The URL can be used to link to this page

Home My WebLink About13959-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z~ 36~9 Date ..... July 9 1985 THIS CERTIFIES that the building addition. Location of Property q q70 Third Street New Su.ffolk /t~ ~Jo: ....................................................... Street Hamlet County Tax Map No. 1000 Section '1 '~ 7 .Block ? ...... Lot ~ 6 Subdivision ................ ~. ............. Filed Map No .... .x....Lot No.. x conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... .M.a.~.. ? ~ ......... 19~..~. pursuant to which Building Permit No ...... ~..~.97.9.~. ......... dated ....... .~?.~- ..~? .............. 19 .~..~, 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 ......... Addition to existing one-family dwelling. The certificate is L~sued to ...... VUCKO JOVCIC ............... ...................... of the aforesaid building. Suffolk County Department of Health Approval ............. ~./.~ .......................... UNDERWRITERS CERTIFICATE NO ............................. ..................... Building Inspector FOR~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No ~3959 Z Permission is hereby granted to:/ ........ ............. .~...-...~..~.....~~......~... .............. .... ~_~ .... 4. , ~-~ .................... to at premises located at .,~..J..~....?. ....... ..~.,~...~ .......... .,~..~....~.... '~ I cou.~ Tax Map No. ,000 Section ...... ....... B,~k ...... .......... Lot No ...... ~. ............... pursuant to application dated ......... .~.~...J,..~. .................. , 19~.~..., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted ia ~ 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 property 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 .DO 4.Vacant Land C.O. $5.0,0 $15.00 Date .......................... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property .... .~....~-~...--....~.....,~..'.~_j ....o~.~~ ................ House No. Street Owner or Owners of Property .......................................................... County Tax Map No. 1000 Section ...././. ~.. ...... Block '~z Lot Subdivision ................................. Filed Map No ........... Lot No .............. Permit No .......... Date of Permit . .-- pplicant ........................ Health Dept. Approva~ ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Tamporaw Certificate ..................... Final Certificate .... .~... .............. Fee Submitted $ .......................... Construction on above described building an~%s all applicable codes and regulations, C" 0'~ ~:['b(o/q Applicant './. .... ':¥...' . .~. Rev. 10-10-78 INSPECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y, STATE ENERGY QODE FINAL COMMENTS ADDITIONAL COMMENTS: ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL · ~OUTHOLD, N.Y. 11971 TEL,: 765-1802, ~ ~ow. OFSOU~,~OLo I ReceivedO.(~ .~ ~ [~. 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 ;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 whkzh 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 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 a 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 tdmit authorized inspectors on premises and in building for necessary,4n~spections, rD . · (Signature of applicant, or name, if a corporation) · (Mailing address of applicant) [ ~2H4' .tare whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Iame of owner of premises Vf~~ ~) tax roll or latest dee applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No...~. · .~.~.~. ................ 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 t~ County TaxMapNo. 1000 Section /f.'.~ .............. Block ..f .............. Lot 4~ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and in'ended use and occupancy of proposed construction: a Existing use and occupancy ~/~ ]~ ~' · , ".,','" .~ .............. ~. '~',/ ....................................... b. Intended use and occupancy..~,~i~. ~......(~v.. ~.' · .~.'. ': .~.'[ · .~)....?~... ............................... 3. Nature ~o. fwork (check which a lcable: New Building ....... Addltmn ......... Alteration .......... Repmr .. Removal .............. Demoht~on ............ Other Work ............... :~ ,. .., , , ~ (to be paid on filing this application) l~'~wel~ing number of dwelling~units Number of dwelling units on each floor If garage, number of cars .... ~ ................................................................... 6. If business, commercial or mixe~d occupancy, specify nature and extent of each type of use ..................... 7. D~ensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Sto~es ........................................ . ....... ,. ~. Dept~ ~ HeiSt Number of Sto~es Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height Number of Sto~es 9. Size oflot: Front . ~ ..~ Rear ...................... ~th .... ~.w. · . ........... ............. 10. Date of Purchase ................ Name of Fomer Owner ............. .... h pi ' it ted 11. Zone or use district m whlc cruises are s ua .................................................. 12. Does proposed construction vi¢late any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ...... 7~, ....... ~ ~ ~.,.... Will e~s fill~e remved fr~m premises~ ~ No. 14. Nme of Owner of premises ~..~ ........ Nme of Architect ........ i ................. Address ................... Phone No ................ . Nme of Contractor ' Address Phone No P~T DIAGR~ Locate cle~ly ~d distinctly ~1 bufld~gs, whether existing or proposed, ~d~ indicate ~1 set-back d~ensions from prope~y ~nes. G~ve street ~d block number or desc~ption accord~g to deed, ~d show streeI nines ~d ~dicate whether inteflor or corner lot. STATE OF NEW YORK, COUNTY OF ................. S.S ................................................. being d' (Name of individual signing contract) above named· He is the .................... q ............................ ~ (Contractor, agent, corpon of said owner or owners, and is duly authorized to perform or have application; that all statements contained in this application are true work will be performed in the mantlet set forth in the application filed Sworn to before me this .... ....... ].~. ~ .day ;r... ~..~d~ ............. 19~.~.' . .J~.: . {6~.~.(~..~. ....·..County ; ,ELAN '. '....'./ NOTARY PUBLIC. Slate of New York No 4707878. Sgffolk County,. I Term Exp~tes March 30, t~ ly sworn, deposes and says that he is the applicant te officer, etc.) erformed the said work and to make and file this the best of his knowledge and belief; and that the terewith. L i , t Memorandum from.. · BUILDING INSPECTORS OFFICE TOWN IIALL, ~X 728, ~)~I~r&IOLD l 197 I 765-1802