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Home My WebLink About15384-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate OI: Occupancy N Z14981 October 10 o .................. Date ................................. 19 86 THIS CERTIFIES that the building ..... A.c..c.e.s.s.o..r.y..b.u..i.l.d.i.n..g; ..................... Location of Property .... .9.1.5.. S..h.eRa. r..d' .D.r.z..v.e .............. S.o..u.t.h.o...d ................ House No. Street Hamlet County Tax Map No. 1000 Section .0.7.8. ........ Block . 01. . .Lot 22 Subdivision .... W..e.s.t..C.r..e.e.k..E..s.t.a.t.e..s ...... Filed Map No..3848 .Lot No. 37 conforms substantially to the Application for Building Permit heretofore fled in this office dated · .Q~.t. ql~¢~c..8. ........ ,19..8.6pursuant to which Building Permit No. 15383Z dated . .O..c.t.qb.e..r..8 ................ 19..8.6, 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 ......... Cons.truct an accessory buildinsin the rear yard. The certificate is issued to Judith W. & James R. Woodhull ..................... ................... of the aforesaid building. Suffolk County Department of Health Approval ........... .n/.a. ........................... n/a UNDERWRITERS CERTIFICATE NO .................................................. Rev. 1/81 Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall $outhold, N.Y. Certificate Of Occupancy No. Z14982 Date ..... 9~?~.~? ................ 19~. THIS CERTIFIES that the building ... DB.q~ ........................................ Location of Property 915 She]2ard Drxve Southold ho~$~ ~o: ....................................................... Street Hamlet County Tax Map No. ] 000 Section 0 7 8 ...Bloc]( 0 'i .Lot 22 Subdivision .~.e.s.~ .~.r.e.e.k., .E.~.~a..~.e.s. ........ Filed Map No. 3848 .Lot No. 37 conforms substantially to the Application for Building Permit heretofore tided in this office dated .... O~.t.Q~r..~ ...... ,19 ~.6. pursuant to which Building Permit No. ~53847. dated ............Oct°bet .... 8 ............19..8.6, wasissued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... Construct a deck addition to an existing one family dwelling. The ce~ificateis issued toJudith W. & James R. Woodhull ..................... ...................... of the aforesaid building. Suffolk County Department of Health Approval ........ .n./.a. .............................. UNDERWRITERS CERTIFICATE NO ................ .n./.a, .............................. Building Inspector Rev~ 1/81 · O~B~[ NO. S TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALl. SOUTHOt. D, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 153~3 Z Permission is hereby granted to: ~....~...~.,......u..s.~...L=, ~o~ ~ ~ ~L~ ~ q ...................... .'. ......... '-' ........ ~ ..... '~ ................. II~1-~*'~ ....... ~-" ;:"~ .......... '~ ' ~ ' ^";i ............ at premises~ocoted at .....~../...'~.' ........ ~.....l~J,.._~...~. ........ ~_,., ................ County Tax Map No. 1000 Section ...... .~.-'J..,~. ....... Block ...... .~..~.. ........ Lot No....~ ,~.....~':~... .......... ~ur~o~t to oppl,~o,on do,,~ .... ~.....~...*,~--....--t ................... , ~93..~., o,~ opp,ov~ by the Building Inspector. Fee $, ~./,.:.,...../...... Building Inspector Rev. 6130/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEP, MiT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15384 Z Permission is hereby granted to:~ . , · ~ ...... ....... at premises located at ..,~, .,/..~........~..qd,,~.,..,.~,-..r~.-',*.*.O-3~~ ............................. County Tax Map No. ]000 Section ...... ..(~...,--]....~. ...... Block ....... ,~.,..~ ........ Lot No. ,..,~r..~ .......... pursuant ,o application dated ...... .O....~.~.....~j. ................., 19..~...~., end approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall $outhold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted m Ilmmmm~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 natura~ 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), Non-conforming 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 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: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.0 0 ~ ,~ 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5.Updated C.O. $15.00 Date ,.. ............. Newconstruct;ion ...... Old or Pre-existing Building ............ adant Land ........... Location of Property...~.//...~.7 ..... .~.X.~. · .¢~../~. No. / ........ County Tax Map No. 1000 Section ............... 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 buildin/l~?,pe?rl~r rne~ts all ~pl,~al~le( ,/ /[-" /~ /(,// codes~nd~//regulations. Rev. 10-10-78 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hail Southold, N.Y. 11971 76.5- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted m Immm.mm 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. For existing buildings (prior to April 1957), Non-conforming 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 buildings. 3. Date of any housing code or safety inspect!on of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 $15.00 5. updated C.O. $15.00 Date .......... NewConstruction ...... Old or Pre-existing Building ...~ ........ Vacant Land ............. Location of Pro arty ............. · .~.¢. C ~ County Tax Map No. 1000 Section ............... 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 codesand regulatjpns. FOUNDATION (1st) FOUNDATION ( 2nd ) ROUGH FRAME & PLUMBING INSULATION FERN. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: BUILDING DEPT. INSPEI:TION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: ] FINAL DATE k~" ............ OEPARTM~NT, ~T FO00Wif I~ iNsPECTiONS: ~. FINAL ~IGN DR CcNST~JC?ON ERRORS, ANC¥ OR JT CERTF~C/~T£ UPANC¥ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL,: 765d803 Approved ~. ~ . .~M~-~..... ~..., 19~(o. Permit No..~.~.~.?.~..~ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT ' 7 1986 Received ........... ,19.. Date .................. , 19.. 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) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....0.c9..~. &( ........................................... · ?.."--b. .V)....VI ............................... Name of owner of premises ,~-~.-.,.,.~-..~. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer· (Name and title of corporate officer) 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 .................................................. ...q. ........ ..................... .................. House Number Street Hamlet County Tax Map No. 1000 Section ...