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Home My WebLink About15155-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No .... .Z.l.~J39.8 ....... Date ...S.e.p.~.e.m.b..e ?..}8., ............... 19 .8.6. THIS CERTIFIES that the building De c k ^ d d i g i o n Location of Property 900 Oak Drive ~ Cutehogue N.Y. House No. Street Ham/er County Tax Map No. 1000 Section ., .1.0.& ...... Block ....0.6. ......... Lot ..... 1.3 .......... Subdivision ............................... Filed Map No ......... Lot No .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated · .J.u..1 y..3.0., ........... 19..8.6pursuant to which Building Permit No .... 1,5. ! .5.5..Z. .......... dated Ju. ly 31 , 86 ........................... 19 .... 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 ......... Deck addition to existing one family dwelling, The certificate is issued to Joan Langemyr (owner, ~.~z~'~) of the aforesaid building. Suffolk County Department of Health Approval ..... N / A UNDERWRITERS CERTIFICATE NO .................................................. Rev. 1/81 Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERi, IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 15155 Z Permission is hereby granted t~: ~.~11 .~~...~.... .............. ~ ............ ~. .~ ....... ....................................... ot premises located at ...~....~.. ....... ~.....).-~ ........ ~.~d~,.~ ............................. County Tax Map No. 1000 Section ..... ./..0....~. ........ Block ..... ..C~....(ft ....... Lot No ......... ..~ ............ Building Inspector. Fee $..~..:~. approved by the 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 This application must be filled in typewriter OR ink, and submitted m Immamma to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survev 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pZ'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 $15,0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. updated C.O. $15.00 Date ............. NewConstruct~on ...... Old or Pre-existing Building ............ Vacant Land ............. c/oo Location of Property , House No. Street Ham/et Owner or Owners of Property,.... ....................................... .. .... County Tax Map No. lO00 Section /~-~)L// Block O.~ Lot... /~ Subdivision ................................. Filed Map No ........... Lot No. t ........... PermitNo.//.~.'/.4.~.'..~. Dato of Permit ~.-'.~.4/~-AApplicant ....~;~_..L'?.y~.ZZ. CO,.~[., . Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters ~pproval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $. ~.~......~.~..~.~.. ~.~.: .~.~. Construction on above described building and p~_rr~it meets all applicable,codec, and regulations. Applicant... ~7~.~..~ '.~..~:~.~. ,~.,.: ....................... Rev, 10-10-78 R~ 3o~2 FOUNDATION (1st) FOUNDATION ( 2nd ) ROUGH FRAME & .PLUMBING INSULATION ?ER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved Disapproved a/c ..................................... BLDG. DEPT. ~t~O~,TOWN OF SOUTHOLO Received ........... ,19, . . (Building Inspector) APPLICATION FOR 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 or areas, and giving a detailed description of layout of property cation. c. The work covered by this application ma) d. Upon approval of this application, the Building shall be kept on the premises available e. No building shall be occupied or shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to Building Zone Ordinance of the Town of Southold Regulations, for the construction of buildings, The applicant agrees to comply with all applicable laws, admit authorized inspectors on premises and in building premises or public streets which is part of this appli- >f Building Permit. Permit to the applicant. Such permit Certificate of Occupancy : of a Building Permit pursuant to the and other applicable Laws, Ordinances or ~or removal or demolition, as herein described. : code, housing code, and regulations, and to nature of applicant, oration) address of applicant) State whether applicant is_owner lessee, agent, architect, engineer, general contrall~p~l~a~pi~)~r buflder. .............................. ....... (~/on the t~x roll or*lgtZ'rslfi~e~lLD~NG I:)EPARTM~NT AT 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 License No ....................... Other Trade s License No ...................... ~t,<5.1802 9 ~M TO 4 PM FOR THE ~:OL[ OWING INSPECTIONS: FOui~DA~"~ON ~O REQUI~D ~OU~EO CON~ETE ROUG~ ~RAMING & pLUMBING INSULATION ~t~AL ConSTRUCTION MUST CONSTR~CTION ~L MEET NOT ~NSI~LE ~R OR CgNS~UC~ON ~RORS. which proposed work will be done'. ................................................ House Number Street Hamlet County Tax Map No. 1000 Section .... /0.~. ....... Block ~ Lot ~ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premis~ and intended use~nd occupancy of proposed construction: a. Existing use and occupancy .... /..~..R..~ t.~... ~....~...~..:... :'.,., ~i. ,; ......................... b. Intended use and occupancy . .~..~..~. ..~..i ~.~, -. ..................... 3. Nature of work (check which applicable): New Building Addition .......... Alterati.~a .... ., ..... " (Description) 4. Estimated Cost · Fee · tto be paid on filing this application) 5. If dwelling, number of dweliing units ............... Number of, ,elling units on each floor ................ If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent ~f each type of use .'... i ................ 7. ' Dimensions of existing structures, if any: Front ........... Rea .............. Depth ............... Height Number of Stories ' ' Dimensions'of same structure With alterations or additions: Front ............... Rear .................. l~ept~ .................. 'I'" Height .................. ~mber of Stories ...................... imensions of entire new consfructlon: Front ......... -.. ..... Rear . . Depth . } ............. Height ............... Nmhber of Stories ........................................................ 9 Size of lot: Frt~nt ' Rear Depth I0. Date of Purchase .......... I. Name of Former Owner 1 1. Zone or use district in which p~emises are situated ....................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...................... ; ......... 13. Will lot be regraded ........ i .................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .................... Address ................... Phone No ................ Name :of Architect ,' Address ......... : ..................................... Phone No ................ Name of Contra to ' Add 15. Is this property locatediwithin 300 feet of a tidal wetland? *Yes ..... No ..... · If yes, Southold Town,Trdstees Permit maybe required. ~ ' "'% i ~ ~% PLOT DIAGRAM Locat.e. clearl.y and d,stlnctl~:~,~l.~f~:~j,~ ~hj~r existing or proposed, and. indicate all set-back dimensions from property lines. Give street and bloel~}~a~,~a~.o~fr~l~d~esc¢~tgn according to deed, and show street names and indicate whether interior or corner lot. '~ ~-% ~."~ STATE OF NEW YOR~, o o COUNTY,.,OF...,,~ -{ ~J~31L J~Id,~ ..... ~.o ...... /V.,~!~/-,....~.Z:..~.~ ~ ~. J .................... being duly sworn, deposes and says that he is the applicant (Name of individual sign!ng contract) above named. H i the ~' (Contractor, agent, corporate officer, etc.) of said. owner or owners, and is dul~.- 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 mannei set forth in the application filed therewith. Sworn to before rhe this ....... · ~ ............... day of!...---~.U. }.~/. ..... ...... , 19 } NOTARY PUl)tiC, State of New Y~ .... r ............... ~r-...; .... //~4~ ............... ' i No~ ~2 - 4e0a~81~ i %Signature of applicant) Qu~llfiecl i~ Suffolk County