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Home My WebLink About13677-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold~ N.Y. Certificate OF Occupancy No. Z-16210 Date September 29, 1987 THIS CERTIFIES that the building SHADE COVER Location of Property 2140 Bo{sseau Avenue Southold, N.Y. House No, Street Hamlet County Tax Map No. 1000 Section . . .0. 5. .5 ...... Block . . ?.6. ..... i ....Lot ...0.5. 8. ........... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated July 20, 1984 pursuant to which Building Permit No. 13677 Z dated .... .J.a.n.u..a .r.y.. ! .5 :..1.9. 8..5 ..... was issued, and conforms to all o f the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... SHADE COVER ON EXISTING PATIO The certificate is issued to VALENTINE & SUSAN STYPE (owner, legf~eToK FoJfa~lCX X X of the aforesaid building. Suffolk County Department of Health Approval ...... .N/.A. ................................ N/A UNDERWRITERS CERTIFICATE NO ................................................. PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 ~ 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) N9 13677 Z ~....: ............. ; ........ .:: ......... ~ ....... : ............................. .;~ .......... : ................................ o, p,,m,,,s ,oco,~ o, ....~z/...~.~. ...... ~~ .......................... County TOx Map N. lO00tSection./~~ Block ..~..~. ........... ~.~.L..ot No..~.....~....~... ...... ;~ Building Inspector, Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m Immmmmm to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with ~ccurate 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. §.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 pz~operty showing alt property lines, streets, buildings and unusual natural or topographic features. 2.Sworn stetement 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 1. Certiflcate of occupancy New Dwelling $25.00, Accessory ,$]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updat:ed C.O. $ 50.00 Date ...... NewCons truc tion.., g. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ................................................................. House No. Street Hamlet Owner or Owners of Property ............................................................ County Tax Map No. 1000 Section o.~ Block o ~, Lot. O ~' ,~. · Subdivision ................................. Filed Map No ........... Lot No .............. PermitNo. I.~.G.1..~..7-:. Date of Permit ..~]!.5'J?..~.Applicant V'ql'*~'~'.~.~. ~J' 5q"le'~ Health Dept. Approval ........................ Labor Dept, Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request ~or Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $. ~.~ ..... .~.~.../.~ .~..'~. ........ Construction on above describedApplicantbUitding ,~.'~and p. ermit meets(~pplicable/,~./zc~codes and .......... regulations. Rev, 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 This is to advise you that the job under building permit no. 13677Z~ issued to valentine Stype on 1/15/85 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 be issued. 'Please fill out the enclosed f~rm, 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 you_r_~, Victor Lessard Executive Administrator VL:gar encl. ~INSPEC ~I,ON F.~ELD , I ~OUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE COMMENTS ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND__! ~/~SU~TION FRAMING [,~FINAL ~ , REMARKS: DATE INSPECTOR TOWN OF SOUTI:IOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 This is to advise you, that the job under building permit no. 1~677Z issued to Valentine Stype~ on _~15/85 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 be 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 y~, Victor Lessard Executive Administrator VL:gar &~ 74s'~ /?47 "FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examineu J~7~y ......... , .. - Approved ~4../. ~7 ..... 1 ~.~rmit No./..~. · ~.~. · .~-. - Disapproved a/c ~~ (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ,19 Date...-]. g'~ 19~'c~ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 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 streets 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 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 admit authorized inspectors on premises and in building for neces.s .~..~..(~.~2.. (Signature of applicant, or name, if a corporation) .2. !?.?., .e. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general' contractor, electrician, plumber or builder. ............................ ow~.~, r. ........................................................... Name of owner of premises .~..i).~*.~?.~.?.C.....k~..~.~.~.C..~.~"l'e '~ .qr- ~.S..oy?)...h~..~,.~?..~-..~...~."~..(~.~. .... (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... ,~ .~4.~. .............. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. · g. j?..o. ...... '..~.95s's ~a'-,... ~yc.. ..................................... House Number Street Hamlet County Tax Map No. 1000 Section .... .O..~7.-~. ........ Block ....... ~ ......... Lot ..... ~..~. .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................... ~ ................................... b. Intended use and occupancy ....~.~..c~. ...... ~ .Ih. 0.~..~Q. .... .~..~?...~4f~.. ................................ 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .... Repair RemOval Demolition Other Work (Description) 4. Estimated Cost .. (to be paid on filing this application) 5. If dwelling, number of dwellingl 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 type of use ..................... 7 Di ' sofexist' g tu' 'f ny Front Rear Depth · menslon in struc res, 1 a : ............................................ Height Number of Stories Dtmens~ons of same structure w~th alterations or addmons: Front ................. Rear .................. Depth ................... '... Height ...................... Number of Stories ................... 8. Dimensions of entire new construcQon:, Front ............... Rear ............... Depth ............ Height ............... Number of Stories ..................................................... Size of lot: Front .......... : ......... Rear ...................... Depth ................... Date of Purchase . ~ .... Name of Former Owner Zone or use district in which premises are situated .................................................. Does proposed construction wo'late any zoning law, ordinance or regulation: Will lot be regmded ........ .[ ................... Will excess fill be removed from premises: Yes No Name of Owner of premises i . Address ................. Phone No ........ Name of Architect ......... i .................. Address ................... Phone No ................ Name of Contractor ........ ~ .................. Address ................... Phone No ................ 10. 11. 12. 13. 14. PLOT DIAGRAM Locate clearly and distinctly al! buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blockl number or description according to deed, and show street names and indicate whether interior or corner lot. i STATE OF NEW YORK, COUNTY OF ................. S.S ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual sigging contract) above named. He is the (Contractor, agent, corporate officer, 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 contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the mann6r set forth in the application filed therewith· Sworn to before me this ~c7C~ L~ ... ~ ............ 19 ?..~ ......... ' ............... day $o taryPublic ......... C ounty~/2~?~t//j .~. ~..~ HtLFN K. DC V0E ~..~.; ............................. NOTARY P~IBLLC, .State 0t New YSrk (Signature of applicant) : ~10. 4707878. Suffo[k C0unt~t lorm £x¢lres March 30, 19 .t