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Home My WebLink About14387-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail 5outhotd, N.Y. Certificate Of Occupancy No. Z14394 Date May. 1.4. ...... 19 8.6. Accessory; THIS CERTIFIES that the building ............................................... Location of Property . .1.625 sh,.ipxard Lane , East Marion . County Tax Map No. 1000 Section . . 3B ........ Block ... J~ ........... Lot ...1.7 ............. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... Q .c.t....2..2 .......... 19..8.Spursuant to which Building Permit No..1.4.3.8. 7.Z .............. dated ...O.c,t. ;..2.2. ................. 19.8..5, 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 ......... Construct accessory building. The certificate is issued to Conrad & Marjorie Volinski ..................... ?o¥.'0;, ..................... of the aforesaid building. Suffolk County Department of Health Approval ...... N../.A. ................................ UNDERWRITERS CERTIFICATE NO .............. N. [.A. ................................ Building Inspector Rev. 1/81 ~0~ NO. ~ TO~,VN 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) N-° 14387' Z Permission is hereby granted to: ...... ~.&..Y... ~.~po~. Co,~'~-'~ ~c~;.¢.o r .~//d/.e ................................................. to ........................................................... ~ ...................... ~ ......... at premises ocarea ar .................................... x-..~ .......................... ,- ........... ~ ............... pursuant to application dated ................ Z.~.../..~....~.. ........................ , 19..?..'...~, and approved by the Bui{dlng 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 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 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 comp{iance 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: I. 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: I. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $ ].5.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 ~...~ ~.. /9 ~ 5.updated C.O. $15.00 Date .' .. ( ............ New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of ..... House No. Street Hem/er Owner or Owners of Property ...C,0. ?.~. ?...~...~..~..~&/..~.... ¥..O.~./?..~.~,/. ............ County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision .............................. ./..Filed Map No ........... Lot No .............. Permit No., J.~(/.,,~.~.?.. Date of Permit ./. .Applicant ..~_,.0~ .~..~,,.C..:y.O..L.!.~..<J.~.,/ ..... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building ara$Lgermit meets all applicable codes and regulations. Applicant ..i.,~...~..,~,,:.~,~'. ................ FIELD INSPECTION COMMENTS FOUNDATION ( 1st ) FOUNDATION 2. · ROUGH FRAME (2nd) PLUMBING INSULATION PER N. Y. STATE ENERGY C~ODE ADDITIONAL COMMENTS: 76S-~.802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING REMARKS: ROUGH PLBG. [,,] INSULATION [~' FI NAL -/ · ' ' ' ' · ".,:<t~FORMNO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~4:)UTHOLD, N,Y. 11971 \ TEL.: 765-1803 Examined ^pproved ... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .................. ,19 b. P~t plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas,~.nd giving a detailed descE!ption of !ayout.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 comfflenced before issuance of Building Permit. d. Ui~on 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. APP,][CATION 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 admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) ..... . ....... .............. (Mfiilfng.address of applicant) State whether.applicant is owner, lessee, agent, architect, engineer, general co, z3tra6for, electrician, plumber or builder. Name of owne'r of premises ........ ~..'7~...~.' .~.....~...~.~. 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 ~ L~cense No. 1. Location of land on which proposed work will be done. ' ......... ............. :... ............... House Number ~' Street Hamlet County Tax Map No. 1000 Section ............. Block ................. Lot ..... 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 ~' ~¢'~ 4~5~ 9. 10. 11. 12. on filing this application) each floor ................ use .................. .... Depth.. ~ ...... ,.. Rear ............... ~ries ................... ..... Deplh ·.. ~.!( ...... Nature of work (check which applicable): New Building ... ~... 'Addition i ......... Alteration ... Repair .............. Removal .............. Demoht.~on ......... .... ,. Other Work ............ Estimated Cost ............... Fee '~' (to be pa If dwelling, number of dwelling units ............... Number of dwelling u~its If garage, number of cars .......................................... ~ ...... If business, commercial or mixed occupancy, specify nature and extent of each type ·. Dimensions of existing structures, if any: Front.. ,~. ........ Rear . .1~!~.. .... Height ............... Number of Stories .......................... i ...... Dimensions of same structure with alterations or additiofls: Front ; ......... i .... Depth ...................... Height ...................... Number :of ~i . Dimensions of entire new construction: Front..../~. ............. ~. ..... .7 ........... Numher of Stones .... · ~ ' Rear....~.~ ........... r D~ .. Size of lot: Front .... ~,~, ............... ' ....... ;~ Date of Purchase ............................. Name of Former Ownerl .............................. district in which premises are situated Zone or use ....................... l ............................ Does proposed construction violate any zoning law, ordinance or regulation: . .:. om premises: Yes ate all set-back dimensions from treet names and indicate whether 13. Will lot be regraded ...... .t't.O ........... . ........ Will excess fill he removed 14. Name of Owner of premises ~/l.r~d.~.' .l~..,,//tt,~-,/.. Address/.~...~.~.~/~.,~..~.!t~ .~: ~ Phone No:~ ~ 2.':/~ ~... Nmne of Architect ........ ' .................. Address ............. . ....... Phone No ................ Nme of Contractor ......................... Address ............. i ......Phone No ................ P~T DIAG~ Locate clo~ly ~d dis~ctly ~1 bufld~gs, whe~er existing or proposed, ~d.]indi prope~y 5nes.,Give street ~d block number or description accord~g to deed, ~d show interior or { 'orner lot. . STATE OF'N~ORK, S S (Name of individual signing contracO '~ ~ above named. He is thc ........... ~~ .................................. : .............................. '(Contractor, agent, corporate officer, ctS.) of said owner or owners, ~d is duly authorized to perfo~ or have perfo~ed th~ said work and to m~e and file this application; that ~1 statements contained ~ ~his application are t~e to thc best of his ~owledge and belief;' and t Lat the work w~l be perfo~ed in the mmncr set forth in the application filed therewith· Sworn to before me this .......... ...... ..... County ~ V a:i ""'"" ...................... ~: ~, {C':~ i ~(Signature of applicant)