Loading...
HomeMy WebLinkAbout11154-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24327 Date MAY 1, 1996 THIS CERTIFIES that the building ADDITION Location of Property 8225 NASSAU POINT ~OAD ~uTCHO~3E, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 118 Block 4 Lot 10 Subdivision Filed Map No. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 18, 1981 .pursuant to which Building Permit No. 11154-Z dated MY 1S, 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 RAISED PATIO-TERP. ACE ADDITION TO EXISTING ONE FAMILY DNELLIN~ The certificate is issued to JOHN A. pURPURA (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A Rev. 1/81 TOWN OF! ~IDUTHG!.p BUILDING D'I~A RY~I~N~ TOWN ~ SOUTH'ObD, N. N? BUILDING :~P,ERMIT ~ (THIS PERMIT MUST BE KEPT ON THE PP. EMIS~S UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: -. ........ /.~ ....... /. ........ ~.~.....~,~ · .................. ./..6.~..~,,..,~ ........ ~./.~: at premises located at .....~....~...,'~...,~... . ...,,..,. .~...~.. ~..~..~.; .~.......;i.i.?'' ......,........D~'NJ r . ?]E:~.~ .~...b..<............ ......................... C0untv Ta× Map No. l~O0· Sea,on ..... L/...~......,,., ~', ~ ,.~l°~k .! ......... .~.. ..... ~C°t No ......... /.0.. ......... Building Inspector. ~e ~ ....... ./A ............ Rev, 6~30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN tL~LL 765-I802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: 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. 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 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. C. 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 Buildin~ - $100.00 3. Copy of Certificate of Occupancy - ~ -25¢ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $I5.00, Commercial $15.00 N C ctio ~ Old 0 Pr existing Building .. House No. Street Hamlet-- Onw Owners --. · ............ er or .............. County Tax Map No 1000, Section ...... Z/.~...,Block ........ 9 ....... Lot ..... Z~. ............ /7 Approval Underwriters Approval ......................... Health Dept - · · Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ ............................. FOUNDATION ( 1 st ) FOUNDATION ( 2nd ) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL,: 765-1802 ~:xamined ....... . .~..~{~.. (.,~19...~-.~ ,pproved ...... :/:/~2Z... (.,~I 9 .:,nnit No ..... /./..(.:Y )isapproved a/c ........ C.~ .~ ..................... (Building Inspector) Application No. //. (. ~: .Y.i~ APPLICATION FOR BUILDING PERMIT Date .......... .~.."../..~., 19 ~./. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building .nspector, 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 Dr areas, and g~ving a detailed description of layout of property must be drawn on the diagram which is part of this appli~ :ation. c. The work covered by this application may not be commenced before issuance of Building Pe.rmit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit ,hall 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 ,hall 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 gmlding 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. Fhe applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to ~dmit authorized inspectors on premises and in buildings for necessary inspections. .............. ~ (Signature o1' applicant, or name, if a corporation) /. . .... .... ,./. ...... · x. (Mailing address of applicant) :~tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder· ,an, eof o,vner of premi '~~...~q{.-t./.~.. .... ./.~.....~... [ .~.~. ..................................... (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 LicenseNo ......................... Electrician's License No ...................... Other Trade's License No ...... ~. ............ I. Location of land on which proposed work will be done... ~.. ............................................. lie House Number Street Hamlet County Tax Map No. 1000 Section . ./../~. ............ Block .... .~. ............ Lot... ~.~gQ ............ Subdivision .~..~... ~(-~N~)' '~' ' ........... Filed Map No.../~.~ .~ ....... Lot...K:?.~.'/:.~,~..~'.4"7 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~"~-..~ t .¢:/. ~. Iq ..~. ............................................... b. Intended use and occupancy ....... .-~..~..DO ...e~-. .... /a,trf~.~ .......................... 3. Nature of work (cheek which applicable): New Building .......... Addition.. · Repair .............. Removal .............. Demolition ............ g " tee ./f L Estimated Cost ...~,~.O0....i .............................. ....... Alteration .......... ~c~'~"~' "~ (Description) (to be paid on filing this application) 5.. If dwelling, number of dwelling ~nits .......... Number of dwelilng units on each floor ................ If garage number of cars 3. If business, commercial or mixed occupancy, specify nature and extent of each type of use ................... L Dimensions of existing structures, if any: Front ...... g..~. .... Rear .... ~t. 576 .... Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ,. ................... !.. Height ...................... Number of Stories ...................... L Dimensions of entire new constluction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ L Sizeoflot: Front ........... ' ........... Rear ...................... Depth ...................... ). Date of Purchase ............................. Name of Former Owner ............................. 1. Zone or use district in which premises are situated ..................................................... L Does proposed construction vie!ate any zoning law, ordinance or regulation: ................................ L Will lot be regraded ......... i.' .....'~ ........... Will excess fill be removed from premises: Yes .No NameName of°f ContractorArChitect ........................... ....... Address × ~.~,. ~. rhone ....... PLOT DIAG RAM Locate clearly and distinctly all' buildings, whethcr existing or proposed, and, indicate all set-back dimensions from -operty lines. Give street and block.number or description according to deed, and show street names and indicate whether terior or corner lot. rATE OF ~EW 5(~K, . a.~ OUNT.Y..OF...~(...~~ ~'~ ....... . ~ .~,...~,.~C~..~..~~being duly sworn, deposes and says that h~ is the applicant (Namer individual ~igning contract) cove named. e is the ............. ~ (~. {Contrac~nt, corporate officer, etc.) f s~d owner or owner--s dul[~ to perform or have perfomed the said work and to m~e and file ~is pplication; that all statements contained m tMs apphcat~o' ' ~ ~' '--" ~ork will be performed in the manner set forth in the application filed therewith. worn to before me this ............. .....