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Home My WebLink About14279-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z13861 Date September 17 19 85 THIS CERTIFIES that the building ....... P.o. 9.1' . (..&..F.e..n.c.e..) ....................... Location of Property 380 Deer Dr. Mattituck I~e ~oi ....................................... Street '~ ................ Hamlet County Tax Map No. 1000 Section ...1.1.4. ...... Block .... 1.0. ......... Lot .. 003 Subdivision Deer Park Filed Map No. 3204 .Lot No. 17 conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... .A.u.~u..s.t..2. 9. ...... 19.8. 5. pursuant to which Building Permit No. 1427q Z dated .... S..ep.t.e.m..b.e.r.. 1. .6 .......... 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 ......... ..... r.~r.-rr.-. Ingroun.~ Swimming Pool wi Fence ...... The certificate is issued to 0 'rcONNOR, DENIS & LINDA ..................... ...................... of the aforesaid building. Suffolk County Department of Health Approval .......... .~./..~ ............................ UNDERWRITERS CERTIFICATE NO. Pending Building Inspector Rev. 1/81 Foyer NO. O TO%VN OF SOUTHOLD BUILDING DEPARTMENT TOWH HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PEPJ~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 14279 Z Permission is hereby gronte.d to: \ c , , ...~,......~.~.~.... ...... ~~ .......... ~.~..~..~.~.~ ............................................. ....~.~.....~.~,....u~.~...~ ..... ~ ~ ~ ' ~~~L ....... ~t premises Iocoted -t .....~. ......... ~ .......... ...~..~ ......... ~ ..................................... · (~ o '~ Counby Tax Map No. lO00 Sect~,~ ...... IJ...~. ......... Block ...... 1 ............... Lot N ......................... Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOU'rlqOLD 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 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 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. B0 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. ' $ 5.0 0 Date ~'/~/--/G--J~5~-~ New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property . "' Owner or Owners of Property . .e' ~ g,;. ?.. ?....~I ~.~. ........ .~..~.~..~ .................. y. - County Tax Map No. 1000 Section ..// ......... Block .... /..~. ........ Lot.. 3 Subdiv,s,on ....... F,,ed Map No. .... .7.'... Permit No, ?..~...~.~...2-Date of Permit....~//.d/.~.., .App I[cant~ . .~.; .~..~.,?.< ~.~.~/g....~.~'".~.~ .~.~Q..~.. . Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval..~...~ ............. Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ...... ~ ............. ¢¢¢¢. o ..... Fee Submitted $ .............. .L/...~. Construction on above described building and. mit. meets al~.p ,.~le codes and regulations. (LO ~- %'~%%% App cant ............. Rs~, 10-10-78 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL INSPECTOR ~/C ,~l E L~D I~S~ E C T ION COMMENTS OUNDAT!ON (1st) OUNDATION {2nd) IOUGH FRAME & PLUMBING ! NSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: Examined .~.~...~...1.[*., 19[.~. ·~' ~FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Received ........... ,19... Disapproved a/c ..................................... APPLICATION FOR 't~ "e, ?.~' Dat~ .... //~'.~ .... 19°~. .. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 Jets 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 Jhall 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 ~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 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. Fhe applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to ~dmit authorized inspectors on premises and in building for necessary insp~eftions. __, ...... ................. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) .State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .. ~.~.O.O.J. $..~...~/. ~/M/:.....~. .......... /~ .............................. If applicant is (as on the tax roll or latest deed) 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 land on which proposed work will be done .................................................. ... ....... ). .......... r/_7 .e,... ......... House Number Street Hamlet County Tax Map No. 1000 Section .... ~.~..~. ........ Block ... I.~. ........... Lot....~. ............. Subdivision..be..e-~....~.O,.~..~.. .................. Filed Map No. ~..~..~..q ..... Lot .... J.~. ........ (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... .~. ~.~. ~. ¢... ~. ~2.g.~.....~?.o../ ................................. b. Intended use and occupancy .................................................................... 3. Nature of. work,(eheck!i,,~l~mh ~pphcable): New Building ...... . ... 'Addition .......... Alteration ........... Repair ..... .-,~..?~5.~ Remova! .............. Demolition ............. : 5.""If dwelling, number of dwelling units ............... Number of dwelling units on each floor ............... If garage, number of cars ... ~ ................................................................... 6. If business, commercial or mi!ed occupancy, spec~y nature and extent of each type of use .................... 7. D~ensions of existing structures, if any: Front ............... Rear .............. Depth .............. Height ............... Number of Stohes ....................................................... Dimensions of same structure with, Depth .................. 8. Dimensions of entire new con ' Height .............. 9. Size of lot: Front .... 10. Dat~ 'of Purchase .'.,~ 11. Zone or use distri~!~ [iic~ 12. Does!proposed~[~lt zo~ 13. Will lot be'regra~d ~,(~ 14. Nam¢ofOwnerof~ .s,~ Name of Contractor , ~,. ~rations or additions: Front ................. Rear ................. ~ht, ~,~, ,. ,~ ........... Number of Stories ......... LI~'~..~.~'~ ...... Rear ............... Depth .............. ? ........ ? .......... :"' :: ...................... , .,/~\,~m-. .....................uePm ...................... ,~'~"'a' .... Name of Former Owner . ,3fc. c ~,ordinance or regulation':'iiiiiiiiiil....iii. ~.~..~. ....... Wili excess fill be removed from premises: Yes ~1(#'~,,~..O.~?.~ff.~,~ddress ~.tg: ~.v, .~..~ ........ Phone,No.~..~.: i~.q.~.~.... '..~. ~.'~ ......... Address ................... Phlg~ No.~qffg ............ Address Phone No PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from prop.erty lines. Give street and block number or description according to deed, and show street names and indicate whether intenor or comer lot. , . J STATE OF ' S S COUNTY O~ .... ! ' , ~' (Name ofi;dividu~l'si~i;k'c'o~'t;a'c'ti .......... being duly sworn, deposes and says that he is the applicant above named, ~Heisthe. ........ ~... , (Contractor, agent, corporate offieer~ etc,.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements co~tained 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 .............. ........ ' Notary Public,/~.~.cf. '.' .4 ~. · ,~ ........... County ~--'~._ ~ // . ~' (/ t~lgnature or applicant) APPROVE AS [{¢T[D N~t~ BUILDING DEPARTMENT AT 70~48~2 O AM TO ~ PM FOR THE FOLLO~NG INSPECTIO~S: 1 FOUN~O~~ TWO REQUIRED FOR PO~E)'~ 2, ROUGH FFL ';;HG & PL~ 3. INSULAI'I&. 4. FINAL CL' .'~UCTtON MUST ALL CO~,ISTRU~. 9N SHALL MEET TH~ REQUIP~i~c~:' ' 'rS OF THE STATE CONST~*;,,'Tr~ON & ENERGY CODES, NOT ~SPONSIBLE ~StGN OR ~ ......... ~"' *