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Home My WebLink About14412-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z-15307 Date February 26, 1987 THIS CERTIFIES that the building ... DECK ADDITION Location of Property 305 Topsail Lane Southold, N.Y. County Tax Map No. 1000 Section 0 79 . . .Block 0 7 .Lot 5 1 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated October 28, 1985 pursuant to which Building Permit No. 14412 z dated .... 0. c..r ?.b.e.r...3.0. ,...1.9.8.......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 ......... DECK ADDITION TO EXISTING ONE FAMILY DWELLING ROBERT G. & MARY W. JONES The certificate is issued to ..................... ?oki, nb;, ~l~/~k'~tb~k ..................... of the aforesaid building. Suffolk County Department of Health Approval N/A N/A UNDERWRITERS CERTIFICATE NO .................................................. N/A PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 TO~N O~ $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 14412 Z Permission is hereby gronted to: , ~~....~..~::...~.~...~.~.~ ................. - '.~. at premises I~ated at .~.~..~...~...~..j ......................................... County Tax Map No. 1000 Section ...... .~. ~...oj ........ Block ...... .~..-J.. ........ Lot No..~'..J ................ ~u~.uo.t to opp,~ot,on doted ...~.~...~. ................ Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 ~LDG. DEPT. ~ TOWN OF SOUTHOL?~.~ APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m Ila~a~a~ to the Building inspec- tor with the following; for new buildings or new use: i, , i ' 1, Final survey of propert~ with accurate location of all buildings,! property lines,'streets, and unusual natural or topographic fbatures, 2, Final approval of Health~Dept of water supply and sewerage disp'o~al-(S-9 form or equal), 3, Approval of electrical installation from Board of Fire Underwriters. ' 4. Commercial buildings, Ihdustrial buildings, Multiple Residences and similar bUildings and installa- tions, a certificate of Code compliance frem 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 i 1. Accurate survey of pZOperty showing all property lines, streets, buildings and unusual natural or topographic features. [ I 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 ~ certificate. C, Fees: of occupancy Add£tions $25.00 1. Certificate , New Dwelling $25.00, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of cortificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ..~.~.~..l~.U..~.~.~..~0. l!.~.~2 ..... NewC°ns t'pucti°n., .,V~, · · Old or Pre-existing Building ............ Vacant Land ............. Locet on of Property..'3.. o. . eZ. . . :"1' t House No. Street Nam/et Owner or Owners of Property i.~..O..i'~(~''T' '..~.:. ~?.? .~d.t~.~ .~ County Tax Map No. 1000 Section . ~3'~ ~ Block ~ ?. Lot Subdivision .L.~.~.~.~.~.~./~.¢.~. t.l'. ~.~..i.(~ .~. ..... Filed Map No ........... Lot No...(dt:'. .......... Permit No.I .0¢..~. [ .~..~.. Date ;f Permit I~.~.)~...Applicant .~.<~-.~..T'....~¢; ~ [~ ~:.~: ........... 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 permit meets ail apl~licable codes and regulations FIELDs IN~ECT~ON COMMENTS FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: : New York Washington Louisville Boston BUILDING DEPT., INSPECTION [ ] FOUNDATION SST [ ] ROUGH PLBG. [ ] FOUNDATION AND [ ] INSULATION [ ] FRAMING ~ FINAL DAT[ · FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved ~...~...., 19~.~.. Permit No..).?~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 ~ 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 admit authorized inspectors on premises and in building for necessary ~sp[ecti~. .... ............ ........ (Signature of applicant, or name, 30( State whether applicant is owner, lessee, agent, architect, engineer, general ~ or builder. .... .......... · ................. ' ,:,-,, .... ........ -, "" 7(2 ..... '",,' y .l, AS Name of owner of premises ~"~ ~ [~ ' ';~; ................ If applicant is a corporation, signature of duly authorized officer. :' ' , BY. ,'~ ..... Or, FY aUILDING DEP&RTMENT AT .............................................. (Name and title of corporate officer) '~LLO~JG INSPECTIONS. Builder's License No. .C. Z3.. , f=OUNDATION ~ REOIJIRED ............... ~=OR POURED CONCRETF ? aOUGH FRAMING & PtUMIBING Plumber's License No ......................... ~. INSULATION ', ~NAL CONSTRUCTION MUST Electrician's License No ....................... 5E COMPLETE FOR C.O. ',[ CONSTRUCTION SHALL MEET · ~ REQUIREMENTS OF THE N Y ~TE CONSTRUCTION & ENERGY , ~.+:^, ~c ,o,A ..... h,~h .,-~,,,osed work will be done ....... )~.E~.....1~.? IRJ.T}J .~IN$1BLE. FOR ..... 1. ~,~',-.,,.,.,,,- ~' ................. v-~ .............. ?IGN ~m e~u~-.,.,,.~ .... ,., .... · ~t;~J Number 0 Street Hamlet County Tax Map No. 1000 Section ......... '7?. ...... 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 ~ .......................................... b. Intended use and occupancy ..... ~L~:~*A*~q~....~. ......................................... 3. Nature of work (cheek which applicable): New Building ' .. Addition ....~. ...... Alteration .......... Removal Demolition Other Work Repair ......................................................... (Description) 4. Estimated Cost...~../.~.fd~. .......................... Fee .......... ............................. (to b? paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7 Dimensions of existing structures, if any: Front ... Rear . ~ Depth Height ......................................................................... Dimensions of same structure with alterations or additions: Front .......... ' Rear Depth Height Number of Stories 8 Dimensions of entire new construction: Front ............. Rear . .. ~ Depth~ l-l~ight .............. Number of Storie~ 9 Si ofl t: Fr nt R Depth . Ze o o ...................... oar ..................... q ~ .............. ~ ...... 10. Date of Purchase ............................. Name of Former Owner; ........ , ...... , ............... 11. Zone or use district in which premises are situated ....................... 2 .......... ~ ...... ......, ..... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...'~A~ .... . ..................... 13. Will lot be regraded .... <'Tbft~ ................... Will excess fill be removed from premises: ' ' Yes No 14. Name of Owner of premises '~q. ~r./~..~...~'.o..~.~.~.. Address ~.o.~..T[q~.O.t.c' .t-.~../?.~.. Phone No..7..6 ~...-.~.o.t.~... Name of Architect ........................... Address ............ j ..... Phone No .... . ............ Name of Contractor ~ecg~,.~e.~.o~. ~?¢,~'t~¢.,9 .... Address (2.o . w' '_hone No. 73/4.7. Z2. .... Locate clearly and distinctly all buildings, whether existing propo ca~l or ensions from property lines. Give street and block number or description according to def, ll~d ~,j~r~til~s~dicate whether i F OO, ;STATE OF NEW YORK, S.S COUNTY OF ................. ~'~ -~ J[- ........................................... ' ...... being duly sworn, (Name of individual signing contract) above named. deposes and says that he is the applicant He is the .......... : ................................................ i ............................. (Contractor, agent, corporate officer, et~.) of said owner or owners, and is duly authorized to perform or have performed thq 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 perfo~ned in the manner set forth in the application filed therewith. Sworn to before me this ........... .c~.~. ......... day of ..... .~...Cr~ .......... , 19 Notary Public,..--~ ...... .~-. /~. ~'~.h~ ~~,~ 7 (Signature of applicant)