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43979-Z
0�0 toG Town of Southold 7/28/2019 P.O.Box 1179 co 53095 Main Rd 1 �'� Southold,New York 11971 ool � �ao�4,,) CERTIFICATE OF OCCUPANCY No: 40558 Date: 7/29/2019 THIS CERTIFIES that the building AS BUILT ADDITION Location of Property: 1420 Ninth St, Greenport SCTM#: 473889 Sec/Block/Lot: 45.-6-9.4 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 7/9/2019 pursuant to which Building Permit No. 43979 dated 7/17/2019 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: "as built"outdoor shower and sliding plass door cottage, as applied for. _ The certificate is issued to Nelson,Ann of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 7/23/2019 Ro Nelson th ignature W �S�FFot� TOWN OF SOUTHOLD moo oay BUILDING DEPARTMENT TOWN CLERK'S OFFICE 14 "o SOUTHOLD, NY L BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 43979 Date: 7/17/2019 Permission is hereby granted to: Nelson, Ann PO BOX 596 Greenport, NY 11944 To: legalize an "as built" outdoor shower & sliding glass door(cottage) as applied for. At premises located at: 1420 Ninth St, Greenport SCTM #473889 Sec/Block/Lot# 45.-6-9.4 Pursuant to application dated 7/9/2019 and approved by the Building Inspector. To expire on 1/15/2021. Fees: AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $400.00 CO -ALTERATION TO DWELLING $50.00 L) To al: $450.00 Building Inspector Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1%lead. 5. Commercial building, industrial building,multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing"land uses: 1. Accurate survey of property showing all property lines, streets,building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied,the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1'. Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00 Date. New Construction: Old or Pre-existing Building: (check one) ,n Location of Property: .Z0 \ \�j�� C-© W House No. Street Owner or Owners of Property: Qc�� � Hamlet �VL� �' Suffolk County Tax Map No 1000, Section Block Lot 1 Subdivision Filed Map. Lot: Permit No. G Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Ap icant Signatur Town Hall Annex1 [ Telephone(631)765-1802 54375 Main RoadFax(631)765-9502 P.O.Box 1179 G Southold,NY 11971-0959 �' �'Es BUILDING DEPARTMENT J U L 2 5 2019 TOWN OF SOUTHOLD DIJ_"7,DRTG DEP'17� t:0 1 t7.� F CERTIFIfAT-ION, Date: k Building Permit No. � ,� � �� „ �,• � � � � , Owner: "424L7t2 W OA (Please print) __-Plumber: (Please print) 1 I certify that the solder used in the water supply system contains less than 2/10 of 1% j lead. i (Plumbers Signature)- i i Sworn to before me this- (J day of , 20� I I Notary Public, County j I TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK j NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY ' COMMISSION EXPIRES JUNE 30, s TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD, NY 11971 4�ets of Building Plans TEL: (631) 765-1802Planning Board approval FAX: (631) 765-9502 OiS rvey Southoldtownny.gov PERMIT NO. Check Septic Form N.Y.S.D.E C. Zo teesApplication d Permit Examined 120 Single&Separate Truss Identification Form Storm-Water Assessment Form l ontact: evn Approved 120 N yy\. Disapproved a/c �/ Phone: � 1 ! 7 0 Expiration 120 �' c Building I pector (� pd I 4 APPLICATION FOR BUILDING PERMIT J U L - 9 2019 Date , 20 INSTRUCTIONS i 1s=��a..t T DE17PT: a. Tis�ap`licaZl� T--1i completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 waterways. 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 issue a Building Permit to the applicant. Such a 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 what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize,in writing,the extension of the permit for an addition six months. Thereafter, a new permit shall be required. 