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Home My WebLink About16919-zFORM NO. 4 TOWN OF 50UTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall $outhold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building CONSTRUCT ACCESSORY DECK Location of Property 420 Cedar Drive Southold, New York I~1~$; HO: .............................. Street Hert~let County Tax Map No. 1000 Section ,..7 .8 ........ Block ,.. 9.9 .......... Lot .. 8, .............. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Pemit heretofore f'ded in this office dated April 8, 1988 pursuant to which Building Permit No. 1.691.9. Z - dated ...A.p.r.i..1..2.5. ~..I .9.8. 8. .......... 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 ......... DETACHED ACCESSORY DECK AS APPLIED FOR The certificate is issued to WILBUR A. VERITY JR. & CARLECE K. VE. RITY ..................... ?o¥,,'o'r, .................. of the aforesaid building. Suffolk County Department of Health Approval .......... .N/.A. ............................ UNDERWRITERS CERTIFICATE NO ..... N /A PLUMBERS CERTIFICATION DATED: N/A uuildi~/~nspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. NO_ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ~l 9 z Do,e ..... ~Z .................... , ,,...r:...~ at premise~ located ot ............................................................................................................................ County Tox Mop No. 1000 Section ......... ,..~.,~... ..... Block ....... ~...~.. ...... Lot No ........ .~..~).,.~.,.. ~ur~ont to ~p~,,~tion ~ot~d ...... ~./.~ ..................................... , ,~Z':..., ond ~pro~ ~ t~ Building Inspector. Fee $....~.~.~ Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 785- 1802 TOWN'O~' SOUTHOLD APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m ~..am~a 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 suppJy 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 pZOperty 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 Dwelllng.$25.00, Accessory ~$10.00 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 4oVacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... New C OhS truc % i on ...... Old or Pre-existing Building .. ~. ~ ....... Vacant Land ............. Location of Property ...~/;c o .~.~ .~.~.~. ~)~, ..... --~ o ~,~-~, o Id/. House No. Street Ham/et Owner or Owners of Property ~..;[~¢ )~..~..e.~'~ ~., q ~a~{~, ~C. \f.~ .] ................ ' .................. ¥.. r.'.'~ County Tax Map No. 1000 Section ............... Block ... Lot...o o Z~ Subdivision ................................. Filed Map No ........... Lot No. Perm ate of Permit . cant ............................... Health Dept. ApprOval ........................ Labor Dept. Approval ...................... Underwriters Approval ........................ Planning Board Approval ..................... Request for Temporary Certificate ..................... Final Certificate ... ~.~ ................ Fee Submitted $ .~..Q]~ . .~-~"]... .................. Construction on above described building and permit meets all applicable codes and regulations. Applicant .... Rev. 10-10-78 · FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... CHECK .......... SEPTIC FORM ............. : NOTIFY $OUTHOLD, N.Y. 11971 .~ ..... TEL.: 765-180:3 CALL Examined ..~.¢ , 19~ Approved ~. ,19~Pe~it No/~.~ ~ ~ ............. " ................................. ..... ........ ....... ~PPLICATIO~ FO~ B~IL~I~G Date ................... 19... INSTRUCTIONS a. T~s application must be completely filled in by Wpewfiter or in ink and submitte~%o the Building Inspecto~, with 3 ~[~.of plus, accurate plot plan to scale. Fee according to schedule. ~. Plot pl~ showing location of lot and of buildings on premises, relationship to adjoining premises or pubic streets or areas, and giv~g a det~led description of layout of property must be drawn on the diagram which is pa~ of this appli- cation. c. The work covered by t~s application may not be commenced before issu~ce of Bufld~g Permit. d. Upon approval of this application, the Building Inspector will issued a Bulldog Pemit to the app~cant. Such pemit shall be kept on the premises ava~able for ~spection ~rou~out the work· e. No build~g shall be occupied or used in whole or in p~t for any purpose whatever until a Certificate of Occup~cy shall have been granted by the Building Inspector. ~PLICATION IS HEREBY MADE to the Building Dep~tment for the issuance of a B~lding Pemit pu~uant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, ~d other applicable Laws, Ord~ces or Regulations, for the construction of bulldogs, additions or alterations, or for removal or demolition, as here~ deschbed. The applicant a~ees to comply with all applicable laws, ordinances, bufld~g code, housing code, and regulations, and to admit authorized inspectors on premises and ~ build~g for necessa~ inspections· (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises.. ~. (-'./.