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Home My WebLink About20358-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20440 Date JANUARY 2, 1992 THIS CERTIFIES that the building Location of Property 775 WOOD LANE House No. County Tax Map No. 1000 Section 86 Subdivision ALTERATION PECONIC~ NEW YORK Street Hamlet Block 6 Lot 9 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 30, 1991 pursuant to which Building Permit No. 20358-Z dated JANUARY 2~ 1992 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 ENCLOSURE OF EXISTING OPEN PORCH ON ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ERNEST & DOROTHY HYNDMAN~ DECEASED (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A / ~ Building Inspector Rev. 1/81 ~' NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 20558 Z Permission is hereby granted to: ..... ~.~....~.~........Q..~..~ ......... ..... ...~..~.~.....-1 ...o...c,. ............................................. ...t~..~: .................. ..~ .......... L~..~.~ .......... ~ ~ ,o ..~.~.........~....~~.....~....e..~.&,.~...~.....~..~.~.. ~.~.~.~.....~.......~.~....~ ................................... : ............................................ at premises oca ed at ...~..~...~. ....... ~iiii~ ........ )..~.~,~'~,~.t,~. ......................................... .... ...... ........................ ........................................................................... County Tax Map No. 1000 Section ........ .~..(,q ........ Block ......~.....~. ......... Lot No...~..c[ ............... pursuant to application dated .....~...~..~J~:~......~... ............ , 19..~..(.., and approved by the Building Inspector. Fee $ ........................ g nspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD · Building Department Town Hall Southold, N.Y. 11971 ~ 765 - 1802 , ~ T~:' :, , · ~ 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 natu re[ or topographic featu res. 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 pz~operty showing all property lines, streets, buildings and unu~uat natural or topographic featu res. 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: l. Certificate of occupancy $25~'00 -- BUSINESS $50.00 2. ~Certific,ate of occupancy on pre-existing dwelling $ 50-. 00 3. L;opy ot certificate of occupancy $ 5.'00, over 5 years Si0.00 5.Updated C.O. $'·50.00 Date .......... ~ ......... NewC°ns%z'uc~ion...~. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ............... /.~., ......... House No. Street Ham/er Owner or Owners of Property .................. County Tax Map No, 1000 Section .......... Block ,.,.,,,.o,,..,, Lot .... . 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 C flcate ..................... Fina Certificate .L., Construction on above described building andper~~pplicable c~des and regulations. ' ... ~o.~o.~ GARY FLANNER OLSEN, ES~. P.O, BOX 706 ~' ~] ~ ~ ,CUTCHOGUE, LI., N,Y. H935 MAP OF [_AMD f-]-lq kl[ o'l- Iv1A I j)E I._ I I-IYNDMAIq A t4 l) FI t'; I-1'¥ N 0 M A 1~.1 AT P t=_C 0 M lC., 'I'OWt,J ()tr $OIII'IIOI. L~.tl ¥. '1 f) ~ o~ ,N ~'4 2.O~ gA ~t4'T4 / I0~ P, IGtl I' OF WAY TO fl-SOl&l,/ GARY FIANNeR OLSeN COUNSEllOR AT LAW P. 0 BOX 7'06 · MAIN ROAD · CUTCHOGUE, LONG ISLAND, NEW YORK 11935 ',' PHONE 516-734-7666 FAX 516-734-7712 December 30, 1991 Re: Hyndman and Richards Dear Mr, Fish: ! understand that you are requiring a building permit in connection with the above matter to replace screens with jalousie windows. ! am enclosing herewith the following: 1. Application for building permit. 2. Application for Certificate of Occupancy. 3, Building permit application fee, $50.00. /1 4. Check Jn the sum of $25.00 for Certificate of Occupant. / / GFO:Imk GARY FLANNER OLSEN Enclosures Southold Town Building Department Main Road SouthoId, NY 1]97! Attn: Gary Fish FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & -PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMME~;TS: DEC 3', 0 BOARD OF HEALTH 3 SETS OF PLANS ....... FORM NO. 1 SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARIMENT SEPTIC FORM · TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 CALL MAIL Examindd ~ .... ,.