The URL can be used to link to this page

Home My WebLink About14723-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z16677 Date Feb. 26, 1988 THIS CERTIFIES that the building . .A..d .d.i.t.i. 9 .n ..................................... ~ - 2265 MILL LANE Location or ~'roperty .................................... .P E C ON I C House No. Street ..................... IJt~r~l'ei' County Tax Map No. 1000 Section ...0.6.7. ...... Block 7 .Lot 5 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · .M.a. r. 9 .h..2. 8. ~..1.9. 8..6 .... pursuant to which Building Permit No. 14 723 Z dated . .A.p~r. i..1..1. ,.. J .9.8.6. ........... 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 ......... Deck addition to existing one family dwelling. The certificate is issued to JAMES J. & KATHRYN NORMAN '" .................. T; gdt ...................... of the aforesaid building. Suffolk County Department of Health ApproYal ...... ~/..A ................................. UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED: N/A / BuiJ~fing Inspector Rev, 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDIHG (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby gronted to: ~,.,~..~.~..~.~ ....... ~.~.~ .~.~.....~~.~.~., ............... ~***~.~...~.....~..***~.**....t.!..~..~... ............. . ............... ..... ~.~......2~....~ ~ ........ ~..~~... ot premises I~ted at ........ ~...~ ...... ~.~...~ ........................................................................ County Tax Map No. 1000 Section ..... ,,,~,,.,,~,,.,~, _.. Block ...... ~.~.. ........ Lot No ..... ..~.~-... ............. pursuant tO application dated ..~~....~ .................. 19~.~., and opprov~ by the Building Inspector. Building Inspector Rev, 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPL)CAT1ON FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted l~ to the Building Inspec- tar wi~h the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natura~ 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: I. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topograph ic features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of braidings. 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 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$10.00 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 ........ .2/.2.6../.8.8 .......... NewCons~.vuct~ on .~.. Old or Pre-existing Building ............ Vacant Land ............. 2265 Mill Lane Pec. Location of Property ................................................................... House No. Street Ham/et Owner or Owners of Property JAMES J. & KATHRYN, NORMAN County Tax Map No. 1000 Section 067 Block 7 Lot 5 Subdivision ................................. Filed Map No ........... Lot No .............. 1~723Z Permit No. Date 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~,/,~eets a appl;able codes and regulations. Applicant' ,.~...~~" .................... F I E LD~ I N~[.EC T I ON COMMENTS FOUNDATION (1st) FOUNDATION ( 2nd ) ROUGH FRAME & FLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 119'/I 3'OWN OF SO~Um~O__L_O _,~ TEL.: 765-1803 ..~2~..~..., 19~.~ Received ........... ,19... Examined Approved~...!..,19.~.~.PermitNo.)~.~..~.~..~..~'x~l~ ,. ~"~'*~, ~" ~'~O ' Disapproved a/c ..................................... ~'~._ ,~ '~ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ................... 1 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 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 adn~it authorized inspectors on premises and rio building for necessary~ecti~zff~'' f~/'/~ ~.~./~ ./~/~.., (Si~n~t.~(r~ of ]~lica'nt; or name] i; (Mailing address of applicant) 17 7 1 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of remises X,~'~"'J' ~7'/~?~'~/XY'~ "~~/~'~/~'-~. (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 .... .~i .z~. ~. .............. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location ofland on which proposed work will be done. .~. .~.~. .~. . ... .-~?. .z..z:. . . .~. . .c~. . . . .~. ........... House Number Street Hamlet County Tax Map No. I000 Section ..... ~. 7 .......... Block .... 7 ............. Lot....~, .-~. ............ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing' use and occupancy .................. ~-~/4/z~;z: "'w~~ ~..' .~..' 2'~'~ ~-~'~. ..................................... b. Intended use and occupancy ................................................... 3. Nature of work (check which applicable): New Building ..... ' ..... Addition . .i ........ Alteration . .; ........ Repair .............. Removal .............. Demolition .............. Other Work ............... ~'~ (Description) 4. Estimated Cost ............................ Fee .. .': .................. ' (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... ~. ........ Number of dwelling uniis on each floor../'. ............. If garage, number of cars ...... ./ .................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .... .'T ................ 7. Dimensions of existing structures, if any: Front .............. Rear ....... . ....... Depth ............... Height ~.~.7~.~?. ( .~.-~.... Number of Stories . .,~...~.7~??.,,..~. .............. ............................ Dimensions of same structure with alterations or additions: Front ............ ..... Rear .................. Depth ...................... Height ..................... ~ Number ofl Stories ...................... Dimensions of entire new construction: Front ............... Rear ........ ! . Depth ............... Height ............... Number of Stories ............................ . ............................ Size of lot: Front ...................... Rear ...................... iDepth ...................... 10. Date of Purchase ............................. Name of Former Owner .: ............................ 11. Zone or use district in which premises are situated ......................... : ............................ 12. Does proposed construction violate any zoning law, ordinance or regulation: .... i ............................ 13. Will lot be regraded ...... ~ ....... x' ........... Will excess fiE-he remoYed from p'~ises: Yes No 14. Name of Owner of premises~..~...~.../?.q..~..~.. Address ./.~..d~..~.~.,~...r~..~2~ Phone No ................ Name of Architect ........................... Address ,~. f:.o...~,~-....~...,~...,~. Phone No ................ Name of Contractor .......................... Address ............... ~ ....Phone No ................ 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 sho, ? street names and indicate whether interior or corner lot. STATE OF NEW 5qO~, COUNTY OF.../'./('. (.f~..' .~,_~' "','~ .... S. S .... /~. Z .Old... ~.~../~...J~... ............. being duly sworn, dep6ses (Name of individual signing contract) above named. and says that he is the applicant He is the ............................................................. : ............................ (Contractor, agent, corporate officer, etc.~ of said owner or owners, and is duly authorized to perform or have performed the shid work and to make and file this application;that all statements contained in this application are true to the best of hi~ 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.,,~'~,, Notary Public~~ ~ .,;,MM .,5...~.."T.~. ."...°T'~... County /,/'2~,0 t,// 'fi'fi-) . . . 4. Z./. . -?. . .< /. . . : ....... ~-I~~ -- (Signature of applicant) :E 0 0 Z M~LL