HomeMy WebLinkAbout17200-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 217269 Date SEPT. 7, 1988
THIS CERTIFIES that the building ADDITION
Location of Property 740 LONGVIEW LANE SOUTHOLD
House No. Street Hamlet
County Tax Map No. 1000 Section 88 Block 04 Lot 50
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 9, 1988 pursuant to which
Building Permit No. 172002 dated JULY 11, 1988
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 DECK ADDITION TO EXISTING ONE FAMILY DWLLING.
The certificate is issued to CHARLES E. & CATHERINE V. ROWAN
(owner, j
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. 181
~os~ xo. s
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MU5T BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF 7HE WORK AUTHORIZED)
N 9 ~ 1.7 2 Q Q Z Dote .....l. 19~~
Permission is hereby ran d to: ,
.~...~~..o .
ct premise located at ....7.T.~....~F.~ ....~cnrrr.~
..........................................................................rr~~......................................................................................
Caunty Tax Map No. 1000 Section .......(~.~G/........ Block `.~...........yLr~ot No ...............~r..-.~..
pursuant to application doted 19.,C1.Cd, and approved by the
Bui ld~ing~/I nsp~ect~or.
Fee `Ir........ ~ '
~ 5
6 in Inspect r
Rev. 6/30/80
FORM NO. 6 A
C~
~ TOWN OF SOUTHOLD
Building Department
Town Hall
U111~LD Southold, N.Y. 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted ~l~~ to the Building Inspec-
torwith 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 electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and instaila-
tions, acertificate 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 property 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 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 POOLS $25.OOALTERATION $25.00
1. Certificate Of occupancy New Dwelling $25.00, Accessory 10.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $ 5 0.00
3. Copy of certificate of occupancy $ 5.00, over S years $10.00
4. Vacant Land C.O. $ 20.00 / C~
S.Uodated C.O. $ 50.00 Date ~-~t.~.`.`~. J.~..1.
NewConstruction,,-,7,,,Old//or Pre-existing Building Vacant Land
Location of Property ....1.`~~?. F~ lRrv.~.:'.r.G'~'Gc% ~
: !~Lr2, , .-~.t'.:! .?`kf
U ~.1~....... .
House No. Sweet Hamlet
Owner or Owners of Property . C L~•c~-1"•`~~ d-.~-/~~ -~-1-G~/~'f'~ ~C? ~G{, ¢1.-7~/"
County Tax Map No. 1000 Section .....~Q....... Block Lot . ~ . .
Subdivision .-.1.~1.~. ...........................Filed Map No. ..........Lot Noyes............ .
Permit No. ~ /0~411.~. Date of Permit ..........Applicant ...~.G,~4,?r:vr; Lc.'°y 7\ Qcc,, ~}-r~/ ;
Health Dept. Approval ..................Labor Dept. Approval .
Underwriters Approval ........................Planning Board Approval , .
Request for Tempo~rar~y{Certificate ..................Final Certificate .
Fee Submitted $ ..'~C~' 5~.. 5~.~:-?
!?L.. .
Construction on above`described buildin p it meets all app 'cab o sand regulations.
ae~. io-ioae ~ 3.x(3 r'
C.d. Z/7d~q
~~FO(k~ TEL. 7G5-180?
~p5 BOG
` TOWN OI' SOUTIIOLD
o'
tis., t.i rc 01~ PTCL OP BUILDING INSPECTOR
~ ~ P.O. BOX 728
~ ~ " ' ~ T01VN HALL
yf, gyp!- SOUTIiOLD, N.Y. 11971
Ol~y~
9~~~~g
To Flhom This May Concern,
We are unable to complete your Certificate
of Occupancy because ,of the following reasons.
/~An application for Certificate of Occupancy
is not on file.
/ / No Underwriters Certificate on file.
The check is (outdated/ of on file )
No Ifcalt-h Dept. Approval on file.
NU final i.ns,pection has been made.
Pleaae contact our office on this matter.
'1'liank you for your cooperation.
I3ui]d.i.ng Permit II ~ ~ ~ ~ ~ 2
Building Dept.
/ No Plumber Solder Certificate on file.
( all permits involving plumbing being
.issued after April 1,1989 )
?lELD IGSP:C:IU:J ~~llnir. ~ ~OhfMLNT°
~o t~
~ o
~ ti _ - - - - y'Id,
FOUtDATION (1st)
FOUNDATION (2nd) _ - ~c
2.
o~
0
P,OUGH FRAME &
PLUMBING _ q
ti
H
3 .
rh n
H
IIJSULATION PER N. Y. '
STATE ENERGY
CODE
x
_ a
y
4 .
FINAL/
C?
E
z
ADDITIONAL COMMENTS: cn
T
F~ti~
O~
2~
1
5
P7
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d .
