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Home My WebLink About14918-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z-15715 Date May I, 1987 THIS CERTIFIES that the building Deck Addition to existing one family .... d~i'l'ffi~ ................................... Location of Property ...4..6.0.5...Rp.b.i.n..sP.n..R.p.a.d .... Southold, New York House No. Street Hamlet County Tax Map No. 1000 Section 08 1 .Block 0 I . .Lot 2 4.5 Subdivision ............................... Filed Map No .......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Flay 19, 1986 14918Z ...................... pursuant to which Building Permit No ...................... dated May 29, 1986 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 AS APPLIED FOR. The certificate isissued to GASTON J. CRIBLEZ ..................... /o¥.'e;, ?~b';c/~(~;~x x ................... of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... N/A UNDERWRITERS CERTIFICATE NO .................................................. PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 FOB~ NO, 0 TOWN OF $OUTHOLD 8UiLDtNG DEPARTAAEHT TOWN HALL SOUTHOLD, N. ¥. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? i4~iS Z Date Permission is hereb/granted to: .... ....... ............. .... ~..,..,o. ....... ~...~. ...................... .....~..~:.~.:.~.:....LL~..7...I. .......... /,q , at premises located ot .....~........!..~.~~....,~....-...dJl..,~.-.~-..,~...J....-~ County Tax Mop No. ]000 Section ...,.O....~...I .......... Block ...... ,O....I .......... Lot No...~,..~,..'..,~...'-~.. .... Building Inspector. Fee $.~...t~ and approved by the Building Inspector Rev. 6/30/80 Bullding Depart Town HallI ,~ , , Southold, N.Y. 1971~-' , 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted g ~ammmm to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with 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.Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5.Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings end "pm-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 buildings. 3.Date of any housing code or safety inspection of buildings or premises, or'other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory.~$10.00 Business $50.00 2. Certificate of-occupancy on pre-existing dwelling $ 50-. 00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.~0 / 4,Vacant Land C.O. $ 20.00 5,Updated C.O. $ 50.00 Date .... ''' '' "-~//..~/./~..~.. NewC°nstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .............. House No. Street Hamlet Owner or Owners of Property ....~. a~'. 7~. % ............................... ...... County Tax Map No. 1000 Section .... 0~../ ....... Block.../ ........... Lot..~...~. ~ .... Subdivision ................................. Filed Map No ........... Lot No .............. Health Dept Approva~ , Labor Dept Approval Underwriters Approval ........................ Planning Board Approval ...................... Request for Tempgrary Certificate ........... K ......... Final Certificate .,, X ................ Fee Submitted ...................... Construction on above described building and perm~y~e codes and regulations. Applicant...,,~.~. · ¥~--~,O~ ......................... Rev. 10-10-78 C0% FIELD INS~ECTION FOUNDATION (1st) COMMENTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS·. BLDG. DEPT, TOWN OF SOUTHOLD 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [~-~L REMARKS: ~. ~~:~¥ .... DATE '~//~//~' INSPECTOR 7GS-~.802 BUILDING DEPT. 1ST [ ] ROUGH DATE "~/~"~/~'~// INSPECTOR FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765d80:3 Examined.~,,,-,,,.. c~ .l~./..~Wp&k .i' ., Approved ~ ~..~.4.., 19~..~. Permit No. ) .~ .~. ' .~.~ . Disapproved a/c ..................................... TOWN OF SOUTHOLD (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildh~gs on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available 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 Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in btfilding for necessary inspections. J__~__--~ ,~ .~ , State whether applicant is owner, lessee, agent, ~chitect, engineer, general contractor, electrician, plumber or builder. Name of owner ofpremises . ~_~4c,4q ~)' Ce- (as on the tax mil or latest deed) If applicant is a corporation, signature of duly authorized officer. Builder's License No .......... 