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Home My WebLink About14942-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ............... Date .................................. THIS CERTIFIES that the building Ad.d~t~on . Mattituck Location of Property .... J ~ ~p. T~ .s .t..IS~_.l .~..Rp.a.d ........................................ House Ho. Street Hamlet County Tax Map bio. 1000 Section .. )96 ....... Block .. )9 ........... Lot.. 0..0.2:.2 .......... Subdivision ............................... Filed Map No ......... Lot No ............. . conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... May. JP ........... 19.8.6. pursuant to which Building Permit No. J 6. .9 6.. .2 .z ............... dated }l .u p .e . .1.6 ..................... 19.8.6., 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 ......... Co.n.s.truc.t .d.e.ck addition to existing dwelling. The certificate is issued to ... JAMES. AND. LIND& ~/Obggg;r ................................. (owner,~t~c~R~FAt) of the aforesaid building. Suffolk County Department of Health Approval .~[.~ UNDERWRITERS CERTIFICATE NO ................ N/A ............................... Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 14942 Z Date ........................... ~ ....................... Permission is herebt granted to: .... ..... ...~..~.~.~.....~...:.~......~.L~.....~-- ,o ......~.~,.~.z~'~.~........P.~..~..~.~.~.,.~.o~.....~..~......~......<~ .................. .,7~,,~.&., ~ ............. z .... ot premises located at ..~....~..~......~~'~./..~.~...~i~.,....~.'~.~..~--~'.~,~ (-~ County Tax Map No. 1000 Section ..... ./...~...(~ ..... Block .... .d,~. ......... Lot No...~....(~...0¢?:....~.. ~r~,, to ~p..~a,,on dated .... ,~.,t~......../..~. .................... , ,~J~.., ond oppro~ ~ ,~e Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department ...... Town Hall TOWN of SOUTHoLD eceipt NoJ;n, INSPECTOR Town Hall Southo~d, New Yor~ ~'" · ~'"' ~'7 ........................................ '" ........... ~ .......... :...~.~ ~ /~ ~ · .................................... . . ~ ~ ~ .............. g.~.~..~ ................................... ' ........ .... . ....................... H-LC' ~C h 2. Certificate of occupancy on pre-ex~L.,u ......... . 3. Copy of certificate of occupancv $1.00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 New Cons t ruc t i on ...... Old or Pre-existing Building Loc~tion o~ ProperW ....... Fee for ~--~. _tificete ~8uilding Permit ~ of Occupancy ~Misc. Date ..................... ~ .... Vacant Land ' House No. Street Ham/et Owner or Owners of Property .... (~ U~ .Y:~ ?. $.. T'...~./../2.'42/-~- .................. County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No..!q.~ .~. ~ Date of Permit ~../~./~(% .ApplicanJ, g~. 4~../~..'. ~'~). ~ ./~.... Health Dept Approval Labor Dept Approval ~ Underwriters Approval ........................ Planning Board Approval ................. i .... Requast for Temporarg Certificate ..................... Final Certificate ....................... Fee Submitted $..,~.~. ~.~. ...... ~ .......... Construction on above described building an_~ermit_ meets all applicable codes and regulations. Applicant. ~., ~?..d~, .t~,..., ,'~.% ~..4~.-~9 .,,~/ ............. 76S-~180,~ BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING .4 ] fINAL REMARKS: ~ FIELD INSPE~TIO~ DATE COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ,~----~ _ ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE " ADDITIONAL COMMENTS: 'FORM NO. ,I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL BLDG. DEPT. TOWN OF $OUTHOLD Examined. ~/~'~A~...' ........,19~. · ~' Received ........... , 1 9... Approved .~./.~....~. ...... , 19~. Permit No./ff~. ~..,~"-"'~ ~ Disapprove~ a/c ...... :~ ................... ....... ................. APPEICATION FO~ BUILDING PERMIT Date .~...