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Home My WebLink About10875-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25506 Date: 01/28/98 THIS CERTIFIES that the buLlding ADDITION Location of Property: 57425 COUNTY ROAD 48 GEEENPORT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 44 Block 2 Lot 4 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 19, 1980 pursuant to which Building Permit No. 10875-Z dated SEPTEMBER 19, 198~0 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 SUNROOM ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to HARRIS, LINDA M & ANO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A PENDING N/A 01/28/98 Rev. 1/81 //Budding Inspector (THIS PERMIT MUST BE KEPT ON: ~HE PREh~I$~S UNTIL ~ULL COMPLETION OF THE WORK AUTHORIZED) i s4~e~:~ 19 ]9...'.!9 N°· 10875 Z: Dote .,~ ,-~, ................................... , ~rmis~ion is hot, by or~nted to: ~ ...................................... .~z~.,.r~T., ........................... . ......................... :~,~.."~{ ................ ............................ at p:rem ses ~ocatea at .................. : ....................... ;. ............... [ ................ ~ ................................... Co~nw ~ ~op ~o. ~00o ~so~.o~ .~ ...... ;. mock~ ~.,..~..:~ ........... lot Uo ........ [ .............. p~rsu~nt to opphcobon~d=t~d ............................., ............. T"?""" 19...~ .., ond opproved by tho Building Inspector. ' 1 5 O0 Fee $ .......... : ............. B~ilding Ins~ec~'~r Form No. 6 'TOWN OF SOUTIIOI,D BUILDING I)EP^RTHENT TOWN I1A[,L 76~-1802 AI'I'I,ICA'I'IOtl I'OR CERTIFICATE OF O(,(.UIAN(.Y [ILi !,> i 8L,)G A. I'llt.~ nppllcatton musf be flllpd ~tl by typewrtl, er Ol'. Iai( nmi mdw. l~tod lo the Imlhlln~ J~t~pecLor with Lbo roi Iowlng~ for new bulJdJag or nm4 I. FhmJ survey of property wtth nccura[~ loch(ion of nit bulhlt~gs, properly Ilne~, 2. Ftonl Approv~J From ll~ntth Dop~. of water supply nnd ~owern~e-dlspom~l(S-9 Form). 3. Approval of etectrtcal tastallation from Board or Fire UnderwrLter,. 4. Sworn statemeot from plumber certifying that the sol. der tl~8tJ lit system contnlnq loqm than 2/10 of 1% lead. 5. Comercia[ buildJag, industrial buildlug, multiple resldeoce¢ and stmilnr Imtldtogs and Jnstalta~ions, a certificate of Code Compliance from architect or englaeer reqponstble for the batlding. 6. Submit Plmmtng Board Approval of completed site plmt requ[rrme.ts. B. ) F.r ~xistl.g buildings (prior to Apr,[ 9, 1957) non-colt[ormlng uses, or ~ "pre-oxtail.g" lnod uses: I. Accurnt~ sorvey of property showing ntt property l lne~, streets, bu[Idjag nnd unusual natural or topographic features. 2. A properly compJeted application a~ld a consent ko }ospect reigned by ~he mppltcaot. If n Certificate of Occupnllcy ]8 (Jellied, the BuJldi.g Inspector mhall stale the reflqOll~ tJJere[ot {n wrt~lag Lo the C, Fees I. Certificate of Occupn,cy - New dweJ. lEng ~25.(10, Addlttmm to dwelling $25.O0, Alterations to dwelling $25.OO, Swimmlog poor $25.00, Accessory buLIdLng $25.OO, ArJdltJonm Lo ~ccesoory boil. ding $25.OO. Btslm~smo~ $5(1.OO. 2. CerttfJc~le of Occupancy on Pre-ex{sEing Building - ~100.OO 3. Copy of Certificate of Occupancy - $5.00 over 5 yoars - ~[O.OO 4. Updated CerttfJcat~ of Occupancy - 5. Temporary Certificnto of Occopancy - RosJ. denttal $15.00, Commer [nl $15.O0 DaLe ............................ OI ti g B Itdt tlouae No. Street' Ilaml ,,,wet or Om, ers oF Property .... ~.~. ~. /~p~ .................................. ;ubdlvtsJon .................................... Ft.l~d Nnp ............ I,ol ...................... 'ermit No ................ Da~e O[ Perm~ ................ Appll. cnn~ ............................. lealth Dept, Approval .......................... Underwriters Approval ......................... 'l ll(llng Board Approval ........................ coNSENT 1N.q r'IgC'l'lO N tOxmeriS) blame{s) do(es) hereby state: That the underslgnpd (is) (are) the owner(~) of the premlaea in the Town , which is shown and dosiqnnted on lbo Suf[olk Corn, fy tax map as District 1000, Section ~__, Block 0--' l~ot_~ That the undersigned (has) {have) [iled, or caused to be [iled, nu nppllcn- tion in the Soutbold Town Building Inspeetor'~ Office [or the following: That the undersigned do(es) hereby give con.~ent to the 13uildlng Inspectors ' t o[ the Town o~ Southold to enter upon the above deaerd>er property, including any and all buildings located thereon, to eond~mt such inspections as they may · ' lnspocttm deem necessary with respect to the afnresald appl~cnt~on, includin~ ' ' to determine that said premises comply wRh all of the laws, ordi,ances, rules and regulations of the Town o[ Southold. Tbeunderslgned, tnconsentlng to such h~spections, do(es) sowiththe knowledge and understanding that any information obtained h, the conduct of such h,speetions may be used as evidence in subsequent prosecutions for lations of the laws, ordinances, rules or regulations or th~or Southc, ld. F~ELD~INSPECTION FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY COpE FINAL COMMENTS ADDITIONAL COMMENTS: FORIV/ NO, ! TOWN ~)F SO~THOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Ex°mined ................... 19 5 (Suildino Inspector) APPLICATION FOR BUILDING PERMIT Date ................. ..~....~....'~... ................ , 19....