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Home My WebLink About17675-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Bulldxng Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-I7585 Date DECEMBER 9, 1988 THIS CERTIFIES that the building. ADDITION Location of Property 520 CLEARUIEWAVENUE SOUTHOLDr NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 070 Block 9 Lot 63 Subdivision FB_iRVIEW PARK Filed Map No. 3388 Lot No. 27 conforms substantially to the Applxcatxon for Building Permit heretofore f~led in thxs office dated DECEMBER 5, 1988 pursuant to which Bulldlng Permit No. i7675-Z dated DECEMBER 9~ 1988 was xssued, and conforms to all of the requirements of the applicable provlsxons of the law. The occupancy for which this certificate is xssued xs DECK ADDITION TO REAR OF EXISTING ONE FAMILY DWELLING The certificate is xssued to ROBERT W. LAUB (owner, of the aforesaid bumldmng. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION D~£~ N/A ' - ' Building 'In~s~ctor ; Rev. 1/81 · 0~ NO. fl 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~ b17675 Z Perm~sston ~s hereby granted to: , ....................................... ... County Tax Map No 1000 Sect,on ,..~,.....~, .~.. Block .... ~ ............ Lot No .... .~..~.. .... pursuant to apphcatlon dated ~?~-'~ ~ .............. , 19.~ and approv~ by the Building Inspector. Building nspector Rev 6/30/80 APPLICATION FOR CERTIFICATE OF OCCUPANCY FORM NO, 6 TOWN OF SOUTHOLD Bulldmg Department Town Hall Southold, N,Y. 11971 ?65 - 1802 A. This application must be filled in typewriter OR ink, and submitted m 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 natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrmal installation from Board of F~re Underwriters. 4. Commercial buddings, Industrial buddings, Multiple Residences and s~mdar buildings and installa- tlons, a certificate of Code compliance from the Architect or Engineer responmble for the budding. 5. Submit Planning Board approval of completed site plan requirements where apphcable. B. For existing buildings (proof to April 1957}, Non-conforming, uses, or burldmgs and "pre-existing" land uses' 1. Accurate survey of p~operty 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 buddings. 3. Date of any houmng code or safety inspect~on of buildings or premises, or other perUnent mforma- t~on required to prepare a certificate. C. Fees' Additions 825.00 POOLS $25.00 ALTERATION $25.00 ]. Certlficate of occupancy New Dwellzng $25.00, Accessory ,$]0.00 Buszness $50.00 2. Cert~hcate of occupancy on pre-existmg dwelhng $ IO0.00 3. Copy of cert~flcate of occupancy $ 5.00, over 5 years $10 00 ..00 5.Updated C.O../ $ 50.00 Date ......... NewC°nstcuCti°n . . ./f'... Old or Pre-existing Building ............ Vacant Land ............. CountyTa×~ap~o lo005ect,o~ ..~..7.~. ..... ~,oc~ ..... '7' ....... 'ot .... ~..~. ...... Su d,v,s,on/. ....... ,,ed Map .... Permit No./. ~. Z .~-.,~ate of Permlt/~,/4/~/.;,~.Apphcant, ./~ ......... ,~....'. ,. Health Dept Approval ~ Labor Dept Approval "' Underwriters Approval ..................... .------. . Planning Board Approval ................. .. . . . Request for Temporary Certificate ..................... Final Certffmate ...... ~.... ..... Fee Subm,tted S.. 2- .~., ~.~. ............... Construct)on on above described budding and permit meets all apphcable codes and regulations. Apphcant . .~ ....... c~..~ .~.~. ................. Rev. 10 10 78 E amined .£..., ,,pproved .... , Disapproved ale .............................. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N Y. 11971 TEL.. 765-1B02 BOARD OF HEALTH .......... 3 SETS OF PLANS .......... SURVEY ................... CHECK .................... SEPTIC FORM .............. NOTIFY CALL ................... MAIL TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. T15.s apphcatton must be completely filled m by typewnter or mmk and submttted to the Budding Inspector, wt sets of plans, accurate plot plan to scale. Fee according to schedule b. Plot plan showing location of lot and of builflmgs on premises, relattonshlp to adjotmng premises or public str or areas, and giving a detailed description of layout of property must be drown on the diagram which Is part of tlus ak caUon. c. The work covered by ti'ns application may not be commenced before issuance of Budding Permit. d. Upon approval of this apphcation, the Building Inspector wall issued a Building Permit to the apphcant Such shall be kept on the premises avadable for mspectlon throughout the work. e. No braiding shall be occupied or used m whole or m part for any purpose whatever until a Certificate of Occupa shall have been granted by the Bmldmg Inspector APPLICATION IS HEREBY MADE to the Bmldmg Department for the issuance of a Bmldmg Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinance- Regulations, for the construction of buddings, additions or alterations, or for removal or demohtmn, as hereto descnb The apphcant agrees to comply wzth all apphcab]e laws, ordinances, budding code, housing code, and regulations, and admit authorized inspectors on premises and m budding for necessary ~spections. ......... (Signature o~ applicant, or name, if a corporation) · .P..