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Home My WebLink About13838-zFORM NO· 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z. 1..5.45.9. Date December 12 19 .86 THIS CERTIFIES that the building Accessory . fP ty 3.9.4..0 [qR.C..H.A.R.D. STREET ORIENT Locatio~t o roper .. ................................................. i~louse No. Street Hamlet County Tax Map No. i000 Section .0 2~ .. ·Block 3 . .Lot .. .3 ;6. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · A.p.r.~.~.4 ....... ,19 8. .Spursuant to which Building Permit No 1383.87. ........... dated ..... A. l?.r.i.i..................4 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 ig ......... A.c.cesso.rX b..%lild, i. ng i.n the .r.e.a.r..y.a.r.d... The certificate is issued to Kevi.n J. Aylwa. rd of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... N/A UNDERWRITERS CERTIFICATE NO .................................................. Rev. 1/81 FO~ NO. · 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) No- 13838 Z Date ...... .~~,.....,, ,~. .....................19.?....~.~ Permission is hereby granted to: /~. 1 ~f~.~~...~L.~L~ ......... .................................. at premise,?ocated at ...~..~..~..~.......~,~/~...~.....~......~..........~.~ ...................... County Tax Map No. 1000 Section ...... .0....~....~.. ...... Block ......... ~ .........Lot No....~.....:...~. ........... pursuant to application dated ...... ~'~ '~......,~.. ..................... , 19~.,.~.C--" and approve~ by the Building Inspector. Fee,~:..~ ...... ~~ ~~~:~ .............. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building 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 m Imammm 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. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre*existing dwelling $ [ 5.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. updated Co O. $15,. 00 Date ...1.2./. 1..0/.8.6. .............. NewConstruction. .. Old or Pre-existing 8uiMing ............ Vacant Land ............. Location of Property 3940 ORCHARD ST. ORIENT House No. Street Hamlet, KEVIN J. AYLWARD Owner or Owners of Property ........................................................... County Tax Map No. 1000 Section 027 .. Block 3 ............................ Lot .... 3.6 Subdivision ................................. Filed Map No ........... Lot No ............ Permit No ........... Date of Permit .......... Applicant ................................ Health Dept. Approval ........................ Labor Dept. Approval ...................... Underwriters Approval ........................ Planning Board Approval .................... Request for Temporary Certificate ..................... Final Certificate ....... .~ ............ Fee Submitted $. ~.5...0.0...c~. ?, .2.3.0.; ........... Construction on above described building and permit meets all applicable codes and regulations. ............................. Rev. 10.10-78 FIELD INSPECTION FOUNDATION (1st) FOUNDATION Z. (2nd) ROUGH FRAME & PLUMBING COMMENTS INSULATION PER N. STATE ENERGY ODE .~..~ITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION ~ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [, ] FINAL DATE A? DATE: lqOTIFY 765- ~ g02 FOlJ. C)~^d 1. FOU'Nr FOR. P~ :~. ROUGI- :7.CV£D AS NOTED )TC~i'NO DEPAI~'TMENT Al; 9 A~~ TO ~' PM FOR TH~ JG INSPECTIONS': ATIO'N,- TWO REQUI~ED~ )URED CONCRETE' - FRAM'lNG & 4. FIN~l. " COK'STRUCTIO~~ MUST B: ~' '~LETE FO~ C.O. ALL C~h '~RUCTION SHALL~EET THE Pr~':'~rMENTS OF THE~. Y. ~TATF C-NcTRUCTION & ENERG~ C~O~Fq. h~m RESPONSIBLE FO~ ~ES:GN ,OR CONSTRMCTION~ ,,J 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 1:1971 TEL.: 755-1802 Examine ' . ..q-.,19 '~' ''~''''' kpproved~...qT. .... 19~.~. Permit No..} .~- .~.~. ~.."~-: Disapproved a/c ..................................... Received ........... ,q9... (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 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing locaion of lot and of buildh~gs 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 pa~ of this apph cat[on. c. The work covered by this application may not be commenced before issuance of Bufld~g Permit. d. Upon approval of~fis application, the Building Inspector will issued a Bulldog Pemit to the applicant. Such pemi shall be kept on the premises available for inspection throughout the work. · ..... c~ e. No building shall be occupied or used in whole or in part for any purpose whatever until a Cemi~cate of Occupm~ shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Dep~tmeut for the issuance of a Building Pemit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordin~ces o Regulations, for the construction of bulldogs, additions or alterations, or for removal or demolition, as herein described The applicant agrees to comply witl~ all applicable laws, ordinances, building code, honsing code, and regulations, and t~ authorized inspectors on prmmses and m bmldmg for nec~upspectmn . admit ~~. (Signature of ab~icant, or n, m~a, ' ) (Mailing address of applicant)~ff~ ~) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buildei or of .. ...................................... If applk;ant is a corporation, signature of duly author/zed officer. (Nane aud title of corporate officer) . Bnilder's License No .......................... Phunber's License No ......................... Electrician s License No ....................... Other Trade's License Ne ...................... I. Location of land on which proposed work will be done ................................................. Itouse Number Street Hamlet County 'Fax Map No. 1000 Section ..... (7~..~-.Q. ....... Block ....... ~. ......... Lot....'~..: b .......... Subdivision ................ (iq'a'n~) ................ Filed Map No ............... Lot ............... 2. State existing use and occupa~remises and intended use and occupancy of proposed construction: b Intemled use and ocr--ancy ..~...~ ~ ~ ~.e":,,?e~.. · ~. Nature of work (check which applicable): New Building . ' Addition .......... Alteration ........ Repair .............. Removal .............. Demolition ......... i .....Other Work ..... .......... ~ (Description) 4. Estimated Cost ...................................... Fee ........ . '~ (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ............. If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each iype of use .................... 7 Dimensions of existing structures if any: Front Rear ~ Depth Height Number of Stories Dhnensions of same structure with alterations or additions: Front .......... I ....... Rear ................. Depth ...................... Height ...................... Numberiof Stories ..................... 8. Dimensions of entire new construction: Front ............... Rear ...... i ......... Depth .............. tteight ............... Number of Stories .......................... ! ............................. 9. Size oflot: Front . ....... Rear ..................... i' Depth ...................... 10. Date of Purchase ............................. Name of Former Ownet ............................. 1 I.Zone or use district in which premises are situated ....................... i .............................. 12. Does proposed construction violate any zoning law, ordinance or regulation: .. .............................. 13. Will lot be regraded ............................ Will excess fill be rem6ved from premises: Yes No 14. Name of Owner of premises .................... Address ............. i ......Phone No ................ Name of Arcliitect ........................... Address ............. i ......Phone No ................ Name of Contractor .......................... Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, andi indicate ail set-back dimensions from property liues. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE.OF NE~/YORK, . ~ t, .c'~g-d~'[.z~.~ .O~...'~. ...................... being duly sworn,~dCposes and says that he is the applicant (Name o f;r'ndividual signiug contract) .~ above named, i He is the d~:t~ ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed th~ said work and to m~e and file this application; that all statements contained h this application are true to the best o~his knowledge and belief; and that the work will be performed in the m~ner set forth in the application filed therewith. Sworn to before me this Nota~ ................ Public,'~.~'.~~ ...... ~ ....... "d" ........... ' ..... ~~ '~ mv,~ ~o~: ........... County ~ .~~~ ,o. ~m0~ - ~,,~ c.~ v i ~ (Signature of applicant)