~.?.~. ........... Block ....... ~] .......... Lot...~.."~.. ............ Subd,ws~on~.~' ' ' . .C_~.q ¢.~. ~ .~..~.0~.o__~.. ............ Filed Map No..~..8..~.~. . ...... Lot .~.7. ........... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~0..O~4...(~¢.c-).~(44¢... O..k.A-). ~xJt~7- ........ b. Intended use and occupancy . ~..~..4.~. ........................................................... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removai .............. Demolition .......... i... Other Work .~..[3$~... ~... ~ (Descriptioh) 4. Estimated Cost . Fee ' (to be paid on filing this application) 5 If dwelli g bet of dwelling units Number of dwelling units each floor · n , hum ............... on ................ If garage, number of cars ............................................ 6. If business, commercial or mixed occupancy, specify.nature and extent of eagh type of use ..................... 7. Dimensions of existing structures, if any: Front....~'~ .......... Rear . .~[... i ....... Depth . ~r.-/. .... Height ~. Number of Stories ~. Dimensions of same structure with alterations or additions: Front ............ ~ ..... Rear .................. Depth ...................... Height ...................... Number oflStories ...................... 8. Dimensions of entire new construction: Front ... J ~. ......... Rear .. I .~1~.. i ...... Depth . ~. ~. ........... Height .... ~ ~'. ........ Number of Stories ...... 1 I. Zone or use district in whichtpremises are situated f.~.$1~33.~i .a~... 12. Does proposed construction v~olate any zomng law, ordinance or regulatmn: . Mq .......................... 13. Will lot be regraded ..... ~0 .................... Will excess fill be removed from premises: Yes 14. Name of Owner of premises .................... Address ............... i .... Phone No ................ Name of Architect Address ' Phone No Name of Contractor .......................... Address ............... i .... Phone No .......... 15. Is this property located withint.O0 feet of a tidal wetland? * ~es ..... No .''.~.. ' .... · If yes, Southold Town Trustees Permit may be required. PLOT 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 description according to deed, and sho~ street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ......... ........ S.S ................................................. 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.)i 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 manner set forth in the application filed therewith. Sworn to before.me this 7 . .da of . tS~C,,Y- ................ ., .. · y .~ ................... ,19... ~I0~11~~ ~ /~" (Signature of applicant) FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved c>~. ~,9-~..~..., 19'~.~. Permit No../..~..~..~.~ .~ Received ........... ,19... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .................. , 19... 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) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .~ .O:..XXg$_..g. ~.....~....~.~...C~.'%. )k&J .t)O~.t.I .............................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) 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 .................................................. ..... .q. ................... ................. ................... House Number Street Hamlet County Tax Map No. 1000 Section .... .'~..~ ........... Block ...... ] ........... Lot...~'..~. ............. Subdivision .~Q .~%..~....~.~..~....~..%.~..O~.. ¢.~. .......... Filed Map No. 3.8.q7. ~ ........ Lot.. ~.'-/ .......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . k O.rY~-~...0..C.C~ .t~. ~3.k.tLC~.. ~>..~...O.k3.3 .~. ¢$r-~. ............................... b. Intended use and occupancy ...(~.*C.]~-...G.'-~(J~. ¢~....31~O....~O.O-.c~.~...O..~...~..O..tot_.~.~e. ...... 3. Nature of work (check which applicable): New Building .......... Addition . .i ........ Alteration .......... Repair .............. Removal .............. Demolition .......... i'" Other Work. ~)¢¢~-~ ........ oi-? 0o.o , (Description) 4 Estimated Cost Fee (to be ipaid on filing this application) 5. If dweiling, number o f dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars ............................................ i ............................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front...cPI .......... Rear . .~. I .... ....... Depth. ~] ........... Height .... 9~ ......... Number of Stories...~ ...................... i ................ .... ........ Dimensions of same structure with alterations or additions: Front ............ i..... Rear ............ ...... Depth ...................... Height ....... ~ ............... Number oX Stories ...................... 8. Dimension,~ pf entire new construction: Front. ~ ........... Rear . .4~..~.~P ..... Depth ..]. ~. .......... Height ! ~.~< . Number of Stories ..-rT~.J~ . . . 9.~ ~feurch~Size°fl°t:Fr°nt .i[~!.% ............ Rear ..II.B,..~/.~. Depth 15hL..~.~t...?..~.1.O.:.O... 10. uateo ese ..~[.?.]./t... ................ Na,rneof,FornterOwnar~Cr'~r.¢.,.!p~c~lq>.~.[0...~.;.l.~..~.~.r.q 11. Zone or use district in which premises are situated ~$i ~..T.f.o~ .................................... ' 12. Does proposed construction violate any zoning law, ordinance or regulation: . 13. Will lot be regraded ... [al.t? ...................... Will excess fill be remove.t from premises Yes 14. Name of Owner of premises .................... Address ............... ~ ....Phone No ................ Name of Architect ........................... Address ............... ! ....Phone No ................ Name of Contractor .......................... Address ............... i ....Phone No .... / .......... 15. Is this property located withinl,00 feet of a tidal wetland? *iYes ..... No .~/... · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, an& indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and shoo street names and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................. ................................................. being duly sworn, depoyes and says that he is the applicant (Name of individual signing contract) above named. He is the ............................................................ · i ........................... (Contractor, agent, corporate officer, etc.)i 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 hisl 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 .... ~..C~. ............. 19 .~-'.~. Notary Public,. .... ~-~%~.... ~ .... ?.' .~...~/~'~ i. County