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Home My WebLink About17001-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17424 Date OCTOBER 19r 198S THIS CERTIFIES that the building Location of Property 1305 LEETON DRIVE House No. County Tax Map No. 1000 Section 59 Subdivision ADDITION SOUTHOLD, NEW YORK Street Hamlet Block 1 Lot 15 Filed Map No. Lot No. conforms substantially to the Application for Building Permit hereto~fore filed in this office dated APRIL 29, 1988 pursuant to which Building Permit No. 17001-Z dated MAY 16, 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 DW~Lr. INGAS APPLIED FOR The certificate is issued to MARY ROGERS (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building In~ector Rev. 1/81 TOWN OP $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTNORIZED) N~ 017001 Z ,,t pre,,,,,es,,,~a~at....Z..Z:...O..~ ........ ~.....~ .................................................... Caun~ To,, Ma,:, No. 7ooo Sec,o,, ......... ,..~..~ ..... ~o,:~ .............. Z ..... Lot No ......... ~ ...... pursuant to application dated ...... ~....,,.~....~... .................. , 19..~,,~., and approved by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD !_~~~_~ Building DepartmentTown Hall ._ONLFG.S%iSouthold, N.Y. 11971 765- 1802 OLD APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A.This application must be filled in typewriter OR ink, and submitted ~ ~m...~.. to the B~ilding 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--iS-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.Su bm it Plann in g Boa rd approval of completed site p lan requirements where applicable. B.For existing buildings (prior to April 1957), Non-conforming uses, or b~Jildings and "pre-existing" land uses: 1. Accurate survey of p~operty 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 $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$]0.00 Business $50.00 2. Certificate of occupancy on pre~existing dwe))ing $ 5 0.0 0 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 5.Updated C.O. $ 50.00 Date .............. ././.././/..~.. New C OhS tl-uc t i on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property /3 0 ~" ' /.--.~ ~ ~'~". . . .~.. !~ Owner or Owners of Property County Tax Map No. 1000 Section . ..~...~. ......... Block../ ............ Lot.../. ~' .......... Subdivision ................................. Filed Map No .......... Lot No ......... Permit No/~ .4~. J Date of P~rmit ................... 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 p/l~rm, it,~qeets al.i. applicable codes and regulations. A cant ............................................... Rev. 10-10-78 TOWN OF SOUTLIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 To Whom 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. /Z/ /No Underwriters Certificate on file. /~' The check is(outdated/not on file.) /Z/ No Health Dept. Approval on file. /5/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit tt _~ 7 Building Dept. ***/--/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) l '700 ]65-1802 BUILDING DEPT. INSPECTION FOUNDATION ZST FOUNDATION FRAMING REMARKS: ~"~, _ [ ] ROUGH PLBG. 2ND [ ] INSULATION [ ~]~FI NAL DATE, 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ~_ ] ROUGH PLBG. FOUNDATION ZND [ ] ~iSULATION FRAMING [/~/FINAL lOOt ]'65-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [//]~INAL REMARKS: 'OUND/~TIO~ 'OUNDATION !. IOUGH FRAME & (1st) ( 2nd ) .PLUMBING NSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIOnaL COHMENTS: ~. .... BOARD OF HEALTH ...... · FORM NO. I SURVEY ......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 CALL ................ MAIL TO: Examineu ~'""//6 ..... Approved, Disapproved a/c ..................................... ~ . TOW. N OF APPLICATION FOR BUILDING PERMIT INSTRUCTIONS C~)~' ~ a, T~s application must be completely ~led ~n by ~pcw~ter or ~n ink and su.~i~~n~n~t~ith 3 sets of plans, accurate plot plan to scale. Fee according to schedule, ifc C~A~ b. Plot pl~ showing location of lot and of build,cs on premises, relationship ~ ~ff~.~r public streets or areas, and giv~g a dethled description of layout of property must be drawn ~ cation. 3' ~ c. The work covered by t~s application may not be commenced before issua~¥~~~.~ d. Upon approval of this application, the Building Inspector will issued a Build~~~.