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) 01 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder —Name of owner of premises�C Q e_4`T' �C_saj (As on the tax roll or latest deed) If applicant is a corporation,,signature:of duly authorized officer (Name and title ofc'oi ,pra( ,offi_cet),,-. Builders License No. - :r Plumbers License No. Electricians License No. Other Trade's License No. -- 1. Loc tion of land on hich proposed w rlc will be done: House Number Street Hamlet County Tax Map No. 1000 Section Block Lot , Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy �'hy a b. Intended use and occupancyLMq\ ,, 3. Nature of work(check which applicable): New Building itio Alteration Repair Removal Demolition Ot er ork (Description) 4. timated Cost Fee (To e paid on filing this application) 5. If dwelling, mber of dwelling units NXnatured its on each floor If garage, num of cars 6. If business, commercial or mi occupancy, specify each type of use. 7. Dimensions of existing structures, if any: nt Depth Height Number of S Dimensions of same structure with alt tions or ad ' ' ns: Front' Rear Depth Heig Number of Stories, 8. Dimensions of entire new const r tion: Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear Depth >Does Purc e Name of Former Owner use district in which premises are situated oposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES NO X Will excess fill be removed from premises? YES NC)K-- 14 Names of Owner of premises Address Phone No. ct Address Phone No Wa44e-o -vva*Tctor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO _ * IF YES,D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. i 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. 18. Are there any covenantsand restrictions with respect to this property? *,YES NO__)� * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, CONNIE C.BUNCH Notary Public,State of New York (S)He is the No.01BU61Asasn (Contractor,Agent,Corporate Officer, etc.) Qualified in Suffolk County O Commission Exoires Aorif 14, 2��- 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 Q-91-\ day o' 20 - 1 (L U Notary Public V SignaV of Applicant .t 1 tuT 1 -� yj¢rGT yO bq"u� 1 C�j H- 0 r' LIUU T b7¢bGT _ F 1 fi it � t o It7 - `Q CI— �a FJV__. fvq reQ 4Apy4 �J.'b84py1�� '-•:,`+a.; .',.r'.,r_ _ _ �'✓•_:O4piUG$y ,tlI64 YiAIS'i tva@r:; "�� _ PSCgNJC ' it F d4y - •SCAL�� 50'�I° of mou„Mar Nide OP LAWD AL1=A- 12.1 t ACQZS Foe GUAVAANS UTA�I� N�L50lJ A0JU -,CUTAfift O LD 4A.I 6O,AAU766 CONPAUY duq JUG eaaTu ju c. 119,1 46 1 YURYflYcn-Juus Iq,lg 68 AT VAU TU Y L & 50 1 7OM!I f D ' UTAQVD,L,Y. .LtfSizA tAUQL '9DSZMWQI• . .--- - T- --- --R— 5us�upo¢7,: Isotc;dui; - p. 'u'ta:YivC�t�n4xy*IT3.:. � •. -.. •r' -, :•. �,••, - t •.:_,. >:' �'t`.r>.::' It±�..^'".'° li•.�i5•;,���''L'• '�1-'ice"• '�:"...ie..,.:esL).;''�''�'-�,.¢tyc.ia�lY.•.. '` .£�.ri.> ' 4 � QP R gIED AS HI ED DATE: 7 I ! B.P.#� J FE B NOTI� BU LDING DEPA- .SENT AT _ - _ i 765-1802 8 AM TO 4 PM FOR THE :i = - ' - -. - - - _ - �, - _ -_ - �_ �• � _ - - - fj�j=T'•�orXLSG�o - "L�; �! FOLLOWING INSPECTIONS: f f u� 3t 11. FOUNDATION - TWO REQUIRED tj't !� /�' �'t FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING = _ 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE -FOR C.O. _ ALL CONSTRUCTION SHALL MEET THE � � � ` REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. �fiaTr '1' rv:_k. ,� +\ - `-1-�•---- %Y,a. `nib' - - .:1'y - , _ • _ 'h` - •�4' - rk .'3 ,yih _ - rim.� - -- lfy'ye���w`'+,�y..�L:.� - `-Cc:�•`:^' -_ ,t� _ _ ,.•�k. _ _ - - _- - �``ay,=-;y2-,- __ _ _ _ _ - ^': :_ _t:_L t".1;, - _ [ S• COMPLY .ivy WITH _f, ALL ��. NEW YORK STATE & TOWN CODES Y AS REQUIRED :-�. -'. .r4-. - _ _ '-i• -_ems `S, _ - _- _ _ - ` = - - '� - SOUTHO STEES ♦J` /�l 1�, c '(•.(� �CJ 1' '��11C 7. 5 fia l l 5 ae�el' A-N2sovtl sLtot�. t-,�ss Mied e-ke OCCUPAOY OR �. - ao c 3 ,, UNLAWFUL . ' :' : - • . --- _ w - - - _.. r. ► �- cc® G m 3 USE IS CERT WITHOUT I OF OCCUPANUY C �e gecV i - • ( y- j