HomeMy WebLinkAbout15722-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
N°...Z":!6.9-9-5. ........ Date June 14, 1988
THIS CERTIFIES that the building ONE FAMILY DWELLING & ACCESSORY GARAGE
Location of Prnnertv 20 Seawood Drive Southold New York
ouse No. Street Hamlet
County Tax Map No. 1000 Section 088 .Block ....0.2 .......... Lot I 0
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
..... .F.e.b.r.u..a.r.y.. 2..7.,.. I 987 pursuant to which Building Permit No. 15722 Z
dated ...F.e.b..r .u.a.r.y...2.8. ,.. J .9.8.7. ..... was issued, and conforms to ail of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is .........
ONE FAMILY DWELLING & ACCESSORY 2 CAR GARAGE AS APPLIED FOR '
Tile certificate is issued to CARMEN BATT I S TA
..................... t'o¥.b), .....................
of the aforesaid building.
Suffolk County Department of Health Approval I 3-80-84 June 8, 1988
UNDERWRITERS CERTIFICATE NO... PENDING - June 9, 1988
PLUMBERS CERTIFICATION DATED: May 6, 1988 - Stephen O'Connor
Building Inspector
Rev. 1/81
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
CrHIS PERJ~IT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N~ 15722~, Z
Permission is hereby granted to:
...~......~....~.~.~.~.:..
..~.~~....~..:.~..:...L../..2.~./. ....
Coun~ Tax Mop No. 11000 Section .... ..,~....~.,,,,~. ...... Block ......~.,....-~..-- ........ Lot No .....-L...~.. ...........
Budding Inspector.
Building Inspector
Rev 6/30/80
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitted ,-~ to the Building Inspec-
tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal--(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or
topographic featu res.
2.Sworn statement of owner or previous owner as to use, occQpancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees: Additions $25.00 POOLS $25.0OALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory '$10.00 Business $50,00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00
4.Vacant Land C.O. $ 20.00 ~7~/~'"7~'~g ~..~..X~."~
5.Updated C.O. $ 50.00 Date ........... /...,~./. .....
NewC°nstructi°n ...... Old or Pre-existing Building ............ Vacant Land .............
Location of Property.. ~ .~. ........ . .~...~....E~.~ ;~%...~,., .~.; ........... . .~.. ? ~..7-.~.o../..~...
House No. /~. St~et Hamlet
Owner or Owners of Property ........................................................
County Tax Map No. 1000 Section .... .~...~.~. .... Block /-.3c~ Lot .... ('~...~)....
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No ........... Date of Permit .......... Applicant ..................................
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $ .............................
Construction on above described building and p?~meets all applicab~~irt~s.
OU~ DA T! O.U
OUNDATIO~
OUGH FR AM~/
PLUMBING
NSULATION
PER N. Y.
STATE ENERGY
CODE
FIliAL
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND I_ ] INSULATION
[ ] FRAMINI [,~l" FINAL
DATE
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
[. ]~/OUNDATION 2ND [ ] INSULATION
/
FRAMING [ ] FINAL
DATE
TOWN OF SOUTHOI,i
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
CERTIFICATION
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
Sworn to before ime this
~ day of ~x~ ,
Notary Public, ~ County
(plumber's signature)
Notary Publzc
765-:[802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ J FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
ti iI
~en~al ~o~o o~pl~abl~ b fbe~c
I) Thermoo~a~ ~e~in~: ~aximum q5 ~F.~ ~nimum 450E
3) ~ecbanical h~bn~ ~e~ ~b~ll mce~ all requ~r~-
nlenfa 'o~ ~,~5. Ener~ C~e. ~$r.
Examlned3~ .~.
Approved~~..~.'g.
Dmapproved a/c
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.; 765-180:3
,19~~/
,1951] PermttNo /
(Bmldmg Inspector)
APPLICATION FOR BUILDING PERMIT
JAN 2 ! 198ir
Rece3. ved ........... , 1 9 ·
Date .~N o~, I:~ ., 19~-_
INSTRUCTIONS
a Tins apphcation must be' completely filled m by typewriter or in ink and submitted to the Bmldmg Inspector,
sets of plans, accurate plot plan to scale. Fee according to schedule.
b Plot plan showing location of lot and of buildings on premmes, relationship to adjoining premises or pubhc stre
or areas, and giving a detatled description of layout of property must be drawn on the diagram which m part of thls ap
cation.
c. The work covered by tlu~ application may not be commenced before issuance of Building Permit
d Upon approval of this apphcatlon, the Building Inspector will issued a Budding Permit to the applicant Such pen
shall be kept on the premises available for mspectlon throughout the work
e No bufldmg shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupm
shall have been granted by the Building Inspector
' E
APPLICATION IS HEREBy MAD to the Bmldmg Department for the lssuancq[gf a Bmldmg Permit pursuant to
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances
Regulations, for the construction of buddings, additions or alterations, or for removal or demolition, as hereto descnb
The applicant agrees to comply with ali apphcable laws, ordinances, bufldmg code, housing code, and regulations, and
admit authonzed inspectors on premises and in building for necessary 1 ctlons
(S~gnature o~phcant, or name, if~a corporatlon)
· ......
....
tmaz.ting address or app±zcant)
State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electncmn, plumber or build'
(as on the tax roll or latest deed)
If applicant ts a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builder's License No D~../,-) .,~
Plumber's License No
Electrlcmn's L~cense No
Other Trade's License No
I Locatlon ofland on whIch proposed work wlll be done :g~"~.~.
