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Home My WebLink About14247-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..~.~.4.?.~7 Date July 30, .8.6 THIS CERTIFIES that the building ..... p.oy. c..~..e.n.c. ~ .o.s.u. ~..e ......................... Location of Property 200 Oak Court East Marion, New York County Tax Map bio. 1000 Section ...0.3.7. ...... Block 06 .Lot 1 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fded in this office dated · .g.u.g.u.s.t.. ?, .......... 198..5. pursuant to which Building Permit No. ! ?.a.~. 7. .z .............. dated September 9, 85 ............................ 19..., was issued, and conforms to all of thc requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... · porch encl.osure to an existing one fam. ily dwelling The certiflcate is issued to Lois Thor? (owner, I~ ~t',~pc of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... N/A UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 FO~M' NO* 0 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) 14247' Z Date .......... ...~.. ........................... , Permission Is hereby granted to: *O~a ~,~' ~ ..~~..~:.¥:.....1/.2..9..~ ............. to .... · ~'~... ..b,~....t.....~..~.'"q'~....~'"~.. .I ~ ,,v__ .,, .............................................. , at premises located at ....c~...~ ....... ~.......~....: ....... ~..c~.....?~....~.~L~:~ ........................... ............................................ ............................................................. County Tax Map No. 1000 Sect~o~-~: ........ ..~. ...... Block ............ ~ ......Lot No ........................ pursuant to application dated .. .~.....~...~..~... ................. , 19.~..~.'.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD I~uilding 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 I~ 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: 1. Accurate survey of p~operty 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. Fees: 1. Certificate of occupancv $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 $15.00 Date NewConstruction ...... Old or Pre-exi§ting Building ............ Vacant Land ............. Location of roperty .... ....... '.< .............. House No. Street Ham/et Owner or Owners of Property ............................................................ County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Z...~..D Permit ~/.~./~. A .~. ~. .~ No. /..'./~. ~/~ate of .. pplicant..~...~ ...... Permit Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ..... ~. ., .~. .0. ................. Construction on above described building and permit meets all applicable codes and regulations. Rev. 10-10-78 [ F~I ELD INSPECTION FONNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING iNSULATION PER N. STATE ENERGY C,ODE COMMENTS FINAL ~ppITIONAL COMMENTS: 765-t802 BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FINAL INSPECTOR 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 kpproved~~ .g .... 19 ~ ?. Permit No. 1.~, .~.~..'2..~... )isapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled hi 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. ib. 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 ~ Certificate of Occupancy thall have been granted by the Building Inspector. i APPLICATION IS HEREBY MADE to the Buildmg Department for the issuance of a Building Permit pursuant to the §uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ~egulations, 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, anql regulations, arid to ttdmit authorized inspectors on premises and in building for necessary insp~i~,~')n,,si~~,/4~ ~f'. ff-'-~j ...... . ..:: ......... .... (Signature of apl(fficant, or name, ifa corporatio ) · ...... ............ (Mailing address of applicant) itate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~[ame of owner of premises...Z~,O.......1'$ .... ~.~'7.'I ../77..]4.~.t.~. .............................................. (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 .... d ff. ~ ................ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map No. I000 Section ...~..~.. ........... Block ...... .~.. ......... Lot ....... / .......... State existing use and occupancy of premises and intended use and occupancy of proposed construction: Nature of work (check which applicable): New Building ..... ' .....'Addition .......... Alteration ......... Repair .............. Removal .............. Demolition .............. Other Work ............... $. If dwelling, number of dwellin~ units ..... ]. Ifg ag umber of cars (Description) (to be paid on filing this application) ........ Number of dwelling units on each floor ................ 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 ............... Number of Stories ...................................................... Dimensions of same structure with alterations or additions: Front ................. Rear ................ Depth ................... !... Height ...................... Number of Stories .................... Dimensions of entire new construction: Front ............... Rear ............... Depth ............. Height ................ Number of Sto.fies .................... , .................................... 9. Size of lot: Front .......... i ............ Rear ............... ' ....... Depth ...................... Date of Purchase /~'.2. 7 ] Name ofF, ormer Owner 1 1. Zone or use district in which p~emises are situated../~.~, t e). +'.'~..~t..~./... .................................... 12. Does proposed construction vi01ate any zoning law, ordinance or regulation: ................................ i3. Will lot be regraded ..... ./~. D. ..... ~ ............ Wili excess fill be removed from premises: . Yes 14. Name of Owner of premises~.~.~:~, t~.-./. ~P./'~ ..... Address ~.~.~.~K,J~. A~.'?.a, .... Phone No.~..7.2.7 .~.~ ~]w. ~.. Name of Architect ....... i ................... Address ..................... Phone No ................ Name' of Contractor ~i: ."~]~..~r~.~4~ ~.& ~LA,~.~..~t*rn.. Address~*~ 5'~ ~ Ik~.~ ~o.x. Phone $o.~.7. F :.]..~.SX~. .... PLOT DIAGRAM Locate clearly and distinctly a~l buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and bloci: number or description according to deed, and show street names and indicate whether interior or ~corner lot. : STATE OF NEW YORK, ' S.S COUNTY 'OF ................. i ........................... i ..................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ............ ' ......... ~ .................... ,. ............................................ . (Contractor, agent, corporate office~,~etc.) of said owner or owners, and is dOly authorized to perform or have performed the said work and to make and ~e this applkatioh; that all statements cogtained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ..... · ~. .... day pf ...................... 19 ...~ Notary Public,. .. ~. Ok. .......... County ....... [ ~. F, '. ~,'" : -,~N M~.,~.T ALL CONS~ RUCT~O~ SHALL M~ CODES. NOT k~ONSIBLE FOR . ~ESIGN OR CONSTRUCT)O~ E~RO~