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Home My WebLink About14201-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building D e c k Location of Property 2325 Nprth Sea Drive Southold /'l~.~ ~io~ ........................................................ Street Hem/et County Tax Map No. 1000 Section .... 0.Sz~ ....;Block ... ~).4 .......... Lot ....... Q.2.4 ....... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated .... ?/.2.5./. ............ 19 8. 2. pursuant to which Building Permit No...1.4.2. 0..1 .Z ............. dated ...8./. J .4/ .................... 198.5.., 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 dwellin .. ............................................ The certificate is issued to Mar3( H. Fand (owner, Xe~d~K of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO ............ .lq./.~. .................................. Building Inspector TOWN OF $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) 14201 Z Permission is hereby granted to: .......... ~..~g......//......./~~ . - ........................ ........ ..~.~..~.....~.~..~.:...~ .................. ........ ~z...~'~cz~.~.,./..f..../..-.~.:....~.~ :'? ~l/~, ,o .............. .......... ............................................................................ ~......~ ....... ~ ............ ;~ ........................... /. ............ at premises located at .......~.~.~....~..,....z~..~/~,~/....J~.~........-~,g~., ..................................... ........................................................................................................................ ~.~.~.~,.....~..- ,,,...-,/. pursuant to application doted ........ .~,~..~r..~.....~2,....~... ................. , 19..~..~.Ta;d approved by the Building Inspector. Fee $.....~Z....M~. ......... Bblldlng Inspector Rev. 6/30180 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ ~ 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. rB. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty 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 occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 ~'/'''~"~'/' '' ~/.~ ~ /.~.~?-~ Date ..... ........ New Bui{ding .~'.~.~.. ~.~. 1 . . Old or Pre-exist'ng Building ............ Vacant Land ............. Location of ProperW- --~ ~Dr~' ~ ¢~ 5~/~ .~ .... ~o~ ~3 ...................... ~l~;; " Owner or Owners of ProperW ..... ~...~'...~. ............................... co~**~ u~p ~o. ~0oo s~o~ .. 0.~ ....... ~o~k ... ~.¢ ....... co~..~.~ ........ Subdivision ................................. Filed Ma~ ~o ........... kot ~o .............. Health Do~t. ~pproval ........................ kabor Dopt. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate Final Certificate ...... Fee Submitted $ ...................... Construction on above described building an~Lp, erreit meets all. applicable codes and regulations. ..................... ELD T N :,j P ~ic'r ~l ON 1 i,'OUNDATIO~ (lst) FOUNDATION (2nd) }tOUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE FINAL 0/'{ C. 0 ADDITIONAL COMMENTS: ' FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 pproved .... ,1,2r. Pe it No. Disapproved a/c ........... ~.' ..... : ........ ../'7 ........ ' (Building Inspector) APPLICATION FOR BUILDING_PEFIIVilT. INSTRUCTIONS Received ........... ,19.. · a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ~ets 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 )r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- :ation. 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 hall 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 g Certificate of Occupancy hall 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 ~ilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or legulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ?he applicant agrees to comply with all applicable laws, ordinances, b~ilding co. de, housing code, and regulations, and. to !dmit authorized inspectors on premises and in building for necessary inspection~:.~(~/~ ::: .......... 7. ,'. ..... (Signature of applica/.ff~, or name, if a corporation) £,--g Or, .//q.".;'/ (Mailing address of applicants ~tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (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 ...... .~.~.'~..~.~Q. ............. Plumber's License No ......................... Electrician's License No ....................... Other Trade s License No ...................... Location of land on which proposed work will be done .................................................. .............................. :7¢o House Number Street ................... I~nlet '"/" .............. County Tax Map No. 1000 Section .... .O.'~...~ ......... Block ....C~..iT/. ........... Lot....Q .~..~. .......... 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 ..... ~. ~ ¥¥1 .Id t ~./'7.....V:.~.~. ~r~ ~ .Vt ¢.c3~... (.O.D. l ~.}.~ .................... b Intended use and occu anc · p Y ......................................... :,...... ;.,......;, ¥ .,,~ ............ ). ew Buildxng .......... ,d&hon ..........Alteration ......... Repair .............. Demolition .............. Other Work. Y.~'l?lo-tz.~ .e: .m?q~..-I ,, , (~s og old a~s~~!ption) 4. Estimated Cost .. Fee .~..~..--~. ~ .. . . .~?:-t~, ~ (to b~ paid on riling this ~pplicatJo~ 5. lf~.welllng,'~b~t, units ............... Number of d veiling units on each floor ................ If garage number of cars 6. If business, commercial or mi~ed occupancy, specify nature and extont of each type of use ..................... 7. D~ensions of existing structures,, if any: Front ............... Re~ ....... ....... Depth .- ....... . ' ...... Height ............... N~mber of Stories ................... : D~ensions of same structure Mth alterations or additions Front .............. Rear .................. Depth ................ ~.. HeiSt .. , umber of ~tofies .......... t .... ~ 8. D~mens~onsofent~re new construction Front ~ ~ Rear ~ ~m T. ~' .... ~ '~' ...... ~ ................................................................. 9. S~ze of lot: Front ...................... R¢~ .............. ~ ....... Depth ...................... 10. ~Dafe of Purch~s~ ......... ~ ................... Nam~ of Fo~e Owner ............................. 1,1. Zone or hie 01st..Jet in which premises are situated ..... . . 12. Does proposed construct~nt v~plate any zoning law, ordinance or re,la :ion: .............................. ' g ....... ~ ............. ~. · , cess n 13. Will lot be re faded t~o. . . Will ex ~' ~e remowd from premises: Yes 14. N~ of Ownor of premises J~&~..~... ~.. Address ~qt~ ~.. ~r'~Y~ Phone No. ~.~'Z/.q.~ N~e of Architect .......................... Address .................. Phone No ................ N~o of Contractor ......................... Address .................. Phone No ................ P~T DIAG~M Locate cle~ly ~d dis~ctly ~1 bufld~gs, whether existing or propos M, ~d~indicate all set-back d~onsions from prop~y 5nes. Giw street and block number or description accotd~g to dee ~d show street n~es a~d indicat~ whether interior o~ comer lot. ~ [ ~ :g 0 ~ t, q .' -"~TATE O.F NEW YORK,... . - ~ ~ ' ': ' " ~ .... t'~ / ' ~'~ OV T¥,9: .... (N~e of individual signing contract) above named. He is the (Contractor, agent , corporate o 'ricer, etc.) of said owner or owners, ~d is d~ly authorized to perform or have perfo: med the said work and to m~e and file ~is application ;~that all statements contained ~ this application are true to the best of his ~owledge and belief; and that the work w~l be perfo~ed in the m~n.er set forth in the application filed there, ?ith. Sworn to before me this ............. ~.~ ........ day ~f .... ~ ............ ,19 ~ Nora, Public,' . ~..... g?.....~ ....... County ................ ~.~8,~ I (Signature ofapplic~t)