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Home My WebLink About21000-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21075 Date OCTOBER 9, 1992 THIS CERTIFIES that the building ADDITION Location of Property 4025 OAKLAWN AVE. EXT. SOUTHOLD NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 70 Block 10 Lot 8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 2 1992 pursuant to which Building Permit No. 210000-Z dated OCTOBER 6, 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 ADDITION (ATTACHED GARAGE) ON AN EXISTING DWELLING. The certificate is issued to FREDERICK STAPON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A v1i / Bu' ing Inspector Rev. 1/81 FORM NO. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N 2N? 2100 0 Z Date ...../0 19. ,~;~~a jr~G~''z`Y /833 Permission its hereby 9~ rants to, r...~. ...!0:9'..5.... ..r its............ sS....,.7,? ro .i llP.?1 Yt~ Gn at premises located at ......4..r~............ ! . 4 i County Tax Map No. 1000 Section ZP....... Block ...../.Q........... Lot No....A? pursuant to application dated ...7,1~-.~f..fi . )9........, and approved by the Building Inspector. Fee S.•Q••• . . Bui ng nspec or Rev. 6/30/80 t y Form No. 6 , TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SEP 28 19'92 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building 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 from Health Dept, of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 17 lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. 3. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. -Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate,of Occupancy - $5.00 over 5 years - $10.00 4, Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ....1~.. 'ew Construction...... Old Or Pre-existing . ~Bui ocation of Property: , z; -Q-".. +-e. . He se No. Street Hamlet ,1wer or Owners of Property .....4.::.Y e~ II 111 runty Tax Map No 1000, Section.... ,V...... Block..~ .Lot. . ,bdivision ....................................Filed Map • ..Lot rmi No. Date Of Permit...... DeWA10I? ,0 0 -Z, Applicant...... f~ U alt ept. Appif6val......... /K Underwriters Approval . ..IKIf . anning Board Approval....... A149 quest for Temporary Certificate........... Fi al Certica e........... a Submitted: Q ec. Ny9 3? Ca~a'O )s APPLICANT LNT OUNDATYON (1st) m OUNDATIOA (2nd) _ o OUCH FRAME & ~ .FLUMBING N H • m n .NSULATION PER N. Y. 3 3 O Oo ~t STATE ENERGY ~tf CODs r Z 'OOF FINAL ~ q _ ADDITIONAL COMMENTS: x ^v H A H O • r H m b H rF 3. Nature o Y f "1drk (check which applicable): New Building ..,...V1 Addition Alterat~io^nJAr!.. Repair . 9,~ KRP~C Yid Removal Demolition Other Work (Describe) t!.......... rCA, ?r eerW4 12-r,..' .............................................Fee 4. Estimated Cost (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 p--.' .....................................................................................................pp.........,...,......... l~r~ 4Fd b. If business, commercial or mixed occupancy, specify nature and extent of each type of use T Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height ....................,...:..:....Number of Stories 8. Dimensions of entire new consfruct on; Front..... Rear Depth Height p....... ,....rNumber of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate7~n zoni'ne law, ordinancy or regulation? Phone No 13. Name of Owner of premises ..~.~.`~`.'.0'.'y.~°''' .'..r...... Address .....~j~~~ ~ Name of Architect .....................................................Address Phone No..........,.,........ Name of Contractor rf7 .,.r~l !'a ~e~Address j ~.!.,tfeZOP"(/ . fSG Phone No.......~.......... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. 4P a ~Gv P r Y'i, c v r STATE OF NEW YORK, ) S.S. COUNTY OF .......being duly sworn, deposes and says that he is the applicant (Name of individual signing application) 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,,,po this application; that all statements contained in this application are tru to the best of his knowledge and belief_;_.' and that the work will be performed in the manner set forth in the" appli i filed therewith. a Sworn to before me this ze tOSE MAGAZINE ' 21ay0 'NO7ARV'PUBCI'C;'Sta}'e'nf'Neiv',Yb:k..., 19inty., t" Mm 30-7661450 Qua]. in Nassau Cwntt . Notary Public . Tttm'Expuas'Marcn'3ar19f (S' nature of applicant) FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE Examined 1SOUTHOLD, N. Y. i ............~.......~j.-?:..>.. Application NO. .....1~3 Approved 19....i'....Permit No................ Disapproved a/c ...........r..... r.... /AV ,,,,l,d,.,ing I . ns ector,.,ctor) (Bui I APPLICATION FOR BUILDING PERMIT Date -!.lr...... rj...... 19. i INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. i 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 application. 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 issue a Building Permit to the applicant. Such permit shall be kept on the premises;avoilable for inspection throughout the progress of the work. e. No building shall be occupied orlused 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 'fall applicable laws, ordinances and regulations. ~'F1.Fr....G?! s~.rN..t (Signature of applicant, or name, if a corporation) (Address of plicont) I State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....ae...Z.....~p...........a - I Nome of owner of premises .,f`,..!2....dS..'.r If applicant is a corPorate signature of duly authorized officer. (Name and title of corpprate officer) I ` Location of land on which proposed work will be done. Map No: Lot No:................,.,. Street and Number Municipality 1 State existing use and occupancy of premises and intended use and occupancy of proposed construction: 4&t b. 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