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Home My WebLink About15057-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...~7.17011 Date June 20, 1988 THIS CERTIFIES that tile building ALTERATION Location of Property 655 Town Harbor Lane Southold, N.Y. County Tax Map No. I000 Section . , .0.6.3. ...... Block 04 ..... Lot 8 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated July 1, 1986 pursuant to which Building Permit No. 15057 Z dated J u 1 y I; 1986 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which tlfis certificate is issued is ......... 'ENCLOSE EXISTING PATIO AS APPLIED FOR CECILIA T. BRESTER The certificate is issued to ..................... ['o'~n'o'r, 'l~¢'~oXr~'~rlVt~x .................... of the aforesaid building. N/A Suffolk County Department of Health Approvai .......................................... UNDERWRITERS CERTIFICATE NO. N / A PLUMBERS CERTIFICATION DATED: N/A ~r~ Cg nspector ...... Rev. 1/81 N? TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15057 Dote ............... ........... - .................. , Permission is hereby granted tq: ~. I., ~,4~._ ~ ..... ......... ...... ~.~...~.......~.~...~.,,z.t~..fl~.. ~~.L,~. ...... ~.~r, zc. ~..r'.~...,,......~-~.,~...~...:......t.t~..'.-/~ ~o ...... .~.~.~.~.Q..~.~ ~...~. ~.~.'E.(t-~.C~.....L....4.'.....~...I..~ ........................................... pursuant to c~ppJicQtion dated ....'~...~..~.~.. ....... I, .......................... , 19~, and approved by the Building Inspector. Fee $,...~.."~....~. 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 A. This application must be filled in typewriter OR ink, and submitted m Imaammaa 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 and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic featu res, 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 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$10.00 Business $50.00 9. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5,00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewC°nstPucti°n ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property House No. , ~ Street ,~ Hamlet Owner or Owners of Property~.r.'!I, .~,~...T..~'....'~.% .'~..,~,~ .~.~ .C ?~..-~. J..I~,,..I~... ............. County Tax Map No. 1000 Section ....(~.~ .~. ...... Block ...0.~. ........ Lot. ~.O..~.'T. ~ Subdivision ................................. Filed Map No ........... Lot No .............. Perm it No. .'.~ Date of Perm i ...Applicant . ..~.. ..... Heatth Dept, Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described buitdin~ and permit meets all applicable codes and regulations. App,,ea .... Rev, 10-10-78 ' FIELD INSPECTION FOUNDATION FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL · ~ gOUTHOLD, N.Y. 11971 TEL,: 765-1803 t.-., 19 · ' ' (Building Inspector) APPLICATION FOR BUILDING PERMIT Received...7 /~ .... ,1~. INSTRUCTIONS a. Tins 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 tins 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 construqtion of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable la[ws, 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, ifa corporation) tmaizing address or app icant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 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 ...... .~. ~...k'r. ~r.~. .......... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... ~'~,~--' ' 1. Location of land on which proposed work will be done ............. &/.'.~.. ~ qO: }~. .............. ............................................................................ House Number Street Hamlet County Tax Map No. 1000 Section . . .s:~..~..~. .......... Block .... ~ ......... Lot..~..~-~..{~..'~'...O..o.? .... 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 ................................................................... b. Intended use and occupancy .~J..t.~.l/l.'.~f~...~;Y]~l.O..Q'..~=."..'t..x3/~rfl~.~..'lC~.[J..~. .. 3. Nature of work (check which applicable): New Building .:... .... Repair .............. Removal ......... .....~ Demolition 4. Estimated Cost ....................... ... ... Fee Addition Alteration ' (Description) (to be p~id on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwethng umts. 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 structures, if any: Front ............... Rear ..... i Depth ........ Height ............... Number of Stories ............................ ~ ......................... Dimensions 0f ~am~ s{ructure 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 ...................... Rear ...................... Depth ...................... 10. Date of Purchase ............................. Name of Former Owner . .~ ........................... 11 Zo district in whi h p mise situ t d · ne or use c re sere ae ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... i ......~1~. ................ 13. Will lot be regraded ............................ Will excess fill be removedI from premises: Yes 14. Name of Owner of premises .................... Address ............. ' Phone No ................ Name of Architect ........................... Address .... :~: .......... ~... Phone No ...... Name of Contractor .~O~ '.~. ~..t~.~. ~.~ ~/~.~ .... Address ~__.'~'. :~.~.;~./~P/~..~hone No. ~.~.~. i .~.'~ 15. Is this property located within l-.00 feet of a t±dal wetland? * '/es ..... No .... -- · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, ind}cate all set-back dimensions from property lines. Give street and block number o~flescript.ion iaecOrth~ttg txy d:?f~, x;.,;s}~,~e,,~ street names and ~nd~cate whether interior or corner lot. ' ' (Signature of applicant) STATE OF NEW YORK, S.S COUNTY OF ................. .................................. >~ ~' ........... being duly sworn, deposes and says that he is the applicant (Name of individual signing cpi~/dq/t) above named. ~f:~//y , ~ ' ~ ~-----.~/~'~' (Contractor, agent, corporate officer, etc.): of smd own~ners, ~d ~s duly authonzed to perform or have perfomed the s~td work and to m~e and file this application; that all statements contained ~ this application are true to the best of hislknowledge and belief; and that: the work will be perfomed in the m~ner set forth ~ the application filed therewith. Sworn to before me this .... .... co7 '