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HomeMy WebLinkAbout16801-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Z.-: L6.8. .6. ......... Date May 10, 1988 THIS CERTIFIES that the building ..... p~.gK..4ppz, z.z.o.~. .............................. 4395 South Harbor Road Southold, New York Location of Property ............................................................... House No. Street Hemlet County Tax Map No. 1000 Section 87 .Block 1 .Lot 7 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated March 2, 1988 16801Z ..................... pursuant to which Building Permit No ................... '... dated.........,........March 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 DWELLING AS APPLIED FOR The certificate is issued to NORMAN & STELLA McCOOK ..................... .................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N/A ~q/A PLUMBERS CERTIFICATIObl DATED: Rev, 1/81 FORM' NO. ~1 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) County Tax Map No. lO00 Section ......... ..~..2 ...... Block ........... ./... ...... Lot No ........... ~ ......... pursuant '0 application dated ......... .~../~ .............................. , 19..~.~ and approved by tlne Building Inspector. uuil~J~ InslSector 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 typewriter OR ink, and submitted .- ~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of properW with accurate location of all buildings, property lines, streets, and unusual natural or topographic featu res. 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 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 featu res. 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 $25.0OALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.(10, Accessory.iS10.00 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.O. $ 20.00 5. Upda ted C.O. $50.00 Date ....... ~./.~'/~.' .~. ......... NewCons truc ~;ion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .. ~5~. .... .,~ Q ~.' .Z-./.-/~. {~. ~ .............. House No. Street Hamlet Owner or Owners of Property . .~..~..~.~...~,. ~..f'2~..~.~..~..~., .~....~..?.~., ??.../~. .......... County Tax Map No. 1000 Section ..... ~ ~ ...... Block ....... J. ....... Lot ....... ? ....... Subdivision ................................. Filed Map No ........... Lot No .............. PermitNo./.J~.(?./.~. Date of Permit ............................... .. . Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ...... ~ .............. Fee Submitted $ ~- ~ O Construction on above described building and permit meets all applicable codes and regulations. Rev. 10-10-78 TOWN OF SOUTIIOLD OFI'"ICE OF BUILDING INSPECTOR iLO, BOX 728 TOWN IIALL SOUTIIOLD, N.Y. 11971 May 5, 1988 TEL. 765-18O2 Mr. & Mrs. Norman. McCook 4395 South Harbor Rd. Southold, New York 11971 To Whom This May Concern, We are unable to complote your Certificate of Occupancy because .of the following reasons. /~ff An application for Certificate of Occupancy is not on fil~. (ENCLOSED) /~/ :lo Underwriters Certificate on file. /~/ The check i~Va~cYed/not on file.) $25.00 /_-/ ~;o Health Dept. Approval on file. /.--_/ No final inspection has been made. P]e,]~3e contact: our office on Thank you for your cooperation. Buildinq Permit t[ l 6 8 0 IZ Building this matter. Plumber Solder Certificate on file. all permits involving plumbing being .issued after April !,1984 ) FIELD .~,.S ..... ~J,~ tID~,~m 1t COMa£NT3 FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS _ . ' APPROVE;) AS NOTED - ROUG~ FRA~N6 ~ ~ - ~. iNSULATION ' ' 4. FINAL ~ CO~UCT!ON MUST At ~CO~'T~LIcT~ON SHALL MEET ..... - ' , ........ THE N.Y : 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] I/NSULATION / FRAMING [ ~ FINAL REMARKS: INSPECTOR Examined. ..~./..~.. Approved · ~.//./. · 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N,Y. 11971 TEL.: 765-1802 ........ 19 ~. Permit No ........../e~.g~). / ~r BOARD OF HEALTH 3 SETS OF PLANS SURVEY . , CHECK SEPTIC FORM ............. NOTIFY CALL .......... MAIL ;d:' ~i Disapproved a/c ..................................... ................................ ~i~' ' e:~' ' APPLICATION FOR BUILDING PERMIT 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, 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 admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) 7o ./. &,e. . ed. . . ,. .< ,,I/., : ...... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .~..a/.q/m~// f ~ Gf t" 57q'1/~, d'd-~' /v7¢ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of co,orate officer) - ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No..(b~-qy,-°~.. · ................ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section .... .~.7 ........... Block ! Lot...~. Subdivision ..................................... Filed Map No ............... Lot ............... (Nmne) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: J a. Existing use and occupancy d~)/~.ce- . ........... : .......... v~ b. Intended use and occupancy .............. ~.. ~.~. ' 3. Nature of work (check which applicable): New Building ..... · ..... Addition .......... Alteration .......... Repa/r .............. Removal .............. Demolition ............ Other Work .,. ~ ',-' /uescnpllon) 4. Estimated Cost ....... ~ ........................ Fee .................................... : " (to be paid on filing this application) 5 Ifdwelli b r ofd lli gO its -- Number fd Ill it h floo · ng, hum e we n n ............... o we ng un s on eac r ............... If garage, number of cars ' 6. If bumness, commercial or m xed~ occupancy, specify nature a~nd extent of each type of use ..................... 7. Dimensions of existing structure{, if any: Front .... fi/.O.~..62 ....Rear .............. Depth ............ Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front .... '77-. ........... Rear .................. Depth .................... [. Height ...................... Number.of. Stories ....................... Dimensions of entire new constrflction Front !0 t . . Rear I0' Depth . t 0 ~ Height .... l ~. ........ Ix~tber of Stories ............. . ...................... ~ ............ ~ ..... Size oflot' Front ~ ~50 . Rear .~.~.r n~th 117 ~,~ '-~0 Date rchas .......... '~. · ~ ..... ~...~. .... Name of Former Owner ..................... JP ....... Zone or use district in which premises are situated ..................................................... Does proposed construction viola~te any zoning law, ordinance or regulation' ,f~ . .. Will lot be regraded, .... '/?. · · i ......& ........... Will excess fill be removed fr~m premises: Yes Name of Architect ...... ;'"';;: ~ ............... Address ........... Phone No ................ Name of Contractor ...... .TT. i ................ Address .... : .............. Phone No ......... 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No .~.[[''' · If yes, Southold Town TruStees Permit maybe required. ! PLOT DIAGRAM Locate clearly and distinctly all !buildings, whether existing or proposed, and. indicate all set-back dimensions from property hnes. Give street and block rtmber or description according to deed, and show street names and indicate whether interior ......... lot. 12. 13. 14. STATE OF NEW YORK, COUNTY OF ................. ............................. ! ................... being duly sworn, deposes and says that he is the applicant (Nam e of in dividual signigg contract) above named. He is the ' i (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 contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the mannel set forth in the application filed therewith. Sworn to before me this ............... .ol. ....... day of! .... ....... HELEN lC DE VOE NOTARY PUBLIC, State of New Ymk No. 4707878, Suffolk Term Expires March BO, 1~ ....... County (Signature of applicant)