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Home My WebLink About11324-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20042 Date JUNE ~8, 1991 THIS CERTIFIES that the building. ADDITION Location of Property 2500-18I MAPLE LANE GREENPORT~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 38.01____Block 1 Lot 18I Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 10, 1981 pursuant to which Building Permit No. 11324-Z dated AUGUST 10~ 1981 __ 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 SCREEN ENCLOSURE ON EXISTING DECK. The certificate is issued to NANCY O'DOHERTY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Building InspecTor Rev. 1/81 Permission is hereby granted to: BUILDING P'ER,~, IT~ (TH:$ PERMIT MUST SE KEPT ON THE~P~E~ZSE$ UNT~,L F~LL COMPL~ION OF THE WORK. AUTHOR ZED)~ ~ NS 1132~ Z D~*o .~ ~......;4~ ......... , Rev. 6/30/80 Form No. 6 TO~4N OF SOUTIIOLD BUILDING DEPARTMENT TOWN I~LL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY \- This application must be filled in by type~riter OR ink and submitted to the building inspector with the following: for new building or new use: I. Final survey of property with accurate location of ali buildings, property lines. streets, and unusual natural or topographzc 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 C~pliance from archi:ect or engineer responsible for the building· 6. Submi~ Planning Board Approval of completed site plan requirements. ;- For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-exist~ng 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 a 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. '. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2.Certificate of Occupancy on Pre-existing Building - $100.00 3.Copy of Certificate of Occupancy - $5.00 OVer 5 years - $10.00 4.Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.OO ew Construction ........... Old Or Pre-existinm Buildin-. ~'/ ' 'ii .................... House No. Street Hamlet ~wer or Owners of Property ................................... sty Tax No 1000, ection..3 : ? .... ..... / .......... et. ,bdivision ............................ Filed Map ............................... ........ Lot .rmit Ne. · · ....... ~ate Of Permit ................ Applicant ....... alth Dept, Approval ....................... '' Underwriters Approval arming Board Approw~l ........................ euest for: Temporary C~rtificate ........... Final Cer 'cte ...... e Submitted' $ ~ ~PdP ....... ~ co - ......................... APPLICANT COMMENTS FIELD INSPECT10~J. 1. FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY O,ODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 Examined..~..?. ,~.. [.¢): .... , 19 .~../ TEL.: 765-1B02, Approved..~?.&/~ ./.~. ..... 19~./. Permit No../f..t/.~..~.~'f~~ ..... .... .... ./../ APPLICATION FOR BUILDING PERMIT Application No.. [ .//. ~..~.~.~.~. ..... Date .. ~,4~.../. O. ..... 190~/~. INSTRUCTIONS a. This application must be completely filled m by typewriter or in ink and submitted in triplicate 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 descr~ptmn of layout of property must be drawn on thc 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 issue 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 m whole m' 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 buildings for necessary inspections. .. ,. , .... ;;.;.;;;;, .... (Signat~gge of applicant, orname, ifac p r t' ) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · .'.C4~.x,~e~4.., ........................................................ Name of owner of premises . .~., ~ Lcd'. c~.~..o (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 .... .~... :7.?. .............. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done. ~-~.~..5.G (& }~. l..~Z, t3-.~....C.'6t..'~. ).~! ............... House Number Street Hamlet (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: 3. Nature of work (check which applic~able): New Building .......... Addition b/ Alteration Repair .............. Removal j ............ Demolition .............. Other Work ............... (Description) 4. Estimated Cost q~//o~.O. 0 . Fee ~/~'~. (to be paid on filing this application) 5. If dwelling, number of dwelling units .. ~2~ Number of dwelling units on each floor. If garage number of cars 6. If business, commercial or mixed oOcupancy, specify aature and extent of each type of use ........... "' 'ri ..... 7. Dimensions o~f existing structures, if any: Front. ~.. ,qt. ,~, ~f ...... Rear ql.ff ./~. ft. ...... Depth .../~.. '. ~ ....... Height . [Of ........... Numbe~ of Stories .../ ................ ~' · ',? ................. r' · '~2 ......... Dimensions of sam.? structure with 'alterations or ~dditions: Front .,~4,~. · ~.. .......... Rea~; . .~.6...~. ........... Depth .... J.~./. ~. ............ !Height .../.tt.~ ................ Number of Stories...tr. .................. .... ;tt / 8. Damensmns of eJat~re new construction: Front ..../ ............ , Rear ../.3 .......... Depth ./.6 ........... Height ... j,0. ......... Number of Stories .../. .................................................... 9, Size of lot: Front ~q-~-· ~t,T,~. ~ .... Rear ...................... ~Depth .... ~ .................. 10. Date of Purchase ................ Name of Fo mer Owner ...... 11. Zone or use district inl/whicl~ premises are situated.,/~3, r f ................. ~. ....... .C(. ........ 12. Does proposed construction violat6 any zoning law, ordinance or regulation: .-~". .............................. 13. Will lot be regraded ... ~. ........................ Will excess fill be~ removed from premises: Yes No_ 14. Name of Owner of premises~z~l]t(...' .t~o gte./* O. ..... Address q$~ n~.,,~-. J~ ...... Phone Noff/.~ Nmne of Architect ... t D ? ...... ~ ............. Address .. g¥~,~6/,9. $$~../Y .... .2 Phone No ................ Natne of Contractor . ~Y.4~e~, .-~'. At,~z~ ....... Address lag ~67~. ~-~a~*/.~.~a4. Phone No. ~{.77~t:/./. 7'.a° .... it9 V¥ i PLOT DIAGRAM Locate clearly and distinctl~ all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block n~mber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEWyO~K/ ~/~Z ............................ ~ .................... 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.) of said owner or owners, and is duly authorized to perform or have perfomed the said work ~d to m~e and file this application; that ~1 statements contained ~ this application a~e true to the best of his knowledge and belief; and that the work will be perfo~ed in the m~ner set forth ~ the applicatiqn filed therewith· Sworn to before me this~ ~' JUDITH T. TERRY Nota~ Pubtm, S~ate of ~ew York ,~~' ' No. 52-0344963 Suff01~ COun~ ~mmisalafl Expires Marc~ 80~ 19~ (Signature of applicant) .,?~ 'o/:' ,.= o,~; $ ,'7£ud'77 L~,/'/' ~ ~ £ ~?, .~£z_'7~ , ,?o rZ~, 6'~z 76~1802 ~ AB TO 4 DB F~ ~N~RpE~IONS: ~R ~U~ED coNCR~E ~ Ro~H _ FRAMING & pLuMBiNG B. INSU~T~O~t 4. FINAL C~RUCTION BE COMPt~ cOR C. O. ' SHALL ~LL cON~RU~tON N. ~ REQUIREME~S OF THE ~A~ cON~ION & NOT ~ OR CON~UCTJON ERRORS 7:1 -II ~/c /,2' SdRE~I 'i S ~ R£~AI