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Home My WebLink About16952-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hail Southold, N.Y. Certificate Of Occupancy Z16901 Hay 2/4, 1988 Date ................................ THIS CERTIFIES that the building deck addition. Location of Property 2585 Bray Avenue Laurel h3~s~ ~/o1 ....................... 's'rfe3i ....................... County Tax Map No. 1000 Section 126 .Block 9 .Lot 10 X X Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated April 18, 1988 16952Z ..................... pursuant to which Building Permit No ...................... May 10,. 1988 dated ............................. 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 addii:ion to existing one-family dwelling. The certificate is issued to 1tARRY & ELEANOR MILLER ..................... ...................... of the aforesaid building. Suffolk County Department of Health Approval .......... N/A ................ UNDERWRITERS CERTIFICATE NO ...................... N/A PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 TOWN 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- 16952 Z Permission is hereby granted to: at premises located at ..~.~,~..~...~........~......~..:......~...~.......~....:~..: ........................... County Tax Map No. 1000 Sectj/~.....~,....~....~. ...... Block .......~..cj ......... Lot No..../....~. .............. pursuant to application dated ..~.~.......[...~. .......................... Jg.~..~.., and approved by the Building Inspector. Fee $.,,~,,"~,.,,.',.,,~... Building Inspector Rev. 6/30/80 765-1802 BUILDING DEPT. INSPECTION REMARKS: [ ] FOUNDATIONIST [ ] ROUGH PLBG. [ ] FOUNDATION :'ND [ ] I/~ULATIO,, N / ~.~ []FRAMING [/]FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IS'r [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]/~NSULATION [ ] FRAMING [?] FINAL REMARKS: DATE FORM NO. 6 I TOWN OF $OUTHOLD Building Department Town Hall Southotd, N.Y. 11971 _, 765- [802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter 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 approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Nomconforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty 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 bu ildings. 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,S25.0,0, 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 $10.00 4.Vacant Land C.O. $ 20.00 ~/~.~/~C~t/' 5.Updated C.O. $ 50.00 Date ....................... .~... Old or Pre-existing Building ............ Vacant Land ............. NewConstruction. Location of Property .................. ;'. .................................. House No. Street I-lam/et Owner or Owners of Property . ~ County Tax Map No. 1000 Section ...... [~. .... Block ...~ .......... Lot ...... !~. ....... Subdivision ....................... Permit Oate of Permit Health Dept. Approval .............. ......... Filed Map No ..... .~..~.. iLot No ..... - ......... ......... Labor Dept. Approval ....................... . Underwriters Approval Planning Board Approval ~- Request for Temporary Certificate .................... Final Certificate ...... .~.. ............. Fee Submitted $. C~.~. ............. Construction on above described bu ilding and permil;,fne~,ts all applicable co~(es and regulations. fl_ ." -.~....~, ~,~j¢( Applicant ...... .¢,~..~¢~.. ~.% .Z'/~. ~ .......... Rev. 10-10-78 FOUNDATION (~t) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL Ye ADDITIONAL COMMENTS: ?,i~ TEL,: 765-18013 Examined..-~i~f~..~t~ .~0.., 19.~.~_~ Approved ..... ~ ~ .., Pe~it No ....... Disapproved a/c ..................................... . ~ x ,,, :..~. (Building Inspector) 'FORM NO. 1 TOWN OF SOUTHOLD CIIECK IZUILDIN(3DEPARTMENT §RPTIC TOWN HALL NOTIFY , :~A~PLICATION FOR BUILDING PERMIT BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... FORM ............. CALL ........ ~ ..... MAIL TO: ,' INSTRUCTIONS a. This applrcatlofl must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, a'ccurate plot pt~ri td 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 appli?ation 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 r, egulations, and to admit authorized inspectors on premises and in building for necessary inspection.~...~ (Signature of applicant, or name,---- --if a corporation) ................. ...... (Mail~ress of applicant, State' whether' appli'can~ is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. / (as on the tax roll or latest deed) If applicant is a ~orporation, signature of duly authorized officer. (Name and title of corporate 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 ...... .~ .......................................... :,. ......... .... ....... House Number / Street Hamlet County Tax Map No. 1000 Section ...~..~.&..~..~)..... Block .. t~..~...~? ........ Lot..~. j .~..~.LO..~. ...... Subdivision ..................................... Filed Map No ............... Lot .... (Name) 2. State existing use and occupancy of premises~-and ?tended use/.)__and occupancy of proposed construction: a. Existing use and occupancy .......... ~ .~......-ff~/~' .. ................................... b. Intended use and occupancy ............. 1 ~... ~ .................................... 3. Nature of work (check which applicable): New Building ..... ' ..... Addition. . Alteration .......... Repair ; ............. Removal .............. Demolition ........... i. Other Work 4. Estimated Cost ....................... Fee ........ ~ ............................ · (to be ipaid on filing this application) 5. If dwelling, number of dwelling units .... l .......... Number of dwelling units on each floor.. If garage, number of ears 6. If business, commercial or mixed occupancy, specify nature and extent o£ each type of use .................... 7 Dimensions of xi ting structu if any: Front Rear ' Depth Height ............... Number of Stories ........................................................ Dimensions'of same structure with alterations or additions: Front ............ ..... Rear ................. Depth ............... ....... Height ................... Number o~ Stories .............. 7' ..... .. ]1/./~.'.. .... Rear ....... : ....... Depth ... f.~. ....... Dimensions (~f erltire new construction: Front f' / ' Height . o7..~ ./ ........ Number of Stories i 9. Sizeoflot: Front .... f~>..o. ....... : ...... Rear .... /.Z~7.) ............. Doptja .../~ .Sf-_-... ............ 10. Date of Purchase ...Z~.~b:.t~?.C~-.~.r-./.~e¢'.~-..~ Na~m_eofFo~er, Owner 11. Zone or use district in wi~ premises are situated i i i i .,_7>..,~v..~'~...~..~.. c~·l f-'O'z~' ""'~-'c''. ~4z;Y;qt~.~.. 12. Does proposed construction violate any zoning law, ordinance or regulation: .... i .Y¢~ ........................ 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .................... Address ............... ; ... Phone No ................ Name of Architect Address ! Phone No Nmne of Contractor .......................... Address .... : .......... . ....Phone No ........ 15. Is this property located within 300 feet of a tidal wetland? *Y~s ..... No .~q.. ~If yes, Southold Town Trustees Permit maybe required. PLO'T DIAGRAM 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 descnphon according to deed m~d show street names and mdmate whether interior or corner lot. : APPROVED AS NOTI NOTIFY gUll,DING DEPAR1 765~ 1802 9 AM TO 4 PM FOLLOWING INSPECTIONS: 1. FOUNDATION . TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL CONSTRUCTION MU~T being duly sworn, depolses and says that he is the applicant He is the .' ............................................................ ~ ............................ (Contractor, agent, corporate officer, etc.)I of said owner or ow~ ners~, mad is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in,this apt31[~afion~ 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 i .............. i Notary Public ........... Coun ~/.~ (Signature of applicant)