The URL can be used to link to this page

Home My WebLink About16782-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall 5outhold, N,Y. Certificate O[ Occupancy Date May 3, 1988 THIS CERTIFIES that the building CONSTRUCT DECK ADDITION Location of Property ... 1.2.0.5. .qa.p.t.a.i.n..K.i.d,d..D.r.i.v.e. .... Matt ituck, N .Y. House No. Street Ham/et County Tax Map No. 1000 Section .... 1.0.6. ..... Block 05 .Lot 13 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated February 28, 1988 pursuant to which Building Permit No. 16782. z . dated March 10, '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 DWELLING The certificate is issued to THEOFANI & MARY BAKTIDY ..................... ~o¥,,~,). '~~~rx .................... of the aforesaid building. Suffolk County Department of Health Approval N/A N/A UNDERWRITERS CERTIFICATE NO .................................................. PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 FO~M' NO. 0 TOV~N OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No-16782 z Permission is hereby granted to: ............ tO ; & ¥ ' '~ ~ !, premises I~ted ~t ..~.~.;i~..ii.~.~.~,;..i.~..~..~"~.E.~.~i;,...~...O~.~ ........... County Tax Map No. 1000 Section ....... L.O...J,9. ....... Block ..... ...(~...~.. ....... Lot No ...... ~J....-~.. ............ pursuant ,o application dated ....~.~~....~..~ ............. , 19..~...~., and approved by the Building Inspector. ~Bulldlng Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in Wpewriter 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 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 installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approva~ 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~perty 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 $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling,S25.,(10, Aqcessory,,,$iO.O0 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50-. 00 3, Copy of certificate of occupancy $ 5.'00, over 5 years $]0.00 4.Vacant Land C.C. $ 20.00 5.Updated C.C. $ 50.00 Date .......................... NewConstruction.//~.. Old or Pre-existing Building ............ Vacant Land ............. Location of Property .. J, .~./~. ~, .... ~,/. .. , ....................... House No. Street Hamlet Owner or Owners of Property . .~./~..~.. ,D~.../Z/./././~ ~ .... ~/~/.< .~/.~.< ....................... County Tax Map No. 1000 Section .../..~/2 ......... Block ..... ~...~. ..... 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 Certificate ..................... Final Certificate ..................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. Applicant ' ' '/~7' ' '~ .............................. Rev. 10-10-70 co I FOUNDATIO.U ( ls t) FOUNDAT I O~U ( 2nd ) EOUGH FRAME & FLUMBING e INSULATION PER N. STATE ENERGY CODE ADDITIONAL COMMEI;TS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION tST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING ~L F'EB 2 61988 ;; tlr ,, , 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N,Y. 11971 TEL.: 765-1802 Examined x?(~o~&~..I..o .... , 19~. ~ 7"-I'''' ~/~O~..~ .I..Q .... 19 ~ ~. Pe~it No. I.& ?.~ ~. Approved Disapproved a/c ................................ .~ l/ (Building Inspector) APPLICATION FOB BUILDING PEBMIT 3 SETS OF PLANS SURVEY ...Y:~.., cugcK .~..¢x~.. SEPTIC FORM ........ : NOTIFY CALL ................ MAIL TO: ~"~ ~/~ ~0 3al INSTRUCTIONS a. Tiffs 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, 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 all applicable laws, ordinances, building code, housing code, and regulations, and to necessary.'~....o-~-.ins 'ons...~..~ admit authorized inspectors on premises and in building for jnsj~12e, c~( (Signature of applicant, or name, if a corporation) · 2. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....G .~,:...~. ~.~... c..~...~v~ .~.cxsY~...~-/~.. ................. · ~r-~,~13 13.,{. ~T~ O~I ......................... Name of owner of premises .......... ............ ('a; 'o'n'/~h'e' ia'x' ;o'li ;; i;t;;t' fiiid) ' If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ALL CO~TRACTOR'S MUST BE S.~..,~JOLK COUNTY LICENSED Builder s License No... JlgO.~ ....... l ......... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ....... x . ........ /. .:. v. .c. . .,. . .: . / .......... House Number Street Hamlet County Tax Map No. 1000 Section .... ./~. · .~. ........ Block ...... X. ........ Lot .... /~.. .......... Subdivision (~jCta7~ fiJ'J~.Z2 ~-~':X3.~7-..t~- .~' 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 ...... .~..)(..77...~7~../Q .... .~. ~. (.$..~..~../~..~ .... .~..1~..C. '.~. .................... b. Intended use and occupancy ...... ~..~.~.. ..... [ ~..~.O7..~(./~..ff~.'..) .......... i .................... 3. Nature of work (check which ~ ' '~' Alteration apphcable): New Building ......... Addition ·:.. ~ . ......... Repair .............. Removal .............. Demolition .............. Other Work.. ............. ! ' (to be paid on filing this application) 5. If dwelling, number of dwelling dnits .... : .......... Number of dwelling units on each floor ................ If garage number of cars I - 6. If business, commercial or mixed occupancy, specify ngqzre and extent of each type of use ............ 7. Dimensions of existing structures, if any: Front .... ~ ........ Rear ..... .D:. ( ......Depth...~.' .~i+'~'' Height . .~-...C). .... Number of Stories ..... ~ ............. - ... Dimensions'of some st)'ucture wilh alterations or additions: Front ... "8. Dimensions ofentir~ new construction Front .... ~.~....' ..... ~Rear .... ~..7 Depth . .~. .... 9. Size of lot: Front ..... /.0..O... [ .......... Rear ...... /.cp..~ ........... Depth ..... /..r~...o, ............ 10. Date of Purchase ........... [ ................. Name of Former Owner ............................. 1 1. Zone or use district in which premises are situated ........................... '~7.~ ..................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... (.~ ...... 13. Will lot be regraded ..... ~ 0. ~ .................. Will excess fill be removed from premises: Yes Name of Architect ..... '; · .C.°?..~.~.."~.?.~.~. .. Address ................... Phone No ................. Nmne of Contractor .~.,fL.~-.~$~" /~.,t~rp~ Address .... 15. Is this property located Within 300 feet of a tidal wetland? *Yes ..... No ..... · If yes, Southold Town TruStees Permit maybe required. PLOW DIAGRAM Locate clearly and distinctly all ~uildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block 4umber or description according to deed, and show street names and indicate whether interior or corner lot. I0O STATE OF NEW YORK, 8. S COUNTY OF ................ .............................. ! ................... being duly ~'n, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ....... ~ .~..7../~./~..cZ..~. · .................................................................. .~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dulyl authorized to perform or have performed the said work and to make and file this application; that all statements contaihed in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner ~et forth in the application filed therewith. ~ to before me this ~ davof lO J:~7 Notary Public ........ County HRtN K. O[ ~E NOTARY pUBLIC,;Sta.t~e o! Hew,Y~ ,~ (Signature of applicant) No. 4707878,1Suffolk Ce. LInTy ~,,~' l'etm Expires ~arch 30,'L9---.~ /