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Home My WebLink About17719-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Offmce of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19742 DATE: February 21r 1991 THIS CERTIFIES that the buildmng. ADDITION Locatmon of Property 475 OYSTER POND LANE House No. Street County Tax Map No. 1000 Section 25 Block 1 Subdmvlslon Filed Map No. ORIENT r N.Y. Hamlet Lot 5 Lot No. conforms substantially to the Application for Bumldmng Permit heretofore fmled an this office dated SEPT. 8, 1988 pursuant to which Bumldlng Permit No. 17719~Z dated DECEMBER 22¢ 1988 was issued, and conforms to all of the requirements of the applicable provisions of t~e law. The occupancy for which thzs certmfmcate ms issued is OPEN iPORCH ADDITION TO EXISTING ONE FAMILY DW~T~.ING The certmflcate ms issued to WILLA GODFI{EY (owner) of the aforesamd bumldlng. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFiCATION DATED N/A Rev. 1/81 Bumldlng Inspector JI~M NO. · TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERJ~IT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 017719 Z Permtssfon ~s hereby gronted to' ....~.~.~..~...,~ .................................. , , premises I~ated ~t ,~D..~-~ .... ~ .......... ~~.", .............. CounW Tax Map No 1000 ~ction .q~ ..... Bilk ....... ~..~ ...... Lot No .... ~.~% ..... pu~,ant to apphcatlon dated .... ~~ ~ ..., Jg.~ ~., and approv~ by the Bu~Jdlng Inspector. Rev 6/30/80 Form No. 6 TOWN OF SOUTIlOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must he filled in by typewrzter OR ink and suhmztted to the bulldlng -inspector ~ith the following: for new huzldzng or new use~ 1. Final survey of prpperty with accurate location of all buzldings, property lines, streets, and u~usuai natural or topographic features. Final Approval from Health Dept. of water supply and sewerage-dzsposal(S-9 form). Approval of electrical installatzon from Board of Fire Underwrzters. 4. Sworn statement from'plumber certifying that the solder used mn system contemns less than 2/10 of 1% lead. 5. Commercial bullring, i~dustrial buzldzng, multiple reszdences and szmmlar buildings znd installatzons, a certificate of Code Complmance from architect or engineer responsible for the buzlding. 6. Suhmzt Plannzng Board Approval of completed s~te plan requzrements. For exzsting buildings (prior to Aprzl 9, 1957) non-conformmng uses, or buildzngs and "pre-exmsting" land uses: i. Accurate survey of property showzng all property lmnes, streets, huzldzng and unusual natural or topographic features. 2. A properly completed applicatzon and a consent to znspect szgned by the applzcant. If a Certmficate of Occupancy ms denmed, the Bumld~ng Inspector shall state the reasons therefor in wrzting to the appizcant. i. Certmficate of Occupancy - New dwelling $25.00, Addztzons to dwelling $25.00, Alterations to dwelling $25.00, Swzmm~ng pool $25.00, Accessory buzidzng $25.00, Addztzons to accessory buzldlng $25.00. Businesses $50.00. 2. Certmfzcate of Occupancy on Pre-ex~stmng Buzldlng - $I00.00 3. Copy of Certmficate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Res~dentzal $15.00, Commercial $15.00 Date February 21, 199! :ow Construction Old Or Pre-existing Building ... ~ ~75 OYSTER POND LANE ORIENT, N.Y. .ocation of rroperty .................................................... House No. Street Hamlet )nwer or Owners of Property........W%LLA.C,~BgRg~....... ................... . . . .. . . .. % ......... 25 I 5 ounty Tax Map No 1000 Section . . Block Lot . ubdivision..............o.... ............. .. . . Filed Map ........... . Lot ................... . .. Dec. 22, 1988 C. TEORP CONSTRUCTION ~rmzt No., [77[9-Z .... Date Of Permit ................ Applicant ..... ealth Dept. Approval ......................... . Undarwrzters Approval ........................ . lanning Board Approval ....................... . equest for: Temporary Certificate ........ ... Final Corticate.~ ......... ' ' ........ :l£LD i:,S~EC?i~:, I{DATE iI ~;W~£~T~ FOUNDATIO:; (1st) FOUNDATION 2. ROUGH FRAME & PLUMBING INSULATION STATE ENERGY CODE FINAL (2nd) FERN. Y. ADDITIO~AL COMME?;TS: 76S.-1802 N BUILDING DEPT. SPEIgTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL .. q..7~.. ~.?.t.~.~.. ~.q .......... · .o~...,9..q ...... forpe~ttto ~~..~. ~..~.~~~ at .o6~o.' ...... t ..... s~,~t ..................... County Tax Map No. 1600 Section . ~ ~ . Block .. . ~.l ..... Lot ...~.~ .... Subdivision ............ Filed Map No ............... Lot No..~.~ ........ ts returned herewith and disapproved on the folIowmg grounds..~-~'~..~-...~..~ ~. ~. 7 ~ I , Buzlding Inspector RV 1/80 Y FORM NO. 1 ,~1 "8 IO~'¢~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL. 765-'1802 Disapproved .......................... .... (Budding Inspector) ~PPLICATIO~ FOB B~IkDI~G P~BMIT INSTRUCTIONS BOARD OF HEALTH ........... B SETS OF PLANS SURVEY .................... CHECK ..................... SEPTIC FORM .............. CALL .................... MAlL TO: ~'~ ~7~ Date .... c~...~.. ....... 