~mit shaJl be kept on the premises available for inspection throu~out the work. 1' ~lK~ e. No bulldog shall be occupied or used in whole or in p~t for any purpose ~hf6~til41~{~ 9fi,Qc~u~cy shall have been granted by the Building Inspector. ~,: ~O~ ~ ~PLICATION IS HEREBY MADE to the Building Dep~tment for the issua~¢ 6TW~n~it pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, ~,t~plioabl~.~s~es or Regulations, for the construction of build,cs, additions or alterations, or for re~d~ or demolition, as herein described. The applicant agrees to comply with all app~cable laws, ordinances, bufld~g code, hous~t~t~ons, and to admit authorized inspecto~ on premises and ~ build~g for necessa~ i~speqti02s. (~Signature of applicant, or hame, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....................... C.o : ............................................. Name of owner of premises .'f..d.~[ ~. 8, .?:('~c~..~. · ................................................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. .............................................. OCCUPANCY OR (Name and title of corporate officer). UNLAWFUL ALL CONTRACTOP,.'S .DST BE ,SUFFOLK COUNTYL CE.s,JSEIS Builder's License No.. J ,-~. J ~..3. (~'~. ............ Plumber's License No ......................... w[THOUI CERI[FlCAIE Electrician's License No ....................... Other Trade's License No ...................... OF OCCUPANCY Location of land on which proposed work will be done .................................................. .............. ,, ..... ........... ............. House Number Street Hamlet County Tax Map No. 1000 Section ....5:~ ........... Block ...... I ............ Lot...[. 5.-~.. ........... 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 ............ .C5).. [.. O~8-~(, . . ~2~.C~C.~a~, ........................... 3. Nature of work (check which applicable): New Building ..... ' ...... Addition. iY'''" Alteration .......... Repair Removal Demolition ' Other Work ' ~ i (D tip.ti ) esc on P., aoo. ' 4 ti d C · Es mate ost .............................. Fee ......... · (to beI paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling un!ts on each floor ................ If garage number of cars ] ' 6. If business, commercial or mixed occupancy, specify nature and extent of each tyEe of use ...................... 7. Dimensionsc~f,e,~s[ing structures, if any: Front.· .c~.ff'~. ~' ...... Rear . .c~.~.. ~-i ~". ....Depth..~oQ..~.~. ....... Height '-t..rTl' Number of Stories I D~menmons'of same structure with alterations or additions' Front ~.~.~ Depth .... ~. :d. ¢ .+. ............ Height .... ?'. '~: ........... Number of Stories...I ..................... -8.. Dimensions o~,e~n,tire new construction: Front ...~1~..~.5-~p Rear .... c~. ~.-[: .... Depth ...].QI;.'~ ........ Height .... ~ ~.T ....... Number of Stories ....... I. ............ i .... 10. Date or Purchase ./..~. 7. ~ ..................... Name of Form.er Owner i/~ .P. '. ~Z~'.~.~i'~. ......... 1 1. Zone or use district in which premises are situated . "~.' -'; ~ · ' 12. Does proposed constructmn viglate any zoning law, ordinance or regulation: . .. i~.(~).. ;~ ...................... 13. Will lot be regraded ...... NcO. .................. Will excess fill be;removd'~ ff6m b;¢mis~si 14. Nmne of Owner of premises lf'E~,q O.~O.qt2P;.$ Address i~O~' Name of Arclutect Address .... vh,,,~ xt 15. Is th~s property located within 300 feet of a tidal wetlan~¢ ~Yd~:;.~.j ~/~ /~... *If yes, Southold Town Trustees Permit maybe required. PLOW DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, in'dicate all set-back dimensions from property lines. Give street and block number STATE OF NEW YORK, S.S CODNTY OE . . .~ ............ .... ........................ (Name of individual signin~g contract) above named. c,,.,. or description according to dee J, and shoW street names and indicate whether AP, PRO)lED AS NOTED 7051-t802 ~ AM TO 4 PM FOR I~IE FOLLOWING INSPECllON8: ' 4. I~NAL .. t~"ON~N MUST .BE COMPLE C.C. ALL J CONSTRUClION IALL MEET coo e. NOT DESIGN OR being duly sworn, depe ~es and says that he is the applicant He is the ............................... . .......................................... (Contractor, agent, corporate officer, etc.)] of said owner or owners, and is duly authorized to perform or have performed the s~id work and to make and file this application; that all statements contained in this application are true to the best of hi~ 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 ........... , . . No~ ..... ............ County ~ ~ t~ ... UNDAJ. ~:)OPIgt / (Signature of applicant) ~f~ary Publl0, State of New York~ d no. 4822663, Suffolk County,,~/O Term Expires December 31.19' u