The URL can be used to link to this page

Home My WebLink About14974-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z ]5.]64 D January 5 19.8.7 No ................. ate ................................ , · THIS CERTIFIES that the building D e c k . Location&Property 5 10o 'MAIN ROAD : LAUREL I:lD~s~ Ho: ....................................................... Street Item/e* County Tax Map No, 1000 Section 12. 5. Block 03 ..... Lot .01.4, Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated JRt.e .~ 19.8.6 hi hB ildi P rmitN 1.49.7..4.Z ......... .................. , .pursuanttow c u ng e o ........ dated .J u n e J .0 .............. 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 ig ......... .Deck add. itio. n t.o ex~,stin.g dwel.ljn, g. The certificate is issued to ...... ~. BAR~...a..~.~.g.~ .¢ARLI~ ..................... of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO ................ N./A .............................. Rev. 1/81 / J~fiilding Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING CTHI5 PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTEIORIZED) Permission is hereb/gronted to: ...... ..~..~.~z,~..~~.....~.~~ ..... .;~.~./.../.~......~,~,~ ......... ..A/~.c~.,...~:~......~.r..~-4.... ko ...~.~T......~.~...~~.....~....~.~ ........... ..... ~ ......................................................................... ~ ........................ 7. .......... ~, ~,~ ,~,~/~, ...~.~.....~~...~.~ ............. ~~ ................ County Tox Mop No. 1OOO Section /..~..../'.~.."~... B~ock ...~.. ~ LotNo pursuont to application doted ..~7~i ii ;~ .......... i'.ii'.i.iii17";'~.., ond' ~7~TJ'"~"~e Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ,~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions ~r~ 2 9~86 in duplicate TOWN of SOUTHOLD OFFICE OF BUILDING INSPECTOR Town Hall Receipt NO,3 1 05 4 SoutholO. New York 11971 O ,e ....... ..................... ................. .............................................................................................. o~ .... ~.~..o.~.x...t.~rz~.¢ ......... ~..~ ........ ~....~ .................. Fee for Fee for rq V,rd S~e [][] ~Ch~ok 3"16 .................. ~..~...o...~ ................... Fee for Fee for i_:._j,,~r~ficate [] ~.l.c. []~i~di~ Per~t L~ of Oc~ancv [] ~isc. Building Inspector House No. Owner or Owners of Property . .~../~./~/Y../.~ .... County Tax Map No, 1000 Sect op .. ~..~..~.~'. .... Location of Property ...... ~ .~.~..'~. ............................. Street Ham/et /./. .~.~'z. . ?. ?. ...... ~ . ..,~-:. . .~. . z. .,,K .............. .. Block .... ~..~. ...... Lot .... ~. Z~/..~...... Subdivision ................................. Filed Map No ........... ~ot No .............. d,/z ' Permit No. ~ ~Oate of Permit . .Applicant . Health Dept Approval . Labor Dept Approval Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. App,,~e.~...~~.~... ~~....(~:~ Rev. 10-10-78 FIELD INSPE~r].O~. DATE COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ~---- ROUGH FRAME & PLUMBING " B. INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS Examined . ~/...("~1~.%=. · FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 .,1 .~..PermitNo./..~.~.Z¢ TOWN OF SOU'I'HOLD Received ........... ,1 Disapproved a/c ..... ~..~w.~ ............ ~ ......... APr LICATION FOR BUILDING PERMIT Date .................. 1 . INSTRUCTIONS a. This appli~ation must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accu!}ate plot plan to scale. Fee according to schedule. b. Plot plan ghowing 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 ~ 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 building for necessary inspections· _ ~ , (Signature of applicant, or name, if a corporation) MAII~ .ROA~ .B0X. Yk182. MATT/glU~CK N.Y, .a,19~2. · · (mailing address or app±~ca~t) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. OWNER FRANK CARLIN HELEN CARLIN Name of owner of premises .......................................................................... (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 ..... 3 ~ < ....... Plumber's License No. % ....................... Electrician's License No ....................... Other Trade's License No ...................... l~II~ ROAD LAUREL ROUTE 25 1. Location of land on which proposed work will be done ............... ; ................... : .............. ¢ House Num bet Street Hamlet County Tax Map No. 1000 Section ..... }~-). ........ Block .... 3 ........... Lot .... ].~. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: House a. Existing use and occupancy .................................... ~ .?.~..~..~ ........................ b. Intended use and occupancy ........................ i~'2{ J ?. :'~'~; :? .... o 10. 11. 12. 13. 14. Nature of work (check wMch apphcable): New Building .......... Addition....X ...... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... ',. ! . .~, .~.~. ~..~ (Description) tima~e~d ~ t~ ~. 6200 ~. Es os ......... , .......................... Fee ..................... (to be paid on filing this application) If ~lw~iling, number df dwellin~ units ............... Number of dwelling units on each floor ............... If garage, number of cars .... , .................................................................... If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height .......... Number of Stories ........................................................ Dimensions of same structure With alterations or additions: Front ................. Rear .................. Depth ....................... Height ...................... Number of Stories ...................... Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number, of,~Stories ......................................................... Size of lot: Front .......... i ............ Rear ...................... Depth ...................... Date of Purchase .......... : ................... Name of Former Owner ............................. 'Zone or use district in which piemises are situated ....... ...... Does proposed construction violate any zoning law, ordinance or regulation: ................................ Will lot be regraded ............................ Will excess fill be removed from premises: Yes No Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect ............................ Address ................... Phone No ................ Name of Contractor ........................... Address ................... Phone No ................ Is this property located withiNl.o0 feet of a tidal wetland? * Yes ..... No .~.. If yes, Southoid Town T~ustees 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 show street names and indicate whether interior or corner lot. STATE OF NEW YORK, CO.U, NTY lOF. .gUFF.OhK.... ' S.S ·..PRANK. ~ARL IN.. HELEN..( ~ARL.ZN ............... being duly sworn, deposes and says that he is the applicant (Name of individual si ~ning contract) above named. He is the .................... ! ..................................................... ..~ .............. (Contractor, agent, corPorate officer, etc.) of said owner or owners, and is d¢ly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this applicatioh are true to the best of his knowledge and belief; and that the work will be performed in the man,er set forth in the application filed therewith. Sworn to before me this o~ .day pf ........... , 19 .... Notary Public, . . ! ~ County (Signature of applicant)