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b
y
5~F F OLK~~ TEL. 7G5-1802
O OG~ ~ TOWN Or SOUTIIOLD
Lt~+a~s '-c UI~PICL• OP I3UILD[NG INSPECTOR
o ~ry F~fs~~ ~ P.O. BOY 728
,u;. ~ [ ~ TONN fIALL
O~ffol ~ SOUTHOLD, N.Y. 11971
9~~1~g
To S9hom This May Concern,
we are unable to complete your Certificate
of Occupancy because .of the following reasons.
/~An application for Certificate of Occupancy
i:; not on Lile.
/ / No Underwriters Certificate on file.
The check is (outdated/ of on file )
No Itealt-h Dept. npproval on file.
No final inspection has been made.
Plcasc contact our office on this matter.
`19~ank you for your cooperati/o~n.
13ui1di.nCf Permit (f ~ ~ ~ G ~ Z
[3u.ilding Dcpt. '
No Plumhcr Solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1989 )
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7a s~ 765-1802
BUI4DING DEPT.
INSPECTION
[ ]FOUNDATION 1ST ( ]ROUGH PLBC.
[ ]FOUNDATION 2ND i CATION
[ ]FRAMING [ FINAL
REMARKS: ~
DATE 0 0 INSPE~L`TTO
17
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T [ ] ROUGIi PLBG.
( ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [FINAL
-,.0~'~1
REMARKS: ~ G~~z~S.~~"'
DATE 0 ~ INSPECTOR
_ _ BOARD OF HEALTH
~ - d J( : ~I 3 SETS OF PLANS
„-F,~,.;~..,,_.y" ""r I FORM N0. 7 i?,
SURVEY
TOWN OFSOUTHOLD CHECK
~1~t T:
Mw~'~'~~ BUILDING DEPARTMENT SEPTIC FORM - - - - - - - - - - - - - ;
TOWN HALL NOTIFY
BLDG. OE?'T. vOUTHOLD, N.Y. 11971 /~,j"-l~~?~-
70WM OF 50U7HOLD ~ TEL.: 765-1802 CALL
MAIL T0:
Examined ll 19 f~.~ `~~j'~
Approved 19~~FermitNo~~!.Z~~~ U~ '~~(~Ig~
Disapprove ad c
(Bu' gInspector...
APPLICATI FOR BUILDING PERMIT
Date 19 .
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, Suffotk 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, b code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary i pe
(Signature of applicant, or name, if a corporation)
~ .5 G~t?[N Crll~rr G`t,U, .Y~,.~4 ut H-oLJ
(Mailing address of applicant) 'I~O~f.. t197~
State whether applicant is owner lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
n
Name of owner of premises .C.~ . L `'-`A"~`R~`yl'R v
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
ALL CONTRACTOR'S MUST $E SUFFOLK COUNTY LICENSED
Builder's License No . .
Plumber's License No . .
Electrician's License No . .
Other Trade's License No .
1. Location of tand on which proposed work will be done. ~d~c~ ~T!,~
House Number Street Hamlet
County Tax Map No. 1000 Section Block ~ . Lot . .
l 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 ~ ..~'r:ia~..., ~i~;l~
b. Intended use and occupancy ~~,F n~,~Da,, Lei, v~~(y/c,~q,' , , , . , , , , , , - ,
. x ,,,,ry;rinrmr~ ;
Nature of work (check which applicable): New Building Addition Y..... Alteration .
3 Repair ~ Remo, al Demolition Other Work .
4. Estimated Cost . , *(Lle~Gripiion)
Fee
(to be paid on f-cling this application)
5. If' dwelling, number of dwelling 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.- Dimensions of existing structure, 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 construction: Front Rear , , , ..Depth , .
Height ber of Stories .
...........p...:..
9. Size of lot: Front ~ um'........... Rear .r De t}t ~ ~ , .
10. Date of Purchase ~ u ! .Name of Former Owner .
11. Zone or use district in which premises are situated . .
12. Does proposed construction violAte a-n}6 zoning law, ordinance or regulation: ?T2 .
13. Will lot be regradedp e ~.V ~11//~~ Will excess rll be re ov d from premises: Yes No
14. Na
ne of Arohitect remises Gam. G. (.F~ Address 7 ~6~°~~.. Phond No. ~',S:~/°, . .
..........:.................Address ...................Phone No.
Name of Contractor , 4 Address ....:..............Phone No. , . .
15. Is this property located within 300 feetyyof a t_gidal wetland? *Yes No
*I.E yes, Southold Town Trustees PermitPLO`i' DIAGRAM ed.
Locate clearly and distinctly all ~'buIldings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
i
.o~_- ~'.~G.~-~
I
STATE OF NE R
COUNfY OF .K,lf'a.
s'S~?
~
• • • • • C•~ • • • ~ • ~ • ; < ~•~`•"r'~~~ being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named,.
Heisthe ...................................~.~f'l.Q.J'.....
(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 contajned in this application are true to the best of his knowledge and belief; and that the
work will be,performed in the mannen~ set forth in the application filed therewith.
Sworn to before me this _
~~.day,,oef'l G/1?. 19
Notary Public, o nt O.
Nowt Pu6lto.tiwrv«r
(Signature o~' applicant)
QwIH1ed
M ~ ?k County
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