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Home My WebLink About13816-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall 5outhold, N.Y. Certificate Of Occupancy No. Z16461 Date December 7, 1987 THIS CERTIFIES that the build~g ..... p~.c k Location of Property 28850 Main Road Cutchogue County Tax Map No. 1000 Section ...I .0.2. ...... Block 6 .Lot 2 I Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated March 3, 1985 ...................... pursuant to which Building Permit No. 138 16 z dated Ma r c h 28, 1985 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 ......... Wood deck, rear of dwelling. The certificate is issued to ANTHONY T. / JANE BLADOS ..................... ?o¥,,'o'r, i i ix ' icPdx'x' ................... of the aforesaid building. Suffolk County Department of Health Approval ., N/A N/A UNDERWRITERS CERTIFICATE NO .................................................. N/A PIAIMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 FO~ NO. II TOWH OF SOUTHOLD I~UILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 13816 Z Permission is hereby granted to: Building Inspector. Fee Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southcld, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m JJJJ~ml 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. B. 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 unumJal 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: Additions $25.00 POOLS $25.00 1. Certificateofpccupancy New Dwelling $25.00, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $I0.00 5.Upctmtect C.O.' $ 50,00 Date ........... r Pre-existing Building ............ Vacant Land ....... NewC°n~tructiom ...... Oldo House No, . ~ ,, /Street :~ -- Ham/et Owner or Owners of Property .. J~ .~.C~. (2. County Tax Map No.. 1000 Section . ./ ........... J~lock ...~. ........ Lot ~/ ........ Subdivision ................................. Filed Map No ........ · .Lot No ............ ...... .... Health De0t Approval ' -- ' kabor Dept Approval Underwr}ters Approval ........................ Planning ~oard Approval ...................... Bequest for Temporary Certificate ..................... Final Certificate ....~..... ............ Con struction o n above described bu ilding~t,~/~e~ :t: all.~~?~nd [egu ,ati . ons. F1ELD INS~ECTION FOUNDATION (1st) FOUNDATION 2. ROUGH FRA~E & PLUMBING (2nd) INSULATION PER N. Y. STATE ENERGY FINAL COMMENTS ~ dx ADDITIONAL COMMENTS TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. ! 1971 TEL. 765~1802 This is to advise you that the job under building permit no. 13816Z issued to Anthony & Jane Blades on 3/28/85 for Addition is completed a final inspection has ( ) has not ( X ) been done. and In order to complete this file, it is necessary that a Certificate of Occupancy he issued. Please fill out the enclosed form, return same to the above office with a check for $25.00 ]payable to the Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with this office for an inspection date Occupancy or use is unlawful without a Certificate of Occupancy. Please help us to clear up this matter so that legal action does not have to be taken. Thank you for your prompt attention. Very truly your~, Victor Lessard Executive Administrator VL:gar encl. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Exainined...~..,'~-'.~..~.~.., 19 ~.,.9/' - Approved . . .'~_~J~d[.~..~'.., 19~...O~Permit No. J. 3.~. t/'~. 7. Disapproved a/c ............ . ......................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ~//dC 19. a. Tlfis 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 street or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli 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 Inspector will issued a Building Permit to the applicant. Such permi 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 Occupanc; 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 th{ Building Zone Ordinance of the Town of Southold, Suffolk County, New York and other applicable Laws, Ordinances o ~moval or demolition, as herein described Regulations, for the construction of buildings, additions or alterations, or fo~ The applicant agrees to comply with all applicable laws, ordinances,.b,b,b,b,b,b,b,b,b,~ admit authorized inspectors on premises and in building for necessa~ /housing co6e, and regulations, and t( ~~if a corporation) ...... ~iling address of a~pli6'ant~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of ~remises ' "~'"/'~'~"/'q'~"7 '/?/"~'~'~ ]q~'~ 'd~/'~Z~)O'~' ....... fi"'''/[a} ;]1 ;l~e ;a'x lo'Ii g; ia't~t'&~dd) ........ Il' 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 ...................... 1. Location of land on which proposed work will be done .................................................. House Number Street / Hamlet CounW Tax Map No., 000 Section.. '~ ~..~ ....... Block .... d ........... Lot .... ~.1 ........... '~ubdivision .............................. ' ....... Filed Map No ............... . Lot ............... (Name) 2. State existing use and occupancy of p~fises and intended use and occupancy of proposed construction: 3. Nature of work (check which applicable): New Building .......... Addition . .I ........ Alteratiolk. ......... Repair .............. Removal .............. Demolition ........... .... Other Work...~ .~.~.. 4. Estimated Cos .......................... Fee ........................... 5. If dw u er of dw ..... Number of dwelling units on each floor ................ If garage number of c~s 6. If business, commercial or mixed occupancy, specify nature and extent of each ty~e of use ..................... 7. D~ensions of existing structures, if any: Front. ~. ~ea~. Depth Height ............... Number of Stories'. '~/' .~.u/~ ~m ....... ~ ....................... D~ensions of same structure with alterations or addi~ns: Front ........... ~ ..... Rear .................. 10. Date of Purchase ............................. ~e of Fomer Owner [ ........................... 11. Zone or use district in which premises are situated .... /~:~.; ...... ~ ........................... 12. Does proposed construction violate any zoning law, ordinance or regulatmn: . ~¢ ........................ 13. Will lot be regraded ....... ~ .... ~ .......... Will excess fill be removed from premises: Yes No 14. Nme of Owner of premises W~.f.~a~(g4z~ Phone No Nme of Architect ........................... Address .............. [ ....Phone No ................ Nme of Contractor ~ Address ~ Phone No PLOT DIAG~M Locate clearly ~d distinctly fll bu~dhgs, whether existing or proposed, and. ifidieate all set-back d~ensions from property ~nes. Give street and block number or description according to deed, ~d show street nines ~d indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................. (Name of individual signing contract) above named. NO'FY BUILDING DEPARTMENT AT; 765-1802 9 AM TO 4 PM FOR THFj FOLLOWING INSPECTIONS: ]. FOUNDATION - TWO REQUIRED[ FOR POtJRED CONCRETE 2. ROUGH - FRAMING & PLUMBING] 3. INSULATION 4. FINAL - CON'STRUCTION MUST BE COMPLETE FOR C.O. , ALL CONSTRUCTION SHALL MEET~ THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENFRGYJ CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ~RP being duly sworn, deposes and says that he is th:e applicant He is the ........................................................ ~ ........... (Contractor, age~t~ ~;;~a't~ ;'f~i~;~, 'e't~.') of said owner or owners, and is duly authorized {o perform or have:performed the ~aid work and to make and file this application; that all statements contained in this application are true to the best of hi ~ 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 .............. .... dayof .... ......... Notary Public, . .... ~ 'iI'l .......... NOTARY PUgLIC, S~ote of NOw ¥off( No. 4707878, SuIf01k C0tl[lt[,.~ ~' "-~J ' (Signature of applicant)