¢...~..o ~...~..w.,..0. q ~,.~h~..d .~ r~.q..~(~. (Mailing address of applicant) State whether applicant zs owner, lessee, agent, archztect, engineer, general contractor, electrician, plumber or build Name of owner ofpremlses .'~.O. ~2:~....[7.. ?.)....~..O~.. F.C.'~ ../ ...................................... (as on the tax roi1 or latest deed) If apphcant is a corporation, signature of duly authorized officer. (Name and Utle of corporate officer) Budder's L~cense No .... ~ODq .e-5/.~- ............. Plumber's Lmense No ........................ Electnclan's License No .................. Other Trade's License No ................... I Location of land on which proposed work will be done House Number Street\ Hamlet County Tax Map No lOOO Sccnon O..'?.~D. ..... ..... Bl?ck . . .cl. ........... Lot..L~..-.~ .... Subd,viSmn-3C..O=O~/t.C.cg..55.0~x~ ............. F{led Map No ~..3.~.g ........ Lot . .~..~(. ........ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction. a. Existing use and occupancy . . .~J.~ ~ .................................................... b. Intended use and occupancy . .~e.c.' .~ .... 3. Nature of work (check v~h~ch applicable)' New Building ........ Addition ~ Repmr ............. Removal ............. Demolition .............. 4. Estlmate'd Cost .. ~ 0 po . .~..--. ........................ Fee ........................... (to be paid on filing this apphcatmn) 5. If dwelling, number of dwelling units ............... Number of dwethng units on each floor .............. If garage, number of cars .................................................................. 6. If business, commercml or mixed occupancy, specify nature and extent of each type of use ................... 7. Dlmensmnsofexistlngstructures, ifany Front ............... Rear .............. Depth ............ Hmght .............. Number of Stones .................................................. Dlmensmns of same structure with alterations or additions Front ............... Rear ............... Depth .................... Ilmght ................... Number of Stones ................... 8. Dimensions of entire new construction. Front ............. Rear .............. Depth ............. Hmght ............... Number of Stones .................................................. 9. Size of lot. Front ..................... Rear .................. Depth .................. 10 Date of Purchase ...................... Name of Former Owner ......................... 1 I. Zone or use district in whmh premises are situated .................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation' .~.q> ..................... 13. Wall lot be regraded .~.o. ........................ Wall excess fill be removed from premises. Yes '~ 14. Name of Owner of premlses~4~, bO...C~... Address ................... Phone No .............. Name of Architect ......................... Address ................. Phone No Name of Contractor .......................... Address ................. Phone No .............. 15.Is this property located within~00 feet of a tidal wetlaud? *YES .... NO .... *If Ires, $outhold Town Trustees Permit may be required. PLOT D1 AG FO[M Locate clearly and distinctly all buddings, whether existing or proposed, and, indicate a/l set-back dtrnenslons fro property hnes. Give street and block number or description according to deed, and show street names and intimate wheth. interior or comer lot. ~2~<~ ~.._.- STATE OF NE~,~.' YORK, S.S COUNTY OF...~'~P,, ...... .p.~..r-%e~l.c:_ . .~.. ~. o.2<j~ ..................... being duly sworn, deposes and says that he is the apphca (Name of lndlwduaI sigmng contract) above named. Heisthe ... (Contractor, agent, corporate officer, etc.) of sa~d owner or owners, and ~s duly authorized to perform or have performed the sam work and to make and file ti apphcat~on, that all statements contained in thru application are true to the best oflus knowledge and belief, and that t! Work w~l be performed in ti~e manner set forth m the apphcanon filed therewith Sworn to before me this .day or D , f g Notary Pubhc, H~EN IL DE VOE NOTARY PUfiLIC, Stale of Hew Yo~ No ,4707878, Suffdk Counky~ c7 Term r~res M~rch ~, lq o ./ ... County (S~gnature of apphca~