House Number Street
County Tax Map No I000 Section 8 ~
(Name)
Hamlet
Block '~.. Lot ~ O
FdedMapNo .~/.~'~2/~.~tot I~r~Lot il~.,,~
State existing use and occupancy of premises and intended use and occupancy of propSsed construction
a Exmtmg use and occupancy
o ' ......
b Intended use and occupancy ..........
3. Nature of work (check which applicable). New Budding ./~. Addition .. Alteration ....
Reparr ..~.;,[.~, Removall. ~k ........ Demolition ............. OtherWork ......... (Description)
4. Estamated Cost.~.~Ji~.o.- ............. Fee
(to be paid on fihng this application)
5. If dwelling, number of dwelling units . . [ . .. Number of dwelling umts on each floor .........
If garage, number of cars .~. ......
6 If business, commercial or mixed occupancy, specify nature and extent of each type of use .............
7. Dumenmons of existing structures, if any Front ...... Rear ........... Depth .......
Height ........ Number of Stones ............................................
Dmaenmons of same structure w~th alterations or additions Front Rear .........
Depth ............ Height ...... . ....... Numb_9/o~f Stones
8. Dtmenmons of entlre~new construction Front . ~' . . Rear . .2 I~ ' ..... Depth' .... .~.~'; "~1"~"~. ~. . ' '
Hmght .. ~ko ~ . . Nu,rn, ber of Stones
----.
..
9 Size of lot Front . . . Rear . Depth '' '-.
10 Date of Purchase .,~t~. ·~../~ / ~'~ . ,,' ~ ~a~E of Former_Qwner .~.- .~.,~'. ~.~ ~.~,/~) .'FT."~"~ .
12 Does proposed construction violate any zoning law, ordinance or regulation' ....~.~Z;L.
13 Wall lot be regraded . .. jP'~.~_ ... ,._ .~ ~, Will excess fillbe.removed from premises--~ i
14 Name of Owner of premises .kZ, Oi~t~?'~. ~zP~7.~J~..~)~tddress~t~a4'r)~7,(4~/O~,ir-/~Phone No~-r/~.,,Z7-' .~'.~.~'~
Name of Architect ......................... Address ................... Phone No ..............
Name of Contractor ..... d~,~ .a~..-. . Address ............. Phone No
this property located w~th~nl00 feet of a tidal wetland? * Yes ..... --'~]~..
15.
Is
· If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM
Locate clearly and dsstlnctly all buddings, whether existing or proposed, and. indicate all set-back dimensions fr~
property hoes. Give street and block number or description according to deed, and show street names and ~ndmate whett
interior or corner lot ~ ~
STATE OF NEW YORK, . S S
COUIxI1Y OF .~.t,,~/=.,.,.,.,.,.,.,.,.,~>. ~/r~.
'.~ .~/.~.(~.mo~/ .~ .~i/' ~ ~"'r'-~' being duly sworn, deposes and says that he is the apphc;
(Name of mdividuaJ s~gmng contract)
above named
[ .d) ...
He m the .... I ' (Contractor, agent, corporate ofhcer, etc.) .....
of smd owner or owners, and is duly authorized to perform or have performed the said work and to make and hie
appbcatmn, that all statements 'contained m this apphcation are true to the best of hm knowledge and behef; and that
work wdl be performed in the manner set forth m the application filed therewith.
Sworn to before me this
....... d~y of "'J 'z:) t'l/'... , 19~'~
Notary Public,
WILLIAM J POSCH
Notary Public, State of N~w York
['lo, 4745524, S~ffolk Ceuoi¥
Term Expires Ma~ch 30, 19
(Signature of apphca
j c~
BI.DO DEPT
'J'OWN OF SOU'i'HOLD
?-J~ -~ .,.,..
/4
!
I,~. ZO ......
LO7' t
not valid, ~tee~ ~ certt~icatl~ hereon sh~ll run ~tv to
~ntsed t~ ..........................
~LT~I~E~ N.Y. 11742 TELEr~IF .............
AT B~YVIEW OATE:
HEAL~ DEPARTMENT-DATA F~ APPR~ TO C~STRUCT ~ ~R~ ~ WHOM THE SU~EY
EOrE: B = MONUMENT · ALDEN W.~UNG, PROFE~IONAL ENGINEER
SUSDIVIS~N ~P F/LED IN T~ OFF/E~ OF THE CLERK OF AND ~ND SURVEYOR N.Y.S. UCENSE NO. 1~845
SUPFOLK ~UN~ ON JUNE ~6 , 1956 ~S ~I~E NO.~SX5 HOWARD W. YOUNG, LAND SURVEYOR
~ L~ ~ ~L(W),~IC T~(~a CE~S(~) ~g ~E~ N.Y.S. LICENSE N0.45893
BRANDIS & SONS, INC, [618
system; plptng, lhafl be
SOLDER USED ~IV WATER
SUPPLY SYSTEM CANNOT
EXCEED 2/I0 of 1% LEAD.
PLUMBER CERTIFICA ZION
ON LEAD
BEFORE
CERTIFICATE OF OCCUPAIVCy
OCCUPANCY OR
USEIS UNI. AWFUL
WITHOUT :CERTIFICATE
OF OCCUPANCY
APPROYED AS'NOTED ,
NOTJ~ BUJLDI~G DEPARTMENT AT
FOUNDA qO~
THE MEQUIR~ENTS ~ tHE N.Y
~TE ~ONS~RUCTION & ENERGY
COD~ ~O?~S~N~LE ~
Zr ti GOI'~C.
H
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PIA~T P-r-...
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