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Home My WebLink About15078-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Cerfi[icafe O[ Occupancy No. Z 16930 ................. Date May 31, 1988 THIS CERTIFIES that the building Add i t i on .. . 3275 Aldrich Lane Laurel Location of t'roperty ............................................................... House No. Street Hamlet County Tax Map No. 1000 Section ! 24 .Block 0 I .Lot 5 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · ..... .J.u.l.y.. J .0 .... [.9.8.6. pursuant to which Building Permit No. 15078Z dated July t0, 1986 ............................ was issued, and conforms to all of the requirements of the applicable provisions of the law. Tile occupancy for which this certificate is issued is ......... Deck addition to an existing one family dwelling. ' Tile certificate is issued to THOMAS E. & MARY ELLEN TOMASZEWSRI to,,.e; .................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N/A . PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 1~O~ HO, ~ TOWN OP $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDiiqG PER~,4 IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Z Permission is hereby gronted to' ..~.~..-2.~:......~.;,,A.....~...~ ...... ..~~ ............~..~. ,,~ v ................. ~ .................... ot premises located at ,,~%~........~...~....~..,..~.-.~ .................................................. County Tax Map No. 1000 Section ,,,..J..~..,.~.. ....... Block ...... ,.~..,J. ......... Lot No ...... '~."~.. ............ pursuant to application doted ..... **~..~....~. ........................... , 19.~.., grid approved by the Building Inspector. Fee $..~.....~,.~,. Building Inspector Rev. 6/30/80 TOWN OF SOUTIIOLD OFt,'ICF, OF IiUILDING INSPECTOR P.O, [lOX 728 TOWN IIALL SOUTIIOLD. N.Y. 11971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. An application for Certificate of Occupancy ts riot on /'_-/ :to Underwriters Certificate on file. /~/ ~o llealth Dept. Approval on file. ~'~o final inspection has been made. PJease contact: our office on this matter. Thank you for your cooperation. Building Permit tl I. ~ ~ ~ L Z Building [)opt. '}**/~/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 1, tow -og j oto j APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m ~ 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 u~e, 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 $25.00, Accessory ,$ ~0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.updated C.O. $ 50.00 Date ...... .~,,~/..,.,,.:...... / NewConstruction ...... Old or Pre-existing Building . .}<~ ........ Vacant Land ............. Location of Property .... ?.~, ~) ............ z.~ ........ House No. Street I-rainier Owner or Owners of Property ,~. ~- o--~ / County Tax Map No. 1000 Section ............../~ .~. Block ....~./..,,...,.. Lot...~.~.......,,,, Subdivision .......... Permit No. Health Dept. Approval ...................... Filed Map No ........... Lot No .............. D ate of Permit 7//. F?,d, .Applicant ....................... ...................... Labor Dept. Approval ...................... .. Underwriters Approval ...................... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permi~eets all applicable codes and regulations. Applicant.. dO 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~/FINAL REMARKS: 'iELD INSUECTION COMMENTS OUNDATION (1st) OUNDATION ( 2nd ) OUGH FRAME & PLUMBING NSULATION PER STATE ENERGY CODE F I N ~/ ADDITIONAL COMMENTS: APPROVED 766-1802 9 ALL ~rATE FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 TEL.: 765-1803 Approved...~ .~.O. .... 19~.~, Permit No. /.'~.~.7.~. .~.. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ................... 19... a. This applleation 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. The work covered by this application may not be commenced before issuance of Building Permit. c. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit d. 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 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 tc admit authorized inspectors on premises and in building for necessa~Ons. ........ '" (Signa;t~r'e'i?' ~l;l;li~a'n~i o; nam,e,"~ if a corporation) ............ (ma±l±ng address of app~±canl:) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder .......... e ......................................................... Name of owner of premises ,e .~. · .~-:... · .~. · · · '/~'" · · "~', ..... ~'7 ............................. (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 .... Plumber's License No .......... Electrician s L~cense N ...................... Other Trade's License No ...................... n or,nd which propos d work, wiil be done ................................................. 1. Locatio on e ~'.~,44..r.. '.~. '.~' House Number Street Hamlet County Tax Map No. 1000 Section ..... /t...~,..~ ...... Block ..... .(~../. ......... Lot .... i'.~%~. ......... Subdivision · ·. . ............... Filed Map No ............... Lot .............. ............. 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a Existing use and occupancy ......... /[4 b. Intended use and occupancy ............. t.* .............. " ....[' ................ 3. Nature of work ,(check which ~pplicable): New Building Repair ~ ' Removal 4. Estimated Cost ......... .......... Addit' :,~ ..... Alteration ........ Demolition Other Work" (Description) (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... ./. ....... Number of dwelling uuits on each floor ............... If garage, number of cars ........................................ ; ........ "~ .'. * ~:, ~ '~ .' ............ 6. If business, commercial or mixed occupancy, specify na~[ure_ and extent of each type ofuse.. )..,.., ..~....~ ...... 7. Dimensions of existing struetu[es, if any: Front .... ~,. ~5~..: ....Rear .... ~. ~......' ? .~ Depth .li. .if.,~ ....... Height ...a:~. ~ ........ Number of~Stones....'~ .............. ;,~ .,~ ................. '? .,~.,. · Dimensions of samo structure With alterations or additions: Front .... ~ .o ........ .. Rear ..... ~..~. ....... Depth ....... ~.~. ........... Height ..... ~ ............... Number of Stones .... ~ ...... ~ .... 8. Dime'nsions of entire new construction: Front .... q,2...~. ....... Rear ... ~..~.. ...... Depth .... ./.~ ...... ,.,a,~h ....... , ........ Nu)nb r of St · . · ' ' orles . . . . .lJ,, , + I e . . . .'"~... ~. ................................... -' .z ,¢,: ' pti 9. S~ze of lot: Front ....... ~ ........ Rear ...; ........... De .............. 10. Date 'of Purchase ....... .7/,?.~. ................ Name of Fornier Owner 11. Zone or use district in whictl premises are situated ......................................... 12. Does proposed construction violat~ any zomng law, ordinance or regulation ...... ~ ..................... 13. Will lot be regraded ....... ~ .~/.~ ................. Will excess fill beremo.ved from premises: Yes 14.Name of Owner of premises ' ............Address.,.d .'..- ............. Phone No .......... Name of Architect ' g Address Phone No Name of Contractor ....... 4 .....'" ............ Address'. .................. Phone No .............. 15. Is this property located withinl.00 feet of a tidal wetland? * Yes ..... N? · If yes, Southold.Town Tvustees Permit may be required. · PLOT DIAGRAM Locate clearly arid distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions frt property lines. Give street and block number or description according to deed, and show street names and indicate whett~ interior or corner lot. STATE OF NEW YORK, COUNTY OF ................ S.S ........................... ...................... being duly sworn, deposes and says that he is the applicm (Name of individual si. ning contract) above named. He is the (Contractor, agent, corp?rate officer, e~c.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file application; that all statements cogtained in this application are true t9 the best of his knowledge and belief; and thht th work will be performed in the manher set forth in the application filed therewith. : Sworn to before me this Nutary tmmic, . dgq~-P~'.....2~, ~.~.; .~...o~-~. ......... County~_._~' .r"----'---- /9 _l~4~g&~ . . ~ignature of avplicant