1~. a This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, witl sets of plans, accurate plot plan t9 scale. Fee according to schedule. b. Plot phm showing locanon of lot and of braidings on premises, relationship to adjoining premises or pubhc sire or areas, and giving a detmled descnphon of layout of property must be drawn on the diagram whmh is par~ of ttus ap, cat~on. ; c. The work covered by ttus Application may not be commenced before ~ssuance of Bu[Idmg Permit. d. Upon approval of thru apphcatlon, the Braiding Inspector will issued a Budding Permit to the apphcant. Such pen shah be kept on the premmes available for mspechon throughout the work. c. No bmldmg shalI be occupied or used in whole or m part for any purpose whatever until a Certfficate of Occupm shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the BufldLug Department for the issuance of a Braiding Permit pursuant to; Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances Regulations, for the constructnon of buildings, a.d. dltions or alterations, or for removal or demolmon, as hereto descnb, Thc applicant agrees to comply ~th all applicable laws, ordinances, buddmg code, housing code, and regulations, and admit authorized inspectors on premises and m budding for necessary ~nspccnons. (S~gnature ot apphcant, or name, If a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engmeer, general contractor, electrician, plumber or build, Name of owner ofpremmes ....~.~, .JY~.~ .J./~. ..... .~'..~-O....~.../~ ......... , ...................... (as on the t~- roll or atest deed) If applicant ts a corporation, stgnflture of duly authorized officer (Name and title of corporate officer) Budder's License No.../,'~. ~-~'~..4./. 7' Plumber's License No ................ Electrmmn's License No ................... Other Trade's License No .................... I. Location of land on winch prOposed work will be done ........................................ ........ ........ ........ House 'Number Street Hamlet County Tax Map No I000 Section . ~ ..z.>. ........ Block ..... ff .......... Lot ...... ..~ ......... , Subdivision ..................... Filed Map No ............ Lot (Name) 2 State eXmtmg use and occupancy of premises and intended use and occupancy of proposed construction a Ex~stmg use and occupancy .......... O mit-. .......................... 3. Natureofwork(check~vhichapphcable).NewBu]ldmg ........ Ad&tlon. .~.: . .. A]teration ..... Rep.',,r ............. Removal ........... Demolition ............ Other Work ......... (Descnptim 4 Sst,mat 'd Cost .... -- ............... Fee ........................... (to be paid on fihng th~s application) 5. If dwelbng, number of dwethng unzts ......... Number o f dwelhng umts on each floor ............ If garage, number of cars .............................................................. 6. If business, commercial or mixed occupancy, specify nature trod extent of each type of use ......... ' ~ ~ ,~4 '~' '& ...... 7. Dm~ensmns of ext~stmg structures, if arty Front . ...~.~. ...... Rear ....... d-. ...... Depth . .,"a. ~/... Height . .~Y ......... Number of Stones . ./. r/.2--, ............ ~, ................... ;... Dunensions of same structure with alterations or additions Front ... :c. ~. ......... Rear .... /. ....... Depth . ~. ~.~ ............ ltm~t ..... '.-~--../,/. .......... Number of Stones ...... 4..~/t-~ ..... 8. Dimensions of entire new construction. Front ~ ~./, Rear ~ 6?. ( .... Depth ~./.~ / Height ..../~.t ........ Number of Stones ..~ ..... ~ ............................... i ~.'~';' ' ' 9. Size oflot. Front ..... ~... ~'~ ...... Rear....*~.. ~. ......... Depth . ~..~ ..... 10. Date of Purchase ........................... Name of Former Owner . ./~..~. .... ~..e.?.~.: .......... I 1. Zone or use dlstnct in whmh premises are situated .... /..~J ....................................... 12. Doesproposedconstructlonv~olate~nyzomnglaw, ordmanceorregulatlon: ..~.-~'. ........................ 13. Will lot be regraded ...... ~ ................ Will excess fill be removed from premises: Yes 14. Name o£Owner ofpremzse~ .~.V.~..~-. ~¢kAddress .~.('7~.. ~.. Phone No. ~.~.-.~. Name of Architect ...... , ................... .~YAddress .~.~, ~Phone No ............. Name of Contractor .4'~ .~..-,., ."~:...-~.: .7~.~'-~/~..... Address ................... Phone No .... ~, ....... 15.Is this property located wlth~ 300 feet of a tidal wetland? *YES.d-...NO .... *If yes, Southold ~own Trustees Permit may be required. PLOT DIAGRAM Locate clearly and d~stmctly all bu~dmgs, whether ex~stmg or proposed, an& mdicate all set-back dimensions fr property hnes Give street and Mock number or description accordmg to deed, and show street names and red,cate whet mtenor or comer lot. / STATE OF NEW YORK. cOUNTY OF. S S (Name of md~wd ual~s~gnmg contract) above named. ...... bemg duly sworn, deposes and says that he ~s the apphc fle is the ............................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to.. pe. rf, qr,m or have performed the smd work and to make and file application, that all statements contained in tins apphdatmn are true to tim best of his knowledge and behef, and that work wdl be performed In the manner set forth in the application filed therewith Sworn to before me this ............ f ...... dayor ............ - .... . .......... ~: (Signature of apphc~