~,,. ..... INSTRUCTIONS a. Th~s apphcatlon must be completely fdled in by typewriter or in ink and subm*tted in triplicate to the Budding Inspector, with 3 sets of plans, accurate plot plan to scale Fee according to schedule b. Pict plan showing location of lot and of buddings on premises, relationship to adjoining premises or pubhc streets or areas, and g~wng a detaded description of layout of property must be drawn on d~agram which *s part of th*s apphcat]on c. The work covered by th*s apphcatlon may not be commenced before ]ssuance of Budding Permit. d Upon approval of th~s apphcat~on, the Budding Inspector wdl issue a Budding Permit to the apphcant Such permit shall be kept on the premises avadable for inspection throughout the work e. No budding shall be occupied or used m whole or m part for any purpose whatever untd a Certificate of Occupancy shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Budding Department for the ~ssuance of a Budding Permit pursuant to the Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances or Regulations, for the construction of buddings, add~tmns or alterations, or for removal or demohnon, as hereto described The apphcant agrees to comply w~th all apphcable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and m buddings for necessary tns~ectlons (S~gnature of apphcant, or name, d a corporation) .. . ,,~o.¢~.. .'.7-~ ~:>. .~.../~.. / AL.. y ............. (Address of apphcant) State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... ,C~.?.../:ff. :.zT~..~. ~...zT'.~..z: .~,. ........................................................................................................................................................ Name of owner of premises ...... ..'~-...°./..~...~.. ........ ~.~./..¢. ................................................................................................... If applicant is a corporate, signature of duly authorized officer. .................... .................... .-......6 ......... : .............. ~' (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ..................................................... Lot No ............. ' ./.~.~..o..~,,:..,../.~,d',~.,.~ ~oo~ t//~--'tom Street and Number~/~ ~ '"(.v..o..,~.:.'Z.~...~./..~..~..l...z~.e...~Z2..~...../~'Z~.,z,)...:: ........ ......................... Mu n Jcipa lity 5 ~,u~l~zz) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... .~...~.~./.~.4Y.~.~.. ............................................................................................... b. Intended use and occupancy ..,,~'.~Z~'Jz~:.......-~.. ........................................................................................................ 3. Nature of work (check which applicable): New Building ....~ .................. Addition .....2~'. ........... Alteration ............... , Repair ......................... Removal ............... ,.... ..... Demoht~on ........................ Other Work .................................... (Description) (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 ......... ; .................................................................................................................................. 6. If business, commercial or m'x~d occupancy, specify nature and extent of each type of use ..................................... ~ Depth ..... ~.. .......................... 7. Dimensions of existing structures, if any: Front ...q..~.. ...........Rear ........... ,4. ............. Height ....... ..~.~. .............................................. NQmber of Stories ....... ~. .................................................................... Dimensions of same structure with alterations or additions: Front ....... .~.~. .............. Rear ....~ .............................. Depth .......... ~.. ......................... . ....... Height ............ ~ ......................... Number of Stories ....................................... 8. Dimensions of entire new construction: Front ......................... Rear ............................ Depth ................................. Height ................................................. Number of Stories ......................................................................................... 9. Size of lot: Front ......... /.t~.) ...................... Rear .............. d.~X~. .................... Depth ....... .'~....~.. ................................... · , //p?~z. Name of Former Owner ...~.~4~/x~/~. ................................................... 11. Zone or use district in which premises are situated ..... ,~k--2~i;..; .................................................................................... 12. Does proposed construction violate any zoning law. ordinance or regulation: ...~..~ .................................................... 13. Will lot be regraded .... Z~.O. ................... Will excess fill be removed from premises: [ ] Yes ~J. No -- ; ~ ' 3 {Address) . (Phone No.) . .... IAddress) ~none i~o.~ (Address) (Phone No.) PLOT DIAGRAM I~ocate clearly and d~st~nctly, all buildings, whether existing or proposed, and indicate all set-back dimensions from properW lines. Give street and block number or description according to deed, and show street names and indicate wheth- er interior Or corner lot. STATE OF NEW YOI~IK, , :: ) COUNTY OF, '..~..~'.~.. ~. ~;~.~.. . ) .....--t~.~...~'.-.. ;~..~.~..~3. ........... ..~..~.~...t~...;~·....P~J../...~...~.. ........................ being duly sworn, deposes and says that he ~s the applicant above named. ' (Name of individual si~ing eon~aet) "e is the ...... ~.~.mZ ........... }..~Z~..e..~ .............................................................................................................................. (Contractor, a~nt, corporate officer, etc.) of said owner or owners, and is dul~ authorized to ~rform or have performed the said w~k and to make and file this application; that all statements contained m thru apphcat~on a~e true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the apphcation filed therewith. ..................... ~2,,&Z)......day of .....~.....~.~,~:..i.l.~.Z,~ ........... 19 .,x..~.. ' ~ ' ' - ' NOTARY P ' v Notary Public, .................~....s~..,.,~'~,.'z./~...,. County . ..~(t~;~t~.~,N~.XOr~ ......................................................................... /....~[(~/ .... , r , , n,o, 52-812585~Suffolk ~o~(St~a~re of applicant) ' ~ ' "? .... ~ - [ ; ,,'- ...... Term Expires' March 30, /00,/~