[~.., 19~ 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 buildings 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, housingxode, and regulations, and to admit authorized inspectors on premises and in building for necessary i spections. '~'~'~u~nature 9~ applicant, or name, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nameof owner ofpremises ...~...~..~..~..~*. · .~..~ ..... -~- '~' .'~.~.~.~. ~/ ~.. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ....... l~l~..--. ~ .... Plumber's License No ...... .~.~.~ ............... Electrician s License No ................... Other Trade's License No... ~.~. · .~. ............. I. Locationoflandonwhichproposedworkwillbedone. .l .C~. . . .~. .~.. . .~. .{.[Jt..~.~.. ..~. . .~. ..,t .............. · ............. ...... House Number Street Hamlet County Tax Map No. 1000 Section ..... /.Q.~. ...... Block ..... /..~. ........ Lot ....... --~.,.'*.'.0~..... Subdivision .......... --'~/~' '(~'a}~) ................ Filed Map No...AT/~.-- ........ Lot .... .~./.'~-. ..... 2. 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 . ~:P .~. /~..~.~ .~.~..~."~.-~.... ~47AJ.~..~..d~..~../~.'...~ ........... ~..'.~. 3. Nature of work (check which applibable): New Building ...~./..~. .... Addition .i?.~./? .... Alteration.., ~ .~.~./~ Repair .... ~.'~ ...... Removal .... ./~. ..... Demolition .... ~'f~-.. ~.... Other Work...~t~. ~ ~ ~ ~ (Desc'fiption) 4. Estimated Cost ....... ./.Q.Q .......................... Fee ......... ; ............................ ' (to be ~aid on filing this a~lication) 5. If dwelling, number of dwelling units .... f~ ...... Number of dwelling uniis on each floor...~ ......... If garage, number of cars .... ~ ......................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of uso .... ~. ~ ~ ~ ~ ...... 7. Dimensions ~sting structures, if any: Front ..... ~ .... Rear .... ~ .... Depth... ~/~ ....... Hei ht ,~ r ' ~ ~ g .... ~ ........ Numbe of Stones ...... ~: ............ ~ .... : .............. ~ ........... . D~ensions o~me structure with alterations or additions: Front ....... ~. .... Rear... ~ ....... Dep~ ....... ~ .......... HeiSt ..... ~ ........... Number of Stofies .... ~~ ..... 8. Dimensi?s of entire new const~ciion: Front .... ~,~ ...... Rear ..... ~-.Z~.. Depth -~ ]~., Height ~ .~r~. ~*~Number of Stories ..... ~/~ ................ ( ~ ................. ~ . 9. Size of lot: Front /~(..[~ ..... Rear ..... 7~*.~ / Depth ~ 10. Date of Purchase ~--~q 7~( NameofFo~r'~Lk[~'~;~'~ ~'~-~ 11. Zone or use district in which premises are situated.. ~ ~ ~. ~ ..... , ............................ 12. Does proposed construction violate any zoning law, ordinance or regulation' ~ ~ ~ 13. Will lot be regraded ..... ~ O. ....... . ............ Will excess fill be removed fr~ premises: Yes 14. Nme of Owner of premises ~ ~.~ ~.~ Address I~.~.~C~s~(~, Phone No. ~ 7~ ~.~ .......... ............. ...... ' N~e of Contractor ......... ~/~. Address ~ , ~ ' , Phone No, 15. Is this property located within 300 feet of a ~idal wet'and? e Yes ..... ~ Yf yes~ Southo~d To~ Trustees Permit may be required. PLOT DIAG~ Locate clearly ~d distinctly ~1 bufld~gs, whether existing or proposed, and, indicate ~1 set-back d~ensions from property lines. Give street and block number or description according to deed, ~d sho~ street n~es and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF .............. .......... ~..'Z~'~. ~...~,~.. ~..:...~...Q?..~...O~....'?~.... being duly sworn, deposes and says tha; he is the applicant (Name of individual signing contract) above named. He is the .... (Q..O~..-.~ ............................................ , ............................ (Contractor, agent, corporate officer, of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his !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 ............... ,~.t' ...... dayof ...... . .~7.. ;o-gj ......... , 19 .~...-~.,~ / Notary Public, . .... ~&}~-~..--~-.. z~.- .... 4~.'9..d/~-. County ~~_-~~