~.~.~ ....... ,,~.~ .~.~..r-.i ...... f.~.. '~/'/.-... 7....(.,*.r:./.e¢.e'...../~.....~.~..c:'.~. ......... ~ J ~" "~; ~'~ ~ , '~:~, '~ . . (as on the tax roll or latest deed) If applicant is a corporatiml/signgttt~e,~of dply ag[hon~ed officer ................. ~:~.~.~';-V! ~[~.~ ;.b · - ~ · ~ · · .~ .... : · ~ (Name and title of co,orate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No.. ~. ~ ~.~ ~; ............... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ....... Y.~. e. . . . ........... .4..~. ~. .~ ,:. . .~.~. .g', ~ "f4,o l d ¥:.?. ....... : .......... House Nnmber Street Ha]nlet County Tax Map No. 1000 Section ~ 7 o~ Block ..O. ~. Lot D o .~.' Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................... b. Intended use and occupancy .... .~.'~ .-~,7.. · ~-f. ~. ................................... 3. Nature of work (check which ap >licable): New Building ..... ' ..... Addition ....~. ..... Alteration /..'. '. i:.. Repair .............. Remc vel .............. Demolition .............. Other Work .............. , (Description) 4. Estimated Cost. f.e'°..,~m "-' ~ " (to be paid on filing this application) 5. If dwelling, number of dwelling units ............. Number of dwelling units on each floor ................ If garage, number of cars ..... i ............ ....................................................... 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 .................. ti ' 'ght Depth ....... ~ .u .~'.: ....... !.. Hel ...................... Number of Stories ...................... Dimansiofis of ;"~tire new construction: Front ............. Rear ............... Depth .............. Height .. ............. Number of Stories ........................................................ 9. Size of lot: Front ........... : .......... Rear ...................... Depth ...................... 10. Date of Purchase ........... ~ ................. Name of Former Owner ............................. 11. Zone or use district in which pretnises are situated ..................................................... 12. Does proposed construction viol!te any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ......... i ................... Will excess fill be ~/emoved from premises: Yes No 14. Name of Owner of premises ~9..f,/.~.q< ff....~.r:.;.~.t' (?'.Address .5/.):.o. .d..~.~.~.,.. 1~..~... Phone No..'7..d. ?../?..'F.F... Name of Architect .......... i ................ Address ................... Phone No ................ Name of Contractor ......... [ ................ Address .... : .............. Phone No ................ 15. Ia this property located ~ithin 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold Town Trustees Permit may be required. ~ PLOT DIAGRAM Locate clearly and distinctly all ibuildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block r~umber or description according to deed, and show street names and indicate whether interior or corner lot. OCCUPANCY OR USE IS UNLAWFUl. ??i"HOUT CERTIFICATE ,','.: ': SCCUPANCY STATE OF NEW YORK, COUNTY OF ................. S.S A~;RO[~ ?,q NOTED N~TI~[¥~W OEPAR~E~T AT 765-1802 9 ~:~,M TO 4 PM FOR THE FOLLOWING iNSPECTIONS 1. FOUNDATION '~0 REQUIRED FOR POURED CONCRETE ~, ROUGH ' FRAMING & PLUMBING ~, INSU~TION 4. FINAL CONSTRUCTION BE COMPLETE FOR ALL ~ONSTSUCTION 8~ THE RE~IR~E~ OF THE N.Y. STATE CONgTRU~ON · CODE~. N~ ~IB~ DESIGN OR CONSTR~ON ERROR8 ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. ' He is the ' ! (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dulyi 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 manner!set forth in the application filed therewith. Sworn to before me this ................. ~. ...... day of. Notary Public ....... ~e--lff~......'~.. HELEN K DE VOE NOTARY PUBLIC, ~tate of New York . No. 4707878, Suffo k County~ro ~rm Ex~ires l~m'ch ~0, 1~ W i .............. County