~, ,, Approved .~...o.~....u~. ~., 19~/.&. Permit No..c~.o..%.~.'?..n~_ Disapproved a/c .... ................................. ................................ ....... (Building Inspector) APPLICA'I ION FOR BUILDING PERP/IIT TO: INSTRUCTIONS a. Tl~s 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 coy&red bytlfis 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 o/F~uilding Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, anj~/othe/applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for reJyFgxal o/~,emotition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building ~e)~, hj;aS~ff[g code,)m~t~egulations, and to admit authorized inspectors on premises and in building for necessary inspecti~. I.~/~/~...~ ~, ({AR¥ lei/iNNER 0[SEN~ ESQ. (Signature of applicant, or name, if a corporation) "~ P.O. BOX 706 CUTCHOGUE, L.L, N.Y. 11935' (Mailing address of applicant) State whether applicant is.owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. --o (as on the tax roll or late'St deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of co,orate officer) - ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 11 Location or land on which proposed work will be donel ........................................... ~ ..... ....'Z. ................................. ...................... ltouse Number Street I-Imnlet County Tax Map No. 1000 Section g%~ Block b Lot .% .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2, State existing use and occupancy of premises and intended use and occupancy of proposed construction: a Exist ng use and occupancy .~xTM K~.\'.v'It- . , ..... ............................. 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ..... ~ .... Repair Rmhoval Demolition Other Work 4. Estimated Cost ,. Fee " (to be paid on filing this application) 5 Ifdw lling tuber ofdw fling its Nu nber f dwelling its on each floe If garage number of cars 6. If business, commercial or mixdd occupancy, specify natnre and extent of each ~ype of use ....... :. : ' 7 Dimensions of existing structures if any' Front Rear Depth Height Nmpber of Stories ........ f Witl lte additi R Dhnensious'o same structure 1 a rations or ons: Front ................. ear ......... ,, .~ .,.,... Depth ~ Height Number of Stories ' 8 Di ensions ofentir nstr ction: Fr Rear Depth , .,.,'. Height Number of S~orics ' 9. Size of lot: Front .......... : ........... Rear Depth 10 Date of Purchase i Name of Fomer Owner 11, Zone or use district in which pr~mises are situated . 12 Docs proposed construction violate any zoning law ordinance or regulation' ' ' 13. Will lot be regraded ........ [ ................... Will excels fill be removed from premises: Y6s : 14. Name of Owner of premises .................... Address ..... ' .............. Phone N0... Nme of Architect Address ' Phone No Nmne of Contractor Address ' Phone No 15. Is this propertylocated~w~th~n' ' ' 300 feet of a tidal wetland? *Yes .. 'No .... *If yes, Southold To~ Trustees Permit maybe required. ~,, .... ,; . ,,, ,,, Locate clearly ~d distinctly ~1~ build~gs, whether existing or proposed, and, indicate ~1' ~et-back d~nsions from property ~nes. Give street and black,number or description according to deed, and show street ames and indicate ~hether NOTtFY ~,Ik.D~NG t)~PAf~TMEN'f AT FeLt,OWING INGP[::CI'IONS, ' ' g~ ~' ALL CONS'mUCT~ON SHALL MEET THE REQUIREMENTS OF THE N.Y~ ~[[ATE CONSTRUCTION & ~ENERG~ (OBES. NOT RESPONSBLE.'FOR STATE OF NEW~(,~ ~ S S DESIGN OR CONSTRUCTION ERRORS .. . .. b ngdu y,wo n, epo na ' ' (Na] individual signing contract) ~ le 3s ~he apphcant above hauled. (~ontractor, agent, corporate officer, etc.) of ¥id owner or owners, ~md is duly[ autho~zed to perform or have performed the said work and to make and file this application; that all statemo[}ts contai~md ~ this application are true to the best c ~s knowledge and belief; and that the work w~l be performed in the m~ner?et [orth in the application ~lcd therewith. / ~ ~;~' (Signature of ~pplfcant,