3.1~.[ .~..'. ...... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ..... ...... ........... House Number Street Hamlet County Tax Map No. 1000 Section ...~. [ ............ Block ...... ] ........... Lot...~..Z/?....~. [ ....... 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 ....... ~ff..~ .................................................... b. Intended use and occupancy ...... ~.~. · .2/~...: .................................................... i 3. Nature of work (check which applicable): New Building .......... Addition.· ! ........ Alteration . .~-~ .... Repair .... ~ ........ Removal .............. Demolition ........... !... Other Work ............... ~, (D riptio j eSC I 4 Estimated Cost ....................... Fee ...... ' ...................... (to be ~aid on filing this application) 5. If dwelling, number of dweiling units ....... Number o f dwelling units on each floor .............. If garage, number of cars ............................................ i ............................ 6. If business, commercial or mixed occupancy, specify nature and extent of each tv~e of use ........ 7. Dimensions of existing structures, ifany: Front .... ~.~.f.--.ff. ff.. Rear ~.~.v.~.~/.~# Depth'' '~.'~7-1~U" ' Height ..... /.~..t. .... Number of Stories ....... i.~. .......... .255.,25,!2,52552 ...... 551.152·5.15--- ...... Ct- ~' t& /r"' Dnnensmns of same ctruc~tture with alterations or additions Front ...../'f: .... ?. ~.. Rear .... .'/~.~' '. ~.. Depth ..... o~./~'. · · 2~ ........ Hmght ........ ~. ............. Number of Stories ...... ~ ............. 8. Dimensions of entire new construction: Front ............... Rear ........ ] ....... Depth ....... ........ Height ............... Number of Stories ............................ ' ............................. 9. Size of lot: Front ....... ?. ~&~'.O.7. ~. .... Rear ...... /../.7.: ~.,~,.. ......De~th .... ~ ~.3, O .~'. ....... 10. Date of Purchase ../~.q.~.'.. ~... ~.~'.~...~. ....... Name of Former Owner~'~'~../~.,..~. ~.~ ......... i 1. Zone or use district in which premises are situated ......................... i ............................ 12. Does proposed construction violate any zoning law, ordinance or regulation: .... ! ............. ~ ......... 13. Will lot be regraded ....... ~' ../~..O. ! '~,~' '~' · ...... Will excess fil~l b9 reft)oreO from premises: YeS 14. Name o'f Owner of p.r.e, mi, s~s (~,~$g~rr~J:. q-k t (~/t .~.. Address ~7~:1~ .g~('~--/~,,* ~..... ~cht,q~No. ~.,(.~ .~.--~.,~. Name of Architect /,qcd/~4~ t~[.o .,~..,~.../....,,~../. ~ Address~ .~..r!i~..,~,,..e~.,~.~.t.~.~..t~. ~t{one No. ~..t'.~.-7.4~. 7 Name of Contractor .... 0 t4'...*~.. ~t~*,~ .~....C~.rt)(~ Address 2~..~..~?...~..~. i .... Phone No. 2/.~.~'.a. ~..:/./..>~.. 15. Is this property located within1.00 feet of a tidal wetland? * ~es ..... ~o . ~... · If yes~ 8outho~.d Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and sho~ street names and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................. · '.~.'~ "~..."~-....'>?.:....~..~'~.~. ..~ .f.~.__.~ ............... being duly sworn, depo!es and says that he is the applicant (Name of individual signing contract) above named. .~. ' He is the ............................................... ; ....................... (Contractor, agent, corporate officer, etc.)! I, of said owner or owners, and is duly authorized to perform or have performed the sa~d work and to make and file this application;that all statements contained in this application are true to the best of hisi 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 ............ {. ~ .day of ............ ,19.. Notary Public ..................... County ................................. 80ffiff ~ (Sight're of applicant) 1 FOR POURED CONCRETE 2 ROUGH FRAMING & PLUMBING 3, INSULATION 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O, ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y ·rATE CONSTRUC~ION & ENERGY CODES NOT RESPONSIBLE FOR ~IGN OR CONSTRUCTgO~ ERRORS. USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY ORAWNI CHKD: DATB~ 4,'7,~ , I' 'L, '1' , , I ' I ~TtN6 AN~ NE~ ~AC ~S ~AY RE RFmU~RF~ NEW vo.K ~T.~ co~..~. ' ~ ~. 1 I +l REV: DATE: DRAWN: CI-IKD: '/F ENGR: