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Home My WebLink About14619-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. zi53!3 Date March 2, 1987 THIS CERTIFIES that the building... ADDI%.I, QI~I ................................... Location of Property 850 MAJORS PATH ORIENT House No. Street Hamlet County Tax Map No. 1000 Section 026 ,Block . ~ ..... Lot P./.q 39.5 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .M..a .r.c.h...5 ~.. 1. 9..8.6 ........ pursuant to which Building Permit No. 14619Z dated .M.a, .r.c.h..7. ~..I.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 ......... Con, struct a deck addition to an existing one family dwelling. The certificate is issued to STUART MA,GER .................... ?o7,,,'o;, ' x .................... of the aforesaid building. Suffolk County Department of Health Approval ..... .N/.A. ................................. UNDERWRITERS CERTIFICATE NO ............. .N/.A. ................................. PLUMBERS CERTIFICATION DATED: N/A Bmldmg I~ Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby' granted to: ............................................... .~......u...~.~./ .......... ,o..~~...~,.~..*...~ ...... ~...~..........~...~.,.....~.. Ot premises ,~ated ot ..~.~....~..~.~.....~....~ ............ ~ ................................. ...~....~~.....~.~ .................................................................................................... CourtW Tax Map No. 1000 Section ..... .~..~ ..... Bilk ......... ~. ........ Lot No ........... ~.:,~ ~,~ua~,, ,o ~,o, d~,,d ..... .~.~..~ ........................ , J~.~..~., ~nd ~,ov~ b~ ,h~ Building Inspector. 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 Wpewriter OR ink, and submitted ~ ~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of propertv 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 pZ~perty 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 o~cupancy on pre-existing dwetiing $15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacan% Land C.O. $5.00 ,~,__ .u. dated O.d. $ s.00 gate..U, ..... Newc°nstpuction ..... Old or Pre-existing Building ............ Vacant Land ............. Location of Property.. ~'~ .................. ~;:";~~Stret .............. ~"~ '~'' Hou~ No. Ham/et Owner or Owners of Prope~y ........................................ - County Tax Map No. 1000 Section O~ ~ Block ~ Lot. ~P ;?, ~, Subdivision~ ~" 3/~/~' ......Filed Map No ........... Lot No .............. Permit No ~~ gate of Permit ....... ./I/~ AppJJcast .~O.. ~ ~ .~bLI 'J~ {,~.~ Health Dept Approval Labor Dept Approval Unde~riters proval Planning Board Approval ..... ~. Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ..... ~ ~ .................. Construction on above described building a~_.~it meets all app~c~ble codes and regulations. Applicant. ~.L,,.~..c.~)..~...,.. ~~'u'' '~ '~' · ......... FIELD INSP~CTION FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE COMMENTS FINAL ADDITIONAL, COMMENTS: 765.'1802 BUILDING DEPT. INSPECTION FOUNDATION XST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FINAL [ ] FRAMING REMARKS: '~=ORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined . .~...o~...'2. .... , 19 .~.(f Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... 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 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 I8 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. . ..-~.e d.~.. ~z,z~-,q..~.~.. ,¢!.~.o....~?.¢. ~ .......... (Signature of applicant, or name, if a corporation) 34_4- .4'.o~e .~. (~. ?.....,~.0...4~?.'L .2~. ¥-/.~..~ ~,.(~:z/.... (Mailing a/ddress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · .~e~.~. ~..,g_. ................................................................................... Name of owner of premises ...... . ./~.(Z......,~?.~.~.~qg¢...7'7....,~. ,O f.<~'.,~ .................................... (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 License No ..... .AJ/~. ............ Other Trade's License No .... .AY./~. ............. 1. Location of land. on which proposed work will be done .................................................. ..... .8..5..o. ........... .... .W.P. ........... .............. House Number Street Hamlet County Tax Map No. 1000 Section ....... ~..~. ...... Block .... ~ ........... Lot.../?/U.. B ~, dk*.-. · · Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: use and occupancy .... ~../~.~....~.'~..~??.~. .... ~. F/,2~..~'~. g~ ............................... a. Existing t b. Intended use and occupancy ... 0~6...~m (~... aa ~N~]~..( ~ ....... 3. Nat~/e of work (check whi{l~ .applicable): New Building ..... ' ..... Addition ........, .~... Alteration .......... Rep~ir .~am.a.~ .~.. ~Oval .............. Demolition ........ Other Work ............... ~; ~0~ ~] (Desc~ption) ~. ~',s~co~.,~,~.~ ......................... ~. . ,~. .~ ..... ~ , ~' (to ~e paid on filing this application) Ifd IIi fd g)nit Nub fdw IIi g~ 5. we ng, number o wellin s ............... m ere e n nit, on eac eot ................ If garage number of cars ..... : ................ 6. If business, commercial or mixed occupancy, spec~y nature and extent of each Itype of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .... ~ ......... Depth ............... Height Number of Sto~es I)~ensions of same structure with alterations or additions: Front ......... ] ....... R~ar .................. Depth . Hoist Numbed of Stories 8. Dimensions of entire new const~cfion: Front ....... 5~ ..... Rear .... ~ ~ ........ D~pth ... (~ ........ ?i~nt ..... /~.'..:... n~ o~ sto~ ...................... ~ .............................. ~. si~o~ot: ~o~t ...~ .... ~ ........... ~r .... !~ ......... ~. n~t~ ...z~.~ ......... 10. ~)ate of Purchase .......... ~ .................. Name of Fo~er owner ............................. 1 l. Zone or use district in which premises are situated . . . ~ . 12. l)oes proposed construction vio~ate any zoning law, ordinance or regulation: .~ .............................. 13. ~ill lot be r~gradod ...... f,o .................. will excess fill be rem~y¢d (~m premises: Yes ~No 14. Nm~ o~ Owner o~ premis~ ~ ~ ~.. Auaress ~ zi.~ q'l,. P~one No.~(~ N~e of Architect ........................... Address ... ~ ~.' ,q r ~ ..... Phone No . -- N~e or contractor ~ ~ ~.'~z~ ~ ' ' ...... Address~..~ ...... Phon, No. ~ PLOT DIAG~M Locate cle~ly md distinctly M! build,ga, whether existing or proposed, md. indicate ~1 set-back d~ensions from property Hhes. Give street and bloc~ number or desc~ption accord~g to deed, ~d ~how st~et n~es and indjca[8 integer or corner lot STATE OF NEW YORK.~ COUNTY OF,,...~, V.~...g~'.. S.S ..... t.t,0.~. (,~. f.~.,.. ~CF.'[~c/"~ .... being duly sworn, deposes and says that he is the applicant : (Name of individual si ~i~'c~)~l~;a'c'ti ...... above named. He is the '~..,~0~¢~.. ~ d)~ ~. r (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dgly 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 manqer set forth in the application filed therewith. Sworn to before me this .................. ~ .... day 0f .... Notary Public, . ................... ............ ..... /' ............ (Signature of applicant) I I OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY -,~ ,OYED AS ~OTED ~ ~.~ BV..~. ~.~- 765-1802 9 ~ TO 4 PM FOR THE FOLLOWING INSPECTIONS: I FOUNDATION ~0 REQUIRED FOR POURED CONCRETE 2 ROUGH FRAMING & PLUMBING 3. INSU~TIO~J 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR ALL CONSTRUCTION SHALL THE REQUIREMENTS OF THE ~A~ CONSTRUCTION & ~ERGY ~DES, NOT RF~NSIBLE FOR h~IGN O~ CON~TRUCT~OA i G" S'T'E_ P