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Home My WebLink About14959-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No .... Z247.1.1 ........ Date .......... .J.u.~.y..2.5. ............. ,19 .a. 6. THIS CERTIFIES that the building ..... s..c .~.e.e.n.. p.o?. c..I)..e.x. ~ .e .n?.~. o..n ................. Location of Property ,.....8.3.6 0. ....... 9??. ~...~. ?,e, c. 9 .n.i.q..B .a F,.B..1 ¥.d.. ........ ~.a.~.~. ~..~ .u.c.k.. Mouse No. Street Ham/et County Tax Map No. 1000 Section ..... .1.2.5....Block ......... 1. 1. .... Lot ..... .2.0 .......... Subdivision ............ .X .................. Filed Map No .... X. ....Lot No ....... X. ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated .~ .aT..3. 0. .............. 19 .8.6. pursuant to which Building Permit No. q 4 9 5 9 g dated ...... ~.u.n..% .9. ............... 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 ......... Screen ~orch extension The certificate is issued to JANET P, REDHEAD (owner, I~c~ ~g ~f~ of the aforesaid building. Suffolk County Department of Health Approval ................ ~ ./.A ....................... UNDERWRITERS CERTIFICATE NO ........................ ~ ./.A ....................... Rev. 1/81 Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALt. SOUTHOLD, N. Y. BUILDING PERMIT CTHI$ PEP,~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 14959 Z Permission is hereby granted to: ......... ~...£../.~~ ......... Coun~ To× Mop No. J000 Sectio. .... Z..~.~ ...... B,o~k ....... /...! ......... Lot No..,~..~.. .......... pursuant ,o application dated ...... ~.~/L~? ........... ~.....~........, 19~..~'., and approved by the BuiJdJng Inspector. Bui ding nspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hale Southold, N.Y. 11971 765- 1802 APPLICATION FOR instructions A. This application must be filled in typewriter OR ink, and submitted ,- ~ 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 featu res. 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 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 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: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 $15.00 ~, ~ ....... Date . ~/..~. ............... NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. kocationofPro ert o~J~o '"~c~.~'c: /~z.~.. /~:~{L.,)~'t~, ~t~[~ P Y ..................... Ho~se No. -- Street Hamlet Owner or O~ner, of Property ~~..~ ........................................... co..~v ~.~ M., ~o. ~o0o S.c, ion .... ~ ...... ,,o.~ ..... (4 ........ ~ot. Z.~ .......... Subdivision., /~ ~ .Filed Map No. .Lot No. Health Dept. ~roval ........................ Eabor D~t. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ......~. .............. ,,. ..... Constru. ction on above described building a[:u~ permit meets all app. Lisable codes and regulations. (~'~:~ ~'~'/L~I ~- Applicant ..~-.~~~.~ ............... Rev, 10-10-7S FIELD INSI~ECTION FOUNDATION (1st) COHHENTS FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 7GS.'1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [~ ] ~.ATION FRAMING ~r.~]~FINAL REMARKS: INSPECTOR .~~/~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTIVlENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examine~. · q .... ,19~..~ Approve~ .C~...~. ..... 19~.~. Permit No. ]. Disapproved a/c ..................................... Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ...~.....c~.Q. 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, housing code, and regulations, and to · ..~/.v"'~'"~'""-~"'":";;'id~ .... · . ~tlr~ ;f .a.pylif~?t.,.~~ 7~m. 7,. if.~ ~Tr.p.. ?t.'...)... State whether applicant is~lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............ .... /~ (as on the tax roll or latest ) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .... Plumber's LicenseNo ......................... Electrician's LicenseNo ....................... Other Trade's License No ...................... ~.~.. ~.~..~--~. ~..~.~.-e~Z~,..'~..~.~ 1. Location of land on which proposed work will be done. ,.../..~ ~: ~/....~... r~...~.~.*.~.. .//.-.. House Number-~"f ~ Street Hamlet County Tax Map No. i000 Section . ./A.~ ........... Block .~ .......... ' ..... Lot"~ .............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~,~.~'. ........ ~ .~.. ~ ...... u. i~t~na~ ~. ~ occup~ .................. 3. Ng0are of work (check which applicable): New Building .......... 'Addition .... Alteration ......... R, epair .............. Rem~oval .............. Demolition .............. Other Work ............... .~ -, (Description) ......... '; '"'f ............. (to be paid 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. Dimensions of existing struetuJes, if any: Front ............... Rear .............. Depth ............... · Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ................... !... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height Number of Stories 9. Size of lot: Front .......... i ............ Rear ...................... Depth ...................... 10. Date of Purchase .............................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12 any zoning law ordinance or regulation: · Does proposed constructmn w01ate ................................. 13. Will l¢t be regraded ........ ~ .................... Will excess fill be removed from premises: Yes No 14 Name of Ow fp emises : Addre Phon No · ncr o r .. .................. ss ................... e ................ Nam6 of Architect ' Address Phone No Name of Contractor ........ i .................. Address ................... Phone No ................ 15. Is this property located within 1100 feet of a tidal wetland? * Yes ..... No ..... · If yes, Southold Town T~ustees Permit may be required. · PLOT DIAGRAM Locate clearly and distinctly , I1 buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and bloc ~ number or description according to deed, and show street names and indicate whether lntertor or corner lot. STATE OF NEW YORK, i S.S COUNTY OF .................. ............................ : ..................... being duly sworn, deposes and says that he is the applicant (Name of individual si~ning contract) He is the. ~-~..~.~. ~..~.. :..~ ........ (Contractor, agent, corporate officer, etc.) of said ov~er or owners, and is doly authorized to perform or have performed the said work and to make and file this application; that all statements contained in thts 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 .............. · ~.~ ....... day o.f .... .~....~.. .......... 197.~.