HomeMy WebLinkAbout16708-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Yo
CERTIFICATE OF OCCUPANCY
No Z19509 Date NOV. 14, 1990
THIS CERTIFIES that the building.
Location of Propert~ 9475 MAIN ROAD
House No. Street
County Tax Map No. 1000 Section 122 Block 006 Lot
Subdivision Filed Map No. Lot No.
ADDITION
MATTITUCK
Hamlet
014
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DEC. 31, 1987 pursuant to which
Building Permit No. 16708Z dated JAN. 7~ 1988
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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING.
The certificate is issued to JUNIUS ~UBBARD
(owner)
of the aforesaid buildinq.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
Rev. 1/81
/Building Inspector
TOW'N OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N°-I 670fl 2:
· / . /J / - // ~, / . ~,
at pre~.se$. ,=te~ at ..... .~.~Z~:=...~:...~...~"',,,,~ ................................................................
County Tax Mop No. 1OOO Section ...... ../..,?.....?'~- .... Block ......... ..~.. ......... Lot No ........ ../. ,.~.... .......
pursuant to (~pplicotion doted ............. W~...~./~..Z ..................... , 19...°~..~., and approved by the
Building Inspector.
Fee *.~...~.~_
6/30/80
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
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.
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 $15.00
Date .... !'.1..~J.q.~ .............................
/. _
:ew Constructional. ~.c. ~..... Old Or Pre-existing Building .................
ocation of Property
House No. Street Hamlet
)nwer or Owners of Property .... .~..~J.t.~..~. ..... ..~(~.Y'.~. ................................. . . .
' Tax Map No i000, Section Block Lot
iubdivision .................................... Filed Map ............ Lot ......................
~ermit No. ]~'-~0~ hate Of Permit ................ cant .........................
............... ~ Appli ....
iealth Dept. Approval ....................... . .. Underwriters Approval...,...... .............. .
lanning Board Approval ........................
equest for: Temporary Certificate ........... Final Certicate ........
ee Submitted:
FOUNDATION ~( ls t)
FOUNDATION
2.
ROUGH FRAME &
.FLUMBING
INSULATION PER N.
STATE ENERGY
CODE
(2nd)
FINAL
ADDITIONAL COMMENTS:
OOCUI:~,NOY OR
USE IS' UNLAWFUL
WIYNO(_~T CERTIFICATE
OF OCOU~%&NCY
INSPECTORS
(516) 765-1802
VICTOR LESSARD, Principal
CURTIS HORTON, Sen/or
VINCENT R. WIECZOREK, Ordinance
ROBERT FISHER, Assistant Fire
Building Inspectors
THOMAS FISHER
GARY FISH
SCOTT L. HARRIS, Supervisor
Southold Town Hall
P.O. Box 1179, 53095 Main Road
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765o1800
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
October 26, 1990
Junius Hubbard
9475 Main Road
Mattituck, N.Y. 11952
Dear Mr. Hubbard:
I am writing to you regarding your Building Permit %16708Zo
This permit has now expired and you have not obtained a Certif-
icate of Occupancy.
Please call our office for an inspection and if the work
passes you must file for the Certificate of Occupancy. I am
enclosing an application for the C.O.
This permit was for a deck on the rear of your house.
If you have any questions please call our office so that
we can help you resolve this matter.
Yours truly,
Enc. Secretary
765-~.802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [~]~AL
E×amined../ . ........... 1 ?
Approved ........... ,l . .?Pe mitNo ............
Disapproved a/c .....................................
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 765-1802
'(B uil~i'hg Inspector)
BOARD OF HEALTH ......
3 SETS OF PLANS .......
SURVEY ·
SEPTIC FORM ............. :
NOTIFY
CALL ................
MAIL TO:
~q~z~ / l ~--
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 oIx premises and in bnlldlng for necessary/4~spections,
.... ...............
(SiJgnature of applicant, or name, if a corporation)
..Pl .~,.'~..?~.....P.,~,.¢..<~.?.~.q. ¢.~.~..?:%: .~
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder.
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
ALL CON, TRACTOR'S MUST~BE S~FOLK COUNTY LICENSED
Builder s License No ..... ~ .............
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
1. Location ofland on which proposed work will be done ..................................................
House Number Street Hamlet
County Tax Map No. 1000 Section ...1...~...~.. ....... Block ..... .~. .......... Lot .... /. ~ ...........
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ..... }.4 ?. C:O .~. .........~... {).O. Xc~ .~. ~ t~. ~. ................................
........
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