'C2~nty ' ' ......... (Signature of' apphcm