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Home My WebLink About14102-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N,Y, Certificate Of Occupancy No ....... Z.'1.~825 .... Date ......... .~.ep.t.e..m.bp.r...6 ........... 19.8.5. THIS CERTIFIES that thc building ...... ql~D.k; .OCl~l.5.t. ~_.o.~... ........................ Location of Property 660 Oakwood Dr. Southold House No. Street .... h~r~/el County Tax Map No. 1000 Section .... 7..0 ...... Block '12 .Lot. 26. fl Subdivision. X X X .............................. Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ~.14. Z. 7 fl , 19 .~.5. pursuant to which Building Permit No. ~I q-q 02Z dated ........ .dT.u.~..2 ............. 19 .~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 ......... ~.a~ ~.4clS.~-qn...~.o existing dwelling. The certificate is issued to ......... Ath~E OLSEN ............ ..................... of the aforesaid building. Suffolk County Department of Health Approval ............. ~/..~ ......................... UNDERWRITERS CERTIFICATE NO ................................................. Building Inspector Rev. 1/81 iroK~w ~qO. ~ TOWN OF $O~THOLD BUILDING DEPARTMENT TOWN HALl. SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No 14102 Z Dote ........... ...~..../..~.m~, ................................. , 19....~..,~.- Permission is hereby granted to: ....... ~.~.~.~. ........ ..o...~.~:~.~ ............................ ~o~,"l'ko/-,/~. ~l,~ 11'~7! ,o .......... ..b..?.~).d ........ ~.~ .......... ~.:~:.~..-.......~. ...... <~...~.~:.~ ...... d~c/?~ .................. County Tax Map No. 1000 Section ......... Z.O.. ........ Block ...... ./...)7. .......... Lot No .......~..~.,.J .......... pursuant to application doted .................. i.~.../.,j. .............................. , 19...~.~.~ end approved by the Building Inspector. Fee ~ ........................ Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southotd, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted im~ 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 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: I. Accurate survey of p~roperty 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 $15.00 4.Vacan~ Land C.O. $5.00 Oate .... .~.~1~. :. ~1~.1~. ............ New Building .~'%[..'~ ..... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .... C? ,,~/ :'.~."~q.. ~) .~. .%.. .D..'~..~... ,-,o,,,e 'No. ....... Street .... Owner or Owners of Property ~'~'.~ ~P'~I[ County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No~..\ .l~..%-...z~. Date of Permit .......... Applicant.. ~:f~,~.~ ?.~-; ............ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary C...ertificate ..................... F i.n~LCertificate '..7%-~ .? ................ Fee Submitted $...~, I~..~...X/.~.. [~..~..~...~. ..... /~ /~ Construction on above described building and permi~e~S'all~aP'91i~ble codes and regulations, ~,,.~.,~. ~,-~(~/~ppucant ~-~¢~.. ~Y'. :/~;~/.~.. ,"".-':;,~ :~4-: .. :~. 7~ ... ................ Rev, 10-10-78 ?'iELD INSPECTION FOU__ND~TI~N . (1st) ?OUNDATION (2nd) 2. ROUGH FRAME & PLUMBING ~NSULATION PER N. Y. STATE ENERGY CODE FINAL COMMENTS ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL,: 765-!80:2 ., 19 ? .6. Permit No ............ .7.././ Received ......... Disapproved a/c ..................................... (Building Inspector) APPLICATION FQR BUILDING PERIVIIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 stree or areas; and giving a detailed description of layout of property must be drawn on the diagram which is part of this app 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 Inspec~tor will issued a Building Permit to the applicant. Such perm shall be kept on the premises available for inspection througbou~ the work. e. No building shall be occupied Or used in whole or in part for any purpose whatever until a Certificate of Occupan( shall have been granted by the Buildirlg Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to ti Building Zone Ordinance of the Town of Southold, Suffolk County, New York, ~f~ther applicable Laws, Ordinances, Regulations, for the construction of buildh~gs, additions or alterations, or fo,r r~o~ir,, or deanolition, as herein describe The applicant agrees to comply with all applicable laws, ordinances, bufldin~od,c(hous~g code, a)nd regulations, and admit authorized inspectors on prenfises and in building for necessary inspe~d~j>ff~/ ~ / (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde ......... o... c f.. ....... , ........................................... Name of owner of premises .............. : ......... · ............................................ (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 LicenseNo ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of laed on which proposed work will be done ........ . ......... . ................................ ....... ? ./-.., ................ ............ House Number Street County Tax Map No. 1000 Section ..... G. ~ ........ Block .... ~ ........ Lot. ~' X Subdivision ..................................... Filed Map No ............... Lot ............... (Nine) 2. State existing use and occupancy of premises and intended use~nd occupancy of proposed construction: a. Existing use and occupancy ...... ,. ..................... b. Intended use and occupancy ........ ~ ....................... ~. ~t,,~ ..., ................... o ~ddi ~ Nature of work (check which applicable): New Building ..... ' ..... tion ........ Alteration .......... Repair ............. Removal ............ Demolition . .] ..... Other Work ..... i (Description) Estimated Cost ~ Fee 5. If dwelling, number of dwellin~ units ............... Number of d If garage, number of ears ... i ............................... 6. If business, commercial or mi~ed occupancy, specify nature and extent 7. Dimensions of existing stmctupes, if any: Front ............... Re, Height ............... Number of Stories .................. Dimensions of same structure w~th alterations or additions: Front .. Depth .................. [... Height ..................... 8. Dimensions of entire new con~tmction: Front ............... Rea (to be paid on filing this application) telling units on each floor ................ of each type of use ..................... .............. Depth ............... ............. Rear .............. ~qumber of Stories ...................... ............... Depth ............... Height ............... N~mber of Stories .......... i, ......... 9. Size of lot: Front ......... ! ............ Rear ............. 10. Date of Purchase ......... i ................... Name of Fora 1 I. Zone or use district in which premises are situated ................ 12. Does. proposed construction violate any zoning law, ordinance or regul~ 13. Will lot be regraded ....... i ............. , ........ Will excess fill 14. Name of Owner of premises .; D.M.,M..e....O../-d. '??,... Address . .~'.~?..6 Name of Architect ........ ~ .................. Address ..... Name of Contractor .......................... Address ..... ... l PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or propo property lines. Give street and block number or description according to de* interior or comer lot. STATE OF NEW ~'D. RK.~ , ' S S COUNTY DF. ,')'~'~'~; ?/' : ' -- (N~me of individual signing contract) above named. He is the i (Contractor, agent, corporate c of said owner or owners, and is dtaly authorized to perform or have perle application; that all statements cogtained in this application are true to th* work will be performed in the manner set forth in the application filed there Sworn to before me this 'X ~ .~,,,. ,~ ..L Not ary~ Public ,/~2.~. ';,~i }..~.~ .~.~. ........... County ...... Depth ...................... r Owner Iion' 1Oql:emr~v~ed fl'.om premises: Yes No t~ .t~.~¢..r~..t>tv,/~,.t'~..4.o.. Phone No ................ ............ Phone No ................ ............ Phone No ................ ~'d, and, indicate all set-back dimensions from . and show street names and indicate whether ,om, deposes and says that he is the applicant filter, etc.) rmed the said work and to make and file this best of his knowledge and belief; and that the ~ith. ........ .......... (Signature of applicant) / /